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SF-EMDR and Quantum Field Theory (QFT) 2015-2018
Beyond the Art of BART: Sensorimotor Focused EMDR for psychotherapy and peak performance: (hearts, guts and minds) Information for clinicians
Presentation by: Dr Art O’MalleyOsteopathy study day
www.artomalley.com
[email protected] 074502009933
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Talk summary
• Disorders of extreme or ‘toxic’ stress
• Risk factors and outcomes
• Triggers and aetiology
• In utero influences
• Neurobiology (handy take-home model)
• Stress hormones and limbic system
• Stages of Thoughts (SF-EMDR stages 1–5) and QFT
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Three brains in one body
Head brain
▪Analytical
▪Logical (objective)
▪Integration of emotions and cognitions
▪Development of insight & meaning
▪Learn from experience
Heart brain
▪Emotional
▪Subjective
▪Heartfelt
▪Loss
▪Grief
▪Panic
▪Anxiety
Gut brain
▪Reactive (reflective)
▪Turbulent
▪Gut feelings
▪Gut instinct
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Head Brain overview (Model)
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Heart–Brain connection Cardiac N.S. independent of rest of nervous system
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Gut–Brain connection to brainstemEnteric nervous system links to CNS
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Hypothalamic–pituitary–adrenocortical (HPA) axis
Lane R. D. et al. Psychosomatic Medicine 71,2 (2009), 117–34
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Brain–immune system interactions research shows direct link
Lane R. D. et al.
Psychosomatic Medicine
71,2 (2009), 117–34
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Learning objectives during conference
• Understanding of different types of traumatic stress
• Focus on infants children and adolescents but SF-EMDR equally applicable to adults
• Update on neurobiology and research of mind and body
• Introduction to SF-EMDR for psychotherapy and peak performance which has evolved since 2008-9 Total of 10 years of treating patients with acute and complex trauma who have developed comorbid mental and physical health disorders
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Recently developed aspects of treatment
• Nature of dissociation
• Visual model of autonomic nervous system
• Evidence for effectiveness of SF-EMDR for psychotherapy and peak performance
• As an integration of head, heart and gut brain reprocessing
• Quintessential model of the brain and neurobiological rationale (2008–2011)
• Links to Quantum Bayesian Theory
Extreme stress in children
• ‘Over the years our bodies become walking autobiographies, telling all those around us friend and foe alike of the minor and major stresses of our lives’
• In other words our bodies keep score in our constant battle to process traumatic (wounding) events
• Bessel van der Kolk (Boston Trauma Centre)
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Reaction to trauma
• Most children have a normal reaction that resolves over time.
• A minority become overwhelmed:
– Hyper-reactive due to chronic stress
– Go on to develop PTSD or
– Developmental trauma disorder
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Trauma in childhood manifests as physical health disorders• Immune and neurological problems:
– Asthma – Allergies– ADHD– Girls, Chronic fatigue syndromeFibromyalgia, Irritable bowel syndromepelvic painDysmenorrhoea Complications post surgery including ICU common cause of PTSD across the lifespan
– Headaches– GIT problems– Complex Regional Pain Syndrome
Conditions associated with Post traumatic Stress disorder or PTSD
• Depression
• Anxiety
• Substance misuse
• Eating disorders
• Obsessive Compulsive Disorders
• Dissociative disorders
• Borderline personality disorder
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Children in foster care
• Rates of PTSD vary from 12 -40% (Kolko et al. Child maltreatment, 2010)
• In the general population: the rates of PTSD for female adolescents is twice that for males (Stam, 2007. Neuroscience and Biobehavioural reviews)
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Following sexual abuse
• 50% victims met criteria for PTSD (Barlow, 2002
• 60% of sexual assault victims in war experience PTSD
• Worldwide massive ongoing tsunami of cases of PTSD
• Untreated victims develop complex trauma with symptoms of dissociation
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Risk factors
• Trauma type increased with multiple versus single traumas
• Exposure to violence esp. domestic violence in early childhood
• Gender
• Age
• Socioeconomic status
• Developmental level
• Past psychiatric history
• Support and acute reaction to trauma17
What improves outcome?
• Child’s perception of family support crucial in moderating the disorder.
• Once established by one month symptoms often persist unless targeted effective trauma-focused therapy is received.
• SF-EMDR for psychotherapy and optimal functioning necessary to improve psychological well being and establish mental toughness and resilience leading to recovery.
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Symptoms of PTSD
• First month after trauma symptoms termed acute stress disorder or ASD >50% go onto develop PTSD
• Late onset PTSD is the norm i.e. after 6 months:
– Cumulative effect of exposure
– Fear conditioning unable to leave homes
– Kindling
– Sensitization effect of sirens police and ambulance
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Children’s symptoms of PTSD
• Regression (thumb sucking, bedwetting)
• Mute or immature speech
• Nightmares (sheer terror monsters)
• Sleep disturbances
• Reenactment through traumatized play
• Hyperarousal with a startle response
• Irritable, angry, detached
• Memory clouded & impaired concentration
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Adolescents symptoms of PTSD
• Sense of foreshortened future
• Forecast future in negative terms
• Regression :
– High risk behaviour
– Suicidality
– Substance misuse
– Non suicidal self-injury
– Depressive withdrawal
Won’t respond to antidepressants until traumas addressed 21
Anticipatory stress response
• Feeling based on emotions:
– Fear
– Distress
– Anger
– Rage
Jaap Panksepp 50 year study of emotions in humans and animals
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– Humiliation
– Shame
– Despair
– Panic
Different emotions and facial expressions
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Disgust Anger
FearHappiness Surprise
Sadness
fMRI of affect and cognition
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Shutdown scale for dissociation 0-3 severity
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1. Fainting
2. Dizziness/transitory blindness
3. Transitory deafness or changed acoustic perception
4. Numbness
5. Transitory paralysis
6. Analgesia
7. Heavy and tired
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Shutdown scale for dissociation, continued
9. Tension
10. Feeling of nausea or cold sweat
11. Ever felt as though you were outside your body
12. Moments when you were unable to speak or could only whisper for a period of time
13. Ever felt suddenly weak and warm
Triggers for victims of terrorist attacks
• Place MEN arena
• Smell
• Sensation
• Texture
• Sound of explosion
• Sound of sirens and emergency services
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• Taste
• Touch
• Anniversary
• Memory thought or feeling
• Somatic e g blown off feet and onto ground
Cranial nerves origin from stem of brain
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Path of 12 Cranial Nerves
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Different neural systems at different time points: amygdala & OFC
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Early processing of salient stimuli. Subcortical route feed-back to OC.
Bottom-up process
Different neural systems at different time points: amygdala & OFC, continued
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Detailed perception
through core system and
emotional reaction (OFC).
Interaction between visual
and somatosensory areas in
recognition of facial emotion,
and possible simulation.
Top-down process
PTSD: hormonal changes
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Hypothalamus
PosteriorPituitary
ACTH
Adrenal kidney
Norepinephrine
Chronic stress
Cortisol
CRF
AnteriorPituitary
Classical triggering response
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LeDoux,
Scientific American, 1994
The brain’s segmented processing capabilities
34From Scientific American
Psychotherapy: roads to processing
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SENSORY CORTEX
SENSORY
THALAMUS
EMOTIONAL
STIMULUS
EMOTIONAL
RESPONSES
“High Road”
“Low Road”
AMYGDALA
Amygdala
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Amygdala
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Working with tsunami victims
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Coordination of threat response by fear centre on automatic pilot
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AMYGDALA
Medial Prefrontal CortexAnterior Cingulate Cortex
Hippocampus
Thalamus
SightsSounds
Smells
+
+
+
_
_
Institute of Medicine on best type of psychotherapy in terrorist attacks
“…scientific evidence on treatment modalities for PTSD does not reach the level of certainty that would be desired for such a common and serious condition among veterans… additional high quality research is essential for every treatment modality.”
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Insular cortex links semantic and autobiographical memory
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Processing of
internal bodily
signals
(Interoception).
Integration of
mental map and
sensory
information to
create sense of
self.
My Dissociation Model (2011)
RAPIDS
CALM
WATERS
FROZEN
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IMEScale
Shutdown
Questionnaire
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Brain structures involved in dealing with fear and stress
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Reptilian brain
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Note similarity to our brainstem which is engaged when threatened
either externally or in our imagination.
Relationship between the cortex, brainstem and environment
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Regulation of Dorsal Vagal Complex in safe environment
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Regulation of Dorsal Vagal Complex in unsafe environment
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Regulation of Dorsal Vagal Complex in life threatening environment
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Parasympathetic system
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The brain stem
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Adolescent brain development
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Cerebellum (little brain)
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Three brains in one
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“Gut instinct”
“Heartfelt”
“Head thoughts”
Interoceptive body maps
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Sensory input and motor output divided between hemispheres
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Brain components
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Corpus callosumLargest tract in the brain
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Cerebral hemispheres
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Corpus Callosum
Hemispheres
• Cerebral hemispheres - the two sections of the cortex on the left and right sides of the brain.
• Corpus Callosum - thick band of neurons that connects the right and left cerebral hemispheres
“Neurons that fire together wire together” Donald Hebb
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Example of extreme neglect
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Borderline personality disorder
• Often presents with co-morbid PTSD or developmental trauma disorder
• Patients’ amygdalae deactivated
• Reduced pain sensitivity
• Hence repeated non-suicidal self injury (NSSI)
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Dissociative subtype
• Complex neural network involved
• Top-down memory suppression occurs involving brain structures:
– Dorsolateral/ventrolateral PfC
– Anterior cingulate cortex
– Presupplementary motor area
– Dorsal premotor cortex
– Intraparietal sulcus
– Right putamen
– Hippocampal inhibition bilaterally
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Horowitz and impact of events scale
• State of intrusive feelings and compulsive actions
• State of denial with emotional numbing and constricted ideation
• Thus over or under modulation of affective response to traumatic stress
• Emotional reprocessing is overwhelmed by extreme traumatic input
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Implications, treatment and research
• Imaginal exposure to trauma related stimuli
• Dissociative and numbing symptoms prevent engagement
• Mood regulation and grounding skills
• Modify disordered attachment schemas
• Develop competence in social interactions
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Basic skills
• Relaxation, mindfulness training, coping skills, anger management and grounding
– Tolerate negative emotion
– Use social support
– Calm/soothe self
– Moderate self-loathing
– Control destructive impulses (self-harm,violence, substance abuse)
– Articulate feelings
– Maintain hope
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Bilateral innervations from periphery to brainstem
Conclusions
• Distinguish types of PTSD symptoms
• Effect of trauma on key brain structures:
• PFC, insular cortex thalamus, superior Colliculus
• Periaqueductal grey brainstem, heart and gut
• Window of affective tolerance emotional regulation and stabilisation WATERS in relation to FROZEN & RAPIDS dissociative states
• Increased activation prefrontal cortex means inhibition of limbic system blood flow
• Over modulation of emotions leading to complex dissociative symptoms
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Current and future research
• Use of impact of multiple events scale (IMES) to select patients with similar symptom patterns Shut D questionnaire to detect dissociation
• Buzzers activate SF-EMDR and help to reorganize tasks and develop meaning from experience
• Research the optimum frequency of bilateral activation for thalamocortical binding (40 Hertz)
• Bidirectional communication between immune and nervous system with enteric and cardiac nervous systems in line with definition of mesentery as a clinical organ
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Thank You
Any Questions
Hol Med Clinic
665 Burnage Lane
Tel 07450209933
www.artomalley.com
Sensorimotor-Focused EMDR: A New Paradigm for Psychotherapy and Peak Performance 2018 www.routledge.com
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Back to the future
Before the big bang
Subatomic particles exist at quantum level
Einstein theory of relativity 1915
Spooky action at a distance
Stephen Hawking Black Holes
New Scientist White Holes
What is bodymind?
How do mind and body communicate?
Quantum information only in imagination
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Quantum Theory of Trauma focused Psychotherapy
Psychosocial and Genomics interact with
Mind (Crisis leading to opportunity)
Mirror neurons activation of intuition
Gene expression via translation/transcription
Brain Body Gut Heart and Mesentery
Proteins neurotransmitters hormones and cytokines linked to energetic response
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Mesentery: a new organ
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Integrated QFT of Psychotherapy
Stress reduction
Psychosomatic illness
Psychoneuroimmunology
Meditation REM like state
Mindbody medicine leading to peak performance problem solving and creativity (final stage of Sensorimotor-Focused EMDR for psychotherapy and peak performance)
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Role of Sleep crucial in homeostasis; impaired in PTSD
Mind cleared by 60% more Cerebrospinal fluid washing through brain to remove the toxic byproducts of body metabolism
Decreased sleep autoimmune destruction
Optimize self care and health via psychosocial and RNA/DNA replication
Role of consciousness and cognition in theory and practice of psychotherapy from mind of patient to their genes
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Quantum Bayesianism (QBism)
Wave function used by observer no objective reality
Outline QB theory of an expected outcome in all forms of psychotherapy
Mixture of daily circadian rhythms and hourly ultradian rhythms from every level of cells to genes to body and mind
QFT of consciousness relates to cognition and creativity
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Variable factors in psychotherapyNovelty (fascination, mystery,
tremendousness)
ENCODE project
2 million eRNAs in environment carry signals to 3 million receptors on genes (epigenetics => nature & nurture codependent
With molecular biology can measure DNA expressed in genes associated with healing of mind and body
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Stress related dysfunction
Top down: relaxation hypnosis meditation
Yoga EMDR TF-CBT
Bottom up:
Somatic experiencing Sensorimotor psychotherapy osteopathy
Telomere (shoelaces) shorter in cancer diabetes heart disease high stress levels mindfulness helps to keep telomeres intact
SF-(EM)DR combines top down with bottom up reprocessing
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How conscious thought interacts with nature and nurture
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Mind crisis &
Opportunities
3 adapt & heal
(HARs)
epigenomics
4 Brains
head heart
gut Immune2 Mirror
neurons
eRNA
intuition
1 mind crisis
& opportunity
Complex cycle of information exchange in psychotherapy
Consciousness
Cognition
Emotion
Sensations
Feelings
Movement
Health (physical mental psychosocial and spiritual)
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Psychoneuroimmunology
Integration of cells of mind CNS PNS and body
Facilitates memory learning behaviour and development of meaning in therapeutic cognition
QFT of exRNA signals between nature and nurture and link to ADLs, psychotherapy
Psychosocial and cultural impacts on health
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Book from 2015 Karnac Books
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SF-EMDR Stage 1 comprehensive assessment and selection of target memories
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BILATERAL AFFECTIVE REPROCESSING THOUGHTS
SF-EMDR Stage 2 for psychotherapy and peak performance
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BODY’S ACCELERATED RECOGNITION THOUGHTSof
SF-EMDR Stage 3 for psychotherapy and peak performance
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BRAIN’S ANS RESILIENT TOGETHERis and
SF-EMDR Stage 4 for psychotherapy and peak performance
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BRAIN’S AXONS REWIRED TRANSMISSIONfor
SF-EMDR Stage 5 Focus on resolution of trauma, mental toughness and optimal functioning
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BETTER ACTIVE RECOVERED TRIUMPHANT
Sensorimotor-Focused EMDR for psychotherapy Stages 1–5• Better integration of top-down and bottom-up
processing
• Most active trauma stored initially at gut level
• Recovered knowledge like our home – i.e. built from our earliest experiences through childhood, adolescence and into adulthood
• Triumph of integration, Proto, core and autobiographical self become one (Damasio). Level of insular cortex and recovery of neural networks
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Thalamortical binding at a gamma wave frequency of 40 Hertz i.e. gamma brainwaves
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Mind-Body Psychotherapy
Mapped onto 90-120 min 4 stage basic rest activity cycle (BRAC) and
Psychological 4 stage Creative Cycle illustrated by
a) Data collection and integration of sensations
b) Arousal Ob/Op private inner work and creative replay (magic remote)
c) Illumination and intuition leads positive experience and light bulb moment
d) Verification reintegration thinking PFC 91
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Lightbulb moment during session occurs as crisis resolved
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Observer and Operator
Novelty
Numinosum
Neurogenesis
Effect
NNNE peak experience Maslow hierarchy
Positive empathic psychosocial relationship
Activity dependent gene expression and neuroplasticity tingling of new networks
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Mind-Body links
Protein from rewiring neurons in brain due to neuroplasticity
Genes below are concordantly expressed during the 90 to 120 min session
C-fos and 10 other alleles are activated priming the basic rest activity cycle of 90-120 mins into action
Simulates REM sleep and integrates sensations emotions with language and meaning
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Model of SF-EMDR session in relation to neuroscience model of Rossi
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Magic Remote
0 30 60 90 120
• Pause at point of maximum distress
• Guided imagery related to gut instinct with creative reprocessing
• Illumination • Breakout into positive feelings and
lighter sensations • Light stream to facilitate initiation
and insight • Incubation• Repeat review • Express negative feelings
and emotions associated with expressions • Verification
• Reappraisal• Reintegration• Thinking space
• Data Collection • Initiation • Sensations
• Bilateral auditory stimulation
• +/- Tactile pulses• +/- Manual castanets
CRISIS
4
2
3
1
deepening
genomics
proteonics
4 stages of psychotherapy
1 initial recognition of problems
2 incubation inward cognitive dissonance emotional recognition and uncertainty distress searching for a solution
(dark night of the soul storm before light)
3 Insight Eureka or lightbulb moment. UC made into new consciousness
4 Growth integrated into cognitive networks adaptive reality self esteem
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Qbism impact on psychotherapy and mindfulness1 QFT relates to consciousness and
behaviour in everyday life
2 Qbism packets of Planck units of sensations feelings emotions thoughts and perceptions
3 Like light having particles or continuous wave function so does creative cycle have a dual nature dependent on observation
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QBism fundamental insight
4 QB dynamics observable at all levels from human mind to genes and cells to all living systems (universe to atomic scale)
5 QB foundation for QFT and emerging consciousness cognition feelings emotions and thoughts as well as our sense of free will and reality itself
(insula of self perception changes with therapy
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Practical implications
Tune in at observer operator level navigate perils of acute and chronic stress which cause most psychopathology and addictions
Emphasize intuition imagination and insight instead of objective rationality
Living primacy of novelty numinosum neurogenesis effect rather than CBT
Facilitate health problem solving and well being
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Happiness in Psychotherapy
Relates to levels of neurotransmitters in neural networks
Role played by hormones
Stress triggers anxiety depression (brain inflammation) and depression
Dopaminergic and serotonergic neurons impaired reducing available levels of dopamine and serotonin
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Neurodegenerative disorders
Disharmony of:
-body
-mind-brain
-spirit
-soul
-energy
Experienced at level of whole person
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Autobiography of a yogi
Cosmic life energy on a par with
Gravitation
Electromagnetism
Weak and
Strong interactions
Chakras seen as nerve plexus along spine coterminous with endocrine and immune systems
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Albert Einstein 1922
“A calm and modest life brings more happiness than the constant pursuit of success combined with constant restlessness”
How often do we pursue the latter rather than the former
Note sold for $1.5 million
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Happiness and Psychotherapy
Western medicine has a lot to learn from
Ancient seers Ayurvedacharyas Ayurvedic herbal medicine
Buddhism
Kirtan
Sammadhi
Leading from illusory world of dukkha to pleasant feelings from contentment to intense joy
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Expansion of consciousness
Measurement collapses the wave function
Includes consciousness of observer
Pauli and Jung embraced (un)certainty
Poincare Einstein Dirac Erickson & Rossi
Stage 3 doesn't’t occur without unconscious activation of stuck bits in stage 2
Trust the unconscious to talk to me
Mindell shamanic perspective & dreaming
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Transformation of Consciousness
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Validation
Focus of attention
Hold & Redirect attention
Use of Opposites Time
Appreciation & Creativity
Toleration of uncertainty
Erickson Resistance Protocol
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Receiving info during 4 stage cycle
Connections & Bridges for value and depth
Capacity to open up trust and allowing
Development and installation of resources
Professional consciousness like measurement in QFT
Opposites (un) conscious (not) knowing
Containment and transformation of resistance
Patient in receptive open state of being
Has sense of value self worth more centred
Meridians activated with interplay of time space
conscious awareness
Quantum Entanglement
Metaphorical connections of space and time
Forty years for ideas to be accepted
Electrons and photons relate to levels of consciousness
Mass energy and particles like connections between mind and body and (un)consciousness
“That is why I build bridges” Erickson to Rossi in 1979
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Energy systems of body
Links to immune and endocrine system
Scientific discovery of new organ the gut mesentery which coordinates information at a spinal cord level
Discovery that immune mediators cross the blood brain barrier and cause inflammation in the brain as a result of chronic and acute stress causing depression (Physical and mental health)
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Authentic communication
Gut and Head connected from birth at 10 weeks gestation two way path of communication facilitated by BRAC
Heartbeat earliest sound we become aware of forms at 8 weeks gestation
Electromagnetic field of heart extends well beyond body
Heart to heart interaction starts from onset of consultation
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Patient feedback
• Mother and daughter with insecure attachment
• Mother and son and daughter with intensive therapy recent keyhole surgery for faulty heart valve
• Feedback in 5 Acts
• Family of 5 involved in serious RTA
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Overcoming anxiety to achieve peak performance
Elite Sport
Business
Academia
Finance
Politics
Teaching
Health Professionals
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10 000 hours of practice
Lack of awareness of time
Autotelicity
The “sweet spot”
Automaticity
2 hours a day for 20 years or
4 hours a day for 10 years or
8 hours a day for 5 years
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Finding your element
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M
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BOKA10
Relevant Factors
Stressors
Getting a competitive edge
Meta cognition
Achieving potential
Being in the Zone
Getting optimal feedback on performance
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Five stages or PARTS to reaching the summit of peak performance
1 Practice Activity Review Transition
2 Plan Action Revolve around Trials
3 Physical Autotelicity Reflexes Toned
4 Pinnacle of Automaticity Rehearse Techniques
5 Performance Actually Reaches Target
Example of saxophone player in book
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Conclusions
• Distinguish types of PTSD symptoms
• Effect of trauma on key brain structures:
• PFC, insular cortex thalamus, superior Colliculus
• Periaqueductal grey brainstem, heart and gut
• Window of affective tolerance emotional regulation and stabilisation WATERS in relation to FROZEN & RAPIDS dissociative states
• Increased activation prefrontal cortex means inhibition of limbic system blood flow
• Over modulation of emotions leading to complex dissociative symptoms
127
Current and future research
• Use of impact of multiple events scale (IMES) to select patients with similar symptom patterns Shut D questionnaire to detect dissociation
• Buzzers activate SF-EMDR and help to reorganize tasks and develop meaning from experience
• Research the optimum frequency of bilateral activation for thalamocortical binding (40 Hertz)
• Bidirectional communication between immune and nervous system with enteric and cardiac nervous systems in line with definition of mesentery as a clinical organ
128
Thank YouAny Questions
Lymm Osteopathy Clinic
16 Grammar School Road
Tel 07450209933
www.artomalley.com
Sensorimotor-Focused EMDR: A New Paradigm for psychotherapy and peak performance Book launch 17th March 2019 in the Peace Centre Warrington @ 5pm
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