 Hello, my name is Stephanie Cook and I'd like to talk about something that really interests me and it's about neuroscience and how and what part does neuroscience play in psychotherapy. So first of all I'd like to talk about why psychotherapists need to know about cortisol. So first of all let's talk about what cortisol is. Cortisol which is known more formally as hydrocortisone is a stress hormone. So it's a hormone that's produced in the brain and it's triggered by things that happen to us in our lives that cause us to feel stressed and when it's released it's in response to stress and it's released from the adrenal glands and it's part of our flight system. So for example if you get to a point in the morning when you'll leave in the house and you're in a hurry and you're late for a meeting and you lose your keys what happens? You go blank you can't think and you can't think because you're producing cortisol which is the stress hormone and it's released by a chain reaction which begins deep within the lower brain by the body's general hormone controller and that's called the hypothalamus and the hypothalamus releases a hormone which is for sure ATCH which triggers the pituitary gland to release another hormone which then in turn stimulates the adrenal glands to release cortisol. So let's have a look to see how that system works. Okay so if you look into the brain you'll see the hypothalamus just underneath the pituitary gland in the brain and that's the gland that releases a message way way down into the adrenal glands which are just above your kidneys and what happens then it releases cortisol which then washes over the body and the brain. So let's have a look at what the long-term effects are for that cortisol release. So as I said initially what happens when you panic or you get scared is you release a surge of the stress hormone and what that does is actually it shuts down your whole system so it stops you thinking it stops you it stops your immune system from working and generally gets you ready for the fight or flight. So you're either going to run or you're going to fight. So if cortisol is is continually produced in your brain and it's left unchecked it can flood it and the result of that is that it can damage neurons in your brain because it's quite toxic. Now the result of that is it can cause long-term damage to a limbic system or the orbital frontal brain. So if you think of the brain as being like a circuit board and it's firing off neurons all the time which help you eventually put down memories about how to do things and those memories are formed in the limbic system which is central to the emotional literacy and to self-regulation. So for example how to do things and and how to help regulate your bodily functions. So if that limbic system is awash with the toxic hormone of cortisol then what that then does is it impacts all of those areas emotional literacy memory and self-regulation. So the child's brain actually develops from birth onwards in fact 90% of the child's brain is developing from birth onwards and while that's developing the connections between the neurons are created. Now what happens as the child is growing up and is being cared for and is being cared for by the parents and is developing emotionally is having a number of intersubjective experiences that are helping it to form memories and one of those memories is about how to emotionally regulate and that develops through a constant attuned and healthy emotional emotional supportive other who help to ensure that the child develops the ability to self-regulate and keep cortisol levels in check. So for example when we're born in the early months of our life we produce cortisol twice a day around sort of 10 o'clock in the morning and around four o'clock in the afternoon and those of us who have babies will know those are the times when our babies are most likely to be crotchety. Now what do we do with a baby that's crotchety we help we hold them we contain them we jiggle them up and down and what that's doing to to the infant's brain is telling that infant it's okay you can stop producing the cortisol and the infant then starts producing hormones that stop them from feeling stressed. So that interaction from the mother or the carer and the child is really important because it's helping the child to lay down memories of what happens when they get stressed now eventually as a child gets older older they're able to regulate themselves. Now if a child does not get that into subjective emotional relatedness the toxic levels of stress hormone are consistently released and the attachment deficits can occur. So what might we observe in the therapy room with a client that's had this experience as a child of having high levels of stress? Well what we might see is that they are hypervigilant because if that stress hormone isn't turned off the hypothalamus in the brain consistently keeps telling the brain to keep passing messages to the adrenal glands to keep producing the hormone what happens then is the toxins keep on being released and it actually doesn't get turned off. So what happens is the client then becomes hypervigilant and what they are more likely to become as they get older is highly anxious and not so readily able to self-regulate. So we'll only take one thing to tip them into high levels of stress so for example in our everyday lives we can normally manage two three four five difficult things a day and we're able to regulate ourselves. For those people who are hypervigilant they can only manage one thing and it only takes a second thing to tip them straight into high stress anxiety levels. So what they might do to be able to cope with that is they may disassociate from those high stress levels so go off in their head somewhere and switch out they may go into capacitation rather than being in the world they'll incapacitate and not do anything about problem solving or they just might stay in the high levels of anxiety. What they will have is a poor ability to self-regulate what they might do as well if they haven't received that intersubjective experience is discount what they can do for themselves or discount high level of problem they might have and discount they can solve it they will consistently be fearful when they go into that stressful state and as I said they'll be hypervigilant and they also may experience a lack of trust and it's likely too that they'll have a poor attachment ability.