Program Descriptions

Brain change and domestic violence

The goal of any domestic violence prevention program that treats offenders is to help the participants adopt and maintain a set of new behaviors and thought processes. It is relatively easy to educate clients about behavioral alternatives to violence. It is more difficult to have them practice these new behaviors within the group and hopefully in their real life home situations. What is most troublesome., though, is helping clients practice, practice, practice these new actions to the point they become totally familiar, habitual and automatic. Fortunately, our knowledge of how the brain works can help counselors promote real change. That is because real change inevitably involves brain transformation. New neuronal networks must be developed, improved and maintained while older, less desired networks are diminished in size and potency. A fuller description of neuronal networks, along with more information about my treatment program can be found in my upcoming article, “The Utilization of Neuroplastic Change Principles in Domestic Violence Treatment: An Experimental Program,” to be published in the October, 2014 issue of the peer-reviewed journal, Partner Abuse.

Here is an example of how such brain change patterns can be described to clients. Let’s  propose a client decides that one aspect of his tendency toward domestic violence is related to his habit of frequently making critical remarks. Although it would be useless to attempt to describe exactly how and where criticism is located in the brain (in reality, an abstract concept such as criticism will be linked with many overlapping circuits in the brain) it is meaningful to most clients to have them envision their criticism as a single network. Thus, the “criticism network” becomes the target for neural diminishment. The only way to do taht, of course, is by lessening the number of times one makes critical remarks as well as the number of times one even thinks about making such remarks. Here the phrase “use it or lose it” becomes paramount. The first goal for this client becomes not making criticisms so that the strength and interconnectivity of the criticism network will be weakened. Next comes building a more desired network, here entitled the “praise network.” Since “neurons that fire together wire together” it is imperative that the client identify and implement giving praise several times a day to his domestic partner, children, etc. By doing so over a fairly lengthy period (I generally estimate about six months) the client’s praise network will gradually evolve from a difficult, awkward task that requires conscious effort toward one in which the client can quickly and gracefully give praise to others in a natural, almost habitual manner. Thus the principles of long-term potentiation predict that the criticism network will be diminished through non-usage while the praise network will grow stronger and more efficient over time.

Arborization will predictably also affect the client’s behavior. For example, as the praise network grows it literally takes up more space in the brain and connects with other networks. So, for instance, the client might discover that giving praise makes it easier to be connected family members since they are now more likely to stay present and even seek his company. Connection in turn leads to engagement which leads to improved empathy toward the people he no longer criticizes and instead praises.

This last possibility demonstrates one way that brain change plans differ from standard behavioral management rpograms. Brain change in intrinsically evolutionary and therefore somewhat unpredictable. As the targeted network expands it links up with other neural networks in patterns unique to the history, wants and needs of the participant. For example, building a praise network might lead from praise to connection to empathy as above but it could also extend from praise toward self-praise and self-nurturing.

 

 

Emotional Styles

I had been looking for a way to supplement my basic batterer intervention curriculum (anger and stress management, communication and conflict-resolution training, CBT exercises) with information that would help my clients to improve their overall functioning long after they have finished the program, and in particular their ability to properly regulate emotions and maintain healthy relationships.   In this respect, I have found the book by Richard Davidson, The Emotional Life of Your Brain (Penguin Books, 2013), to be immensely useful.   How we go about getting our needs met is described from a neuroscientist’s perspective, based in studies of how behavior is related to specific brain functioning.  Compared to other theories on personality, his concept of  Emotional Styles is easier to understand and more suited to the work we do with partner-abusive clients.  The table below is central to the materials I have put together, based on Davidson’s research, for my programs here in the San Francisco Bay Area, United States.  We go over this table in group, after each clients has completed the Emotional Styles questionnaire.  Afterwards, we discuss how our program’s standard material, as well as suggestions by Davidson, can help improve their functioning in the various categories.

The Six Dimensions of Emotional Style

Dimension

Description, Brain Basis, and Impact on Emotion Regulation/Relationships

Resilience How slowly or quickly you recover from adversity.  Marked by greater left activation in the Prefrontal Cortex (a center of intention and self-control), and  by inhibitory signals to the Amygdala (a center of flight-or-fight responses).  Low resilience is associated with depression, intense emotions (such as anger), and impulsive behaviors. Individuals low in resilience get discouraged easily, or obsess over minor failures, and give up on long-term goals.
Outlook How long you are able to sustain positive emotion.  Individuals with a positive outlook have high neuronal activity in the Ventral Striatum, where neurons release dopamine, a neurotransmitter that plays a role in motivation, desire and positive emotion, as well as endogenous opiates (“runner’s high”).  Activity in this part of the brain is increased by signals from the Prefrontal Cortex.  Individuals with a negative outlook are more likely to be depressed, avoid social relationships, and to be unmotivated to pursue goals.
Social Intuition How adept you are at reading faces and body language and picking up social signals from people around you.  High social intuition is associated with high activity in the Fusiform Gyrus, and low levels of activity in the Amygdala.  Low social intuition can lead to isolation, poor interpersonal communication, anger, increased conflict and aggression, and depression.
Self-Awareness How well you perceive bodily feelings that reflect emotions (in addition to beliefs, values, motives, etc.).  High self-awareness is characterized in the brain by high levels of activity in the Insula, which is connected to the “visceral” organs – e.g., heart, lungs, stomach, sexual organs.  Low self-awareness is associated with difficulties in accurately gauging levels of stress, such as increased heart rate, as well as identifying emotions.  People who have poor self-awareness are less likely than others to take care of themselves.  They are more at risk for depression, feeling overwhelmed by their emotions and engaging in impulsive or aggressive behavior.
Sensitivity to Context How good you are at regulating your emotional responses to take into account the context you find yourself in.  Excellence at determining context is associated with high levels of neuronal activity in the Hippocampus, a part of the brain that is also associated with the transfer of short-term memories into long-term storage.  Individuals who have poor sensitivity to context have experienced some sort of trauma in the past (e.g., have grown up in an abusive or highly dysfunctional home, experienced serious assaults or accidents).  They tend to react to mild or moderate stress or provocation as though they were being re-traumatized.  In intimate relationships, this would include reacting to being yelled at by punching the other person, or interpreting a partner’s request for space as an indication of betrayal or abandonment.
Attention How sharp and clear your focus is, as determined by patterns of neuronal activity in the prefrontal cortex. Individuals who are high on the attention dimension are able to detect a high degree of detail in the environment without being overwhelmed, but can also focus their attention on something specific if they need to without shutting out everything else entirely.  Individuals who are at the low end, who tend to be unfocused, can miss important social cues, or hyper-focus too much, causing miscommunication and relationship conflict.

Couples Counselling Team in Malmö, Sweden and Solution Focused Counselling

Solution Focused Counselling in Domestic Violence Cases:

The last couple of years Domestic Violence have been in focus in Sweden. Severe cases and murders challenged the authorities and much effort have been made to provide individuals and families with professional help.

In Sweden the individual view on domestic violence still dominates – abuser and abused are treated individualy by most professionals working with domestic violence. In our Couple Counselling Team in Malmö we see a lot of couples every year and many of them are in conflicts they can´t handle. 25% of the couples are in hard conflicts where one or both cross the other persons bounderies by humiliations and physical abuse. Most of the couples we meet can be categorizad as situational violence, we don´t see the most severe cases (intimate terror cases).

We are interested in and will focus more on how to use Solution Focused Brief Therapy in our couples sessions. We want to challenge the dominating idea in our field and develop a relational model for working with domestic violence couples. Solution Focused Brief Therapy focuses couples goals and exceptions and there are interesting research being done pointing in direction of the importance of mutual agreement (couples and therapists) on goals and the goals described in specific details.

In Malmö there is also a team working individually with severe domestic cases and our plan is to collaborate with them to develop different options for individuals, couples and families struggling with hard conflicts, violence and abuse.

In our team we are also working with Single Session, a very brief model for counselling, with all couples who choose that when they schedule a session. In Single Session work we evaluate the sessions by using two scales before and efter the sessions – a stress scale and a handle the problem scale and we also use SRS.