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The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
The impact of touch on emotion regulation development and in psychotherapy.
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The impact of touch on emotion regulation development and in psychotherapy.

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Touch plays a powerful role in human development and emotional regulation. Despite this fact it is not used effectively in therapy. This talk explores current research into the biological and …

Touch plays a powerful role in human development and emotional regulation. Despite this fact it is not used effectively in therapy. This talk explores current research into the biological and psychological effects of touch and how to use touch to increase emotional regulation skills.

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  • Touch plays a vital role in the building of the brain, the mind, and the self. Failure to thrive: Infants die with out contact. Before there was a verbal dialog there was a physical knowing… Emotional communication happens faster then conscious cognition. (100 ms not 500 ms) Touch can either be damaging — for instance, abuse — or profoundly loving, as in the skin-on-skin contact of an infant with his care providers.
  • Spinoreticular tract The philogentically oldest of these pathways. It goes from the spine to the reticular activating system (RAS). The RAS is a major body regulator of level of conscious arousal. This pathway mediates the emotional arousal aspects of pain and the motivation to stop the pain. When a person stubs her toe, this information is read by the brain as, “ouch.” Spinothalamic tract Runs from the spine and to the thalamus. It conveys information to the brain about specific areas of pain, sensation, and temperature. This area can localize the pain to a given region. This area is the one that makes a person say, “I cut my arm!” Spinomesencephalic tract This tract, through communication, is responsible for modulating and reducing the pain response. Through activating the Para Ventriculate nucleus (PVN) serotonin and opiates produced endogenously. These chemicals signal the body to interrupt the pain response. When this area comes on line, one might state, “My arm feels better.”
  • Just as touch plays a profound role in the development of the child, it can play a profound role in the regulation of the nervous system… Therapeutic touch has been shown to decrease cortisol production, substance P (mediating pain responses), Therapeutic touch has been shown to increase dopamine, serotonin, and oxytocin production (known to mediate maternal behaviors, attachment and partner boding). In infants it has been shown to increase birth weight, cortical development, length of the infant, reduce asymmetry between frontal lobes (associated with depression), increase the ability to self-soothe, and re-regulate cardiac vagal tone (an indication or autonomic regulation).
  • Just as touch plays a profound role in the development of the child, it can play a profound role in the regulation of the nervous system… Therapeutic touch has been shown to decrease cortisol production, substance P (mediating pain responses), Therapeutic touch has been shown to increase dopamine, serotonin, and oxytocin production (known to mediate maternal behaviors, attachment and partner boding). In infants it has been shown to increase birth weight, cortical development, length of the infant, reduce asymmetry between frontal lobes (associated with depression), increase the ability to self-soothe, and re-regulate cardiac vagal tone (an indication or autonomic regulation).
  • Transcript

    • 1. The Neurobiology of Touch and Trauma Somatic Experiencing from Dysregulation to Coherence Mike Changaris, Psy. D. This work is copy written under the creative commons attribution license you may use this work as a whole or adapt it as long as you site this author as the source.
    • 2. A Mother’s Touch… ‘Kangaroo care’  ‘Kangaroo care’ An infant is held skin-to-skin to their mother or father, generating heat for the newborn much like a baby kangaroo receives in its mother’s pouch.  http://today.msnbc.msn.com/id/38988444/ns/today-parenting  “We’d resigned ourselves to the fact we were going to lose him; we were just trying to make the most of those last precious moments.”  “We thought, ‘What a blessing, we get to see his eyes before he passes away,’ ” Kate said. “But they stayed open!”
    • 3. Embodied Arrival  Invitation to orient... To room, To others, To skin contact with chair  Top Down and Bottom Up  The Brain Story: Insula, Anterior Cyngulet, and the Orbital Frontal Cortex  Mindful Self Massage
    • 4. Overview  Begin to understand the role of touch in the communication of emotion and in affect regulation.  Understand key brain regions involved in trauma, touch, pain and emotion regulation.  Review some of the recent literature on the psychophysiological impacts of touch treatments.  Recognize affect dysregulation and key neural structures involved.  Begin to understand how to incorporate touch treatment in to a treatment plan.
    • 5. Who we are is created through touch…
    • 6. Touch is Communication…  Touch is one of the most understudied senses, yet it can be a profound communicator of emotion.  Recent studies have found that people can identify multiple emotions through physical touch such as anger, fear, disgust, love, gratitude, and sympathy via touch with a high degree of accuracy. (Hertenstein, Holmes, McCullough, & Keltner, 2009)  People can decode emotional information communicated by touch by simply watching touch on a film. (Hertenstein, Holmes, McCullough, & Keltner, 2009; Keysers, Wicker, Gazzola, Anton, Fogassi & Gallese, 2004)
    • 7. Touch Interventions for Trauma  Touch can be used in several ways to reduce the symptoms of trauma. 1. To re-establish the regulation of the autonomic nervous system. 2. To desensitize individuals to trauma triggers. 3. To increase the ability to attend to interceptive cues from the body. 4. To reduce fight/flight activation 5. Support the growth of emotion regulation centers in the brain.
    • 8. Affect Regulation  Four Main Types of Affect Regulation.  Cognitive regulation is deciding to use an affect regulation skill.  Co-regulation the regulation through the interaction with another person or animal.  Auto-regulation the internalized regulation or automatic regulation processes.  Self-Regulation the integration of the above types of affect regulation.
    • 9. Cognitive Regulation and Touch  Any touch based skill some one uses consciously to regulate their emotional response.  Lineahan: Soothing in the 5 senses. (dbtselfhelp.com)  For Example:  Placing one’s hand on one’s heart  Tapping  Standing in a warm shower  Massaging one’s feet/ self massage.  Taking a bath  Progressive muscle relaxation.  Chi Gung Slapping
    • 10. Co-regulation Regulation and Touch  Co-regulation is regulation of emotions through the interaction with another person or animal.  Co-regulation through indirect mirroring.  Requires the ability of the individual to tolerate, mirror and contain the affective state of the other.  Sub-cortical dialog of “neuroception”  Individuals w/ Antisocial Personality lack this ability to modulate w/ another. (Research on pupil dilation).  Listening w/ the hands  Co-regulation provided through conscious intervention.  Placing of a hand on the back of some one upset.  Increasing one’s positive affect and then contacting the other.  Client and therapist negotiating where contact would feel supportive and providing that contact.
    • 11. Auto-regulation and Touch  Auto-regulation is the internalized pattern of affect regulation.  Automatic Thoughts, Schema’s and Cognition  Patterns of cognition, self talk, and beliefs  Situational triggers  Interaction between cognitive and emotional systems  Automatic Emotions: Loops of emotions…  Cingulet Gyrus: Can replay emotional events of the past as if they are happening and plays a role in depression.  Daniel Hughes – Story of Katie  RIG’s – Representation of interactions generalized.
    • 12. Self-Regulation and Touch  Self-Regulation is the integration of auto-regulation, patterns of co-regulation, and one’s cognitive regulation skills.  As a person becomes more integrated these types of affect regulation work together to allow the individual to tolerate a range of stressors, different emotions and even exceeding their current affective auto-regulation capasity with comfort.
    • 13. Touching Emotions 1. Brake up into dyads 2. Decide who will be the receiver first. 3. The partners let each other know where they feel safe receiving touch (e.g. shoulders, upper back etc.). 4. Receiver sits in a chair and chooses an emotion they will evoke through (memory of emotion, evoking the felt experience in the body etc.). 5. Negotiate contact 6. Giver: Attempt to listen with the hands and see if they can identify the emotion being communicated. 7. Then switch roles. 8. Share in dyads. Share in larger group.
    • 14. Instructions 1. Choose partner. 2. Choose who gives touch first. 3. Negotiate contact (be safe). 4. Receiver: Choose emotion. 5. Giver: Listens with hands to attempt to identify the emotion.
    • 15. Neurobiology of Affect Regulation HPA-Axis and Thalamus  Hypothalamus Pituitary Adrenal-axis (HPA-- axis): Is made up of the hypothalamus, pituitary gland, and adrenal cortex. Its main task is to mobilize a powerful en ergetic defense when a person is threatened and to return to rest when the threat is gone. The HPA-- axis triggers cortisol secretion. Touch based interventions co uld help restore regulation to this system. Touch treatment been shown to reduce cortisol levels.  Thalamus: Is a relay station for the brain. A damaged thalamus can result in a coma. Sensory information from touch reaches the cortex th rough connections in the thalamus It plays a role in modul ating levels of arousal. The thalamus may be the seat of human consciousness.
    • 16. Neurobiology of Affect Regulation HPA-Axis and Thalamus  Hypothalamus Pituitary Adrenal-axis (HPA-- axis): Is made up of the hypothalamus, pituitary gland, and adrenal cortex. Its main task is to mobilize a powerful en ergetic defense when a person is threatened and to return to rest when the threat is gone. The HPA-- axis triggers cortisol secretion. Touch based interventions co uld help restore regulation to this system. Touch treatment been shown to reduce cortisol levels.  Thalamus: Is a relay station for the brain. A damaged thalamus can result in a coma. Sensory information from touch reaches the cortex th rough connections in the thalamus It plays a role in modul ating levels of arousal. The thalamus may be the seat of human consciousness.
    • 17. Neurobiology of Affect Regulation Hippocampus  The hippocampus Is found in the medial temporal lobe.  The three major theories used to explain hippocampus f unctioning are that the hippocampus is involved in: beh avioral inhibition, declarative memory consolidation, and sense of place. In those with PTSD hippocampus declines have been noted.  Dissociative Identity Disorder (DID), one study found a 26% decline compared with controls. No studies were found linking hippocampal growth with touch therapies.  However, touch reduces cortisol production and high levels of cortisol. Hippocampal declines can be reduced through reregulatio n of cortisol.
    • 18. Neurobiology of Affect Regulation Hippocampus  The hippocampus Is found in the medial temporal lobe.  The three major theories used to explain hippocampus f unctioning are that the hippocampus is involved in: beh avioral inhibition, declarative memory consolidation, and sense of place. In those with PTSD hippocampus declines have been noted.  Dissociative Identity Disorder (DID), one study found a 26% decline compared with controls. No studies were found linking hippocampal growth with touch therapies.  However, touch reduces cortisol production and high levels of cortisol. Hippocampal declines can be reduced through reregulatio n of cortisol.
    • 19. Neurobiology of Affect Regulation The Insula  The insula is a part of the limbic cortex.  The insula has been postulated to be involved in the felt experience of introceptive cues from the body, viscera, appetit e, and addiction and plays a role in the integration of body se nsation of the primary emotions (such as anger, sadness, happiness, and disgust).  It has connections with the amygdala and the orbital frontal cortex through connections with the thalamus.  Touch in combination with the individual’s attention has been shown to activate the insula in fMRI studies.  The insula registers both painful touch and pleasant touch.
    • 20. Neurobiology of Affect Regulation The Insula  The insula is a part of the limbic cortex.  The insula has been postulated to be involved in the felt experience of introceptive cues from the body, viscera, appetit e, and addiction and plays a role in the integration of body se nsation of the primary emotions (such as anger, sadness, happiness, and disgust).  It has connections with the amygdala and the orbital frontal cortex through connections with the thalamus.  Touch in combination with the individual’s attention has been shown to activate the insula in fMRI studies.  The insula registers both painful touch and pleasant touch.
    • 21. Neurobiology of Affect Regulation Cingulate Gyrus  The cingulate gyrus is often referred to as the limbic cortex.  At three to nine months of development, the infant grows the abilit y to modulate social engagement through immobility and withdrawing (noradrenalin) and active protection through fight/flight (dopamine), monitors internal and external behavior, attends to mistak es, and modulates behavior for more successful outcomes.  The anterior is discussed here and is related to autonomic homeostasis, reward anticipation; heart rate, decision-making, emotions, and modeling the emotions of others.  It plays a central role in integration of bottom up and top down neural processes.  The cingulate gyrus is involved in the limbic touch circuit.
    • 22. Neurobiology of Affect Regulation: the Amygdala  The Amygdala is often known as the fear center of the brain. Although it could be better conceptualized as a smoke detector. It notices changes in the insula, and other limbic structures.  The amygdala is involved in classical conditioning and emotional memory. Likely involved in “flash bulb” memories).  The amygdala becomes nearly fully developed by the age of one year.  Early in life it plays a role in the infant’s indiscriminant impulsive drive to social interaction.  Touch has been shown to have strong links to the amygdala, the insula, and other limbic structures.
    • 23. Neurobiology of Affect Regulation Basal Ganglia… Septal Nucleus  Basal Ganglia (BG): Is central to the modulation of movement, emotional set, anticipation of mov ement, eye movement, motivation, and reward. Physical touch increases ne urotransmitter production key for basal ganglia functioning.  Septal Nucleus: Plays a role in pleasure, relaxation and rest. It has an inhibitory effect of cortisol.  In early development, the amygdala pushes the infant toward indiscriminant social contact.  As the child develops, the septal nucleus provides regulation for amygdalar impulses.  Stressful touch to rats increased the septal nucleus secretion of dopamine and activation of the hypothalamic circuits.  In rat pups, a damaged septal nucleus leads to increased aggression and loss of maternal behaviors.
    • 24. Neurobiology of Affect Regulation Basal Ganglia… Septal Nucleus  Basal Ganglia (BG): Is central to the modulation of movement, emotional set, anticipation of mov ement, eye movement, motivation, and reward. Physical touch increases ne urotransmitter production key for basal ganglia functioning.  Septal Nucleus: Plays a role in pleasure, relaxation and rest. It has an inhibitory effect of cortisol.  In early development, the amygdala pushes the infant toward indiscriminant social contact.  As the child develops, the septal nucleus provides regulation for amygdalar impulses.  Stressful touch to rats increased the septal nucleus secretion of dopamine and activation of the hypothalamic circuits.  In rat pups, a damaged septal nucleus leads to increased aggression and loss of maternal behaviors.
    • 25. Neurobiology of Affect Regulation Orbital Frontal Cortex  Orbital Frontal Cortex: “emotion and reward” area of the prefrontal cortex .  This is likely the most abstract area of emotional pro cessing.  It is also the last to mature.  It reaches full maturity in the early twenties.  It is involved in decision making and expectation.  Pleasant touch increases activation in the OFC.
    • 26. Neurobiology of Affect Regulation Orbital Frontal Cortex  Orbital Frontal Cortex: “emotion and reward” area of the prefrontal cortex .  This is likely the most abstract area of emotional pro cessing.  It is also the last to mature.  It reaches full maturity in the early twenties.  It is involved in decision making and expectation.  Pleasant touch increases activation in the OFC.
    • 27. 4 Types of Neuroplastic Changes  Experience Independent: Changes driven entirely by genetic determination. (e.g. Layered Structure of Brain: Brain Stem, Limbic, Cortex)  Experience Expectant: Changes that are biologically determined and need only be activated by life events. (e.g. language formation, facial recognition and attachment)  Experience Dependant: Changes that are individual idiosyncratic and are dependent on the specific environmental event occurring. (e.g. The first month of the year is January, there are six degrees between any one and Kevin Bacon).  These types of development interact. Extreme events (chemical, physical, and learning) can alter any of these developmental processes (This Presenter’s Personal Conjecture Based on the Eval of Current Lit).  Shifts in functional relationships between structures (see dysregulation).
    • 28. Clinical Story  The Story of the two guards at the cave…  When you call up a memory it calls the pattern of neuronal behavior up and often it is in a “plastic state.”  Using touch to help support witnessing presence to remain connected to sensation long enough for the new possibility to integrate.
    • 29. Two Main Types of Affective Dysregulation  Developmental: Developmental dysregulation occurs when there are either disruptions in the developmental environment or physical systems of the brain leading to altered growth in the cortical structures, hormones, neurotransmitters, or the relationship between structures.  Incident Driven Dysregulation: In a catalyzing event, through which the brain and self undergo fundamental functional alterations. (Most PTSD Research and treatment focus on this type of dysregulation)
    • 30. Developmental Dysregulation  Example: If a child misses the processes that lead to the maturation of the septal nucleus, that child could display impulsivity and tendency to socialize indiscriminately, and the cortical structures that myelinated after the development of the septal nucleus could display disruptions functioning as well.  More the 60% of children who have been traumatized (developed PTSD after an event) display major to moderate disruptions in multiple neuocognitive abilities (e.g. Memory, Language, Spacial reasoning, Attention/Concentration etc..)  A disruption in a key neurocognitive domain can lead to disruptions in all the developmental processes that rely on these domains to develop.
    • 31. Developmental Dysregulation  These children tend to be improperly diagnosed, receive improper treatment, and their educational needs not attended to.  Effects more then 3,000,000 children per year in America alone.  Although, there has been a call for the diagnosis of developmental trauma by Bessel Van Der Kolk and others, it is yet to be included in the DSM-V.  Write the committee!
    • 32. Incident Driven Dysregulation  This is the main focus of the current PTSD liturature.  Two main forms of dysregulation (These types are not exclusive but people show a predominance in a direction)  Hyperactivation: Reflects an upregulation of stress hormone production and an underactivation of emotion regulation centers. Display increased Cortisol and Heart Rate when read a trauma script. (70% of sample)  Hypoactivation: Reflects an under-activation of stress response and an over activation cortical structures, which regulate stress. Displays a decreased Cortisol production and Hear Rate when read a trauma script. (30% of sample)
    • 33. Dysregulation  The body and mind are full of rhythms functioning coherently… From the daily rhythm of sleep to waking, to the diurnal pattern of cortisol secretion.  Dysregulation occurs when the normal coherent relationship between these patterns is disrupted in such a way that the brain or mind has difficulty returning to its normal homeostatic range (Liberzon, Taylor, Fig, & Koeppe, 1998).  Post-traumatic stress disorder (PTSD), there is an upregulation of the threat system such that it triggers a dissociative shutdown, it over-produces stress hormones, reacts too intensely to triggers, or it is triggered too easily to produce stress hormones.
    • 34. Hyperactivation  The hyperactivated individual floods with information from the body and has less capacity to regulate the intense sensation.  Ruth Lanius Found in an fMRI Study…  Over activation in the insula (bringing extreme amounts of information from the body’s interceptive cues)  Under-activation of the anterior cingulate cortex (ACC) (area needed to regulate the body sensations brought up from the insula)  Under-activation medial prefrontal cortex (mPFC) (area needed to regulate the body sensations brought up from the insula)
    • 35. Hypoactivation  For the hypoarousal type, only a small amount of interceptive cues get into the limbic cortex and are quickly squelched by cortical structures, leaving the individual feeling disconnected, emotionally flat, and dissociated.  Ruth Lanius Found in an fMRI Study…  Down regulation of physical sensations from the insula cortex.  Hyperactivation activation in the anterior cigulet cortex (ACC).  Hyperactivation in the medial prefrontal cortex mPFC.
    • 36. Porges: Poly-vagal Theory  Autonomic Nervous System Regulates: Stress, Arousal, Heart Rate, Breath Rate, Digestion etc…  Autonomic Nervous System has Two Branches….  The Sympathetic Branch: Fight and Flight response.  Parasympathetic Branch: Two Systems… Rest and digest, and Freeze.
    • 37. Porges: Poly-Vagal Theory… Two Parasympathetic Branches  Evolutionarily Newer (VVC): Rest and digest or Social Engagement System. Functions when we feel safe.  Evolutionarily Older (DMNX): Freeze Response… Functions like a circuit braker to shut down the nervous system under extreme threat of death. A time dependent physiological process.  A feed back loop is possible (Lizards from the 1900’s): Injection of the stress hormone adrynilyn can maintain the freeze response indefinantly.
    • 38. Poly-Vagal Theory The way it works… V.V.C. Brake Disengages Sympathetic Nervous system Engages V.V.C Brake Engaged at rest and Socially Engaged. DMNX Engages Shutting Down Consciousness
    • 39. Somatic Experiencing Theory  Fight, Flight are defensive strategies…  They are time limited aimed at removal of a threat.  Freeze response is a defensive strategy…  It is time limited and follows a predictable pattern of behavior.  Often the freeze response can not complete because of its multi-sensory association with the fight or flight response (coupled in the felt-experience of the event).  Overactive fight/flight response leads to maintianance of the freeze response indefinantly.
    • 40. Somatic Experiencing Theory  Psychological adaptations to trauma occur when the individual develops strategies to co-opt other neurological systems to override the need to access states that could re- trigger traumatic experience.  In SE theory, the return of social engagement behavior can indicate a re-regulation of the nervous system.  Some indications of social engagement are: The inner ear tuning to the range of the human voice, breathing becoming slow and smooth, orienting towards the therapist, and the individual growing curious about his or her environment.
    • 41. Video Demo…
    • 42. Four major touch pathways Type AAlpha - Quick myelinated pathway mediating proprioception from skeletal muscles. Type A Beta - Slightly slower myelinated pathway mediating skin touch, hair follicle endings, and deep touch. Type A Sigma - Slower thinly myelinated pathway mediating temperature and pain. Type C - Slow unmyelinated pathway mediating pain, temperature and itch.
    • 43. Three Pain Touch Pathways… 1. Spinoreticular tract “Ouuuch!” 2. Spinothalamic tract “I Hurt My Arm!!!” 3. Spinomesencephalic tract “I feel better now…”
    • 44. Touch Pain Pathways: Spinoreticular track  The philogentically oldest of these pathways.  It goes from the spine to the reticular activating system (RAS).  The RAS is a major body regulator of level of conscious arousal.  This pathway mediates the emotional arousal aspects of pain and the motivation to stop the pain.  When a person stubs her toe, this information is read by the brain as, “ouch.”
    • 45. Touch Pain Pathways Spinothalamic tract  Runs from the spine and to the thalamus.  It conveys information to the brain about specific areas of pain, sensation, and temperature.  This area can localize the pain to a given region.  This area is the one that makes a person say, “I cut my arm!”
    • 46. Touch Pain Pathways Spinomesencephalic tract  This tract, through communication, is responsible for modulating and reducing the pain response.  Through activating the Para Ventriculate nucleus (PVN) serotonin and opiates produced endogenously. These chemicals signal the body to interrupt the pain response.  When this area comes on line, one might state, “My arm feels better.”
    • 47. Sensory Processing  Primary Sensory Motor Region: Receives raw sensory data. If damaged leads to paralysis or muscle spasm.  Secondary: Integrates sensation with perception.  Damage to the secondary sensory area can lead to: Difficulty localizing and integrating sensory input; Losing propreaceptive input, such that the person feels lost in space.  Damage to the secondary motor area leads to loss of: The urge to move (basal ganglia); Organized patterns of movement; Emotional drives for movement.
    • 48. Sensory Processing  Tertiary: Integrates higher order abstractions and concept formation.  Multi-sensory Integration: Creates the seamless felt experience of reality
    • 49. Biology of Touch Sensory Integration  Through the visuotactile mirroring mechanism, people model each other’s emotions and experiences by integrating touch and vision.  Two Visuotactile Systems:  Non-intentional system models Inannimate Objects • Intentional system models relational touch and may mediates the experience of “resonating with another.” (Co-Regulation)
    • 50. Effects of Touch in Therapy  Touch is as vital as food  Touch can affect multiple neurobiological systems that are targets of anti-depressants, anxiolytic medications.  Having one positive emotion after a stressful event or the experience of a triggering event can speed the reduction of cortisol levels, and reduce physiological indicators of stress.  Soothing, safe touch can be an effective means to provide an experience of safety, evoke the relaxation response and for some positive emotions
    • 51. Effects of Touch in Therapy  Just as touch plays a profound role in the development of the child, it can play a profound role in the regulation of the nervous system…  Therapeutic touch has been shown to decrease cortisol production, substance P (mediating pain responses),  Therapeutic touch has been shown to increase dopamine, serotonin, and oxytocin production (known to mediate maternal behaviors, attachment and partner boding).  In infants it has been shown to increase birth weight, cortical development, length of the infant, reduce asymmetry between frontal lobes (associated with depression), increase the ability to self-soothe, and re-regulate cardiac vagal tone (an indication or autonomic regulation).
    • 52. Effects of Touch in Therapy  In parents, it has been shown to increase the quality of their relationship, infant-parent synchrony, perception of partner support, reduce frontal lobe asymmetry, and reduce the effects of post-partum depression.  Massage has been shown to reduce symptoms of depression, state anxiety, and PTSD
    • 53. Changes in Auto-regulation Through Touch  Internalization of the therapist as a safe regulator of affect  The coupling of difficult emotional content with the safe containment of the therapist and effects of touch the client builds new regulatory possibilities.  Changes occur in the ACC and its modeling and play back of emotional events.  The client reduces for the client the number of conflicts their ACC needs to monitor through its conflict monitoring function and the number of number of emotional exchanges with a successful outcomes.
    • 54. Changes in Auto-regulation Through Touch  The internalization of the therapist as a safe regulator of affect.  As the therapist coaxes the client’s orbital frontal cortex online through safe touch and emotional mirroring through touch, these areas likely are strengthened.  The safe contact with the therapist could allow for increased ability of the client to tolerate his interceptive responses to events and thus allows him to be available to a wider range affect without dysregulating and be an active participant in a wider range of life experiences.  As a new-felt experience of contact with one’s physical form and physical contact with a self–regulating other is internalized, the individual has the ability to auto-regulate through touch.
    • 55. QUESTIONS
    • 56. Containment Through Contact 1. Brake up into dyads 2. Decide who will be the receiver first. 3. The partners let each other know where they feel safe receiving touch (e.g. shoulders, upper back etc.). 4. Negotiate contact 5. Containment Exercise 6. Then switch roles. 7. Brief sharing in dyads
    • 57. Containment Exercise  Provide containing touch: Resting at the skin  Using invetational language ask your partner to notice the contact with your hand.  Invite them to move their attention to a place that feels good on the inside.  Gently ask them to move their attention to place that feels slightly uncomfortable,  Invite them to move their attention back to a place inside that feels good.  Ask them to notice the felt experience of contact with your hand.

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