Alternative Approaches to TBI,PTSD and Burnout

V o l u m e O n e

Alternative Approaches to TBI, PTSD and Burnout

Cynthia Beard, Tamme Buckner, Vija Rogozina, Kelley Seriano

Edited by Megan Winkler, NSI Editorial Coordinator

Jan 16

08 Fall

Neurosculpting® Journal Vol. 1, Jan 2016

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Contents Meditative Approaches for Traumatic Brain Injury Recovery ................................................ 2

Neurosculpting® Yoga Mitigates Burnout in Athletes ............................................. 11

Unaddressed PTSD in Adult Sufferers of Childhood Abuse and Application of Neurosculpting® Modality ........................................................................................... 15

Meditation and the Mind-Body Connection in Athletes ........................................... 22

Meditative Approaches for Traumatic Brain Injury Recovery Cynthia Beard, Certified Neurosculpting® Facilitator Fellow Introduction With the increased visibility of meditation practices and instruction in recent years, researchers are exploring how meditation impacts various clinical populations. Interest in the impacts of meditation on those recovering from traumatic brain injuries (TBI’s) has led to several research studies and many anecdotal reports on the subject. Reports are mixed on the efficacy of meditation in this population, depending on the type of meditation that is used. At the very least, there are no conclusive indications that meditation is harmful to those with TBI’s. Further explorations of specific types of meditation, along with other circumstances, could yield a deeper understanding of when and how to incorporate meditation into TBI recovery. In addition to summarizing the state of research on the subject, this paper will also make suggestions about the application of the Neurosculpting® modality for those who have sustained a TBI. Definition and Scope Although the term “concussion” is popular in casual conversation, the “traumatic brain injury” (TBI) is a broader term used in clinical settings to describe a variety of injuries that impact the brain. The National Institute of Neurological Disorders and Stroke (NINDS) defines traumatic brain injury as: “a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.”1 The symptoms can vary, depending on the location and severity of the injury, and some people might not realize that they have sustained a TBI. Although loss of consciousness does not always occur with mild TBI’s, even a mild TBI has the potential to result in a momentary loss of consciousness. NINDS lists the main symptoms of a mild TBI as: “headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking.”2

1 "Traumatic Brain Injury: Hope Through Research." Traumatic Brain Injury: Hope Through Research. Accessed January 14, 2016. http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm. 2 Ibid.


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More severe TBI’s, on the spectrum of moderate to severe, can involve other symptoms, and in some instances, X-‐rays and a computed tomography (CT) scan are needed to determine whether the injury includes bone fractures or other skeletal structural problems. NINDS describes the symptoms of moderate and severe TBI’s as including “a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation,” in addition to the symptoms of a milder TBI.3 Although it is difficult to determine the number of TBI’s that occur each year, due to underreporting, it is believed that approximately 5.3 million people in the U.S. have a disability caused by a TBI. The number of people impacted in Europe is 7.7 million.4 A rise in the number of reported cases is believed to be associated with a rise in motor vehicle usage.5 In the U.S. as of 2010, it is estimated that 235,000 people are hospitalized due to a TBI, with 1.1 million people receiving treatment in emergency rooms. In addition to these non-‐fatal instances of TBI, approximately 50,000 people in the U.S. die due to complications from severe TBI’s.6 These numbers indicated that the vast majority of TBI patients survive the injury. The Department of Defense tracks the estimated number of U.S. military service members and veterans who are diagnosed with a TBI. The number of cases has grown substantially since the year 2000, perhaps due to wider awareness among physicians. While the year 2000 saw a reporting of 10,958 cases in the U.S. military, by 2011 the number of cases was 32,907. Since then, there has been a slight decline in instances, with 2014 totaling 25,111 cases. Most of the cases of TBI in the military are classified as mild, with active service members typically returning to work within seven to ten days.7 Treatment, Recovery, and Complications The treatment for traumatic brain injuries can vary depending on the severity of the injury. While mild injuries typically require almost no formal care, moderate and severe injuries might involve outpatient or inpatient hospital visits, follow-‐up appointments, and rehabilitation plans.8 Even mild TBI’s (often referred to as concussions) should be monitored to ensure that the symptoms do not worsen over time. During the initial recovery phase, it is important for the patient to take efforts not to exhaust the brain’s ability to process cognitive information. Physical rest is also recommended in order to prevent the injury from worsening.

3 Ibid. 4 Bob Roozenbeek, Andrew I.R. Maas, and David K. Menon, “Changing Patterns in the Epidemiology of Traumatic Brain Injury,” Nature Reviews Neurology 9 (April 2013): 231. 5 Ibid, 232. 6 J.D. Corrigan, A.W. Selassie, and J.A. Orman, “The Epidemiology of Traumatic Brain Injury.” Journal of Head Trauma Rehabilitation 25 (March-‐April 2010): 72-‐80. 7 DoD Worldwide Numbers for TBI. http://dvbic.dcoe.mil/dod-‐worldwide-‐numbers-‐tbi. 8 Mayo Clinic Staff, “Traumatic Brain Injury: Treatments and Drugs.” http://www.mayoclinic.org/diseases-‐conditions/traumatic-‐brain-‐injury/basics/treatment/con-‐20029302


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Moderate and severe TBI’s are ideally diagnosed in an emergency room setting, in order for the severity of the injury to be evaluated thoroughly. This type of injury might also be accompanied by other issues, and there is the potential for secondary damage to occur in the aftermath of the initial injury. The early stage of treatment involves monitoring the patient’s vital signs, including blood pressure and oxygen saturation level, along with further assessment of other potential symptoms or complications. In some instances, medications are prescribed to treat the initial injury and reduce the possibility of complications. These can include diuretics to ensure that there is no buildup of fluid and anti-‐seizure medications to prevent further damage to the brain and body. Severe TBI’s might require the patient to be put into a medically-‐induced coma to allow the brain to receive adequate rest. If a TBI is particularly severe, surgery may also be necessary to address secondary aspects of the injury. Bleeding caused by the injury could lead to blood clots, which might need to be removed, and any bone fractures in the skull could also need surgical intervention. In cases where there is too much pressure on the brain due to swelling, a surgeon might create an opening that will allow space for the pressure to be relieved, as well as the ability to drain excess fluid. After these early stages of emergency care and intervention, the physician might refer the patient to therapeutic care specialists for ongoing rehabilitation. These could include a psychiatrist or other psychological care coordinator, alongside therapists who work with the patient on a regular basis. Physical and occupational therapy can play an important role in helping the patient restore functionality to daily activities. Speech therapy may also be advised if the patient faces challenges in communication. A vocational therapist can help the patient identify whether the patient will need to seek a new field of employment in order to prevent further injury post-‐recovery. The patient may also receive further referrals based on the specific needs that are identified, and a social worker or case manager could be beneficial in identifying financial and other resources for support. Because of the emotional and cognitive stress caused by TBI’s, patients are often encouraged to seek support in order to cope with various daily challenges.9 These might include joining a support group, writing down things that might be difficult to remember otherwise, establishing and maintaining a daily routine for consistency, and making modifications to one’s work schedule and other responsibilities such as family obligations. Patients should also allow adequate time to rest between activities, take time off from work, if possible, reduce distractions such as noise and other sensory stimulations, and avoid multitasking.

9 Mayo Clinic Staff, “Traumatic Brain Injury: Coping and Support.” http://www.mayoclinic.org/diseases-‐conditions/traumatic-‐brain-‐injury/basics/coping-‐support/con-‐20029302


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Although most TBI patients do not face life-‐threatening complications, there are instances when the location and severity of the injury may lead to serious risks.10 These can include prolonged loss of consciousness, including the possibility of coma, a persistent vegetative state, or in rare instances no activity in the brain stem (referred to as brain death). Typically, a coma can improve to where the patient has, at least, a partial consciousness that will gradually lead to an increased awareness and more active consciousness. Other complications that need to be monitored are conditions that could escalate to further risks if left unaddressed. These can include fluid buildup, infections (including meningitis), damage to the blood vessels, nerve damage, cognitive and communication problems, emotional changes (such as depression or anxiety), sensory problems and sensitivities, and degenerative brain diseases. Due to the wide scope of scenarios that can occur with TBI’s, there is no fixed recovery time that a patient can anticipate. The symptoms of a mild TBI might improve in the course of a week or possibly a month, but the symptoms of moderate to severe TBI’s can persist much longer.11 Moderate injuries may take six to nine months before the patient feels a sense of full recovery, although there are instances where the recovery process might last for years or even a lifetime.12

State of Research While there have been numerous studies on the use of meditation for recovery from traumatic brain injury, varied outcomes have led to recommendations that further studies should be conducted. One research review, in particular, analyzed 17 studies from a larger selection of 42 studies, and determined that there is some, albeit limited, evidence that treatment plans incorporating meditation can be helpful. The authors of this review focused on the benefits of cognitive behavioral therapy (CBT), while noting that more comprehensive treatment plans are not as widely used.13 Another review includes a bibliographic compilation of several research studies on the impact of Jon Kabat-‐Zinn’s mindfulness teachings on patients with TBI’s. While some studies have shown that mindfulness practices are helpful for those recovering from a TBI, another study did not find there to be a measurable benefit.14 The summary recommended that the location and severity of the injury might determine whether to incorporate meditation into a recovery treatment program.

10 “Traumatic Brain Injury: Complications.” http://www.mayoclinic.org/diseases-‐conditions/traumatic-‐brain-‐injury/basics/complications/con-‐20029302 11 Michigan TBI Services and Prevention Council, Recovering from Mild Traumatic Brain Injury/Concussion: A Guide for Patients and Their Families, 2008. https://www.michigan.gov/documents/mdch/TBI_Recovery_Guide_10.8.08_252053_7.pdf 12 Glen Johnson, Traumatic Brain Injury Survival Guide, 2010. http://www.tbiguide.com/getbetter.html 13 A.l. Sayegh, D. Sanford, and A.J. Carson. “Psychological approaches to treatment of postconcussion syndrome: a systematic review.” Journal of Neurology, Neurosurgery, and Psychiatry. Vol. 81, No. 10. October 2010. p. 1128-‐34. http://www.ncbi.nlm.nih.gov/pubmed/20802219 14 “Can Meditation Help TBI?” http://hprc-‐online.org/mind-‐tactics/hprc-‐articles/can-‐meditation-‐help-‐tbi


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There is currently a study underway with the Veterans Administration Office of Research and Development, in collaboration with the Graduate School of Psychology at Palo Alto University. This study will measure brain activity using functional magnetic resonance imaging (fMRI) before and after an 8-‐week meditation program called Inner Resources for Veterans (IRV) in comparison to a group that will receive educational information about PTSD and TBI without meditation.15 As of November 2015, the study was still recruiting participants. Anecdotal Reports Much of the anecdotal reports on the benefits of meditation for TBI recovery have focused on mindfulness techniques, as taught by Jon Kabat-‐Zinn. For instance, an article targeted toward social workers has advocated that social workers should learn about Kabat-‐Zinn’s mindfulness teachings and promote that particular modality for veterans who are recovering from TBI and post-‐traumatic stress disorder (PTSD).16 The author specifically recommended Kabat-‐Zinn’s eight-‐week Mindfulness-‐Based Cognitive Therapy (MBSR) program of mindfulness training at the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. In another article on the subject, the author has summarized a case study of a person recovering from a TBI, and how she has gone on to study mindfulness meditation in greater depth with Kabat-‐Zinn. The author also outlined a three-‐minute breath meditation that could be used by readers.17 One challenge in evaluating the effectiveness of meditation and mindfulness practices is that meditation teachers and healthcare practitioners cannot always ascertain whether TBI patients are applying these techniques regularly. For instance, a blog on a U.S. military website discusses mindfulness meditation training for veterans recovering from TBI. The author went on to qualify his remarks by acknowledging the limitations of the statistical data on the percentage of veterans who are regularly meditating.18 While a lot of the discussions about meditation for those with TBI’s has focused on the military, another population that receives attention is athletes recovering from sports-‐related injuries. In an online PowerPoint presentation by a physical therapist, the author concluded: “It is recommended that athletes learn how to meditate BEFORE they sustain an injury of any kind to help their recovery.” Another recommendation, which will be further explored later in this paper, is: “The athlete needs to find the type of meditation that works best for them.”19 Finally, some anecdotal reporting on implementing meditation practices for TBI recovery has stemmed from personal experiences. Although these personal accounts might be dismissed by those who prefer

15 “Meditation in Veterans With PTSD and Mild TBI.” https://clinicaltrials.gov/ct2/show/NCT02280304 16 Kate Jackson. “Mindfulness-‐Based Approaches to Traumatic Brain Injuries.” Social Work Today. Vol. 14, No. 6, p. 18. http://www.socialworktoday.com/archive/111714p18.shtml 17 Victoria Tilney McDonough, “The Role of Mindfulness, Meditation, and Prayer After Brain Injury,” http://www.brainline.org/content/2009/12/the-‐role-‐of-‐mindfulness-‐meditation-‐and-‐prayer-‐after-‐brain-‐injury_pageall.html 18 Myron J. Goodman. “Let Your Brain Relax: Mindfulness Meditation Can Reduce Some TBI Symptoms.” 15 April 2015. http://www.dcoe.mil/blog/15-‐04-‐15/Let_Your_Brain_Relax_Mindfulness_Meditation_Can_Reduce_Some_TBI_Symptoms.aspx 19 Barbara Rein, PT, ATC., “Meditation and Sports Medicine.” https://www.braininjurymn.org/annual_conference/CONF-‐2013-‐presentations/Thursday-‐III-‐E-‐Rein.pptx


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statistical evidence and research reports, patients seeking holistic treatment plans will still find value in learning from those who have had similar personal experiences. In one instance, the author observed that her acceptance of her current situation was crucial to her recovery, and also that she benefited from meditation.20 She did not mention the type of meditation that she practiced, however, or whether she already had a practice prior to the injury. Another online resource is a series of videos by someone who has recovered from a TBI. The videos include guided meditations that can be accessed for free, and the facilitator has developed a teaching practice that delves further into meditative studies.21 Types of Meditation There are a number of meditation modalities that are popular and widely known in various parts of the world. Some meditation approaches are incorporated into a larger spiritual practice, while others are secular or not attached to a specific religious tradition. In the case of meditation for TBI patients, Jon Kabat-‐Zinn’s mindfulness teachings have received the most attention. There are also a number of guided meditations that have been made widely available for free or, in some instances, to be purchased. These guided meditations do not necessarily have an association with a particular modality. Listener feedback to some guided meditations indicates that the usefulness of directed meditations can vary depending on the circumstances. For instance, Amazon reviewers of one meditation recording have mixed reports. While most reviewers indicated that the recording was very helpful, another reviewer conveyed that the narration was too difficult to follow post-‐concussion.22 Another emerging modality called Neurosculpting® also shows promise for those recovering from TBI’s. Again, there are some specific considerations that need to be taken into account when applying Neurosculpting® in this setting. This will be discussed in greater detail in the next section. Neurosculpting® is a modality developed by Lisa Wimberger that connects the science of meditation with the actual practice. In group and individual sessions, the facilitator addresses how the brain responds to stress, and recommends various ways to tap into the brain’s ability to rewire itself. This basic premise is supported by research over the past two decades on the neuroplasticity of the brain, and the ways in which the neurology of the brain can change over time.23 One goal of Neurosculpting® is to reduce the influence of the limbic brain (the fight-‐or-‐flight center) and enhance the prefrontal cortex (the logic and compassion region of the brain).

20 Mandy Rogers. “Losing My Identity After a Concussion.” 14 December 2012. http://www.mindbodygreen.com/0-‐7101/losing-‐my-‐identity-‐after-‐a-‐concussion.html 21 Lesley Ewen, “Breath Meditation.” http://brainstreams.ca/learn/healing-‐brain/breath-‐meditation 22 Belleruth Naparsteck, Meditation for Traumatic Brain Injury (TBI), Health Journeys, Inc. 3 September 2012. http://www.amazon.com/Meditation-‐Traumatic-‐Brain-‐Injury-‐TBI/dp/1935072102 23 Eric Garland, “Neuroplasticity, Psychosocial Genomics, and the Biopsychosocial Paradigm in the 21st Century,” in Health & Social Work Vol. 34, No. 3 (2009): 191-‐199. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933650/


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All Neurosculpting® meditations involve the same basic format, with the specific narrative content modified based on a client or group’s needs. A basic outline of a Neurosculpting® meditation can be mapped out this way: Part one is a down-‐regulation of hyperactive amygdala activity and an engagement with parasympathetic response. Part two involves practices to enhance activity in the prefrontal cortex for emotional regulation. Part three increases the activity across the corpus callosum between Wernicke’s and Broca’s area in the left hemisphere and their counterparts in the right hemisphere, as well as increasing activity in the parietal lobes as related to proprioception through visual and sensory-‐motor cueing. Part four links somatosensory engagement to perceptual shifts in patterns. Part five enables the user to easily identify and replicate the process in day-‐to-‐day activities.24 Part three, in particular, can vary based on a specific topic, such as navigating change or coping with grief, and sessions with individuals can be tailored more specifically to a client’s needs. Neurosculpting® and TBI In working with a client who is recovering from a severe TBI, I have made some observations about the complexities of teaching meditation in this type of situation. The client had a long-‐time existing Buddhist meditation practice prior to the injury, and had also studied Neurosculpting® previously. We realized in our initial post-‐concussion session that the client had a limited ability to process detailed narratives in meditation. As a result, we shifted to a more basic guided breath meditation that still used the Neurosculpting® format. We spent about twenty minutes focusing on the breath, which included visualizing the breath as a color associated with empowerment. The client imagined the color of empowerment filling the body in a way that offered a sense of strength in the midst of healing. Over time, we gradually introduced other visualization elements into the meditations, while still being careful not to overstimulate the client. One success involved the merging of the Neurosculpting® model with the progressive relaxation techniques of autogenics. Dr. Norman Katz, Ph.D., has adapted autogenics to a style that is less rigid than the original format that was taught by Dr. Johannes Heinrich Schultz. Katz has explained: Autogenic training is a psychological method of self-‐hypnosis to promote healthy reactions of mind and body and to integrate said reactions. The autogenic state is similar to hypnosis. Hypnotic imagery is used to enhance and deepen the autogenic process. The results of becoming proficient in the process may enable you to achieve rest, recuperation, self-‐relaxation,of the autonomic nervous system functions, pain relief, quicken sleep and better knowledge of self. All possible results . . . cannot be guaranteed, but have been noted in the research.25 While combining autogenics with Neurosculpting®, we maintained the Neurosculpting® format that begins with a down-‐regulation of the amygdala and the tendency toward a fight-‐or-‐flight response. Part three, as described in the previous section of this paper, was the part of the meditation where we

24 Lisa Wimberger, http://neurosculptinginstitute.com/what-‐is-‐neurosculpting/ 25 Norman Katz, http://www.normankatzphd.com/autogenics-‐training.html


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introduced autogenics cues. The client appreciated the opportunity to focus on the body, such as this suggestion: “My body is warm,” even noticing a warming sensation in the body as the mind focused on imagery associated with warmth. Because Neurosculpting® meditations tend to use color associations for various concepts (such as empowerment, as mentioned earlier), we continued to apply this technique alongside the autogenics cues. For instance, with the statement “My body is warm,” I encouraged the client to envision colors that could be associated with warmth. Another aspect of Neurosculpting® that was merged with autogenics involved physically tapping with the fingers areas that felt activated during the meditation. An example of this might involve tapping the fingers of one’s non-‐dominant hand to the center of the chest if the chest feels less constricted. This “somatosensory engagement” (as described above) entrains further neural associations between the fingers and other parts of the body, which can be recalled as a way to cope with stressful moments long after the meditation is over. In other words, in a moment of stress during the course of a day, the client can tap the part of the body, such as the chest, that had felt a sense of tension release during the meditation. We experimented with this combination of Neurosculpting® and autogenics for several sessions while increasing the narrative complexity of the meditations. For instance, along with the autogenics cues that focus on different aspects of the body, we began to add more color visualizations that helped the client feel a greater sense of inner strength and courage. When I asked the client to imagine a color associated with courage, that color could then be drawn in with the breath, in tandem with the autogenics cue, “My breath is slow and steady.” The goal in making the meditations progressively complex was to facilitate the client’s ability to process more verbal information, which indeed was the result. Holistic Approaches to Traumatic Brain Injury Treatment Earlier in the paper, it was mentioned that treatment for TBI’s can vary based on the extent and location of the injury. In the case of the client for whom Neurosculpting® was blended with autogenics, the client was aware that meditation is not a substitute for clinical care. Neurosculpting® facilitators function as instructors, and not as clinical diagnosticians or therapists. The client continued to have regular appointments with a team of healthcare providers who planned the client’s treatment plan. This included physical therapy, occupational therapy, and appointments with a physician. Each of those practitioners monitored the patient’s overall progress during the recovery process. Because Neurosculpting® is not clinical care, the meditation sessions with the client were considered elective and not part of an official treatment plan. For those who seek out meditation instruction, it is important to remember that a meditation facilitator is not in a position to provide medical advice, but rather, to teach techniques that can help the client develop skills to enhance neuroplasticity. Conclusion Traumatic brain injuries affect people in different ways, depending on the severity and the location of the injury. Some injuries improve quickly, while others linger for months and possibly even years. Due to this vast scope of possibilities, the experience with meditation will vary based on a given set of circumstances. If someone who is recovering from a TBI would like to incorporate a meditation practice into the healing process, the main suggestion would be to keep the meditations as basic as possible. Over time, it is


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possible to increase the complexity, but there is no need to rush the process or to expect a certain outcome in a defined period of time. As blogger Mandy Rogers wrote about her own journey, which was quoted earlier in this paper, accepting one’s current situation and allowing the present moment to exist without resistance is an important step in navigating the recovery process.26 Meditation is not a competition, and each day can present a different set of circumstances. Ultimately, learning how to make peace with one’s recovery process will help to down-‐regulate that part of the brain that is conditioned to respond with fight-‐or-‐flight, and that is a form of healing in itself.

26 Mandy Rogers. “Losing My Identity After a Concussion.” 14 December 2012. http://www.mindbodygreen.com/0-‐7101/losing-‐my-‐identity-‐after-‐a-‐concussion.html


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Neurosculpting® Yoga Mitigates Burnout in Athletes Kelley Seriano, Certified Neurosculpting® Facilitator Fellow and Neurosculpting® Yoga Teacher Introduction Celebrities, professional athletes, and CEOs around the world have a little secret that allows them to work overtime while not burning out. Meditation allows the brain and body to reset. Neurosculpting® meditation refers to resetting as brain calibration. It is any regular, mindfully taught therapeutic yoga, plus some. Science has shown us that combining meditation with movement helps rebuild a new positive thought pattern with greater strength, hence Neurosculpting® Yoga was developed. The co-‐creator of Neurosculpting® Yoga, Michelle Lee, explains the process like this: Think of yoga as a seed, a source full of healing in and of itself. If yoga is a seed, you might think of Neurosculpting® Yoga as a nutrient-‐rich blanket gently layered on top of the yoga seed to nourish, expand and even amplify the potential. Using Neurosculpting® language, specific sequencing, and guided visualization Neurosculpting® Yoga enhances the whole-‐brain process involved in both regular yoga and meditation to create an even deeper integration between right and left hemispheres of the brain to prime your mind, body, and spirit for a more complete healing experience. Brain-‐body calibration, originally developed to help those suffering from pain, has shown tremendous positive effects on athletes, including those at the professional, Olympic and college levels, as well as weekend warriors. Definition and Scope The Neurosculpting® Yoga process: The languaging is specific, to create psychologically safe spaces and calm the resistance center of the brain. Naturally in athletics, individuals are taught to push harder, get competitive and really fire up the adrenaline and cortisol in the body. Neurosculpting® Yoga helps remove excess adrenaline and cortisol in an individual by bringing their nervous system from a sympathetic nervous condition to parasympathetic state. Not only burnout, but illness and disease can come from being stuck in the sympathetic nervous system for too long. The dharma talk in regular yoga is enhanced in Neurosculpting® Yoga to incorporate a neuroscience nugget to engage the left hemisphere of the brain, followed by brief grounding meditation. This is where brain recalibration happens. In turn, this process will allow the individual to build neuroplasticity in their brain. Neuroplasticity helps with learning. In turn, not allowing the individual to form counter-‐productive habits that may cause burnout. Rather, enhance the positive and more fulfilling thoughts. This process engages the prefrontal cortex for creating more permission and compassion. This is a way to override any reactive response to an athlete’s performance. The yoga asana is sequenced mindfully with grounding pauses to incorporate the theme through breathwork, somatic tapping, and visualization. Much can be said for grounding; grounding resets the body and helps an individual get the prefrontal cortex online, while down-‐regulating the flight, fight, or


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freeze condition of the limbic center which has shown to be is where an individual is at in the case of burnout. Breathing allows the diaphragm to open, which creates more space for deeper breathing, again, encouraging rest, digest, and a calm body. Somatic tapping has proven to release any subconscious stress or trauma from the body and is extremely proficient in rewriting any failures in the game or memories that may inhibit achievement. An athlete will have the ability to map towards positive experiences, like winning the game and ultimate peak performance. The final savasana is longer, and may be done sitting up or laying down. It incorporates a Neurosculpting® meditation with Neurosculpting® language to help fill in a desired quality. Permission to lay down will just be another way to rebuild muscles that may be overused while kicking in the parasympathetic nervous system. One out of five of the most competitive elite athletes reported injury as the reason for quitting one’s sport. Rest and digest will help avoid injury and disease. Findings on Burnout Cutting-‐edge physical training programs frequently require overloading athletes to obtain maximum training gains. This can take both a physical and mental toll on an athlete. The pressures to do and achieve more keep growing, and far too rarely is consideration given to the costs of operating in this non-‐stop fashion. With the heavy amounts of pressure that is on athletes today, performance can begin to decline and suffer and/or an athlete can start breaking down emotionally and physically. Sports are synonymous with intense competition. The state of burnout is often regarded as the endpoint of this breakdown process and is characterized by the absence of energy and motivation as well as complete mental and physical exhaustion. What leads to burnout is too much emotional pressure and training stress coupled with too little recovery and constantly being in a sympathetic nervous state. Training stress can come from a variety of sources on and off the field, such as physical, travel, time, or social demands (e.g., Metzler, 2002). Tons of models have been developed to explain how the burnout process unfolds. One of them, proposed by Silva (1990), conceptualizes burnout as a training stress syndrome where too much stress can first produce staleness, then overtraining, and eventually burnout. All of these things are related back to our brain. Our brain doesn’t know the difference between what is happening and what isn’t. This is true with our thoughts; our thoughts affect our performance. Part of the remedy for dealing with the ups and downs of the sports rollercoaster involves knowing that every day will not be the same. Staleness is defined by a clear drop in athlete motivation and a plateau in performance. Being overtrained combined with no sense of grounded space causes athletes to often exhibit psychophysiological malfunctions and performance declines. Overtrained athletes are more likely to think thoughts of defeat which in turn cause actions of defeat because the limbic center, which is the reactive part of the brain that has taken over. According to Silva and many other sport scientists who have studied burnout, the only way to halt this cycle is to rest, usually not a satisfying prescription to athletes who feel they cannot stop and want to “push through” their negative thoughts and symptoms. Raedeke (1997) has suggested that an x-‐factor in burnout could be a sense of being trapped by circumstances within a sport. In other words, an athlete may recognize a need to stop, but feel compelled to continue (e.g., to keep a scholarship, social pressure, or starting role), which can further exacerbate training stress.


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Another factor that can contribute to burnout is the nature of an athlete’s motivation, again a sign that the athlete is operating from the limbic center of the brain, fight or flight. Individuals in our culture typically get involved with sports for different reasons like having fun, learning new skills, getting exercise, and making new friends (e.g., Ewing & Seefeldt, 1989). Intrinsic motivation has been linked to superior athletic performance, including the peak performance state known as flow (e.g., Csikszentmihalyi, 1990). Athletes may sometimes end up feeling controlled by the very rewards they are pursuing, which may undermine their raw desire to participate in their sport and create a sense of being trapped, potentially fueling burnout (Weinberg & Gould, 2011). Taking a step back, and seeing the bigger picture can allow for avoiding burnout. Burnout is the brain’s limbic center, which is the stress response kicking in. Your brain’s stress response kicks in when you perceive you are under threat. The thought of losing a game or not performing at peak level can cause a downward spiral. It works like this: the amygdala is an almond-‐shaped structure in the brain. Its name comes from the Greek word for “almond.” As with most other brain structures, you actually have two amygdalae. Each amygdala is located close to the hippocampus, in the frontal portion of the temporal lobe. Your amygdalae are essential to your ability to feel certain emotions and to perceive them in other people. This includes fear and the many changes that it causes in the body. If you are being followed at night by a suspect-‐looking individual and your heart is pounding, the chances are that your amygdalae are very active. The adrenals, the hormones they secrete, and the nervous system make up the stress response system (or SRS). Your SRS is the basis of the mind-‐body connection. This network is the interface between mind and body, and is how the body communicates with the mind and the mind communicates with the body. Mammals have evolved this superb mechanism to ensure we have the best possible chance of survival when faced with a life-‐threatening situation. Imagine you are in the game and you are about to score a point and you hear movement behind you. You stop still, heart pounding and turn your head to orientate your eyes and ears to the sound. You see the competitor pounding towards you – then your competitor blocks you from scoring a point. At times like this you’d want every muscle in your body to work to the peak of its ability – and your brain to on.

"A state of fatigue or frustration brought about by devotion to a cause, way of life, or relationship that failed to produce the expected reward."— Herbert J Freudenberger, U.S. psychologist who coined the term "burnout." "A state of physical, emotional and mental exhaustion caused by long-‐term involvement in emotionally demanding situations." — Elliot Aronson, Professor Emeritus of Psychology at the University of California.

Burnout is considered a process, not an event. A build-‐up of symptoms slowly takes us out of our prefrontal cortex, which is the executive thinking center, our natural resources for coping with pressure and strain. Everyone has their own breaking point, both emotional and physical, and in burnout, our brain finally tells us that enough is enough.


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A key factor in burnout is that it often affects the most dedicated and motivated people along with the mildly interested. It strikes people who are highly committed to their work, and is characterized by deep exhaustion and a profound sense of disillusionment, due to the emotional and physical drain. Burnout happens to the best of us. Putting a Neurosculpting® Yoga program in organizational sports is something that is becoming more and more common. We now understand the five-‐step process can address the major burnout symptoms. References and Sources "Stress and the Brain." Stress and the Brain. Accessed January 17, 2016. http://www.youramazingbrain.org/brainchanges/stressbrain.htm. http://www.cic-‐learning.co.uk/alertnet trauma/study/page/show/159/understanding_stress/types_of_stress_and_symptoms "THE BRAIN FROM TOP TO BOTTOM." THE BRAIN FROM TOP TO BOTTOM. Accessed January 17, 2016. http://thebrain.mcgill.ca/flash/d/d_04/d_04_cr/d_04_cr_peu/d_04_cr_peu.html. Kaufman, Keith A. "Understanding Student-‐Athlete Burnout." NCAA.org. December 10, 2014. Accessed January 17, 2016. http://www.ncaa.org/health-‐and-‐safety/sport-‐science-‐institute/understanding-‐student-‐athlete-‐burnout. Giordano, Rose. "How Athletes Avoid Burnouts." ACTIVE.com. Accessed January 17, 2016. http://www.active.com/health/articles/how-‐athletes-‐avoid-‐burnouts. Scalco, Daniel. "8 Simple Ways to Avoid Burnout." The Huffington Post. April 16, 2015. Accessed January 17, 2016. http://www.huffingtonpost.com/daniel-‐scalco/burnout-‐tips_b_7065300.html. "Neurosculpting® Yoga -‐ The Neurosculpting Institute." The Neurosculpting Institute. 2015. Accessed January 17, 2016. http://neurosculptinginstitute.com/neurosculpting-‐yoga/. Stricker, Paul R. "Pressure to Perform." HealthyChildren.org. November 21, 2015. Accessed January 17, 2016. https://www.healthychildren.org/English/healthy-‐living/sports/Pages/Pressure-‐to-‐Perform.aspx. Rubenstein, David. "Brain-‐Body Calibration Reduces Time Athletes Spend on Disabled List and Provides Anti-‐Aging Benefits." Marketwire. March 22, 2011. Accessed January 17, 2016. http://www.marketwired.com/press-‐release/brain-‐body-‐calibration-‐reduces-‐time-‐athletes-‐spend-‐on-‐disabled-‐list-‐provides-‐anti-‐aging-‐1415868.htm. Seal, KH, TJ Metzler, KS Gima, D. Bertenthal, S. Maguen, and CR Marmar. "Result Filters." National Center for Biotechnology Information. September 1, 2009. Accessed January 17, 2016. http://www.ncbi.nlm.nih.gov/pubmed/19608954. Lonsdale, Chris, Ken Hodge, and Elaine Rose. "Athlete Burnout in Elite Sport: A Self-‐determination Perspective." Journal of Sports Sciences 27, no. 8 (2009): 785-‐95. "Mihaly Csikszentmihalyi." Pursuit of Happiness. March 25, 2010. Accessed January 17, 2016. http://www.pursuit-‐of-‐happiness.org/history-‐of-‐happiness/mihaly-‐csikszentmihalyi/.


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Unaddressed PTSD in Adult Sufferers of Childhood Abuse and Application of Neurosculpting® Modality Vija Rogozina, Certified Neurosculpting® Facilitator Fellow

Introduction In the world of contemporary neuroscience, the mind-‐body connection has finally been established as an empirically proven fact. Now that numerous research studies confirm that the mind and body are interconnected and inseparable, the word ‘mindbody’ has been suggested to convey the real state of things. Since mindfulness and meditation techniques began to gain recognition for their long-‐term benefits, they have received much interest and visibility in the media. However, the rest of the medical world and mental health system protocols are still catching up to tangibly incorporate the mind-‐body connection into practical, effective solutions that provide long-‐term healing beyond dealing with the symptoms. This gap can be debilitating, especially for those suffering from neurodegenerative issues that include post-‐traumatic stress disorder (PTSD) as an originating cause, particularly PTSD caused by childhood abuse, as this has commonly gone untreated early on and can remain unaddressed into adulthood, resulting in chronic illness, addictions, and many other challenges. The main scope of this paper is to suggest that the effective application of the Neurosculpting® modality to the healing process of those suffering from childhood-‐trauma-‐related PTSD can fill the service gap. Neurosculpting® unites neuroscience and meditation techniques, offering development of self-‐awareness, self-‐empowerment, and autonomy, all vital elements for human wellbeing. Since the process offers a method of self-‐directed neuroplasticity that involves intentional rewiring of old neural networks, practitioners and clients are finding it effective to break the reinforcement cycle of instinctual emotions linked to the traumatic events. Neurosculpting® employs mind-‐active meditation and strategies developed based upon recent neuroscience theory and research. Interest in the impacts of meditation on those suffering from PTSD has prompted research studies whose outcomes indicate long-‐term health benefits of meditation practice, and as a result, some organizations now incorporate meditation instructions into their routine. A few examples are corporate mindfulness programs, schools such as the Mindful Schools Initiative, universities (usually as part of the physical education), and the Department of Corrections Yoga Behind Bars initiative. In businesses, schools, and hospitals here and around the world, people are now learning meditative practices to become more productive, pay better attention, heal faster, and feel less stressed.1 Some therapies, especially the third wave of therapy, include meditation practice as an essential part of the approach. The main focus of the third wave of therapy is on the process of cognition rather than on the content of cognition. It’s not just about having a negative thought; it’s how much attention you pay

1 Hanson, Rick, and Richard Mendius. Buddha's Brain the Practical Neuroscience of Happiness, Love, & Wisdom. Oakland, CA: New Harbinger Publications, 2009.


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to it.2 Some examples of the third wave therapies are Acceptance and Commitment Therapy (ACT) and Mindfulness-‐Based Cognitive Therapy (MBCT).

Acceptance and the self-‐empowerment generated by strategies may allow the PTSD sufferer to willfully pay attention to their cognition process, reduce stress, and perhaps find healing that can be deep and long lasting. Dr. Gabor Maté, who works with patients challenged by hard-‐core drug addiction, mental illness, and HIV states: “Each of us must reclaim the autonomy we lost when we parted company with our ability to feel what was happening within. That lost capacity for physical and emotional self-‐awareness is at the root of much of the stress that chronically debilitates health and prepares the ground for disease.”3

Definitions The National Institute of Mental Health (NIMH) describes PTSD as follows:

When in danger, it’s natural to feel afraid. This fear triggers many split-‐second changes in the body to prepare to defend against the danger or to avoid it. This ‘fight-‐or-‐flight’ response is a healthy reaction meant to protect a person from harm. But in post-‐traumatic stress disorder (PTSD), this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger. PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers. PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes.4

Optimizing PTSD Treatments (OPT) is a clinical trial funded by the National Institute of Mental Health (NIMH). OPT lists symptoms of PTSD as: frequent thoughts of the trauma, avoiding things that remind you of the trauma, intense feelings of fear and anxiety, nightmares and/or sleep problems, jumpiness or a tendency to be easily startled, irritable or angry, difficulty concentrating, loss of interest in things you used to enjoy.5 Prevalent opinions of PTSD are still largely linked to the experiences of war veterans and survivors of highly traumatic events, and not so much to the consequences of inadequate early development or

2 Satterfield, Jason M. "Cognitive Behavioral Therapy: Techniques for Retraining Your Brain." English. 2015. http://www.thegreatcourses.com/courses/cognitive-‐behavioral-‐therapy-‐techniques-‐for-‐retraining-‐your-‐brain.html. 3 Mate, Dr. Gabor. "When The Body Says No -‐ Chapter One -‐ Dr. Gabor Maté." Dr Gabor Mat. Accessed January 15, 2016. http://drgabormate.com/preview/when-‐the-‐body-‐says-‐no-‐chapter-‐one/. 4 "Post-‐Traumatic Stress Disorder." NIMH RSS. Accessed January 15, 2016. https://www.nimh.nih.gov/health/topics/post-‐traumatic-‐stress-‐disorder-‐ptsd/index.shtml. 5 "What Is PTSD?" Optimizing PTSD Treatments. Accessed January 15, 2016. http://www.ptsdoptions.com/what-‐is-‐ptsd/.


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unresolved childhood trauma. Consequently, a large population of people with unaddressed PTSD symptoms do not seek treatment and often fall “between the cracks,” so to speak. An anecdotal case study presented in this paper is an example of this state of affairs. The case study deals with PTSD of a person who suffered childhood sexual abuse, overlaid with a few severe traumatic experiences in the later years, manifesting in problematic symptoms impacting his quality of life, including drug and alcohol addictions. PTSD presents certain challenges for treatment as the memory of the traumatic experience is stored in the emotional, limbic brain. Studies indicate that even if a person recovers from PTSD, he or she may continue to show mild symptoms.6 This is possibly due to the limbic region of the brain’s inability to tell time so the memory of an event of 10 to 20 years ago can be triggered by a similar situation today. State of Research on Meditation and PTSD The Journal of Clinical Psychology (Vol 66 Issue 1) published a research study called “Mindfulness Intervention for Child Abuse Survivors.” Twenty-‐seven adult survivors of childhood sexual abuse participated in a pilot study comprising an eight-‐week mindfulness meditation-‐based stress reduction (MBSR) program and daily home practice of mindfulness skills. Three refresher classes were provided through final follow-‐up at 24 weeks. Assessments of depressive symptoms, post-‐traumatic stress disorder (PTSD), anxiety, and mindfulness, were conducted at baseline, week four, week eight, and at 24 weeks. At eight weeks, depressive symptoms were reduced by 65 percent. Statistically significant improvements were observed in all outcomes post-‐MBSR, with effect sizes above 1.0. Improvements were largely sustained until 24 weeks. Of three PTSD symptom criteria, symptoms of avoidance/numbing were most greatly reduced.7 There is currently a study underway with the Veterans Administration Office of Research and Development, in collaboration with the Graduate School of Psychology at Palo Alto University. This study will measure brain activity using functional magnetic resonance imaging (fMRI) before and after an 8-‐week meditation program called Inner Resources for Veterans (IRV) in comparison to a group that will receive educational information about PTSD and TBI without meditation. As of November 2015, the study was still recruiting participants.8 Presently PTSD Support Services lists the following treatments as resources for PTSD treatment alternatives, describing the most common practices:

• Group treatment practiced in VA PTSD Clinics and Vet Centers for military veterans and in mental health and crisis clinics for victims of assault and abuse

• Brief psychodynamic psychotherapy that focuses on the emotional conflicts caused by the traumatic event

• Exposure therapy that involves therapeutic confrontation of a past trauma by either repeatedly imagining it in great detail or going to places that are strong reminders of the trauma experience

• Cognitive-‐behavioral therapy that involves learning skills to cope with anxiety (such as breathing retraining or biofeedback), shift negative thoughts (via "cognitive restructuring"), manage anger,

6 Perlmutter, David, and Alberto Villoldo. Power up Your Brain: The Neuroscience of Enlightenment. Carlsbad, CA: Hay House, 2011. 7 Kimbrough, Elizabeth, Trish Magyari, Patricia Langenberg, Margaret Chesney, and Brian Berman. "Mindfulness Intervention for Child Abuse Survivors." Journal of Clinical Psychology 66, no. 1 (2010): 17-‐33.


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prepare for stress reactions ("stress inoculation"), handle future trauma symptoms, resist urges to use alcohol or drugs when they occur ("relapse prevention"), and to both communicate and relate more effectively with people ("social skills" or marital therapy).

• Drug therapy; several kinds of antidepressant drugs have achieved improvement in most, but not all, clinical trials, and some other classes of drugs have shown promise8

The question arises: Why do PTSD Support Services not list mindfulness techniques as an effective tool in dealing with PTSD symptoms? Finally, a study of the effect of the Transcendental Meditation program in treating PTSD in veterans was conducted in 2007. In the form of the Transcendental Meditation program, CAM offers a method of eliminating deep-‐rooted stress, the efficacy of which has been demonstrated in several related studies. Any discussion of CAM and post-‐traumatic stress disorder should include a study of its application to Vietnam War veterans in which improvements were observed on all variables, and several participants were able to return to work after several years of being unable to hold a job. The intervention has been studied for its impact on brain and autonomic nervous system function. It has been found to be highly effective against other stress-‐related conditions such as hypertension, and to improve brain coherence—a measure of effective brain function. It should be considered a possible “new and improved mode of treatment” for PTSD, and further studies of its application made.9 Neurosculpting® Modality and Meditation Neurosculpting® is a modality developed by Lisa Wimberger that bridges science and meditation. Facilitated in both group and individual sessions, this approach addresses how the brain responds to stress, and recommends various ways to tap into the brain’s ability to rewire its own neural mindscape. This basic premise is supported by research over the past two decades on the neuroplasticity and neurogenesis of the brain, and the ways in which the neurology of the brain can change over time. One of the main goals of Neurosculpting® is to diminish the influence of the fight-‐or-‐flight center (limbic brain) and enhance the executive function of the prefrontal cortex (PFC). In Lisa Wimberger’s own words:

Neurosculpting® was developed as a method to enhance self-‐directed neuroplasticity through the union of neuroscience and meditation practices for the purpose of down-‐regulating chronic CNS arousal states. Unique to the Neurosculpting® methodology is its methodical structure and intentional whole-‐brain engagement designed to down regulate the limbic center of the brain through specific languaging, and simultaneously up-‐regulate areas of the prefrontal cortex through life practices including brain-‐specific nutrition. Neurosculpting® uses self-‐directed neuroplasticity to induce brain activity and re-‐patterning in a five-‐part system. Part one is a down-‐regulation of hyperactive amygdala activity and an engagement with parasympathetic response. Part two involves practices to enhance activity in the prefrontal cortex for emotional regulation. Part three increases the activity across the corpus callosum between Wernicke’s and Broca’s area in the left hemisphere and their counterparts in the right hemisphere, as well as

8 PTSD Support Services, Treatments of PTSD. http://www.ptsdsupport.net/ptsd_treatments.html 9 Hankey, Alex. "CAM and Post-‐Traumatic Stress Disorder." Evidence-‐based Complementary and Alternative Medicine. July 6, 2006. Accessed January 15, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1810367/.


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increasing activity in the parietal lobes as related to proprioception through visual and sensory-‐motor cueing. Part four links somatosensory engagement to perceptual shifts in patterns. Part five enables the user to easily identify and replicate the process in day-‐to-‐day activities.10

As stated earlier, Neurosculpting® bridges science and mindfulness techniques, providing brain-‐based approach to meditation, which is completely secular and can work for anyone within their own belief system framework. Case Study Ken came to the author’s Neurosculpting® introductory class at the low emotional point. He just turned 41 and was overwhelmed with sadness and grief. His best friend overdosed a few days earlier, he was going through an intense breakup, he was depressed and aware of his unaddressed PTSD and his resulting anger related issues. Ken had a meditation practice but it didn’t seem to help. He was actively looking for help to get better. In addition to his other symptoms, Ken was also suffering from a chronic prostatitis. He was also still not fully recovered from his sister’s suicide that took place four years ago when she shot herself with a gun. This incident caused a reaction of severe shock mixed with a surprise since Ken always assumed that he would be the one to commit suicide, not his sister. His family members’ opinions reinforced this belief. Furthermore, Ken was sexually abused as a child, beaten up physically, and spent his early childhood years in the state of perpetual disempowerment. His main coping strategy during his childhood years was a “flight” reaction: becoming invisible and hiding from his abusive mother-‐in-‐law. As Ken was growing up, he gradually developed alcohol and drug addiction. He also had two head traumas and considered himself lucky to survive those accidents. A relatively well-‐known local performing musician, Ken was establishing himself in that capacity on a national level, taking pride and satisfaction in what he does and sensing much larger potential within himself. By the time he started applying Neurosculpting® techniques he made a conscious choice to get well. Ken already moved away from the addictions and had a well-‐developed sense of self-‐awareness. He was tired of being perpetually frustrated by his own limbic reactions, by living a life of a starving artist and was ready for a real change. He was ready for a personal transformation but didn’t quite know how to initiate it. Ken also realized that his old PTSD wasn’t fully addressed and he was willing to work on that issue.

Ken suffered from most PTSD symptoms, especially instinctual emotions of anger and anxiety. According to Ken, since his teenage years, his predominant coping mechanism was aggression. As a result of that coping mechanism, he strived to be the most feared person in the room so no one could hurt him. Drugs and alcohol further fueled this unhealthy perception that gave him a sense of empowerment and invincibility. By the time of the first Neurosculpting® workshop, Ken had already devised his own wellness program: meditation practice, cutting down on long working hours, quitting coffee, picking up physical exercise and paying attention to healthy nutrition. He knows what he wants in life, and he was clearly prepared to work on his limiting beliefs and self-‐sabotaging behavior, realizing the power of the mind in changing these beliefs and behavior. Ken deeply resonated with theory and practice of Neurosculpting® and agreed to a committed practice of private sessions once a week for a few months.

10 Wimberger, Lisa. "What Is Neurosculpting." The Neurosculpting Institute. 2015. http://neurosculptinginstitute.com/what-‐is-‐neurosculpting/.


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The program was mostly based on the series of exercises described in Lisa Wimberger’s book, New Beliefs New Brain: Free Yourself From Stress and Fear, with additional tailored practices that are described in a separate document entitled “Ken’s Case Study” by Vija Rogozina, a Fellow of the Neurosculpting® Institute. Among other tools and practices, the SCARF model was introduced as this model can be applied – and tested – in any situation where people collaborate in groups, including all types of workplaces, educational environments, family settings and general social events. The SCARF model provides a usable way for practitioners to remain mindful of five domains of human social experience: Status, Certainty, Autonomy, Relatedness, and Fairness.11

Ken was already sufficiently aware of his cognitive senses and physical reactions but was very eager to learn the tools that allowed him to be proactive in his self-‐regulation and exercise a free will to disengage from the old stories by down-‐regulating the limbic system. After ten sessions Ken was reporting success stories of cognitive self-‐control and self-‐empowerment that came from internal validation. By that time, he was so impressed by the change in his behavior he considered taking a teacher-‐training in the Neurosculpting® modality so he could share it with others. After two and a half months of sessions, Ken took a summer tour with his band, calling it the best tour of his musical career, largely attributing it to his new way of being in the world. Conclusion Ken is an example of a perfect client who was ready for his own healing, understanding that it is a process (not just content) and that this process requires time and patience. He took his full attention and commitment during this process. A sense of autonomy and the cognitive element of Neurosculpting® seemed to be important pieces for Ken that was missing in other meditation practices. Usually, when a person is unwell, and he or she is trying to see a doctor, being diagnosed might bring a sense of relief (an element of uncertainty is illuminated). Perhaps in a similar way, during a severe emotional trauma, understanding the dynamics and biology behind it might bring a relief in “diagnosis” rather than speculating, and perhaps, expecting the worst-‐case scenario. Meditation practice and use of the specific Neurosculpting® tools add to the sense of autonomy. It is well known that patients that are in control, even if it is only a perceived control, recover faster. From the biological point of view, we are extraordinarily powerful creatures. The more conscious attention we pay to any particular circuit, or the more time we spend thinking specific thoughts, the more impetus those circuits or thought patterns have to run again with minimal external stimulation. In addition, our minds are highly sophisticated “seek and ye shall find” instruments. We are designed to focus in on whatever we are looking for.12 If a traumatized individual focuses on the fact that he or she is in charge of his or her emotional response and healing process and given the Neurosculpting® techniques, it empowers the individual. It also gives him or her a choice in using the available tools to down-‐regulate the limbic responses, assuming that self-‐awareness is sufficiently developed. In the author’s opinion and experience, this is 11 Rock, David. "SCARF: A Brain-‐based Model for Collaborating with and Influencing Others." NeuroLeadership Journal, no. 1 (2008). http://www.your-‐brain-‐at-‐work.com/files/NLJ_SCARFUS.pdf. 12 Taylor, Jill Bolte. My Stroke of Insight: A Brain Scientist's Personal Journey. New York: Viking, 2008.


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exactly what makes this modality so uniquely powerful in rewriting trauma. It is imperative for people who suffered traumatic events in childhood to realize that their PTSD might be deeply rooted and covered by other symptoms (e.g. depression, anxiety, anger, addictions and other unproductive behaviors) and that due to neuroplasticity, they can be effectively reversed. With a wider acceptance of the mind-‐body connection in the medical world, this knowledge might get broader outreach and people might start looking for ways to heal themselves without the stigma of seeking mental help. Finally, it is the author’s hope that the National Institute of Mental Health will conduct a formal research study to support anecdotal evidence of the effects the Neurosculpting® modality can have to treat PTSD.


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Meditation and the Mind-Body Connection in Athletes Tamme Buckner, Certified Neurosculpting® Facilitator Fellow There is an opportunity that every athlete can grasp when it comes to their preparation to compete. Not all athletes take advantage of this opportunity. However, the ones that do have found massive success. What is this opportunity? It is the preparation of the brain to compete. The Mind Game. This is something that can not only help an athlete excel but can also help prevent injuries, navigate stress and sustain energy levels. It’s easy to understand why so many athletes choose to focus solely on the physical aspect as their competitions demand top physical shape. Every athlete is aware of the return payout of physical practice and preparation. Far fewer realize the payout that mental preparation can bring, but with new ideas and awareness of meditation techniques like Neurosculpting® the benefits are being realized. We’ve all seen it happen. The last shot at the buzzer missed. The botched golf swing. The interception on a football field. The last pitch in a game strike out. A full range of errors. I dare you to ask any baseball fan to recall the last play, bottom of the 10th inning in the 1996 World Series between the Boston Red Socks and the New York Mets. A slow rolling ball hit down the first base line; a play the first baseman had made countless times. Yet on this night, it rolled to the left of his glove, through his legs and into right field resulting in losing the game, later losing game seven and the World Series. “When our brains get caught up in thoughts from the past…or thoughts of the future…it creates a stress response, and we can’t use the part of the brain that keeps us engaged in the moment,” says Dr. Kristen Race, Ph.D., founder of Mindful Life and expert on brain-‐based mindfulness solutions. “If we’re too stressed about performance, we can’t make good decisions and solve problems and stay composed,” says Dr. Race. Recent studies by researchers at Coventry University and Staffordshire University found that increased stress and anxiety, including fear of failure, do affect athletic performance in competitive situations.”1 Enter the vast universe of the brain. There has been numerous research done during the past decades that has changed what we now know about the brain. Of great importance are the gifts of neuroplasticity. Neuroplasticity is the “brain's ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.”2 The key in the athletic competitive space is “adjust their activities in response to new situations or changes in their environment.” Most athletes’ environments are constantly changing. If an athlete can thrive in this environment they can achieve great success. This is what we call “being in the flow.” A recent study published in the Psychology of Sport and Exercise examined the relationships

1 Yu, Christine. "Mindfulness for Athletes: The Secret to Better Performance?" Life by Daily Burn Mindfulness for Athletes The Secret to Better Performance Comments. June 10, 2014. Accessed January 15, 2016. http://dailyburn.com/life/fitness/mindfulness-‐techniques-‐athletes/. 2 "Neuroplasticity." MedicineNet. Accessed January 15, 2016. http://www.medicinenet.com/script/main/art.asp?articlekey=40362.


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between mindfulness, flow dispositions and mental skills adoption.3 What was discovered is that “those who reported a greater sense of mindfulness were more likely to experience a higher state of flow -‐ the feeling of being totally in the moment which has been linked to enhanced performance.”4 Some other benefits reported for athletes are focus and concentration; confidence and optimism; optimal BodyMind integration; coordination and mastery; increased ability to enter peak awareness & slowing of time; heightened intuition resulting in greater team cohesion & anticipation; untapped energy & vitality; deepened relaxation and lasting wellbeing.5 Just ask professional coaches Phil Jackson and Pete Carroll, who have both embraced meditation into their coaching programs. Phil Jackson was the head coach of the Chicago Bulls from 1989 until 1998, during which Chicago won six NBA championships. His next team, the Los Angeles Lakers, won five championships from 2000 until 2010. In total, Jackson has won 11 NBA titles as a coach.6 Pete Carrol is the head coach and executive vice president of the Seattle Seahawks of the National Football League (NFL). He is a former head coach of the New York Jets, New England Patriots, and the University of Southern California (USC) Trojans. Carroll is one of only three football coaches who have won both a Super Bowl and a college football national championship.7 Both of these coaches understand the importance of the mental game. Jackson’s key concept while coaching was the idea of “one breath, one mind.” He believed that “as much as we pump iron and we run to build our strength up, we need to build our mental strength up... so we can focus... so we can be in concert with one another." George Mumford, who is the meditation coach Phil Jackson hired had this to say when asked what meditation can offer athletes. “The opportunity to be in the moment. In sports, what gets people’s attention is this idea of being in the zone, or playing in the zone. When they are playing their best, they can do no wrong, and no matter what happens they are always a step quicker, a step ahead. That happens when we are in the moment, when we are mindful of what is going on. There’s a lack of self-‐consciousness, there’s a relaxed concentration, and there’s this sense of effortlessness, of being in the flow…. When we are in the moment and absorbed with the activity, we play our best. That happens once and awhile, but it happens more often if we learn how to be more mindful.”8 Pete Carroll is someone who has a desire to fundamentally change the way players are coached. One of his players Russel Okung had this to say about meditation. “Meditation is as important as lifting weights and being out here on the field for practice. It's about quieting your mind and getting into certain states where everything outside of you doesn't matter in that moment. There are so many things telling you that you can't do something, but you take those thoughts captive, take power over them and change them.”9 One such solution for creating this space and state of mindfulness and flow during competition is a technique called Neurosculpting®. Founder Lisa Wimberger describes Neurosculpting® as a: 3 Kee, Ying Hwa, and C.K. John Wang. "Relationships between Mindfulness, Flow Dispositions and Mental Skills Adoption: A Cluster Analytic Approach." Psychology of Sport and Exercise 9, no. 4 (2008): 393-‐411. http://www.sciencedirect.com/science/article/pii/S1469029207000702. 4 Yu, “Mindfulness for Athletes: The Secret to Better Performance?” 5 "Meditation." Mind Sport Institute RSS. Accessed January 15, 2016. http://www.mindandsport.org/portfolio/meditation-‐2/. 6 "Phil Jackson." Wikipedia. Accessed January 15, 2016. https://en.wikipedia.org/wiki/Phil_Jackson. 7 "Pete Carroll." Wikipedia. Accessed January 15, 2016. https://en.wikipedia.org/wiki/Pete_Carroll. 8 “Meditation.” Mind Sport Institute RSS. 9 Roenigk, Alyssa. "Lotus Pose on Two." ESPN. August 23, 2013. Accessed January 15, 2016. http://espn.go.com/nfl/story/_/id/9581925/seattle-‐seahawks-‐use-‐unusual-‐techniques-‐practice-‐espn-‐magazine.


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mental training process that quiets our fight-‐or-‐flight center and activates our prefrontal cortex. It also engages left and right brain stimulation and incorporates a somatic awareness for a whole-‐brain and whole-‐body approach to meditation and rewiring. It’s a lifestyle of day-‐to-‐day exercises, nutritional tenets, and meditations designed to allow dialogue between the compartmentalized and silenced parts of ourselves. It involves learning about a brain-‐supportive diet, exercising, identifying and enhancing opportunities for neuroplasticity throughout your day, and practicing regular meditations for mental training. The benefits of this regimen are deep and long-‐lasting. Neurosculpting® contributes to increased cognitive functioning, reduces emotional and physical stress, supports a healthy immune system and a reduction in inflammation, increases growth hormones in the brain by way of exercise, stimulates creativity, supports mood regulation, and creates a ripe platform for creating new beliefs.10

The benefits are virtually endless and translating all of this to the athlete’s “mental game” offers multiple levels of rewards. In a sports world where a great majority of time is spent on physical training, this is what can give an athlete the upper edge. As a Neurosculpting® fellow and facilitator, I get to share, lead classes and guide meditations. I was contacted by the head coach of the equestrian team at Texas A&M University, Tana McKay, before their season began. McKay is in her 17th season at one of the nation's premier equestrian programs. They have won the national championship 11 times. McKay is someone who understands the mental game and has had her team regularly meet with sports psychologists. In fact, painted on the wall in their tack room in large letters is this quote: “It’s not the will to win that matters -‐ everyone has that. It’s the will to prepare to win that matters” I was invited to lead a Neurosculpting® class for her 55 collegiate athletes and we did just that: work with the will to prepare to win. I dove in deep with an explanation of the brain. We talked about how they can get triggered into a stress state before, during and even after a competitive ride. We talked about the uncertainty that their horse can bring. I then guided them on three Neurosculpting® meditation journeys. Neurosculpting® meditations are a guided process using very deliberate language that down-‐regulates the limbic response (fight or flight) and up-‐regulates the prefrontal cortex where our higher human capabilities lie. From this space, we get to create new neurological maps, where we can learn to navigate stress, learn how to be in the flow and create the space of “mindfulness.” I also shared with the group about how their diet choices can help support their brain. We then discussed the fact that all of the tools I shared with them could translate to their studies as students and also ripple into their personal relationships with their teammates, coaches, friends, and family. I left the girls with recordings of the guided meditations so they could continue to use them and a few weeks later sent a 10 question survey to assess any results. They were very positive. Of the athletes that responded 100 percent said they would recommend this technique to other student athletes. Seventy-‐five percent believe having a mindfulness practice helps their athletic performance. Sixty-‐six percent said having a mindfulness practice helps their academic performance. Fifty-‐eight percent said they used these techniques not only in their competitive athletic environment but also in a personal way. McKay had this to say about the

10 Wimberger, Lisa. Neurosculpting: A Whole-‐brain Approach to Heal Trauma, Rewrite Limiting Beliefs, and Find Wholeness. Boulder, CO: Sounds True, 2014. Xviii-‐xix.


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experience:

I feel strongly about the mental preparation for our athletes especially when they are dealing with a 1,200-‐pound animal that is essential to their success. I have found that equestrian athletes that are mentally prepared will be more successful. The Neurosculpting® meditations that were shared have had a significant impact on our riders and has provided our athletes with more tools to be successful.

At the writing of this piece McKay’s team is halfway through their season and sitting with a 6-‐1 record. I’m hoping for a 12th national championship for them this year.

Health & Medicine

Alternative Approaches to TBI,PTSD and Burnout