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Can direct neurofeedback help individuals with a diagnosis of schizophrenia?

The effects of the unprecedented coronavirus will be felt by all for a currently unknown period of time.  The fear-driven behavioral responses that this pandemic has been producing is a reflection of how deep and strong our survival response goes.  And, yet, at some point, relief will come in the form of a vaccine.  However, there is another health challenge that stirs fear in the hearts of many, the life-long diagnosis of the severe mental disorder of schizophrenia.

One of my very first clients that I saw as a Marriage and Family Therapist Trainee carried a diagnosis of schizophrenia.  My client challenged me to learn more about this disorder in order to provide the best quality of service I could at that point in my training.  I learned that schizophrenia, although not as common as other mental disorders, affects feelings, thinking, and behaviors and the symptoms can be very disabling.  Symptoms of schizophrenia are categorized using the medical terms of either positive, negative, or cognitive.  Positive symptoms add and negative symptoms take away.

For example, positive symptoms might include hallucinations, delusions, or repetitive movements that are hard to control.  Negative symptoms include reduced feelings of pleasure, reduced speech, apathy, reduced social drive and social interest, and loss of motivation.  The underlying cause or causes of this severe mental disorder are still unknown and available treatments focus on eliminating the symptoms of the disease.  The first line of attack as far as treatment is concerned is antipsychotic medications.  Once a medication is found to work, then psychosocial treatments, such as therapy, is offered to help individuals learn and use coping skills.  Research has shown that participating in such psychosocial treatments reduces relapses and/or hospitalizations; however, the most challenging aspect of treatment is nonadherence to medication.  Therefore, a focus on increasing treatment adherence could have a positive effect on all impacted by this severe mental disorder.

Individuals with schizophrenia struggle to live life independently and improving this situation is a significant mental health priority.  It seems as though the negative symptoms of this disorder are associated with poorer functional status and quality of life than are the positive symptoms and this may be because primary negative symptoms generally do not respond well to the antipsychotic medications currently available.  Research has suggested that up to 60% of patients may have prominent clinically relevant negative symptoms that require treatment.  With this information it then becomes more easily understandable why these individuals may not be compliant with their medications – because those medications don’t work for them.  The question now is what is being done to support these individuals and address this unmet medical need?

Well, there is hope on the horizon.  An article recently published in the Journal of the American Medical Association Psychiatry looked into the use of transcranial direct current stimulation (AKA direct neurofeedback) as an add-on therapy for negative symptoms of schizophrenia.  In this double-blind randomized clinical trial of 100 individuals diagnosed with schizophrenia with predominant negative symptoms, results showed that this non-medication treatment was effective and safe in ameliorating negative symptoms.

If you would like to read more, click on the button below:

Compassion for Survivors of Trauma – a New View of Substance Use Disorder/Addiction!

I remember being assigned to read the book by Dr. Gabor Maté, In the Realm of Hungry Ghosts, while in graduate school and simply feeling gratitude, compassion and validation afterwards.  I never believed in the medical model of addiction that describes the symptom of addiction as a chronic disease of the brain, even suggesting a genetic component to the disease, implying that if my parent(s) had addictions, most likely I would too.  Now, don’t get me wrong, the brains of people who struggle with addiction are different, yet those changes are created as a response to the adverse childhood experiences (AKA TRAUMA) these people survived.  And if your parents suffered from addictions when you were growing up, that experience is traumatic to a child!

I’ve written before about the impact of adverse childhood experiences, especially on physical health later in life as well as addiction; however, I felt compelled to revisit it again when I learned of research that found over 96% of the study participants suffering from substance use disorders, including prescription opioids, nicotine, and cocaine, had trauma histories.  When comparing the groups based upon their drug of choice, the prescription opiate group reported more traumatic childhood experiences than the other groups and a younger age of their first adverse childhood event.  So, when you learn about the underlying dynamics associated with substance use, the thought of “Just Say No” to drugs seems crazy!

Trauma comes in many packages and I’m grateful that the new California Surgeon General (Dr. Nadine Burke Harris) is focusing on early childhood, health equity and Adverse Childhood Experiences and toxic stress as her key priorities. (For more information on the ACEs Aware initiative, visit www.ACEsAware.org.)  It is time to stop blaming the victims and participate in bringing this information forward in order to educate.  What we don’t know, we don’t know.  However, once we know better, we can do better.  With this knowledge, we can bring more empathy and compassion in our interactions with people that struggle with substances.  We can take extra steps to explain this new research to them, validating their experiences and bringing them hope that they can heal from these past traumatic experiences and release their attachment to something that is harmful to them.  We can empower them to explore various healing modalities, such as psychotherapy, neurofeedback, meditation, hypnosis, guided imagery, and expressive arts, such as yoga, writing and drawing, all of which have been shown to support post-traumatic growth.

To read more about this research, click on the box below:

5 Intention-setting Ideas to Support Change

I believe most of us have thought to ourselves “I hate change” at least once in our lives.  And the message we often hear is “Change is hard”.  Perhaps it is these messages, thoughts, and/or beliefs that underlie the approximate success rate of 10% for the New Year resolutions set at this time of year!

On the other hand, we know that change is inevitable and constant – perhaps the only experience we can count on to always be there.  The hope that comes from the trust in change is that we don’t get stuck in a rut.  However, the universe invites us to be co-creators of the changes we want to make in our lives.  This co-creation requires us to commit to learning new things . . . whether that is to learn to do something new or to learn something new about ourselves.

We are very supported at this time to initiate the process of change due to the fact that we are in the midst of a current Eclipse Gateway.  Eclipses support growth and the 2 weeks between the Solar Eclipse (12/26/9) and the Lunar Eclipse (1/10/20) is a potent time for transformation and renewal.  So, if you might want to catch the wave of energy, consider trying the following intention-setting ideas to support change this month:

  1. Reframe Change.  Perhaps consider simply reframing change as growth – or a growth opportunity – as it will help move you in the direction of embracing change versus denying its value.  You still have a choice, whether to take the growth opportunity or not.  As we begin to lean into the process of change or growth, we must also recognize the loss it creates.  If we decide to try something new, it often means that something we were familiar with falls away, even if it is due to the limits of time or resources.  Therefore, it is important to honor our feelings around the loss and even doubt that might arise around whether we made the right choice for our growth.  In those moments, reminding yourself that all of our choices bring with them information to help guide us toward our highest good will soothe the doubt, so you can’t make a bad one!
  2. Embrace Emotions!  Fear is often underlying the sense of loss of the familiar and doubt in the process of change, so it is important to look fear in the face.  Remember, emotion (even fear) is simply [E]nergy in [motion], which means turning to look at it even for a moment, instead of distracting yourself or running from it, changes it immediately!  Inviting your greatest fear, and its various emotional friends, such as anxiety, anger, or sadness, to sit for a moment with you so you might listen to what it has to say, will begin to bring clarity around what it is that you value most in life, not what others have told you in the past.  Emotions are one of the most powerful guides on our journey to discover our highest self.  Consider allowing your emotions to participate in your decision-making process and use their energy to guide you forward toward fulfilling your heart’s true desires!
  3. Think Small.  We tend to set lofty new year resolutions and when we don’t experience immediate results, we might get discouraged, providing fuel to our fears.  I like to remind myself that Rome wasn’t built in a day.  So, perhaps consider a very small change you would like to make in your life, and put it on your calendar every day, so you can track your progress.  For example, you might decide to add more walking to your daily routine.  Consider starting with very specific, yet small goals, such as parking further away from the stores you visit, taking the stairs at work or walking around the block.  Then each day, check it off your list when you achieved the goal and celebrate in some way, even if only to say out loud to yourself “See, I told you I could do it!”
  4. Find a Partner.  Whether your heart desires more peace, health, happiness, clarity, or love, change or growth requires you to transform into someone different than who you are currently.  Having someone support you on your journey of transformation is very helpful.  This person can be a source of encouragement when you sense discouragement creeping in.  They can challenge the fear that works to disconnect you from your highest self.  They can help to hold us accountable as well as provides support when we do begin to sense the discomfort that comes with change.  Discomfort is part of the process of change so having a partner to share those experiences of discomfort with can make us feel less alone on our journey.  Consider identifying someone in your life that might be willing to be that support partner for you, someone that believes in you and will help you embrace the growth your desire.
  5. Visualize.  It is important to visualize the change you desire, because if you can’t imagine the change you want, how do you know what direction to start out in on your journey?  Visualizing the result of your efforts to change or grow will support the discovery process.  Remember too that discovery is not a linear, straight line.  Often, it involves taking a winding road that might make you feel a little lost for awhile.  In those moments of disorientation, bringing your visualization back into mind will remind you of the value of change or growth, deepening your understanding of your heart’s desire and refueling the process of change.  Perhaps consider a tool to document your visualization, whether it is to draw it out, write it down, or create a vision board, so that you might reflect on your heart’s desire each day.  This practice will ease the integration of the new steps you are taking to co-create the new you!.

As always, if you try any of these intention-setting ideas for holistic health, I would love to hear about the impact they might have had for you.  Please send me an email at linda@sanctuary4compassion.com to share!

Might direct neurofeedback reduce impulsive behaviors?

The symptom of impulsivity can be found listed under several mental/behavioral health diagnoses, including but not limited to intermittent explosive disorder, substance abuse, OCD, PTSD and binge eating disorder.  When the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5™) was published in 2013 and included binge eating disorder, I finally felt validated and, at the same time, gratitude for discovering yoga, which helped to reduce my anxiety and my out-of-control eating, especially in light of the fact that I didn’t want to start taking any prescription medications.

My relationship with food has been a long and winding road.  I have memories when I was 4 or 5 of sitting at my kitchen table by myself, long after everyone else finished eating and was allowed to move on, because I was not allowed to leave the table until I finished everything on my plate, including those horrible green vegetables.  I tried every trick in the book, including slipping some to the dog under the table and putting some in my mouth, wiping my mouth with a napkin and spitting what was in my mouth into the napkin.  I also hear my parents in my mind saying “Eat your food!  There are people starving in Africa” and thinking to myself “Great, send them my food!”.

From there, after my parents got divorced, food became scarce for most of my adolescence.  My parents’ divorce and subsequent relationship was very contentious, pushing me into the land of anxiety.  I began to worry about where my next meal would be coming from and if it would be enough.  The pattern that grew from there involved eating large amounts of food (even if I wasn’t hungry) when food was available and eating very quickly (to ensure I got enough before it disappeared).  I also have memories as a young adult where I would eat my meal very quickly and then eat what was left by others on their plates.

As time passed, my relationship with food changed when my weight began to increase.  At this point, I would not allow myself to eat anything until the end of the day, after I had taken care of everyone else’s needs on my list.  Only then, almost like a reward for completing my “To Do” list for others and my sense of self-restraint or control, would I allow myself the indulgence of fulfilling one of the most basic human needs.  What didn’t change at this point though, was the speed in which I ate and the amount of food I would eat!

I then ventured into the many ‘diets’ being promoted.  My weight began to yo-yo.  My life felt so out-of-control as did I!  It wasn’t until I discovered yoga that I found myself in a space to really confront this unhealthy relationship I had with food, facing the fears lying beneath my journey in the land of anxiety.  And even with the support of my yoga practice (and a boost from some hypnotherapy), it took me many more years to see food as simply a source of energy for my body, like gas or electric for a car.

So how excited was I when I read the recent promising research on using direct neurofeedback (i.e., transcranial direct current stimulation or tDCS) to reduce impulsive behaviors!  Although it is not exactly clear how it does so, a positive effect was found in 74 out of 92 research studies.  It warms my heart to learn that there is an alternative to prescription medications, something that specifically supports the brain’s innate ability to reorganize itself towards health, and does so relatively quickly.

If you would like to read a little more on this research, click on the box below:

5 Intention-setting Ideas to Bring More Joy Into Your Life

This time of year can be stressful for most of us to say the least!  For some, including myself, it might also bring up memories of loss, family discord, and unfulfilled dreams.  So I did a little research on tools that have been shown to shift us into a space of joy and, when integrated into a regular practice, can make that joy more sustainable and available to us any time of year (also see my Reflections below on Positive Psychology).

To take a deeper dive, perhaps consider saving this website (https://itsallgoodhere.com/) in your Favorites and set a new year intention to explore these tools more.

In the meantime, consider the following intention-setting ideas to try this month:

  1. Positive Moments.  Consider setting an intention to identify at least one positive moment each day in the month of December.  You may consider it small, even insignificant, such as the first sip of your morning coffee or tea on a cold morning or climbing under the warm blankets at the end of your day.  It doesn’t matter.  What matters is that you take time to reflect on that moment and hold the experience in your awareness, perhaps for 10 to 20 seconds.  Then, consider sharing that positive moment with someone.  If you do this at night and would prefer, you can share it on Social Media.  The act of sharing allows the positive moment’s effects to linger for longer, inviting a deeper level of positivity into the body and mind.
  2. Personal Strengths.  Another option to consider for setting an intention for the month of December is to identify one of your personal strengths and then think about how you used it today or within the last couple of weeks.  You can stay with one of your personal strengths all month and challenge yourself to identify multiple times/ways you used it or challenge yourself to identify a new strength each day, along with an example of how you applied it in your life.  Or it can be a combination of both, it is all good!
  3. Set a Goal!  Perhaps start by simply reflecting on how you felt the last time you accomplished something you set out to do.  Can you remember the feelings that come with accomplishment, such as satisfaction, peace, motivation, joy?  From there, consider setting one small, attainable goal each day this month with a further intention to track your progress.  It can again be something simple like making your bed, finishing that book that you started awhile ago or reaching out to a friend that you haven’t connected with recently.  The key is to track your progress, specifically to reflect on how many times you met your goal that day.
  4. Reframe Negative as Positive.  This intention-setting idea might be a little more tricky – looking for the ‘silver lining’ in what our culture might label as negative.  When we are able to discover some benefit from an experience that brought us some level of aggravation or upset in the moment, we are doing what is called a ‘positive reappraisal’.  How do we do this?  Well, it starts with identifying something, whether an event or a routine activity that we find distasteful, for whatever reason.  Perhaps it is doing the dishes or getting stuck in traffic.  From there, we search for how these things might provide us with some positive outcome that we simply have been ignoring or have refused to consider in the past.  So, for the dishes, we might reframe it as now I have dishes ready for the next meal or the kitchen looks more welcoming.  For getting stuck in traffic, consider that you have more time to listen to your favorite podcast or music.  The more you practice this skill, the easier it gets and you tend to discover multiple positive aspects to every situation!
  5. Random Acts of Kindness.  Honda does not have to have the corner on this market!!  And it doesn’t have to cost you a thing!  During this season of connection, consider doing something kind for someone else each day this month.  It can simply be offering a genuine smile as you pass them walking by, opening a door for someone, or helping someone carry their bags in or out of their car.  Remember to take a moment to reflect on what you feel afterwards, sensing how the joy you feel inside is spreading out and touching others!

Is positive psychology really effective?

When we experience loss, it is normal and natural to feel sad.  It is also normal and natural when we are under stress to use safety seeking strategies such as pulling back from support structures, such as friends and family.  At the same time, it can sometimes be difficult to move through such normal experiences and rediscover the joys in life.  We can get stuck under the weight of loss and stress, feeling alone and on edge, especially when the stress is chronic.

Reminders of loss often arise at this time of year, whether it is the loss of the innocence of our childhood or the loss of someone that we loved.  Mix in the stress of the holiday season, when our “To Do” list grows long, and it is a recipe for pulling us down into the gloom and making us more susceptible to falling ill.  It can be especially challenging when experiencing this sense of spiraling downward when we don’t have any tools to support us in turning it around.

When we feel alone and don’t want to bother anyone with our troubles, where can we turn to support our navigation through such powerful emotions that tend to knock us off balance?  Is it truly possible to use positive psychology to get us unstuck and back in balance?  Can the technology wave of online help deliver such life balancing tools, allowing us to take this journey from the privacy of our homes?

Well, a new randomized controlled trial took a look at a facilitated online positive emotion regulation intervention with caregivers responsible for people with a diagnosis of dementia.  It was a 6-week intervention that focused on testing the effects on positive emotion, depression, anxiety, and physical health.  This study demonstrated that there are tools that can teach us to experience a more positive attitude and when we have a more positive attitude, it reduces the powerful emotions of anxiety and depression!  This study supports the use of online, remotely delivered programs to support the navigation towards psychological well-being through the use of positive psychology tools.

If you would like to read more about this research, click on the link below:

2020 Monthly Film Viewing and Reviewing Parties

Come join the party on the last Sunday of each month starting in February, 2020!

Doors will open at 6:30 pm so that you can get some popcorn and hot tea before the movie starts.  Doors will close when the movie starts at 7 pm.

After each movie, a discussion will be facilitated so consider bringing a journal to take note of what you took away from the film or what you learned from other film critics.

Vision Board Playshop to Support Your New Year Intentions!

Registration for this event is required as space is limited.  If interested, Please make sure to reserve your spot by either calling (657) 204-6262 or emailing me at linda@sanctuary4compassion.com soon!

Is direct neurofeedback safe and effective for depression when pregnant?

I believe most of us want to do what is best for our health, such as eating well, exercising, getting enough sleep and staying connected with friends and family and I imagine maintaining our health and wellbeing takes another step up on our list of priorities when we think about getting (or are) pregnant.  If we smoke, we might consider stopping.  If we drink alcohol, we again might consider stopping.  However, if we experience a mood imbalance (think anxious and/or depressive symptoms), do we consider stopping any medications we are taking that are currently supporting our experience of more balance in our moods?  And what happens if we begin to experience some of these symptoms for the first time during our pregnancy, do we consider taking medications while pregnant or try to tough it out?

It is not uncommon for physicians to encourage women to stop such mood management medications as the side effects can be premature birth and low birth weight, similar to the impacts of smoking and drinking during pregnancy.  Where does this leave moms-to-be that are either taking such medications or might experience antenatal anxiety and/or depression?  There is research that shows babies have higher levels of the stress hormone cortisol when moms experience untreated depression, which increases the risk of that baby developing anxiety, depression, and other mental and behavioral challenges later in life.  So it is well known that depression in pregnancy negatively affects both mom’s and her baby’s health, so is there any other option?

A recent pilot randomized controlled research trial shows hope for a non-invasive, non-medication brain stimulation treatment option, specifically transcranial direct current stimulation (tDCS), also referred to as direct neurofeedback.  The results of this trial reflect the feasibility and acceptability of such an option along with encouraging preliminary effectiveness and no serious adverse (i.e., side) effects in this under-treated population.  The effects even lasted a month after delivery!  The results of this pilot study supported the next step to a definitive random controlled trial to evaluate tDCS for antenatal depression.

If you might be interested in reading more about this treatment option, either for yourself or someone you know that is struggling with such a decision, please click on the link below to learn more:

Do emotions have a role in healing childhood trauma?

I sense that most of us are aware that our brain, especially the rational part (i.e., prefrontal cortex) does not reach full development until age 25 or so, which implies, by default that until that age, we tend to operate more from the emotional parts, such as the amygdala.  And, as our brains develop, the connections between the two (emotional and rational) centers are still developing as well.  What we may not be so aware of is the impact of childhood trauma on such connections.  We also may not be fully aware of many of the situations that are now understood to be traumatizing to children.

Let me start with the latter.  Extensive research has been ongoing since the original group of participants were recruited for the Adverse Childhood Experiences Study between 1995 and 1997 in California.  Although the study ended in 1997, most states continue to collect such information through the Behavioral Risk Factor Surveillance System.  The information collected focuses on child abuse and neglect and other household challenges, including intimate partner violence, substance abuse and mental illness in the household, parental separation or divorce, and if a household member was incarcerated. This research has resulted in the inclusion of a new diagnosis of Complex posttraumatic stress disorder, also referred to as developmental PTSD, within the International Classification of Diseases, 11th Edition, recently officially endorsed by WHO’s World Health Assembly and set for implementation outside of the US in 2022.

This is a HUGE step forward in identifying the underlying cause of most challenging symptoms to mental health, including anxiety and depression, and how these symptoms link to most chronic physical diseases, such as heart disease and cancer!  I have been known to say we don’t need a Diagnostic and Statistical Manual (DSM) of Mental Disorders, we simply need The Book of Trauma.  When we all can embrace the idea that there is nothing wrong with us and instead can understand it is what happened to us when we were little that makes it so difficult to live a life full of joy and meaning today, there will no longer be any stigma to seeking support and we can begin the process of healing by shedding the shame and suffering we have been carrying.

Now to expand on the awareness of the impact such developmental PTSD has on the growing connections between the emotional and rational parts of a child’s brain.  When we are little and presented with trauma (as defined above), the emotional input to the brain is overwhelming to the point where we only ‘feel’ and are unable to ‘think’ because the developing rational part of the brain is hijacked by the emotional part, cutting off the connections that encourage a more balanced perspective.  The most familiar and natural fear responses of ‘fight or flight’ in many cases may not be an option for children.  Therefore, the ‘freeze’ response may be the most accessible, especially in young children.  The freeze response is used when the presenting danger cannot be escaped or beaten down, and if either were to be attempted, might actually increase the risk of harm.  The freeze response is a survival response that encourages stillness and silence to avoid being seen and offering a mental escape instead.  What this normal response to danger also does is narrow the range of emotional awareness to flavors of fear and shuts down the development of a more diverse range of emotions, including engagement, joy, comfort, confidence, empowerment and enthusiasm.  When the freeze response helped us to survive the traumas of our childhood, it also stunted our emotional intelligence (aka alexithymia), locking us in a world where danger lurks around every corner, even as adults.

So what can we do to unlock the door to the fear chamber and open it up to a safer, more peaceful existence?  In order to facilitate improvements in trauma-specific symptoms, such as anxiety, depression, dissociation, impulsivity, and interpersonal problems, emotions need to be welcome to express themselves.  Working with a therapist that embraces the intelligence of emotions, through perhaps using Emotionally-focused therapy, can address the emotional challenges associated with alexithymia and thus, begin to resolve issues of childhood trauma.

To read a little more of the research on how working with emotions heals childhood trauma, click on the link below: