We are on the verge of establishing a new paradigm in healthcare, one that is unifying and highly effective. Instead of treating our epidemics of anxiety, depression, diabetes, obesity, cancer, and addiction as separate problems, we see them as symptoms of the same underlying cause: stress overload.
Just as medical treatments and mental health programs are struggling to turn around these epidemics, brain science has shown that by using a simple, structured system of techniques to switch off stress overload, our treatments can be more effective. By using EBT as a "bolt-on" to any treatment program for these problems, the cascade of stress chemicals, inflammation, and emotional and behavioral extremes can quiet down. Our natural resilience increases, and we have a better chance of charting a healthier, happier future for ourselves, those we love, and our nation.
Whether you use EBT to treat a health issue or to enhance the quality of your life, what follows is a summary of the science of the method. In a time of complexity, the method is simple. We were all born with resiliency pathways that enable us to tap into our inherent strength, goodness, and wisdom. Let’s use those pathways and strengthen them, so they activate easily and often to bring out the best in each of us. EBT gives us that power.
An epidemic of stress-induced health problems Stress reactivity and chronic stress are the modifiable root causes of the up to 90 percent of health problems. The epidemics of emotional and behavioral health problems, chronic disease, accidents, and suicides in the U.S. can be traced to excessive stress.
Now 45 percent of Americans have at least one chronic disease. Nearly 10 percent of the U.S. population has diabetes, and 35 percent of all adults have metabolic syndrome (a combination of obesity, high blood pressure, type 2 diabetes, and poor lipid profiles). Mental illness and substance abuse affect 20 percent of Americans, and deaths by suicide have increased by about 30 percent since 1999. Despite spending double what other wealthy countries spend per person on healthcare, including a per-capita pharmaceutical expense that is the highest in the world, the U.S. ranks last in life expectancy among the 12 wealthiest industrialized nations.
Traditional stress-reduction methods have fallen short The traditional methods of treating stress, including psychotherapy, medications, and healthy habits, have not prevented the explosive growth of stress-induced health problems. Until now, we have relied primarily on one-on-one psychotherapy and Cognitive behavioral therapy (CBT). The work force of psychotherapists cannot keep up with the rapidly increasing demand. What's more, CBT, the foundation of traditional care, is reliant on a high-functioning neocortex. Neuroscience research has shown cognitive methods are effective at lower levels of stress and can give us an illusion that we are effectively treating our stress symptoms. But in the high levels of stress so prevalent in modern life, when individuals are stress reactive rather than stress resilient, research confirms that cognitive methods may often "fail the stress test."
We can use emotions in new ways to rapidly reduce stress Advances in neuroscience have led to a growing awareness that the root cause of stress problems is the circuitry in the emotional brain. Given that it is not feasible to apply traditional psychotherapy to the prevention and treatment of the explosive growth of stress-related problems, and with concerns about excessive reliance on cognitive methods, new methods are needed. What we need is a form of self-therapy, a way for ordinary people to have a therapist "in their pocket," a scalable, brain-based way to process their intense negative emotions, switch off strong emotional drives for common excesses, and recover from stress overload whenever it occurs.
Low-stress emotions do not cause stress problems Most people find processing emotions to be relatively easy in low-stress states. These emotions are "homeostatic," and change rapidly, giving us an accurate way to identify what we need. These emotions, such as feeling sad, angry, afraid, hungry, tired, or tense, are signs of the activation of a homeostatic or self-correcting circuit. These circuits are negative feedback loops like an air conditioner and a heater, so they buffer our emotions and help us meet our needs with relatively little stress.
Deficits in processing high-stress emotions are the problem It is in the high-stress emotional states, which are “allostatic” and become stuck "on," that we need a self-help way to switch off extreme emotions, thoughts, and behaviors. These emotions, such as hostility, depression, panic, and numbness, do not guide us to identify and meet our needs. They are faulty messengers that activate strong drives for common excesses and maladaptive states. They create a self-reinforcing, positive feedback loop, so that we are not able to self-correct, but instead activate a body-brain loop of stress that causes stress levels (and emotions, behaviors, and thoughts) to careen out of control. The brain reflexively repeats old ineffective responses of maladaptive behavior, which contributes to a broad range of health problems and promote needless personal suffering. By processing our allostatic emotions into homeostatic emotions, we switch off the circuits that cause stress reactivity and activate the circuits that cause stress resilience. Once we return to a homeostatic state, our emotions naturally direct us to meet our needs in healthier, more adaptive ways. Rather than fighting the stress response, we process our emotions and tame it.
The new "5-Point System" empowers people to process high-stress emotions Dr. Laurel Mellin, a health psychologist, developed a structured system for processing allostatic emotions into homeostatic emotions, using simple tools to change our physiology and responses in daily life. This method is emotional brain training (EBT). She conceptualized the brains emotional states in terms of five stress levels, mirroring the parallel discoveries of psychiatrist Bruce Perry. Instead of monitoring emotions ("How do I feel?"), individuals identified their "number," or physiologic stress state, on a scale of one to five ("What number am I?"). As emotional processing techniques vary with stress level, there is one emotional technique for each of five levels of stress. As the emotional brain is the survival brain, the inspiration for the tools was the optimal dyadic emotional processing associated with a responsive parenting style and a secure attachment. This EBT 5-Point System of Emotional and Behavioral Regulation provides a unifying system for processing emotional stress and promoting optimal physiologic responses to daily life.
With help from her collaborators at UCSF, Dr. Mellin brought about major breakthroughs in understanding the scientific basis of the method. She and her colleagues proposed a new paradigm in healthcare based on rewiring the stress response. In addition to the contributions of Dr. Mellin's UCSF colleagues, EBT integrates the research of many scientists, including UCSF's Michael Merzenich (neuroplasticity), Stanford's Robert Sapolsky (stress), University of Rockefeller's Bruce McEwen (allostatic load), Feinberg School of Medicine's Bruce Perry (physiologic brain states), NYU's Joseph LeDoux and Harvard's Elizabeth Phelps (emotional memories), UCSF's Robert Lustig (stress and reward endocrinology), and previous director of NIMH, Thomas Insel (neural circuitry).
Technology makes learning and using EBT scalable The aspect of EBT that was essential for scalability was a technology platform. In a high-stress state, technology could enhance the user's effectiveness in being aware of their stress levels and applying the corresponding emotional tools to change them in real time. Technology designer Joseph Mellin, conceptualized the technology for Brain Based Health, including the first mobile app for "the five-point system" and EBT Chief Technology Officer, Dev Singh, is the lead programmer. For users who want to connect with others who could offer a warm, listening presence, the platform includes a peer-to-peer "connection" system featuring private telephone access for five-minute calls to practice the tools and weekly telegroups for learning and support. The groups and individual coaching are facilitated by health professionals who are certified in the method. These professionals do not give advice. Instead, they coach participants in using the tools effectively to experience optimal brain function and advise themselves. The absence of a philosophy or belief system other than self-directed emotional neuroplasticity adds to the method’s potential for universality.
It is the right time for a new paradigm to emerge The fundamental conceptual basis of Brain Based Health is that, as individuals, we have the power to access tools to switch off and reprogram the emotional circuitry that can trigger stress reactivity and promote the onset and exacerbation of a broad range of health problems. By using a simple, structured technology-based system of emotional resiliency, more people can privately and quickly take charge of their stress, and with it, their unwanted emotions, thoughts, and behaviors. They can take on more of the role of being their own "therapist," moving from stress reactivity to stress resiliency. This could ease the crushing demand on the mental health workforce and perhaps even decrease the need for medications, procedures, and devices.
The transition to Brain Based Health will take time, but training the brain for resilience will be likely to prevail. It’s a rapid and easy way to change our physiology. Current methods have often lost their physiologic roots, and as our stress circuitry controls our physiology, this approach could improve individual control over our chemical, electrical, and organ response to stress. As we continue to learn about emotional brain training, the approach will become easier and even more scalable. Studies that support the method’s effectiveness have been conducted at UCSF, the University of Illinois at Chicago, and the University of Kentucky, and more research is needed to build our knowledge.
A new golden age of preventing and treating stress-induced problems As most diseases of modern life are caused or exacerbated by physiologic stress, we are in a new age of healthcare: finding innovative and scalable ways for our population to move from stress reactivity to stress resilience. Up until 1900, most human medical problems were infectious diseases. This led to the golden age of bacteriology, in which methods of eradicating “germs” with antibiotics rapidly reduced the epidemics of infectious diseases. During the next 100 years, medicine flourished and made remarkable advances, but often only treated symptoms and managed diseases rather than curing them. What may be emerging is a growing awareness that we are at the start of another golden age, this time of neuroplasticity, rewiring the self-regulatory circuitry and stress habit (set point) of the brain.
With growing recognition that the brain is the central organ of stress reactivity and a root cause of most health problems, the nature of healthcare is likely to change. Episodes of stress reactivity can occur at any time. A fundamental need is to have continuous, self-directed control of stress. Although the pre-brain-based healthcare model was based on weekly appointments with a health professional, the intervention need is continuous stress resiliency treatment. Perhaps the use of in-depth one-on-one psychotherapy plus self-directed resiliency training may be the most effective option for people who are suffering from emotional health problems. Medications can decrease the stress caused by disease and heal the brain enough from trauma that the prefrontal cortex can effectively use resiliency tools, but they come with serious side effects. If there is ever a solution, it will be training the brain for resilience. That simple switch from states of high stress and negative emotions to low stress and positive emotions uses our endogenous chemicals effectively. It causes the activation of a broad range of healing brain chemicals and the deactivation of harmful chemicals, something that the use of medication alone cannot do.
The healthcare of the future will emphasize the use of the transformative power of our amazing brain for emotional regulation and positive emotional neuroplasticity. Rather than relying excessively on the healthcare system to save us, we can rely more on self-care and peer support, people helping themselves and helping others. By using the tools day by day to train our brains for optimal resilience, we stand our best chance of turning around the epidemic of stress-induced problems and ensuring the health and wellbeing of our citizens.