(HS 059410 van der Kolk 2023) Basic Clinical Science

Course overview

Bessels Section: One of the most important findings regarding traumatic stress has been how it affects the developing brain, different forms of trauma at different stages of development, have significantly different effects on brain functioning and mental development. We will examine prospective and retrospective data on various forms of trauma on neural development, as well as epigenetic changes. We will look at how trauma affects ones relationship towards ones body, identity and the sense of self; we will view how neurofeedback can help regulate abnormal brain circuitry, and present the latest data on how psychedelic agents can change mental and neurobiological processes. Ressler and Teicher Section: Posttraumatic stress disorder (PTSD) manifests after exposure to a traumatic event and is characterized by avoidance/numbing, intrusive symptoms and flashbacks, mood and cognitive disruptions, and hyperarousal/reactivity symptoms. These symptoms reflect dysregulation of the fear system likely caused by poor fear inhibition/extinction, increased generalization, and/or enhanced consolidation or acquisition of fear. Increasingly, animal models of trauma exposure as well as human neuroimaging of PTSD suggests that sensory cortical areas are involved in the encoding of trauma, in addition to the well-established threat circuitry such as amygdala and anterior cingulate cortex. These data support a multimodal representation of trauma that can be experienced in different ways from primarily sensory phenomena, to dissociation, to classic threat-based hyperarousal and intrusive symptoms. I will discuss the evidence for genetic, neurobiological, and neural circuit mechanisms to understanding PTSD and future approaches to neurobiology-based interventions for posttraumatic stress disorder that have been developed via a bench to bedside translational models. Singer Section: Recently the fields of contemplative and social neurosciences have provided ample evidence for the beneficial effects of mindfulness- and compassion-based practices on mental health, resilience and social cohesion. I will present an overview of findings from two mental training studies, the ReSource and the CovSocial projects, on diverse training outcomes ranging from changes in brain structure and function, stress hormones, interoceptive body awareness to subjective wellbeing, prosocial behavior and cooperation. Whereas the first project, the ReSource project, was a large-scale 9-month longitudinal mental training study including more than 90 measures, the CovSocial project investigated how to reduce mental health problems exacerbated during the Covid19 pandemic through a purely app-based 10-week online program comparing the differential efficiency of classic mindfulness versus partner-based socio-emotional training (Dyads). I will discuss the findings in the context of their relevance for clinical applications and society at large.¿ Siegel Section: Mindfulness and compassion practices are now part of mainstream psychotherapy, while recently research on psychedelic-assisted psychotherapy has mushroomed, offering not only possible breakthrough treatments for trauma, but providing new insights into the nature of psychological distress and mechanisms of healing.¿¿ Why have we humans sought non-ordinary states to heal psychological injuries for millennia? How can recent research developments inform our clinical practice even if were not participating in the studies? This presentation will explore the common healing factors in non-ordinary states of consciousness and their practical applications in diverse forms of therapy.