Workshop Brain-Based Therapy and Trauma
25 e 26 de Setembro
Veja o programa integral aqui.
Abaixo um excerto do prefácio do último livro do Prof. Dr. John Arden.
Embracing the 21st Century Integrative Approach
The fragmented Cartesian and one-dimensional model Pax Medica trends of the 20th century are being replaced by an integrated multidimensional model of the 21st century. Brain-based therapy integrates the common factors. Thanks to major developments in psychotherapy research, neuropsychology, epigenetics, psychoneuroimmulogy, and nutritional neuroscience, we know far more about what contributes to brain health. The contributions from these fields are now being combined with psychological research on such areas as development, memory, cognition, and attachment (Arden & Linford, 2009a,b; Cozolino, 2010). A robust and multidimensional approach is synthesizing knowledge gained in all these areas. Contributions from this large body of research contribute to a coherent and integrated whole, like pieces of the puzzle in the next figure.
Psychotherapy researchers who have pioneered outcome management studies and those who have contributed to EBPs are looking for common factors among therapies (Barlow & Craske, 2007; Lambert, 2008). To do so, research in neuroscience, memory, attention, cognition, and developmental psychology, such as attachment research, is needed.
The emerging brain-based common-factor approach must include client education. We are now in a far better position to make sense of anxiety and depression and how to help people overcome these problems. The more clients know about what they are experiencing from a science-driven rather than a theory-driven perspective, the more tangible are the remedies. The sea change in psychotherapy, therefore, should include a strong effort to depathologize psychological problems. If clients are given actual information that includes a description of what the scientific literature says about anxiety, depression, and the brain in layman’s terms, their experience is demystified and relies less on confusing circular descriptions.
If clients are not given coherent practical information, they run the risk of thinking that they have some kind of incurable illness that only a mental health professional understands and that the prognosis may not be hopeful. Labeling a psychological disorder without explaining it is not only disrespectful but tends to make clients feel less hopeful that something can be done about it. Not providing a coherent and understandable road map about what to do to achieve relief, beyond taking medication, perpetuates the false hope of Pax Medica. Like most people they probably want to understand why they are having a difficult time recovering from excessive anxiety or depression and want to know what to do about it.
A brain-based description of clients’ psychological problems can offer tangible road maps for constructive steps to be taken with you in therapy. It is similar to the narrative therapy concept of externalizing the problem so that the problem is the problem, not clients themselves. Ironically, clients’ brains are central to their problems. Explain that their anxiety is partly connected to the overactivity of the amygdala and the right prefrontal cortex (R-PFC) relative to the left. Then explain that avoidance kindles even more activity in the R-PFC, which serves only to increase anxiety. Alternatively, incremental exposure to what makes them anxious activates the left PFC and eventually increases positive emotions and calms amygdala overactivity. This knowledge can increase clients’ motivation to engage more and avoid less.
The changes happening in the 21st century will dissolve the separate schools of psychotherapy and their special languages accessed only by members. The alphabet soup of special clubs—CBT, ACT, IPT, DBT, EMDR, EFT, RET, and so on—needs to discarded in favor of one model focused on brain-based common factors. The new model is not eclectic as if therapists pick and choose tricks from each of the clubs. Instead, it discards beliefs that make sense only within a particular belief system.
Brain-based therapy discriminates between what is therapeutic and what is not. It requires techniques consistent with how the brain works. Like all client-centered oriented therapies, it relies on the therapist’s alliance with the client, while at the same time it employs common methods from a wide range of theoretical perspectives.
The change requires no gurus. In fact, gurus of the Cartesian schools distract at best and derail at worst the effort to find common factors to serve those in need of psychological services. The future is more open sourced than proprietary; no one group will own it. Conferences of the future will feature speakers who explore the common factors. The focus on the stature or popularity of the individual speakers will fade while the focus shifts to the topics and interrelationships they explore.
Moving beyond the separate schools of psychotherapy necessitates shedding of one of the lingering effects of the Cartesian Era: a brainless psychology. Yet a word of caution about the recent development of merely tacking on the words “neuroscience” and “mindfulness” to conferences and publications. Sometimes they are only window dressing, ways to flow with the latest fad. To ensure that these efforts actually contribute to the change, they must be grounded in science.
Brain-based therapy is not a new type of therapy but an integrative approach that finds common denominators among schools of psychotherapy. A brain-based approach moves us beyond pure theory and combines many fields of research. For example, psychotherapy research has illuminated what factors are important to the psychotherapeutic relationship. In particular, outcome management studies have confirmed Carl Rogers’s insights into the importance of enhancing the therapeutic alliance.
Attachment studies have revealed how various types of attachment styles play out in relationships through the life span, the potential to develop anxiety and/or depression, and brain activation patterns associated with the various attachment styles. Developmental psychology has shed light on how early adversity can impair psychological development and the brain as well as what factors lead to resiliency through the life cycle.
Evidence-supported practices have matured significantly since being introduced over the last 30 years. In fact, some of the early pioneers of EBPs have now moved to find common factors among approaches.
Memory research in many ways forms the foundation for understanding the human experience. When memory systems become deregulated, psychological problems result. Memory research has also shown how adequate integration of memory systems increases mental health.
Neuroscience is the relatively new area. Thanks to research using fMRI, positron emission tomography (PET), single photon emission computed tomography (SPECT), and many other tools, we have an operational understanding of those brain systems involved in anxiety disorders and depression.
The truly integrated model of psychotherapy in the 21st century must not perpetuate dualism of the Cartesian Era. Instead, it should incorporate how the mind, brain, and immune system interact as people adapt to their particular interpersonal and cultural environment. Too often in the past, psychotherapeutic efforts have focused single aspects of clients’ lives and disregard other parts. Until recently, Western medicine has taken the same disjointed path. Integrative and functional medicine attempt to take into account the multiple physiological systems in the human body and how they interrelate dynamically. Why wouldn’t psychotherapy do the same thing?
The immune system, for example, is not only affected by the mind but affects the brain and the mind in a bidirectional relationship. Excess inflammatory cytokines can result in more susceptibility to develop PTSD posttrauma (see Chapter 7) and “sickness behavior” resulting in depression (see Chapter 9). Similarly, type 2 diabetes increases depression, and depression increases the vulnerability to develop diabetes. Even the multiple systemic effects of the gastrointestinal (GI) track affect the mood and cognition, while mood affects the GI track. Approximately 80% of the serotonin in the body is found in the GI tract, not in the brain, which means that serotoninergic activity in the GI tract affects the brain. The vagus nerve system that extends to enervates most of the organs in the thoracic cavity, including the heart, comes down from the brain, but activity goes back up as well. A person’s vagal tone contributes to better or worse affect regulation and to anxiety and irritability accordingly. These are but a few of the many domains relevant to psychotherapy. We need to account for their interactions in therapy and inform clients about how their mental health and physical health are connected and can be enhanced.
John Arden in “Brain2Brain: Enacting client change through the persuasive power of neuroscience”
Workshop Brain-Based Therapy and Trauma
25 e 26 de Setembro
Veja o programa integral aqui.
A formação é integralmente dada em inglês (dos EUA, de fácil compreensão para os menos fluentes) e requer pré-inscrição de 90€ (valor sem devolução, em caso de não comparência).
O custo total, com IVA incluído, da formação depende da rapidez com que proceder à sua pré-inscrição:
Valor de inscrição até 24 de Setembro: 235€
As pré-inscrições podem ser pagas por PayPal aqui, ou por transferência bancária para a conta do Santander NIB 0018 0003 29983202020 10; neste caso, deverá enviar o comprovativo da transferência para email@example.com.
Existe a possibilidade de assistir à distância, para quem prefira aceder em sistema de videoconferência, na nossa sala virtual de formação; sendo um número de lugares muito limitado, irá certamente esgotar muito rapidamente, por isso, se não residir em Lisboa e não se pretender deslocar, faça já a sua pré-inscrição.
Se quiser dar uma espreitada à ante-estreia, veja este vídeo da 1ª parte de uma introdução que o Prof. John Arden fez, em videoconferência, exclusivamente para a Oficina de Psicologia:
Brain-based therapy – introdução.Parte 1 em videoconferência