DandleLION Webinar 5-6-2016...May 06, 2016 · Describe neuroception 4. Identify 2 caregiving...
Transcript of DandleLION Webinar 5-6-2016...May 06, 2016 · Describe neuroception 4. Identify 2 caregiving...
5/6/2016
Affective Capabilities and Vulnerabilitiesof the Hospitalized Infant
Mary Coughlin MS, NNP, RNC‐EPresident and Global Learning Officer
Caring Essentials CollaborativeBoston, MA
5/6/2016
“That which touches the heart is engraved in the memory” ‐Voltaire
5/6/2016© 2015 Caring Essentials Collaborative, LLC
Upon completion of this workshop participants will:1. List the primary sensory afferents innervating human
skin and their associated neural pathway2. Explain the difference between emotions and feelings3. Describe neuroception4. Identify 2 caregiving activities that will benefit from this
new knowledge
Objectives
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https://www.youtube.com/watch?v=cnUNBR1XWRQ
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Neuroanatomy of Emotion
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Organs of Emotion
The Cerebral Cortex
The Frontal Lobe The Dorsolateral Cortex Orbitofrontal Cortex The Anterior Cingulate Cortex
The Temporal Lobe The Amygdala The Hippocampus
The Insula
The Hypothalamic‐Pituitary Axis & Septal Area
The Hypothalamus The Pituitary Gland The Septal Area
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The Thalamus & Basal Ganglia The Thalamus The Subthalamic Nucleus The Striatum & Pallidum The Nucleus Accumbens
Discriminative Versus
Affective Touch
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Receptor Type Modality Conduction Velocity
A β Fiber Group
Low‐threshold mechanoreceptors Discriminative Touch 60 ms ‐1
A δ Fiber Group
Nociceptors Pain 12 ms ‐1
Cool receptors Temperature ‐
C Fiber Group
Nociceptors Pain < 2 ms ‐1
Warm & cool receptors Temperature < 2 ms ‐1
Itch receptors Itch < 1 ms ‐1
Low‐threshold mechanoreceptors (CT) Emotional Touch < 2 ms ‐1
Sensory Afferent Nerves
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Schematic model of affective and sensory‐discriminative pathways for dynamic touch in hairy skin. CT afferents show an inverted U curve, while Ab afferent discharge increases linearly with velocity. Within cortex, reciprocal connections between posterior insula and secondary somatosensory cortex may allow mutual modulation of affective‐and sensory‐related processing
Morrison et al 2010
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“This C‐tactile system is not there to sense the physical world, it’s there to feel the physical world... It’s coding something very important, particularly during early development.”
‐Mclone 2012
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https://www.youtube.com/watch?v=apzXGEbZht0
5/6/2016© 2015 Caring Essentials Collaborative, LLC
Emotions and Feeling
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Organs of Emotion
The Cerebral Cortex
The Frontal Lobe The Dorsolateral Cortex Orbitofrontal Cortex The Anterior Cingulate Cortex
The Temporal Lobe The Amygdala The Hippocampus
The Insula
The Hypothalamic‐Pituitary Axis & Septal Area
The Hypothalamus The Pituitary Gland The Septal Area
5/6/2016© 2015 Caring Essentials Collaborative, LLC
The Thalamus & Basal Ganglia The Thalamus The Subthalamic Nucleus The Striatum & Pallidum The Nucleus Accumbens
Neuroscience
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What is the functional or adaptive significance of a given emotion?
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Take Away
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“… an emotion consists of a very well orchestrated set of alterations in the body that has, as a general purpose, making life more survivable by taking care of a danger, of taking care of an opportunity, either/or, or something
in between…To feel an emotion… is very simply the process of perceiving what is going on in the organs when you are in the throws of an emotion, and that is
achieved by a collection of structures, some of which are in the brain stem, and some of which are in the cerebral
cortex, namely the insular cortex along with a host of other structures.” Antonio Damasio
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What happens in the Vagus doesn’t stay in
the Vagus!
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“. . .when the heart is affected it reacts on the brain; and the state of the brain again reacts through the pneumo‐gastric [vagus] nerve on the heart; so that under any excitement there will be much mutual action and reaction between these, the two most important
organs of the body.” Darwin
Polyvagal Theory
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Porges 2004
Stress ‐ Fear
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Susceptibility to Fear
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Pre‐existing Sensitivity (gene + environment)
Learning of Fear (traumatic event)
Consolidation of Fear (hours ‐ days following event)
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LaPierre & Heller 2012; Tronick & Beeghly 2011
Affect / Emotion
NEOCORTEX
Sensation / Felt Sense / Body Experience
Meaning / Beliefs / Identifications / Self Talk
LIMBIC
BRAIN STEM
Meaning‐Making
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Fraley et al 2012; Beckes et al 2015
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“…attachment‐related patterns contribute to the organization of biological pathways in the brain and body that underlie emotion regulation capacities
and mental representations of the self and others.”
Compromised Cortical Development
Engelhardt et al 20155/6/2016© 2015 Caring Essentials Collaborative, LLC
Dialogical Self Theory
‘I exist because there is a You’
Stone et. al. 2012
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“It is an absolute human certainty that no one can know his own beauty or perceive a sense of his own worth until it has been reflected back to
him in the mirror of another loving, caring
human being.” ― John Joseph Powell
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“Could a greater miracle take place than for us to look through each others’ eyes for an instant?”
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Empathy
- Henry David Thoreau
https://www.youtube.com/watch?v=1Evwgu369Jw
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“I know it may seem small and insignificant, but it’s not about what it is, it’s about what it can become”
–The Once-ler, Dr Seuss’ The Lorax
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Beckes, L., Ijzerman, H., & Tops, M. (2015). Toward a radically embodied neuroscience of attachment and relationships. Frontiers in Human Neuroscience, doi: 10.3389/fnhum.2015.00266.
Engelhardt, E., Inder, T.E., Alexopoulos, D., Dierker, D.L., Hill, J., Van Essen, D., & Neil, J.J. (2015). Regional impairments of cortical folding in premature infants. Annals of Neurology, 77, 154‐162.
Fraley, R.C., Roisman, G.I., & Haltigan, J.D. (2013). The legacy of early experiences in development: formalizing alternative models of how early experiences are carried forward over time. Developmental Psychology, 49(1) 109‐126.
LaPierre, A. & Heller, L. (2012). Healing developmental trauma: how early trauma affects self‐regulation, self‐image, and the capacity for relationship. Berkeley, CA: North Atlantic Books.
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References
McGlone, F., Olausson, H., Boyle, J.A., et. Al. (2012). Touching and feeling: differences in pleasant touch processing between glabrous and hairy skin in humans. The European Journal of Neuroscience, 35(11), 1782‐1788.
McGlone, F., Wessberg, J., & Olausson, H. (2014). Discriminating and affective touch: sensing and feeling. Neuron, 82(4), 737‐755.
McGlone, F. & Reilly, D. (2010). The cutaneous sensory system. Neuroscience & Biobehavioral Reviews, 34(2), 148‐159.
Morrison, I., Loken, L.S., & Olausson, H. (2010). The skin as a social organ. Experimental Brain Research, 204, 305‐314.
References
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Porges, S.W. (2004). Neuroception: a subconscious system for detecting threats and safety. Zero to Three, May, 19‐24.
Stone, S.A., DeKoeyer‐Laros, I., & Fogel, A. (2012). Self and other dialogue in infancy: normal versus compromised developmental pathways. In H.J.M Hermans (ed.), Applications of Dialogical Self Theory. New Directions for Child and Adolescent Development, 137, 23‐38.
Tronick, E. & Beeghly, M. (2011). Infants’ meaning‐making and the development of mental health problems. American Psychology, 66(2), 107‐119.
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