第四章 同理理解：进化对我们大脑的影响

第四章

同情的理解：进化如何塑造了我们的大脑

正如我提到的，羞耻和自我批评是多种心理健康问题的根源（Gilbert & Irons, 2005; Gilbert, 2014）。CFT的主要目标之一是帮助客户来访将其内部体验的关系从评判和谴责的角度转变为理解和同情的角度。这项工作的一个核心主题是帮助客户来访认识到，他们经历的许多方面都不是他们的错——不是他们选择或设计的——同时帮助他们直接而积极地采取行动改善生活。这种向同情的转变始于帮助客户来访理解他们的情绪和动机与大脑和心智如何进化的关系，以及进化给人类带来的某些有趣的问题。因此，在CFT中，同情始于理解心智。

旧大脑与新大脑

20世纪90年代，Paul Maclean提出了三脑理论（Maclean, 1990），将人脑分为三个部分，反映了不同阶段的大脑进化。三脑理论包括爬行脑，负责基本的身体功能以及攻击和生殖驱动力；古哺乳动物脑——即边缘系统，涉及记忆、情绪和学习；以及新哺乳动物脑（大脑皮层），负责自我意识、象征思维、问题解决等高级认知过程。虽然大脑的实际运作并不那么简单（Cozolino, 2010），但Maclean的工作突显了进化如何塑造我们的大脑所带来的挑战，并为我们提供了一种与客户来访探讨这些动态的好方法。

在CFT中，我们使用“旧大脑”和“新大脑”的语言来与客户来访讨论这一概念（Gilbert, 2010）。在治疗中，有时使用“情绪大脑”来代替“旧大脑”会更有用，特别是在讨论情绪动态时。由于大脑的不同部分在我们的进化历史中以不同的时间演化，并为我们的祖先服务了不同的目的，因此旧大脑、新大脑和身体之间的互动可能会很复杂，从而给我们带来问题。理解这一点对客户来访来说是非常解放的，因为它有助于澄清为什么他们的情绪会感觉如此失控，以及为什么这不是他们的错。

让我们看看如何与客户来访探讨这一概念。在介绍这一概念时，我们要提供信息，但不要长篇大论。以下是一个如何初步探讨这一概念的例子，以Josh为例：

治疗师：Josh，我们一直在讨论你的愤怒，这是你长期以来一直挣扎的问题。在学习如何处理这样的情绪时，探讨它们的来源以及它们在我们大脑和心智中的运作方式是有用的。我们聊聊这个怎么样？ Josh：好的。 治疗师：如果我们从进化的角度来看，人类的大脑实际上非常复杂。它有点像我们有一个旧大脑，负责所有让我们的远古祖先生存下来的事情——基本的情绪和动机，帮助他们保护自己免受威胁并完成生存所需的任务——还有一个新大脑，负责解决问题、心理图像、自我意识和深层次的思考——比如我们想成为什么样的人，这一切意味着什么等等。这有道理吗？ Josh：嗯，我觉得有道理。 治疗师：让我们从你提到的情况来思考这个问题。你说过有时你会在工作中感到愤怒。能谈一谈吗？ Josh：主要是当我的同事质疑我，或者没有做他们说要做的事情时。那时我会非常生气。 治疗师：所以你的同事质疑你让他们做的事情，你的旧情绪大脑会将其视为威胁，然后愤怒就来了。这种愤怒是不是来得很快？ Josh：哦，是的。有时候甚至在他们提出问题之前我就生气了。如果他们做出表情，或者看着我好像不同意我说的话，我就会开始生气。我只是想让他们闭嘴，按要求做事。 治疗师：从进化的角度来看，我们的旧情绪大脑是为了帮助我们识别和应对威胁而设计的——就像我们的祖先生活在充满真实物理威胁的世界中一样——狮子、老虎、熊等等。愤怒是一种威胁情绪，准备我们去战斗。听起来你的旧大脑已经学会了将同事质疑你或不按约定行事视为潜在威胁，你的大脑反应就像是有老虎要攻击你一样。 Josh：（若有所思地看着）我想是这样。确实感觉像是威胁。 治疗师：让我们深入探讨一下。当你的同事质疑你或没有做你要求的事情时，你的新大脑中有什么想法？你在想些什么？ Josh：（停顿，思考）我在想他们是在挑战我——好像他们不尊重我或不信任我。如果他们尊重我，就会按我要求的去做，对吧？然后我在想事情可能完不成，或者做不好，这最终会归咎到我身上。我的老板会责怪我，即使我已经做了我该做的。 治疗师：（点头）有没有任何心理图像——比如在你脑海中播放的画面或电影——与这些想法一起出现？ Josh：（思考片刻）有。我能看到它在我的脑海中发生。我能想象他们翻白眼，背后议论我，不理我。我能想象我的老板来找我，问我出了什么问题——把没完成的事情归咎于我。这真是令人抓狂，你知道吗？ 治疗师：（点头，同情地）这确实令人抓狂。除了那种旧大脑的愤怒，新大脑还会增加很多其他东西——被嘲笑和忽视的想法，以及后果的图像——你的老板责备你。当愤怒出现时，有很多事情在发生。 Josh：是的，我想确实如此。

旧大脑：强大，但不够明智

在与客户来访探讨“旧大脑”和“新大脑”概念时，CFT治疗师常会说，“我们的‘旧情绪大脑’非常强大，但不是很聪明或明智。” 许多人可能有过向客户来访解释基本认知行为模型的经验，并使用苏格拉底式对话探讨不同的思维方式如何导致不同的情绪和行为（反之亦然）。在CFT中，我们希望理解并探讨这些动态与进化大脑的关系。

我们的旧大脑进化是为了激励我们的祖先做必要的事情以求生存，它们通过基本情绪系统（恐惧、愤怒、欲望、性欲等；Panksepp & Biven, 2012; Panksepp, 1998）和原型动机（照顾、竞争、性）的进化来实现这一点，其中许多是社会导向的（Gilbert, 2010; 2014）。当被外部或内部刺激触发时，通过各种神经递质和激素系统的介导，这些情绪和动机可以非常有力地引导和塑造我们的注意力、思维和推理、心理图像和动机（Panksepp & Biven, 2012; Gilbert, 2010）。我们将在第五章进一步讨论这一过程，但主要观点是，这些旧大脑的情绪和动机可以组织我们的大脑和身体，使我们容易陷入具有挑战性的感情体验中。例如，当Josh因同事的行为感到愤怒时，他会将注意力集中在感知到的威胁上（如同事质疑他、事情没有完成、被羞辱和责备的想法），产生与威胁相关的持续性思维和图像，并产生纠正同事的动机。当然，我们的旧情绪大脑也与身体体验模式有关，这些模式在塑造情绪感受中起着重要作用。

尽管旧情绪大脑在组织我们的思维方面非常强大，但它在区分思想和幻想与来自外部世界的真实刺激方面并不擅长。我们的情绪主要由隐性（非意识）处理系统产生，这些系统由各种输入触发——来自外部环境的信息；我们自己的思想、记忆和图像；以及身体体验（Gilbert, 2010）。因此，我们的情绪大脑和底层生物系统会对思想和图像作出强烈反应，几乎就像它们是真实的。这就是为什么我们会参与性幻想——性图像刺激大脑和内分泌系统的部分，产生性感觉，并在身体中产生相应的活动以引发性反应。改变情绪的关键在于处理和改变情绪大脑的隐性输入。

好消息是我们可以选择集中我们的思想和心理图像，以帮助产生我们想要的情感体验。我们将在本书的后半部分大量探讨这一动态。挑战在于，旧大脑、新大脑和身体之间的互动可以创造一种情感惯性，其中边缘系统中的条件性情感激活触发新大脑的思维、图像和记忆（以及身体反应），这些反应又反馈到旧大脑结构（如杏仁核）以加强最初引发它们的情感反应。当然，这一过程也可以反向进行，从记忆、思想（他不尊重我）、心理图像或身体感觉开始，旧大脑将其识别为威胁，导致相关的情感体验，过程继续进行。这对客户来访来说是一个富有成效的探索领域，因为他们开始理解不同的情绪和动机与特定的注意力、思维、图像、动机和身体体验模式之间的关联，并学习如何巧妙地处理这些体验及其背后的情绪和动机。

这是一个简化版的大脑活动过程，但它是基于情感神经科学研究（如Panksepp & Biven, 2012）。了解这些大脑和身体的互动对客户来访也有许多积极影响，这些都符合我们对同情的关注：

• 从评判和回避困难情绪转向好奇地检查和理解这些情绪在大脑中的表现。
• 认识到他们的情绪工作方式不是他们的错，而是因为我们大脑的进化方式以及大脑和身体各部分之间的相互作用。
• 提供线索，帮助他们开始以同情的方式处理情绪——通过创造新的、有益的输入来影响他们的旧情绪大脑。

让我们考虑一下如何引入这一概念

治疗师：Jenny，我想再多谈谈旧大脑和新大脑的概念，因为我认为这有助于我们更好地理解你的焦虑。首先，我想用一个比喻。你有宠物吗？ Jenny：有，我喜欢宠物。我有一只叫Penelope的狗。 治疗师：Penelope——多美的名字！我们有一只叫Sadie的狗。你有围栏的院子给Penelope吗？ Jenny：有，我有一个围起来的后院。 治疗师：我们没有——我们家后面是一片树林，所以我们决定保持开放，享受森林的景色。 Jenny：真好。 治疗师：确实很好，但有时也会带来挑战。我们有时会让Sadie出去，她会在后院玩耍。但由于没有围栏，有时会有其他狗闯入——你知道的，四处嗅嗅，尿在几块石头上，诸如此类。 Jenny：（点头） 治疗师：当其他狗闯入时，Sadie会变得非常防御性。 Jenny：她在保卫她的领地。 治疗师：没错！所以她会评估另一只狗。如果她认为自己能对付那只狗，她会发出威胁信号——站高，脖子上的毛竖起来，低吼。另一方面，如果那只狗看起来又大又吓人，她可能会做出顺从的姿态——也许趴下，仿佛在说：“这里不需要闹事。”（做出低头的手势） Jenny：（笑）是的，我在狗公园见过Penelope做同样的事。 治疗师：（微笑）那么，假设这种情况发生在Penelope或Sadie身上。事情变得有些紧张，但过了一会儿，另一只狗失去了兴趣，走开去别人的院子里撒尿。五分钟后，Penelope怎么样了？ Jenny：她没事。很快就恢复正常了。 治疗师：Sadie也是。虽然一开始她因为这只狗侵犯了她的领地而感到不安，但五分钟后，她就会过来讨摸，乞求吃点东西。（左右晃动头部，微笑） Jenny：没错。（微笑） 治疗师：现在，假设同样的事情发生在你或我身上。我们在家里，一个陌生人走进来，四处张望，也许从冰箱里拿东西，还在沙发角上撒尿…… Jenny：（笑） 治疗师：对不起……这个狗的比喻有点过头了！如果这种事情发生，我们可能会像Sadie或Penelope一样反应。我们可能会感到受到威胁，想要保护自己的领地。如果情况看起来可控，我们可能会变得强硬——“嘿，这是我的房子。我希望你立刻离开。” Jenny：是的。（点头） 治疗师：另一方面，如果入侵者看起来非常危险——比如说，他手里拿着枪，我们可能会做出顺从的姿态。（双手张开）“没关系。随便拿吧……没有人需要受伤……”我们的反应与Sadie或Penelope不会有太大不同。 Jenny：54 （继续点头） 治疗师：那么，问题是，假设一段时间后，入侵者失去兴趣离开了。五分钟后，你或我会怎么样？五小时后呢？五天后呢？ Jenny：（友好地）我会吓坏了！ 治疗师：（微笑）我可能也会。为什么会吓坏？我们的脑子里会发生什么？会有什么样的想法或画面？ Jenny：我会想着可能发生的事情。他可能会伤害我。我会担心他会不会再回来，下次会做什么。 治疗师：你的脑海里会出现什么样的画面？ Jenny：我可能会一遍又一遍地想象这件事再次发生。 治疗师：这些想法和幻想可能会加剧你的恐惧，让你持续害怕？ Jenny：确实会。 治疗师：没错！这就是你或我和Penelope或Sadie之间的区别。这与我们的旧大脑和新大脑之间复杂的沟通方式有关。狗有那些旧大脑的威胁反应，但当威胁消失后，它们会很快平静下来。而我们…… Jenny：我们会继续害怕。 治疗师：我们的想法和心理图景会反馈到我们的情绪大脑，加剧引起这些想法的恐惧——就像往火上浇汽油。所以，我们的情绪可以集中我们的注意力，触发我们脑海中的想法和画面——这些想法和画面反过来又会加剧引起它们的情绪。这有道理吗？ Jenny：（点头）就像我在课堂上想到人们嘲笑我，这加剧了我的恐惧。 治疗师：就是这样。重要的是要意识到这不是我们的错。你和我没有选择拥有这样复杂的大脑；这只是它们的工作方式——我们天生如此。但如果我们想要处理像恐惧和焦虑这样的情绪，了解这些大脑的工作原理会有所帮助。 Jenny：嗯哼。 治疗师：还有一点。想可怕的事情会加剧害怕的感觉。最可怕的念头之一就是：“我有问题。”（停顿） Jenny：（停顿，低头）我经常这么想。 治疗师：（停顿，然后用温和的语气继续）当这个念头出现时，你感觉如何？ Jenny：糟糕透了。 治疗师：（点头）确实糟糕透了。这就是为什么在CFT中，我们专注于培养对自己的同情和善意——我们希望找到思考和行动的方式，让我们感到安全，而不是受到威胁。 Jenny：那会很好。 治疗师：那么，我们就从这里开始吧。

上述例子展示了CFT治疗师如何向客户来访介绍旧大脑/新大脑的动态

上述例子展示了CFT治疗师如何向客户来访介绍旧大脑/新大脑的动态。使用狗的比喻旨在强化进化模型，首先展示我们的情感反应和行为中与哺乳动物相似的进化特征，然后探讨使我们面临独特问题的不同之处（即旧大脑/新大脑的复杂动态）。你会注意到，治疗师在这个比喻的解释过程中做了很多讲解。虽然很难通过文字传达，但我试图让读者感受到治疗师如何监控客户来访的非言语行为，并通过提问、节奏控制、肢体语言、语调和尝试幽默来维持互动，即使重点是在解释。每当我们有可能时，我们都希望尽早且频繁地将这些讨论与客户来访的实际经验联系起来——甚至在比喻中也是如此（这就是为什么治疗师问Jenny关于她自己的狗）。我们还可以看到，治疗师在客户来访微笑和点头时使用幽默，而在讨论转向Jenny的自我批判时则放慢速度，表现出对客户来访情感体验的共鸣。

在这个过程中，我们要保持关注我们试图与客户来访探讨的过程。一些客户来访可能会争辩说，伴随对入侵者恐惧而产生的威胁驱动思维是完全合理的，这些思维可能会触发有助于避免未来受害的行为（例如安装报警系统）。他们是对的。我们并不是想传达我们的思维和图景能够激发并被情绪大脑激发的能力是坏事。这既不是好事也不是坏事——只是事情的运作方式。关键在于，这种动态对我们来说可能是复杂的，有时会加剧不那么有帮助的威胁反应。这种交流有助于示范同情的理解——帮助客户来访从判断和贴标签（将思维和情绪视为正确或错误、好或坏）转变为专注于理解（将思维和情绪视为心理体验，以及它们之间有时复杂的动态）。最后，你会注意到，在这个小故事结束时，治疗师将例子与治疗中的一个更大主题联系起来——Jenny的自我批判如何维持她的威胁反应，以及同情如何在这方面提供帮助。

情绪惯性

正如上述例子所示，我们可以探讨旧大脑情绪、新大脑思维和图景以及身体感觉之间的互动如何维持情绪的能量。例如，如果在新大脑或旧大脑中检测到威胁（通过一个想法如“她不喜欢我”或先前条件化的威胁触发因素——比如闻到强奸犯曾经使用的香水味），它可能会引发恐惧或愤怒的情绪，这些情绪本身又会引发与之相关的思维和图景，以及身体的兴奋和紧张感（心跳加速、颤抖、紧咬牙关、肩部紧张等）。一旦这种体验的瀑布效应发生，系统的每个元素（新大脑、旧大脑、身体体验）都可以触发其他元素，加剧持续的情绪反应。新大脑的图景和思维、身体体验以及我们所处的环境（这些环境本身由情绪驱动的行为塑造）都可以作为持续输入到旧情绪大脑的因素，这既可能是好的也可能是坏的。

这种探索对客户来访是有用的，因为我们可以将我们在治疗中（和家庭作业中）所做的大部分工作框架为处理情绪大脑的各种输入。我们努力发展同情的思维方式和同情的图景，以帮助自己感到安全而不是受到威胁，并找到应对情境的有效方法，而不是基于威胁的反复思考。我们努力发展有效满足需求的行为方式，并通过身体帮助自己找到平衡而不是恐慌。

在促进这种讨论时，我发现画图很有用。我通常会在纸上或白板上画出一个简单的大脑。然后在大脑中间标记一个红色区域，大致位于边缘区的位置，代表旧情绪大脑。接着在大脑前部的四分之一处画一个框，代表新大脑的思维中心。在讨论时，我会从情绪大脑画箭头到新大脑的“思维框”，然后再画回去，以展示旧大脑和新大脑如何互动以维持持续的情绪反应的循环性质。我们还可以画类似的箭头从大脑向下到身体，再从身体回到大脑，以展示身体反应如何成为维持情绪循环的一部分。

安抚节律呼吸

正如我上面提到的，我们的情绪主要是由隐性处理系统引起的，这些系统会对各种输入作出反应——来自外部世界通过感官传递的信息、来自大脑较新部分产生的思维和图景的信息，以及来自身体的信息。越来越多的研究表明，处理来自身体的输入可以在帮助平衡情绪方面发挥重要作用。因此，在CFT中，我们最早引入的一种干预措施是专门针对身体的。在CFT中，我们称之为安抚节律呼吸（SRB），它涉及有意放慢呼吸。

在SRB中，我们指导客户来访放慢呼吸的节奏，并将注意力集中在放缓的感觉上。需要注意的是，这与我们将在第七章介绍的正念呼吸不同。在正念呼吸中，我们将注意力集中在正常的呼吸过程上，作为一种注意力的锚点，并一次又一次地将注意力带回到呼吸上。而在SRB中，重点在于创造一种放缓的感觉——放慢身体，放慢心灵。这种放缓可以通过激活副交感神经系统来帮助客户来访减轻威胁情绪的强度，从而开始从驱动这些情绪的新大脑/旧大脑/身体惯性中解脱出来。让我们考虑一下如何向客户来访介绍SRB：

安抚节律呼吸

现在，我想介绍一种称为安抚节律呼吸的练习。这种练习涉及通过呼吸来放慢身体和心灵的速度。具体来说，我们将放慢呼吸，并将注意力集中在放缓的感觉上。

• 让我们从坐直姿势开始，双脚平放在地板上，双手可以放在膝盖上。头部保持直立、庄严但放松的姿势。随着你对这项练习越来越熟练，你可以在各种情况下和体位中使用它，但我们先从一个舒适、直立的姿势开始。
• 如果你喜欢，可以闭上眼睛，将注意力集中在呼吸进入和离开身体的感觉上。只需注意这种呼吸的感觉。（暂停十到二十秒）
• 现在我们要放慢呼吸。让你的呼吸速率变慢，吸气时用四到五秒，稍作停顿，然后呼气时再用四到五秒。深吸一口气——1—2—3—4。（稍作停顿）然后慢慢呼气——1—2—3—4。
• 让我们用这种方式呼吸几分钟。在此过程中，让我们将注意力集中在放缓的感觉上——放慢身体，放慢心灵。如果这个呼吸速率太慢，试着找到一个对你来说舒适和安抚的速率。目标是以一种放缓和安抚的方式呼吸。
• （等待两分钟，或你选择的时间长度。时间应基于为客户来访创造一个成功的学习体验——而不是一个让他讨厌的体验！如果明显客户来访有抵触情绪，我们可以从三十秒开始。）
• 当你准备好时，让呼吸恢复到正常速率，轻轻地睁开眼睛。（等待客户来访的眼睛睁开）让我们探讨一下这种感觉。

一旦SRB练习结束，我们将花几分钟时间探讨客户来访对这项练习的体验。与所有放松练习一样，SRB的效果会随着练习的增加而增强，因此我们不应期望客户来访立即有显著的效果。我们可以解释说，以这种方式放慢呼吸并不能消除威胁情绪，但可以减轻它们，并为其他事情的发生创造空间（如正念观察我们的思维和情绪，以及转向同情的思维方式）。我通常在第一次会议后将SRB作为家庭作业布置——通常是每天练习两到三次，每次三十秒。我们需要与客户来访一起解决问题，尤其是如何提醒自己进行练习，因为最大的障碍往往是忘记练习。设置手机闹钟可以作为SRB练习的提示，也可以计划固定的时间进行练习（例如，特定时间段，或者——如果客户来访喜欢看电视——在每个节目的第一个广告时段）。SRB还为我们提供了一个很好的方式来介绍治疗将涉及定期的家庭练习，并塑造家庭作业的参与度——几乎任何人都能在一天中找到几次三十秒的时间来练习。这给了我们机会在每次会议开始时探讨家庭练习的情况。然后，我们可以对他们进行正面强化，协作解决可能出现的障碍，并在会议接近尾声时帮助制定新的家庭练习计划。

一些客户来访可能由于创伤条件或其他因素而讨厌专注于呼吸或身体。在这种情况下，我们不想将练习变成暴露试验（尽管我们以后可能会探讨这一点）——这里的目的是帮助他们以一种安抚的方式集中注意力。对于这些人，我们可以选择许多优秀的渐进式肌肉放松练习之一，或者与他们合作，找到一种他们可以集中注意力的安抚方式。（Paul Gilbert的一个小组决定握住网球，专注于其质感。）关键是要找到方法，让客户来访以一种不需要大量时间和精力的方式集中注意力，以达到安抚的效果。

总结

在本章中，我们探讨了帮助客户来访考虑大脑进化的方式，以及这如何给他们带来挑战。目标是开始促进从评判和攻击自己（和他人）的情绪和反应转向对大脑（和心灵）如何以及为何以这种方式工作的探究性理解。在下一章中，我们将深入讨论三种进化的情绪调节系统，以及进化如何塑造这些系统，以非常不同的方式组织我们的大脑和身体。

本章知识点阐述

进一步阐述的知识点

1. 羞耻和自我批评的根源

• 心理健康问题：羞耻和自我批评是多种心理健康问题的根源。CFT的目标是帮助客户来访从评判和谴责的角度转变为理解和同情的角度。
• 责任与改善：帮助客户来访认识到许多经历不是他们的错，同时鼓励他们采取行动改善生活。

2. 大脑的进化

• 三脑理论：
  • 爬行脑：负责基本身体功能、攻击和生殖驱动力。
  • 古哺乳动物脑（边缘系统）：涉及记忆、情绪和学习。
  • 新哺乳动物脑（大脑皮层）：负责自我意识、象征思维、问题解决等高级认知过程。
• 复杂互动：大脑的不同部分在不同的时间演化，服务于不同的目的，因此旧大脑、新大脑和身体之间的互动可能会很复杂，给人们带来问题。

3. 旧大脑与新大脑

• 旧大脑：负责基本情绪和动机，帮助识别和应对威胁。
• 新大脑：负责高级认知过程，如自我意识、问题解决和深层次的思考。
• 情绪与认知：旧大脑的情绪反应和新大脑的认知加工相互作用，可能导致情绪失控和复杂的心理状态。

总结

在CFT中，同情的理解始于对大脑和心智如何进化的认识。通过帮助客户来访理解他们的情绪和动机与大脑进化的关系，治疗师可以帮助客户来访从评判和谴责的角度转变为理解和同情的角度。旧大脑和新大脑的互动解释了为什么情绪会感觉如此失控，这有助于客户来访认识到许多经历不是他们的错，从而减轻自我批评和羞耻感。通过这一过程，客户来访可以更好地理解自己的情绪，学会更有效地管理情绪，从而改善生活质量。

进一步阐述的知识点

1. 旧大脑的特点

• 强大但不聪明：旧大脑非常强大，可以迅速引导和塑造我们的注意力、思维、心理图像和动机，但它在区分思想和现实刺激方面并不擅长。
• 基本情绪系统：旧大脑通过基本情绪系统（如恐惧、愤怒、欲望等）和原型动机（如照顾、竞争、性）来激励我们的祖先生存。
• 隐性处理：旧大脑的情绪主要由隐性处理系统产生，这些系统由外部环境、内部思想、记忆和身体体验等多种输入触发。

2. 情绪与认知的互动

• 情感惯性：旧大脑、新大脑和身体之间的互动可以创造情感惯性，其中条件性情感激活触发新大脑的思维、图像和记忆，这些反应又反馈到旧大脑结构，加强情感反应。
• 双向过程：这一过程可以双向进行，从记忆、思想、心理图像或身体感觉开始，旧大脑将其识别为威胁，导致相关的情感体验，过程继续进行。

3. 同情的理解

• 从评判到理解：通过了解大脑和身体的互动，客户来访可以从评判和回避困难情绪转向好奇地检查和理解这些情绪在大脑中的表现。
• 非个人化：客户来访认识到他们的情绪工作方式不是他们的错，而是因为我们大脑的进化方式以及大脑和身体各部分之间的相互作用。
• 同情的处理：提供线索，帮助客户来访开始以同情的方式处理情绪——通过创造新的、有益的输入来影响他们的旧情绪大脑。

总结

在CFT中，理解旧大脑和新大脑的互动对于帮助客户来访从评判和回避困难情绪转向好奇地检查和理解这些情绪在大脑中的表现至关重要。旧大脑虽然强大，但在区分思想和现实刺激方面不擅长，主要通过基本情绪系统和原型动机来激励生存。通过了解这些大脑和身体的互动，客户来访可以更好地理解不同的情绪和动机与特定的注意力、思维、图像、动机和身体体验模式之间的关联，并学习如何巧妙地处理这些体验及其背后的情绪和动机。这一过程不仅有助于客户来访减少自我批评和羞耻感，还能提高他们的情绪调节能力，从而改善生活质量。

进一步阐述的知识点

1. 旧大脑与新大脑的互动

• 旧大脑：负责基本的情绪和动机，如恐惧、愤怒、欲望等。当威胁消失后，旧大脑会迅速恢复平静。
• 新大脑：负责高级认知过程，如自我意识、象征思维、问题解决等。新大脑可以产生持续的思维和心理图景，这些图景会反馈到旧大脑，加剧情绪反应。

2. 情绪的持续性

• 动物的反应：动物在威胁消失后会迅速恢复平静，因为它们的旧大脑反应是即时的，不会持续。
• 人类的反应：人类的新大脑会产生持续的思维和心理图景，这些图景会反馈到旧大脑，导致情绪的持续和加剧。

3. 恐惧的自我强化

• 思维和图景：恐惧和焦虑可以通过持续的思维和心理图景自我强化。这些图景会反馈到旧大脑，进一步加剧恐惧。
• 自我批判：最可怕的念头之一是“我有问题”。这种自我批判会加剧负面情绪，使人感到更加无助和绝望。

4. 同情的理解

• 非个人化：了解大脑的工作原理有助于客户来访认识到，他们的情绪反应不是他们的错，而是大脑的自然反应。
• 培养同情：通过培养对自己和他人的同情和善意，可以帮助客户来访找到让自己感到安全而不是受到威胁的方法。

总结

在CFT中，理解旧大脑和新大脑的互动对于帮助客户来访更好地处理情绪如恐惧和焦虑非常重要。旧大脑负责基本的情绪和动机，当威胁消失后会迅速恢复平静。而新大脑负责高级认知过程，会产生持续的思维和心理图景，这些图景会反馈到旧大脑，加剧情绪反应。通过了解这一过程，客户来访可以更好地理解自己的情绪反应，减少自我批判，培养对自己的同情和善意，从而改善情绪管理和生活质量。通过这种方式，治疗师可以帮助客户来访找到让自己感到安全而不是受到威胁的方法。

进一步阐述的知识点

1. 旧大脑与新大脑的互动

• 旧大脑：负责基本的情绪和动机，如恐惧、愤怒、欲望等。当威胁消失后，旧大脑会迅速恢复平静。
• 新大脑：负责高级认知过程，如自我意识、象征思维、问题解决等。新大脑可以产生持续的思维和心理图景，这些图景会反馈到旧大脑，加剧情绪反应。

2. 情绪的持续性

• 动物的反应：动物在威胁消失后会迅速恢复平静，因为它们的旧大脑反应是即时的，不会持续。
• 人类的反应：人类的新大脑会产生持续的思维和心理图景，这些图景会反馈到旧大脑，导致情绪的持续和加剧。

3. 恐惧的自我强化

• 思维和图景：恐惧和焦虑可以通过持续的思维和心理图景自我强化。这些图景会反馈到旧大脑，进一步加剧恐惧。
• 自我批判：最可怕的念头之一是“我有问题”。这种自我批判会加剧负面情绪，使人感到更加无助和绝望。

4. 同情的理解

• 非个人化：了解大脑的工作原理有助于客户来访认识到，他们的情绪反应不是他们的错，而是大脑的自然反应。
• 培养同情：通过培养对自己和他人的同情和善意，可以帮助客户来访找到让自己感到安全而不是受到威胁的方法。

总结

在CFT中，理解旧大脑和新大脑的互动对于帮助客户来访更好地处理情绪如恐惧和焦虑非常重要。旧大脑负责基本的情绪和动机，当威胁消失后会迅速恢复平静。而新大脑负责高级认知过程，会产生持续的思维和心理图景，这些图景会反馈到旧大脑，加剧情绪反应。通过了解这一过程，客户来访可以更好地理解自己的情绪反应，减少自我批判，培养对自己的同情和善意，从而改善情绪管理和生活质量。通过这种方式，治疗师可以帮助客户来访找到让自己感到安全而不是受到威胁的方法。此外，通过图示和具体案例，治疗师可以更直观地向客户来访解释这些复杂的动态，帮助他们更好地理解和应用这些知识。

CHAPTER 4 Compassionate Understanding: How Evolution Has Shaped Our Brains

As I’ve mentioned, shame and self-­criticism underlie a wide range of mental health problems (Gilbert & Irons, 2005; Gilbert, 2014). A primary goal in CFT is to help clients shift the relationship they have with their internal experiences from a perspective of judgment and condemnation to one of understanding and compassion. A core theme in this work is to help clients recognize that many aspects of their experience are not their fault—­things that they neither chose nor designed—­while helping them take responsibility for working directly and actively to improve their lives. This shift to compassion begins with helping clients understand their emotions and motives in relation to how their brains and minds have evolved, and how evolution has presented human beings with some interesting problems. So in CFT, compassion begins with understanding the mind.

OLD BRAINS AND NEW BRAINS In the 1990s, Paul Maclean introduced the concept of the triune brain (Maclean, 1990), which described the human brain in terms of three parts, reflecting different stages of brain evolution. The triune brain included a reptilian brain, which is responsible for basic bodily functions as well as aggressive and reproductive drives; a paleo-­mammalian brain—­the limbic system, having to do with memory, emotion, and learning; and the neo-­mammalian brain (the cerebral cortex), which does the heavy lifting in terms of things like self-­awareness, symbolic thought, problem solving, and other higher-­order cognitive processes. While the reality of how the brain works isn’t quite so straightforward (Cozolino, 2010), Maclean’s work highlights some of the challenges presented by how evolution has shaped our brains, and gives us a nice way to explore these dynamics with our clients. In CFT, we discuss this concept with clients using the language of “old brain” and “new brain” (Gilbert 2010). In therapy, it can sometimes be useful to use the term “emotional brain” synony- mously with “old brain” when we’re specifically talking about the dynamics of emotion. Because different parts of the brain evolved at different times in our evolutionary history and served differ- ent purposes for our ancestors, the ways our old brains, new brains, and bodies interact can be tricky and can create problems for us. Understanding this can be very freeing for our clients, as it helps clarify why their emotions can feel so out of control, and why it’s not their fault. Let’s look at some ways to explore this idea with clients. When we’re introducing it, we want to provide information, but not go on with lengthy monologues. Here’s an example of how we might initially approach the concept with Josh: Therapist: Josh, we’ve been discussing your anger, which you’ve struggled with for some time. In learning to work with emotions like these, it can be useful to explore where they come from, and how they work in our brains and minds. How about we chat about that for a bit? Josh: All right. Therapist: If we look through the lens of evolution, we see that the human brain is actually very tricky. It’s kind of like we have an old brain, which takes care of all the stuff that kept our ancient ancestors alive—­basic emotions and motivations that helped them protect themselves from threats and do the things needed for survival—­and a new brain, responsible for things like problem solving, mental imagery, self-­awareness, and deep thinking—­about what sort of person we want to be, what it all means, that sort of thing. Does that make sense? Josh: Yeah, I think so. Therapist: Let’s think about this in terms of a situation you’ve discussed. You mentioned that you sometimes become angry at work. Could you talk a bit about that? Josh: It’s mostly when my coworkers question me, or don’t do something they said they were going to do. I get really pissed off then. Therapist: So your coworkers question something you’ve asked them to do, and your old, emotional brain registers that as a threat, and here comes the anger. Does it come up pretty quickly? Josh: Oh yeah. I get angry sometimes even before they ask a question. If they make a face, or look at me like they disagree with what I’m saying, I start getting angry. I just want to set them straight, like “Can’t you ever just shut up and do what you’re asked to do?” Therapist: From an evolutionary perspective, our old, emotional brains are designed to help us identify and respond to threats—­just like they did for our ancestors, who lived in a world with lots of real physical threats. You know—­lions, tigers, bears, and the like. Anger is a threat emotion that prepares us to fight. It sounds like your emotional brain has learned that your coworkers questioning you or not doing what they’ve agreed to do are potential threats, and your brain responds like they’re tigers out to get you. Josh: (With a look of consideration.) I guess so. I mean, it is threatening. Therapist: Let’s explore that. Let’s explore what’s going on in your new brain while this is happening. When your coworkers are questioning you or fail to do what you’ve asked of them, what thoughts are going through your mind? What are you thinking? Josh: (Pauses, thinking.) I’m thinking that they’re challenging me—­like they don’t respect me or trust me. If they respected me, they’d just do what I ask, right? And then I’m thinking that things aren’t going to get done, or aren’t going to get done right, which will then come back to me. My boss is going to let me have it, even though I did everything I was supposed to do. Therapist: (Nods.) Is there any mental imagery—­like pictures or movies playing out in your mind—­that goes along with those thoughts? Josh: (Thinks for a moment.) Yes. It’s like I can see it happening in my mind. I can picture them rolling their eyes, talking about me behind my back, and blowing me off. I can just see my boss coming to me, asking me what the problem is—­blaming me for stuff not getting done. It’s maddening, you know? Therapist: (Nods and speaks sympathetically.) That does sound maddening. So in addition to that old-­brain anger, the new brain is piling on a lot of other stuff—­thoughts of being mocked and blown off, and images of the consequences—­your boss coming down on you. There’s a lot of stuff going on when that anger comes up. Josh: Yeah, I guess there is.

The Old Brain: Powerful, But Not Very Wise One thing you’ll frequently hear CFT therapists say when exploring the idea of the old brain and the new brain with clients is that our “old, emotional brains are very powerful, but they aren’t very clever or wise.” Many of us may have experience explaining the basic cognitive behavioral model to our clients and using Socratic dialogue to explore how different patterns of thinking can lead to different types of emotion and behavior (and vice versa). In CFT, we want to understand and explore these dynamics in relation to the evolved brain. Our old brains evolved to motivate our ancestors to do what was necessary to survive, and they did this via the evolution of basic emotion systems (fear, anger, desire, lust, and so on; Panksepp & Biven, 2012; Panksepp, 1998) and archetypal motives (caregiving, competitive, sexual), many of which are socially oriented (Gilbert, 2010; 2014). When triggered by an external or internal stimu- lus, working through the action of various neurotransmitter and hormonal systems, these emotions and motives can very powerfully orient and shape our attention, thinking and reasoning, mental imagery, and motivation (Panksepp & Biven, 2012; Gilbert, 2010). We’ll discuss this process further in chapter 5, but the idea is that these old-­brain emotions and motives can organize our minds and bodies in ways that make it easy for us to feel trapped inside challenging affective experiences. For example, when Josh is feeling anger related to his coworkers’ behavior, he experiences a narrowing of attention onto the perceived threat (their questioning him, things not getting done, the idea of being humiliated and reprimanded), threat-­related perseverations in the form of thoughts and imagery, and the motivation to set his coworkers straight. Of course, our old, emotional brains are also associated with patterns of bodily experience as well, patterns which play a large role in shaping how the emotion is felt. While the old, emotional brain is powerful in how it can organize our minds, it’s not very good at distinguishing thoughts and fantasies from actual stimuli coming in from the external world. Our emotions occur largely as a result of implicit (nonconscious) processing systems that are triggered by various inputs—­information from the outside environment; from our own thoughts, memories, and imagery; and from our bodily experience (Gilbert, 2010). As a result, our emotional brains and underlying biological systems can respond powerfully to thoughts and imagery, almost as if they were real. This is why we engage in things like sexual fantasies—­sexual imagery stimulates parts of the brain and endocrine system that produce sexual feelings, with corresponding activity in the body to produce sexual responses. Changing emotion is all about working with and changing implicit inputs to the emotional brain. The good news is that we can choose to focus our thoughts and mental imagery in ways that help produce the sorts of affective experiences we want to have. We’ll be exploring this dynamic a great deal in the second half of this book. The challenging news is that interactions between old brain, new brain, and body can create an emotional inertia, in which conditioned emotional activation in the limbic system triggers new-brain thoughts, imagery, and memories (as well as bodily responses) that then feed back to old-­brain structures like the amygdala to fuel the very emotional response that created them. Of course, it can work the other way around, beginning with a memory, thought (he doesn’t respect me), mental image, or bodily sensation that the old brain registers as a threat, leading to related emotional experiences, with the process continuing. This is fertile ground for exploration with clients, as they begin to understand how different emotions and motives are associated with specific patterns of attention, thinking, imagery, motivation, and bodily experience, and then learn skillful ways to work with these experiences and the emotions and motives that underlie them. This is a simplified version of how things play out in the brain, but it’s based in affective neuro- science research (e.g. Panksepp & Biven, 2012). Learning about these brain and body interactions can also have a number of positive effects for our clients, all of which fit with our focus on compassion: • Shifting from judging and avoiding their challenging emotions to curiously examining and understanding how they play out in the mind. • Recognizing that the way their emotions work isn’t their fault, but occurs because of how our brains evolved and the ways different parts of our brains and bodies interface with one another. • Giving clues as to how they can begin to compassionately work with their emotions—­ through creating new, helpful inputs to their old, emotional brains. Let’ consider how we might introduce this concept: Therapist: Jenny, I’d like to chat a bit more about this old-­brain/new-­brain piece, because I think it might help us understand your anxiety a bit better. To start, I’d like to use an analogy. Do you have any pets? Jenny: Yes, I love pets. I have a dog named Penelope. Therapist: Penelope—­what a wonderful name! We have a dog named Sadie. Do you have a fenced-­in yard for Penelope? Jenny: Yes, I’ve got a fenced backyard. Therapist: We don’t—­the area behind our house is wooded, so we’ve decided to leave it open, to enjoy the view of the woods. Jenny: Nice. Therapist: It is nice, but it sometimes presents challenges. We let Sadie outside sometimes, and she’ll hang out in our backyard. But because we don’t have a fence, sometimes another dog will wander through—­you know, sniff around, pee on a few rocks, that sort of thing. Jenny: (Nods.) Therapist: When another dog wanders in, Sadie can get pretty defensive. Jenny: She’s defending her territory. Therapist: Exactly! So she’ll sort of size up the other dog. If she thinks she can take it, she’ll make a threat display—­stand tall, with the hackles on the back of her neck standing up, growling a bit. On the other hand, if the dog looks big and scary, she might make a submissive gesture instead—­maybe cowing down, as if to say, “No need to have any trouble here.” (Makes bowing-down gesture.) Jenny: (Laughs.) Yeah, I’ve seen Penelope do the same thing at the dog park. Therapist: (Smiles.) So let’s imagine that this happens to Penelope or Sadie. Things get a bit tense, but after a little while, the other dog gets bored and wanders off to pee on someone else’s yard. Five minutes later, how is Penelope? Jenny: She’s fine. Right back to normal. Therapist: Sadie, too. While she was initially upset because this dog invaded her territory, five minutes later she’s coming to get scratched, begging for a treat. (Moves head back and forth a bit, smiling.) Jenny: Exactly. (Smiles.) Therapist: So now let’s imagine that this same thing happens to you or me. We’re at home, and a stranger walks into the house, wanders around looking at things, maybe grabs something out of the fridge, pees on the corner of the couch… Jenny: (Laughs.) Therapist: Sorry…took the dog analogy a bit too far! If this were to happen, we might respond like Sadie or Penelope. We’d likely feel somewhat threatened, and probably want to protect our territory. If the situation seemed manageable, we might get assertive—­“Hey, this is my house. I’d like you to leave at once.” Jenny: Yeah. (Nods.) Therapist: On the other hand, if the intruder seemed very dangerous—­say, he was holding a gun, we might make a submissive display. (Holds hands up in an open gesture.) “It’s okay. Take whatever you want…there’s no need for anyone to get hurt…” We’d respond in ways that aren’t terribly different from how Sadie or Penelope might. Jenny: 54 (Continues to nod along.) Therapist: So here’s the question. Let’s imagine that after a while, the intruder gets bored and leaves. How would you or I be doing five minutes later? Five hours later? Five days later? Jenny: (good-­naturedly) I’d be freaking out! Therapist: (smiling) I probably would, too. Why would we be freaking out? What would be going on in our minds? What thoughts or images might play out for us? Jenny: I’d be thinking about what could have happened. That he could have really hurt me. I’d be worried that he might come back, thinking about what he might do the next time. Therapist: What images might be coming up in your mind? Jenny: I’d probably be picturing it happening again and again. Therapist: And those thoughts and fantasies might fuel your fear, keeping you afraid? Jenny: They sure would. Therapist: Exactly! That’s the difference between you or me and Penelope or Sadie. It has to do with the tricky way our old and new brains communicate with each other. The dogs have those old-­brain threat reactions, but when the threat is gone, they’ll tend to calm down fairly quickly. We, on the other hand… Jenny: We keep it going. Therapist: Our thoughts and mental images feed back to our emotional brains, and fuel the fear that caused them—­like pouring gasoline on a fire. So our emotions can focus our attention and trigger thoughts and images in our minds—­ thoughts and images that can then come back and fuel the very emotions that triggered them. Does that make sense? Jenny: (nodding) Like how those thoughts I have in the classroom about people laughing at me fuel my fear. Therapist: Just like that. It’s important to realize that this isn’t our fault. You and I didn’t choose to have brains that work in such tricky ways; it’s just how they work—­ what we were born with. But if we’re going to work with emotions like fear and anxiety, it can help to know how these brains work. Jenny: Mmm-­hmm. Therapist: One last thing. Thinking scary thoughts can fuel feelings of being scared. One of the scariest thoughts we can have is, There’s something wrong with me. (Pauses.) Jenny: (Pauses and looks down.) I have that thought all the time. Therapist: (Pauses, then continues with a kind tone of voice.) And how does it feel when that thought comes up? Jenny: Terrible. Therapist: (Nodding.) It does feel terrible. That’s why in CFT we focus on developing compassion and kindness for ourselves and others—­we want to find ways of thinking and acting that help us feel safe, rather than threatened. Jenny: That would be really nice. Therapist: Well, let’s work on that, then. The example above demonstrates how a CFT therapist might introduce old-­brain/new-­brain dynamics with a client. The use of the dog analogy is meant to reinforce the evolutionary model, initially demonstrating the evolved aspects of our emotional responses and behaviors that are similar to other mammals, and then exploring differences (the tricky old-­brain/new-­brain dynam- ics) that set us up for unique problems. You’ll note that there was a good bit of therapist talking there, as the analogy was explained. While it’s hard to convey in print, I’ve tried to give a sense of how the therapist would monitor the client’s nonverbal behavior and use questions, pacing, body language, tone of voice, and attempts at humor to maintain engagement and create an interactive experience, even when the focus is on explanation. Whenever possible, we want to link such dis- cussions to the client’s experience early and often—­even within the analogy (which is why the therapist asked Jenny about her own dog). We also see the therapist doing some mirroring of the client’s affective experience—­using humor when she is smiling and nodding along, and then rever- ently slowing things down when the discussion bridges to the Jenny’s own experience of self-­ criticism and things get a bit heavy. In doing this, we want to keep our focus on the process we’re trying to explore with the client. Some clients might argue that the threat-­driven thoughts that accompany fear of the intruder are completely valid, and could trigger behaviors (installing an alarm system, for example) that could help us avoid victimization in the future. They’d be right about this. We’re not trying to convey that the ability of our thoughts and imagery to fuel and be fueled by our emotional brains is bad. It’s neither good nor bad—­it’s just the way things work. The point is that this dynamic can be tricky for us, and can sometimes fuel threat responses that aren’t terribly helpful. This sort of inter- change can be useful in modeling compassionate reasoning—­helping clients shift from judging and labeling (thoughts and emotions as either right or wrong, good or bad) to a perspective that instead is focused on understanding (thoughts and emotions as mental experiences, and the sometimes tricky dynamics between them). Finally, you’ll note that as the vignette concludes, the therapist links the example back to a larger theme in the therapy—­how Jenny’s self-­criticism functions to keep her threat response activated, and how compassion can help with this.

Emotional Inertia As the above vignette demonstrates, we can explore how interactions among old-­brain emo- tions, new-­brain thoughts and imagery, and bodily sensations can work to maintain the energy of an emotion. For example, if a threat is registered in either the new or old brain (via a thought such as She doesn’t like me or a previously conditioned threat trigger—­like smelling the cologne that was worn by a rapist), it can trigger emotions of fear or anger, which themselves can give rise to thoughts and imagery associated with the emotion, as well as bodily sensations of arousal and tension (racing heart, shakiness, tensed jaw, tight shoulders, and so on). Once this cascade of experience occurs, each element of the system (new brain, old brain, bodily experience) can serve to trigger the others, fueling the ongoing emotional response. New-­brain images and thoughts, bodily experi- ences, and the environments we are in (themselves shaped by emotion-­driven behaviors) can all serve as ongoing inputs to the old, emotional brain—­for good or ill. This exploration can be useful to clients, as we can frame much of the work we do in therapy (and homework) as working with various inputs to the emotional brain. We work to develop com- passionate ways of thinking and compassionate imagery to help ourselves feel safe rather than threatened, and to find helpful ways of working with situations rather than threat-­based rumina- tion. We work to develop ways of behaving that are effective in getting our needs met. And we work with the body to help ourselves find balance rather than panic. In facilitating this discussion, I sometimes find it useful to draw it out on a piece of paper or whiteboard. I start by drawing a rudimentary brain. Then I’ll mark a red area in the middle of the brain, about where the limbic area is, to represent the old, emotional brain. I’ll then draw a box around the front fourth of the brain to represent the new-­brain thinking centers. While discussing things, I’ll draw arrows from the emotional brain to the new-­brain “thinking box,” and then back, to demonstrate the cyclical nature of how old and new brain can interact to fuel an ongoing emo- tional response. We can also draw similar arrows going down to and back from the body, to dem- onstrate how bodily responses can be a part of the cycle that maintains an emotion.

SOOTHING RHYTHM BREATHING As I mentioned above, our emotions occur largely as a result of implicit processing systems which respond to a wide range of inputs—­information coming in from the outside world through our senses, information coming down from the newer parts of the brain that produce thoughts and imagery, and information coming up from the body. Increasingly, we’re discovering that working with that input from the body can play a powerful role in helping to balance emotions. So one of the very first interventions we introduce in CFT is specifically targeted at the body. In CFT, we call this soothing rhythm breathing (SRB), and it involves purposefully slowing down the breath. In SRB, we guide clients to slow down the pace of their breathing and focus their attention on the sensation of slowing. It’s important to note that this is different from mindful breathing, which we’ll introduce later, in chapter 7. With mindful breathing, we focus attention on the normal process of breathing as an anchor for the attention, and bring our attention back to the breath again and again. In SRB, the focus is on creating a sense of slowing—­slowing down the body, and slowing down the mind. This slowing can help clients soften the intensity of threat emotions by activating the parasympathetic nervous system, and hence begin to shift away from the new-­brain/old-­brain/ body inertia that drives these emotions. Let’s consider how we might introduce SRB to a client:

SOOTHING RHYTHM BREATHING Now, I’d like to introduce a practice called soothing rhythm breathing. This practice involves slowing down our bodies and minds by working with the breath. Specifically, we’re going to be slowing down the breath, and focusing our minds on the sensations of slowing. •Let’s start by sitting in an upright posture, with both feet flat on the floor, and perhaps folding the hands in the lap. The head is held in an upright, dignified but relaxed posture. As you gain experience with the practice, you’ll be able to use it in all sorts of situations and body postures, but we’ll start like this, with a nice, comfortable, upright posture. •If you like, allow your eyes to close, and bring your attention to the sensation of your breath entering and leaving your body. Just notice this sensation of breathing. (Pause ten to twenty seconds.) •Now we’re going to slow down the breath. Allow your rate of breathing to slow, taking four to five seconds on the in-­breath, pausing for a moment, and then taking four to five seconds on the out-­breath. Breathing in deeply—­1—­2—­3—­4. (Pause for a moment.) Then slowly breathing out—­1—­2—­3—­4. •Let’s take a couple of minutes to breathe in this way. As we do, let’s focus our attention on the sense of slowing—­slowing down the body, slowing down the mind. If this rate of breathing is too slow, see if you can find a rate that is comfortable and soothing for you. The idea is to breathe in a way that is slowing and soothing. •(Wait two minutes, or however long you choose to do the practice. The timing should be based on making it a successful learning experience for the client—­not an aversive one in which he loses himself in thoughts about how much he hates it! So if it’s clear that the client is resistant, we can start with thirty seconds.) •When you’re ready, allow your breath to return to its normal rate, and gently allow your eyes to open. (Wait until client’s eyes are open.) Let’s explore what that was like. Once the SRB exercise is over, we’ll take a few minutes to explore the client’s experience of the practice. As with all relaxation exercises, the effects of SRB increase with practice, so we shouldn’t expect clients to have immediate dramatic effects. We can explain that slowing down our breathing in this way doesn’t make threat emotions go away, but can soften them, and create some space for other things to happen (like mindful observation of our thoughts and emotions, and shifting into compassionate ways of thinking). I usually assign SRB as homework after the first session—­often having clients practice it for thirty seconds at a time, two or three times per day. We’ll need to problem-­solve with clients around how they will remind themselves to do it, as the biggest obstacle is often forgetting to practice. Setting phone alarms can serve as a prompt for SRB practice, as can planning regular times to do it (for example, at specific times of day, or—­if the person is a televi- sion watcher—­during the first commercial of every program). SRB also provides us with a nice way to introduce the idea that therapy will involve regular home practice, and to shape homework participation—­almost anyone can find thirty seconds to practice a couple of times per day. This gives us the opportunity the create a nice routine in which we explore, at the beginning of each session, how the home practice went. We can then give them positive reinforcement for practicing, work collaboratively with them to overcome obstacles that may have arisen, and then help to develop a new home practice plan as the session winds down. Some clients may hate focusing on the breath or body, due to trauma conditioning or other factors. If this is the case, we don’t want to turn the exercise into an exposure trial (which we may very well want to explore later)—­the purpose here is to help them focus their attention in a soothing way. For these folks, we can choose one of the many excellent progressive muscle relaxation prac- tices that have been developed, or even work with them to find something they could focus their attention on that would be soothing. (One group of Paul Gilbert’s decided to hold tennis balls and focus on their texture.) The point is to come up with ways for clients to focus their attention in soothing ways that don’t take extraordinary amounts of time or effort.

SUMMARY In this chapter, we explored ways to help clients consider the manner in which their brains evolved and how this can create challenges for them. The goal is to begin facilitating a shift away from judging and attacking themselves (and others) for their emotions and reactions, replacing these habits with a curiosity-­driven understanding of how and why their brains (and minds) work the way they do. In the next chapter, we’ll deepen this discussion to explore three evolved emotion-­ regulation systems, and how evolution shaped these systems to organize our minds and bodies in very different ways.