horizons blog |
How Im continuing to provide therapy and support for children & adults remotelyIts a really tricky time and in the last few days, everything has changed. All my clients children and adults are being looked after by therapists and health care professionals offering alternative non contact services and sessions
Today Im doing my first music therapy session to a client via skype or Zoom - its not ideal but maintaining the contact and interaction and continuing with the person's rehabilitation program is very important. I will also be offering telephone support to a 10 yr old who is still in school, to maintain the contact and the work weve been doing over the last 4 weeks, to have a break now would be really detrimental to him and his well being. Other ways are managing are to do facilitated sessions over Skype and Zoom with a child and a parent or carer. Its possible, not ideal but in my view the best way is to keep the contact and do what you can to provide support to that person. With adults its easier as Adults are able to go to a space where they can be quiet and thoughtful and talk over Zoom, with EMDR therapy there are very effective ways of working over video and we are lucky that this has already been well researched as an effective therapy intervention. So please dont worry if you need to continue psychological support for you or your child, your therapist, counsellor etc will be able to find other ways of working and supporting you.
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In the 2019 New Year edition of The New Scientist the lead article reveals resolutions that really are worth making.
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From the Dana Foundation publication 'Brain in the News' a report of a 13 yr old girl training her memory using every device and tool available, cards, phones, computer and tablet, she's entering a global memory competition. However, you don't have to consider entering a competition to be motivated to improve your memory skills. |  |
Scientists at the McGovern Institute for Brain Research say that memory is not an innate ability but a skill that needs working on. Its all too easy to say 'oh, but my memory is going, its my age' when all it takes is a little practice and structure. Scientists believe that the trick to developing memory skills is through association from new information to old information. They say it gets easier to remember things by adding information to them like context, image or narrative, even though that seems like there are more things to remember, more complexity, that is just how the human brain works. Consider a spatial map, like a complex mental landscape, this is how the brain places memories.
One strategy that relates to the memory working in a 'content-addressable network' is to combine new information with old information you are already familiar with. So take the example of your home, put some information on your bed, on a shelf, in the bathroom etc. no more than four items should be in one place. Then link them in your head and try to recall them.
If you have problems remembering names, try associating new people with key pieces of information - a bit like hashtagging I suppose?! On meeting a new person and hearing their name, put that person in a familiar place or location. The recall will be easier with both bits of associated information tied together. Go on - try it out. If you dont use it - you will lose it!
A recent article in The New Scientist reports on the link between smacking children and violence in the teenage years. A growing list of countries have banned smacking including Sweden and Germany and soon become illegal in Scotland. Research from Canada analysed child survey data from 88 countries. Results indicated that 13 yr olds in countries with full smacking bans were less likely to get into frequent physical fights with their peers. The UK National Society for the Prevention of Cruelty to Children stated that bans keep children safe from adults, but also from their peers. Overall evidence points to the situations where children who experience smacking when younger will model this behaviour in different societal contexts especially those complex ones in the teenage years where behavioural impulse can override rational thinking.
Teenagers develop their sense of identity and a sense of self that will endure into adulthood during this major period of development. This is a defining period, working out who you are, what you like, how you see yourself, how others may see you and a whole load of other complex changes in thinking and emotional processes relating to who you think you are!
Neuroscience studies have shown physiological grey matter changes in the teen brain in relation to the development of identity. The brain region responsible for this important growth is the dorsolateral prefrontal cortex (dmPFC on the diagram). In her book 'Inventing Ourselves The Secret Life of the Teenage Brain', Professor Sarah Jayne Blakemore, www.ucl.ac.uk/icn/people/sarah-jayne-blakemore,
amzn.eu/edn9BCX discusses research showing development and activity in dmPFC when teens are thinking about other people, how they compare to others and what others may think of them. These thoughts become an overwhelming concern as teens develop the capacity to deal with them. Even the thought that others may be thinking about them or the perception or slight possibility someone may be thinking about them, how I look; what I like; who I am - will light up this part of the brain. Compared to adults there is a significant difference. Adults use a different cognitive process and neural pathways when considering these questions, so the thinking of the self is unique and changing in these formative years.
Why the blog on this? I have major concerns about how social media is impacting this area of brain development. Teens can't seem to help this way of thinking when they are in the midst of this, it is a functional brain process, not a psychological thought or emotional response - it's out of their control. This change is concrete and necessary in humans' neurological development in the progression to adulthood.
Teens can only think in this way, at this stage and this way is in relation to others - peers being the most important group EVER - their peers, friends, distant friends, groups, colleagues, acquaintances, potential friends, partners etc..
The teen's sense of self is very much driven by their social world - friendships, relationships, interactions with others, as they feed the brain and pathways form. Sarah Jayne Blakemore @sjblakemore describes this as the 'looking glass self' - an introspective viewpoint, you judge yourself as a teen by what others think of you, how others may think of you and how they interact with you. This forms the identity and the sense of who we are.
Herein lies the problem with today's social media looking glass. As I've been researching this area, this has become a real concern. Our teens currently have some very virtual looking glasses! they are engulfed with what-ifs and maybes about who is looking at them, who is waiting for them to post, who is out there and what everyone thinks about them! These interactions are not taking place in reality, in the two-way day to day interactions but in their virtual one-way possible reactions, full of perceptions and anticipations. How stressful!
They cannot help checking, wondering & worrying. This is their feedback which is forming their pathways. Such complexity is bound to cause confusion and I wonder what impact this is having on their developing, malleable brains. The self-identity which evolves through these teenage years is based on experience and interaction with others and with the environment. Our teens have this extra and really complex aspect of one-way interaction and time lagging feedback. Trying to form a sense of self in such a maze of virtual and perceived social interactions from peers who you have indirect, direct and even possible relationships with must be changing how the dmPFC develops and how the teens' identity develops, the sense of who you are. What is the further impact on development into adulthood? Will this lead to problems as the brain matures, with personality and identity crisis, with the brain developing in this confused way that could become embedded with insecurities, anxieties and lack of confidence in who we really are? How does the young adult cope with this world without the solid foundation of their identity - scary isn't it?
Teenagers develop their sense of identity and a sense of self that will endure into adulthood during this major period of development. This is a defining period, working out who you are, what you like, how you see yourself, how others may see you and a whole load of other complex changes in thinking and emotional processes relating to who you think you are!
Neuroscience studies have shown physiological grey matter changes in the teen brain in relation to the development of identity. The brain region responsible for this important growth is the dorsolateral prefrontal cortex (dmPFC on the diagram). In her book 'Inventing Ourselves The Secret Life of the Teenage Brain', Professor Sarah Jayne Blakemore, www.ucl.ac.uk/icn/people/sarah-jayne-blakemore,
amzn.eu/edn9BCX discusses research showing development and activity in dmPFC when teens are thinking about other people, how they compare to others and what others may think of them. These thoughts become an overwhelming concern as teens develop the capacity to deal with them. Even the thought that others may be thinking about them or the perception or slight possibility someone may be thinking about them, how I look; what I like; who I am - will light up this part of the brain. Compared to adults there is a significant difference. Adults use a different cognitive process and neural pathways when considering these questions, so the thinking of the self is unique and changing in these formative years.
Why the blog on this? I have major concerns about how social media is impacting this area of brain development. Teens can't seem to help this way of thinking when they are in the midst of this, it is a functional brain process, not a psychological thought or emotional response - it's out of their control. This change is concrete and necessary in humans' neurological development in the progression to adulthood.
Teens can only think in this way, at this stage and this way is in relation to others - peers being the most important group EVER - their peers, friends, distant friends, groups, colleagues, acquaintances, potential friends, partners etc..
The teen's sense of self is very much driven by their social world - friendships, relationships, interactions with others, as they feed the brain and pathways form. Sarah Jayne Blakemore @sjblakemore describes this as the 'looking glass self' - an introspective viewpoint, you judge yourself as a teen by what others think of you, how others may think of you and how they interact with you. This forms the identity and the sense of who we are.
Herein lies the problem with today's social media looking glass. As I've been researching this area, this has become a real concern. Our teens currently have some very virtual looking glasses! they are engulfed with what-ifs and maybes about who is looking at them, who is waiting for them to post, who is out there and what everyone thinks about them! These interactions are not taking place in reality, in the two-way day to day interactions but in their virtual one-way possible reactions, full of perceptions and anticipations. How stressful!
They cannot help checking, wondering & worrying. This is their feedback which is forming their pathways. Such complexity is bound to cause confusion and I wonder what impact this is having on their developing, malleable brains. The self-identity which evolves through these teenage years is based on experience and interaction with others and with the environment. Our teens have this extra and really complex aspect of one-way interaction and time lagging feedback. Trying to form a sense of self in such a maze of virtual and perceived social interactions from peers who you have indirect, direct and even possible relationships with must be changing how the dmPFC develops and how the teens' identity develops, the sense of who you are. What is the further impact on development into adulthood? Will this lead to problems as the brain matures, with personality and identity crisis, with the brain developing in this confused way that could become embedded with insecurities, anxieties and lack of confidence in who we really are? How does the young adult cope with this world without the solid foundation of their identity - scary isn't it?
During my recent training on adolescence, a child psychotherapist had some interesting insights which resonated with me as a parent of a teen.
For adults, our memories of the teenage years are the most emotionally charged that we have and the most resonant in terms of how we view ourselves. The teen years are the forming of our real selves, our real personalities, the risks we took, the friends we made, the music we listened to. The brain remembers more of these years than earlier years and there are fewer gaps. This is to do with the development of the brain at this time of life and how those memories are stored to be retrieved in later life.
Maybe this is why so many parents, educators and all adults struggle with teens behaviour. It matters, because? Well, because we know what risks are taken, we know the consequences of those risks and we know that once you've got past this stage in your development into adulthood then certain opportunities have passed you by.
Adults also remember the intense emotions of those years, the pain of heartbreak, the pain of not fitting in, the pain of the friendships and the sheer joy of taking a risk and it paid off, of doing something you knew you weren't allowed to do, of falling in love so deeply for the first time. Of doing something that a few years later as an adult you know that you just wouldn't take the risk of doing because you're executive skills have developed - how could you have been so stupid!
So why do we fear and judge these years so harshly, because we know and we remember! WE cant bear it can we? We would rather they were put in a situation where they weren't exposed to these risks, those pains, those extremes highs and lows which could impact them for the rest of their lives. Not only impacting their opportunities but themselves, how they cope, their personalities - how they view love, friendships and life....
Big Stuff isn't it?!
Feeling powerless? Helpless? You're right there's not a lot we can do - we can accept it, we can reflect it, don't deny it, be alongside it and be there. Don't judge, don't restrict but enable the teenager to get through this as you did.
Remember that some of your feelings of outrage and incredibility may just come from within you, from your own experiences and memories!
For a long time, pregnant women have felt the responsibility and guilt regarding stress during their pregnancy and how this may impact their developing, unborn child. Not only are women worried about their diet, exercise and other health factors when carrying the child but also their own personality and how they respond to stress and whether they could pass this onto their child.
Is this the mother's sole responsibility? It seems to make sense that as the baby is growing inside the womb then whatever the mother is doing, eating, etc. will have a direct impact on that developing baby.
However, a recent article in the New Scientist explains that Epigenetic changes in DNA maeans that Dads have a shared responsibility. Offspring have two sets of genes combined to make up their DNA and in conception, they inherit genes from both parents.
New studies show that men who have suffered trauma or significantly stressful events, such as divorce in the family, can carry a modified DNA which is passed onto their offspring through their sperm. These men weren't necessarily born with this modified DNA but certain chemical changes through epigenetic mechanisms in response to outside influencers during the lifetime of that father modified the DNA. This modified DNA was found to be present in sperm, showing a trans-generational modification to the unborn child.
Mothers have often felt the focus and guilt of a child who is fretful or has difficulty coping with stressful situations as a baby, toddler or later in life. However, this research shows that it is a combination of the mothers and fathers DNA and personalities which impacts the unborn child's DNA and predisposition to certain behaviours. This helps to understand what factors have impacted these predispositions and how this manifests in the child's coping mechanisms and behaviour. The hope is that a more detailed understanding will enable targeted interventions, which could, in turn, modify the DNA of the child through Epigenetic mechanisms.
www.newscientist.com/article/2168952-changes-in-your-sperm-reveal-if-youve-had-a-difficult-life/
Over the past few years Neuroscience research has shown that the teen years are arguably the most important and formative phase of neurological development in the life of a human. During these years, adults often see teens as taking unnecessary risks, sensation seeking, considering themselves as invincible and not caring about what their adults think. If only it was that simple!
Research has shown that teens are aware of the level of risk in some of the actions they take - for example not wearing a cycle helmet or taking an illegal drug. They know the risks of injury, of illness, of addiction and they know what the consequences are and they know they could be dire, in fact, they have the same level of understanding of these risks as do adults.
However, there is something else at play here which dominates and overrides any knowledge of risks and their outcomes. The teenager becomes super sensitive to rewards but not the stickers, sweets or comic type rewards of their 'toddlerdom' but other more 'mature' rewards such as money, food (yes, always) and the most dominant during these years, the social reward from a peer or even the perception of it! Teens care about their peers, the judgements on them, they are developing a unique sense of self and worth which is heavily influence by their peers. They really do care about this!
As adults we have forgotten these intense feelings in relation to our peers, we are able to rationally recognise them, but we have little concept of their influence and force! Risk behaviour is unique to the teenager's developmental phase. Their decision making and deliberations when considering the risk/reward balance and outcomes is much less or none existent when the overriding enticement of potential rewards of social recognition is present.
This intense development in the brain of a teenager is considered a 'storm', where a surge of neurotransmitters and neurohormones are flooding the brain and driving the teen's behaviour. These intense emotions (adults barely remember and who would want to) the self-consciousness, the embarrassment, the shame, the self-criticising and the hypersensitivity to any perceived judgement or emotions – DIRE! For the teenager these extreme feelings activate areas of the brain which are similarly activated when there is a physical pain - that is intense. This is not a choice, not a rational decision - who would want that in their lives?!
Counter this with a massive surge in feeling good about yourself because your neurotransmitters for rewards are racing, you're feeling great, euphoric, on top of the world – who’s going to be the winning team? The reward mechanism of dopamine and serotonin are also quite addictive - the more you get the more you want. You’ve taken a risk and its paid off, in front of your peers as well!
So, neuroscience has proven that most teens can't help it. The decisions they make are based on a determined neurobiological mechanism, one overriding the other.
This then begs the question of how we can help teens to consider risks - can we direct or can we only influence and take preventative measures? Consider the cycle helmet use - a new piece of research published last week yet again shows the use of helmets reduces the risk of brain injury by 53% www.braininjuryhub.co.uk/news/study-finds-cycle-helmets-reduce-traumatic-brain-injury-by-53
However, we can assume that the overriding reward of looking cool, with your hair looking good, with the helmet on your handlebars, is so so much more rewarding and pleasure giving that the risk or worry of getting a brain injury... it's SO worth it! If your friends see you as well.. then bingo! (even if they haven’t, they might have done).
Laurence Steinberg and Sarah Jane Blakemore both suggest that health, parenting and education interventions should aim on developing a capacity for self-regulation and self control in the teen. The person is more able to recognise why, what or who influences their choices and what the possible risks may be. We know about self-regulation for the emotionally maturing 8-10 yr old children who don’t have the capacity to calm themselves down or recognise their feelings.
For the teenager, the consideration of the risk/reward scenario and the intensity and sensitivity of these feelings in an environment where they are more dependent with additional social pressures of social media added into the mix is a different ball game and has significantly changed in the past 5 years alone. More on this in a later blog...
Or, do we as the adults limit the opportunities to take risks especially where there may be potential injuries? US research shows that newly qualified drivers who have their peers as passengers are far more likely to have an accident. In some US states, laws have been passed to prevent a young driver having a passenger of their own age.
Please comment and share!
Blog thoughts taken from Inventing Ourselves The Secret Life of the Teenage Brain, Sarah-Jayne Blakemore http://amzn.eu/78oZ0Mh and The Age of Opportunity, Laurence Steinberg http://amzn.eu/cqSzgPv
All Neurorehabilitation therapy following a neurological injury or illness, is aimed at improving the independence of a person physically as well as psychologically to assist with engagement in activities of daily living through the improvement of function and abilities.
Recent neuroscience research has shown that one of the major routes for engaging with a person is through language and communication, using appropriate sensory stimulation. Elements of music are processed as non-verbal language-like structures with semantic and syntactic elements. These are processed and synchronised across multiple brain regions.
Listening to and participating in musical activities using rhythm, pitch, timbre and harmony enables neural processing and synchronisation across multiple brain regions. Neurologists have suggested that music activates more parts of the brain than any other single human activity.
Music Therapy in Neurorehabilitation is the therapeutic application of music to cognitive, affective, sensory and motor dysfunction due to disease or injury to the human nervous system.
Neurologic Music Therapy interventions are based on neuroscientific research models of music perception, production and processing on the non-musical brain and the behaviour it evokes on many levels of neurological functioning, including learning and neuroplasticity.
All Neurological music therapy techniques have a strong evidence-base, showing how it can help clients maintain or improve their speech and communication, motor skills, cognition or learning skills as well as behavioural modification and emotional well-being.
Standardized clinical techniques have been developed using scientific evidence. Such techniques include those focused on motor function using rhythmic auditory stimulation, patterned sensory enhancement and therapeutical instrument music performance. Communication functions, using musical speech stimulation, respiratory exercises, rhythmic speech cueing and vocal intonation therapy. Also for cognition, musical mnemonics, musical executive function training and mood and memory training to name a few. Such techniques use aspects of music such as rhythm, as an auditory stimulus, as a cue to begin a movement, sustain the movement and eventually entrain the brain to embed the movement once the cue has been taken away.
Individual treatment objectives for neurorehabilitation can be grouped into three main approaches depending on the patients’ needs
Music therapists working in neurorehabilitation contribute to an interdisciplinary team. The team includes physio therapists, speech and language therapists, occupational therapists and neuropsychologists.
Recent neuroscience research has shown that one of the major routes for engaging with a person is through language and communication, using appropriate sensory stimulation. Elements of music are processed as non-verbal language-like structures with semantic and syntactic elements. These are processed and synchronised across multiple brain regions.
Listening to and participating in musical activities using rhythm, pitch, timbre and harmony enables neural processing and synchronisation across multiple brain regions. Neurologists have suggested that music activates more parts of the brain than any other single human activity.
Music Therapy in Neurorehabilitation is the therapeutic application of music to cognitive, affective, sensory and motor dysfunction due to disease or injury to the human nervous system.
Neurologic Music Therapy interventions are based on neuroscientific research models of music perception, production and processing on the non-musical brain and the behaviour it evokes on many levels of neurological functioning, including learning and neuroplasticity.
All Neurological music therapy techniques have a strong evidence-base, showing how it can help clients maintain or improve their speech and communication, motor skills, cognition or learning skills as well as behavioural modification and emotional well-being.
Standardized clinical techniques have been developed using scientific evidence. Such techniques include those focused on motor function using rhythmic auditory stimulation, patterned sensory enhancement and therapeutical instrument music performance. Communication functions, using musical speech stimulation, respiratory exercises, rhythmic speech cueing and vocal intonation therapy. Also for cognition, musical mnemonics, musical executive function training and mood and memory training to name a few. Such techniques use aspects of music such as rhythm, as an auditory stimulus, as a cue to begin a movement, sustain the movement and eventually entrain the brain to embed the movement once the cue has been taken away.
Individual treatment objectives for neurorehabilitation can be grouped into three main approaches depending on the patients’ needs
- Restorative – using interventions to regain skill and function in a number of areas
- Compensatory – using techniques to help patients compensate for loss of function and ability
- Psycho-socio-emotional using interventions to engage, for emotional expression and communication and coping with difficulties
Music therapists working in neurorehabilitation contribute to an interdisciplinary team. The team includes physio therapists, speech and language therapists, occupational therapists and neuropsychologists.
futurism.com/researchers-depression-may-be-a-physical-illness-linked-to-inflammation/
Such an interesting article sent by a friend of mine. There has been alot of evidence pointing to the reality that having a compromised immune system can impact the development of certain illnesses: Cancer, diabetes, chronic stress, dementia to name a few. The brain's immune system is finely tuned and the importance of keeping a healthy immune system to ward off these diseases is so important. Diet plays a big part in this and so do the chemicals that are in our food which impacts the absorption of the right nutrients - such as essential amino acids and enzymes which impact immune cell functioning.
Such an interesting article sent by a friend of mine. There has been alot of evidence pointing to the reality that having a compromised immune system can impact the development of certain illnesses: Cancer, diabetes, chronic stress, dementia to name a few. The brain's immune system is finely tuned and the importance of keeping a healthy immune system to ward off these diseases is so important. Diet plays a big part in this and so do the chemicals that are in our food which impacts the absorption of the right nutrients - such as essential amino acids and enzymes which impact immune cell functioning.
The book linked from Amazon is one that Ive used with children up to about age 10yrs to help them understand how their brain can adapt and change as they develop. In addition, it shows how keeping healthy and eating well can impact the brain.. I love this book
Look at this on Amazon
Look at this on Amazon
Epigenetics affects how genes are read by cells, and subsequently how they produce proteins. What you eat, where you live, when you sleep, how you exercise – all of these can eventually cause chemical modifications around the genes that will turn those genes on or off over time. In certain diseases such as Cancer or Alzheimer’s, various genes will be switched into the opposite state, away from the normal state.
Epigenetics Is modifiable. With 20,000+ genes, what will be the result of the different combinations of genes being turned on or off?
Epigenetics Is modifiable. With 20,000+ genes, what will be the result of the different combinations of genes being turned on or off?
