DandleLION Webinar 5-6-2016...May 06, 2016 · Describe neuroception 4. Identify 2 caregiving activities that will benefit from this new knowledge

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

5/6/2016© 2015 Caring Essentials Collaborative 5/6/2016© 2015 Caring Essentials Collaborative

https://www.youtube.com/watch?v=cnUNBR1XWRQ

5/6/2016

Neuroanatomy of Emotion


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


The Thalamus & Basal Ganglia The Thalamus The Subthalamic Nucleus The Striatum & Pallidum The Nucleus Accumbens

Discriminative Versus

Affective Touch


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

5/6/2016

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


“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


5/6/2016© 2015 Caring Essentials Collaborative, LLC 5/6/2016© 2015 Caring Essentials Collaborative, LLC

5/6/2016

5/6/2016© 2015 Caring Essentials Collaborative, LLC 5/6/2016© 2015 Caring Essentials Collaborative, LLC

https://www.youtube.com/watch?v=apzXGEbZht0


Emotions and Feeling


5/6/2016

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


The Thalamus & Basal Ganglia The Thalamus The Subthalamic Nucleus The Striatum & Pallidum The Nucleus Accumbens

Neuroscience


What is the functional or adaptive significance of a given emotion?

5/6/2016© 2015 Caring Essentials Collaborative

Take Away


“… 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

5/6/2016

What happens in the Vagus doesn’t stay in

the Vagus!


“. . .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


Porges 2004

Stress ‐ Fear


Susceptibility to Fear


Pre‐existing Sensitivity (gene + environment)

Learning of Fear (traumatic event)

Consolidation of Fear (hours ‐ days following event)

5/6/2016

LaPierre & Heller 2012; Tronick & Beeghly 2011

Affect / Emotion

NEOCORTEX

Sensation / Felt Sense / Body Experience

Meaning / Beliefs / Identifications / Self Talk

LIMBIC

BRAIN STEM

Meaning‐Making


Fraley et al 2012; Beckes et al 2015


“…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


5/6/2016

“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


“Could a greater miracle take place than for us to look through each others’ eyes for an instant?”


Empathy

- Henry David Thoreau

https://www.youtube.com/watch?v=1Evwgu369Jw


“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

5/6/2016

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.


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


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.


References Pre-order TODAY

Endorsed by NANN with

recommendations by Susan Ludwig, Carole Kenner &

Heidelise Als!

5/6/2016

5/6/2016© 2015 Caring Essentials Collaborative [email protected]

Documents

DandleLION Webinar 5-6-2016...May 06, 2016 · Describe neuroception 4. Identify 2 caregiving activities that will benefit from this new knowledge