What is the insula? The important mental health brain structure you've never heard of.

I recently posted a vlog onYouTube about an area of the brain that is extremely important for mental health professionals to know about: The insula. To see the vlog go here! As promised, I wanted to also include a blog here describing this area of the brain, what it does, and why it's important!

The Insula Explained:

The insula, or the “Interoception Center,” is the main site of interoception. Interoception is one’s ability to feel into internal experience and connect with internal sensations. For instance, feeling hungry, warm, or jittery are all examples of interoception. This too-often overlooked area of the brain is extremely important because without a strong and regulated insula, emotion identification and regulation become very difficult. Imagine, for example, that a client suffers from panic disorder. If they cannot feel into the body and be aware of the physical sensations that part of their panic, it would be extremely difficult to treat their panic disorder! This is because the experience of emotion is not simply cognitive; Emotion is always experienced in the body.

When an individual is able to “feel into” the body and connect with internal sensations, those sensations provide critical information about the emotion the individual is experiencing. The ability to do this is often called “felt sense” by trauma expert Peter Levine (2009). In different mental health conditions, however, this can be difficult for clients. In several disorders the insula is underactive, meaning that it is difficult to feel into the body and be aware of emotional experiences. In some other disorders, the insula becomes overactive, leading to a misinterpretation of bodily sensations as dangerous or catastrophic.

Thus, one goal of trauma treatment is to build a strong but regulated insula that gives accurate information about internal states. With a more regulated insula, individuals improve interoception and experience fewer emotional outbursts and dissociative symptoms (including numbing). Additionally, with a strong insula individuals are better able to feel into their own bodies, identify the emotions they are experiencing, and regulate them. 

For two free insula strengthening tools you can start using right away, click HERE

Source: insula

Anxiety: The Perpetual Game of Mental Whac-A-Mole

Regardless of the type of anxiety you experience, you know it feels exhausting. This is for a couple of reasons. First, anxiety wears us out because it’s characterized by sympathetic nervous system arousal. This autonomic arousal, known as the “stress response” or the “fight or flight response,” is responsible for about 1,400 biochemical and psychophysiological changes in the body that make us feel tense, vigilant, nervous, and ready to act. While this can be helpful for short periods of time, such as when we swerve to avoid having a car accident, or when we can benefit from an extra boost of energy before an athletic competition, it can be unhelpful if we stay in this state too long or at the wrong time (such as when you’re trying to fall asleep at night). Unfortunately, it can be difficult to control when we feel anxious, and to what extent, and the result for some people is that they feel anxious or worried all the time.

Second, anxiety is exhausting because of how it impacts our thoughts. Anxiety tells us that there is always something that needs attention, or needs worried about, and it won’t let us relax until we’ve addressed all of those worrisome thoughts. But here’s the problem: It often feels as though you can never quite squash all of the thoughts you believe to be the cause of anxiety. This, too, contributes to a constant state of anxiety.

For people suffering from anxiety, worrisome thoughts seem to function like a never-ending game of Whac-A-Mole, the popular children’s arcade game where you hit plastic moles that keep popping up with a padded mallet. But unlike Whac-A-Mole, there is no end to the anxious thoughts that pop up. People suffering from this unending game of mental Whac-A-Mole can become very good at squashing each worry, one after another. However, while they become skilled at talking themselves out of believing each anxious thought, there is always another worry waiting to “pop up.” After a while squashing these anxious thoughts becomes exhausting, and ultimately it just doesn’t work.  

So what does work? To address mental Whac-A-Mole consider working on reducing the high stress response underlying the thoughts. While this may not be sufficient for stopping the Whac-A-Mole completely, it is often necessary, as it is frequently the case that underlying autonomic arousal fuels anxious thoughts. What happens is the nervous energy, which we can feel in our body, is picked up by our thoughts, which then try to make sense out of the anxiety. It does this by creating thoughts consistent with those anxious feelings. Thus, the problem is not always the anxious thoughts, rather, a big part of the problem can be the underlying arousal and anxious sensations. If you can tackle the stress response and the related physical and emotional reactions, it can be a major step toward managing anxious thoughts as well. Here are some techniques that can reduce a high stress response:

If your anxiety feels overwhelming or difficult to manage, consider seeking mental healthservices, as professional treatment for anxiety can be very effective for many people!


Originally published at: https://www.psychologytoday.com/blog/workings-well-being/201703/anxiety-the-perpetual-game-mental-whac-mole

My Therapist Keeps Telling Me To Breathe…. Why?

If you’re like a lot of people who’ve been to therapy, you’ve probably heard your therapist tell you to breathe. The recommendation might have been in passing, or perhaps they even taught you some specific diaphragmatic breathing exercises to practice at home. Either way, you may have asked yourself why this seems to be a thing. Why emphasize something you’re already doing? I’m breathing right now, and I bet you are too. I breathed yesterday, and the day before that, and I’ll breathe every day from now until I die.

When I’ve brought up breathing to clients, I’ve seen the initial, “I’m paying you for this?” look more than once. But breathing the right way is really good for you and might just help you reduce some of the symptoms that brought you to therapy in the first place. Let me explain.

Take Home Point 1: Normal breathing and diaphragmatic breathing are NOT the same thing.

This is critical to understand. Diaphragmatic breathing is when you fill your whole diaphragm with air, breathing fully in, and fully out. This is different from what most of our breathing tends to look like day to day, which is usually “chest breathing.” Chest breathing is faster and much more shallow, and does not utilize our entire diaphragm. Chest breathing can be associated with a heightened stress response, increased toxins in the body, and less oxygen in the brain, and is usually not very healthy. However, it’s what we’re all used to, and to create more healthy breathing habits takes training.

Take Home Point 2: In order to reduce your anxiety you must breathe through the diaphragm. All other breathing is pointless (other than it keeps you alive).

The error a lot of people make when practicing breathing exercises is that they don’t actually breathe through the diaphragm. Maybe it’s because they don’t know how to, or perhaps they erroneously think they are (but actually aren’t). For most people, there seems to be a lack of understanding regarding how important this actually is, so I want to emphasize this. If you are not breathing through your diaphragm during a mindful breathing exercise, you’re wasting your time.

Take Home Point 3: Breathing through the diaphragm activates the vagus nerve; vagus nerve activation is what reduces your anxiety.

When you breathe through your diaphragm, something amazing happens: You activate your vagus nerve, which tells your brain to stop producing anxious feelings and start relaxing. Here’s a depiction of the vagus nerve – it’s the bright yellow band running from the brain to the organs.


So here’s what happens when you breathe through the diaphragm:

1.     You inhale fully, expanding your diaphragm.

2.     As your diaphragm fills with air, the diaphragmatic wall pushes downward, like a balloon that is filling up.

3.     When the diaphragmatic wall drops, it begins to squish your internal organs a liitle bit.

4.     Wrapped around your internal organs is the vagus nerve, so as the organs are getting slightly compressed, so is the vagus nerve.

5.     When the vagus nerve is pressed, such as when you breathe through your diaphragm, it activates!

6.     After activating, the vagus nerve sends a signal upward, through the spine to the brain, telling the brain to stop the stress response and activate the relaxation response.

7.     The brain can then reduce the stress response and everything associated with it (fast heart rate, that nervous jittery/buzzing sensation, foggy thinking) and replace it with the relaxation response!

This whole process takes about 45 seconds. That’s right – we can literally calm down and reclaim a sense of control over our emotions, thanks to how our bodies are naturally built, in less than a minute. Amazing, right? So, the next time you’re told to breathe, consider trying it, but make sure you’re breathing through the diaphragm!

If you aren’t sure whether what you’re doing is diaphragmatic breathing, and want to ensure you’re breathing optimally, click HERE to request my free mini-guide, “Diaphragmatic Breathing 101: Five Ways To Breathe Well.” It contains five breathing strategies that take the guesswork out of diaphragmatic breathing.