Couples Therapy: Addressing Sexual Problems within the context of Interpersonal Neurobiology

1. Couples Therapy: Addressing Sexual Problems within the context of Interpersonal Neurobiology PRESENTED BY: Marcus R. Earle, Ph.D. Terrina Picarello, M.A, L.A.C. PSYCHOLOGICAL COUNSELING SERVICES, Ltd. Scottsdale, AZ 480-947-5739 www.pcsearle.com

2. Topics Restoring Sexual Intimacy after Rupture Practical Applications of Interpersonal Neurobiology (INB) with Couples Reptile Brain / Fight, Flight, Freeze Facilitating Self-directed neuroplasticity

3. Reptiles eat their young • Fight • Flight • Freeze

4. Reptile CEO • Something to Consider • Mother Nature has a bias toward producing gene copies. • And is biased against personal quality of life. • Reptiles do not take care of their young, in fact they often eat them. • Reptiles go through life without a mate.

5. Why Explain Organizing framework Eliminate who is right and wrong Common ground across theories and methods Motivating to clients and clinicians Concrete, in the body, physical Based on blending of Biology/Neurology/Psychology, hard science Implicit memory Nonverbal processes are addressed Innovating with truly new methods Fear extinction Facilitates Empathy for self and others

6. Self-Directed Neuroplasticity As your mind changes, your brain changes. • What you decide to notice changes your neural activity. These temporary changes can become habitual and create lasting changes such as: • Changes in brainwaves ( alterations in the firing patterns of synchronized neurons) • Increased or decreased use of oxygen and glucose/ metabolic processes • Impacts ebbs and flows of neurochemicals

7. Negativity Bias: Causes in Evolution “Sticks” - Predators, natural hazards, social aggression, pain (physical and psychological) “Carrots” - Food, sex, shelter, social support, pleasure (physical and psychological) During evolution, avoiding “sticks” usually had more effects on survival than approaching “carrots.” Urgency - Usually, sticks must be dealt with immediately, while carrots allow a longer approach. Impact - Sticks usually determine mortality, carrots not; if you fail to get a carrot today, you’ll likely have a chance at a carrot tomorrow; but if you fail to avoid a stick today - whap! - no more carrots forever.

8. Key Consequence of the Negativity Bias: Threat Reactivity • Two mistakes: • Thinking there is a tiger in the bushes when there isn’t one. • Thinking there is no tiger in the bushes when there is one. • We evolved to make the first mistake a hundred times to avoid making the second mistake even once. • This evolutionary tendency is intensified by temperament, personal history, culture, and politics. • Threat reactivity affects individuals, couples, families, organizations, nations, and the world as a whole.

9. Results of Threat Reactivity (Personal, Relational) Our initial appraisals are mistaken Overestimating threats Underestimating opportunities Underestimating inner and outer resources We update these appraisals with information that confirms them; we ignore, devalue, or alter information that doesn’t. (Bad data in/bad data out) Thus we end up with views of ourselves, others, and the world that are ignorant, selective, and distorted.

10. Costs of Threat Reactivity (Personal, Relational) Feeling threatened feels bad, and triggers stress response and biological/neurological consequences. We over-invest in threat protection. Acting while feeling threatened leads to over-reactions, makes others feel threatened, and harms relationships. The Approach system is inhibited, so we don’t pursue opportunities, we play small, and give up too soon. In the Attach system, we bond tighter to “us,” with more fear and anger toward “them.”

11. Three Pillars of Integration These three pillars map to three core functions of the nervous system: Receiving/learning Regulating Prioritizing/selecting

12. Psychological Antidotes • Approaching Opportunities • Satisfaction, fulfillment --> Frustration, disappointment • Gladness, gratitude --> Sadness, discontentment, “blues” • Affiliating with “Us” • Attunement, inclusion --> Not seen, rejected, left out • Recognition, acknowledgement --> Inadequacy, shame • Friendship, love --> Abandonment, feeling unloved or unlovable • Avoiding Threats • Strength, efficacy --> Weakness, helplessness, pessimism • Safety, security --> Alarm, anxiety • Compassion for oneself and others --> Resentment, anger

13. Complexity Certainty (predictability) Harmony (Edge of Rigidity) R I G I D I T Y Edge of Chaos Uncertainty (unstable and fragile) CHAOS Daniel J. Siegel, MD

14. A Coherent Personal Narrative • It is essential that each partner take the time to create their own coherent personal narrative. (e.g., Trauma Egg/Genogram) • The couple can then create and integrate a coherent “we” narrative. • From this coherent narrative of “we” attunement, resonance, joining, and secure attachment can occur.

15. Teflon or Velcro Just having positive experiences is not enough. They pass through the brain like water through a sieve, while negative experiences are caught, and stick like Velcro. We need to catch positive experiences actively to have them integrated into our nervous system.

16. If you fail to Velcro positive experiences, you might believe you had none • Look for positive facts, and let them become positive experiences. • Savor the positive experience: • Sustain it for 10-20-30 seconds. • Feel it in your body and emotions. • Intensify it. • Sense and intend that the positive experience is soaking into your brain and body - registering deeply in emotional and body memory.

17. Whole Body Awareness for Velcro Data Storage Sense the breath in one area (Heartmath) Sense the body as a whole, and engage whole body breathing Sense experience as a whole: sensations, sounds and thoughts all arising together as one unified whole event It’s natural for this sense of the whole to be present for only a second or two, then crumble; just open up to it again and again.

18. Kinds of “Good” to take in The small pleasures of ordinary life, like your partner bringing you coffee in bed The satisfaction of attaining goals or recognizing accomplishments - especially small, everyday ones like getting to church on time Feeling grateful, contented, and fulfilled Things are alright; nothing is wrong; there is no threat in this moment Feeling safe and strong The peace and relief of forgiveness Being included, valued, liked, respected, loved by others The good feelings that come from being kind, fair, generous Feeling loving Recognizing your positive character traits Spiritual or existential realizations, “God moments”

19. Teflon bad data in the moment • When something is off the mark or offensive, choose NOT to Velcro the event. • Take the information as a learning and let your nervous system be Teflon for the negative feeling state that the Reptile might use later.

20. Why It’s Good to Take in the Good In general, adds positive contents to implicit memory Internalizes psychological growth (e.g., it usually feels good and goes well to speak from my heart) Associates rewards to good steps; boosts motivation Brings in missing “supplies” (e.g., love, worth) to help remedy deficits and heal painful experiences Encourages prosocial experiences and actions that add to attachment potential

21. References Begley. S. 2007. Train Your Mind, Change Your Brain. Ballantine. Carter, C. 2010. Raising Happiness. Ballantine. Hanson, R. (with R. Mendius). 2009. Buddha’s Brain: The Practical Neuroscience of Happiness, Love, and Wisdom. New Harbinger Siegel, Daniel J. 1999. The Developing Mind, Guilford Press. Siegel, Daniel J. 2010. Mindsight, Norton. Siegel, Daniel J., Mary Hartzell, M.Ed. 2004. Parenting from the Inside Out. Penguin. Kornfield, J. 2009. The Wise Heart. Bantam. LeDoux, J. 2003. Synaptic Self. Penguin. Linden, D. 2008. The Accidental Mind. Belknap. Siegel, D. 2007. The Mindful Brain. Norton. Thompson, E. 2007. Mind in Life. Belknap. Levine, Peter A., and Mate, Gabor. 2010. North Atlantic Books.