How CBT & Neuropsychology Work Together

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Full Episode Transcript

Julie

Hi. My name is Dr. Julie Osborn, and I'm a doctor of psychology and a licensed clinical social worker specializing in cognitive behavioral therapy. I'm here to help you bring the power of CBT into your own life. So in this podcast, which is going to be really interesting to you guys, is I am interviewing my friend and colleague Dr. Victoria Smith, who is a neuropsychologist. So she's going to explain to us what that even means and for all of us to be able to understand our brains a little more and how CBT can help with some of the mental health struggles that we all go through on a regular basis. So let me first start by introducing Dr. Victoria Smith and let her explain to us what she does and what neuropsychology is.

Victoria

Hi, Julie. Thank you for having me. So neuropsychology is a broad field. I'll talk specifically about my background. I did my background in assessment, primarily, and traumatic brain injury. So obviously the field is more expansive than that, but that's what I was trained in.

Julie

Excellent. How do you use that today in your practice?

Victoria

Okay, so let me back up a bit, too. So I have a Master's degree in neuropsychology. My PhD is in clinical health. So my Master's degree was actually a really unique program. We did a lot of research. We did EEGs, we did a lot of assessment, and we did a lot of study, a lot of neuroscience neuroanatomy. So I think it's what the neuroscience right now has helped me really apply that information that I learned there to be able to better help my clients now who want understanding of how the brain is functioning and how it can actually interfere with healthy functioning, but how it's actually sourced from a very healthy vantage point.

Julie

Right. I think that's great. That's why I wanted you to talk today, because people are very focused on wanting to understand their brains. Why does my brain think so much? Why can't I control my thoughts? Like, what's going on? And they have all those questions that sometimes we have answers, sometimes we don't. I know, but you can explain more about how that brain is being affected by how we're feeling. Okay. That's the right way to put it.

Victoria

Yeah. I mean, that can happen. And then also we have to understand that we're wired to our brains to behave in a certain way.

Julie

Right.

Victoria

So sometimes it's not always connected to, like, what we're thinking. But you're absolutely right. It's just about feeling. And let me kind of back up, too, and say that understanding neuroplasticity can be helpful. That's the piece that I kind of want to talk about. The brain is not fixed.

Julie

Right?

Victoria

So sometimes we feel like, stuck in a rut, like, oh, things are never going to get better. But actually, the brain is very changeable. Now, this has been really supported by current, like, imaging studies. What we've always kind of known. We've analyzed it in animal studies, and now on human studies, we can see the brain is actually very what they call has a lot of neuroplasticity, so we can actually change our wiring. So I think one of the things I wanted to stress is kind of to I want people to feel empowered, so if they have this information, they know that I can apply some of these information and feel like I can do something to change my circumstances. For example, one basic area I like people to understand is chronic stress behaves like any kind of immediate traumatic stress, right. So it can build over time. And what we know from imaging studies is chronic stress actually reduces what we call the connectivity of the brain.

Julie

Right.

Victoria

These are pathways that deliver neurotransmitters to different parts of the brain. This is very important.

Julie

Right.

Victoria

We want our brain to have maximum access in pathways so it kind of flows well evenly.

Julie

Is that right?

Victoria

Yeah. In a very basic way. You want it to have as many diverse pathways as possible. An unhealthy brain has minimal so what we see in chronic stress and imaging studies is people pathways are reduced.

Julie

Wow.

Victoria

The good news is that when treated, the brain can act, go back and act in. They can build the pathways and act in a healthy manner.

Julie

Again, to me, that's huge and exciting. Exciting, right. And that goes back to that hot thought. You guys know what the hot thoughts or thoughts that are not 100% true? That I'm stuck. And now I can really tell you when you're telling me no, I'm stuck. I'm stuck. That you actually can change when you're thinking differently and taking care of yourself, that your brain can heal itself on some level.

Victoria

Yeah, that's just one example. The connectivity thing. Then there's a neurotransmitter issue, too.

Julie

Right.

Victoria

We know that stress can reduce certain neurotransmitters and things can improve certain neurotransmitters. We'll get into the amygdala, but that area has some sensitivity to it, too. There's a place called I think one of the things, too, is that the amygdala is very sensitive, and when we're overly stressed, an area called the lateral nucleus doesn't function properly to neurotransmitters that it receives. So I think that's just also important, too, to know that when we do addresses, we're addressing it from a connectivity issue, a neurotransmitter issue, a structural issue. So, again, we're improving ourselves. When we talk about ways to target it, we're improving it from multi angles.

Julie

Which makes me think that's why I have Dr. Smith on, because you can tell how smart she is. Every time we talk and she tells me stuff, I'm like, oh, wow.

Assuming tell me if it's true because we're dressing it from different angles. That also gives me hope that it's not just, oh, I need to get this one thing right to get that correct. Is that correct?

Victoria

Yes.

Julie

Okay.

Victoria

Yeah. And I think it should make us feel like I said empowered.

Julie

Right?

Victoria

Yes. And honestly, we'll kind of go through things, but sometimes it just takes very little. And I only say that because there are people who like to exercise and I think that they can see the positive benefit. But that's one of our strongest areas. I think we always hear that. And actually the research supports that the exercise is so beneficial for the brain.

Julie

Okay, and how does exercise help with the things you're already talking to us about?

Victoria

So when we talk about like that connectivity issue okay, so when it's one way to increase connections, it actually when people exercise, they affect basically how serotonin is received by that lateral nucleus, resulting in a calmer amygdala. Right, yeah. And that's very beneficial to us. And I know some people don't want to hear about exercise because they think that they're limited, but just keep in mind, just pick something I know we're getting a little bit ahead of. I'm getting ahead of myself here. But pick something that you like. Yes, pick something that's easy to do, like set yourself up for success. Put it in your calendar. I think we're all at fault for that. We get busy and we think, I'll do it tonight after work and then after work, we're tired and we say tomorrow morning. But if we slot to that, we're more likely to do it or make ourselves accountable by connecting with a friend, saying, hey, can we do this together? We don't have to be together, but we can just make a commitment to each other to do that or sign up for something. Like, there's all this stuff now on the Internet, and lo and behold, people do stay committed even though they don't know these people. They're on the Internet where they have to check that little box that day. Most people are going to follow through.

Julie

Yes, those are all great ideas. And that falls under what I talk about a lot is your self care. So whenever you give time for self care, you can put exercise in there as well. And to know also that you might not get this quote, runner's hottie, but it doesn't mean it's not working on your brain still, right?

Victoria

Yes, absolutely.

Julie

That's good. So don't think I didn't feel all.

Victoria

This great this or great that.

Julie

It's still working. Yes, it's still working. Kind of like I mean, it gives me an idea of like, say you're on a diet, you need to be on it. Follow the diet every day until you start seeing the weight come off. You don't lose a pound every single day because you're eating well.

Victoria

Right.

Julie

It's cumulative. It takes consistency. Is that fair to say? Yeah. For you to really see the results. Exactly, yeah.

Victoria

Okay, so I guess let me also say you asked me to do this talk and I thought I'd focus on anxiety because obviously neuroscience is so broad and we could go on forever about different aspects of it. So I thought I'd take one area. And I like anxiety because obviously I don't like anxiety. I was going to say I think it's important, okay. Because in 2020, I think as a clinician, we all saw like, a rise in anxiety, and we know what's happened to the service of psychology. Right now, we're all full, and anxiety, obviously, is one of the things, anxiety and depression. But anxiety is just so elevated. We don't have time to go into that and the reasons why, but we just know that it's here, right? So we want to give people tools to deal with it. I think it's important to understand that there are really two types to me, anxiety that we can kind of talk about. One is what I call cortical anxiety, and the other one is amygdala driven anxiety.

Victoria

Okay. So cortical anxiety is like the person who wakes up at night and can't shut their brain off and maybe goes into obsessive mode, is worried about something and can't stop thinking about it. That's cortical, because you can ask that person, what's on your mind? What are you thinking? And they can tell you.

Julie

Right.

Victoria

The other type of anxiety is amygdala anxiety. And that's the people who say, in the middle night, I sat up in bed and I was having a panic attack, and obviously they weren't thinking of anything. They were sleeping.

Julie

Yes.

Victoria

And you say, what are you thinking about? Nothing. I was asleep. Right, and then you really tried if you try to press that person, I mean, I've done that. I've been saying, like, okay, let's try to get to the stores maybe subconscious, but it's really just the amygdala being overactive.

Julie

Right.

Victoria

And there comes back to that chronic issue I was talking about. It's like you're holding on to something even at a subconscious level. And so your Meg's a lot is basically working. It's housing that energy, if you will. There's another great little example always floating around on instagram TikTok or whatever. It says that professor holding that glass, I think, and he says, how much this weight? And it's very light, obviously. And the students are raising their hand like 2oz, making their guesses, and he says, yeah, okay, but how much would it weigh in an hour? And they're like, that'd be heavier. How about at the end of the day, your arm would be breaking?

Julie

Right.

Victoria

So that's what chronic stress is doing to our brain and our amygdala. It's holding on to it. It's basically overactive.

Julie

Let me ask let me check for a second. So tell me just a little more so they can understand. What is the amygdala?

Victoria

Good question. Okay, so the amygdala helps us react to all sorts of potential dangers, okay? Right. So it's in our DNA, because our ancestors, the ones who survived and gave us this, basically it's a magnificent, beautiful thing because it's very protective and it works in less than a second. I don't know the exact number on the milliseconds, but it fires away.

Julie

Right.

Victoria

So obviously it's a wonderful thing to have. Is it uncomfortable when we're under conditions of chronic stress and we don't need it? Yes, of course.

Julie

Right.

Victoria

But are we happy to have it when we're avoiding getting hit by a mass cross? Yes. And so that's amygdala anxiety right there in action. We're running down a path and we see a snake and we don't know if it's dangerous or not, but we run, we might scream, and that's hard to do. The cortex is the thing that says, oh, it's probably not dangerous or far away, or it still makes me uncomfortable. I'm getting off this road. That's the cortex.

Julie

Right.

Victoria

And so the cortex is more like the cortex is what assigns meaning to something. Right. So then you can work on CBT with that, like, okay, making assumptions and addressing that thing. But the amygdala is different.

Julie

Hi. My name is Dr. Julia Osborne, and I'm a doctor of psychology and a licensed clinical social worker specializing in cognitive behavioral therapy. I'm here to help you bring the power of CBT into your own life. So in this podcast, which is going to be really interesting to you guys, is I am interviewing my friend and colleague Dr. Victoria Smith, who is a neuropsychologist. So she's going to explain to us what that even means and for all of us to be able to understand our brains a little more and how CBT can help with some of the mental health struggles that we all go through on a regular basis. So let me first start by introducing Dr. Victoria Smith and let her explain to us what she does and what neuropsychology is.

Victoria

Hi, Julie. Thank you for having me. So neuropsychology is a broad field. I'll talk specifically about my background. I did my background in assessment, primarily, and traumatic brain injury. So obviously the field is more expansive than that, but that's what I was trained in.

Julie

Excellent. How do you use that today in your practice?

Victoria

Okay, so let me back up a bit, too. So I have a Master's degree in neuropsychology. My PhD is in clinical health. So my Master's degree was actually a really unique program. We did a lot of research. We did EEGs, we did a lot of assessment, and we did a lot of study, a lot of neuroscience neuroanatomy. So I think it's what the neuroscience right now has helped me really apply that information that I learned there to be able to better help my clients now who want understanding of how the brain is functioning and how it can actually interfere with healthy functioning, but how it's actually sourced from a very healthy vantage point.

Julie

Right. I think that's great. That's why I wanted you to talk today, because people are very focused on wanting to understand their brains. Why does my brain think so much? Why can't I control my thoughts? Like, what's going on? And they have all those questions that sometimes we have answers, sometimes we don't. I know, but you can explain more about how that brain is being affected by how we're feeling. Okay. That's the right way to put it.

Victoria

Yeah. I mean, that can happen. And then also we have to understand that we're wired to our brains to behave in a certain way.

Right.

Victoria

So sometimes it's not always connected to, like, what we're thinking. But you're absolutely right. It's just about feeling. And let me kind of back up, too, and say that understanding neuroplasticity can be helpful. That's the piece that I kind of want to talk about. The brain is not fixed.

Right?

Victoria

So sometimes we feel like, stuck in a rut, like, oh, things are never going to get better. But actually, the brain is very changeable. Now, this has been really supported by current, like, imaging studies. What we've always kind of known. We've analyzed it in animal studies, and now on human studies, we can see the brain is actually very what they call has a lot of neuroplasticity, so we can actually change our wiring. So I think one of the things I wanted to stress is kind of to I want people to feel empowered, so if they have this information, they know that I can apply some of these information and feel like I can do something to change my circumstances. For example, one basic area I like people to understand is chronic stress behaves like any kind of immediate traumatic stress, right. So it can build over time. And what we know from imaging studies is chronic stress actually reduces what we call the connectivity of the brain.

Right.

Victoria

These are pathways that deliver neurotransmitters to different parts of the brain. This is very important.

Right.

Victoria

We want our brain to have maximum access in pathways so it kind of flows well evenly.

Julie

Is that right?

Victoria

Yeah. In a very basic way. You want it to have as many diverse pathways as possible. An unhealthy brain has minimal so what we see in chronic stress and imaging studies is people pathways are reduced.

Julie

Wow.

Victoria

The good news is that when treated, the brain can act, go back and act in. They can build the pathways and act in a healthy manner.

Julie

Again, to me, that's huge and exciting. Exciting, right. And that goes back to that hot thought. You guys know what the hot thoughts or thoughts that are not 100% true? That I'm stuck. And now I can really tell you when you're telling me no, I'm stuck. I'm stuck. That you actually can change when you're thinking differently and taking care of yourself, that your brain can heal itself on some level.

Victoria

Yeah, that's just one example. The connectivity thing. Then there's a neurotransmitter issue, too.

Right.

Victoria

We know that stress can reduce certain neurotransmitters and things can improve certain neurotransmitters. We'll get into the amygdala, but that area has some sensitivity to it, too. There's a place called I think one of the things, too, is that the amygdala is very sensitive, and when we're overly stressed, an area called the lateral nucleus doesn't function properly to neurotransmitters that it receives. So I think that's just also important, too, to know that when we do addresses, we're addressing it from a connectivity issue, a neurotransmitter issue, a structural issue. So, again, we're improving ourselves. When we talk about ways to target it, we're improving it from multi angles.

Julie

Which makes me think that's why I have Dr. Smith on, because you can tell how smart she is. Every time we talk and she tells me stuff, I'm like, oh, wow.

I'm.

Julie

Assuming tell me if it's true because we're dressing it from different angles. That also gives me hope that it's not just, oh, I need to get this one thing right to get that correct. Is that correct?

Victoria

Yes.

Julie

Okay.

Victoria

Yeah. And I think it should make us feel like I said empowered.

Right?

Victoria

Yes. And honestly, we'll kind of go through things, but sometimes it just takes very little. And I only say that because there are people who like to exercise and I think that they can see the positive benefit. But that's one of our strongest areas. I think we always hear that. And actually the research supports that the exercise is so beneficial for the brain.

Julie

Okay, and how does exercise help with the things you're already talking to us about?

Victoria

So when we talk about like that connectivity issue okay, so when it's one way to increase connections, it actually when people exercise, they affect basically how serotonin is received by that lateral nucleus, resulting in a calmer amygdala. Right, yeah. And that's very beneficial to us. And I know some people don't want to hear about exercise because they think that they're limited, but just keep in mind, just pick something I know we're getting a little bit ahead of. I'm getting ahead of myself here. But pick something that you like. Yes, pick something that's easy to do, like set yourself up for success. Put it in your calendar. I think we're all at fault for that. We get busy and we think, I'll do it tonight after work and then after work, we're tired and we say tomorrow morning. But if we slot to that, we're more likely to do it or make ourselves accountable by connecting with a friend, saying, hey, can we do this together? We don't have to be together, but we can just make a commitment to each other to do that or sign up for something. Like, there's all this stuff now on the Internet, and lo and behold, people do stay committed even though they don't know these people.

Victoria

They're on the Internet where they have to check that little box that day. Most people are going to follow through.

Julie

Yes, those are all great ideas. And that falls under what I talk about a lot is your self care. So whenever you give time for self care, you can put exercise in there as well. And to know also that you might not get this quote, runner's hottie, but it doesn't mean it's not working on your brain still, right?

Victoria

Yes, absolutely.

Julie

That's good. So don't think I didn't feel all.

Victoria

This great this or great that.

Julie

It's still working. Yes, it's still working. Kind of like I mean, it gives me an idea of like, say you're on a diet, you need to be on it. Follow the diet every day until you start seeing the weight come off. You don't lose a pound every single day because you're eating well.

Victoria

Right.

Julie

It's cumulative. It takes consistency. Is that fair to say? Yeah. For you to really see the results. Exactly, yeah.

Victoria

Okay, so I guess let me also say you asked me to do this talk and I thought I'd focus on anxiety because obviously neuroscience is so broad and we could go on forever about different aspects of it. So I thought I'd take one area. And I like anxiety because obviously I don't like anxiety. I was going to say I think it's important, okay. Because in 2020, I think as a clinician, we all saw like, a rise in anxiety, and we know what's happened to the service of psychology. Right now, we're all full, and anxiety, obviously, is one of the things, anxiety and depression. But anxiety is just so elevated. We don't have time to go into that and the reasons why, but we just know that it's here, right? So we want to give people tools to deal with it. I think it's important to understand that there are really two types to me, anxiety that we can kind of talk about. One is what I call cortical anxiety, and the other one is amygdala driven anxiety.

Okay?

Victoria

Okay. So cortical anxiety is like the person who wakes up at night and can't shut their brain off and maybe goes into obsessive mode, is worried about something and can't stop thinking about it. That's cortical, because you can ask that person, what's on your mind? What are you thinking? And they can tell you.

Right.

Victoria

The other type of anxiety is amygdala anxiety. And that's the people who say, in the middle night, I sat up in bed and I was having a panic attack, and obviously they weren't thinking of anything. They were sleeping.

Yes.

Victoria

And you say, what are you thinking about? Nothing. I was asleep. Right, and then you really tried if you try to press that person, I mean, I've done that. I've been saying, like, okay, let's try to get to the stores maybe subconscious, but it's really just the amygdala being overactive.

Right.

Victoria

And there comes back to that chronic issue I was talking about. It's like you're holding on to something even at a subconscious level. And so your Meg's a lot is basically working. It's housing that energy, if you will. There's another great little example always floating around on instagram TikTok or whatever. It says that professor holding that glass, I think, and he says, how much this weight? And it's very light, obviously. And the students are raising their hand like 2oz, making their guesses, and he says, yeah, okay, but how much would it weigh in an hour? And they're like, that'd be heavier. How about at the end of the day, your arm would be breaking?

Right.

Victoria

So that's what chronic stress is doing to our brain and our amygdala. It's holding on to it. It's basically overactive.

Julie

Let me ask let me check for a second. So tell me just a little more so they can understand. What is the amygdala?

Victoria

Good question. Okay, so the amygdala helps us react to all sorts of potential dangers, okay? Right. So it's in our DNA, because our ancestors, the ones who survived and gave us this, basically it's a magnificent, beautiful thing because it's very protective and it works in less than a second. I don't know the exact number on the milliseconds, but it fires away.

Right.

Victoria

So obviously it's a wonderful thing to have. Is it uncomfortable when we're under conditions of chronic stress and we don't need it? Yes, of course.

Right.

Victoria

But are we happy to have it when we're avoiding getting hit by a mass cross? Yes. And so that's amygdala anxiety right there in action. We're running down a path and we see a snake and we don't know if it's dangerous or not, but we run, we might scream, and that's hard to do. The cortex is the thing that says, oh, it's probably not dangerous or far away, or it still makes me uncomfortable. I'm getting off this road. That's the cortex.

Right.

Victoria

And so the cortex is more like the cortex is what assigns meaning to something. Right. So then you can work on CBT with that, like, okay, making assumptions and addressing that thing. But the amygdala is different.

Right?

Victoria

The amygdala is not about making sense. It's just a response. It's our response set to something. Okay. And again, the amygdala is very protective and also it innovates, basically head to toe in our body. So from our heart rate, our breathing, our muscle tone, blood pressure, bowels. So that's that feeling that you get, that's very physiological. So you might feel everyone's different. Everyone has their way of behaving, but some people might get trembling, some people might get nauseated, some people have diarrhea. Everyone is short of breath. I'm going to pass out all that.

Julie

This is my question. So if somebody says, okay, my make bill seems to be on fire all the time. Right, but I didn't say maybe have the trauma, but I'm a warrior. Some people are worried about like, I was worried I was a little kid, I was worried. I'm still worried. So that would be more from the cortex, maybe that I'm a warrior because I'm giving meaning that this is scary. Yeah. Does that make the illegal fire up? And that's why maybe we'd wake up middle of the night feeling anxious because of the bigger picture is I'm worrying all the time. So that makes my mental up on alerts.

Victoria

Yes, it can be booked. That's a great question because I'm talking about delineating the two, but actually it can be both. So that's important to know. You have to know, like learn, okay, where's mine? Like you could take an assessment, like, okay, am I feeling the very physical stuff? Am I feeling the thought stuff or am I both? And that gear that allows you to work with your therapist, like, what do I want to start targeting first or do I want to do something for both of them?

Julie

Okay, so wherever we'll keep learning and then we can learn about what do I do for both of them.

Victoria

Okay.

Julie

And how the CBT fits in, but I don't want to keep giving us some good information.

Victoria

Yeah. So I think the one thing that I like to know is that again, the amygdala, I might have already said this, but the amygdala works faster than the cortex, right. So I think that's important to me. That was my AHA. Okay. Don't ever like, go with that immediate feeling, boss, with a stack of papers on your desk and you go, you immediately start maybe trembling. Don't, because you know what, that's just your ambulance and your cortex hasn't made sense of it yet. I love that.

Julie

That is good.

Victoria

And for me, that was like my AHA, like, okay, quit.

Julie

So that would be someone that would be a reactive person, right?

Victoria

Yes.

Julie

I feel something and I do. I talked with the CBT model. I would say most people live off their moods. So most people are living off their amygdala, actually. So they feel something and then they pick a behavior, even if it's negative. I talk about like, hey, that beer helped calm me down, or sleeping all day, I didn't have to deal with anything. The avoidance.

Right.

Julie

So obviously that's why most people don't get better, because they're reacting off their moves instead of giving that cortex a minute, which is your thoughts to say, okay, I have all this paper, my boss, but he said this is for the next two weeks, so don't worry about it right now.

Victoria

Right?

Julie

Yes. Okay.

Victoria

And what you just said about having a beer and that's wiring.

Right.

Victoria

So we're creating.

Right.

Victoria

There a habit because all of a sudden we just got like, let's say we got relaxed. You might not think it consciously, but really your body says, I know what to do next time I'm anxious, I can have a beer.

Right.

Victoria

So it's wiring. And that's part of this is like, we know now that the brain's wiring is changeable. So you can break out of a habit and not have that same stimulus response basically reinforced. Right. But it can be challenging. It's not always easy. It really depends on the power of the reinforcement.

Right.

Victoria

If you always felt great after having that one beer after work, guess what? It's going to be hard to break that habit.

Julie

Yeah.

Victoria

Because it works for you.

Julie

Because it works. Exactly. So that's great. So just to reiterate this, because like you said, for your AHA moment, I'm having AHA moments here, that when we react to something instead of doing the say, okay, my middala is reacting.

Victoria

Right.

Julie

But I need to take a minute to make sense of what's going on or assess what's going on. You said, is that the right word? Yes.

Victoria

And I almost like saying it's worthy of pause. Yes, pause. Because your amygdala is talking.

Julie

Amygdala is talking.

Victoria

Yeah. And so your amygdala basically is in the driver's seat. And also another thing I like to think of is neuropsychology talked about this all the time is like anxiety hijacks the frontal lobe, and it's really the same thing. The amygdala is hijacking the frontal lobe when you cannot like deer in the headlights, right. That's the whole hijack thing. And people sometimes forget about they say the autonomic nervous system, when I'm talking about the sympathetic, when I'm talking about the amygdala, people say, oh, it's fight or flight. Okay, yes. And freeze. Don't forget about the treats. Yeah, I think because some people say they don't think they're in that camp. They go, it's not anxiety because I just breathe it is anxiety. Yeah, but the frozen feeling is basically that the frontal lobe is shut off at that point and you can't think yourself out of box.

Julie

Okay, yeah, that makes sense. That makes sense. Okay, excellent.

Victoria

Okay, so you wanted to talk about.

Julie

How you use dr. Smith. Does the CBT as well? That's how we met each other actually in this field is both having that in common. So what are the tools you use with your clients to deal with anxiety or depression or whatever you want to focus today?

Victoria

So I guess when we can identify thoughts and we know that it's really cortical anxiety that's driving or with depression, then we use mood record or the thought records and attack it from basically the standard cognitive behavioral therapy model to.

Julie

Ask yourself, okay, what am I thinking right now?

Victoria

What am I telling myself? And then we go through, write all those things down, identify distortions, talk about the way they make us feel, see which things would feel different if we untwist our thinking. That's the standard to me, and it's very effective for depression and anxiety. But I think the piece, I think that sometimes at least myself got neglected was the amygdala based, okay? And that one's going to be different because we're not going to be talking about what you're thinking. We're going to be talking about how you're feeling, what you could do to mitigate some of your body's knee jerk reactions to things and what are some.

Julie

Of the tools for that?

Victoria

Well, before I even I'll say that, but I want to do a plug for somebody that has kind of, I feel like put this neuroscience into very understandable terms. Rick Hanson I took a course. I actually am not done, but I took a course and he's talking about all this neuroplasticity. That's his thing. I feel like for somebody who wants to wrap their brains around this a little bit more, hear more about it, he's worth a listen. He's on YouTube. Ted Talks. His name is Rick Hanson.

Julie

Okay.

Victoria

And I'm not sure what his programs are labeled. I know the one I'm taking is like a program in neuroplasticity, but you.

Julie

Can just Google it.

Victoria

You can just Google it and you'll find it and it's what I'm talking about and maybe has a different spin on it, but he talks about, like, pausing, too.

Julie

Excellent.

Victoria

Yeah. And to me, I think that's part of it is I want people to give them some power that they feel like they can do something, but it's not always like, it might not be this that they're listening to, but we might link them to something that could be helpful. I always feel like reading as much as you can about something gives you just more information, and there might be something that clicks with you, connects with you, and you feel like, oh, I.

Julie

Can do this, how it acknowledges power. And when you're reacting, instead of freaking out, like, why am I feeling this way? I was like, oh, I understand what the amigo is and what it does. Right, okay.

Victoria

Yeah. So one other thing about the mango. I mentioned chronic stress, how it changes it, and the other one is lack of sleep. Those are the big two.

Right.

Victoria

So it's not just lack of sleep, but it's that continuity.

Right.

Victoria

Because when we sleep, we hit different phases. I don't remember all the terms, but I know that some of them, like delta, are the restorative phase, if I remember correctly. I might be wrong about that. But there's a restorative phase of sleep, and we need to have that to feel rested.

Right.

Victoria

That also repairs our cells, helps our immune system, but it helps our amygdala.

Right.

Victoria

So when we're sleep deprived, our amygdala is not working as well. Right. So to me, that's another huge one.

Julie

Huge.

Victoria

If you want to feel healthier and respond to better to stress and anxiety, get some sleep.

Julie

Yes. I have one of my podcasts called get a Good Night's Sleep, if you guys want to listen to it. But I've learned a long time ago from doctors that even in the animal kingdom, sleep is the most important thing for everybody. And when you start getting good sleep, you feel like you can cope better and handle stress better.

Victoria

Yes.

Julie

Right. And that's because the megalodon reacting so much. Yes.

Victoria

So they said if you don't sleep, you're more likely to have a reactive and a more susceptible experience to anxiety just because of that connection. Just that.

Julie

I love that. Did you guys hear that? Take notes. So important. I know I'm an egg sometimes, but I'm always talking about sleep, and we minimize it. Oh, I got six and a half. I'm like, well, that ain't enough.

Victoria

That isn't enough.

Julie

Our world is just well, I'll have a little caffeine. I'll get by. I'm busy. But you got to find that window if you need to turn the TV off early or whatever, get off your phone. If it's just sometimes the extra half hour, an hour makes the world of difference, right? Yes, absolutely. Excellent. Okay, so sleep. Super important.

Victoria

Sleep.

Julie

Okay. What were some other things you said with the amygdala?

Victoria

Well, the exercise. Exercise, it really results in a calmer amygdala that's the bottom line.

Julie

And do they say, I think the big question is I think people set themselves up so they don't succeed. I have to go for an hour every day.

Victoria

It's not an hour. The research shows 30 minutes.

Julie

Beautiful.

Victoria

It's something that really hasn't changed over time.

Right.

Victoria

Five days a week, 30 minutes of time. And again, like I said, it doesn't have to be running through a park. It could be just anything that increases your heart rate. Even if it's remember the aerobics and stuff like something like that, where you don't have to leave your bedroom.

Julie

Right?

Yeah.

Julie

You can watch something on YouTube or just walking in place.

Victoria

There's so many things now on the Internet that are free and available for all ages. Right. So the other thing I think is important, too, is I think we've exercised before and had injuries. It puts you out for a while. I bite off more than I can chew. But there's even things that adapted to older people, the 50 plus crowd. And so I always try not to have an excuse because there's things for older people and where they make adjustments. Another plug. Denise Austin, remember Hero? She has something that she's doing all these exercise videos for the older crap. Now, I love her stuff, and she does free stuff all the time. You can sign up, too, but she does these free little clips. That's awesome. Yeah. So before you hop in the shower, just do a little video to me. Yes.

Julie

Okay. Excellent. Any other things that you recommend we're getting they make a lot of just kind of calm. Yes.

Victoria

Okay. These are some other exercises that have been shown to be powerful. I just have a few, but these are the ones that the research has supported as being effective. Okay. Meditation. So I know that also it's hard for some people. So, again, if you're having trouble doing it on your own, like, maybe grab a little app or I don't know. You were talking about one earlier, John Kevinson. Yes. People like that do a guided one, and that way it's not just you just struggling to sit there.

Julie

Most of us get distracting.

Victoria

Yes.

Julie

And be patient where it takes time to really like it. Good.

Victoria

Exactly. It's like anything, it's a skill and you've got to practice it.

Julie

Yes.

Victoria

So meditation has been shown to be efficacious for creating a healthier amygdala. The other one is very simple. Deep breathing. I can't say that enough. And do it several times a day. And don't do it. Don't wait till you're anxious to do it. That's my biggest one, I think people forget. And again, if you have to schedule it in your calendar, do that. Just whatever it takes. Some people tell me, oh, I put a sticky note where I brush my teeth in the morning. And then once, after a couple of weeks have gone by and it's an established habit, I take the sticking note down and I don't do it anymore. But now I know it.

Julie

Yeah. Because a lot of people don't understandably, don't do anything like, say, breathing until they feel anxious. Right. It's not a habit like, say, brushing your teeth.

Right.

Julie

We're hoping to brush your teeth to avoid cavities. You don't start brushing your teeth once you have a cavity.

Right.

Julie

So it's all that planning ahead, like you said. Yes. With the phone, you can always do a reminder, just breathe. Part of your getting ready for bed at night. Yes, exactly. Because then your body gets more used to it. Right.

Victoria

And yeah, bedtime is the perfect time. Waking up midday, maybe your lunch, and then going to bed. Just do the deep breathing. It doesn't take a long time. And I think you're the one who turned me on to what's his name, dr. Wyle.

Julie

Andrew Wild Has. I know I've talked about this on other podcasts, you guys, too, but it's the yes. If you look up, he has a video on YouTube, breathing Doctor, Andrew Wyld. And it's like five or six minutes, but it'll walk you through it. And that one's very helpful.

Victoria

And it walks you through the why, too, like why that works and why he's using that technique. I find that helpful. Sometimes when I talk to people about deep breathing, they want something to follow. And so for people who want some technique to follow, that's great for that. Yes. And some people can just, you know, I have a handout that I use. It just goes over basic deep breathing, and that's fine. But again, lots of things work. You have to find what you like.

Julie

Best and what works for you and stick with it. Exactly.

Victoria

Right, okay. And then the other things are imagery.

Julie

Okay.

Victoria

And then muscle relaxation, you can do from top to bottom of muscle relaxation. That's a standard activity. But honestly, any of those are just as effective as the others, except with exercise being the best and sleep being the best.

Julie

The best. Okay. Yeah. And for you guys that are using the minor removed book, if you go to chapter 14, which is on understanding anxiety in the back, it talks about breathing, progressive muscle relaxation and imagery. So it talks about all those. And again, I tell everyone, not everything is going to work for you, but you want to find something. Right. Sleep is obviously for all of us, but find what works for you and stick with it, and that will make a big difference.

Yeah.

Julie

And let me ask you one last question before we go. Does the research show how long it takes to kind of feel the positive effects?

Victoria

You know, that's a really good question. I actually don't know the specific answer to that question, so I'm not going to make it up.

Julie

Okay. But it might depend on it might depend on the person i.

Victoria

Suppose I would think, yeah, that would be my guess. But I don't know how long it would take to actually I will look that up, Julie, because I feel like some of that research about the imaging and I want to see how long did they have those people do whatever it was like the exercise or change their sleep or do some of the meditation stuff and after how many weeks did they see a result? That would be good to know. Actually, that's a really good thing to know because then you can tell your clients, right? Hey, in the study it took X amount of time for people to really feel a big difference.

Julie

Now, I know with the CBT research that it was a ten week research study. That this is the one they replicate all the time and they do the Pet scan before and after, okay, that in ten weeks they saw a change in people's brain chemistry. So that I can say for sure. And that was nothing.

Victoria

Do you know where that was done?

Julie

Out of the original, I believe, was UCLA, like decades ago. And every time they replicate the study, they get the same outcome.

Victoria

Okay.

Julie

Because we know CBT is the most researched and most successful therapy out there for people, right. And it adds this positive psychology we're talking about a little bit today, where we can maybe use the words like acceptance and forgiveness and gratitude, but being mindful, the imagery, I think the breathing, the meditation allows us to be more present, which can also help us.

Right.

Julie

And all of these things, I know I talk about the Vineyard mood I use all the time, that's my go to book, but that has all of these aspects in it now. So it's kind of incorporated more than it did in the past and talks about exercise. So that's kind of what you're saying. So for sure, I know with CBT, within ten weeks you're going to see an outcome and that probably will overlap a little bit with this other research.

Victoria

I thought of one more thing I want to add, okay. And I think I got this from Rick Hanson's kind of talks, but because Amygdala is so powerful, if anyone doesn't know where it sits in the brain, it's kind of in the center of our brain. It's a little kind of nugget that sits at the end of our hippocampus. Hippocampus is what stores our memory and so powerful connections there. And so because it's our protective and alert system, it's delivering information to, again, our memory system. And what happens is that like, we don't go about our day and maybe nine out of ten good things happen and the one out of ten bad thing, that's what we're sticking with.

Right.

Victoria

Again, that's our little Amygdala talking to the hippocampus and then our frontal lobe and making sense out of that. So one of the goals is pay attention to the nine out of ten things. Not that one out of ten.

Julie

Right.

Victoria

So sometimes it's just a refocus. There's the rewiring thing. It's like, okay, let me take in that nine out of ten that happened and not focus on that one thing.

Julie

Excellent. No, it's really good because I've talked I've shared on the podcast before, but sometimes when I'm feeling overwhelmed with the day or what I need to get done tomorrow, then I'll think about all the things I did get done, and the list is always way bigger than what I did get done. Right, of course. Or that could be what went well today instead of that one phone call was uncomfortable. Right. I didn't feel good about how things went at the end of a session with somebody. So, yes, if you think about everything that went well, that's an exercise in itself.

Victoria

That's an exercise in itself. And your point about gratitude, if you combine something like that with the breathing at the end of the day, think about to me, like, getting into my bed every night is luxury. I've got a roof over my head, food in my refrigerator, on a mattress. I'm not in Ukraine. I'm not somewhere where I'm fleeing for my life. I'm not walking up some road from another country. You know what I mean? It's just, like, safe. We have so much to be we live in an abundant conditions, and so that in itself is like right.

Julie

And that's what you're telling your brain, then I'm safe, I'm grateful. I have more than I need. I have everything I need, and that can help.

Victoria

More than we need.

Julie

Yes.

Victoria

And it's such a good feeling to go to bed and say, isn't this great?

Julie

Yes. Excellent. Well, thank you.

Victoria

You're welcome. We got educated today I want to.

Julie

Add to, and Dr. Smith's going to give you more information on how to contact her, if you like to. But being a neuropsychologist, you also do testing for people, right?

Victoria

Yes.

Julie

So what are some of the diagnoses that you test for?

Victoria

The common sort of assessments that I do are for head injury or for dementia. So that's the common attention deficit training, too, and attention deficit disorder assessment. Adults. I don't do it for children anymore because it's a whole anyhow I just do it for adults.

Julie

Okay.

Victoria

Yeah.

Julie

Excellent. Okay. So can you share with the listeners if they would like to reach you, like email or phone number, whatever way is best to contact you?

Victoria

Yeah. So if you want to do email, my email is Vgsmithphd@gmail.com, and my cell phone and office number is 714-615-1519.

Julie

Excellent. So she's located in Orange County.

Victoria

Orange County Fullerton right now only. Fullerton for in person? Yes, for in person.

Julie

Okay. And you're still doing telehealth?

Victoria

Still also doing telehealth.

Julie

Okay. Excellent. Okay. So hey, everyone, thanks for being with us here today. I hope it was helpful. If you have any burning questions. As always, we'd love to hear from you. You can email me at mycbtpodcast@gmail.com you can follow me on my Instagram, at mycbt podcast, on Facebook under Dr. Julia Osborne, and my website is my cognitivebehavioural Therapy.com. I'd love to get your emails and your feedback, and as always, I'll always check with you before I share them on air. But I know they're helpful to our listeners. And if you have any suggestions of information you'd like to hear, please let me know as well. So hit the subscribe button to make sure you won't miss another episode. Thanks for joining me. Stay safe and remember to always make decisions based on what's best for you, not how you feel.

Julie

Right?

Victoria

The amygdala is not about making sense. It's just a response. It's our response set to something. Okay. And again, the amygdala is very protective and also it innovates, basically head to toe in our body. So from our heart rate, our breathing, our muscle tone, blood pressure, bowels. So that's that feeling that you get, that's very physiological. So you might feel everyone's different. Everyone has their way of behaving, but some people might get trembling, some people might get nauseated, some people have diarrhea. Everyone is short of breath. I'm going to pass out all that.

Julie

This is my question. So if somebody says, okay, my make bill seems to be on fire all the time. Right, but I didn't say maybe have the trauma, but I'm a warrior. Some people are worried about like, I was worried I was a little kid, I was worried. I'm still worried. So that would be more from the cortex, maybe that I'm a warrior because I'm giving meaning that this is scary. Yeah. Does that make the illegal fire up? And that's why maybe we'd wake up middle of the night feeling anxious because of the bigger picture is I'm worrying all the time. So that makes my mental up on alerts.

Victoria

Yes, it can be booked. That's a great question because I'm talking about delineating the two, but actually it can be both. So that's important to know. You have to know, like learn, okay, where's mine? Like you could take an assessment, like, okay, am I feeling the very physical stuff? Am I feeling the thought stuff or am I both? And that gear that allows you to work with your therapist, like, what do I want to start targeting first or do I want to do something for both of them?

Julie

Okay, so wherever we'll keep learning and then we can learn about what do I do for both of them.

Victoria

Okay.

Julie

And how the CBT fits in, but I don't want to keep giving us some good information.

Victoria

Yeah. So I think the one thing that I like to know is that again, the amygdala, I might have already said this, but the amygdala works faster than the cortex, right. So I think that's important to me. That was my AHA. Okay. Don't ever like, go with that immediate feeling, boss, with a stack of papers on your desk and you go, you immediately start maybe trembling. Don't, because you know what, that's just your ambulance and your cortex hasn't made sense of it yet. I love that.

Julie

That is good.

Victoria

And for me, that was like my AHA, like, okay, quit.

Julie

So that would be someone that would be a reactive person, right?

Victoria

Yes.

Julie

I feel something and I do. I talked with the CBT model. I would say most people live off their moods. So most people are living off their amygdala, actually. So they feel something and then they pick a behavior, even if it's negative. I talk about like, hey, that beer helped calm me down, or sleeping all day, I didn't have to deal with anything. The avoidance.

Victoria

Right.

Julie

So obviously that's why most people don't get better, because they're reacting off their moves instead of giving that cortex a minute, which is your thoughts to say, okay, I have all this paper, my boss, but he said this is for the next two weeks, so don't worry about it right now.

Victoria

Right?

Julie

Yes. Okay.

Victoria

And what you just said about having a beer and that's wiring.

Julie

Right.

Victoria

So we're creating.

Julie

Right.

Victoria

There a habit because all of a sudden we just got like, let's say we got relaxed. You might not think it consciously, but really your body says, I know what to do next time I'm anxious, I can have a beer.

Julie

Right.

Victoria

So it's wiring. And that's part of this is like, we know now that the brain's wiring is changeable. So you can break out of a habit and not have that same stimulus response basically reinforced. Right. But it can be challenging. It's not always easy. It really depends on the power of the reinforcement.

Julie

Right.

Victoria

If you always felt great after having that one beer after work, guess what? It's going to be hard to break that habit.

Julie

Yeah.

Victoria

Because it works for you.

Julie

Because it works. Exactly. So that's great. So just to reiterate this, because like you said, for your AHA moment, I'm having AHA moments here, that when we react to something instead of doing the say, okay, my middala is reacting.

Victoria

Right.

Julie

But I need to take a minute to make sense of what's going on or assess what's going on. You said, is that the right word? Yes.

Victoria

And I almost like saying it's worthy of pause. Yes, pause. Because your amygdala is talking.

Julie

Amygdala is talking.

Victoria

Yeah. And so your amygdala basically is in the driver's seat. And also another thing I like to think of is neuropsychology talked about this all the time is like anxiety hijacks the frontal lobe, and it's really the same thing. The amygdala is hijacking the frontal lobe when you cannot like deer in the headlights, right. That's the whole hijack thing. And people sometimes forget about they say the autonomic nervous system, when I'm talking about the sympathetic, when I'm talking about the amygdala, people say, oh, it's fight or flight. Okay, yes. And freeze. Don't forget about the treats. Yeah, I think because some people say they don't think they're in that camp. They go, it's not anxiety because I just breathe it is anxiety. Yeah, but the frozen feeling is basically that the frontal lobe is shut off at that point and you can't think yourself out of box.

Julie

Okay, yeah, that makes sense. That makes sense. Okay, excellent.

Victoria

Okay, so you wanted to talk about.

Julie

How you use dr. Smith. Does the CBT as well? That's how we met each other actually in this field is both having that in common. So what are the tools you use with your clients to deal with anxiety or depression or whatever you want to focus today?

Victoria

So I guess when we can identify thoughts and we know that it's really cortical anxiety that's driving or with depression, then we use mood record or the thought records and attack it from basically the standard cognitive behavioral therapy model to.

Julie

Ask yourself, okay, what am I thinking right now?

Victoria

What am I telling myself? And then we go through, write all those things down, identify distortions, talk about the way they make us feel, see which things would feel different if we untwist our thinking. That's the standard to me, and it's very effective for depression and anxiety. But I think the piece, I think that sometimes at least myself got neglected was the amygdala based, okay? And that one's going to be different because we're not going to be talking about what you're thinking. We're going to be talking about how you're feeling, what you could do to mitigate some of your body's knee jerk reactions to things and what are some.

Julie

Of the tools for that?

Victoria

Well, before I even I'll say that, but I want to do a plug for somebody that has kind of, I feel like put this neuroscience into very understandable terms. Rick Hanson I took a course. I actually am not done, but I took a course and he's talking about all this neuroplasticity. That's his thing. I feel like for somebody who wants to wrap their brains around this a little bit more, hear more about it, he's worth a listen. He's on YouTube. Ted Talks. His name is Rick Hanson.

Julie

Okay.

Victoria

And I'm not sure what his programs are labeled. I know the one I'm taking is like a program in neuroplasticity, but you.

Julie

Can just Google it.

Victoria

You can just Google it and you'll find it and it's what I'm talking about and maybe has a different spin on it, but he talks about, like, pausing, too.

Julie

Excellent.

Victoria

Yeah. And to me, I think that's part of it is I want people to give them some power that they feel like they can do something, but it's not always like, it might not be this that they're listening to, but we might link them to something that could be helpful. I always feel like reading as much as you can about something gives you just more information, and there might be something that clicks with you, connects with you, and you feel like, oh, I.

Julie

Can do this, how it acknowledges power. And when you're reacting, instead of freaking out, like, why am I feeling this way? I was like, oh, I understand what the amigo is and what it does. Right, okay.

Victoria

Yeah. So one other thing about the mango. I mentioned chronic stress, how it changes it, and the other one is lack of sleep. Those are the big two.

Julie

Right.

Victoria

So it's not just lack of sleep, but it's that continuity.

Julie

Right.

Victoria

Because when we sleep, we hit different phases. I don't remember all the terms, but I know that some of them, like delta, are the restorative phase, if I remember correctly. I might be wrong about that. But there's a restorative phase of sleep, and we need to have that to feel rested.

Julie

Right.

Victoria

That also repairs our cells, helps our immune system, but it helps our amygdala.

Julie

Right.

Victoria

So when we're sleep deprived, our amygdala is not working as well. Right. So to me, that's another huge one.

Julie

Huge.

Victoria

If you want to feel healthier and respond to better to stress and anxiety, get some sleep.

Julie

Yes. I have one of my podcasts called get a Good Night's Sleep, if you guys want to listen to it. But I've learned a long time ago from doctors that even in the animal kingdom, sleep is the most important thing for everybody. And when you start getting good sleep, you feel like you can cope better and handle stress better.

Victoria

Yes.

Julie

Right. And that's because the megalodon reacting so much. Yes.

Victoria

So they said if you don't sleep, you're more likely to have a reactive and a more susceptible experience to anxiety just because of that connection. Just that.

Julie

I love that. Did you guys hear that? Take notes. So important. I know I'm an egg sometimes, but I'm always talking about sleep, and we minimize it. Oh, I got six and a half. I'm like, well, that ain't enough.

Victoria

That isn't enough.

Julie

Our world is just well, I'll have a little caffeine. I'll get by. I'm busy. But you got to find that window if you need to turn the TV off early or whatever, get off your phone. If it's just sometimes the extra half hour, an hour makes the world of difference, right? Yes, absolutely. Excellent. Okay, so sleep. Super important.

Victoria

Sleep.

Julie

Okay. What were some other things you said with the amygdala?

Victoria

Well, the exercise. Exercise, it really results in a calmer amygdala that's the bottom line.

Julie

And do they say, I think the big question is I think people set themselves up so they don't succeed. I have to go for an hour every day.

Victoria

It's not an hour. The research shows 30 minutes.

Julie

Beautiful.

Victoria

It's something that really hasn't changed over time.

Julie

Right.

Victoria

Five days a week, 30 minutes of time. And again, like I said, it doesn't have to be running through a park. It could be just anything that increases your heart rate. Even if it's remember the aerobics and stuff like something like that, where you don't have to leave your bedroom.

Julie

Right?

Victoria

Yeah.

Julie

You can watch something on YouTube or just walking in place.

Victoria

There's so many things now on the Internet that are free and available for all ages. Right. So the other thing I think is important, too, is I think we've exercised before and had injuries. It puts you out for a while. I bite off more than I can chew. But there's even things that adapted to older people, the 50 plus crowd. And so I always try not to have an excuse because there's things for older people and where they make adjustments. Another plug. Denise Austin, remember Hero? She has something that she's doing all these exercise videos for the older crap. Now, I love her stuff, and she does free stuff all the time. You can sign up, too, but she does these free little clips. That's awesome. Yeah. So before you hop in the shower, just do a little video to me. Yes.

Julie

Okay. Excellent. Any other things that you recommend we're getting they make a lot of just kind of calm. Yes.

Victoria

Okay. These are some other exercises that have been shown to be powerful. I just have a few, but these are the ones that the research has supported as being effective. Okay. Meditation. So I know that also it's hard for some people. So, again, if you're having trouble doing it on your own, like, maybe grab a little app or I don't know. You were talking about one earlier, John Kevinson. Yes. People like that do a guided one, and that way it's not just you just struggling to sit there.

Julie

Most of us get distracting.

Victoria

Yes.

Julie

And be patient where it takes time to really like it. Good.

Victoria

Exactly. It's like anything, it's a skill and you've got to practice it.

Julie

Yes.

Victoria

So meditation has been shown to be efficacious for creating a healthier amygdala. The other one is very simple. Deep breathing. I can't say that enough. And do it several times a day. And don't do it. Don't wait till you're anxious to do it. That's my biggest one, I think people forget. And again, if you have to schedule it in your calendar, do that. Just whatever it takes. Some people tell me, oh, I put a sticky note where I brush my teeth in the morning. And then once, after a couple of weeks have gone by and it's an established habit, I take the sticking note down and I don't do it anymore. But now I know it.

Julie

Yeah. Because a lot of people don't understandably, don't do anything like, say, breathing until they feel anxious. Right. It's not a habit like, say, brushing your teeth.

Victoria

Right.

Julie

We're hoping to brush your teeth to avoid cavities. You don't start brushing your teeth once you have a cavity.

Julie

Hi. My name is Dr. Julia Osborne, and I'm a doctor of psychology and a licensed clinical social worker specializing in cognitive behavioral therapy. I'm here to help you bring the power of CBT into your own life. So in this podcast, which is going to be really interesting to you guys, is I am interviewing my friend and colleague Dr. Victoria Smith, who is a neuropsychologist. So she's going to explain to us what that even means and for all of us to be able to understand our brains a little more and how CBT can help with some of the mental health struggles that we all go through on a regular basis. So let me first start by introducing Dr. Victoria Smith and let her explain to us what she does and what neuropsychology is.

Victoria

Hi, Julie. Thank you for having me. So neuropsychology is a broad field. I'll talk specifically about my background. I did my background in assessment, primarily, and traumatic brain injury. So obviously the field is more expansive than that, but that's what I was trained in.

Julie

Excellent. How do you use that today in your practice?

Victoria

Okay, so let me back up a bit, too. So I have a Master's degree in neuropsychology. My PhD is in clinical health. So my Master's degree was actually a really unique program. We did a lot of research. We did EEGs, we did a lot of assessment, and we did a lot of study, a lot of neuroscience neuroanatomy. So I think it's what the neuroscience right now has helped me really apply that information that I learned there to be able to better help my clients now who want understanding of how the brain is functioning and how it can actually interfere with healthy functioning, but how it's actually sourced from a very healthy vantage point.

Julie

Right. I think that's great. That's why I wanted you to talk today, because people are very focused on wanting to understand their brains. Why does my brain think so much? Why can't I control my thoughts? Like, what's going on? And they have all those questions that sometimes we have answers, sometimes we don't. I know, but you can explain more about how that brain is being affected by how we're feeling. Okay. That's the right way to put it.

Victoria

Yeah. I mean, that can happen. And then also we have to understand that we're wired to our brains to behave in a certain way.

Right.

Victoria

So sometimes it's not always connected to, like, what we're thinking. But you're absolutely right. It's just about feeling. And let me kind of back up, too, and say that understanding neuroplasticity can be helpful. That's the piece that I kind of want to talk about. The brain is not fixed.

Right?

Victoria

So sometimes we feel like, stuck in a rut, like, oh, things are never going to get better. But actually, the brain is very changeable. Now, this has been really supported by current, like, imaging studies. What we've always kind of known. We've analyzed it in animal studies, and now on human studies, we can see the brain is actually very what they call has a lot of neuroplasticity, so we can actually change our wiring. So I think one of the things I wanted to stress is kind of to I want people to feel empowered, so if they have this information, they know that I can apply some of these information and feel like I can do something to change my circumstances. For example, one basic area I like people to understand is chronic stress behaves like any kind of immediate traumatic stress, right. So it can build over time. And what we know from imaging studies is chronic stress actually reduces what we call the connectivity of the brain.

Right.

Victoria

These are pathways that deliver neurotransmitters to different parts of the brain. This is very important.

Right.

Victoria

We want our brain to have maximum access in pathways so it kind of flows well evenly.

Julie

Is that right?

Victoria

Yeah. In a very basic way. You want it to have as many diverse pathways as possible. An unhealthy brain has minimal so what we see in chronic stress and imaging studies is people pathways are reduced.

Julie

Wow.

Victoria

The good news is that when treated, the brain can act, go back and act in. They can build the pathways and act in a healthy manner.

Julie

Again, to me, that's huge and exciting. Exciting, right. And that goes back to that hot thought. You guys know what the hot thoughts or thoughts that are not 100% true? That I'm stuck. And now I can really tell you when you're telling me no, I'm stuck. I'm stuck. That you actually can change when you're thinking differently and taking care of yourself, that your brain can heal itself on some level.

Victoria

Yeah, that's just one example. The connectivity thing. Then there's a neurotransmitter issue, too.

Right.

Victoria

We know that stress can reduce certain neurotransmitters and things can improve certain neurotransmitters. We'll get into the amygdala, but that area has some sensitivity to it, too. There's a place called I think one of the things, too, is that the amygdala is very sensitive, and when we're overly stressed, an area called the lateral nucleus doesn't function properly to neurotransmitters that it receives. So I think that's just also important, too, to know that when we do addresses, we're addressing it from a connectivity issue, a neurotransmitter issue, a structural issue. So, again, we're improving ourselves. When we talk about ways to target it, we're improving it from multi angles.

Julie

Which makes me think that's why I have Dr. Smith on, because you can tell how smart she is. Every time we talk and she tells me stuff, I'm like, oh, wow.

I'm.

Julie

Assuming tell me if it's true because we're dressing it from different angles. That also gives me hope that it's not just, oh, I need to get this one thing right to get that correct. Is that correct?

Victoria

Yes.

Julie

Okay.

Victoria

Yeah. And I think it should make us feel like I said empowered.

Right?

Victoria

Yes. And honestly, we'll kind of go through things, but sometimes it just takes very little. And I only say that because there are people who like to exercise and I think that they can see the positive benefit. But that's one of our strongest areas. I think we always hear that. And actually the research supports that the exercise is so beneficial for the brain.

Julie

Okay, and how does exercise help with the things you're already talking to us about?

Victoria

So when we talk about like that connectivity issue okay, so when it's one way to increase connections, it actually when people exercise, they affect basically how serotonin is received by that lateral nucleus, resulting in a calmer amygdala. Right, yeah. And that's very beneficial to us. And I know some people don't want to hear about exercise because they think that they're limited, but just keep in mind, just pick something I know we're getting a little bit ahead of. I'm getting ahead of myself here. But pick something that you like. Yes, pick something that's easy to do, like set yourself up for success. Put it in your calendar. I think we're all at fault for that. We get busy and we think, I'll do it tonight after work and then after work, we're tired and we say tomorrow morning. But if we slot to that, we're more likely to do it or make ourselves accountable by connecting with a friend, saying, hey, can we do this together? We don't have to be together, but we can just make a commitment to each other to do that or sign up for something. Like, there's all this stuff now on the Internet, and lo and behold, people do stay committed even though they don't know these people.

Victoria

They're on the Internet where they have to check that little box that day. Most people are going to follow through.

Julie

Yes, those are all great ideas. And that falls under what I talk about a lot is your self care. So whenever you give time for self care, you can put exercise in there as well. And to know also that you might not get this quote, runner's hottie, but it doesn't mean it's not working on your brain still, right?

Victoria

Yes, absolutely.

Julie

That's good. So don't think I didn't feel all.

Victoria

This great this or great that.

Julie

It's still working. Yes, it's still working. Kind of like I mean, it gives me an idea of like, say you're on a diet, you need to be on it. Follow the diet every day until you start seeing the weight come off. You don't lose a pound every single day because you're eating well.

Victoria

Right.

Julie

It's cumulative. It takes consistency. Is that fair to say? Yeah. For you to really see the results. Exactly, yeah.

Victoria

Okay, so I guess let me also say you asked me to do this talk and I thought I'd focus on anxiety because obviously neuroscience is so broad and we could go on forever about different aspects of it. So I thought I'd take one area. And I like anxiety because obviously I don't like anxiety. I was going to say I think it's important, okay. Because in 2020, I think as a clinician, we all saw like, a rise in anxiety, and we know what's happened to the service of psychology. Right now, we're all full, and anxiety, obviously, is one of the things, anxiety and depression. But anxiety is just so elevated. We don't have time to go into that and the reasons why, but we just know that it's here, right? So we want to give people tools to deal with it. I think it's important to understand that there are really two types to me, anxiety that we can kind of talk about. One is what I call cortical anxiety, and the other one is amygdala driven anxiety.

Okay?

Victoria

Okay. So cortical anxiety is like the person who wakes up at night and can't shut their brain off and maybe goes into obsessive mode, is worried about something and can't stop thinking about it. That's cortical, because you can ask that person, what's on your mind? What are you thinking? And they can tell you.

Right.

Victoria

The other type of anxiety is amygdala anxiety. And that's the people who say, in the middle night, I sat up in bed and I was having a panic attack, and obviously they weren't thinking of anything. They were sleeping.

Yes.

Victoria

And you say, what are you thinking about? Nothing. I was asleep. Right, and then you really tried if you try to press that person, I mean, I've done that. I've been saying, like, okay, let's try to get to the stores maybe subconscious, but it's really just the amygdala being overactive.

Right.

Victoria

And there comes back to that chronic issue I was talking about. It's like you're holding on to something even at a subconscious level. And so your Meg's a lot is basically working. It's housing that energy, if you will. There's another great little example always floating around on instagram TikTok or whatever. It says that professor holding that glass, I think, and he says, how much this weight? And it's very light, obviously. And the students are raising their hand like 2oz, making their guesses, and he says, yeah, okay, but how much would it weigh in an hour? And they're like, that'd be heavier. How about at the end of the day, your arm would be breaking?

Right.

Victoria

So that's what chronic stress is doing to our brain and our amygdala. It's holding on to it. It's basically overactive.

Julie

Let me ask let me check for a second. So tell me just a little more so they can understand. What is the amygdala?

Victoria

Good question. Okay, so the amygdala helps us react to all sorts of potential dangers, okay? Right. So it's in our DNA, because our ancestors, the ones who survived and gave us this, basically it's a magnificent, beautiful thing because it's very protective and it works in less than a second. I don't know the exact number on the milliseconds, but it fires away.

Right.

Victoria

So obviously it's a wonderful thing to have. Is it uncomfortable when we're under conditions of chronic stress and we don't need it? Yes, of course.

Right.

Victoria

But are we happy to have it when we're avoiding getting hit by a mass cross? Yes. And so that's amygdala anxiety right there in action. We're running down a path and we see a snake and we don't know if it's dangerous or not, but we run, we might scream, and that's hard to do. The cortex is the thing that says, oh, it's probably not dangerous or far away, or it still makes me uncomfortable. I'm getting off this road. That's the cortex.

Right.

Victoria

And so the cortex is more like the cortex is what assigns meaning to something. Right. So then you can work on CBT with that, like, okay, making assumptions and addressing that thing. But the amygdala is different.

Right?

Victoria

The amygdala is not about making sense. It's just a response. It's our response set to something. Okay. And again, the amygdala is very protective and also it innovates, basically head to toe in our body. So from our heart rate, our breathing, our muscle tone, blood pressure, bowels. So that's that feeling that you get, that's very physiological. So you might feel everyone's different. Everyone has their way of behaving, but some people might get trembling, some people might get nauseated, some people have diarrhea. Everyone is short of breath. I'm going to pass out all that.

Julie

This is my question. So if somebody says, okay, my make bill seems to be on fire all the time. Right, but I didn't say maybe have the trauma, but I'm a warrior. Some people are worried about like, I was worried I was a little kid, I was worried. I'm still worried. So that would be more from the cortex, maybe that I'm a warrior because I'm giving meaning that this is scary. Yeah. Does that make the illegal fire up? And that's why maybe we'd wake up middle of the night feeling anxious because of the bigger picture is I'm worrying all the time. So that makes my mental up on alerts.

Victoria

Yes, it can be booked. That's a great question because I'm talking about delineating the two, but actually it can be both. So that's important to know. You have to know, like learn, okay, where's mine? Like you could take an assessment, like, okay, am I feeling the very physical stuff? Am I feeling the thought stuff or am I both? And that gear that allows you to work with your therapist, like, what do I want to start targeting first or do I want to do something for both of them?

Julie

Okay, so wherever we'll keep learning and then we can learn about what do I do for both of them.

Victoria

Okay.

Julie

And how the CBT fits in, but I don't want to keep giving us some good information.

Victoria

Yeah. So I think the one thing that I like to know is that again, the amygdala, I might have already said this, but the amygdala works faster than the cortex, right. So I think that's important to me. That was my AHA. Okay. Don't ever like, go with that immediate feeling, boss, with a stack of papers on your desk and you go, you immediately start maybe trembling. Don't, because you know what, that's just your ambulance and your cortex hasn't made sense of it yet. I love that.

Julie

That is good.

Victoria

And for me, that was like my AHA, like, okay, quit.

Julie

So that would be someone that would be a reactive person, right?

Victoria

Yes.

Julie

I feel something and I do. I talked with the CBT model. I would say most people live off their moods. So most people are living off their amygdala, actually. So they feel something and then they pick a behavior, even if it's negative. I talk about like, hey, that beer helped calm me down, or sleeping all day, I didn't have to deal with anything. The avoidance.

Right.

Julie

So obviously that's why most people don't get better, because they're reacting off their moves instead of giving that cortex a minute, which is your thoughts to say, okay, I have all this paper, my boss, but he said this is for the next two weeks, so don't worry about it right now.

Victoria

Right?

Julie

Yes. Okay.

Victoria

And what you just said about having a beer and that's wiring.

Right.

Victoria

So we're creating.

Right.

Victoria

There a habit because all of a sudden we just got like, let's say we got relaxed. You might not think it consciously, but really your body says, I know what to do next time I'm anxious, I can have a beer.

Right.

Victoria

So it's wiring. And that's part of this is like, we know now that the brain's wiring is changeable. So you can break out of a habit and not have that same stimulus response basically reinforced. Right. But it can be challenging. It's not always easy. It really depends on the power of the reinforcement.

Right.

Victoria

If you always felt great after having that one beer after work, guess what? It's going to be hard to break that habit.

Julie

Yeah.

Victoria

Because it works for you.

Julie

Because it works. Exactly. So that's great. So just to reiterate this, because like you said, for your AHA moment, I'm having AHA moments here, that when we react to something instead of doing the say, okay, my middala is reacting.

Victoria

Right.

Julie

But I need to take a minute to make sense of what's going on or assess what's going on. You said, is that the right word? Yes.

Victoria

And I almost like saying it's worthy of pause. Yes, pause. Because your amygdala is talking.

Julie

Amygdala is talking.

Victoria

Yeah. And so your amygdala basically is in the driver's seat. And also another thing I like to think of is neuropsychology talked about this all the time is like anxiety hijacks the frontal lobe, and it's really the same thing. The amygdala is hijacking the frontal lobe when you cannot like deer in the headlights, right. That's the whole hijack thing. And people sometimes forget about they say the autonomic nervous system, when I'm talking about the sympathetic, when I'm talking about the amygdala, people say, oh, it's fight or flight. Okay, yes. And freeze. Don't forget about the treats. Yeah, I think because some people say they don't think they're in that camp. They go, it's not anxiety because I just breathe it is anxiety. Yeah, but the frozen feeling is basically that the frontal lobe is shut off at that point and you can't think yourself out of box.

Julie

Okay, yeah, that makes sense. That makes sense. Okay, excellent.

Victoria

Okay, so you wanted to talk about.

Julie

How you use dr. Smith. Does the CBT as well? That's how we met each other actually in this field is both having that in common. So what are the tools you use with your clients to deal with anxiety or depression or whatever you want to focus today?

Victoria

So I guess when we can identify thoughts and we know that it's really cortical anxiety that's driving or with depression, then we use mood record or the thought records and attack it from basically the standard cognitive behavioral therapy model to.

Julie

Ask yourself, okay, what am I thinking right now?

Victoria

What am I telling myself? And then we go through, write all those things down, identify distortions, talk about the way they make us feel, see which things would feel different if we untwist our thinking. That's the standard to me, and it's very effective for depression and anxiety. But I think the piece, I think that sometimes at least myself got neglected was the amygdala based, okay? And that one's going to be different because we're not going to be talking about what you're thinking. We're going to be talking about how you're feeling, what you could do to mitigate some of your body's knee jerk reactions to things and what are some.

Julie

Of the tools for that?

Victoria

Well, before I even I'll say that, but I want to do a plug for somebody that has kind of, I feel like put this neuroscience into very understandable terms. Rick Hanson I took a course. I actually am not done, but I took a course and he's talking about all this neuroplasticity. That's his thing. I feel like for somebody who wants to wrap their brains around this a little bit more, hear more about it, he's worth a listen. He's on YouTube. Ted Talks. His name is Rick Hanson.

Julie

Okay.

Victoria

And I'm not sure what his programs are labeled. I know the one I'm taking is like a program in neuroplasticity, but you.

Julie

Can just Google it.

Victoria

You can just Google it and you'll find it and it's what I'm talking about and maybe has a different spin on it, but he talks about, like, pausing, too.

Julie

Excellent.

Victoria

Yeah. And to me, I think that's part of it is I want people to give them some power that they feel like they can do something, but it's not always like, it might not be this that they're listening to, but we might link them to something that could be helpful. I always feel like reading as much as you can about something gives you just more information, and there might be something that clicks with you, connects with you, and you feel like, oh, I.

Julie

Can do this, how it acknowledges power. And when you're reacting, instead of freaking out, like, why am I feeling this way? I was like, oh, I understand what the amigo is and what it does. Right, okay.

Victoria

Yeah. So one other thing about the mango. I mentioned chronic stress, how it changes it, and the other one is lack of sleep. Those are the big two.

Right.

Victoria

So it's not just lack of sleep, but it's that continuity.

Right.

Victoria

Because when we sleep, we hit different phases. I don't remember all the terms, but I know that some of them, like delta, are the restorative phase, if I remember correctly. I might be wrong about that. But there's a restorative phase of sleep, and we need to have that to feel rested.

Right.

Victoria

That also repairs our cells, helps our immune system, but it helps our amygdala.

Right.

Victoria

So when we're sleep deprived, our amygdala is not working as well. Right. So to me, that's another huge one.

Julie

Huge.

Victoria

If you want to feel healthier and respond to better to stress and anxiety, get some sleep.

Julie

Yes. I have one of my podcasts called get a Good Night's Sleep, if you guys want to listen to it. But I've learned a long time ago from doctors that even in the animal kingdom, sleep is the most important thing for everybody. And when you start getting good sleep, you feel like you can cope better and handle stress better.

Victoria

Yes.

Julie

Right. And that's because the megalodon reacting so much. Yes.

Victoria

So they said if you don't sleep, you're more likely to have a reactive and a more susceptible experience to anxiety just because of that connection. Just that.

Julie

I love that. Did you guys hear that? Take notes. So important. I know I'm an egg sometimes, but I'm always talking about sleep, and we minimize it. Oh, I got six and a half. I'm like, well, that ain't enough.

Victoria

That isn't enough.

Julie

Our world is just well, I'll have a little caffeine. I'll get by. I'm busy. But you got to find that window if you need to turn the TV off early or whatever, get off your phone. If it's just sometimes the extra half hour, an hour makes the world of difference, right? Yes, absolutely. Excellent. Okay, so sleep. Super important.

Victoria

Sleep.

Julie

Okay. What were some other things you said with the amygdala?

Victoria

Well, the exercise. Exercise, it really results in a calmer amygdala that's the bottom line.

Julie

And do they say, I think the big question is I think people set themselves up so they don't succeed. I have to go for an hour every day.

Victoria

It's not an hour. The research shows 30 minutes.

Julie

Beautiful.

Victoria

It's something that really hasn't changed over time.

Right.

Victoria

Five days a week, 30 minutes of time. And again, like I said, it doesn't have to be running through a park. It could be just anything that increases your heart rate. Even if it's remember the aerobics and stuff like something like that, where you don't have to leave your bedroom.

Julie

Right?

Yeah.

Julie

You can watch something on YouTube or just walking in place.

Victoria

There's so many things now on the Internet that are free and available for all ages. Right. So the other thing I think is important, too, is I think we've exercised before and had injuries. It puts you out for a while. I bite off more than I can chew. But there's even things that adapted to older people, the 50 plus crowd. And so I always try not to have an excuse because there's things for older people and where they make adjustments. Another plug. Denise Austin, remember Hero? She has something that she's doing all these exercise videos for the older crap. Now, I love her stuff, and she does free stuff all the time. You can sign up, too, but she does these free little clips. That's awesome. Yeah. So before you hop in the shower, just do a little video to me. Yes.

Julie

Okay. Excellent. Any other things that you recommend we're getting they make a lot of just kind of calm. Yes.

Victoria

Okay. These are some other exercises that have been shown to be powerful. I just have a few, but these are the ones that the research has supported as being effective. Okay. Meditation. So I know that also it's hard for some people. So, again, if you're having trouble doing it on your own, like, maybe grab a little app or I don't know. You were talking about one earlier, John Kevinson. Yes. People like that do a guided one, and that way it's not just you just struggling to sit there.

Julie

Most of us get distracting.

Victoria

Yes.

Julie

And be patient where it takes time to really like it. Good.

Victoria

Exactly. It's like anything, it's a skill and you've got to practice it.

Julie

Yes.

Victoria

So meditation has been shown to be efficacious for creating a healthier amygdala. The other one is very simple. Deep breathing. I can't say that enough. And do it several times a day. And don't do it. Don't wait till you're anxious to do it. That's my biggest one, I think people forget. And again, if you have to schedule it in your calendar, do that. Just whatever it takes. Some people tell me, oh, I put a sticky note where I brush my teeth in the morning. And then once, after a couple of weeks have gone by and it's an established habit, I take the sticking note down and I don't do it anymore. But now I know it.

Julie

Yeah. Because a lot of people don't understandably, don't do anything like, say, breathing until they feel anxious. Right. It's not a habit like, say, brushing your teeth.

Right.

Julie

We're hoping to brush your teeth to avoid cavities. You don't start brushing your teeth once you have a cavity.

Right.

Julie

So it's all that planning ahead, like you said. Yes. With the phone, you can always do a reminder, just breathe. Part of your getting ready for bed at night. Yes, exactly. Because then your body gets more used to it. Right.

Victoria

And yeah, bedtime is the perfect time. Waking up midday, maybe your lunch, and then going to bed. Just do the deep breathing. It doesn't take a long time. And I think you're the one who turned me on to what's his name, dr. Wyle.

Julie

Andrew Wild Has. I know I've talked about this on other podcasts, you guys, too, but it's the yes. If you look up, he has a video on YouTube, breathing Doctor, Andrew Wyld. And it's like five or six minutes, but it'll walk you through it. And that one's very helpful.

Victoria

And it walks you through the why, too, like why that works and why he's using that technique. I find that helpful. Sometimes when I talk to people about deep breathing, they want something to follow. And so for people who want some technique to follow, that's great for that. Yes. And some people can just, you know, I have a handout that I use. It just goes over basic deep breathing, and that's fine. But again, lots of things work. You have to find what you like.

Julie

Best and what works for you and stick with it. Exactly.

Victoria

Right, okay. And then the other things are imagery.

Julie

Okay.

Victoria

And then muscle relaxation, you can do from top to bottom of muscle relaxation. That's a standard activity. But honestly, any of those are just as effective as the others, except with exercise being the best and sleep being the best.

Julie

The best. Okay. Yeah. And for you guys that are using the minor removed book, if you go to chapter 14, which is on understanding anxiety in the back, it talks about breathing, progressive muscle relaxation and imagery. So it talks about all those. And again, I tell everyone, not everything is going to work for you, but you want to find something. Right. Sleep is obviously for all of us, but find what works for you and stick with it, and that will make a big difference.

Yeah.

Julie

And let me ask you one last question before we go. Does the research show how long it takes to kind of feel the positive effects?

Victoria

You know, that's a really good question. I actually don't know the specific answer to that question, so I'm not going to make it up.

Julie

Okay. But it might depend on it might depend on the person i.

Victoria

Suppose I would think, yeah, that would be my guess. But I don't know how long it would take to actually I will look that up, Julie, because I feel like some of that research about the imaging and I want to see how long did they have those people do whatever it was like the exercise or change their sleep or do some of the meditation stuff and after how many weeks did they see a result? That would be good to know. Actually, that's a really good thing to know because then you can tell your clients, right? Hey, in the study it took X amount of time for people to really feel a big difference.

Julie

Now, I know with the CBT research that it was a ten week research study. That this is the one they replicate all the time and they do the Pet scan before and after, okay, that in ten weeks they saw a change in people's brain chemistry. So that I can say for sure. And that was nothing.

Victoria

Do you know where that was done?

Julie

Out of the original, I believe, was UCLA, like decades ago. And every time they replicate the study, they get the same outcome.

Victoria

Okay.

Julie

Because we know CBT is the most researched and most successful therapy out there for people, right. And it adds this positive psychology we're talking about a little bit today, where we can maybe use the words like acceptance and forgiveness and gratitude, but being mindful, the imagery, I think the breathing, the meditation allows us to be more present, which can also help us.

Right.

Julie

And all of these things, I know I talk about the Vineyard mood I use all the time, that's my go to book, but that has all of these aspects in it now. So it's kind of incorporated more than it did in the past and talks about exercise. So that's kind of what you're saying. So for sure, I know with CBT, within ten weeks you're going to see an outcome and that probably will overlap a little bit with this other research.

Victoria

I thought of one more thing I want to add, okay. And I think I got this from Rick Hanson's kind of talks, but because Amygdala is so powerful, if anyone doesn't know where it sits in the brain, it's kind of in the center of our brain. It's a little kind of nugget that sits at the end of our hippocampus. Hippocampus is what stores our memory and so powerful connections there. And so because it's our protective and alert system, it's delivering information to, again, our memory system. And what happens is that like, we don't go about our day and maybe nine out of ten good things happen and the one out of ten bad thing, that's what we're sticking with.

Right.

Victoria

Again, that's our little Amygdala talking to the hippocampus and then our frontal lobe and making sense out of that. So one of the goals is pay attention to the nine out of ten things. Not that one out of ten.

Julie

Right.

Victoria

So sometimes it's just a refocus. There's the rewiring thing. It's like, okay, let me take in that nine out of ten that happened and not focus on that one thing.

Julie

Excellent. No, it's really good because I've talked I've shared on the podcast before, but sometimes when I'm feeling overwhelmed with the day or what I need to get done tomorrow, then I'll think about all the things I did get done, and the list is always way bigger than what I did get done. Right, of course. Or that could be what went well today instead of that one phone call was uncomfortable. Right. I didn't feel good about how things went at the end of a session with somebody. So, yes, if you think about everything that went well, that's an exercise in itself.

Victoria

That's an exercise in itself. And your point about gratitude, if you combine something like that with the breathing at the end of the day, think about to me, like, getting into my bed every night is luxury. I've got a roof over my head, food in my refrigerator, on a mattress. I'm not in Ukraine. I'm not somewhere where I'm fleeing for my life. I'm not walking up some road from another country. You know what I mean? It's just, like, safe. We have so much to be we live in an abundant conditions, and so that in itself is like right.

Julie

And that's what you're telling your brain, then I'm safe, I'm grateful. I have more than I need. I have everything I need, and that can help.

Victoria

More than we need.

Julie

Yes.

Victoria

And it's such a good feeling to go to bed and say, isn't this great?

Julie

Yes. Excellent. Well, thank you.

Victoria

You're welcome. We got educated today I want to.

Julie

Add to, and Dr. Smith's going to give you more information on how to contact her, if you like to. But being a neuropsychologist, you also do testing for people, right?

Victoria

Yes.

Julie

So what are some of the diagnoses that you test for?

Victoria

The common sort of assessments that I do are for head injury or for dementia. So that's the common attention deficit training, too, and attention deficit disorder assessment. Adults. I don't do it for children anymore because it's a whole anyhow I just do it for adults.

Julie

Okay.

Victoria

Yeah.

Julie

Excellent. Okay. So can you share with the listeners if they would like to reach you, like email or phone number, whatever way is best to contact you?

Victoria

Yeah. So if you want to do email, my email is Vgsmithphd@gmail.com, and my cell phone and office number is 714-615-1519.

Julie

Excellent. So she's located in Orange County.

Victoria

Orange County Fullerton right now only. Fullerton for in person? Yes, for in person.

Julie

Okay. And you're still doing telehealth?

Victoria

Still also doing telehealth.

Julie

Okay. Excellent. Okay. So hey, everyone, thanks for being with us here today. I hope it was helpful. If you have any burning questions. As always, we'd love to hear from you. You can email me at mycbtpodcast@gmail.com you can follow me on my Instagram, at mycbt podcast, on Facebook under Dr. Julia Osborne, and my website is my cognitivebehavioural Therapy.com. I'd love to get your emails and your feedback, and as always, I'll always check with you before I share them on air. But I know they're helpful to our listeners. And if you have any suggestions of information you'd like to hear, please let me know as well. So hit the subscribe button to make sure you won't miss another episode. Thanks for joining me. Stay safe and remember to always make decisions based on what's best for you, not how you feel.

Victoria

Right.

Julie

So it's all that planning ahead, like you said. Yes. With the phone, you can always do a reminder, just breathe. Part of your getting ready for bed at night. Yes, exactly. Because then your body gets more used to it. Right.

Victoria

And yeah, bedtime is the perfect time. Waking up midday, maybe your lunch, and then going to bed. Just do the deep breathing. It doesn't take a long time. And I think you're the one who turned me on to …what's his name? Dr. Wyle?

Julie

Andrew Wild. I know I've talked about this on other podcasts, you guys, too, but it's the yes. If you look up, he has a video on YouTube, breathing Doctor Andrew Wyld. And it's like five or six minutes, but it'll walk you through it. And that one's very helpful.

Victoria

And it walks you through the why, too, like why that works and why he's using that technique. I find that helpful. Sometimes when I talk to people about deep breathing, they want something to follow. And so for people who want some technique to follow, that's great for that. Yes. And some people can just, you know, I have a handout that I use. It just goes over basic deep breathing, and that's fine. But again, lots of things work. You have to find what you like.

Julie

Best and what works for you and stick with it. Exactly.

Victoria

Right, okay. And then the other things are imagery.

Julie

Okay.

Victoria

And then muscle relaxation, you can do from top to bottom of muscle relaxation. That's a standard activity. But honestly, any of those are just as effective as the others, except with exercise being the best and sleep being the best.

Julie

The best. Okay. Yeah. And for you guys that are using the minor removed book, if you go to chapter 14, which is on understanding anxiety in the back, it talks about breathing, progressive muscle relaxation and imagery. So it talks about all those. And again, I tell everyone, not everything is going to work for you, but you want to find something. Right. Sleep is obviously for all of us, but find what works for you and stick with it, and that will make a big difference.

Victoria

Yeah.

Julie

And let me ask you one last question before we go. Does the research show how long it takes to kind of feel the positive effects?

Victoria

You know, that's a really good question. I actually don't know the specific answer to that question, so I'm not going to make it up.

Julie

Okay. But it might depend on it might depend on the person.

Victoria

Suppose I would think, yeah, that would be my guess. But I don't know how long it would take to actually I will look that up, Julie, because I feel like some of that research about the imaging and I want to see how long did they have those people do whatever it was like the exercise or change their sleep or do some of the meditation stuff and after how many weeks did they see a result? That would be good to know. Actually, that's a really good thing to know because then you can tell your clients, right? Hey, in the study it took X amount of time for people to really feel a big difference.

Julie

Now, I know with the CBT research that it was a ten week research study. That this is the one they replicate all the time and they do the Pet scan before and after, okay, that in ten weeks they saw a change in people's brain chemistry. So that I can say for sure. And that was nothing.

Victoria

Do you know where that was done?

Julie

Out of the original, I believe, was UCLA, like decades ago. And every time they replicate the study, they get the same outcome.

Victoria

Okay.

Julie

Because we know CBT is the most researched and most successful therapy out there for people, right. And it adds this positive psychology we're talking about a little bit today, where we can maybe use the words like acceptance and forgiveness and gratitude, but being mindful, the imagery, I think the breathing, the meditation allows us to be more present, which can also help us.

Victoria

Right.

Julie

And all of these things, I know I talk about the Vineyard mood I use all the time, that's my go to book, but that has all of these aspects in it now. So it's kind of incorporated more than it did in the past and talks about exercise. So that's kind of what you're saying. So for sure, I know with CBT, within ten weeks you're going to see an outcome and that probably will overlap a little bit with this other research.

Victoria

I thought of one more thing I want to add, okay. And I think I got this from Rick Hanson's kind of talks, but because Amygdala is so powerful, if anyone doesn't know where it sits in the brain, it's kind of in the center of our brain. It's a little kind of nugget that sits at the end of our hippocampus. Hippocampus is what stores our memory and so powerful connections there. And so because it's our protective and alert system, it's delivering information to, again, our memory system. And what happens is that like, we don't go about our day and maybe nine out of ten good things happen and the one out of ten bad thing, that's what we're sticking with.

Julie

Right.

Victoria

Again, that's our little Amygdala talking to the hippocampus and then our frontal lobe and making sense out of that. So one of the goals is pay attention to the nine out of ten things. Not that one out of ten.

Julie

Right.

Victoria

So sometimes it's just a refocus. There's the rewiring thing. It's like, okay, let me take in that nine out of ten that happened and not focus on that one thing.

Julie

Excellent. No, it's really good because I've talked I've shared on the podcast before, but sometimes when I'm feeling overwhelmed with the day or what I need to get done tomorrow, then I'll think about all the things I did get done, and the list is always way bigger than what I did get done. Right, of course. Or that could be what went well today instead of that one phone call was uncomfortable. Right. I didn't feel good about how things went at the end of a session with somebody. So, yes, if you think about everything that went well, that's an exercise in itself.

Victoria

That's an exercise in itself. And your point about gratitude, if you combine something like that with the breathing at the end of the day, think about to me, like, getting into my bed every night is luxury. I've got a roof over my head, food in my refrigerator, on a mattress. I'm not in Ukraine. I'm not somewhere where I'm fleeing for my life. I'm not walking up some road from another country. You know what I mean? It's just, like, safe. We have so much to be we live in an abundant conditions, and so that in itself is like right.

Julie

And that's what you're telling your brain, then I'm safe, I'm grateful. I have more than I need. I have everything I need, and that can help.

Victoria

More than we need.

Julie

Yes.

Victoria

And it's such a good feeling to go to bed and say, isn't this great?

Julie

Yes. Excellent. Well, thank you.

Victoria

You're welcome. We got educated today I want to.

Julie

Add to, and Dr. Smith's going to give you more information on how to contact her, if you like to. But being a neuropsychologist, you also do testing for people, right?

Victoria

Yes.

Julie

So what are some of the diagnoses that you test for?

Victoria

The common sort of assessments that I do are for head injury or for dementia. So that's the common attention deficit training, too, and attention deficit disorder assessment. Adults. I don't do it for children anymore because it's a whole anyhow I just do it for adults.

Julie

Okay.

Victoria

Yeah.

Julie

Excellent. Okay. So can you share with the listeners if they would like to reach you, like email or phone number, whatever way is best to contact you?

Victoria

Yeah. So if you want to do email, my email is Vgsmithphd@gmail.com, and my cell phone and office number is 714-615-1519.

Julie

Excellent. So she's located in Orange County.

Victoria

Orange County - Fullerton right now only. Fullerton for in-person? Yes, for in person.

Julie

Okay. And you're still doing telehealth?

Victoria

Still also doing telehealth.

Julie

Okay. Excellent. Okay. So hey, everyone, thanks for being with us here today. I hope it was helpful. If you have any burning questions. As always, we'd love to hear from you. You can email me at mycbtpodcast@gmail.com you can follow me on my Instagram, at mycbtpodcast, on Facebook under Dr. Julia Osborn, and my website is my cognitivebehaviouraltherapy.com. I'd love to get your emails and your feedback, and as always, I'll always check with you before I share them on air. But I know they're helpful to our listeners. And if you have any suggestions of information you'd like to hear, please let me know as well. So hit the subscribe button to make sure you won't miss another episode. Thanks for joining me. Stay safe and remember to always make decisions based on what's best for you, not how you feel.

Episode #87