Category: Neuroscience

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

I got to talk on the radio recently about depression, suicide, and teenagers. I’m glad to continue to spread the message about adolescent mental health concerns, even though it’s always sobering to consider how mental and physical health issues can be created or exacerbated by so many preventable factors.

I’m a big fan of the Adverse Childhood Experiences (ACE) Scale as a quick way to look at what sorts of factors may have been present – or absent – in my clients’ lives that may impact them to this day. None of us exist in a bubble. There’s good research on how trauma, neglect, race, class, immigration status, gender and gender identity, and so much else plays into how others treat us, brain function, and how we end up feeling about ourselves. (Here’s a recent reminder of racial bias affecting views toward young black girls.)

In my work as a therapist, I continue to be committed to seeing my clients as individuals whose own stories and experiences are a part of a larger social and cultural framework.

Some helpful stats about the importance of ACEs.


A More Realistic (and Hilarious) Pain Scale

I always laugh a lot at the hilarious pain scale (and explanation that creator Allie Brosh gives) on her now-inactive blog Hyperbole and a Half. Brosh is a depression survivor and her blog (and book of the same name) are often gut-splittingly on target. While our society often is more quick to recognize physical pain than emotional pain, cool neuroscience shows that emotional pain often registers in the same brain regions as when we, say, stub a toe or break a leg. In other words, emotional pain is still real. And painful. picture-22

When Clients Cry, I Think…

When Clients Cry, I Think…

Unlike pop culture’s idea of therapy, I do not exist to make people cry. I don’t get excited when someone sheds tears. I don’t think, ‘Hurrah, now this is therapy!’

Instead, I feel compassion for the pain I see before me. After all, tears are one way we show our suffering.

But there’s something else to remember, too, next time you cry. Neuroscience is teaching us that we have the best chance of being happy when we can easily go into and out of our thoughts, our physical sensations, and our emotions.

For most of us, our thoughts are easy to go into but can be hard to shift away from. (“I can’t stop thinking about…”) When we bring our attention to our bodies when we’re stressed, we may notice a clenching or tightness in our chest or gut.

And then there are emotions. Most of us try to avoid our emotions – especially the ones that are painful and confusing. We’d rather do just about anything else to avoid them, including overeating, numbing out through alcohol or drugs or TV, or getting really, really busy with work or family or friends.

But we can’t block some emotions without also potentially blocking out others. We can’t decide to just feel happiness, joy, and gratitude without also allowing ourselves to experience sadness, grief and anger. I wish it was different, but the brain doesn’t work like that.

So when I see a client cry, I don’t think Hurrah! But I do feel glad for that particular person that they are allowing themselves to feel what needs to be felt. It’s only when we can be with all of life – the painful and the pleasurable and everything in between – that we have the best chance of health and happiness.

Reversing the Stress Response — New Relevant Research on Relaxation

CureThe research continues to come out that mindfulness meditation can be useful to calm us down and, over time, rewire the brain for more relaxation and less of a hair trigger toward anger and stress. I loved listening to this interview on the NPR show Fresh Air with science writer Jo Marchant. Marchant’s just published a book called “Cure” and the interview gets into the mind-body connection and connects it to meditation, placebos, virtual reality, and other fascinating topics.

So often we think that living with anxiety is “just the way I am” — but neuroscience is showing that the brain is capable of change throughout our lifetime. If you can get better at driving, cooking, or riding a bicycle, then you can get better at recognizing stress, combating it, and reversing anxiety and depression. My belief in mindfulness meditation – guided by personal experience and the research – is why I continue to offer it to clients as a crucial part of talk therapy.

You’re probably not crazy

Am I crazy?Lately I’ve been reflecting on the magic I’ve found in three words that I’ve been using often in my therapy office. These three words lead clients to visibly relax — to breathe more deeply, sit more comfortably, and move quickly (if temporarily) through layers of worry.

The words are these: You’re not crazy.

Oftentimes, therapists forget to tell our clients they aren’t crazy. We assume that our clients already know this — that they have a sense that what they’re experiencing is solidly in the range of normal human experience. But the truth is that life can be so difficult and paralyzing and isolating that it can be easy to begin to believe that nobody else thinks this way, or feels this way, or is this way.

And yet what neuroscience has been teaching us lately is that even very scary mental health concerns have very real neurobiological underpinnings. There are good, brain-based reasons to explain why kids and adults sometimes feel depressed and anxious. There are clear brain-based reasons that show why people sometimes experience temporary relief in self-harm. There are straightforward, brain-based reasons why trauma survivors often are flooded by memories. It’s important for clients to know that they  are having a very normal (if challenging) response to what’s probably an abnormal, stressful situation. In other words, they’re not crazy.

Of course, there’s a difference between hearing your therapist say something and believing it. But after clients have trusted me with their vulnerabilities and truths, it can be powerfully reassuring for them to know that I still think they’re as sane as the next guy — or me. It’s not a magic pill, but it’s a start.

Is your sanity feeling threatened? Contact Dana to set up a time to talk through what’s been going on with you and figure out a plan to move forward, sanity intact.


“I shouldn’t be feeling like this”

Physical and emotional painSomething I hear a lot is “I shouldn’t be feeling like this.” Instead, we think we should be feeling happy about our lives when we’re not, or shouldn’t be feeling jealous or worried or upset when that’s exactly how we’re feeling in the moment.

Compare that to physical pain. We rarely tell ourselves we shouldn’t be feeling the pain of a headache or stomachache. We accept that our physical pain is real and figure out how to take care of it — with a nap, or medicine, or whatever is right for that moment. We know that telling ourselves “I shouldn’t be feeling this papercut right now” doesn’t actually help the papercut feel better.

So why the difference? After all, brain scans show that humans register emotional pain in the same part of our brains where we register physical pain. In other words, to our brain there’s not a whole lot of difference between the pain of feeling rejected and the pain of a sprained ankle. They both hurt; they both need gentle attention and care. And while counseling can’t take fix sprains or cuts or physical bruising, it does provide first aid for the very real emotional challenges that we all experience.

Ready to get help? Contact Dana to set up an appointment to talk through your goals.