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TRANSCRIPT
Peter Janetzki © 2016
Peter JanetzkiDip.T., Grad. Dip.Soc.Sc., M.Soc.Sc.(Counselling).
CCAA (Clin), PACFA Reg
A Neuropsychotherapy
Approach with Couples
Peter Janetzki © 2016
Everything is Inter-connected
Peter Janetzki © 2016
COPINGMEANING WORTH
COPINGMEANING WORTH
IF
THEN
CONTENT
INTER-personalPROCESS
Inter-personal interaction
Intra-personalIntra-personal
Peter Janetzki © 2016
Neuropsychotherapy
Peter Janetzki © 2016
1. The Two Primary Tasks of the Brain
2. The Bottom Up Approach
3. The Power of Procedural Learning
4. The Brain’s Response to Perceived Threats
5. The Critical Nature of The Polyvagal System
6. The Window of Tolerance
7. The Pillars of Neuropsychotherapy
Neuropsychotherapy Principles
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SURVIVE&
THRIVE
Neuropsychotherapy Principle #1
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Bottom Up Approach
THE 3 PART BRAIN
Neuropsychotherapy Principle #2
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Survival Brain
– the first part of the brain to develop
– fastest part of the brain
– runs automatic functions that keep us alive i.e. breathing, heartbeat, digestion
– its #1 job is our survival
Automatic Brain
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Emotional & Experiential Brain
– next fastest part of the brain
– runs on past experiences & emotions
– fear is it fastest trigger
– fires up our defences
– learns by repetition
Impulsive Brain
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Smart Brain– the last part of the
brain to develop
– slowest part of the brain
– helps us to think through decisions
– the first to switch off when under stress
– has the power to override the impulsive brain
– last part to mature
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When my
Impulsive Brain FIRES UP my
Smart Brain Switches OFF
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UP Regulate
DOWN Regulate
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THE POWER OF
PROCEDURAL LEARNING
Neuropsychotherapy Principle #3
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Procedural Learning
Procedural memory does not involve conscious
thought.
• talking • walking
• playing a musical instrument
• sport skills • riding a bike• driving a car
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Procedural Learning Facilitates Automatic Responding to Unconscious Future Predictions
“[Procedural] memory shapes how
we experience the present and how
we anticipate the future, reading us
in the present moment for what
comes next based upon what we
have experienced in the past.”(Siegel, 2006. cited by Fisher, 2014)
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Including our responses to
PERCEIVED THREATSFIGHT
FLIGHTFREAKFREEZE
Procedural memory does not involve conscious thought
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UP Regulate
DOWN Regulate
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THE BRAIN’S RESPONSE
TO PERCEIVED THREATS
Neuropsychotherapy Principle #4
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Spinal Cord
Polyvagal – Sympathetic & Parasympathetic System
Hypothalamus
Pituitary
ACTH - Adrenocorticotropic hormone Hormonal System
CytonkinesImmune System
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THE CRITICAL NATURE OF
THE POLYVAGAL SYSTEM
Neuropsychotherapy Principle #5
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The Social Engagement System
Head Movement
Vocalisation
Facial Movement
Our Environment
Bra
inst
em
Adapted from Porges SW., Cleveland Clinic Journal of Medicine. 2009 Apr; 76(Suppl 2): S86–S90
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Neuroception: A Subconscious System for Detecting Threats and Safety at a Glance
http://stephenporges.com/index.php/component/content/article/5-popular-articles/20-neuroception-a-subconscious-system-for-detecting-threats-and-safety-
• Neuroception is the process of perception & evaluation • Neuroception is how neural circuits distinguish whether
situations or people are safe, dangerous or life threatening
• This rapid response hardware and software integration takes place in the primitive parts of our brain that work at a sub-conscious level
• Our neuroception determines our response of immobilization, mobilization, and social engagement/communication
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THE WINDOW OF
TOLERANCE
Neuropsychotherapy Principle #6
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Sympathetic Hyper-arousal:Too much arousal to integrate
Parasympathetic Hypo-arousal:Too little arousal to integrate
The Window of ToleranceAdapted from Ogden, Minton, & Pain, 2006.p.27,32; Corrigan & Nutt, 2010, p.2
Window of Affect Tolerance:Moderate, regulated arousal
EMOTIONAL
AROUSAL
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SympatheticHYPER-arousal
ParasympatheticHYPO-arousal
Window of ToleranceOptimal Arousal Zone
Process & Respond- Uncomfortable Emotions can
be tolerated - Cogitative processing &
integration of information
“FIGHT or FLIGHT” (Spin Out)- Increased sensations- Emotionally reactivity- Hypervigilance- Intrusive Imagery - Disorganized cogitative processing
“IMMOBILISATION” (Shut Down) - Minimize sensations- Numbing of emotions- Disabled cogitative processing- Reduced physical movement
Adapted from Ogden, Minton, & Pain, 2006.p.27,32; Corrigan & Nutt, 2010, p.2
EMOTIONAL
AROUSAL
Peter Janetzki © 2016 Adapted from Ogden, Minton, & Pain, 2006.p.27,32; Corrigan & Nutt, 2010, p.2
EMOTIONAL
AROUSAL
Shut Down
Spin Out
UncontrollableIncongruence
Dysregulated
Over-regulated
Window of Tolerance‘The Sweet Spot’
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Uncontrollable & Controllable Incongruence
Controllable Incongruence
A Sense of DISEMPOWERMENT
Uncontrollable Incongruence
A Sense of EMPOWERMENT
We Move Forward RESILENCEWe Move Backward RETREAT
Patterns of AVOIDENCE
Patterns of APPROACH
Increase in DYSREGULATION Increase in REGULATION
Shrinking World Expanding World
Peter Janetzki © 2016 Adapted from Ogden, Minton, & Pain, 2006.p.27,32; Corrigan & Nutt, 2010, p.2
EMOTIONAL
AROUSAL
Shut Down
Spin Out
UncontrollableIncongruence
Dysregulated
Over-regulated
Therapy that stays in the middle (too safe) will not access dysregulated arousal and subsequent regulation
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Emotional Maturity involvesManaging my Impulsive/Survival Brain &Engaging my Smart Brain so that IChange my Procedural Learning &Respond from a position ofEmotional Security (the best in me) not Reactivity (often the worst in me)
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THE PILLARS OF
NEUROPSYCHOTHERAPY
Neuropsychotherapy Principle #7
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Bottom –up development
Safety (Physical/Emotional)
Co
nn
ect
Co
ntr
ol
Mo
tivati
on
Actualisation
Socially Integrated
En
vir
on
men
t
Base materials genetic make upFoundation SAFETY
Pillars (Needs)
Attachment (Connection)
Control
Motivation (Pain/Pleasure)
Integrated model of NeuropsychotherapyProf Pieter J Rossouw 2016 ©Used with permission
Top Structure (Actualisation)
Thriving, Learner
Enriched
Compromised
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What Clients Bring to the Room
Co
nn
ect
Co
ntr
ol
Mo
tivati
on
What Clients Experience in the Room
SAFE
UNSAFE
Crumbling Pillars
Strengthening Pillars
AbandonmentDisconnectionGrief & Loss
DisempoweredLack of OptionsUncontrollable Incongruence
Overwhelmed buy Life's ChallengesStuck in Dirty PainUncontrollable Incongruence
Reason to Choose
Power to Choose
Motivation to Choose
Self-Validation ILOC Self-Soothing
TherapeuticAlliance & Validation
Controllable IncongruenceOptions
Controllable IncongruenceRegulation
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Putting it All Together
With Couples
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The Christian Wholeness FrameworkDr John Warlow (2010)
www.christianwholeness.com
CU
RE
Connect
Understand
Respond
Engage Others & Evaluate
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IF
THEN
CONTENT
INTER-personalPROCESS
Same Themes
BehaviourallyOpposite
COPINGMEANING WORTH
COPINGMEANING WORTH
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COPINGMEANING WORTH
IFCOPINGMEANING WORTH THEN
CONTENT
INTER-personalPROCESS
CONTENT
INTER-personalPROCESS
IMPULSIVE BRAIN
MEANINGMEANING
SURVIVAL BRAINCoping Behaviours
IMPULSIVE BRAIN
SURVIVAL BRAINCoping Behaviours
Peter Janetzki © 2016
COPINGMEANING WORTH
IFCOPINGMEANING WORTH THEN
CONTENT
INTER-personalPROCESS
IMPULSIVE BRAIN
MEANINGMEANING
SURVIVAL BRAINCoping Behaviours
IMPULSIVE BRAIN
SURVIVAL BRAINCoping Behaviours
Circuit BreakCalm Down
Connect & Challenge
ClarifyWanting & Desire Now
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MEANINGMEANING
Circuit BreakCalm Down By
1. Not reacting2. Not taking it
personally3. Breathing
Connect & Challenge
1. What is the meaning for me?
2. Is this valid for here & now?
Clarify & Share What I Want
Without Demanding
IMPULSIVE BRAIN
SURVIVAL BRAINCoping Behaviours
IMPULSIVE BRAIN
SURVIVAL BRAINCoping Behaviours
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CONTENT
INTER-personalPROCESS
Window of Tolerance Window of Tolerance
MUSH
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Case Illustration
Early 40’s
Early 30’s
Young Teen
M 2yrs amicable
Infant
Xleft left controlling passive
CSA
CSA
CSAJail
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• Early sessions focused on safety and understanding as well as normalising her responses & the 3 part brain
• Exploring her overshooting the window & hypervigilance, his avoidance in relation to procedural learning. Also the underlying themes around worthlessness.
• Session around finances• Next session around Red Zone/ Black Zone• Next session the flow diagram
Peter Janetzki © 2016
Peter Janetzki © 2016
Peter Janetzki © 2016
Peter Janetzki © 2016
References & ReadingsCozolino, L. (2014). The neuroscience of human relationships: Attachment and the developing
social brain (2nd Ed). New York, NY: Norton.
Cozolino, L. (2010). The neuroscience of psychotherapy: Healing the social brain (2nd Ed). New York, NY: Norton.
Cozolino, L. (2013). The social neuroscience of education: Optimizing attachment and learning in the classroom. New York, NY: Norton.
Grawe K. (2007). Neuropsychotherapy: How the neurosciences inform effective psychotherapy. New York, Taylor & Francis
Porges, S.W. (2004). Neuroception: A subconscious system for detecting threats and safety. Zero to three.
Porges, S.W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. New York, NY: Norton.
Porges S.W. (2009). The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic Journal of Medicine. 76(Suppl 2): S86–S90
Rossouw, P.J. (Ed.). (2014). Neuropsychotherapy: Theoretical underpinnings and clinical applications. Sydney: Mediros.
Peter Janetzki © 2016
References & ReadingsJournals
International Journal of Neuropsychotherapy
Neuropsychotherapy
Neuropsychotherapy in Australia
The Neuropsychotherapist
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