Cognition and Emotion: Thank You! - anzatsa.org€¦ · Cognition and Emotion: How Our Thoughts and...

Cogni&ons & Emo&ons 24/10/13

Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 1

Robert E. Longo, MRC, LPC, NCC, BCIA‐EEG Serendipity Healing Arts Lexington, North Carolina

Cognition and Emotion: How Our Thoughts and Feelings Look

Inside our Brain and in our Heart

Thank You!

Thank you to Russ Pratt, Jason Freeland,

William Wainwright, and Melissa Braden,

Jessica Pratley, and Dale Tolliday of the

ANZATSA 2013 Conference Committee.

Back Home Brief History of Today’s Presentation

 2001 Conferences at turn of century focused on trauma and its impact on the brain.

 2007 Began using Biofeedback and

Neurofeedback with sexually abusive youth.

 The neurobiological model continues to

evolve.

 The mind body sciences continue to advance.

Literature Examples

 The China Study (2005) ~ T. Colin

Campbell

 Anatomy of and Epidemic (2011) ~ Robert

Whitaker

 The Emotional Life of your Brain (2013) ~

Richard Davidson with Sharon Begley

Right Brain vs. Left Brain

 Right brain = negative emotions

 Left brain = positive emotions

 Right brain = dislikes

 Left brain = likes



Patent Filed: April, 2012 VALIDATING SELF-REPORTING WITH BRAIN WAVES

Original Images from Patent

Neutral Positive Avoidance

Prefrontal Lobe Gamma Asymmetry

Negative Reaction Positive Reaction to Smoking

Wellness Assessment



Definitions “Complementary Medicine,” “Alternative Medicine,” “Integrative Medicine,” “Functional Medicine,” and “Holistic Medicine”

  These terms appear on the Internet and in marketing.

  They have different definitions and meaning.

  The terms are often used to mean the array of health care approaches with a history of use or origins outside of mainstream medicine.

  They are actually hard to define and may mean different things to different people.

In a Psychology Today blog, Allen Frances, MD, psychiatrist and

former chair of APA’s DSM-IV Task Force, lambastes APA’s claim that

its DSM-5 revisions process has been “transparent to an

unprecedented degree,” calling it “Newspeak,” the derisive term

writer George Orwell coined in the novel “1984” to describe a

bureaucratic authority’s intentionally misleading speech.

In “Transforming Diagnosis,” Thomas Insel, MD, director of

the National Institute of Health (NIMH), wrote on April 29,

2013:

“The strength of each of the editions of DSM has been

“reliability”—each edition has ensured that clinicians use the

same terms in the same ways. The weakness is its lack of

validity. … “Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC)

project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to

lay the foundation for a new classification system.

Criticism of DSM-V Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system. Through a series of workshops over the past 18 months, we have tried to define several major categories for a new nosology (see below). This approach began with several assumptions:

A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,

Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,

Each level of analysis needs to be understood across a dimension of function,

Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.

Paraphilias

Can we rely on the DSM-V?

Overview

 What is Neuroplasticity

 What is Biofeedback?

 Biofeedback Applications

 Electroencephalography

 QEEG & Brain Waves

 What Measures Show Us

 Treatment and Outcomes

 Diet and Mood

Heart versus Head

Sayings:

 Cut off from feelings.

 All choked up.

 Get out of your head.

 Heart Felt

 Heart Sick

 Heartless



What is Neuroplas4city? 1) Change occurs only when the brain is in the mood (attention is critical) (Behavioral circumstances /neurotransmitters are released) 2) Change strengthens connections between neurons engaged at the same

time. 3) Neurons that fire together wire together Brain strengthens things that

reliably occur. 4) Initial changes are just temporary. If the brain judges the experience to be

novel (good or bad) they become permanent. 5) Brain plasticity is a 2 way street + or ‐ can drive brain change positively or

negatively. i.e. chronic pain (brain fires pain signal) and bad habits (become good at the bad habit) can result from plasticity.

6) Memory is crucial for learning. Brain is remembering as we develop a skill. 7) Motivation is a key factor for brain growth and plasticity. When changes occur

new networks are developed. Brain can repair itself and reorganize itself. New skills acquisition is important for plasticity and change.

How neuroplas4city and cogni4ve reserve protect

cogni4ve func4oning

Overall cognitive status can vary across an individual's life span in response to factors that promote either positive or negative neuroplasticity. Positive neuroplasticity refers to he physiological ability of the brain to form and strengthen dendritic connections, produce beneficial morphological changes, and increase cognitive reserve. Negative neuroplasticity refers to the same physiological ability of the brain to atrophy and weaken dendritic connections, produce detrimental morphological changes, and decrease cognitive reserve. Factors that promote positive neuroplasticity include physical activity, education, social interaction, intellectual pursuits, and cognitive remediation. Factors that promote negative neuroplasticity include poor health, poor sleep hygiene, poor nutrition, substance abuse, and depression and anxiety. Implications for promoting positive neuroplasticity and avoiding negative neuroplasticity across the life span are emphasized to facilitate optimal cognitive health and ensure successful cognitive aging.

Vance DE, Roberson AJ, McGuinness TM, Fazeli PL.

The Window of Tolerance

  Increased Sensations   Emotional Reactivity   Intrusive Imagery   Disorganized Cognitive Processing   Hypervigilance Hyperarousal Zone

______________________________________________________________________

Window of Tolerance Optimal Arousal Zone

______________________________________________________________________

  Relative Absence of Sensation Hypoarousal Zone   Numbing of Emotions   Disabled Cognitive Processing   Reduced Physical Movement

The three zones: a simple model for understanding the regulation of autonomic arousal. Page 27. Trauma and the body: a sensorimotor approach to psychotherapy.

2006 Ogden, Minton, & Pain

What is Biofeedback? “Biofeedback is a non‑invasive form of treatment. The therapist a9aches sensors or electrodes to the body and these sensors provide a variety of readings – feedback – which is displayed on the equipment for the patient to see. The signals typically measure skin temperature, muscle tension and/or brainwave function. With this information, patients can learn to make changes so subtle that at first they cannot be consciously perceived. With practice, however, the new responses and behaviors can help to bring relief and improvement to a variety of disorders.”

Definition adopted by BCIA, AAPB and ISNR May 18, 2008

Forms of Biofeedback

Peripheral biofeedback includes physical responses:

1)   EMG ‑ Muscular reactivity and tension (Electromyography) 2)   Thermal ‑ Hand and foot temperature (Thermofeedback) 3)   HRV ‑ Heart rate and blood pressure (Heart Rate Variability) 4)   SCL / GSR ‑ Sweat gland activity (Galvanic Skin Response) 5)   Respiration ‑ Respiratory function‑breathing pa9erns and rate 6)   RSA Feedback (respiratory sinus arrhythmia ‑ heart rate speeding

and slowing from respiration). Brainwave Biofeedback (neurofeedback) addresses brain waves and brain function.

Biofeedback Applica4ons  When patients experience trauma, relaxation training is the standard operating procedure for recovery, and includes mindfulness and guided imagery.

 Trauma patients need to practice relaxation for 90 days (every day).

 Witness state – observing ego (third eye); a distancing technique (the ability to observe yourself in action).

 FDA states that biofeedback is a standard relaxation “Therapy”



Biofeedback

Contraindications   Biofeedback seems to have a very low potential for damage (if used properly, of

course.) There are no absolute contraindications and few relative

contraindications for biofeedback:

•Unevaluated symptoms. Biofeedback should not be used for treating unevaluated

symptoms.

•1a. Unevaluated symptoms, Medical: Biofeedback almost always

produces an enhanced feeling of general well-being (APA Task Force, 1980).

Symptomatic relief can mask underlying problems. For a safe and effective

application, a medical evaluation of the client is required before applying

biofeedback.

•1b. Unevaluated symptoms, Psychological: Biofeedback is

contraindicated for psychoses and major affective disorders.

•Cognitive impairment. Cognitive impairments that interfere with an understanding

of the biofeedback process can preclude successful treatment.

•Apprehensive clients: If a client views biofeedback with apprehension the

procedure should not be applied.

http://www.coedu.usf.edu/zalaquett/biofeedback/information.htm

Biofeedback Teaches

 Self‑monitoring: how to become sensitive to your stress pa9erns and symptoms, and then

 Self‑regulation: how to change these responses to decrease or eliminate discomfort and unpleasant sensations.

 Self‑Regulation = Self‑Control

What is a Quan4ta4ve Electroencephalograph?

Quantitative Electroencephalography (QEEG) is the measurement, using digital technology, of electrical patterns at the surface of the scalp which primarily reflect cortical activity or "brainwaves". A multi‐electrode recording of brain wave activity is recorded and converted into numbers by a computer. These numbers are then statistically analyzed and are converted into a color map of brain functioning.

How EEG Works

EEG, is a tool used to image the brain while it is resting or performing a cognitive task. This allows the detection of the location and magnitude of brain activity involved in the various types of cognitive functions. EEG provides the opportunity to view and record brain activity by using electrodes to monitor the amount of electrical activity at different points on the scalp (10‐20 International System).



10/20 Interna4onal System

BRODMANN AREAS SITE BRODMANN AREA

  Fpz 10, 11, 32

  Fp1 10, 11, 46

  Fp2 10, 11, 46

  F7 45, 47, 46

  F8 45, 47, 46

FUNCTION

  Emotional Inhibition

  Oversensitive, Impulsive

  Motivation & Attention

  Cognitive Emotional Valencing‐ Lateral Orbital Frontal

  Irritability, Intrusive, Depression

  Social Awareness‐ Approach Behaviors

  Emotional Inhibition‐ Lateral Orbital Frontal

  Impulsivity, Tactlessness, Mania

  Social Awareness‐ Avoidance Behaviors

  Working Memory‐ Visual & Auditory

  Divided & Selective Attention‐ Filtering

  Broca’s Area‐ Semantic Short Term Buffer (Word Retrieval)

  Prosody

  Working Memory‐ Spatial & Visual, Gestalt

  Facial Emotional Processing

  Sustained Attention

BRODMANN AREAS SITE BRODMANN AREA   F3 8, 9, 46

  F4 8, 9, 46

  Fz 8, 6, 9

  C3 3, 1, 4

  C4 3, 1, 4

  Cz 6, 4, 3

FUNCTION

  Short Term Memory‐ Verbal Episodic Retrieval

  Facial Recognition, Object Processing   Planning & Problem Solving‐ Wisconsin Card

Sort (rigidity)

  Short Term Memory‐ Spatial/Object Retrieval   Vigilance Area‐ Selective & Sustained

Attentional Area

  Personality Changes   Intention & Motivation‐ Poverty of Speech,

Apathy   Possible Anterior Cingulate‐ Internal vs.

External Attention   Basal Ganglia Output

  Sensory & Motor Functions




  T3 42, 22, 21

  T4 42, 22 ,21

  T5 39, 37, 19

  T6 39, 37, 19

FUNCTION

  Language Comprehension‐ Verbal Understanding

  Wernicke’s Area‐ Inner Voice   Long Term Memory‐ Declarative &

Episodic Processing   Event Sequencing‐ Visualization   Amygdala/Hippocampal Area

  Personality‐ Emotional Tonality (anger, sadness)

  Categorization & Organization   Visualization   Auditory Cortex

  Meaning Construction‐ Angular Gyrus   Acalcula   Short Term Memory

  Facial Recognition‐ Emotional Content. Amygdalic connection.


  P3 7, 40, 19

  P4 7, 40, 19

  Pz 7, 5, 19

  O1, O2 18, 19, 17

  Oz 18, 17, 19

FUNCTION

  Digit Span Problems   Information Organization Problems   Self‐ boundaries Excessive Thinking

  Visual processing‐ Spatial Sketch Pad, Vigilance

  Personality‐ Excessive Self‐concern, Victim Mentality

  Agnosia, Apraxia, Context Boundaries, Rumination

  Attentional Shifting‐ Perseverance   Self‐Awareness, Orientation Association Area   Agnosia, Apraxia

  Visual Processing   Procedural Memory, Dreaming

  Visual Processing, Hallucinations

BRODMANN AREAS



New Study Shows That Stress Can Reduce Brain

Volume And Func4on, Even In Healthy Individuals

“We find that the accumulation of stressful life events was affecting key regions of the brain. These key regions are the regions we believe regulate our emotions, help us control our impulses and help us process our daily experience. They also control our physiology. These regions have implications for long‐term health.”

Ansell, E. (2012) Stress Causes Brain Shrinkage. Brain in The News. The Dana Foundation. February 2012. Page 2.

Emily Ansell is Assistant Professor of Psychiatry, Yale School of Medicine.

QEEG Brain Map   Subject is 14 y.o. male with history of TBI, attachment issues, and sexually abusive.

 Was adopted at a young age.

Eyes Closed Magnitude & Dominant Frequency

TBI, Mylina4on, Insomnia, and Anxiety

COHERENCE /CONNECTIVITY

Informa4on Processing Problems

ASYMMETRY

Anxiety mixed with Depression EEG Abnormali4es



Brodmann Loca4ons

  Fp1 Cognitive Emotional Valancing, Irritability, Intrusive,

Depression Social Awareness- Approach Behaviors.

  Fp2 Emotional Inhibition, Impulsivity, Tactlessness, Mania

Social Awareness- Avoidance Behaviors.

  F8 Prosody (the patterns of stress and intonation in a language),

Working Memory- Spatial & Visual, Gestalt, Facial

Emotional Processing, Sustained Attention.

  T6 Facial Recognition- Emotional Content, Amygdalic connection

(limbic system, memory).

Under‐arousal (Depression) and Over‐arousal (Anxiety)

Cognitive Processing Brainwave Func4on

Hagmann, P., Cammoun, L., Gigandet, X., Meuli, R. Honey, C.J.,

Wedeen, V.J., & Sporns, O. (2008). Mapping the Structural Core of

Human Cerebral Cortex. PLoS Biology. 6 (7) e159 pp. 1479-1493.

www.plosbiology.org Suggested Supplements

 Acetyl‐l‐carnatine

 Calcium

 Copper

 DMAE

 Magnesium

 Omega‐3s

 Pantothentic Acid

 Potassium

 Theanine

 Thiamine

 Vitamin B1

 Vitamin B12

 Vitamin B6

 Vitamin C

 Vitamin E

 Zinc



Nega4ve Thought or Distrac4ng Thought? Coherence and Calm

The Vagus Nerve The vagus nerve is either one of two cranial nerves which are extremely long, extending from the brain stem all the way to the viscera (all internal organs in the chest, abdomen, and pelvis). The vagus nerves carry a wide assortment of signals to and from the brain, and they are responsible for a number of instinctive responses in the body. You may also hear the vagus nerve called Cranial Nerve X, as it is the 10th cranial nerve, or the Wandering Nerve. A great deal of research has been carried out on the vagus nerve, as it is a rather fascinating cranial nerve. The vagus nerve helps to regulate the heart beat, control muscle movement, keep a person breathing, and to transmit a variety of chemicals through the body. It is also responsible for keeping the digestive tract in working order, contracting the muscles of the stomach and intestines to help process food, and sending back information about what is being digested and what the body is getting out of it. Besides output to the various organs in the body, the vagus nerve conveys sensory information about the state of the body's organs to the central nervous system. 80‐90% of the nerve fibers in the vagus nerve are afferent (sensory) nerves communicating the state of the viscera to the brain.

  http://www.wisegeek.com/what‐is‐the‐vagus‐nerve.htm

The Vagus Nerve R. Gevirtz 2012

The vagus nerve: pathway to the limbic

system

The Vegus Nerve The Vegus Nerve



The Role of Breathing An important distinction involves understanding the role of breathing in the generation of coherence and its relationship to the techniques of the HeartMath System. Because breathing patterns modulate the heart’s rhythm, it is possible to generate a coherent heart rhythm simply by breathing slowly and regularly at a 10‐second rhythm (5 seconds on the in‐breath and 5 seconds on the out‐breath). Breathing rhythmically in this fashion can thus be a useful intervention to initiate a shift out of stressful emotional state and into increased coherence. However, this type of cognitively‐directed paced breathing can require considerable mental effort and is difficult for some people to maintain.

http://www.emwavepc.com/emwave_pc_science_research.html

HeartMath HRV measures emotions and specifically frontal lobe emotional valence.

The first source of HRV is Respiratory Sinus Arrhythmia (RSA) / the heart rate speeding and slowing from respiration.

Emotional Valence – The positivity or negativity of emotions.

Heart Rate Variability Tachogram

Hour‐Long Example

Heart rhythm of a 33‐year‐old male experiencing anxiety. The prominent spikes are due to pulses of activity in the sympathetic

nervous system. http://www.heartmath.org/research/research‐science‐of‐the‐heart‐2‐2/

Low Coherence

High Coherence HeartMath

Ordered and harmonious heart rhythms are an indicator of one’s “coherence level”. High coherence is a state associated with positive emotional a9itudes which send signals to the brain that reduce stress, improve brain function, hormonal balance, immune response, coordination and reaction times. The emWave PC system determines the degree of coherence found in the heart rhythm pa9erns and displays changes in real‑time.



HRV Time/Interbeat Intervals

Heart rate variability is a measure of the beat‑to‑beat changes in heart rate. This diagram shows three heartbeats recorded on an electrocardiogram (ECG). Note that variation in the time interval between consecutive heartbeats, giving a different heart rate (in beats per minute) for each interbeat interval. [The example above shows the inhale process.]

Physiological entrainment during coherence. The top graphs show an individual’s heart rate variability, blood pressure rhythm (pulse transit time), and respiration rhythm over a 10‑minute period. At the 300‑second mark (center dashed line), the individual used HeartMath’s Quick Coherence® technique to activate a feeling of appreciation and shift into the coherence state. At this point, the rhythms of all three systems came into entrainment: notice that the rhythmic pa9erns are harmonious and synchronized with one another instead of sca9ered and out‑of‑sync. The bo9om graphs show the frequency spectra of the same data. The left side of the graphs shows the spectral analysis of the three physiological rhythms before the shift to coherence. Notice how each pa9ern looks quite different from the others. The graphs on the right show that in the coherence state the rhythms of all three systems have entrained to oscillate at the same frequency.

Heart rhythm paPerns during different emotional states. These graphs show examples of real‑time heart rate variability pa9erns (heart rhythms) recorded from individuals experiencing different emotions. The incoherent heart rhythm pa9ern shown in the top graph, characterized by its irregular, jagged waveform, is typical of stress and negative emotions such as anger, frustration, and anxiety. The bo9om graph shows an example of the coherent heart rhythm pa9ern that is typically observed when an individual is experiencing a sustained positive emotion, such as appreciation, compassion, or love. The coherent pa9ern is characterized by its regular, sine‑wave‑like waveform. It is interesting to note that the overall amount of heart rate variability is actually the same in the two recordings shown above; however, the pa;erns of the HRV waveforms are clearly different.

Plas4city: Heart to Brain Effects  As mentioned, vagal stimulation has been shown to effect depression and seizure activity.

 Regular practice with an HRV device may: …decrease arousal by promoting an increase in alpha band frequencies and a decrease in beta frequencies overall and in areas critical to the regulation of stress.

(Sherlin et al., 2010, APB,35)

Anxiety/Stress/Overarousal Sadness/Depression/Underarousal



Integra4on Integra4on

KB 31yof Stress and Insomnia

6/29/2012 First try acer Respirate 6/29/12 Think Posi4ve and Think Nega4ve (Dog=Posi4ve Work = Nega4ve)

Neurofeedback 30 Minute Session HRV during NFB 6/29/2012



The QEEG brain map below illustrates the pre post tes&ng of a 15 year old male diagnosed with

ADHD and opposi&onal defiant disorder (ODD) in addi&on to sexually abusing a sibling. The pa'ent

par'cipated in weekly biofeedback sessions over a three month period. Of significance is the

lowering of Delta and Theta brain wave magnitude.

  2/4/08 Pre‐Treatment

05/09/08 Post‐Treatment

ADHD Post Biofeedback

Diet and Mood Link Between Fast Food and Depression Confirmed

ScienceDaily (Mar. 30, 2012) — A new study along the same lines as its predecessors shows how eating fast food is linked to a greater risk of suffering from depression.

According to a recent study headed by scientists from the University of Las Palmas de Gran Canaria and the University of Granada, eating commercial baked goods (fairy cakes, croissants, doughnuts, etc.) and fast food (hamburgers, hotdogs and pizza) is linked to depression.

Published in the Public Health Nutrition journal, the results reveal that consumers of fast food, compared to those who eat little or none, are 51% more likely to develop depression.

http://www.sciencedaily.com/releases/2012/03/120330081352.htm

A Few Side Notes

 Gluten can effect emotion, cognition and behavior.

 Food sensitivities can also effect emotion, cognition and behavior.

Gluten on the Brain

Compliments Dr. Richard Soutar Food Sensi4vi4es



Food Sensi4vi4es Food Sensi4vi4es

Foods to Check First

Testing can be expensive. Some food allergies and sensitivities are very common.

The following foods trigger allergies and related symptoms (leaky gut/inflammation), so check them first:

 Gluten (Wheat)

 Dairy

 Sugar

 Soy

Contact Informa4on

Web site:

www.roblongo.com

E‐mail:

[email protected]

Cognition and Emotion: Thank You! - anzatsa.org€¦ · Cognition and Emotion: How Our Thoughts and...

Documents

Transcript of Cognition and Emotion: Thank You! - anzatsa.org€¦ · Cognition and Emotion: How Our Thoughts and...