Connie Isele, NCC, LPC, EMDR II, RMT 
 Psychotherapist & Holotropic Breathwork Practitioner 


 You are the orchestrator of your own life.
Likewise, you are the conductor to your healing.

I come equipped with some sheet music for guidance and an array of instruments to choose from. 
From here, we create the movement towards transition.

Contents

 Mind/Body Health: The effects of Traumatic Stress 

 
A Brief Description of EMDR Therapy

  
Spiritual Emergence Defined

   The Ultimate Journey: Consciousness and the Mystery of Death

  Non-Ordinary States of Consciousness in Healing and Health

   What is Holotropic Breathwork?

 Dan Siegel - Mindfulness, Psychotherapy and the Brain


Mind/Body Health: The Effects of Traumatic Stress
What is a Traumatic Stress Reaction?
People who experience or witness horrible events such as school shootings, combat, rape, torture, natural disasters, accidents or other things in which their physical safety and life -- or the safety and life of others -- was in danger have experienced a traumatic stress. People who are repeatedly exposed to life or death situations, such as EMT and rescue squad workers, police officers, fire fighters and medical personnel on burn wards or trauma units where stress levels and mortality rates are high also witness trauma. Anyone who has experienced these things has experienced a shock and, even if all ultimately escape danger, the people who lived through the event may feel like life “just isn’t the same anymore.” People may experience a variety of reactions, many of which are understandable in the context of experiencing or witnessing traumatic events such as the hurricanes. Experiencing physical or emotional symptoms in response to a traumatic event is normal and is called a traumatic stress reaction.

Physical Symptoms of Traumatic Stress
Anyone affected by the hurricanes or other traumatic stress may experience:
· Fatigue
· Being easily startled
· Headaches
· Sweating
· Gastro-intestinal problems

Emotional Symptoms of Traumatic Stress
Those affected by traumatic stress may feel:
· Fear
· Anger
· Guilt
· Anxiety
· Reduced awareness
· Feeling like you are numb or not part of the world
· Helplessness
· Hopelessness

What is PTSD?
PTSD stands for Post Traumatic Stress Disorder. This is similar to a stress reaction and, in fact, many people who have experienced a traumatic event do develop PTSD. Those with PTSD may experience many of the same emotional and physical symptoms as those with a traumatic stress reaction. Those with PTSD, however, experience trauma along with intense fear, helplessness or horror and then develop intrusive symptoms (such as flashbacks or nightmares). Their symptoms will last more than a month and get in the way of normal life.

Traumatic stress is not uncommon. In fact:
· About 70 % of U.S. adults have experienced a severe traumatic event at least once in their life and one out of five go on to develop symptoms of PTSD
· Approximately 8% of all adults have suffered from PTSD at any one time
· If you include children and teens, an estimated 5% of all Americans will develop PTSD during their lifetime or more than 13 million people
· About one in 10 women will develop PTSD symptoms during their lifetime or double the rate for men because they are much more likely to be victims of domestic violence, rape or abuse.
· Almost 17% of men and 13% of women have experienced more than three traumatic events during their life.

The Mind/Body Connection
Suffering traumatic stress can affect your emotions as well as your body and the two are so connected that it can be hard to tell the difference. For instance, traumatic stress can cause you to lose concentration, forget things, or have trouble sleeping. It may be difficult to determine on your own whether these symptoms are because you do not feel well physically or because you are still upset. Traumatic stress also can lead you to eat in unhealthy ways or to eat foods that are not healthy, and those eating patterns can affect how you sleep or how your stomach feels. Stress can cause headaches, but the pain from the headaches can also make your stress worsen. Because the body and the mind work in concert, traumatic stress can cause a cycle that makes it seem like the body and mind are working against one another, worsening symptoms like pain and fatigue.

Coping with Traumatic Stress
There are things you can do to help yourself if you have suffered traumatic stress as a result of an event such as a school shooting.
- Give yourself time to heal. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the losses you have experienced. Try to be patient with changes in your emotional state.
- Ask for support from people who care about you and who will listen and empathize with your situation. But keep in mind that your typical support system may be weakened if those who are close to you also have experienced or witnessed the trauma.
- Communicate your experience in whatever ways feel comfortable to you - such as by talking with family or close friends, or keeping a diary.
- Find out about local support groups that often are available such as for those who have suffered from natural disasters. These can be especially helpful for people with limited personal support systems.
- Try to find groups led by appropriately trained and experienced professionals such as psychologists. Group discussion can help people realize that other individuals in the same circumstances often have similar reactions and emotions.
- Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals and get plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through relaxation techniques. Avoid alcohol and drugs.
- Establish or reestablish routines such as eating meals at regular times and following an exercise program. This can be especially important when the normal routines of daily life are disrupted. Even if you are in a shelter and unable to return home, establish routines that can bring comfort. Take some time off from the demands of daily life by pursuing hobbies or other enjoyable activities.
- Help those you can. Helping others, even during your own time of distress, can give you a sense of control and can make you feel better about yourself.
- Avoid major life decisions such as switching careers or jobs if possible because these activities tend to be highly stressful.

When Should I Seek Professional Help?
Many people are able to cope effectively with the emotional and physical demands brought about by a natural disaster by using their own support systems. It is not unusual, however, to find that serious problems persist and continue to interfere with daily living. For example, some may feel overwhelming nervousness or lingering sadness that adversely affects job performance and interpersonal relationships.

Individuals with prolonged reactions that disrupt their daily functioning should consult with a trained and experienced mental health professional. Psychologists and other appropriate mental health providers help educate people about common responses to extreme stress. These professionals work with individuals affected by trauma to help them find constructive ways of dealing with the emotional impact.

With children, continual and aggressive emotional outbursts, serious problems at school, preoccupation with the traumatic event, continued and extreme withdrawal, and other signs of intense anxiety or emotional difficulties all point to the need for professional assistance. A qualified mental health professional such as a psychologist can help such children and their parents understand and deal with thoughts, feelings and behaviors that result from trauma.

APA is grateful to Paul J. Rosch, M.D.. President, The American Institute of Stress, for his help in developing this fact sheet.

 

A Brief Description of EMDR Therapy

8 PHASES OF TREATMENT
The amount of time the complete treatment will take depends upon the history of the client. Complete treatment of the targets involves a three pronged protocol (1-past memories, 2-present disturbance, 3-future actions), and are needed to alleviate the symptoms and address the complete clinical picture. The goal of EMDR therapy is to process completely the experiences that are causing problems, and to include new ones that are needed for full health. "Processing" does not mean talking about it. "Processing" means setting up a learning state that will allow experiences that are causing problems to be "digested" and stored appropriately in your brain. That means that what is useful to you from an experience will be learned, and stored with appropriate emotions in your brain, and be able to guide you in positive ways in the future. The inappropriate emotions, beliefs, and body sensations will be discarded. Negative emotions, feelings and behaviors are generally caused by unresolved earlier experiences that are pushing you in the wrong directions. The goal of EMDR therapy is to leave you with the emotions, understanding, and perspectives that will lead to healthy and useful behaviors and interactions.

Phase 1: History and Treatment Planning
Generally takes 1-2 sessions at the beginning of therapy, and can continue throughout the therapy, especially if new problems are revealed. In the first phase of EMDR treatment, the therapist takes a thorough history of the client and develops a treatment plan. This phase will include a discussion of the specific problem that has brought him into therapy, his behaviors stemming from that problem, and his symptoms. With this information, the therapist will develop a treatment plan that defines the specific targets on which to use EMDR. These targets include the event(s) from the past that created the problem, the present situations that cause distress, and the key skills or behaviors the client needs to learn for his future well-being. One of the unusual features of EMDR is that the person seeking treatment does not have to discuss any of his disturbing memories in detail. So while some individuals are comfortable, and even prefer, giving specifics, other people may present more of a general picture or outline. When the therapist asks, for example, "What event do you remember that made you feel worthless and useless?" the person may say, "It was something my brother did to me." That is all the information the therapist needs to identify and target the event with EMDR.

Phase 2: Preparation
For most clients this will take only 1-4 sessions. For others, with a very traumatized background, or with certain diagnoses, a longer time may be necessary. Basically, your clinician will teach you some specific techniques so you can rapidly deal with any emotional disturbance that may arise. If you can do that, you are generally able to proceed to the next phase. One of the primary goals of the preparation phase is to establish a relationship of trust between the client and the therapist. While the person does not have to go into great detail about his disturbing memories, if the EMDR client does not trust his clinician, he may not accurately report what he feels and what changes he is (or isn't) experiencing during the eye movements. If he just wants to please the clinician and says he feels better when he doesn't, no therapy in the world will resolve his trauma. In any form of therapy it is best to look at the clinician as a facilitator, or guide, who needs to hear of any hurt, need, or disappointments in order to help achieve the common goal. EMDR is a great deal more than just eye movements, and the clinician needs to know when to employ any of the needed procedures to keep the processing going. During the Preparation Phase, the clinician will explain the theory of EMDR, how it is done, and what the person can expect during and after treatment. Finally, the clinician will teach the client a variety of relaxation techniques for calming himself in the face of any emotional disturbance that may arise during or after a session. Learning these tools is an important aid for anyone. The happiest people on the planet have ways of relaxing themselves and decompressing from life's inevitable, and often unsuspected, stress. One goal of EMDR therapy is to make sure that the client can take care of himself.

Phase 3: Assessment
Used to access each target in a controlled and standardized way so it can be effectively processed. Processing does not mean talking about it. See the Reprocessing sections below. The clinician identifies the aspects of the target to be processed. The first step is for the person to select a specific picture or scene from the target event (which was identified during Phase One) that best represents the memory. Then he chooses a statement that expresses a negative self-belief associated with the event. Even if he intellectually knows that the statement is false, it is important that he focus on it. These negative beliefs are actually verbalizations of the disturbing emotions that still exist. Common negative cognitions include statements such as "I am helpless," " I am worthless," " I am unlovable," " I am dirty," " I am bad," etc. The client then picks a positive self-statement that he would rather believe. This statement should incorporate an internal sense of control such as "I am worthwhile/ lovable/ a good person/ in control" or "I can succeed." Sometimes, when the primary emotion is fear, such as in the aftermath of a natural disaster, the negative cognition can be, "I am in danger" and the positive cognition can be, "I am safe now." "I am in danger" can be considered a negative cognition, because the fear is inappropriate -- it is locked in the nervous system, but the danger is actually past. The positive cognition should reflect what is actually appropriate in the present. At this point, the therapist will ask the person to estimate how true he feels his positive belief is using the 1-to-7 Validity of Cognition (VOC) scale. "1" equals "completely false," and " 7" equals "completely true." It is important to give a score that reflects how the person "feels," not " thinks." We may logically " know" that something is wrong, but we are most driven by how it " feels." Also, during the Assessment Phase, the person identifies the negative emotions (fear, anger) and physical sensations (tightness in the stomach, cold hands) he associates with the target. The client also rates the disturbance using the 0 (no disturbance)-to-10 (the worst feeling you? ve ever had) Subjective Units of Disturbance (SUD) scale.

Reprocessing
For a single trauma reprocessing is generally accomplished within 3 sessions. If it takes longer, you should see some improvement within that amount of time.
Phases One through Three lay the groundwork for the comprehensive treatment and reprocessing of the specific targeted events. Although the eye movements (or taps, or tones) are used during the following three phases, they are only one component of a complex therapy. The use of the step-by-step eight-phase approach allows the experienced, trained EMDR clinician to maximize the treatment effects for the client in a logical and standardized fashion. It also allows both the client and the clinician to monitor the progress during every treatment session.

Phase 4: Desensitization
This phase focuses on the client's disturbing emotions and sensations as they are measured by the SUDs rating. This phase deals with all of the person's responses (including other memories, insights and associations that may arise) as the targeted event changes and its disturbing elements are resolved. This phase gives the opportunity to identify and resolve similar events that may have occurred and are associated with the target. That way, a client can actually surpass her initial goals and heal beyond her expectations. During desensitization, the therapist leads the person in sets of eye movement (or other forms of stimulation) with appropriate shifts and changes of focus until his SUD-scale levels are reduced to zero (or 1 or 2 if this is more appropriate). Starting with the main target, the different associations to the memory are followed. For instance, a person may start with a horrific event and soon have other associations to it. The clinician will guide the client to a complete resolution of the target.

Phase 5: such as a 5 or 6 on the VOC scale.

Phase 6: Body scan
After the positive cognition has been strengthened and installed, the therapist will ask the person to bring the original target event to mind and see if he notices any residual tension in his body. If so, these physical sensations are then targeted for reprocessing. Evaluations of thousands of EMDR sessions indicate that there is a physical response to unresolved thoughts. This finding has been supported by independent studies of memory indicating that when a person is negatively affected by trauma, information about the traumatic event is stored in motoric (or body systems) memory, rather than narrative memory, and retains the negative emotions and physical sensations of the original event. When that information is processed, however, it can then move to narrative (or verbalizable) memory and the body sensations and negative feelings associated with it disappear. Therefore, an EMDR session is not considered successful until the client can bring up the original target without feeling any body tension. Positive self-beliefs are important, but they have to be believed on more than just an intellectual level.

Phase 7: Closure
Ends every treatment session The Closure ensures that the person leaves at the end of each session feeling better than at the beginning. If the processing of the traumatic target event is not complete in a single session, the therapist will assist the person in using a variety of self-calming techniques in order to regain a sense of equilibrium. Throughout the EMDR session, the client has been in control (for instance, he is instructed that it is okay to raise his hand in the "stop" gesture at anytime) and it is important that the client continue to feel in control outside the therapist's office. He is also briefed on what to expect between sessions (some processing may continue, some new material may arise), how to use a journal to record these experiences, and which techniques he might use on his own to help him feel more calm.

Phase 8: Reevaluation
Opens every new session At the beginning of subsequent sessions, the therapist checks to make sure that the positive results (low SUDs, high VOC, no body tension) have been maintained, identifies any new areas that need treatment, and continues reprocessing the additional targets. The Reevaluation Phase guides the clinician through the treatment plans that are needed in order to deal with the client? s problems. As with any form of good therapy, the Reevaluation Phase is vital in order to determine the success of the treatment over time. Although clients may feel relief almost immediately with EMDR, it is as important to complete the eight phases of treatment, as it is to complete an entire course of treatment with antibiotics.

PAST, PRESENT, AND FUTURE
Although EMDR may produce results more rapidly than previous forms of therapy, speed is not the issue and it is important to remember that every client has different needs. For instance, one client may take weeks to establish sufficient feelings of trust (Phase Two), while another may proceed quickly through the first six phases of treatment only to reveal, then, something even more important that needs treatment. Also, treatment is not complete until EMDR therapy has focused on the past memories that are contributing to the problem, the present situations that are disturbing, and what skills the client may need for the future. Excerpts from: F. Shapiro & M.S. Forrest (2004) EMDR: The Breakthrough Therapy for Anxiety, Stress and Trauma. New York: BasicBooks.


 
Spiritual Emergence Defined

The following is an extract from "The Stormy Search for the Self" by Stan and Christina Grof. They coined the phrase 'spiritual emergence' for this phenomenon, and this is one of the best books available on the topic.

"In the most general terms, spiritual emergence can be defined as the movement of a individual to a more expanded way of being that involves enhanced emotional and psychosomatic health, greater freedom of personal choices, and a sense of deeper connection with other people, nature and the cosmos. An important part of this development is an increasing awareness of the spiritual dimension in one's life and in the universal scheme of things.

Spiritual development is an innate evolutionary capacity of all human beings. It is a movement towards wholeness, the discovery of one's true potential. And it is as common and natural as birth, physical growth, and death - an integral part of our existence. For centuries, entire cultures have treated inner transformation as a necessary and desirable aspect of life. Many societies have developed sophisticated rituals and meditative practices as ways to invite and encourage spiritual growth. Humanity has stored the treasure of emotions, visions and insights involved in the process of awakening in paintings, poetry, novels and music, and in descriptions provided by mystics and prophets. Some of the most beautiful and valued contributions to the world of art and architecture celebrate the mystical realms.

For some individuals, however, the transformational journey of spiritual development becomes a "spiritual emergency", a crisis in which the changes within are so rapid and the inner states so demanding that, temporarily, these people may find it difficult to operate fully in everyday reality. In our time, these individuals are rarely treated as if they are on the edge of inner growth. Rather they are almost always viewed through the lens of disease and treated with technologies that obscure the potential benefits these experiences can offer.

In a supportive environment, and with proper understanding, these difficult states of mind can be extremely beneficial, often leading to physical and emotional healing, profound insights, creative activity and permanent personality changes for the better.

When we [the Grof's] coined the term spiritual emergency we sought to emphasize both the danger and opportunity inherent in such states. The phrase is, of course, a play on words, referring to both the crisis, or "emergency", that can accompany transformation, and to the idea of "emergence", from the Latin emergere: 'to rise' or 'to come forth'. This name thus indicates a precarious situation, but also the potential for rising to a higher state of being. The Chinese pictogram for crisis perfectly represents this idea. It is composed of two elementary signs, one of which means 'danger' and the other 'opportunity'.

The potential for spiritual emergence is an innate characteristic of human beings. The capacity for spiritual growth is as natural as the disposition of our bodies toward physical development, and spiritual rebirth is as normal a part of human life as biological birth. Like birth, spiritual emergence has been seen for centuries by many cultures as an intrinsic part of life, and, like birth, it has become pathologized in modern society. The experiences that occur during this process cover a wide spectrum of depth and intensity, from the very gentle to the overwhelming and disturbing."

Why does Spiritual Emergence happen?

It seems that at the core of this experience our Soul/Spirit is demanding recognition, healing and transformation. It is the healing crisis of the whole Being. From the core of our Being there is a cry for freedom and true expression. We are being asked to awaken to the Truth of who we are - to know ourselves. It demands we shed limiting beliefs and old ways, and strip away the illusions and false images about ourselves and life.

The wide range of triggers of spiritual emergence suggests that our readiness for inner transformation is by far the most important factor. For some people it can be very intense and frightening, for others it may be a gentle unfolding. This experience is not only confined to those engaged in regular spiritual practices, such as meditation, prayer or yoga, which are specifically designed to activate spiritual energies. It can happen to anyone at anytime.

It may begin as a sense of longing for something more, a longing that leads us to explore our inner depths or to embark upon a quest for meaning. It can also be triggered by emotional intensity or stress, physical exertion, disease, intense sexual experience, childbirth, shock or other forms of trauma, exposure to psychedelic drugs and artistic or creative practices. These are all powerful experiences that have the potential to open us fully, and open a way to the hidden depths of our psyche.

For anyone undergoing this process, the crisis is often due to the intense activation of the psyche involved. Psychological upheaval can happen as a result of the radical clearing of various old traumatic memories and imprints. The process is by its very nature potentially healing and transformative.


Forms Spiritual Emergence can take

Ego death and dark night of the soul: These states can arise as a stage in a particular spiritual practice or as a result of life circumstances that challenge one's sense of identity, self-image or status. They centre on the dissolution of the self - our inner and outer worlds - and a consequent loss of reference points.

The awakaning of Kundalini: This refers to the spiritual energy that arises from the base of the spine. Some symptoms are - tremors of energy rising up the spine; sensations of extreme hot or cold; perception of flashing lights; psychological upheaval.

Shamanic crisis: This typically involves images/sensations/dreams focused on a quest or journey to the underworld where demons or animal spirits are often encountered, culminating in experiences of death, dismemberment and annihilation before a rebirth.

Near-death experience: These experiences often involve an unusual and profound shift in the experience of reality. This usually includes an out-of-body experience and can involve profound lessons about life and universal laws.

Episodes of unitive consciousness: An experience of transcending the ordinary distinction between object and subject and experiencing ecstatic union with humanity, nature, the cosmos and God.

Crisis of psychic opening: This may involve channeling, telepathy, clairvoyance, out-of-body experiences and meaningful coincidences.

Past life experience: People can behave irrationally because they are experiencing something from the past as part of their current life, or else a person can be haunted by physical feelings and emotions that are seemingly unconnected to anything in the personal history.

Possession states: This is characterized by an uncanny sense that one's body and psyche have been invaded and are being controlled by an alien energy or entity that has personal characteristics. It can be another type of 'crisis of psychic opening'.

Alien Abduction Phenomena: Alien abduction experiences are characterized by subjectively real memories of being taken secretly and/or against one's will by apparently non-human entities, usually to a location interpreted as an alien spacecraft (i.e., a UFO).

Psychological renewal through the central archetype: This usually involves themes of death and rebirth, battles of opposing cosmic forces (eg good and evil), and a conviction of being the world saviour. If properly understood and treated as a difficult stage in a natural developmental process, spiritual emergence/emergencies can result in emotional and psychosomatic healing, deep positive changes of the personality, and the solution of many problems in life.




Going With Love by Renn Butler    Book review of:
The Ultimate Journey:
Consciousness and T
he Mystery of Death  
by Stanislav Grof, M.D., M.A.P.S., 2006.  

   
Death and dying are the most universal and important experiences in human life, yet until the late 1960s, prominent members of Western civilization—including our medical doctors, psychiatrists, psychologists, anthropologists, and philosophers—showed an astonishing lack of interest in these crucial areas. “The only plausible explanation for this situation is massive denial of death and psychological repression of everything related to it.” So begins Stanislav Grof’s new opus on death, dying, and transcendence, The Ultimate Journey, a heartfelt review of past and present efforts to redress this serious omission in our culture.

Grof writes that our modern industrial civilization typically gives more attention to the wardrobe, makeup, and even plastic surgery for the corpse than to counseling dying individuals and their families. This is in marked contrast to preindustrial societies for whom death and dying were paramount in their worldviews and important inspiration for much of their art and architecture. For example, the shamans of many cultures—going back at least thirty thousand years—began their careers with a spontaneous or induced experience of death and rebirth. They explored, firsthand, territories of the psyche that transcend the boundaries of individual consciousness. Similarly, in the rites of passage, initiates were guided into non-ordinary or holotropic (“moving toward wholeness”) states of consciousness and had a personal experience of numinous realities that transcend biological death. In the ancient mysteries, neophytes participated in various mind-expanding processes or “technologies of the sacred” to move beyond individual consciousness and experience directly the higher transpersonal dimensions of existence. The Goddess Mysteries of Eleusis, for example, held near Athens for almost two thousand years—and which it is now virtually certain used ergot, a naturally occurring form of LSD—had as their participants many of the creative and intellectual giants of Western culture. Pythagoras, Plato, Aristotle, Epictetus, Euripedes, Sophocles, Plutarch, Pindar, Marcus Aurelius, and Cicero all attest to the life-changing power of their holotropic experiences at Eleusis or the other mystery sites.

Grof also reviews the themes of the Egyptian, Tibetan, Mayan, and medieval European Books of the Dead. These sacred texts had a dual purpose: to prepare the dying for the adventures in consciousness that follow biological demise and to guide initiates through experiences of psychospiritual death and rebirth in healing rituals. Preparation for death in these cultures was recognized as identical to spiritual practice for living. In the central theme of the book, Grof writes that the preindustrial societies recognized a basic fact of human nature that we have forgotten—that facing death in supported holotropic states opens connections with transpersonal dimensions of reality beyond death, resulting in a transcendence of the fear of dying, as well as healing of emotional and psychosomatic problems, increased vitality, and higher functioning in everyday life.

The benefits of undergoing these inner transformative experiences have now been rediscovered in modern times through powerful experiential processes such as LSD psychotherapy and Holotropic Breathwork. Grof and his colleagues conducting sessions in these modalities for the past fifty years found that individuals working through unfinished aspects of their biological birth also confront and consume their fear of death in the process. These perinatal sequences then automatically open out into experiences of spiritual rebirth, archetypal and mythological domains, and unitive ecstasy. Rather than the ultimate biological disaster and personal defeat, death represents a gateway to a fantastic cosmic panorama, a vastly freer mode of consciousness which the individual experiences as his or her own rediscovered higher nature.  

People who experience death and rebirth sequences of whatever provenance automatically develop an interest in spirituality of a non-sectarian, universal, and all-encompassing nature, feelings of planetary citizenship, and a high value placed on warm human relationships. They also discover what the mystics have understood, that the representations of death in the psyche, including its substantial bardo states and hells, are, like all forms, actually empty and ultimately products of our own consciousness—a consciousness that is now recognized as essentially commensurate with the Absolute Consciousness and All There Is.

Grof further enriches this promising new picture by reviewing important developments in the fields of thanatology, scientific study of reincarnation, near-death experiences, out-of-body experiences, and messages and visits from the Beyond. Reputable published data from researchers in these fields, while by themselves cannot be considered “proof” of survival of consciousness after death, together represent a wave of compelling anomalous phenomena that have not been convincingly explained in the traditional scientific paradigms. Grof suggests that the conflict between science and spirituality was completely unnecessary and reflects a misunderstanding between different domains of reality.

In the book’s most engaging section, Grof reviews the groundbreaking work with terminal cancer patients conducted by staff at the Spring Grove Hospital in Maryland, the last federally funded research project with psychedelics in the U.S. until the modern era. Describing in detail the research design, protocols, and procedure of these sessions, as well as a number of poignant case studies, Grof recounts the dramatic and often surprising therapeutic results the Spring Grove team observed in the five categories of: alleviation of emotional suffering, physical pain and distress, fear of death and attitude toward dying, time orientation and basic hierarchy of values, and psychological condition of the survivors. He and his colleagues repeatedly witnessed an astonishing process “that closely resembled the initiation practices of the ancient mysteries of death and rebirth and often involved experiential sequences similar to those reported in the Tibetan and Egyptian Books of the Dead.” The inner experiences of these individuals gave them access to transpersonal and unitive domains of consciousness that helped them to live their final days, weeks, and months with less physical pain and fear of death, with more peace of mind, enjoyment of the present moment, and improved quality in their relationships. The accounts of these individuals’ transitions are deeply moving and represented exceptionally rewarding experiences for the caregivers. Based on this and other well-published research, Grof invites administrators, legislators, and politicians to inform themselves by reading the professional and scientific journals, rather than the questionable reports of sensation-hunting journalists. He makes a heartfelt and convincing case that we may be depriving the dying of powerful healing tools to make their transitions easier, more joyful, and more dignified.

Grof concludes The Ultimate Journey with two chapters on conscious dying graciously offered from Laura Huxley’s book This Timeless Moment. The first chapter describes the support Aldous Huxley gave to his wife Maria during her dying process: “Let go, let go. Forget the body, leave it lying here; it is of no importance now. Go forward into the light. Let yourself be carried into the light. No memories, no regrets, no looking backwards, no apprehensive thoughts about your own or anyone else’s future. Only light. Only this pure being, this love, this joy. Above all, this peace. Peace in this timeless moment, peace now, peace now…” The second chapter, “O Nobly Born!” describes his second wife Laura’s support years later during Aldous’ own death: “Light and free you let go, darling; forward and up. You are going forward and up; you are going toward the light. Willingly and consciously you are going, willingly and consciously, and you are doing this beautifully—you are going toward the light—you are going toward a greater love…You are going toward Maria’s love with my love. You are going toward a greater love than you have ever known. You are going toward the best, the greatest love, and it is easy, it is so easy, and you are doing it so beautifully.”

I recommend this book to anyone seeking to come to terms with their own or anyone else’s mortality. From its strikingly appealing cover, its presentation of humanity’s rich mythologies of death and rebirth, the reviews of consciousness research, and forty pages of brilliantly reproduced sacred frescoes, evocative tomb paintings, vivid mandalas, and precious personal photos—this book is itself an urgently needed manual for conscious dying and conscious living. It seems clear that our industrial civilization is plundering the earth to compensate for a deep unconscious fear of death and dying. Yet modern consciousness research is confirming what the shamans, mystics, and priestesses have always known. As the poet Rabindrananth Tagore realized: “Death is not extinguishing the light; it is putting out the lamp because dawn has come.”


 


Non-Ordinary States of Consciousness in Healing and Health:
The work and techniques of Stanislav Grof
Dr. Michael Weir and Christine Perry

Introduction

This presentation is based on our clinical experience working with techniques that induce non-ordinary states of consciousness (NOSCs). Within a community psychiatry setting we have employed programmes based upon Holotropic Breathwork (HBW), a technique developed by Stanislav and Christina Grof, Patricia Carrington’s Clinically Standardised Meditation (CSM) and supportive psychotherapy.

What is the NOSC?

The study of consciousness is not only the preserve of psychiatrists. It is central to many other academic disciplines, philosophical traditions and a host of religions. 

          ‘Our ordinary waking consciousness is but one form of  consciousness.
           All around us lie infinite worlds, separated only by the thinnest veils’             
                                                                                                                                      (William James)

        ‘In the Hindu and devotional traditions, these realms as described as different  
        levels of samadhi. In the Christian, Sufi, and Jewish mystical traditions, certain 
        texts and maps describe the states of consciousness evoked through prayer, 
        concentration and silence… The Buddhist tradition offers hundreds of techniques 
        for the opening of consciousness. New realms of consciousness can also open 
        spontaneously through what is called grace, or they may occur under the pressure 
        of circumstance.’                                                (Jack Kornfield: A Path with Heart)

Rudolph Steiner and Sri Aurobindo in their extensive works claimed that spontaneous awakenings would become increasingly likely events for growing numbers of people. It is not only mystics and meditation practitioners who hold these views. Several pioneering psychiatrists have advocated that the spontaneous opening of consciousness should not be understood as a pathological process. They carefully distinguished between experiences offering rich healing potential and pathological processes that offered no such benefits.

Grof coined the term ‘Spiritual Emergency’ and developed support networks in the USA for those going through such experiences. Likewise California based Lee Sannella described clinical presentations of individuals inadvertently opening this latent potential. He discovered that meditation and yoga techniques, or the use of psychoactive substances, awakened this psychic potential.

The Italian psychiatrist and founder of Psychosynthesis, Roberto Assagioli, also ascribed credibility to ‘spiritual awakening’. He described crises that preceded or were caused by ‘spiritual awakening’ and explored how the experiences could be processed and built upon. Ken Wilber’s extensive writings have added much needed rigour and intellectual weight to the study of higher states of consciousness.

What is the value or relevance of these ideas for Psychiatrists and Mental HealthServices?

There are many ways NOSCs have relevance for psychiatry. They expose the limitations of the biomedical model and the Newtonian-Cartesian paradigm within which it is structured. This itself is an important contribution to scientific enquiry. Karl Popper’s acclaimed thesis was that the questioning and challenging of existing models and understandings is the true essence of science. Thomas Kuhn described the turbulence and controversy that the development of radically different theories evoked. Most certainly NOSCs and their potential to enhance mental health are seen as nonsensical and unacceptable by reductionist psychiatry.

These ideas have more to offer than just challenging the status quo. For instance they offer great insight into the potential for well-being. They lend support to transpersonal thinkers such as Abraham Maslow and the concepts of self-realisation, self-actualisation and enlightenment. More pragmatically they offer new and innovative avenues for therapeutic interventions. Grof described NOSCs with the potential for healing as ‘Holotropic states’ and used them specifically to address unresolved distress and related psychopathology. Even more challengingly, he claimed they had the potential to heal problems of a collective or global nature!

Stanislav Grof MD

Stanislav Grof was a former professor of psychiatry at Johns Hopkins University, a former chief of psychiatric research at the Maryland Psychiatric Institute, and a scholar in residence for fourteen years at the Esalen Institute. He has written many books including LSD Psychotherapy, Beyond the Brain, and The Adventure of Self-Discovery. His initial exposure to NOSCs was through his work in Prague with LSD. He continued with LSD for several years after his move to America but later explored non-drug ways of evoking the NOSC.

Grof’s studies revealed hidden domains of consciousness, which could readily be experienced and explored through the NOSC. His subjects reported re-exposure to events from their earlier life that carried particular significant. These provided insight, acceptance or the resolution of distress. Grof came to believe that NOSCs often offered the first real exposure to traumatic events and the opportunity for their resolution and integration. Modern neuroscience has developed theoretical models of trauma processing that support Grof’s position.

Other experiences reported during NOSCs are less readily explicable by reductionist models, for example, powerful energetic experiences, which offer cathartic or re-balancing benefits. Likewise Grof’s views on the centrality of birth trauma are particularly challenging to conventional thought. To a significant degree he supports the position on birth held by the psychoanalyst Otto Rank.

Grof resolutely claimed that dealing with the birth process embraced the experience of being born and also the experience of dying. He saw these experiences as a boundary between the personal and the transpersonal and proposed that birth trauma was the archetype or epitome of all subsequent traumas the human experienced throughout his / her life. Thus, dealing with birth trauma in the NOSC helped achieve a degree healing not possible with other therapies.

Beyond the process of birth, Grof discovered dimensions that went to the level he called transpersonal. His view was that the human psyche consisted of the personal realm, based on life experiences, and the transpersonal, which dealt with archetypal patterns and spiritual sources beyond one’s personal life history. Birth trauma functions as a kind of gateway between the personal and transpersonal. (In our work transpersonal / mystical domains are commonly reported by subjects).

Holotropic Breathwork (HBW)

Holotropic Breathwork requires adequate time and the correct environment for the experiential session and the processing of experiences. Breathing techniques combined with evocative music are used to trigger the Holotropic state. The individual breathes in the manner directed whilst lying on the floor with closed eyes. Subjects are encouraged not to anticipate what will happen and to accept and express the experiences that are evoked. As Grof says, the ‘inner radar’ or ‘inner healer’ selects the most relevant material that needs to be processed. The patient or client is encouraged to stay with, and express, the experiences as they arise.

HBW requires facilitators and subjects to have radically different mindsets to those employed in conventional therapies. The facilitator is there to support the process, not to direct or interpret it. Only on rare occasions is direct communication with the breather required. The mere presence of a caring facilitator whilst the breather embraces powerful inner experiences helps in the integration / resolution process.

Focused bodywork is employed post-breathwork to intensify any physical discomfort that has emerged during the session. The intensification and disinhibited expression of such discomfort mobilises and releases trapped emotional material. It is our view that this aspect of the therapy may offer rich potential for the treatment of psychosomatic conditions.

Grof advocates close physical contact and the expression of care once the breathing and bodywork have been completed. This intimacy helps address trauma caused by the omission of warmth or acceptance during formative years. Mandala drawing and the opportunity to share experiences and insights complete the HBW cycle.

Our Clinical Experience

One of the co-presenters, MW, has used HBW with individuals interested in personal development and self-exploration. However, our work has focussed on patients with psychiatric disorders. These have included recurrent depression, PTSD, alcohol dependence and anxiety and panic disorders. In general we have worked with patients with chronic histories who have already been exposed, without great success, to a range of medications and therapies. The precise results of this work are being included in a paper currently in preparation. However, based on the work we have undertaken in both settings we can offer the following broad conclusions:

Conclusions

1. HBW is extremely challenging, conceptually and emotionally, to professionals trained in conventional health care

2. It is a safe and effective method to experience NOSCs

3. It is a powerful tool for self-exploration and personal growth

4. It offers rich therapeutic potential but is not a cure-all

5. Careful selection of patients and ongoing support to consolidate benefits are required

6. It is most successful as a strategy for personal growth and self-exploration rather than as a treatment focused on symptom resolution.

7. There are side effects and selection criteria are necessary.

References

Assagioli, R. (1986) Psychosynthesis: A Collection of Basic Writings Psychosynthesis  
          Research Foundation, Fourth Impression

Grof, S. (2000) Psychology of the Future: Lessons from modern consciousness
          research.
State University of New York Press

Kornfield, J. (1993) A Path with Heart: A guide through the perils and promises of
          spiritual life
Bantam Books

Sannella, L. (1987) The Kundalini Experience – Psychosis or Transcendence Integral 
          Publishing

Wilber, K. (1979) No Boundary; Eastern and Western Approaches to Personal Growth
          Shambhala Publications 2001

© Christine Perry and Michael Weir 2002

 


What is Holotropic Breathwork?
From: www.holotropic.com

Holotropic Breathwork is a powerful approach to self-exploration and healing that integrates insights from modern consciousness research, anthropology, various depth psychologies, transpersonal psychology, Eastern spiritual practices, and mystical traditions of the world. The name Holotropic means literally "moving toward wholeness" (from the Greek "holos"=whole and "trepein"=moving in the direction of something).

The process itself uses very simple means: it combines accelerated breathing with evocative music in a special set and setting. With the eyes closed and lying on a mat, each person uses their own breath and the music in the room to enter a non-ordinary state of consciousness. This state activates the natural inner healing process of the individual's psyche, bringing him or her a particular set of internal experiences. With the inner healing intelligence guiding the process, the quality and content brought forth is unique to each person and for that particular time and place. While recurring themes are common, no two sessions are ever alike.

Additional elements of the process include focused energy release work and mandala drawing. Holotropic Breathwork is usually done in groups, although individual sessions are also possible. Within the groups, people work in pairs and alternate in the roles of experiencer and "sitter". The sitter's role is simply to be available to assist the breather, not to interfere or interrupt the process. The same is true for trained facilitators, who are available as helpers if necessary. 

Grof Transpersonal Training

What is Grof Transpersonal Training?

GTT is a program for experiencing and studying Holotropic Breathwork and the transpersonal perspective. It is a two-track program that can be used either to become a certified practitioner or simply to experience this practice in a more in-depth format. It is the best way to spend time with HB co-developer and one of the founders of transpersonal psychology, Stanislav Grof.  Although semi-retired, Stan still teaches at some of the modules.  The rest are led by GTT director Tav Sparks and a carefully selected teaching and facilitating staff.   Modules may also have guest faculty who are leaders in the transpersonal and related fields. Past guest teachers have included Jack Kornfield, Angeles Arrien, Andrew Harvey, Richard Tarnas, and others. 

Besides the practice and theory of HB, modules topics have included Shamanism; The Books of the Dead; Astrology; Spirituality and Addiction; Death and Dying; Gender; Modern Popular Culture; and others.  A special annual event is "Ecstatic Remembrance," the Kirtan (chanting) module led by Jai Uttal (nominated for a 2002 Grammy for his album Mondo Rama).

You will participate when you choose, in a residential setting, in groups of moderate size, for one or two six-day modules at a time. You will be with people from around the world who are excited about Holotropic Breathwork and its possibilities, and join them in going deeper into the work and your personal journey than you may have been able to in shorter workshops. And you will become connected with the larger community of HB practitioners and experiencers.

What is the format of the program?

 In keeping with the HB tenet that your inner wisdom is the best guide, GTT is designed to be flexible. Once you apply and are accepted into the program, you may participate in any of the six-day modules, which are usually offered in pairs so you can take one or both. Pairs of modules are spread out through the year, and you may attend as many or as few as you wish, and at whatever time. Thus each person can participate at her or his own pace depending on one's own process, available time, and financial considerations. You do not have to become certified, and if you do, you are welcome to continue attending modules at any time (at a reduced fee).

For those who wish to become certified, there are two tracks, Educational and Practitioner. Both have the requirements of attendance at seven modules (four on required topics and three optional), and a two-week closing intensive. In addition, the training includes ten hours of consultation with a certified practitioner and 150 total hours (including those done before starting the training) of participation in HB workshops led by Stan or a certified practitioner. In addition, those wishing to become independent workshop leaders (Practitioners), must apprentice at least four times at workshops with previously certified practitioners before leading groups of their own. Practitioner certification is not guaranteed, but is at the discretion of Stan Grof and the training staff.

Who is the Grof Transpersonal Training program for?

The program is designed to work for people with various levels of interest and needs.  If you have previously tried HB, either a few or many times, and want to learn more about it while going even deeper into your personal journey, you may want to attend at least one module. 

Although many in the program are in the helping professions, it is in no way a requirement for participation, or even to become a practitioner. People with all kinds of backgrounds have come through the training, including business people, artists, academics, ministers, nurses, filmmakers, teachers, bodyworkers, writers, builders, doctors, musicians, veterinarians, attorneys, and more.

A training group generally consists of people from many countries, and of varying ages and income levels. There has been limited racial diversity, but we hope this will change. People come with widely varied interests and reasons for participating. There are all types of spiritual paths represented, and individuals in many different stages of life. Gay and straight people attend, sometimes in couples, and occasionally siblings or parents with grown children attend together. What they have in common is a passion for Holotropic Breathwork, and based on this and on taking the inner journey together, groups usually bond quickly, and deep connections are made.

Where do training events take place?

Currently, modules are held in the United States at retreat centers near Taos, New mexico and Joshua Tree, California. Internationally, training groups are currently underway in Austrailia, Denmark, and Mexico and beginning soon in Spain. A special three-year group is also offered in Germany. Past groups have completed certification in Argentina, Australia, Brazil, Germany, Italy, the Scandinavian countries and Spain.  

How does someone begin the training?

Some of the training modules do not require any previous experience with Holotropic Breathwork, or an application to the training. For those events, just contact us for registration information. If you wish to attend any of the modules on "mandatory" topics -- Practice of Holotropic Breathwork, Spiritual Emergency, or Psychopathology -- we would like to have you complete an application to the training, even if you do not plan to become a certified practitioner. The application requests that you have experienced five HB sessions in a workshop setting, either with a certified practitioner or with Stan Grof. However, if you do have some prior HB experience, but less than the five session, and wish to attend the module, please let us know as exceptions may be made. After applying and being accepted, you will regularly be sent notices for upcoming training events.


                                                                                                                        

 

Dan Siegel - Mindfulness, Psychotherapy and the Brain
An Interpersonal Neurobiology Approach to Psychotherapy:
Awareness, Mirror Neurons, and Neural Plasticity in the Development of Well-Being

Daniel J. Siegel, M.D.

 

Overview

In this article the principles of an interdisciplinary approach to psychotherapy called “interpersonal neurobiology” will be summarized with an emphasis on neuroscience findings regarding the mirror neuron system and neural plasticity. Interpersonal neurobiology is a “consilient” approach that examines independent fields of knowing to find the common principles that emerge to paint a picture of the “larger whole” of human experience and development. Interpersonal neurobiology attempts to extract the wisdom from over a dozen different disciplines of science to weave a picture of human experience and the process of change across the lifespan.

The perspective of “interpersonal neurobiology” is to build a model within which the objective domains of science and the subjective domains of human knowing can find a common home. An interpersonal neurobiology approach to psychotherapy draws on the basic framework of this interdisciplinary view in exploring the ways in which one individual can help others alleviate suffering and move toward well-being. The central idea of interpersonal neurobiology is to offer a definition of the mind and of mental well-being that can be used by a wide range of professionals concerned with human development.

The Mind:

   A Definition – The mind can be defined as an embodied process that regulates the flow of energy and information. Regulation is at the heart of mental life, and helping others with this regulatory balance is central to understanding how the mind can change. The brain has self-regulatory circuits that may directly contribute to enhancing how the mind regulates the flow of its two elements, energy and information. 
   Mind Emergence – The mind emerges in the transaction of at least neurobiological and interpersonal processes. Energy and information can flow within one brain, or between brains. Naturally other features of our world, nature and our technological environment, can also impact on how the mind emerges. Within psychotherapy, we can see that relationships with another person profoundly shape the flow of energy and information between two people, and within each person. 
   Mind Development – The mind develops across the lifespan as the genetically programmed maturation of the nervous system is shaped by ongoing experience. We now know that about one third of our genome directly shapes the connections within our brains. Though genes are extremely important in development, we also know that experience shapes our neural connections as well. When neurons become active they have the potential to stimulate the growth of new connections among each other. With one hundred billion neurons and an average of ten thousand synaptic connections linking one neuron to others, we have trillions of connections within our brains. These synaptic linkages are created by both genes and by experience. Nature needs nurture. Experience shapes new connections among neurons by how genes are activated, proteins produced, and interconnections established within our spider-web like neural system. 
   Mental Well-Being – An interpersonal neurobiology view of well-being states that the complex, non-linear system of the mind achieves states of self-organization by balancing the two opposing processes of differentiation and linkage. When separated areas of the brain are allowed to specialize in their function and then to become linked together, the system is said to be integrated. Integration brings with it a special state of functioning of the whole which has the acronym of FACES: Flexible, Adaptive, Coherent, Energized, and Stable. This coherent flow is bounded on one side by chaos and on the other by rigidity. In this manner we can envision a flow or river of well-being, with the two banks being chaos on the one side, rigidity on the other. One way of viewing the symptoms of the Diagnostic and Statistical Manual for psychiatric diagnoses is as manifestations of rigidity or of chaos. This flow of well being can be seen to reveal the correlations among an empathic relationship, a coherent mind, and an integrated brain as three points on a triangle depicting well-being.

Promoting Well-Being

What does an interpersonal neurobiology approach to psychotherapy offer as a framework for considering how therapy works and how to work in therapy? Therapeutic experiences that move an individual toward well-being promote integration. Deviations from this integrated flow are revealed as rigidity and/or chaos and result in symptomatic conditions that may be experienced as inflexible, maladaptive, incoherent, deflated and unstable. To achieve the goal of promoting integration it has been helpful to delineate at least nine domains of integration that can remain in the therapist’s mind within the process of psychotherapy. Besides briefly outlining these domains, this article will focus specifically on the nature of interpersonal integration highlighting recent contributions from the studies of the mirror neuron system and neural plasticity. A fuller description of the clinical implications of these domains within psychotherapy can be found in other publications.

Domains of Integration

1. Integration of Consciousness

The mind flows as energy and information are channeled through the process of attention. The nomenclature of science refers to the presence of three general mechanisms of attention: exogenous, endogenous, and executive. Exogenous attention is a form of attentional focus driven by the immediacy of an often external stimulus, such as a loud sound. A more sustained, self-generated form is called endogenous attention in which the individual chooses to focus attention on a particular stimulus. With executive attention one can create a flexible response not governed by the external world or by a singular focus of attention. The integration of consciousness involves the development of executive forms of attention that are associated with the larger capacities for self-regulation, such as the balancing of emotion, improved stress response, and enhanced social skills. Self-awareness has its roots within the central regulatory systems of the brain and thus may play an important role in various forms of psychotherapy and in various psychiatric disorders. In many ways, how we have developed the capacity to have a receptive, flexible form of awareness enables us to have freedom to focus our attention in ways that are most helpful to us and to those around us.

Enhancing this receptive awareness in the present moment is sometimes called “mindful awareness.” Mindfulness is defined as paying attention, in the present moment, on purpose, without grasping onto judgments. Mindful awareness has the quality of receptivity to whatever arises within the mind’s eye, moment to moment. Recent studies of mindful awareness practices reveal that it can result in profound improvements in a range of physiological, mental, and interpersonal domains of our lives. Cardiac, endocrine, and immune functions are improved with mindful practices. Empathy, compassion, and interpersonal sensitivity seem to be improved. People who come to develop the capacity to pay attention in the present moment without grasping on to their inevitable judgments also develop a deeper sense of well-being and what can be considered a form of mental coherence.

Within psychotherapy the focus of attention on various domains of mental, somatic, and interpersonal life can create the neural firing patterns in the brain that enables new synaptic connections to be established. Neural plasticity, the change in neural connectivity induced by experience, may be the fundamental way in which psychotherapy alters the brain. Based on the modification and growth of synapses and the potential differentiation of neural stem cells into fully integrated neurons, neural plasticity reveals how the brain’s interconnectedness can change throughout the lifespan. Consciousness may play a direct role in harnessing neural plasticity by altering previously automatic modes of neural firing and enabling new patterns of neural activation to occur.

The basic steps linking consciousness with neural plasticity are as follows: Where attention goes, neural firing occurs. And where neurons fire, new connections can be made. In this manner, learning a new way to pay attention within the integration of consciousness enables an open receptive mind within therapy to catalyze the integration of new combinations of previously isolated segments of our mental reality.

2. Vertical Integration

Taking the perspective of the vertical plane of our somatic architecture, we can envision the anatomically and functionally differentiated elements of our bodies to extend from our head to our toes. Vertical integration directly links these elements within awareness so that new connections can be established. We know that the mind is embodied, built in part from its roots in somatic reality, but often seduced to live in the land of the purely non-physical world we can isolate as “mental.” Linking the basic somatic regulatory functions of the brainstem with the limbic circuits’ generation of affective states, motivational drives, attachment, and appraisal of meaning and laying down of memory is a first layer of vertical integration.

Above the limbic circuitry emerged the neocortex, or “outer bark” of our evolving brains. The cortex, unlike the brainstem, is quite underdeveloped at birth and is shaped by both genetics and especially by experiences out in the world. In general, the posterior regions of the cortex are specialized for perception of the physical world (our first five senses) and the body itself is registered in the more forward aspects of this posterior region. In the frontal lobe of the cortex we have our motor and pre-motor planning areas that enable us to carry out behaviors. The forward most part of this frontal lobe is the prefrontal cortex. The side part of this area, known as the dorsolateral prefrontal region, is considered an essential circuit for working memory that enables us to pay attention to something in the here-and-now. Toward the middle of the prefrontal cortex, just behind the forehead area, are several regions that are sometimes thought to be the “higher part” of the limbic circuitry and a core aspect of the social circuits of the brain: the orbital frontal area behind the eyes, the medial prefrontal cortex behind the forehead, and the anterior cingulate just behind it. These more midline structures, along with a region called the insular cortex, serve important functions in linking body, affective state, and thought. For the purpose of this discussion of the beneficial effects of psychotherapy, we’ll refer to these midline structures as the “middle prefrontal cortex” as they generally work as a team with each other.

A review of the anatomy of the middle prefrontal cortex reveals that it has a major integrative function, linking body-proper, brainstem, limbic circuits, and cortex to each other. In this manner these middle prefrontal circuits may carry out what we are labeling as vertical integration. What does this term really mean? This idea means that fibers literally physically connect the input of somatic and vertically distributed neural structures with one another. A wide array of independent studies in basic brain research reveals that these middle prefrontal areas are crucial for generating nine aspects of life: 1. Body regulation: Balance of the sympathetic (accelerator) and parasympathetic (brakes) branches of the autonomic nervous system. 2. Attuned communication: Enables us to tune into others’ states and link minds. 3. Emotional balance: Permits the lower limbic regions to become aroused enough so life has meaning, but not too aroused that we become flooded. 4. Response flexibility: The opposite of a “knee-jerk” reaction, this capacity enables us to pause before acting and inhibit impulses giving us enough time to reflect on our various options for response. 5. Empathy: Considering the mental perspective of another person. 6. Insight: Self-knowing awareness, the gateway to our autobiographical narratives and self-understanding. 7. Fear extinction: GABA (an inhibitory neurotransmitter) fibers project down to the amygdala and enable fearful responses to be calmed. 8. Intuition: Being aware of the input of our body, especially information from the neural networks surrounding intestines (a “gut feeling”) and our heart (“heartfelt feelings”) enables us to be open to the wisdom of our non-conceptual selves. 9. Morality. The capacity to think of the larger good, and to act on these pro-social ideas, even when alone, appears to depend on an intact middle prefrontal region.

By focusing awareness on the input from the body, our affective states, and our range of thoughts and ideas, the first steps toward vertical integration can be encouraged by the therapist. With a receptive mind, it may be that this vertical integration naturally occurs. But for many individuals coming to therapy, having the intention to pay attention to the body’s signals is a purposeful act that can transform a disconnected way of living into a richer, more integrated way of living.

It is relevant to note that these nine middle prefrontal functions can be seen to emerge not only with mindful awareness practices, but at least the first seven are also associated with the outcome of secure attachment between child and caregiver. This finding may suggest that experiences of “mental attunement” – interpersonal in the case of attachment or internal in the practice of mindful awareness – may be at the heart of developing an integrated brain and well-being. Healthy self-regulation, through relationships and self-reflective observation, may depend on the development of the integrated circuits of these prefrontal regions.

Mental attunement may depend on a quality of openness to living in the moment that may be essential for the therapist’s own stance and serve as a strategic goal for the process of therapy itself. Of note from the neuroscience literature are preliminary studies suggest that mindful meditation practice, as one example of a receptive mental state, may actually lead to enhanced growth of the middle prefrontal regions as well as preserved neural tissue in these regions with aging.

3. Bilateral Integration

The nervous system of vertebrates is asymmetric with left being different from right in animals from zebra fish to lizards, toads, chickens, pigeons, apes, and us. With more complexity comes more adaptability. Cortical function and structure are driven by the lower asymmetries of the limbic and brainstem areas and various forms of research have revealed that the right and left cortex perceive and create reality in quite distinct ways. In this brief overview these differences will be highlighted to illustrate the importance of bilateral integration.

The right hemisphere develops first after birth, its activity and synaptogenesis more robust during the first two to three years of life. After that period, there are a series of cyclical waves of left, then right, and then left sided dominance in growth and activity. In general the right and left sides of the brain have the following characteristics that have been supported by a range of scientific and clinical investigations.

The right mode of processing: A. Holistic – things are perceived in the whole of their essence. B. Visuospatial – the right side works well with seeing a picture and is not proficient at decoding the meaning of words. C. Non-verbal – eye contact, facial expression, tone of voice, posture, gestures, and timing and intensity of response are the non-verbal components of communication that the right mode both sends and perceives from others. D. A wide range of functions, including the stress response, an integrated map of the whole body, raw, spontaneous emotion, autobiographical memory, a dominance for the non-verbal aspects of empathy. The right mode has no problem with ambiguity and is sometimes called “analogic” meaning it perceives a wide spectrum of meaning, not just a digital restricted definition of something.

The left mode of processing: A. Linear – the left loves this sentence, one word following the next. B. Logical – specifically syllogistic reasoning in which the left looks for cause-effect relationships in the world. C. Linguistic – these words are the left’s love. D. Literal – the left takes things seriously. In addition, the left is sometimes considerer the “digital” side, with on-off, yes-no, right-wrong patterns of thinking.

One proposed manifestation of impaired left-right integration can be that the drive of the left hemisphere to tell stories, to explain in a linear fashion using words, would be compromised if the story were about the self. Given the repeated finding of autobiographical memory being primarily mediated within the right hemisphere, what would a life-story be like if the narrating left hemisphere could not easily access the non-verbal autobiographical details of the right side of the brain? Before we turn to such narrative incoherence, let’s first look at the integration of memory.

4. Integration of Memory

Memory can be defined as the way in which a past experience alters the probability of how the mind functions in the future. Memory shapes how we experience the present and how we anticipate the future, readying us in the present moment for what comes next based on what we’ve experienced in the past. This broad view enables us to examine the findings of two aspects of memory and explore how their integration can promote well-being. Segregation of these memory functions, in contrast, may be seen as one aspect the source of mental suffering.

Experience creates the activation or “firing” of neurons. This neuronal activation can in turn lead to alterations in the connections among neurons, the basis of neural plasticity. Throughout our lives we embed experience into memory via a first layer of processing called “implicit” or “non-declarative” memory. Before one and a half years of age, this early implicit layer of memory is the only form available to the growing infant. But even beyond that early age, we continue to create implicit memories but they are then often selectively integrated into the next layer of processing called “explicit” or “declarative” forms of memory.

Implicit memory involves the perceptual, emotional, and behavioral neural responses activated during an experience. It is likely that our bodily sensations are also a form of implicit memory, but these have not been formally studied in research paradigms. Mental models, or generalizations of repeated experiences called “schema,” are also a form of implicit memory. The brain also readies itself to respond in a fashion called “priming” in which past experiences shape the way we prepare for the future.

Implicit memory encoding does not require focal, conscious attention. A second crucial feature of implicit memory is that when we do retrieve an element of implicit memory into awareness we do not have the internal sensation that something is being accessed from a memory of the past. We just have the perceptual, emotional, somatosensory, or behavioral response without knowing that these are activations related to something we’ve experienced before.

The second layering of memory is called explicit and involves the two forms of factual (or “semantic”) memory and episodic (or memory for an episode of an experience in the past). Episodic memory has a sense of the self and of time. Both semantic and episodic memory appear to require focal attention for their encoding and when they are retrieved from storage into present awareness they do have the internal sensation that something is being activated from the past. The hippocampus may serve an important role in memory integration as it functions as an “implicit memory puzzle piece assembler” that clusters the basic building blocks of the various elements of implicit memory together into framed pictures of semantic and episodic memory. These framed pictures of explicit memory can then be further integrated into autobiographical memory, a function that may involve rapid eye movement sleep as our dreams integrate our past experiences, our daytime events, and our emotional themes of our lives.

One proposal about trauma’s effects on memory is that it may transiently block the integrative function of the hippocampus in memory integration. With massive stress hormone secretion or amygdala discharge in response to an overwhelming event, the hippocampus may be temporarily shut-down. In addition to this direct effect of trauma of hippocampal function, some people may attempt to adapt to trauma by dividing their conscious attention, placing it only on non-traumatic elements of the environment at that time. The resultant neural configuration of blocked hippocampal processing, when reactivated, can present itself as free-floating, unassembled elements of perception, bodily sensation, emotion, and behavioral response without the internal sense that something is coming from the past. Beliefs and altered states of mind may also enter consciousness as the implicit mental models and priming become activated in response to environmental or internal triggers resembling components of the original experience. This “implicit-only” form or memory can be one explanation for the flashbacks and symptomatic profile of Post Traumatic Stress Disorder.

The key to memory integration is the neural reality that focal attention allows the puzzle pieces of implicit memory to enter the spotlight of attention and then be assembled into the framed pictures of semantic and self-memories. With such reflective focus, what was once a memory configuration capable of intrusion on a person’s life can move into a form of knowing that involves both deep thoughts and deep sensations of the reality of the past.

5. Narrative Integration

As we continue to grow throughout the first five years of life, explicit autobiographical recollection becomes even further integrated into narrative memory which involves the detection and creation of thematic elements of our lives. The brain appears to be able to have a narrative function that can detect themes of our life story and to draw heavily on prefrontal functions as they continue to integrate neural maps that form the underlying architecture of our episodic and autobiographical memory systems. With narrative reflection, one can choose, with consciousness, to detect and then possibly change old maladaptive patterns.

In the attachment research world, it is coherent narratives, stories that deeply make sense of our lives, which are the most robust predictor of how children will attach to us. This finding suggests that parents who have made sense of their lives, as revealed in their coherent life narratives, will be those that somehow offer their children patterns of communication that promote well-being. In brief, we can summarize the exploration of this finding by suggesting that it is the parents’ neural integration that helps them create a coherent narrative, and helps them be receptive to their child’s own mind and communicative signals. Such a pattern may reflect the central role of inter- and intrapersonal mental attunement in the development of well-being.

6. State Integration

As the brain becomes activated in the moment, it coalesces its firing patterns into clusters of activation we can call a “state of mind.” These repeated and enduring states of activation of the brain can help define what we see as our personality, our patterns of perception and emotional and behavioral responses that help us denote who we are. We can embrace the differentiated states of mind and their drive to satisfy different needs for familiarity and comfort, novelty and challenge, connection and love, mastery and exploration. State integration refers to the way we embrace and nurture these different states and their defining needs across time. Late adolescence is thought to be a time of resolution of these conflictual states, with mental well-being emerging when such state integration is done well and mental turmoil present when resolution is not achieved. Finding balance in the integration of states enables us to find our needs satisfied and to create meaning in the pursuit of those various dimensions of our lives.

7. Temporal Integration

As we move from our earliest years and our prefrontal cortices begin to develop our capacity for reflection on the nature of time begins to emerge. First available as a form of mental time travel that enables an early form of self-knowing awareness, this reflective capacity to link past, present, and future soon reveals itself in an awareness of the finite nature of our time on this planet. We learn that people’s lives are often limited to a century or so, and that the experience of death is an inevitable part of each of our lives. Temporal integration directly confronts this organizational role of time, and our transient lives, in helping us consider the deep questions of purpose in life.

8. Interpersonal Integration and the Mirror Neuron System

Our brain is the social organ of the body. The structure of our neural architecture reveals how we need connections to other people in order to feel in balance and to develop well. As we’ve seen in the function of the middle prefrontal regions, the brain integrates input from other people with the process of regulating the body, balancing emotional states, and the creation of self-awareness. This visceral, social, and self integration suggests that our minds are woven from the integration of aspects of reality that on the surface appear to be quite disparate. How could bodily, interpersonal and mental go together? To explore this dimension, let’s use the example of mirror neurons to highlight the integration of these domains of reality.

Discovered in the mid-nineteen nineties, the mirror neuron system reveals how the brain is capable of integrating perceptual learning with motor action to create internal representations of intentional states in others. Initial studies in monkeys revealed that if a monkey sees someone pick up an object, his own motor system will become primed to imitate that same action. In humans, the mirror neuron system is much more complex and emerging studies reveal that many ways in which our internal, one-to-one, and larger social experiences may be shaped by the integrative nature of this system.

For example, the mirror neuron system is thought to be an essential aspect of the neural basis for empathy. By perceiving the expressions of another individual, the brain is able to create within its own body an internal state that is thought to “resonate” with that of the other person. Resonance involves a change in physiologic, affective, and intentional states within the observer that are determined by the perception of the respective states of activation within the person being observed. One-to-one attuned communication may find its sense of coherence within such resonating internal states. In addition, the behavior of larger groups, such as families and social gatherings may reveal this shared state of internal functioning.

The clinical implications of this work are profound and help therapists to understand not only the inherently social nature of the brain but that their own bodily shifts may serve as the gateway toward empathic insights into the state of another person. Mediated via the insula, perceptions of another’s affective expressions may alter our own somatic and limbic states and then be examined through a prefrontal process of interoception, interpretation, and attribution to another’s states.31 Being open to our own bodily states as therapists is a crucial step in establishing the interpersonal attunement and understanding that is at the heart of interpersonal integration. The term “countertransference” can be used to refer to this important way in which our own non-verbal shifts in brain state may offer us a direct glimpse into the internal world of our patients.

The mirror neuron system offers us a new vista into the neural basis of not only imitation, social behavior and empathy, but also the interpersonal experiences that may promote a state of well-being. Mirror neurons reveal the fundamental integration within the brain of the perceptual and motor systems with limbic and somatic regulatory functions. The mirror neuron system also illuminates the profoundly social nature of our brains. This social basis of neural function may offer new pathways for us to understand how psychotherapy leads to the process of change. When two minds feel connected, when they become integrated, the state of firing of each individual can be proposed to become more coherent. Literally this may mean that the corresponding activations between the body-proper, limbic areas and even cortical representations of intentional states between two individuals enter a state of “resonance” in which he matches the profiles of the other. The impairment of such shared states has been proposed to be a characteristic of forms of psychopathology, including schizophrenia. Recent studies in individual with autism spectrum disorder reveal impairment in the capacity to perceive emotional expressions in others that is associated with markedly diminished mirror neuron activation. With impaired mirror neuron system functioning, the social brain is unable to share in the rapid social interactions that depend on a shared set of neural profiles that create an embedded matrix of both social behavior and non-verbal understanding of the meaning of social interactions.

In the process of psychotherapy involving a range of individuals with intact mirror neuron systems, shared states with the therapist may be an essential component of the therapeutic process. As two individuals share the closely resonant reverberating interactions that their mirror neuron systems make possible, what before may have been unbearable states of affective and bodily activation within the patient may now become tolerable with conscious awareness. Being empathic with patients may be more than just something that helps them “feel better” – it may create a new state of neural activation with a coherence in the moment that improves the capacity for self-regulation. What is at first a form of interpersonal integration in the sharing of affective and cognitive states now evolves into a form of internal integration in the patient. With the entry of previously warded-off states of being in conscious awareness, the patient can now learn to develop enhanced self-regulatory capacities that before were beyond their skill set. It may be that as interpersonal attunement initiates a new form of awareness that makes intrapersonal attunement possible, new self-regulatory capacities become available.

If the mirror neuron system were to be focused on one’s own states of mind, we can propose that a form of internal attunement would allow for new and more adaptive forms of self-regulation to develop. The practice of focusing attention in the present moment on one’s own intentions and somatic states, such as the breath, have been a mainstay of mindful awareness practices over thousands of years. The recent findings that such practices are associated with enhanced physiological, psychological and interpersonal functioning may fit into the larger framework that integrated states correlate with well-being. A “Mirror Neuron-Mindfulness Hypothesis” can be offered that proposes that the focusing of one’s non-judgmental attention on the internal state of intention, affect, thought and bodily function may be one way in which the brain focuses inward to promote well-being. As the therapist attempts to achieve such an open, receptive state of awareness toward both internal state changes and for interpersonal signals sent by the patient, the patient’s own mind may be offered the important social experiences to create a similar state. In this way the mirror neuron system may serve a powerful role as the neural basis of mental attunement within and between both patient and therapist.

Studies of attachment reveal that the parent’s openness to a child’s signals and the coherence of the parent’s own narrative are important predictors of a child’s development of secure attachment. Such factors seem to promote a form of resiliency in the child which helps self-regulation unfold as the child matures. Psychotherapy may naturally harness these developmental origins of well-being in creating a resonant state in which the therapist is sensitive to the patient’s signals and also has made sense of his or her own life. Being open to the many layers of our experience, often involving the non-verbal world of sensation and affect in addition to our verbal understanding is an important stance for the therapist to create toward the internal and interpersonal worlds. Within this framework, the state of brain activation in the therapist serves as a vital source of resonance that can profoundly alter the ways in which the patient’s brain is activated in the moment-to-moment experiences within therapy. Such interactive experiences allow the patient to “feel felt” and understood by the therapist, and they also may establish new neural net firing patterns that can lead to neural plastic changes. Ultimately lasting effects of psychotherapy must harness such experiences that promote the growth of new synaptic connections so that more adaptive capacities for self-regulation and well-being can be established.

9. Transpirational Integration

As individuals move forward in achieving new levels of integration across the eight domains described above, clinical experience reveals a fascinating finding in which people begin to feel a different sense of connection to both themselves and the world beyond their previously skin-defined sense of self. The term “transpiration” denotes how new states of being seem to emerge as a vital sense of life is breathed across each of the domains of integration. One feeling that many patients have articulated is a sense that they are connected to a larger whole, beyond their immediate lives, than the previous sense of isolation they may have been feeling from others, and even from themselves. It may be that our highly evolved mirror neuron systems reveal the fundamental ways in which we are neurally constructed to feel connected to each other. Because neural plasticity appears to enable the brain to change throughout the lifespan, it may be that psychotherapy for individuals at any age can allow for interpersonal experiences to open the door to change.

Our work as psychotherapists is to dedicate our lives to help alleviate suffering in individuals, couples, and families, and also to be a part of a larger effort to bring integration and healing into the many layers of our interconnections with each other. When we examine the deep layers of our neural selves we come to glimpse not only the roots of our mental and social lives, but the essential reality of our selves as part of an integrated whole across the span of life.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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