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Use Neuroscience in the Treatment of Anxiety

• Positives: We know more about anxiety-based disorders than any other disorders
  • Science gives explanations, evidence, authority, destigmatizes difficulties
• Concerns: It can be difficult to explain, answer questions
  • Clients may feel a lack of responsibility
  • Oversimplification is inevitable

Enhancing Engagement in Treatment

• Don’t neglect the therapeutic relationship!
• Address the challenges of anxious clients
• Remember that strategies are effortful
• Guide the process using client’s goals
• Maintain motivation

Neuroplasticity

• Define Neuroplasticity in everyday language
• Therapy is about creating a new self
• ”Rewiring” as an accessible concept for change
• Re-consolidation: the modification of emotional memories

Identify Two Neural Pathways to Anxiety

• Amygdala – bottom-up triggering of emotion, physicality of anxiety
• Cortex – top-down emotion generation based in cognition
• Explain the two pathways to clients
• How anxiety is initiated in each pathway and how pathways influence each other

Client Friendly Explanations

• Use illustrations to create concrete understanding
• Fight/flight/freeze responses
• The “language of the amygdala”
• Anxiety and the cortex
• Help clients recognize the two pathways to anxiety

Neuroplasticity in the Amygdala (Essential for all Anxiety Disorders, PTSD, OCD, Depression)

• Sleep and the amygdala
• The influence of anxiety
• Breathing techniques to reduce activation
• Relaxation, meditation, and yoga to modify responses
• Exposure as opportunities for the amygdala to learn
• Combatting avoidance
• When anxiety indicates that the amygdala can learn new responses
• Push through anxiety to change the amygdala

Neuroplasticity in the Cortex (Essential for GAD, SAD, OCD, PTSD, Depression)

• ”Survival of the busiest” principle – strengthen or weaken specific circuitry
• The healthy (adaptive) use of worry in the cortex
• ”You can’t erase: You must replace”
• Recognize and modify the impact of uncertainty
• Training correct uses of distraction
• Left hemisphere techniques – cognitive defusion, coping thoughts, fighting anticipation
• Right hemisphere techniques – imagery, music
• Mindfulness and anxiety resistances

Neuroplasticity and Medications for Anxiety Disorders, OCD, PTSD, Depression

• Medication’s effects in the rewiring process
• The myth of the chemical imbalance
• The danger of sedating the brain with benzodiazepines
• Promoting neuroplasticity with SSRIs, SNRIs
• The effectiveness of CBT and meds

Move Beyond Diagnostic Categories to Focus on Anxiety Pathways

• Anxiety is a component of many diagnoses (depression, substance abuse, etc.)
• Amygdala- and cortex-based techniques help in other disorders
• Targeting brain-based symptoms rather than disorders
• Worry, obsessions, rumination respond to similar cortex-based techniques
• Panic, phobic responses, and compulsions respond to amygdala-based techniques

Research, Risks and Limitations

• Empirical versus clinical and anecdotal evidence
• Clinical considerations for specific clients and settings
• Efficacy of particular interventions may vary

Faculty

Daniel J. van Ingen, Psy.D. Related seminars and products: 2

Licensed Psychologist

The IMA Group

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Daniel van Ingen, Psy.D., is passionate about the treatment of anxiety and believes that his strategy of anxiety tolerance training requires non-medication treatment strategies. He has developed easy-to-understand explanations and techniques that quickly fuel the road to recovery.

A licensed clinical psychologist in Florida, Dr. van Ingen maintains a private practice that specializes in anxiety treatment called Anxiety Shrinks! Prior to private practice, he worked at a VA hospital, colleges, a drug treatment program, and outpatient clinics.

Dr. van Ingen, trained as a scholar-practitioner, has many empirical studies published on cognitive behavioral therapy for anxiety disorders, parenting research, and disabilities. He has presented at national and international conferences for over 15 years and has trained providers in 30 states over 5 years. His book, Anxiety Disorders Made Simple: Treatment Approaches to Overcoming Fear and Building Resiliency, (PESI, 2014), has received outstanding reviews from psychologists, psychiatrists, and social workers alike. He has been dubbed the Sarasota Parenting Doctor in his private practice work with families.

Dr. van Ingen blogs anxiety articles and posts weekly parenting podcasts on his “Parenting Doctors Podcast” on iTunes.

Speaker Disclosures:

Financial: Daniel van Ingen maintains a private practice. He receives a speaking honorarium from PESI, Inc.

Non-financial: Daniel van Ingen has no relevant non-financial relationship to disclose.