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Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 1
Robert E. Longo, MRC, LPC, NCC, BCIA‐EEG Serendipity Healing Arts Lexington, North Carolina
Cognition and Emotion: How Our Thoughts and Feelings Look
Inside our Brain and in our Heart
Thank You!
Thank you to Russ Pratt, Jason Freeland,
William Wainwright, and Melissa Braden,
Jessica Pratley, and Dale Tolliday of the
ANZATSA 2013 Conference Committee.
Back Home Brief History of Today’s Presentation
2001 Conferences at turn of century focused on trauma and its impact on the brain.
2007 Began using Biofeedback and
Neurofeedback with sexually abusive youth.
The neurobiological model continues to
evolve.
The mind body sciences continue to advance.
Literature Examples
The China Study (2005) ~ T. Colin
Campbell
Anatomy of and Epidemic (2011) ~ Robert
Whitaker
The Emotional Life of your Brain (2013) ~
Richard Davidson with Sharon Begley
Right Brain vs. Left Brain
Right brain = negative emotions
Left brain = positive emotions
Right brain = dislikes
Left brain = likes
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 2
Patent Filed: April, 2012 VALIDATING SELF-REPORTING WITH BRAIN WAVES
Original Images from Patent
Neutral Positive Avoidance
Prefrontal Lobe Gamma Asymmetry
Negative Reaction Positive Reaction to Smoking
Wellness Assessment
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 3
Definitions “Complementary Medicine,” “Alternative Medicine,” “Integrative Medicine,” “Functional Medicine,” and “Holistic Medicine”
These terms appear on the Internet and in marketing.
They have different definitions and meaning.
The terms are often used to mean the array of health care approaches with a history of use or origins outside of mainstream medicine.
They are actually hard to define and may mean different things to different people.
In a Psychology Today blog, Allen Frances, MD, psychiatrist and
former chair of APA’s DSM-IV Task Force, lambastes APA’s claim that
its DSM-5 revisions process has been “transparent to an
unprecedented degree,” calling it “Newspeak,” the derisive term
writer George Orwell coined in the novel “1984” to describe a
bureaucratic authority’s intentionally misleading speech.
In “Transforming Diagnosis,” Thomas Insel, MD, director of
the National Institute of Health (NIMH), wrote on April 29,
2013:
“The strength of each of the editions of DSM has been
“reliability”—each edition has ensured that clinicians use the
same terms in the same ways. The weakness is its lack of
validity. … “Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC)
project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to
lay the foundation for a new classification system.
Criticism of DSM-V Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system. Through a series of workshops over the past 18 months, we have tried to define several major categories for a new nosology (see below). This approach began with several assumptions:
A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,
Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,
Each level of analysis needs to be understood across a dimension of function,
Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.
Paraphilias
Can we rely on the DSM-V?
Overview
What is Neuroplasticity
What is Biofeedback?
Biofeedback Applications
Electroencephalography
QEEG & Brain Waves
What Measures Show Us
Treatment and Outcomes
Diet and Mood
Heart versus Head
Sayings:
Cut off from feelings.
All choked up.
Get out of your head.
Heart Felt
Heart Sick
Heartless
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 4
What is Neuroplas4city? 1) Change occurs only when the brain is in the mood (attention is critical) (Behavioral circumstances /neurotransmitters are released) 2) Change strengthens connections between neurons engaged at the same
time. 3) Neurons that fire together wire together Brain strengthens things that
reliably occur. 4) Initial changes are just temporary. If the brain judges the experience to be
novel (good or bad) they become permanent. 5) Brain plasticity is a 2 way street + or ‐ can drive brain change positively or
negatively. i.e. chronic pain (brain fires pain signal) and bad habits (become good at the bad habit) can result from plasticity.
6) Memory is crucial for learning. Brain is remembering as we develop a skill. 7) Motivation is a key factor for brain growth and plasticity. When changes occur
new networks are developed. Brain can repair itself and reorganize itself. New skills acquisition is important for plasticity and change.
How neuroplas4city and cogni4ve reserve protect
cogni4ve func4oning
Overall cognitive status can vary across an individual's life span in response to factors that promote either positive or negative neuroplasticity. Positive neuroplasticity refers to he physiological ability of the brain to form and strengthen dendritic connections, produce beneficial morphological changes, and increase cognitive reserve. Negative neuroplasticity refers to the same physiological ability of the brain to atrophy and weaken dendritic connections, produce detrimental morphological changes, and decrease cognitive reserve. Factors that promote positive neuroplasticity include physical activity, education, social interaction, intellectual pursuits, and cognitive remediation. Factors that promote negative neuroplasticity include poor health, poor sleep hygiene, poor nutrition, substance abuse, and depression and anxiety. Implications for promoting positive neuroplasticity and avoiding negative neuroplasticity across the life span are emphasized to facilitate optimal cognitive health and ensure successful cognitive aging.
Vance DE, Roberson AJ, McGuinness TM, Fazeli PL.
The Window of Tolerance
Increased Sensations Emotional Reactivity Intrusive Imagery Disorganized Cognitive Processing Hypervigilance Hyperarousal Zone
______________________________________________________________________
Window of Tolerance Optimal Arousal Zone
______________________________________________________________________
Relative Absence of Sensation Hypoarousal Zone Numbing of Emotions Disabled Cognitive Processing Reduced Physical Movement
The three zones: a simple model for understanding the regulation of autonomic arousal. Page 27. Trauma and the body: a sensorimotor approach to psychotherapy.
2006 Ogden, Minton, & Pain
What is Biofeedback? “Biofeedback is a non‑invasive form of treatment. The therapist a9aches sensors or electrodes to the body and these sensors provide a variety of readings – feedback – which is displayed on the equipment for the patient to see. The signals typically measure skin temperature, muscle tension and/or brainwave function. With this information, patients can learn to make changes so subtle that at first they cannot be consciously perceived. With practice, however, the new responses and behaviors can help to bring relief and improvement to a variety of disorders.”
Definition adopted by BCIA, AAPB and ISNR May 18, 2008
Forms of Biofeedback
Peripheral biofeedback includes physical responses:
1) EMG ‑ Muscular reactivity and tension (Electromyography) 2) Thermal ‑ Hand and foot temperature (Thermofeedback) 3) HRV ‑ Heart rate and blood pressure (Heart Rate Variability) 4) SCL / GSR ‑ Sweat gland activity (Galvanic Skin Response) 5) Respiration ‑ Respiratory function‑breathing pa9erns and rate 6) RSA Feedback (respiratory sinus arrhythmia ‑ heart rate speeding
and slowing from respiration). Brainwave Biofeedback (neurofeedback) addresses brain waves and brain function.
Biofeedback Applica4ons When patients experience trauma, relaxation training is the standard operating procedure for recovery, and includes mindfulness and guided imagery.
Trauma patients need to practice relaxation for 90 days (every day).
Witness state – observing ego (third eye); a distancing technique (the ability to observe yourself in action).
FDA states that biofeedback is a standard relaxation “Therapy”
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 5
Biofeedback
Contraindications Biofeedback seems to have a very low potential for damage (if used properly, of
course.) There are no absolute contraindications and few relative
contraindications for biofeedback:
•Unevaluated symptoms. Biofeedback should not be used for treating unevaluated
symptoms.
•1a. Unevaluated symptoms, Medical: Biofeedback almost always
produces an enhanced feeling of general well-being (APA Task Force, 1980).
Symptomatic relief can mask underlying problems. For a safe and effective
application, a medical evaluation of the client is required before applying
biofeedback.
•1b. Unevaluated symptoms, Psychological: Biofeedback is
contraindicated for psychoses and major affective disorders.
•Cognitive impairment. Cognitive impairments that interfere with an understanding
of the biofeedback process can preclude successful treatment.
•Apprehensive clients: If a client views biofeedback with apprehension the
procedure should not be applied.
http://www.coedu.usf.edu/zalaquett/biofeedback/information.htm
Biofeedback Teaches
Self‑monitoring: how to become sensitive to your stress pa9erns and symptoms, and then
Self‑regulation: how to change these responses to decrease or eliminate discomfort and unpleasant sensations.
Self‑Regulation = Self‑Control
What is a Quan4ta4ve Electroencephalograph?
Quantitative Electroencephalography (QEEG) is the measurement, using digital technology, of electrical patterns at the surface of the scalp which primarily reflect cortical activity or "brainwaves". A multi‐electrode recording of brain wave activity is recorded and converted into numbers by a computer. These numbers are then statistically analyzed and are converted into a color map of brain functioning.
How EEG Works
EEG, is a tool used to image the brain while it is resting or performing a cognitive task. This allows the detection of the location and magnitude of brain activity involved in the various types of cognitive functions. EEG provides the opportunity to view and record brain activity by using electrodes to monitor the amount of electrical activity at different points on the scalp (10‐20 International System).
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 6
10/20 Interna4onal System
BRODMANN AREAS SITE BRODMANN AREA
Fpz 10, 11, 32
Fp1 10, 11, 46
Fp2 10, 11, 46
F7 45, 47, 46
F8 45, 47, 46
FUNCTION
Emotional Inhibition
Oversensitive, Impulsive
Motivation & Attention
Cognitive Emotional Valencing‐ Lateral Orbital Frontal
Irritability, Intrusive, Depression
Social Awareness‐ Approach Behaviors
Emotional Inhibition‐ Lateral Orbital Frontal
Impulsivity, Tactlessness, Mania
Social Awareness‐ Avoidance Behaviors
Working Memory‐ Visual & Auditory
Divided & Selective Attention‐ Filtering
Broca’s Area‐ Semantic Short Term Buffer (Word Retrieval)
Prosody
Working Memory‐ Spatial & Visual, Gestalt
Facial Emotional Processing
Sustained Attention
BRODMANN AREAS SITE BRODMANN AREA F3 8, 9, 46
F4 8, 9, 46
Fz 8, 6, 9
C3 3, 1, 4
C4 3, 1, 4
Cz 6, 4, 3
FUNCTION
Short Term Memory‐ Verbal Episodic Retrieval
Facial Recognition, Object Processing Planning & Problem Solving‐ Wisconsin Card
Sort (rigidity)
Short Term Memory‐ Spatial/Object Retrieval Vigilance Area‐ Selective & Sustained
Attentional Area
Personality Changes Intention & Motivation‐ Poverty of Speech,
Apathy Possible Anterior Cingulate‐ Internal vs.
External Attention Basal Ganglia Output
Sensory & Motor Functions
Sensory & Motor Functions
Sensory & Motor Functions
BRODMANN AREAS SITE BRODMANN AREA
T3 42, 22, 21
T4 42, 22 ,21
T5 39, 37, 19
T6 39, 37, 19
FUNCTION
Language Comprehension‐ Verbal Understanding
Wernicke’s Area‐ Inner Voice Long Term Memory‐ Declarative &
Episodic Processing Event Sequencing‐ Visualization Amygdala/Hippocampal Area
Personality‐ Emotional Tonality (anger, sadness)
Categorization & Organization Visualization Auditory Cortex
Meaning Construction‐ Angular Gyrus Acalcula Short Term Memory
Facial Recognition‐ Emotional Content. Amygdalic connection.
BRODMANN AREAS SITE BRODMANN AREA
P3 7, 40, 19
P4 7, 40, 19
Pz 7, 5, 19
O1, O2 18, 19, 17
Oz 18, 17, 19
FUNCTION
Digit Span Problems Information Organization Problems Self‐ boundaries Excessive Thinking
Visual processing‐ Spatial Sketch Pad, Vigilance
Personality‐ Excessive Self‐concern, Victim Mentality
Agnosia, Apraxia, Context Boundaries, Rumination
Attentional Shifting‐ Perseverance Self‐Awareness, Orientation Association Area Agnosia, Apraxia
Visual Processing Procedural Memory, Dreaming
Visual Processing, Hallucinations
BRODMANN AREAS
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 7
New Study Shows That Stress Can Reduce Brain
Volume And Func4on, Even In Healthy Individuals
“We find that the accumulation of stressful life events was affecting key regions of the brain. These key regions are the regions we believe regulate our emotions, help us control our impulses and help us process our daily experience. They also control our physiology. These regions have implications for long‐term health.”
Ansell, E. (2012) Stress Causes Brain Shrinkage. Brain in The News. The Dana Foundation. February 2012. Page 2.
Emily Ansell is Assistant Professor of Psychiatry, Yale School of Medicine.
QEEG Brain Map Subject is 14 y.o. male with history of TBI, attachment issues, and sexually abusive.
Was adopted at a young age.
Eyes Closed Magnitude & Dominant Frequency
TBI, Mylina4on, Insomnia, and Anxiety
COHERENCE /CONNECTIVITY
Informa4on Processing Problems
ASYMMETRY
Anxiety mixed with Depression EEG Abnormali4es
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 8
Brodmann Loca4ons
Fp1 Cognitive Emotional Valancing, Irritability, Intrusive,
Depression Social Awareness- Approach Behaviors.
Fp2 Emotional Inhibition, Impulsivity, Tactlessness, Mania
Social Awareness- Avoidance Behaviors.
F8 Prosody (the patterns of stress and intonation in a language),
Working Memory- Spatial & Visual, Gestalt, Facial
Emotional Processing, Sustained Attention.
T6 Facial Recognition- Emotional Content, Amygdalic connection
(limbic system, memory).
Under‐arousal (Depression) and Over‐arousal (Anxiety)
Cognitive Processing Brainwave Func4on
Hagmann, P., Cammoun, L., Gigandet, X., Meuli, R. Honey, C.J.,
Wedeen, V.J., & Sporns, O. (2008). Mapping the Structural Core of
Human Cerebral Cortex. PLoS Biology. 6 (7) e159 pp. 1479-1493.
www.plosbiology.org Suggested Supplements
Acetyl‐l‐carnatine
Calcium
Copper
DMAE
Magnesium
Omega‐3s
Pantothentic Acid
Potassium
Theanine
Thiamine
Vitamin B1
Vitamin B12
Vitamin B6
Vitamin C
Vitamin E
Zinc
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 9
Nega4ve Thought or Distrac4ng Thought? Coherence and Calm
The Vagus Nerve The vagus nerve is either one of two cranial nerves which are extremely long, extending from the brain stem all the way to the viscera (all internal organs in the chest, abdomen, and pelvis). The vagus nerves carry a wide assortment of signals to and from the brain, and they are responsible for a number of instinctive responses in the body. You may also hear the vagus nerve called Cranial Nerve X, as it is the 10th cranial nerve, or the Wandering Nerve. A great deal of research has been carried out on the vagus nerve, as it is a rather fascinating cranial nerve. The vagus nerve helps to regulate the heart beat, control muscle movement, keep a person breathing, and to transmit a variety of chemicals through the body. It is also responsible for keeping the digestive tract in working order, contracting the muscles of the stomach and intestines to help process food, and sending back information about what is being digested and what the body is getting out of it. Besides output to the various organs in the body, the vagus nerve conveys sensory information about the state of the body's organs to the central nervous system. 80‐90% of the nerve fibers in the vagus nerve are afferent (sensory) nerves communicating the state of the viscera to the brain.
http://www.wisegeek.com/what‐is‐the‐vagus‐nerve.htm
The Vagus Nerve R. Gevirtz 2012
The vagus nerve: pathway to the limbic
system
The Vegus Nerve The Vegus Nerve
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 10
The Role of Breathing An important distinction involves understanding the role of breathing in the generation of coherence and its relationship to the techniques of the HeartMath System. Because breathing patterns modulate the heart’s rhythm, it is possible to generate a coherent heart rhythm simply by breathing slowly and regularly at a 10‐second rhythm (5 seconds on the in‐breath and 5 seconds on the out‐breath). Breathing rhythmically in this fashion can thus be a useful intervention to initiate a shift out of stressful emotional state and into increased coherence. However, this type of cognitively‐directed paced breathing can require considerable mental effort and is difficult for some people to maintain.
http://www.emwavepc.com/emwave_pc_science_research.html
HeartMath HRV measures emotions and specifically frontal lobe emotional valence.
The first source of HRV is Respiratory Sinus Arrhythmia (RSA) / the heart rate speeding and slowing from respiration.
Emotional Valence – The positivity or negativity of emotions.
Heart Rate Variability Tachogram
Hour‐Long Example
Heart rhythm of a 33‐year‐old male experiencing anxiety. The prominent spikes are due to pulses of activity in the sympathetic
nervous system. http://www.heartmath.org/research/research‐science‐of‐the‐heart‐2‐2/
Low Coherence
High Coherence HeartMath
Ordered and harmonious heart rhythms are an indicator of one’s “coherence level”. High coherence is a state associated with positive emotional a9itudes which send signals to the brain that reduce stress, improve brain function, hormonal balance, immune response, coordination and reaction times. The emWave PC system determines the degree of coherence found in the heart rhythm pa9erns and displays changes in real‑time.
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 11
HRV Time/Interbeat Intervals
Heart rate variability is a measure of the beat‑to‑beat changes in heart rate. This diagram shows three heartbeats recorded on an electrocardiogram (ECG). Note that variation in the time interval between consecutive heartbeats, giving a different heart rate (in beats per minute) for each interbeat interval. [The example above shows the inhale process.]
Physiological entrainment during coherence. The top graphs show an individual’s heart rate variability, blood pressure rhythm (pulse transit time), and respiration rhythm over a 10‑minute period. At the 300‑second mark (center dashed line), the individual used HeartMath’s Quick Coherence® technique to activate a feeling of appreciation and shift into the coherence state. At this point, the rhythms of all three systems came into entrainment: notice that the rhythmic pa9erns are harmonious and synchronized with one another instead of sca9ered and out‑of‑sync. The bo9om graphs show the frequency spectra of the same data. The left side of the graphs shows the spectral analysis of the three physiological rhythms before the shift to coherence. Notice how each pa9ern looks quite different from the others. The graphs on the right show that in the coherence state the rhythms of all three systems have entrained to oscillate at the same frequency.
Heart rhythm paPerns during different emotional states. These graphs show examples of real‑time heart rate variability pa9erns (heart rhythms) recorded from individuals experiencing different emotions. The incoherent heart rhythm pa9ern shown in the top graph, characterized by its irregular, jagged waveform, is typical of stress and negative emotions such as anger, frustration, and anxiety. The bo9om graph shows an example of the coherent heart rhythm pa9ern that is typically observed when an individual is experiencing a sustained positive emotion, such as appreciation, compassion, or love. The coherent pa9ern is characterized by its regular, sine‑wave‑like waveform. It is interesting to note that the overall amount of heart rate variability is actually the same in the two recordings shown above; however, the pa;erns of the HRV waveforms are clearly different.
Plas4city: Heart to Brain Effects As mentioned, vagal stimulation has been shown to effect depression and seizure activity.
Regular practice with an HRV device may: …decrease arousal by promoting an increase in alpha band frequencies and a decrease in beta frequencies overall and in areas critical to the regulation of stress.
(Sherlin et al., 2010, APB,35)
Anxiety/Stress/Overarousal Sadness/Depression/Underarousal
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 12
Integra4on Integra4on
KB 31yof Stress and Insomnia
6/29/2012 First try acer Respirate 6/29/12 Think Posi4ve and Think Nega4ve (Dog=Posi4ve Work = Nega4ve)
Neurofeedback 30 Minute Session HRV during NFB 6/29/2012
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 13
The QEEG brain map below illustrates the pre post tes&ng of a 15 year old male diagnosed with
ADHD and opposi&onal defiant disorder (ODD) in addi&on to sexually abusing a sibling. The pa'ent
par'cipated in weekly biofeedback sessions over a three month period. Of significance is the
lowering of Delta and Theta brain wave magnitude.
2/4/08 Pre‐Treatment
05/09/08 Post‐Treatment
ADHD Post Biofeedback
Diet and Mood Link Between Fast Food and Depression Confirmed
ScienceDaily (Mar. 30, 2012) — A new study along the same lines as its predecessors shows how eating fast food is linked to a greater risk of suffering from depression.
According to a recent study headed by scientists from the University of Las Palmas de Gran Canaria and the University of Granada, eating commercial baked goods (fairy cakes, croissants, doughnuts, etc.) and fast food (hamburgers, hotdogs and pizza) is linked to depression.
Published in the Public Health Nutrition journal, the results reveal that consumers of fast food, compared to those who eat little or none, are 51% more likely to develop depression.
http://www.sciencedaily.com/releases/2012/03/120330081352.htm
A Few Side Notes
Gluten can effect emotion, cognition and behavior.
Food sensitivities can also effect emotion, cognition and behavior.
Gluten on the Brain
Compliments Dr. Richard Soutar Food Sensi4vi4es
Cogni&ons & Emo&ons 24/10/13
Robert E. Longo MRC, LPC, NCC, BCN (c) 2013 14
Food Sensi4vi4es Food Sensi4vi4es
Foods to Check First
Testing can be expensive. Some food allergies and sensitivities are very common.
The following foods trigger allergies and related symptoms (leaky gut/inflammation), so check them first:
Gluten (Wheat)
Dairy
Sugar
Soy
Contact Informa4on
Web site:
www.roblongo.com
E‐mail: