Please enable JavaScript.
Coggle requires JavaScript to display documents.
The Neuroscience of Psychological Therapies (Understanding the basis of…
The Neuroscience of Psychological Therapies
Understanding the basis of the human brain
Development, Structure and Processing
Phineas Gage
A construction worker, in 1848, survived an accident in which an iron bar went through his skull, seriously damaging the frontal lobe
One of the first detailed reports of psychiatric symptoms following traumatic brain injury
he lived 12 more years
he had a big personality change: from responsible and socially well-adapted, to negligent, irreverent, profane, and unable to take responsibilty
Question was if damage to specific parts of the brain cause specific personality changes?
20th century
beginning to systematize study (e.g. Adolf Meyer)
comprehensive case reports of patients who presented behaviour disturbances after head injuries
proposed a set of disorders called "traumatic insanities", which included consciousness alterations, psychosis, and neurological symptoms
Today
New technologies (e.g. MRI, fMRI, MEG, CT, PET, TMS...)
Testing patients without harm
Insights into structure and live processing
Paul MacLean, 1960
Proposed the Triune Brain Therory
"3 brains" each is connected to the other two, but operates individually with a distinct "personality"
Lizard Brain - "reptilian brain"
Brain stem, cerebellm, (autonomic system)
Fight or flight (instinctive bahaviours)
Autopilot
Mammal Brain
Limbic System (hippocampus, thalamus, amygdala)
Emotions, memories, habits (avoiding pain, achieving pleasure)
Decisions
Human Brain
Neocortex
Language, abstract thought, imagination, consciousness (higher cognitive functions)
Reasons, rationalizes
The Fear Response
The Brain:
is about survival (not happiness)
focusses on negative stimuli
is input-dependent work in progress
Look at video-clips
Altered Brain Functions associated with specific mental health problems
How to measure them and what to learn from them
The Lymbic System
If the lymbic system is less active:
more positive, hopeful state of mind
more activation possible in the cortex
If the lymbic system is overactive
negative, depression/anxiety dominate
Amygdala
monitors incoming stimuli for anything threatening
when DANGER is detected --> activates the fight, flight, freeze stress response
In PTSD
hyper-responsivity also during the presentation of traumatic scripts, cues, reminders
Prefrontal Cortex (PFC)
connected with the amygdala
exerts inhibitory control over stress responses
In PTSD
PFC shrinks
Hippocampus
the hub of memory and lerning
highly sensitive to stress hormones (e.g. cortisol)
In PTSD
a highly activated amygdala interfers with hippocampus functioning
reduced hippocampal calues in patients with PTSD
memory is often corrupted by trauma; recall is impaired; the past is present
Trauma has the potential to disrupt typical neurodevelopmental processes and contribute to long term consequences
chronic abuse and multiple traumas have a greater neurobiological impact
A person with PTSD perceives the world very differently, they feel threatened by many things. In therapy be aware of this. And give them a much sense of control as you can. Ask for permission before you do anything. Be respectful of possible imparied memory
Burnout
Maslach
Burnout is now recognized as a legitimate medical disorder and has its own ICD-10 code
suggested that it can be developed through the chronic mismatch between the individual and crucial workplace components
The incremental onset of burnout can be described as "the accumulation of hundreds of thousands of tiny disappointments, each one herdly noticeable on its own" (Gunderman)
similar patterns in the brains of people who have experienced severe life trauma and of people suffereing from clinica lburnout
neural circuits can be damaged by both situations of extreme trauma and by accumulated everyday stress
"...the chronic psychosocial stress that characterizes burnout not only impairs people's personal and social functioning, it also can overwhelm theri cognitive skills and neuroendocrine systems - eventually leading to distinctive changes in the anatomy and functioning of the brain"
A vicious sycle: over-activated amygdala --> affects mPFC --> less inhibitory control --> more stimulation of amygdala...
Golkar, 2014
burnout group (n=40); control group (n=40)
1) task measuring ability to regulate emotions
more difficulty in downregulating emotional responses to negative images
2) brain's connectivity (resting-state fMRI)
relatively enlarged amygdala
weaker correlations activity in teh amygdala medial PFC
Savic, 2015
burnout group (n=40); control group (n=40)
1) degree of burnout (Maslach Burnout Inventory)
the perceived stress correlated positively with the amygdala volumes
2) MRI: cortical thickness, amygdala, mPFC volume, etc
larger amygdala
mPFC thins
smaller hippocampus
Affected Brain Functions Through Psychotherapy
Phineas Gage
his most serious mental changes were temporary
In later life, hi was far more functional, and socially far better adapted
The Effects of Psychotherapy on Brain Function: A sstematic and critical review
londitudina studies addressing the impact of psychotherapy on the brain
psychiartic disorders: obsessive-compulsive disorder, anic disorder, unipolar major depressive disorder, posttraumatic stress disorder, specific phobia, schizophrenia
The Theory of latent vulnerability: Reconceptualizing the link between childhood maltreatment and psychiatric disorder
early neglectful or maltreating environments --> adaptation or calibration reflected in neurocognitive systems --> long-term vunerability to mental health problems
The current situation:
when maltretment is confirmed, intervention occurs at two stages:
addressing issues of risk
pproviding clinical interventions if a child meets criteria for psychiatric disorer
Which opportunity are we missing?