Rewire the Anxious Brain: Neuroscience-Informed Treatment of Anxiety, Panic and Worry

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Hannah Smith, MA, LMHC, CGP Related seminars and products

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Hannah Smith, MA, LMHC, CGP, an author, business owner, and innovator, is a licensed mental health therapist and internationally board-certified group psychotherapist, consultant & clinical trainer with nearly 25 years of experience in her dual passions: helping others recover from multiple difficult life circumstances and improve their well-being and enhancing the knowledge of clinicians who work in the field of clinical care. With undergraduate degrees in hard sciences and master’s degrees in in special education and counseling psychology, she combines her knowledge in unique ways to analyze and synthesize difficult concept into “feet-to-the-pavement,” practical applications for clinical practitioners at all levels. She has done extensive study and work in neuroscience-informed treatment of anxiety and trauma and is certified in interpersonal neurobiology through the Mindsight Institute. Her work experience, both in the US and abroad, has given her a unique perspective, cross-cultural awareness, sensitivity & respect, and a relatability that puts people at ease and makes her highly approachable. Her dynamic and thought-provoking, teaching style is invigorating, making learning fun, personal, and practical.

 

Speaker Disclosures:
Financial: Hannah Smith maintains a private practice and receives a speaking honorarium from Cascadia Training. She receives royalties as a published author. Hannah Smith receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Hannah Smith is a member of the American Group Psychotherapy Association, and the Washington Mental Health Counselors Association.

Objectives

1. Ascertain the underlying neurological processes that impact anxious symptoms for clients.
2. Develop client engagement in treatment using personalized goals and attending to the therapeutic relationship.
3. Evaluate the differences between amygdala-based and cortex-based anxiety symptoms and identify how these symptoms inform treatment interventions.
4. Communicate strategies for calming and training the amygdala in order to alleviate symptoms of anxiety.
5. Implement methods for teaching clients to retrain the cortex so that anxiety is resisted rather than exacerbated.
6. Analyze how psychotropic medication impacts neuroplasticity in the brain; identify related treatment implications.

Outline

Use Neuroscience in the Treatment of Anxiety

Positives:

• We know more about anxiety-based disorders than any other disorders
• Science gives explanations, evidence, authority, destigmatizes difficulties

• It can be difficult to explain, answer questions
• Clients may feel a lack of responsibility
• Oversimplification is inevitable

• Don’t neglect the therapeutic relationship!
• Address the challenges of anxious clients
• Remember that strategies are effortful
• Guide the process using client’s goals
• Maintain motivation

• Define Neuroplasticity in everyday language
• Therapy is about creating a new self
• ”Rewiring” as an accessible concept for change
• Re-consolidation: the modification of emotional memories

• Amygdala – bottom-up triggering of emotion, physicality of anxiety
• Cortex – top-down emotion generation based in cognition
• Explain the two pathways to clients
• How anxiety is initiated in each pathway and how pathways influence each other

• Use illustrations to create concrete understanding
• Fight/flight/freeze responses
• The “language of the amygdala”
• Anxiety and the cortex
• Help clients recognize the two pathways to anxiety

• Sleep and the amygdala
• The influence of exercise
• Breathing techniques to reduce activation
• Relaxation, meditation, and yoga to modify responses
• Exposure as opportunities for the amygdala to learn
• Combatting avoidance
• When anxiety indicates that the amygdala can learn new responses
• Push through anxiety to change the amygdala

• ”Survival of the busiest” principle – strengthen or weaken specific circuitry
• The healthy (adaptive) use of worry in the cortex
• ”You can’t erase: You must replace”
• Recognize and modify the impact of uncertainty
• Training correct uses of distraction
• Left hemisphere techniques – cognitive defusion, coping thoughts, fighting anticipation
• Right hemisphere techniques – imagery, music
• Mindfulness and anxiety resistances

• Medication’s effects in the rewiring process
• The myth of the chemical imbalance
• The danger of sedating the brain with benzodiazepines
• Promoting neuroplasticity with SSRIs, SNRIs
• The effectiveness of CBT and meds

• Anxiety is a component of many diagnoses (depression, substance abuse, etc.)
• Amygdala – and cortex-based techniques help in other disorders
• Targeting brain-based symptoms rather than disorders
• Worry, obsessions, rumination respond to similar cortex-based techniques
• Panic, phobic responses, and compulsions respond to amygdala-based techniques

• Empirical versus clinical and anecdotal evidence
• Clinical considerations for specific clients and settings
• Efficacy of particular interventions may vary

Target Audience

• Social Workers
• Psychologists
• Counselors
• Teachers
• Occupational Therapists
• Marriage and Family Therapists
• Case Managers
• Addiction Counselors
• Therapists
• Nurses
• Speech-Language Pathologists
• Other Mental Health Professionals

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