philosophy and works of the psychiatrist Milton H. Erickson provide a framework of self-awareness and self-responsibility integral to overall health and well-being. Erickson’s creative approaches to psychotherapy and speculation that his unique success may be in a tangible way related to neuroplasticity, piqued our interest in exploring neuroplasticity as a central avenue to brain health. We found the work of others who also support this concept. We share an admiration for the work of neurologist Oliver Sacks, whose many books have shown that deeper understanding of one’s uniqueness is integral to health. Another book that influenced our thinking is The Brain that Changes Itself6 by physician Norman Doidge, in which Doidge emphasizes the personal triumph of overcoming limitations through challenging, ingrained, habitual patterns of perception and thinking.
We draw on the work of Mindfulness Based Stress Reduction (MBSR) as it was developed by Jon Kabat-Zinn, PhD, and the Center for Mindfulness at the University of Massachusetts Medical School. Clinical research strongly supports the positive effects of MBSR, which is being integrated into other therapy protocols.7 We are also inspired by Mindfulness-Based Relapse Prevention (MBRP), which uses empirically supported interventions developed by Alan Marlatt, Sarah Bowen, and Neeha Chawla, and others, at the University of Washington, Addictive Behaviors Research Center.
The process of brain resiliency is supported by neuroscientist Michael Merzenich, whose research at the University of California shows that the brain has the capacity to change itself in both physical and functional ways.8 Merzenich is a leading proponent of therapeutic approaches to overcome functional limitations. These ideas are supported by a 2006 study by Dr. Sherry Willis and colleagues with the National Institute on Aging that was the first to document long-term, positive effects of cognitive training on brain function in older adults. The study showed that at nearly any point in your life, you can strengthen your brain by doing tasks that are new and complex and that stimulate a balanced variety of areas within the brain.9
The work of Ernest Rossi, PhD, has provided a platform from which we have designed and implemented many of our activities. Rossi posits we can enhance neural networking, stimulate dendritic growth, and promote a healthy rebalance of neurotransmitters through engaging in three areas: novelty, environmental enrichment, and physical activity. Rossi states, “Novelty, exercise, and life enrichment facilitate gene expression and brain growth.”10 He emphasizes that by pushing beyond boundaries of comfort, one can expand possibilities as well as accelerate the process of healing. Rossi has initiated supportive research, currently in progress, to document the effect of creative problem solving on genetic expression. In addition, “Gene expression and brain plasticity can consolidate the healing reconstruction of fear, stress, and traumatic memories and other symptoms in everyday life.”11
Expression that is not limited by cognitive or verbal elements is a basic and fundamental construct of our approach. Another is being able to envision a positive future without the limitations of addiction. Elements of past, present, and future behaviors are entwined in our activities. Acceptance of what is unchangeable, learning needed skills in the present, and envisioning success in a future time are embedded lessons in most activity. In subtle ways, the activities teach learning to relax, enjoying the moment, looking at how others have fun in sober ways, recognizing that all individuals have limitations, and making associations with current capabilities that will lead to a healthy and happy future.12
What makes Engage the Group, Engage the Brain distinct is we tested each of these activities in groups with actual clients in recovery. We obtained feedback from participants and refined and adjusted activities as needed. All samples displayed in this book are the original work of clients in our groups, who graciously gave us permission to use them. The process of compiling these activities has been immeasurably rewarding for us. The clients are consistently appreciative and enthusiastic, and each session brings its own novelty and enrichment. The unexpected resourcefulness that seems to arise in nearly every session is exciting and gratifying.
It is our hope and expectation that our efforts will offer practical directions for other clinicians to feel the energy generated through this process. Science has not yet brought us to a place where we can state with certainty that these activities actually lead to neuroplasticity and help strengthen recovery; however, we offer these materials as our contribution to a promising new direction.
Introduction Notes
1. A. Thomas McLellan, David C. Lewis, Charles P. O’Brien, and Herbert D. Kleber, “Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation,” JAMA, no. 284 (13, 2000): 1689–1695.
2. “Drug Abuse and Addiction: One of America’s Most Challenging Public Health Problems,” National Institute on Drug Abuse, last modified June 2005, accessed June 29, 2015. http://archives.drugabuse.gov/about/welcome/aboutdrugabuse/index.html.
3. James O. Prochaska, John Norcross, and Carlo DiClemente, Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward (NewYork: Avon Books, 1994).
4. William R. Miller and Stephen Rollnick, Motivational Interviewing: Helping People Change, Third Edition (New York: Guiford Press, 2012).
5. Ernest L. Rossi, Roxanna Erickson-Klein, and Kathyrn L. Rossi, eds., The Collected Works of Milton H. Erickson Volume 3: Opening the Mind (Phoenix: Milton H. Erickson Foundation Press, 2008).
6. Norman Doidge, The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science (New York: Penguin, 2007).
7. Jon Kabat-Zinn, Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness (New York: Delta, 2005).
8. Dean C. Buonomano and Michael M. Merzenich, “Cortical Plasticity: From Synapses to Maps,” Annual Review of Neuroscience, no. 21 (1998), 149–86.
9. Sherry L. Willis, Sharon L. Tennstedt, Michael Marsiske, Karlene Ball, Jeffrey Elias, Kathy Mann Koepke, K. M., et al., “Long-term Effects of Cognitive Training on Everyday Functional Outcomes in Older Adults,” Journal of the American Medical Association, no. 296 (23: 2006), 2805–2814.
10. Ernest L. Rossi and Kathyrn L. Rossi, Creating New Consciousness in Everyday Life: The Psycho-Social Genomics of Self Creation (Los Osos: Palisades Gateway Publishing, 2013).
11. Ibid., 964–967.
12. Philip Zimbardo, Richard Sword, and Rosemary Sword, Time Cure: Overcoming PTSD with the New Psychology of Time Perspective Therapy (San Francisco: Jossey-Bass, 2012).
How to Use This Book: A Facilitator’s Guide
Through our experience in the field, we have learned a variety of strategies that will help you conduct dynamic groups. In this section, we share our methods for engaging participation and maximizing opportunity for therapeutic transformation.
The activities in the book may be done in any order as they might fit into your group.
Group Management: We always begin these activities with a short summary emphasizing patience, being aware of self in the present moment, and the importance of self-care. Starting with a brief review of the body’s needs for a balance of nutrition, sleep, and exercise, we also emphasize a need for good spiritual and mental health. We briefly call attention to each of the six areas
