Sunday 4 December 2016

Rewiring your troubled brain is key to healing

Advances in brain science are also transforming how psychotherapy is practised, says psychotherapist Gayle Williamson

Gayle Williamson

Published 05/07/2015 | 02:30

MIND YOURSELF: Scientists now know that mindfulness changes the brain’s structure
MIND YOURSELF: Scientists now know that mindfulness changes the brain’s structure

A few years ago, a young woman called Laura (not her real name) came to see me for chronic anxiety. There was no part of her life where she felt relaxed and in control, and she had frequent panic attacks. She'd grown up an only child in a chaotic home with an alcoholic mother and a depressed father, neither of whom had been able to offer her the kind of nurturing relationship that children need to thrive and develop resilience.

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Instead, she grew up not knowing how to be close to others, unable to manage her emotions and feeling in general like the world was a dangerous place.

I knew that offering Laura a safe, relational experience with me - in other words, what was missing for her while growing up - would help her to heal, even if I didn't appreciate then that this change would happen at the level of neurons in her brain. What I also didn't know then was that it was Laura's emotional right-brain that was overreactive as a result of her childhood experiences and that some of my interventions needed to activate her logical left brain in order to help her manage her emotions. And I had no idea just how powerful the ancient practice of mindfulness could have been for her.

However, psychotherapy has been undergoing a quiet revolution in recent years. While one of our main aims has always been to empower clients to help themselves, I believe we now have greater clarity around how we can do that. And it's thanks to neuroscience and a growth in research between various disciplines, which are giving us valuable new findings to incorporate into our work and allowing us to target our interventions to different parts of the brain.

Imaging technologies have shed fascinating light on how the brain actually works and provided solid evidence for various mechanisms for change, such as psychotherapy and mindfulness. And one of the biggest discoveries of the past two decades or so is deceptively simple: the fact that increasing our ability to pay attention to something in the present moment (ie mindfulness) actually changes our brain's structure.

In 1890, father of psychology William James knew the power of strengthening attention, saying: "The faculty of voluntarily bringing back a wandering attention over and over again is the very root of judgment, character and will". James just didn't have brain science backing him up.

Today, there's almost an epidemic of mindfulness; but there are a lot of misconceptions about it, such as that it's a just a relaxation technique, that it's about clearing your mind of all thoughts or that it's a spiritual/religious practice. But it's more useful to think of it as a kind of 'brain hygiene', as Daniel J Siegel of the Mindful Awareness Research Centre in the US terms it - a mental activity that encourages neuroplasticity, which is the growth of new neurons and new connections between neurons. At its most basic, it involves focusing our awareness on something - whether that's your breathing or washing dishes. It's also about learning to watch what's going on in your mind: to observe your thoughts and feelings instead of automatically reacting to them and believing everything you think and feel.

Maybe you're already wondering, 'why would I want to change my brain, and what exactly would I be hoping to change?' It's known that what you are exposed to, the experiences you have as a child, help to shape your brain. There may have been painful situations to which you had to adapt in order to cope. But even though the conditions then no longer exist, whatever adaptation you made - eg, shutting down your emotions or cutting off from your body - remains etched in your brain as a neurological pattern, so your body and mind keep acting as if the conditions still exist.

So, say you lived in a chaotic home like Laura above, where you constantly walked on eggshells. You will have experienced regular triggering of your 'fight or flight' response - where lots of adrenaline is released into your body to help you flee danger, real or anticipated. Eventually, this becomes a well-worn path of anxiety in your brain. So as an adult, you find it hard to manage your emotions and you anticipate threats everywhere. Now we know, however, that mindful attention can create new neuronal pathways in your brain and calm its emotional centre.

Bear with me for a brief lesson in brain architecture: essentially, we have a left and right brain. The left brain is the logical side, it's concerned with language, labelling things, making lists and factual memory; while the right, non-verbal side is concerned with autobiographical memory (the story of who you are and what has happened to you) and emotion, and it also has links to the entire body.

Most psychological issues can be attributed to a breakdown in communication between the two hemispheres - but mindfulness helps to link them again.

Areas of the right or left brain are also often underdeveloped in childhood. Your right brain, for example, may not have developed properly if you were raised in an emotionally cold, neglectful home. To survive, you may have taken refuge in the left side of your brain, shutting down painful awareness of the emotions of your right side. It's something I see frequently - where a client has great recall for the streets where they lived, names of schoolfriends or even historical events (the factual memory function of the left brain) but little or no memory of what their relationship with their mother or father was like (autobiographical memory function of the right side).

Cut off from their emotions and their body, they may also have a monotone voice and lack facial expression or energy. Now I know that I can help strengthen their right brain and develop regions associated with empathy, self-awareness and memory by, for example, introducing them to a mindful body scan - simply being guided through noticing each part of the body, from the little toe to the nose.

It would be easy to see mindfulness as the panacea for all ills, with other benefits such as a stronger immune system, chronic pain management, flexibility in our thinking and behaviour, emotional resilience and greater empathy with others. However, it is not advised for the newly bereaved or traumatised where emotions are still too raw. And because most of our problems grew out of challenging relationships, it is still in the therapeutic relationship that the critical healing takes place.

Recently, I have been working with a client very similar to Laura. I have been able to teach her about her brain, mind and memory and work with her in a focused way to help her calm her overreactive right brain and become more comfortable in her body. "It's like, because I can almost visualise new connections being made in my brain each time I meditate, I just feel empowered, more hopeful," she said last time we met. And for therapists, we now have a practical, proven new tool in our toolbox.

* Sources: Full Catastrophe Living by Jon Kabat-Zinn; Mindsight by Daniel J Siegel.

* Cited client cases are composites of several clients, with any identifying characteristics disguised in order to protect confidentiality.

Gayle Williamson is an Irish Association of Counselling and Psychotherapy-accredited psychotherapist, see ferneytherapy.ie

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