Repost: Love Was Love That Night…Until Hate Walked In: Mindful Grieving After Tragedy

Repost: Love Was Love That Night…Until Hate Walked In: Mindful Grieving After Tragedy

This blog post originally appeared in The Huffington Post.

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I feel extraordinary heartbroken at the news of the shooting death of at least 49 human beings who came together in a place they felt safe; a place whose four walls bore witness to love without its shackles.  The Pulse nightclub in Orlando, Florida was a place in which lovers could hold hands and kiss, to revel in a feeling of belonging without the still all-to-common threats of discrimination, alienation, and condescension. Inside those doors love was love, until hate walked in.

Hate walked in and obliterated this sanctuary, tearing apart lives that he thought were less worthwhile than his own, and infiltrated the heart and soul of a community and greater world who has had to fight for its birthright; to love and be loved.  This is what hate does. He is at once insidious and blatantly hostile, unrelenting, unforgiving, and lacks a conscience. He is heartless and mindless, self-serving and sadistic to the core.

As I grapple with the way hate snuffed the life out of so many vibrant beings this past Sunday, I grieve.  I am at once angry, anxious, sad, and shocked. You see, tragedies like these reverberate in the hearts and minds of much of humanity, as it rips through the basic foundation that we lay our trust upon. That is, we don’t expect people to just shoot other human beings in cold blood because of who they are and whom they love.

I am struggling with how to grieve along side you. My own journey of grief includes humbly offering all of us some words about grief from a psychological perspective, and providing five ways to grieve mindfully.

What Grief Is and Isn’t

Psychologically speaking, according to Dr. Kubler-Ross (1969), “Grief is an emotional response to loss.”

This emotional response is conceptualized as a non-linear expression of different stages of feeling states including Denial, Anger, Bargaining, Depression, and Acceptance (aka: “DABDA”).

Biologically speaking, grief is a homeostatic process, a journey that our mind, brain, and body need to engage in, to best recover from the trauma of a loss. This is an evolutionary need, since attachment and connection to others is embedded within our limbic circuitry. Yes, whether we are conscious of it or not, or like it or not, relationships deeply imprint upon our neural circuitry.

Grief is not, by any means, a one-size-fits-all kind of process. In fact, it is a uniquely individual process that often feels amorphous and difficult to capture with words. When it comes to grief, there is no “normal” or typical way to go through it, and despite what some believe, in my opinion, there is no “normal” time period allotted for grief.

It takes a boat-load of self-compassion to allow oneself to feel whatever it is you are feeling at any given time, without judgment, without comparison to another’s explicit portrayal of their own process. In this way, to grieve is to be mindful of our own thoughts and feelings.

While there is no one “right” way to grieve, to actually grieve is essential for our ability to employ our human capacity to find a renewed sense of meaning. Grief elicits resilience and the capacity to continue to hold this tragedy in our hearts and minds, while still forging forward with purpose and direction.

Five ways to Grieve Mindfully

  1. Accept your feelings: Allow yourself to feel what you feel at any given moment, with a sense of self-compassion, and without judgment.
  2. Express your feelings: Just as important as accepting your feelings, is expressing them in a way that is helpful to you. Journaling, talking about the experience, scrapbooking, or dancing, for example, are helpful ways to process grief instead of allowing the feelings to stay stuck.
  3. Reach out: During this time, it is important to reach out in multiple ways. Reach out for guidance from a spiritual counselor or a psychologist. Reach out to share stories of your loved one with others. Reach out to offer support to other grievers. Find a balance between being with yourself, and being with others, but ultimately, reach out – don’t isolate.
  4. Continue to take care of yourself and others. Living life while grieving often feels like scaling a mountain. Grieving takes energy and can often feel draining. As much as possible during this tough time, continue to eat well, exercise, and maintain wellness practices.
  5. Celebrate life: It is important through the grief process to keep the memory of the tragic incident alive in some way that inspires healing, but also reflects and honors your mourning process. This can include donating to a charity, meditating on behalf of a loved one or a community, and even planting a tree in honor of the tragedy.

 

At times like this, many of us are also challenged in our own grieving process to try to explain the unexplainable to others in our life. I, therefore, invite you to also read my post: Five Strategies to Help Us Help Our Children And Ourselves In Times of Trauma.

Today, together as one world and one nation, we are grieving. Here are some resources so that we may process this horrific tragedy together. You are not alone.

Orlando:

  • Victim Service Center of Central Florida

https://www.victimservicecenter.org/

  •  APG Health Behavioral Healthcare

http://www.apghealth.com/

  •  Psychology Today List of Support and Grief Groups for Victims and Families

https://groups.psychologytoday.com/rms/prof_results.php?city=Orlando&spec=14

NYC:

  • Center for Bereavement

http://www.centerforbereavement.com/

  • NYC Innovations in Mental Health List of Bereavement Groups

http://newyorkcity.ny.networkofcare.org/mh/services/subcategory.aspx?tax=PN-8100.1000

  • Psychology Today List of Support and Grief Groups for Victims and Families

https://groups.psychologytoday.com/rms/prof_results.php?state=NY&spec=14

 

If you don’t see what you are looking for, and need a referral to a psychologist or a support network during this time, please directly reach out to me with your name and a brief paragraph regarding the type of help you are seeking.  I will help you find a safe space to grieve. Please contact me at DrWolkin@BrainCurves.com.

With pure love for all my fellow mourners,

Jennifer Wolkin, PhD

Repost: The Science of Trauma, Mindfulness, and PTSD

Repost: The Science of Trauma, Mindfulness, and PTSD

This blog post originally appeared on Mindful.org

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If we were able to prove that individuals suffering from PTSD are experiencing reversible neurological changes, would that help to alleviate any taboo associated with trauma, so sufferers are able to get the treatment they need? New treatment protocols for PTSD that integrate mindfulness techniques may make that a possibility in the near future.

Mindfulness-based techniques in this context have recently gained traction with the support of more empirical findings. Overall, there is a lot of evidence supporting mindfulness as a treatment approach for adults with PTSD, and a recent burgeoning literature corroborating positive neurological changes is following suit.

First, I want to define trauma and PTSD.

Trauma Defined:

Trauma is a broad term, and according to the American Psychological Association (APA), it is an emotional response to a terrible event. Unfortunately, said terrible event can constitute a plethora of possibilities, including combat, rape, natural disasters, and assaults. There are other potentially traumatic events, and though less talked about, are no less palpable. Ultimately, any event might be considered traumatic if you have experienced and/or witnessed a threat to your life, your body, your moral integrity, or had a close encounter with violence or death.

Usually, when we are faced with danger, we go into fight-or-flight mode, during which our bodies release hormones to help us act faster, to either fight or flee. Trauma inhibits this very normal and evolutionary response to danger. What trauma does, instead, is elicit a profound sense of helplessness, during which one feels paralyzed from doing anything to be relieved from the circumstance.

PTSD Defined:

Post Traumatic Stress Disorder or PTSD, is described as a severe response to trauma, and it is most powerfully characterized by three prominent symptoms, which include:

  1. Re-experiencing the event
  2. Avoiding any reminders of the event, or feeling emotionally numb
  3. Hyper-arousal, which consists of a very sensitive startle response

In addition to these three expressions of symptoms, PTSD causes a huge deal of distress and severely limits functioning in many different domains of life. As its name implies, PTSD is technically a “disorder”, and it is listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

I respect the need to classify something as a disorder in order for rigorous assessment of specific symptoms that can lead to a comprehensive and individually-tailored treatment plan. Yet, I believe, that there’s nothing truly disordered about having a reaction to seeing atrocities and tragedies beyond our mind’s ability to fathom. To hear more about this point of view, listen to this poignant, sensitive and informative interview with Barry Boyce, editor-in-chief of Mindful magazine.

There’s nothing truly disordered about having a reaction to seeing atrocities and tragedies beyond our mind’s ability to fathom.

The Brain and PTSD

In order to understand the neurological implications of PTSD, it is important to quickly parse the concept of neuroplasticity. For many hundreds of years scientists thought that, like physical development, once the brain reached maturity, it ceased to grow and develop in any way.

The modern view is antithetical to this, given research that continues to show ways in which the human brain is in a constant state of change. In this way, it is believed, new experiences actually impact our neural circuitry; that over the course of a life, our brain map reflects new and changing pathways. This idea is expressed eloquently and through case example in one of my favorite books, The Brain that Changes Itself, by Norman Doidge, MD.

Most of us view this notion of a neuroplastic brain through a rose-colored lens. Yes, neuroplasticity affords the brain an opportunity to heal from injury. Let’s not forget, though, that experience can also negatively change someone’s neuro-profile. So, in sync with neuroplastic principles, when trauma is encountered, the brain changes in response to the event in order to cope and adapt to the situation. These brain changes often don’t serve us going forward. While our brain adapts to develop a psychological defense against further trauma, it is not a brain that thrives long-term.

Neurological Components of PTSD

Neuro-imaging techniques, such as MRI and FMRI, have allowed scientists to examine brains of patients suffering from PTSD. Three of the areas impacted by trauma include the

  1. Amygdala
  2. Hippocampus
  3. Pre-frontal cortex (PFC)

 

The amygdala is a structure in the brain’s limbic system (known as the emotional seat of the brain) that helps determine whether or not a threat is approaching, and if so, sends out a danger signal, initiates the fight-or-flight response, and then helps indicate when the threat is gone. When one has experienced trauma, the amygdala remains hyper-alert to even non-threatening stimuli, and activates the fight-or-flight response system despite being safe. While experiencing PTSD, the brain can get caught up in a highly alert and activated loop during which it looks for and perceives threat everywhere.

While experiencing PTSD, the brain can get caught up in a highly alert and activated loop during which it looks for and perceives threat everywhere.

The hyperactive amygdala is constantly interacting with the hippocampus, the area of brain that plays a role in memory function. Brain scans have found smaller hippocampi in those with PTSD, perhaps reflecting the impaired memory experienced post trauma. Usually, the hippocampus works to connect and organize different aspects of memory, and is responsible for locating the memory of an event in its proper time, place and context. When experiencing PTSD, memory becomes fragmented, and the hippocampus has trouble coherently piecing together memory, from discriminating from past or present, and from integrating memory of experiences with feelings and factual knowledge. This is an extraordinarily distressing component of PTSD and manifests in the form of intrusive memories and flashbacks. Triggering memories provoke the amygdala, maintaining its hyper-activity.

The third area of the brain affected by trauma is the frontal lobe; specifically, the PFC. This area of the brain is involved in regulating behaviors, impulses, emotions, and fear responses. In those with PTSD, the PFC is notably less active and less able to override the hippocampus as it flashes fragments of memory, nor to signal the amygdala that the danger is not real.

As the above research suggests, the neuroplastic brain indeed responds to trauma. As certain areas of the brain become hyperactive, and others deregulated, throwing off the fine-tuned and exquisite orchestration that usually works to keep someone safe from real threats—PTSD is cultivated.

What are the positive benefits of mindfulness for adult patients suffering from PTSD in relation to the brain?

Mindfulness and the Brain:

There is a significant amount of data supporting mindfulness as a treatment approach for patients with PTSD. Much of the literature, however, doesn’t speak to the neurological changes that occur during the mindfulness process. Research regarding mindfulness mediation’s impact upon the brain in general points to changes in brain structure and function that could account for the reduction of symptoms of PTSD.

Changes in Brain Structure:

As I mentioned earlier, deregulation of the brain areas associated with emotional regulation and memory are key contributors to the symptoms associated with PTSD in addition to the over activity of the fear center, the amygdala. Mindfulness reverses these patterns by increasing prefrontal and hippocampal activity, and toning down the amygdala.

In fact, brain scans confirm that mindfulness meditation is correlated with an increase in gray matter in the hippocampus, a decrease of gray matter in the amygdala, and neuroimaging studies have found that mindfulness meditation also helps to activate the PFC.

Impact on Brain Function:

A recent study looking at the neural functional impact of mindfulness meditation on those with PTSD implicates the interaction of two “opposing” brain networks in mediating beneficial outcomes.

In this study, 23 male veterans who served in Afghanistan and Iraq were divided into different treatment groups, one of which included mindfulness-based exposure treatment (MBET).

Results indicated that while each treatment group showed promise, the men in the group receiving Mindfulness-Based Exposure Therapy (MBET) experienced actual post-treatment brain changes that indicate mechanisms by which mindfulness could potentially help in the treatment of PTSD.

Functional magnetic resonance imaging (fMRI) indicated that at the start of the study, the veterans showed increased activity in regions associated with perceived external threats. After receiving MBET, fMRI showed increased activity in what is known as the brain’s default mode network (DMN). The DMN consists of interacting brain regions associated with internally focused meandering and wandering thought. Additionally, fMRI also showed that the DMN increased its connections with what’s known as the Executive Network, associated with the purposeful shifting of attention.

Both these networks were working in sync, providing insight into how mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.

…Mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.

The small sample size, the gender bias of the group, and the inclusion of only veterans means that there is room for much more extensive empirical exploration with regards to mindfulness as applied specifically to those with PTSD.

Mindfulness and PTSD:

Overall, these neural correlates of symptom reduction can potentially shed light on the therapeutic possibility of mindfulness-based treatments going forward. There is, without a doubt, great potential for these treatments in helping people better process trauma, and hopefully decrease a lot of potential suffering.

Yet, a caveat worth heeding: Given the precarious nature of the symptoms of PTSD, the most efficient and safe treatment should only be obtained by a professional. It is my opinion that mindfulness, as an integrative approach under professional supervision, is the most prudent.

In honor of PTSD awareness month, I invite you to learn more about the various aspects of PTSD as it relates to gender, relationships with others, chronic pain, heart health, and brain injury.

Please click here to download my free resource packet on PTSD. Inside you will also find helpful quotes and resources related to trauma and PTSD, and NEW this year, I have included an additional post on an oft-forgotten element of trauma: Post Traumatic Growth.

Download Dr. Wolkin’s BrainCurves: PTSD Reference Packet here.

Repost: How To Achieve Mindful Living? Just Mind The Gap!

Repost: How To Achieve Mindful Living? Just Mind The Gap!

This blog post originally appeared on About Meditation.

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I want to bust a myth associated with what it truly means to “practice mindfulness.” And I want to share some tips about how to bring mindfulness into your life.

I have found that the most common misconception about mindfulness meditation is that it can only be achieved “on the cushion.”

That is, unless we are sitting in the lotus position on a cushion, eyes closed, back aligned, thumbs grazing forefingers, hands resting on thighs, then we aren’t practicing mindfulness.

No doubt, this is a feasible and efficient way to cultivate mindfulness. But it’s not the only way.

3 Steps To Mindful Living

I like to conceptualize three categories of mindfulness practice that we can engage in for increased well-being!

1. Formal Meditation

This is what I refer to when I speak about “on the cushion.” It entails intentionally taking time out of our schedule and finding a specific physical space to embark on meditative practice.

This time gives us an opportunity to bear witness to our minds, and to understand and reflect upon our habitual tendencies with a sense of kindness and curiosity rather than judgment.

2. Informal Meditation

The amazing thing about mindfulness is that you can apply it to any action you engage in on a daily basis; cooking, cleaning, walking to work, talking to a friend, driving – anything at all.

In this way, we can continue to deepen our ability to be mindful and train our mind to stay in the present moment rather than habitually straying into the past or future.

Here’s the basic idea. We don’t need to be sitting somewhere specific in order to stay non-judgmentally present to every sensation as it unfolds.

Informal mindfulness meditation means we can rest in mindful awareness at any time of day, no matter what we’re doing.

mindful living3. Mindful Living

We begin to live mindfully when our continued formal and informal mindful meditation practices positively impact our relationship with ourselves and with others.

Mindfulness then becomes both a practice and a way of life.

It is not necessarily meditation at all, but the by-product, so to speak. In fact, by engaging in both formal and informal meditation practice, you can cultivate a way of being and a way of life that embodies mindfulness-based principles like gratitude, loving-kindness, and compassion.

While I do guide my patients in both more formal and informal mindfulness practice, the crux of the work we do falls under the category of mindful living.

Nurturing The Power To Choose Our Response

To me, the essence of mindful living is summed up in Dr. Viktor Frankl’s quote:

Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.

With this definition, mindfulness can translate into taking pause, and minding the gap (as my late friend Dr. Jamie Zimmerman speaks so eloquently about in her Ted talk between an event (stimulus) and how we choose to show up for it (response).

Minding The Gap

This one extra moment can make a difference in how we live our lives. This pause can start with making conscious choices about what our presence looks and feels like in each moment.

This is true regardless of where or with whom that moment occurs—at home with our children, alone in our cars, at work among colleagues, and so on.

In every situation, we can choose to:

  1. REACT from a place of fear and perhaps anger, or
  2. RESPOND more mindfully.

 

Reacting is a reflexive, and sometimes impulsive, way to behave in a situation. It’s not adaptive and often leads to increased stress and tension.

In contrast, responding is a more mindful approach and can include active listening and a gentler tone of speech. But in order to respond in lieu of reacting, we need to STOP.

Stop. Take a breath. Observe. Proceed (more mindfully).

Just ONE extra moment to take a step back, regroup, and consider a healthier response can make a huge difference.

Beyond Fight Or Flight

When we are not in imminent danger, but we are still on that precipice at which our sympathetic nervous system is gearing up for a fight or flight reflexive reaction and our bodies are just about to unleash a cascade of increased stress-hormones, and our minds are roaring with resentment and anger, we need to STOP before immediately reacting.

The great irony is that by stopping for just ONE moment, we are really moving. We are moving into our own selves and out into the world with greater presence and a more mindful disposition.

The more we practice mindful living, the richer our interactions and experiences, and the more we thrive.

Repost: How the Brain Can Change Your Experience of Pain

Repost: How the Brain Can Change Your Experience of Pain

This blog post originally appeared on Mindful.Org

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Imagine being poked by a thermal probe that heats a small area of your skin to 120.2 degrees Fahrenheit. Ouch.

Now imagine trying mindfulness meditation, and having that probe touch your skin again. Painful, you’d think. Not as much.

Researchers at the Wake Forest Baptist Medical Center found that the brains of meditators respond differently to pain—a huge finding, given the continued skepticism regarding the benefits of mindfulness meditation as an effective treatment for pain with unique mechanisms above and beyond providing a placebo effect.

The research is even more poignant given that pain is one of the most pervasive, debilitating, and expensive health problems faced by approximately 100 million Americans. Until recently, the go-to treatment has been opioid medications, which have a high side-effect profile, and are highly addictive. More and more, doctors and patients alike are looking toward non-pharmacological ways to supplement current treatment options to help reduce pain and the toll it takes on quality of life.

Mindfulness as a Treatment for Pain

As mindfulness meditation is being introduced into the mainstream to help combat pain, many questions are surfacing about whether it really helps, and the exact mechanisms by which it might provide some benefit.

Jon Kabat-Zinn, the pioneer who brought mindfulness to the West as a possible psychological intervention, was the first to study the connection between mindfulness meditation and pain. In his 1985 study, 90 chronic pain patients were trained in Mindfulness-Based Stress Reduction (MBSR). Results indicated statistically significant reductions in measures of present-moment pain, negative body image, inhibition of activity by pain, mood disturbance, and psychological symptomatology, including anxiety and depression. Additionally, pain-related drug utilization was reduced. Since that study, there have been many more with similar findings.

The mechanisms behind how mindfulness reduces pain proposed in these studies continue to include mindfulness meditation’s ability to provide pain relief by cultivating the ability to parse between the objective sensory dimension of pain, and the more subjective judgement that we attach to the pain that constructs the way we experience it.

Pain is a complex phenomenon, mainly due to it being a multi-dimensional and subjective experience that consists of sensory, affective, and cognitive elements. Meaning, when we first experience a sensation of pain, we begin to judge it as bad and as something we want to immediately eradicate. Then, we start to conspire ways to escape the pain, to find any solution we can come up with, all the while continuing to judge our pain as negative. The subjective judgement we add inflates the pain, making the experience of it far more noxious than the sensory experience alone.

Mindfulness meditation can be used as a tool to create more awareness of the sensation of pain itself, without the judgment or resistance, and the affective and cognitive evaluation that we often project upon it. When we impose a litany of negativity upon our pain, it only becomes worse, and potentially elicits other difficulties including depression and anxiety.When we become more aware of what we are actually experiencing, without the overlay of our judgment, the overall perception of pain is reduced.

Kabat-Zinn articulated this well in The Mindful Solution to PainHe writes, “From the perspective of mindfulness, nothing needs fixing. Nothing needs to be forced to stop, or change, or go away.” Kabat-Zinn is making the case for awareness of a sensation, without the overlay of our thoughts, in order to elicit healing. He goes on to say “…It is only awareness itself that can balance out all of our various inflammations of thought and the emotional agitations and distortions that accompany the frequent storms that blow through the mind, especially in the face of a chronic pain condition.”

While focusing on the sensory experience of pain could sound counterproductive, it actually provides a pathway to pain relief that is different than the traditional pharmacologic interventions that aim to quell the sensation of pain immediately.

Mindfulness Meditation and Possible Mechanisms of Pain Relief

With the advent of modern imaging techniques such as the functional magnetic resonance imaging (fMRI), neuroscientists are finding changes in the brain that are in sync with Kabat-Zinn’s proposed mechanisms.

  • The brains of meditators respond differently to pain: Grant et al. (2011) used functional and structural MRI to ascertain the brain mechanisms involved in mindfulness-related pain reduction. They found that during pain, meditators (albeit in a non-meditative state while being studied) had increased activation in areas associated with processing the actual sensory experience of pain (including primary and secondary somatosensory areas, insula, thalamus, and mid-cingulate cortex). They also found decreased activity in regions involved in emotion, memory, and appraisal (including medial pre-frontal cortex (mPFC), orbital frontal cortex (OFC), amygdala, caudate, and hippocampus).
  • Activation of different neural pathway than a placebo: Zeidan et al.’s most recent (2015) study found mostly consistent results and went a step further and accomplished the feat of proving that mindfulness meditation has a different neural pathway than, and reduces pain intensity above and beyond, placebo. In this study, relative to other comparison groups, mindfulness meditation was associated with decreased activity in the brain area called the thalamus. This possibly reflects the inability of sensory information from reaching areas of the brain associated with thinking and evaluation.

 

Despite the increased elucidation of neural mechanism related to mindfulness-related pain reduction, and its viability as an additional tool doctor’s can “prescribe,” questions still remain. There are many conflicting studies that seem to indicate that mechanisms may vary based on a meditator’s expertise level, as well as a meditator’s engagement in Focused Attention (FA) vs. Receptive Attention (RA) also called Open Monitoring. Findings also differ by stimulus type (heat vs. laser), and diverse experimental directives. Additionally, more research is needed to parse between mindfulness’s ability to reduce both acute and chronic pain.

While mindfulness meditation is not the end all be all panacea for pain, there is enough evidence to indicate that mindfulness practice does in fact lead to reductions in pain intensity and unpleasantness, even more so than placebo. The proof is even in the brain circuitry.  In this way, it can be a safe addition to treatment options that have heretofore mostly included highly addictive opioids.

Mindfulness Practice for Pain Relief: The Body Scan Meditation

So how can we put this theory and research into actionable guidance for our own lives? One of the most effective mindfulness practices with regards to pain reduction is the body scan technique, which provides us with the ability to identify physical discomfort in different parts of the body.

The body scan can allow us to use our bodies to experience present-centered, non-judgmental awareness. We can learn to be aware of whatever sensation arises in our bodies, particularly the painful ones, and then we learn to notice the difference between the direct experience of these sensations and the indirect perceptions that we add on to that experience.

The body scan allows us to non-judgmentally identify what we are feeling and where we are feeling it as we narrow our focus on each detailed part of our body. Yet, we also begin to train our minds to broaden our focus away from the intricate body parts to a broader and more spacious awareness of the body as it exists as a whole, with different co-existing parts and sensations. A greater understanding of what our body endures allows us the opportunity to see what it feels, accept it, and cultivate compassion for it, without immediately judging it or trying to escape it.

I invite you to take the time to try a guided body scan meditation. In this practice, I guide you through an 18-minute body scan. It is my hope that together we can work toward a more mindful approach to pain relief.

Repost: Your Two-Brain Lifestyle: How to Heal Mind, Brain and Gut

Repost: Your Two-Brain Lifestyle: How to Heal Mind, Brain and Gut

This blog post originally appeared in The Huffington Post.

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Less might sometimes be more, but two brains are most definitely better than one! How extraordinary then that research continues to confirm a second brain that resides in our guts.

Yes, our gut has its own neural network, the enteric nervous system (ENS). Our ENS doesn’t wax philosophical or make executive decisions like the gray shiny mound in our skulls. Yet, in a miraculously orchestrated symphony of hormones, neurotransmitters, and electrical impulses, both of our “brains” communicate back and forth.

This connection is actually what accounts for those proverbial butterflies in our stomach and has vast implications on our overall health and wellness. Changes in the diversity of the trillions of bacteria that reside in our gut (called the gut microbiota) can impact upon our mental state. And on the flip side, psycho-social factors, including the way we think and feel, have been implicated in gut problems.

Given my personal experience with SIBO, and professional experience with hundreds of women suffering from depression, anxiety, and GI difficulties, I enjoy teaching about how to live what I like to call a “Two-Brain Lifestyle.”

Here are four ways to begin your two-brain lifestyle journey:

 1. Diet:

“Diet is a central issue when it comes to preserving our gastrointestinal health, because by eating and digesting we literally feed our gut microbiota, and thus influence its diversity and composition.” –– Professor Francisco Guarner (University Hospital Valld’Hebron, Barcelona, Spain)

There is more and more research linking diets to both our gut and brain health. Certain diets elicit a healthier bacterial balance. Overall, and generally speaking, a diet rich in whole, unprocessed, unadulterated, and non-genetically modified foods help to maintain a proper pathogenic gut bacteria ratio. More specifically, the following are key recommendations:

A. Probiotic Intake:

Probiotics can be found in foods such as yogurt, or kimchi, and can also be taken in supplement form. Among other benefits, probiotics keep the bacterial ecosystem in our gut healthy, which in turn helps keep us healthy overall.

The positive impact of probiotics on gut flora has been widely studied in the last few years. In a 2013 study in Gastroenterology, 12 of 25 healthy women ate a cup of yogurt twice a day for four weeks. The rest of the women ingested no yogurt. All women had pre and post brain scans while being asked to respond to a series of images depicting different facial expressions. Results indicated that the women who ate yogurt were calmer when shown various emotions than the control group. Showing that the yogurt changed the subjects’ gut microbiota, which also modified their brain chemistry.

This means probiotics are potential game changers when treating anxiety and mood difficulties.

B. Low Sugar/Low Simple Carb Diet:

It is hard to say this, given that a love for chocolate has a special place in many of our lives, but excess sugar upsets the balance in the gut by nurturing more pathogenic bacteria, which leads to increased systemic inflammation. And inflammation is a major player in the inception of chronic disease, including mental health difficulties — no good!

In a recent study, researchers fed a group of mice a diet high in sugar and then tested their mental and physical function. The sugar diet negatively impacted the mice’s gut microbiota, impaired their cognitive flexibility, and ability to efficiently adapt to changing situations. The change in gut bacteria also negatively affected the mice’s long-term and short-term memory.

Basically, sugar makes you forgetful and possibly impairs adaptability, but don’t fret, the chocolate craving can still be met: The darker the chocolate, the less sugar. Also, if you don’t want to cut sugar completely out of your diet, eating less overall can still improve wellness.

 2. Physical Exercise:

Ever feel like vomiting when you are scheduled for a job interview? That is just a crude reflection of how stress negatively impacts many aspects of our gut, but give exercise a try, it’s a well-known stress-buster!

A 2014 study found that rugby players not only have more diverse microbiota, but also a high amount of a particular bacterial species associated with decreased rates of obesity and metabolic diseases. While the study didn’t separate the effects of exercise, stress, and diet, it certainly provides evidence for exercise’s possible beneficial impact on gut microbiota diversity.

3. Therapy:

Our gut microbiota talk to the brain and impact how we think and feel, and, the way we think and feel has a profound impact upon the gut. Therefore, negative thinking styles and certain emotional states can disrupt gut functioning and even lead to dysfunction and disease.

Cognitive Behavioral Therapy (CBT) is a type of therapy geared toward identifying and reframing negative and counterproductive thought patterns. In a 2003 study of patients with IBS, a significant number reported less pain, bloating, and diarrhea after 12 weeks of CBT. Stands to reason that therapy should be part of a thorough treatment plan for chronic gut upset!

 4. Relaxation and Stress-Reduction Exercises: 

Studies have shown that stress puts us at risk for dysbiosis, a shift away from healthy gut diversity. This then strips us of a defense against infectious disease, which can potentially wreak havoc on the Central Nervous System (CNS).

Beyond utilizing exercise, which we already talked about, stress reduction and relaxation techniques, such as meditation, help bring the gut environment back to homeostasis. In a recent study from Harvard University affiliates, forty-eight patients with either IBS or Inflammatory Bowel Disease (IBD) took a 9-week session that included meditation training. The results showed reduced pain, improved symptoms, stress reduction, and a decrease in inflammatory processes.

Go with your gut

Just as the best way to boost our brain is by maintaining impeccable gut health vis-a-vis the content of our diet, so too, it might be impossible to heal a distressed gut without considering the impact of stress and our emotions.

So just remember, you are what you eat, and you are what you think, and there are ways to do both more mindfully.