Psychoeducation: Neurophysiology 101 (simplified) for

Persons with Neurologic Conditions

Mike Martelli, Ph.D.

One of the most sensitive parts of the brain is in the Limbic System. This is the part of the brain in the very middle, just above the base and it is in close proximity to the primary sources of blood supply in the brain. It is especially sensitive to changes in blood flow, blood oxygen and blood sugar, infection, and sudden acceleration and deceleration of the brain (i.e., closed head injury and traumatic brain injury), as well as brain swelling. Some of the important functions of the Limbic System include Memory, which derives in history from mammals and sense of smell, and complex attention. A useful acronym for the functions of the Limbic System is: F.E.S.T., or Fatigue, Emotional amplification, Sensitivity to stimulation, and Temperature & Taste (& smell).

Importantly, the brain, after injury, brain cells have to work much harder to accomplish the same results. Thus, the brain becomes more sensitive to demands in any of these areas. That is, if one gets fatigued, which will happen much sooner, emotions will get more intense and increased stress will be experienced, and sensitivity to stimulation (e.g., conversations, two people talking at once, noise, crowds, light, patterns and flickering light, etc.) and reduced tolerance of heat or temperature change will also result. Importantly, different structures of the limbic system control different functions. For example, the Amygdala regulates anger, fear and stress responses, while the Hippocampus controls memory. When these areas are injured, they require more blood. Therefore, when angry and under stress, more blood is used by the Amygdala, and less is available for the Hippocampus. Therefore, memory becomes very poor under stress.

Even more importantly, all healing requires relaxation. All stresses produce increased physiologic arousal or a fight-flight emergency nervous system response. Stress is the normal, healthy way our bodies respond to stressful demands in the environment. This response is biologically programmed and is based in the "fight-or- flight" response that enabled our ancestors to mobilize their strength via our Sympathetic or emergency nervous system (e.g., increases in muscle tone, heart rate, breathing, etc.) to fight off or escape such stressful dangers as saber tooth tigers. When the stressor ends (e.g., tiger is killed or escaped from), our physiological systems relax and recuperate (i.e., Parasympathetic Rebound, when blood flow increases through relaxed organs to heal the damage caused by increased arousal or injury) and then return to normal baseline.

Unfortunately, after injury, the natural stress response seems to selectively arouse (irritate) organs weakened by injury. So, for instance, instead of blood pressure and muscle tension and breathing and alertness all going up equally, muscles that were injured will differentially get very tight, or attention in an injured brain will cause confusion or distraction, or the Amygdala will steal the blood away from the Hippocampus memory center. This presents a problem because stress can become a chronic response pattern such that even mild stresses have the potential to block the relaxation necessary for healing. Even more importantly, emotions caused by stresses resulting from the injury (e.g., loss of abilities, pain), and a "catastrophic reaction" to changes caused by injury, disruption of regular activities, etc., represents a constant source of stress that can prevent shutting down the fight-flight stress response (i.e., parasympathetic rebound, relaxation & recovery) & preventing natural recovery & recuperation necessary for healing. Further, because the Limbic system that controls emotions was damaged, it produces amplified emotional reactions and catastrophic reaction to losses and stresses of injury, which even further elevates physiologic arousal beyond what would happen if another part of the brain had been attacked (i.e., the double whammy. The disease want to destroy, and almost as if by design, it knows it can perpetuate itself by keeping you distressed, so it attacks the emotional controls centers that then amplify your distress). In response, as a kind of means of protection from catastrophic anxiety, chronic stress, and chronic pain, your brain can slow down in terms of EEG waves and blood flow, which slows thinking and produces cognitive inefficiencies. .

Importantly, healing can only occur when the nervous system is relaxed and blood can produce healing through normal flow to muscles and nerves. To the extent that patients with lingering problems can learn to make their damaged organs relax (despite having amplified stress responses), and allow blood flow and healing despite the stresses that follow injury, they will Recover/heal.

TMS/PTBS DAILY REMINDERS

Adapted from John E. Sarno, MD (M.F.Martelli, Ph.D.)

Catastrophic Reactions, the Propagation Imperative & 5 Commandments of Rehabilitation

Mike Martelli, Ph.D.

Pinnacle Rehabilitation & Concussion Care Centre of Virginia

Early after injury, the discovery of losses of accustomed abilities, especially ability to perform simple physical

Another important concept with regard to rehabilitation is the Propagation Imperative. Basically, this imperative dictates that every force and organism, good or bad, strives to expand and grow and take over. For instance, have you ever heard of a fungus that only wants a little piece of an apple? Or a cancer that only wanted a little piece of skin and was satisfied?...or a sperm cell that had a headache?...or an army that wanted to give up territory? In traditional psychoanalytic theory, two basic forces in life are seen as battling for supremacy. These are Eros, or Life Instinct, and Thanatos, or Death Instinct. Life for psychoanalysts is a struggle between life forces and energy versus death forces and energy. The two are seen as opposites engaged in a battle for life or death.

Rehabilitation can be viewed using this conceptualization. Brain injuries and strokes represent death forces with an ultimate goal of progressing from disease and disability to death. Recovery, in contrast, strives for expanding health and life.

Importantly, energy multiplies in a cyclical fashion that feeds itself with increasing momentum. If it proceeds in a negative direction, more and more energy will be robbed from the healing life reserve, wasted in poisonous attitudes and made unavailable for relearning and accomplishment. For example, an anger or depression habit in response to physical losses can reduce activity and hence relearning, which will lead to more depression by depletion of brain chemicals that protect mood, and, in turn, lead to poorer progress and more reason to be depressed. Propagation means growth towards disease, disability and death, or the opposite of life.

The antidotes included in the "Five Commandments of Rehabilitation" should be considered life force medicines that interrupt rehabilitation poison growth cycles. Antidotes like the "Five Commandments", a positive vision of a gradually improved future, and planning and practicing compensatory strategies serve to protect the healing reserve by inoculating persons against depression, anger, and destructive emotion. This ensures that energy and motivation will be available so that desired life goals can persistently pursued, with each step of progress adding new energy, momentum, hope and effort for the next step.

With the utilization of incremental goals and achievements, energy is turned toward protecting the life forces and healing reserve, using the Rehabilitation Commandments as antidotes against poisonous attitudes, and letting positive, baby step life achievements pull survivors toward a more desirable future. Remember, anything that is consistently repeated will become a habit. Therefore, promote the attitude and activity routines that will produce facilitative habits that turn energy toward protecting attitudes, taking antidotes and letting your healing reserve pull survivors like a magnet toward their positive life goals.

Remember the Five Commandments of Rehabilitation (see Above)

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Science, Sports and Rehabilitation Imperatives

Mike Martelli, Ph.D.

For many years, Whitey traveled the country doing motivational talks to businesses and athletes. He always repeated the World Series game story and admonished others against thinking about what they didn't want, as this could make it happen. Instead, he offered strong alternative advise that basically suggested "Always think about what you want, and program yourself to get it."

Your Vision Dictates Your Reality, Your Future, and Your Destiny!!!!!

Compensatory Habit Retraining is the use of strategies, self-talk, notes, log books, breaking things down into small steps, doing things one step at a time, using checklists, etc.

It feels like a Pain in the Butt.

Not remembering, however, is a Colossal, Gigantic Pain in the Butt.

So be aware, When Habit Retraining Strategies become Habitualized, they become Automatic and produce good memory and other skills, and are No Longer a Pain in the Butt.

Think of Retraining with Strategies As a Temporary Pain in the Butt that is really an Opportunity to Get Rid of Permanent Gigantic Pains in the Butt.

M.F. Martelli, PhD and J.B. Finkelstein, DC : 1999

© 1997: M.F. Martelli, Ph.D. & "Obstacle Busters" Cope Group Members: Jan Flowers, Tom Byrnes, Jack Hodges, Dr. Joel Finklestein, Brain Stephens, John Mitchell, Tom Hale, Jim Fenerty, Evelyn Phillips, Rick Peters, J.P. Gibson, John Mitchell, Tom Hale, Jim Fenerty, Evelyn Phillips, Rick Peters, J.P. Gibson, Danny Burnett, Chris Hignutt, Tommy Peden, DavidBrummet, Sarah Goldmann, Matt Tacey, Jay Weaver & Lynn Batley, David Mourer, Rudy Lee, Patrick Quinn, Dennis Weymouth, Laura Watts, Laura Hunter, Barbara Watts, JD Smith, Jamal Alkayed, Charles Smith, Linda Beales, and others...

For Additional Habit Retraining and Rehab Related Readings

Simplified Neurophysiology & Recovery Requirements, Catastrophic Reaction & Recovery, Etc.

Vulnerable Personalities, Sample Protocols for Emotional Management, Etc.

HeadsUp - A Great Online Survivor Newsletter with many features and good articles!

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