THE SCIENCE OF RECOVERY: INTRODUCTION TO BRAIN DEVELOPMENT & NEUROPLASTICITY

Presented by Joseph Christensen, M.A. Licensed Marriage & Family Therapist Master Addiction Counselor

June 22, 2016 Thomas Durham, PhD

Director of Training NAADAC, the Association for Addiction Professionals www.naadac.org [email protected] PRODUCED BY

NAADAC, the Association for Addiction Professionals www.naadac.org/webinars WWW.NAADAC.ORG/WEBINARS www.naadac.org/braindevelopmentandneuroplasticity Cost to Watch: CE Certificate Free

CE Hours Available: To obtain a CE Certificate for the time you spent watching this webinar: 1.5 CEs 1. Watch and listen to this entire webinar.

CE Certificate for 2. Pass the online CE quiz, which is posted at NAADAC Members: Free www.naadac.org/braindevelopmentandneuroplasticity 3. If applicable, submit payment for CE certificate or join CE Certificate for NAADAC. Non-members: 4. A CE certificate will be emailed to you within 21 days of $20 submitting the quiz. USING GOTOWEBINAR – (LIVE PARTICIPANTS ONLY)

. Control Panel

. Asking Questions

. Audio (phone preferred)

. Polling Questions WEBINAR PRESENTER

Joseph Christensen, M.A. Licensed Marriage and Family Therapist Master Addiction Counselor E-Mail: [email protected]

MindMap, LLC All slides copyright J. Christensen (2016)

Webinar Learning Objectives

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LO #1 Increase Knowledge LO #2 Comprehend a LO #3 Learn The 10 Principles of & Understanding of the medical definition of healthy Neuroplasticity that supports latest science involving the brain functioning including active engagement and positive brain and mind. the basic neurological client gains in counseling. systems involved. PRESENTER BACKGROUND

• 26 years experience in mental health counseling, previously licensed in 3 states (California (2000), Oregon (2007) and Washington (2011). Currently practicing in California. • 21 years brain development inquiry. (A History of the Brain-2,000 original slides in PowerPoint in 14, progressive, modular ½ day trainings). • 17 years chemical dependency background and Master Addiction Counseling experience. (Primary Author of Oregon Health Authority 40-hour approved Brain Based Recovery Mentoring- Medicaid Eligible.)

FIRST OVERARCHING CONCEPT

BRAIN BASED RECOVERY MENTORING: TOWARDS A UNIFIED MODEL OF CHANGE WHAT “SHOULD” BE MANDATORY

Mental Health Development Spectrum (Brain/Body/Mind)

Chemical Use Environmental Spectrum Factors THE MINIMUM YOU NEED TO KNOW

Client Presentation

Brain Development Environmental Factors Chemical Dependency Mental Illness BRIEF HISTORY OF PARADIGMS Behavioral Genetics

Evolutionary Developmental Psychology Brain Biology Development

Cognitive- Pediatric Affective Neuropsychology Neuroscience HOW DOES THE BRAIN MAKE THE MIND?

Associated Implications In Daily Life Genes Panic Disorder 7,464 We sort new information through a threat assessment filter. Major Depressive Disorder 10,151 Mood filters reality.

Alcohol Use 2,326 Alcohol and civilization co-occurred; Genetic loads for alcoholism. Alcohol Resistance 249 Alcohol use is not a simple disorder; many factors are involved in the disease process.

Accessed 6.13.16 3 MAJOR “ITERATIONS” OF THE ADULT MIND

Birth 1ST MAJOR “ITERATION” OF THE ADULT MIND

Puberty

Birth Threshold Reproductive Threshold 2 MAJOR “ITERATION” OF THE ADULT MIND

Puberty 25 Years

Birth Threshold Reproductive Threshold Emotional Regulation 3RD MAJOR “ITERATION” OF THE ADULT MIND

Puberty 25 Years 30 - 45 Years

Birth Threshold Reproductive Threshold Emotional Regulation Thinking WIth Multiple Abstractions COGNITIVE DEVELOPMENT

Reflexes Single Reflexes 3-4 Weeks Mapping 7-8 Weeks Systems 10-11 Weeks

Actions Single Actions 3-4 Months Mapping 7-8 Months Systems 11-13 Months

Representations Single Represent. 2 Years Mapping 3.5 - 4.5 Years Systems 6-7 Years

Abstractions Single Abstractions 10-12 Years Mappings 14-16 Years Systems 18-20 Years

Kurt Fischer and Samuel Rose, 2000 COGNITIVE DEVELOPMENT

Mapping Abstract Complex Age 6 7-12 Relationships

Representational Systems Age 10 13-20 Single Abstractions

Abstract Mapping Age 15 17-30

Abstract systems Age 20 23-40 or never

Systems of Abstract Systems Age 25 30-45 or never

Kurt Fischer and Samuel Rose, 2000 PRACTICAL IMPLICATIONS

Blind Alleys

Mystery ?

Magical Thinking ADULT DEVELOPMENT SUMMARIZED

First Iteration of the Mind Second Iteration Body-Mind Third Iteration Survival Oriented Major Increase In Brake Power Reproductive Oriented Thinking & Applying Mental Filters (Sadness Access To Spectrums Of Multiple Abstractions To and Anger) Mood Daily Living Very Limited (No) Cognitive Increasing Awareness Awareness POLLING QUESTION #1 DO YOU BELIEVE THERE IS SUCH A THING AS AN ADDICTIVE PERSONALITY? YES OR NO Treatment May Not Reverse

Genetic Expression of Harmful Genes Previous Structural Damage From Early Use Changes In Structure & Function Behavior Patters & Personality Connectomic Wiring; Developmental Lags & Challenges to Stress Learned Ways of Thinking, Response. (Altered Feeling and Acting. Thresholds) What Parts of the Brain’s Wiring Was Changed? GAS, BRAKES & ZONE OF EFFICACY Stimulants “Uppers”

Zone of Intact Functioning

Depressants “Downers”

CLOSED HEAD INJURY Eye Opening Score Description

None 1 Not attributable to ocular swelling. To pain 2 Pain stimulus is applied to chest or limbs. To speech 3 Nonspecific response to speech or shout; Spontaneous 4 Eyes are open, but does not imply awareness. Motor Response

No response 1 Flaccid Extension 2 Decerebrate posturing: Intern. shoulder rotation Abnormal Flexion 3 Decorticate posturing: Abnormal flexion Withdrawal 4 Normal flexor response Localizes Pain 5 Pain stimulus applied causes limb to remove it. Obeys commands 6 Follows simple commands Verbal Response

No response 1 No vocalization Incomprehensible 2 Vocalizes, but no recognizable words Inappropriate 3 Intelligible speech Confused 4 Responds to questions/conversational/disoriented Oriented 5 Normal orientation to time, person, and place.

Keith Owen Yeates, 2000. p. 93 PATHOLOGY OF CLOSED HEAD INJURY

Type of Insult Pathology Primary Skull Fracture Intracranial contusions and hemorrhage Shear-strain injury Secondary Brain Swelling Cerebral edema Elevated intracranial pressure Hypoxia-ischemia Mass lesions (hematoma) Neurochemical Excessive Production of free radicals Excessive release of excitatory neurotransmitters. Disruption of cellular calcium homeostasis.

Delayed White matter degeneration and cerebral atrophy Posttraumatic hydrocephalus Posttraumatic seizures STRUCTURAL EFFECTS

STRUCTURAL EFFECTS

IMPLICATIONS FOR ONSET & RECOVERY

Threshold #1 Threshold #2 Threshold #3 DEALING WITH COMPLEXITY (LIKE ADDICTIONS & MENTAL ILLNESSES) Clinical Impairment

Subclinical Impairment

Impairment Threshold

Intact Function Impairment Threshold

Impairment Threshold Impairment Threshold

Intact Function Clinical Low Challenge Task Impairment

Subclinical High Challenge Task Impairment

Impairment Threshold High Biological Risk Buffer Zone Development Low Biological Risk Intact Function Time Development

Reserve Time

Reserve LACK OF A “GOLD STANDARD” IN BRAIN FUNCTIONING

Clip Source Wikipedia: Thalamus.pgn FAST & SLOW FEAR PATHWAYS

Cerebral Cortex Slow “Circuit” Hippocampus

Thalamus Amygdala

Fast “Circuit”

Adapted from Joseph LeDoux, 1994 Emotional, Behavioral and Hearing Autonomic Responses OBTAINING A BASELINE 1ST MEASURE : HPA & SNS 2ND MEASURE: VAGAL DOMINANCE 3RD: SYS REACTION WITHOUT VAGAL WITHDRAWAL 4TH : STRENGTH : INHIBITION OF HPA 5TH MEASURE : IMMUNE SYSTEM RESPONSE 6TH MEASURE : POSITIVE INCREASES 7TH : ADRENAL CORTEX/ BRAIN HORMONE LEVELS HOW DOES THE BRAIN WORK? HOW DOES THE BRAIN GROW? WHY DOES THE BRAIN’S STRUCTURE MATTER? HOW DO RELATIONSHIPS CHANGE THE BRAIN? HOW CAN WE BUILD HEALTHY BRAINS?

Behavioral Genetics

Evolutionary Developmental Psychology Brain Biology Development

Cognitive- Pediatric Affective Neuropsychology Neuroscience 1ST SCIENCE: BEHAVIORAL GENETICS INHERITED TRAITS BEHAVIORAL GENETICS

Phenotype

Gene Activation / Suppression

Genotype : Loads

Structure of DNA CODING ERRORS

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Mutations: deletion, duplication and inversion. Single_chromosome_mutations.png. Richard Wheeler, 2007. GENETIC LOADING = EXPRESSED TRAITS

Proximal Ultimate Causes Causes SWITCHING GENES ON OR OFF

Genes On/Off Intensity

Up Regulation Expression Promotion Genes Suppression- Down Repression Regulation GENETIC EXPRESSION Phenotype • The Expressed Genetic Content Genotype • The Entire Genetic Content 2ND SCIENCE: DEVELOPMENTAL BIOLOGY FROM 1 CELL TO 10 TRILLION DAY ONE LESSONS FROM DEVELOPMENTAL BIOLOGY

Timetables/Development

Ontogeny & Phylogeny

Fate Maps – Cell Differentiation Active Learning Environmental Genetic In Social Variables Contributions Networks PEDIATRIC NEUROPSYCHOLOGY Clinical Low Challenge Task Impairment

Subclinical High Challenge Task Impairment

Impairment Threshold High Biological Risk Buffer Zone Development Low Biological Risk Intact Function Time Development

Reserve Time

Reserve COGNITIVE AFFECTIVE NEUROSCIENCE MOOD SETS MIND

Memory Storage & Brain Filters Sorting Retrival On Reality WHAT’S A TRIGGER ALL MIND’S DISTORT INFORMATION BIOLOGICAL PSYCHOLOGY Callous Indifference

You MAJOR MILESTONES AGES 3 - 40

Age 40

Age 16

Age 10

Age 3 THE WESTERN SCIENTIFIC DEFINITION OF CHANGE WHY CAN OUR SPECIES CHANGE?

Meta-Cognition Conscious Thoughts Thinking

Mood Feeling

Behaving Habits Choices THE GOOD NEWS!! LACK OF A “GOLD STANDARD” IN BRAIN FUNCTIONING Pre- Relapse Contemplation

Maintenance Contemplation

Action Preparation

Use It or Lose It Use Interference Improves Function

Experience Transference Neuroplasticity Specific &

Age Development Repetition

Salience Intensity Time Neuroplasticity & Use It or Lose It Development Use It or Lose It

Neuroplasticity & Development

Use Improves Function Use It or Lose It

Neuroplasticity & Development Use Experience Improves Specific Function Use It or Lose It

Neuroplasticity Use Repetition & Improves Function Development

Experience Specific Use It or Lose It

Use Intensity Improves Neuroplasticity Function & Development

Experience Repetition Specific Use It or Lose It

Use Time Improves Function Neuroplasticity & Development Experience Intensity Specific

Repetition Use It or Lose It Use Salience Improves Function Neuroplasticity & Experience Time Development Specific

Intensity Repetition Use It or Lose It Use Age Improves Function

Neuroplasticity Experience Salience & Specific Development

Time Repetition

Intensity Use It or Lose It Use Transference Improves Function

Experience Age Neuroplasticity & Specific Development Salience Repetition

Time Intensity Use It or Lose It Use Interference Improves Function

Experience Transference Neuroplasticity Specific &

Age Development Repetition

Salience Intensity Time Change Purposeful Purposeful

Change

Focused Purposeful

Change

Persistent Focused Purposeful

Effort Change Focused

Persistent POLLING QUESTION #2 AS IT PERTAINS TO PEOPLE, THE SAYING “YOU CAN’T TEACH A OLD DOG NEW TRICKS” HAS BEEN SHOWN TO BE: A. A FACT B. PARTLY TRUE C. LARGELY A MYTH THANK YOU!

Joseph Christensen, M.A. Licensed Marriage and Family Therapist Master Addiction Counselor E-Mail: [email protected]

MindMap, LLC WWW.NAADAC.ORG/BRAINDEVELOPMENTANDNEUROPLASTICITY Cost to Watch: CE Certificate Free

CE Hours Available: To obtain a CE Certificate for the time you spent watching this webinar: 1.5 CEs 1. Watch and listen to this entire webinar.

CE Certificate for 2. Pass the online CE quiz, which is posted at NAADAC Members: Free www.naadac.org/braindevelopmentandneuroplasticity 3. If applicable, submit payment for CE certificate or join CE Certificate for NAADAC. Non-members: 4. A CE certificate will be emailed to you within 21 days of $20 submitting the quiz. Upcoming Webinars

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