As a clinician, it's important to understand the latest developments in brain science because it explains why traumatized individuals experience such strong and distressing symptoms. This understanding can help therapists choose techniques that change the brain in ways that reduce these symptoms.
Of course, every clinician at some point or another has heard clients bemoan the fact that they just can’t change.
That may be a good time to let them know the findings of cutting edge brain science, including bottom-up and top-down brain change approaches.
Bottom-Up Approaches To Brain Change
Bottom-up techniques work through the body to change the brain, especially the lower, subcortical areas of the brain outside of conscious awareness and conscious control.
Bottom-up techniques may alter these brain areas in the following ways: 1. Less activation in the fear center (Amygdala) of the brain,
which reduces how strongly you react to trauma triggers, increases the relaxation response, and decreases hypervigilance and the feeling of “always being on guard.” 2. More regulated activation of the interoception center (Insula),
which lessens how strongly you react to trauma triggers as well as reduces anger, emotional outbursts, dissociation, and numbing. 3. More activation of the memory center (Hippocampus) of the brain,
which increases feeling of safety, reduces fear, increases ability to cope with negative memories, and helps individuals experience traumatic events as occurring in the past.
Examples of bottom-up techniques include:
- Breathing exercises
- Body scan
- Progressive muscle relaxation
- Autogenic training
- Tai chi
- Some meditations
Top-Down Approaches to Brain Change
In top-down techniques, the mind is engaged to change the brain. In other words, the brain, especially the higher cortical areas, can be altered with thoughts. For example, top-down techniques can be used to strengthen the prefrontal cortex (thinking center) or cingulate (emotion regulation center).
Top-down techniques may alter these brain areas in the following ways: 1. Increased activation of the thinking center (Prefrontal Cortex),
which help improve focus, concentration, problem-solving, decision-making, self-awareness, emotional intelligence, and connection to others. 2. Increased activation of the emotion regulation center (Cingulate Cortex),
which helps improve conflict monitoring, emotion regulation, thought regulation and, more broadly, self-regulation.
Examples of top-down techniques include:
- Cognitive reappraisal or restructuring
- Talk therapy
- Some acceptance and commitment therapy techniques
- Trauma-focused interventions that emphasize discussing traumatic events in detail
- Some meditations
Learn how to put some of these techniques into action by downloading this FREE WORKSHEET on Brain-Changing Tips, Tools & Handouts to Move Therapy Forward,
from my new book Trauma Treatment Toolbox.