1. health and fitness
2. disorders
3. mental disorder
4. panic and anxiety

The Art and Science of Brain Care :
Psychotherapy Networker Symposium
Washington, D.C.
March 26, 2015
Linda Graham, MFT
[email protected]
www.lindagraham-mft.net
Linda Graham, MFT
Marriage and Family Therapist – 25 years
Psychodynamic
Attachment
Trauma
Mindfulness
Neuroscience
Bouncing Back: Rewiring Your Brain for Maximum
Resilience and Well-Being
2013 Books for a Better Life award
2014 Better Books for a Better World award
Emerging Philosophy of Self Care
 Macro – big tools, big practices
Vacations, work out in gym, support group
 Micro – small tools, small practices
 Take a nap, stretch your body, self-
compassion break
Compassion Fatigue
 Exhaustion
 Lack of job satisfaction
 Feeling powerless to effect change
 Despair
Brain Care
 The brain learns from experience
 Can choose to respond differently
 Regulate stress
 Rewire old patterns
 “Little and often”
 Create new habits, new coping strategies
Human Brain:
Evolutionary Masterpiece
 100 billion neurons
 Each neuron contains the entire human genome
 Neurons “fire” hundreds of time per second
 Neurons connect to 5,000-7,000 other neurons
 Trillions of synaptic connections
 As many connections in single cubic centimeter of
brain tissue as stars in Milky Way galaxy
How to Replenish Human Brain
 Exercise-Movement
 Sleep - Rest
 Nutrition
 Laughter-Play
 Learn Something New
 Hang Out with Healthy Brains
Exercise - Movement
 Macro
 cardio – BDNF
 Yoga, qi gong – move the energy
 Micro
 3-minute better than nothing workout
 Move your body once every hour
 Sense and savor walk
Sleep - Rest
 Macro – 8 hours every night
 Housekeeping
 Reset nervous system
 Consolidate learning
 Sleep hygiene
 Micro
 Take mental breaks; switch the channel
 Take a nap
 Mini-meditate (10 breaths)
Take Mental Breaks
 Focus on something else (positive is good)
 Talk to someone else (resonant is good)
 Move-walk somewhere else (nature is good)
 Every 90 minutes; avoid adrenal fatigue
Nutrition
 Macro
 Eat healthy!

More protein, more water, less sugar, less carbs,
less calories, less caffeine/alcohol
 Micro
 Savor (eat a raisin meditation)
 Eat one meal a day without doing anything else
Laughter-Play
 Macro
 Have a good time at family/friends
dinner/celebration
 Schedule a play date
 Schedule a silly date
 Micro
 Watch a 4-minute Happify Daily video
 Read two minutes of jokes
Learn Something New
 Macro
 Speak a foreign language
 Play a musical instrument
 Juggle
 Play chess
 Micro
 Learn a new poem, quote, flower, bird each day
Hang Out with Healthy Brains
 Macro
 Participate in a conference, support group, book club,
choir, cycling group
 Practice gratitude at family dinners
 Micro
 Read 10 pages of a good book, magazine article, blog
post
 Send the link of the above to a friend
 Send a text or email of gratitude, acknowledgement,
appreciation to friend, co-worker
Kindness is more important than wisdom,
And the recognition of that is the beginning of
wisdom.
- Theodore Rubin
6 C’s of Coping
 Calm
 Compassion
 Clarity
 Connections to Resources
 Competence
 Courage
Keep Calm and Carry On
Serenity is not freedom from the storm
but peace amidst the storm.
- author unknown
Regulate Stress
 Macro
 Change conditions causing stress

Job, boss, get family member into therapy
 Micro
 Work with brain to



Manage disruptive emotions
Tolerate distress
Down-regulate stress
3 Motivational Systems
 Threat-protection
 cortisol
 Satisfaction-reward
 dopamine
 Soothing-comfort-caregiving
 oxytocin
Window of Tolerance
 SNS – explore, play, create, produce…. OR
Fight-flight-freeze





Baseline physiological equilibrium
Calm and relaxed, engaged and alert
WINDOW OF TOLERANCE
Relational and resilient
Equanimity
 PNS – inner peace, serenity…. OR
Numb out, collapse
Hand on the Heart
 Touch – oxytocin – safety and trust
 Deep breathing – parasympathetic
 Breathing ease into heart center
 Brakes on survival responses
 Coherent heart rate
 Being loved and cherished
 Oxytocin – direct and immediate antidote to stress
hormone cortisol
 Pre-empt stress reponse
Touch
 Hand on heart, hand on cheek
 Head rubs, foot rubs
 Massage back of neck
 Hugs – 20 second full bodied
Calm through the Body
 Hand on the heart
 Body scan
 Progressive muscle relaxation
 Soles of the feet
 Sense and savor walk
Compassion
 Being touched, moved by experience of pain and
suffering
 Flow of kindness, tenderness, care and concern
toward experiencer of pain and suffering
 Wise action to alleviate pain and suffering
 One cannot live with sighted eyes and feeling heart
and not know the misery which affects the world.
- Lorraine Hansberry
 Compassion is a verb. – Thich Nhat Hanh
Open Heart/Mind to Larger Perspective
 Macro
 Spiritual practice
 Altruism-generosity
 Service – volunteer, career
 Micro
 Mindful Self-Compassion



Mindfulness
Self-Compassion
Common Humanity
Compassion Practice
 Mindfulness
 Awareness of what’s happening
 (and our reaction to what’s happening)
 Self-Compassion
 Acceptance of what’s happening
 (and our reaction to what’s happening)
 Compassion – Common Humanity
 Wise effort in response to what’s happening
 (and our reactions to what’s happening)
Self-Compassion
 Kind, gentle attention to self when there is hurt, pain,
shame, suffering
 Powerful and immediate antidote to self-criticism, selfloathing
 Practice not to feel better but because we feel bad
 Putting own oxygen mask on first when other people
are not around
 Come into loving connected presence
 Compassion leads to calm leads to clarity; platform for
wise action to alleviate suffering of others.
Compassion Research and Study
 Center for Investigating Healthy Minds (U. Wisconsin)
 http://www.investigatinghealthyminds.org
 Center for Mindful Self-Compassion (U.C. San Diego)
www.centerformsc.org
 Kristin Neff: www.self-compassion.org
 Christopher Germer: www.mindfulselfcompassion.org
 Center for Compassion and Altruism Research and Education (CCARE -
Stanford)
 http://ccare.stanford.edu
 Greater Good Science Center (U.C. Berkeley)
 www.greatergood.berkeley.edu
 Compassionate Mind Foundation (Paul Gilbert)
 www.compassionatemind.co.uk
Benefits of Self-Compassion
 Increased motivation; efforts to learn and grow
 Less fear of failure; greater likelihood to try again
 Taking responsibility for mistakes; apologies and




forgiveness
More resilience in coping with life stressors
Less depression, anxiety, stress, avoidance
Healthier relationships; more support and, less control
and/or aggression
Increased social connectedness, life satisfaction, and
happiness
Practices of Mindful Self-Compassion
 Affectionate Breathing
 Loving Kindness with Self-Compassion
 Self-Compassion Break
 One for Me, One for You
 Compassion with Equanimity
Affectionate Breathing
 Sit comfortably; breathe slowly and gently.
 Incline your awareness toward your breathing
with tenderness and curiosity
 Let the body breathe itself; notice the natural
nourishing and soothing of the body
 Feel the whole body breathe
 Allow the body to be gently rocked by the breath
 Savor the stillness and peace in the body
Loving Kindness with
Self-Compassion




Sit comfortably, focus on gentle breathing, in and out
Feel breath in entire body; let your body breathe you
Breathe into areas of physical stress, discomfort
Notice difficult emotions; incline awareness toward
contraction or discomfort
 Self-compassion phrases: “May I be….”
 Your own phrases of kindness, tenderness, care
 Rest in stillness and peace in body
Self-Compassion Break
 Notice moment of suffering
 Ouch! This hurts! This is painful.
 Soothing touch (hand on heart, cheek, hug)
 Kindness toward experiencer
 May I be kind to myself in this moment
 May I accept this moment exactly as it is
 May I accept myself in this moment exactly as I am
 May I give myself all the compassion I need to
respond to this moment wisely
Caregiving
 Breathing in, “nourishing, nourishing”
 Breathing out, “soothing, soothing”
 In imagination, “nourishing for me, nourishing
for you, soothing for me, soothing for you”
 “One for me, one for you”
 Practice breathing “one for me, one for you”
when in conversation with someone
Caregiving with Equanimity
Everyone is on his or her own life journey.
I am not the cause of this person’s suffering,
nor is it entirely within my power to make it go
away,
even if I wish I could.
Moments like this are difficult to bear,
Yet I may still try to help if I can.
Negativity Bias – Left Shift
 Brain hard-wired to notice and remember
negative and intense more than positive and
subtle; how we survive as individuals and as a
species
 Leads to tendency to avoid experience
 Positive emotions activate “left shift,” brain is
more open to approaching experience,
learning, and action
Positive Emotions - Benefits
 Less stress, anxiety, depression, loneliness
 More friendships, social support, collaboration
 Shift in perspectives, more optimism
 More creativity, productivity
 Better health, better sleep
 Live on average 7-9 years longer
 Resilience is direct outcome
Practices of Positive Emotions
 Gratitude
 Take in the Good
 Circle of Support
 Positivity Portfolio
Gratitude
 2-minute free write
 Gratitude journal
 Gratitude buddy
 Carry love and appreciation in your wallet
Take in the Good
 Notice: in the moment or in memory
 Enrich: Felt sense in the body
 Absorb: savor 10-20-30 seconds, install in long-
term memory
Circle of Support
 Call to mind people who have been supportive
of you; who have “had your back”
 Currently, in the past, in imagination
 Imagine them gathered around you, or behind
you, lending you their faith in you, and their
strengths in coping
 Imagine your circle of support present with
you as you face difficult people or situations
Positivity Portfolio
 Ask 10 friends to send cards or e-mails
expressing appreciation of you
 Assemble phrases on piece of paper
 Tape to bathroom mirror or computer monitor,
carry in wallet or purse
 Read phrases 3 times a day for 30 days
 Savor and appreciate
Clarity - Mindfulness
Focused attention on
present moment experience
without judgment or resistance.
- Jon Kabat-Zinn
Mindfulness
 Pause, become present
 Notice and name
 Step back, dis-entangle, reflect
 Catch the moment; make a choice
 Shift perspectives; shift states
 Discern options
 Choose wisely – let go of unwholesome,
cultivate wholesome
Mindfulness and Psychotherapy
 Even-hovering attention
 Unconditional positive regard
 Observing ego
 “What are you noticing now?”
 Catch the moment; make a choice
Autobiography in Five Short
Chapters – Portia Nelson
I
I walk down the street.
There is a deep hole in the sidewalk
I fall in.
I am lost…I am helpless
It isn’t my fault.
It takes me forever to find a way out.
II
I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don’t see it.
I fall in again.
I can’t believe I’m in the same place
But, it isn’t my fault.
It still takes a long time to get out.
III
I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in…it’s a habit
My eyes are open,
I know where I am.
It is my fault.
I get out immediately.
IV
I walk down the same street
There is a deep hole in the sidewalk.
I walk around it.
V
I walk down another street.
-Portia Nelson
Connections
 Increasing the social connections in our lives is
probably the single easiest way to enhance our
well-being.

- Matthew Lieberman
 Friendships, marriage, support groups, book
clubs, church choirs, cycling groups
Connections
 Seeing Ourselves as Others See us
 Compassionate Friend
 Wished for Outcome
Seeing Ourselves as Others See Us
 Imagine sitting across from someone who
loves you unconditionally
 Imagine switching places with them; see
yourself as they see you; feel why they love
you and delight in you; take in the good
 Imagine being yourself again; taking in the love
and affection coming to you; savor and absorb.
Compassionate Friend
 Sit comfortably; hand on heart for loving awareness
 Imagine safe place
 Imagine warm, compassionate figure –
Compassionate Friend
 Sit-walk-talk with compassionate friend
 Discuss difficulties; listen for exactly what you need
to hear from compassionate friend
 Receive object of remembrance from friend
 Reflect-savor intuitive wisdom
Wished for Outcome
 Evoke memory of what did happen
 Imagine new behaviors, new players, new
resolution
 Hold new outcome in awareness,
strengthening and refreshing
 Notice shift in perspective of experience, of
self
Competence, Mastery, Efficacy
You can’t stop the waves,
But you can learn to surf.
-Jon Kabat-Zinn
Power Posing
 Amy Cuddy TED talk
 Before important meeting or interview:
 Stand tall and straight, like mountain pose in
yoga
 Lift your arms in triumph
 or
 Place hands on hips (Wonder Woman)
Coherent Narrative
 This is what happened.
 This is what I did.
 This has been the cost.
 This is what I learned.
 This is what I would do differently going
forward.
Find the Gift in the Mistake
 Regrettable Moment – Teachable Moment
 What’s Right with this Wrong?
 What’s the Lesson?
 What’s the Cue to Act Differently?
 Find the Gift in the Mistake
Courage
It’s as wrong to deny the possible
As it is to deny the problem.
- Dennis Seleeby
A ship is safe in harbor, but that’s not what ships are for.
- Grace Hopper
Yes, risk-taking is inherently failure-prone.
Otherwise, it would be called sure thing-taking
- Tim McMahon
Do One Scary Thing a Day
 Venture into New or Unknown
 Somatic marker of “Uh, oh”
 Dopamine disrupted
 Cross threshold into new
 Satisfaction, mastery
 Dopamine restored
Resilience, Creativity, Flow and Flourishing
I am no longer afraid of storms, for I am learning
to sail my ship.
- Louisa May Alcott
There is a natural and inviolable tendency in
things to bloom into whatever they truly are in
the core of their being.
All we have to do is align ourselves with what
wants to happen naturally and put in the effort
that is our part in helping it happen.
- David Richo
Mastering the art of resilience does much more
than restore you to who you once thought you
were. Rather, you emerge from the experience
transformed into a truer expression of who you
were really meant to be.
- Carol Orsborn
The Art and Science of Brain Care :
Psychotherapy Networker Symposium
Washington, D.C.
March 26, 2015
Linda Graham, MFT
[email protected]
www.lindagraham-mft.net