By Lucy Barish

Until about 15 years ago, scientists believed humans were born with all the brain cells (neurons) they would ever have. However, with new methods in brain imaging, they have learned that the brain does, indeed, grow. This is called neuroplasticity, and they have discovered new ways to help brains grow into greater resilience and mental health.

We know that cavemen, who had to face the dangers of saber-toothed tigers, developed an effective way to deal with such dangers—the famous “fight or flight” response. The part of the brain in the more primitive limbic system, particularly the amygdala, the seat of emotion, would signal danger, causing cortisol, a stress hormone, to flow through their bodies, causing quick, hopefully life-saving decisions.

Although we modern humans have a prefrontal cortex that enables us to learn, reason, make decisions and execute them, we still have a primitive limbic system that can cause us to perceive dangers where there are none, causing anxiety and other emotional problems such as obsessive-compulsive disorder, agoraphobia (fear of the outside world), post-traumatic stress disorder (PTSD) and, of course, depression.

Scientists have also discovered that a child’s view of the world is formed in the first six years of life based upon how they are seen and treated and what they see, as well as caregivers’ attitudes and behaviors. This world “map” is unconscious. If parental figures are good enough, a benign view of the world develops. If not, constant fear makes the amygdala hyperalert and hypervigilant, constantly on the lookout for danger, along with inflammation of the body and consequent physical illnesses.

More and more articles are being published that show that anti-anxiety and anti-depression medications, both older and newer, are not as helpful as first thought and often come with significant side effects. Of course, there are situations in which medication is vital, but understanding the brain and its ability to change and grow as well as methods to induce growth is vital to the psychotherapist. While talk therapy and understanding the early history that has caused a client to perceive the world and feel in dysfunctional ways is vital, it is also very important to take how the brain changes into account.

In an earlier article, I discussed the importance of life coaching as a part of psychotherapy, which many therapists discount. However, they can teach clients to change their brains, helping them become more mindful of their emotional reactions and understand how to make them less reactive and more positive.

One way is to breathe and cue. When a client becomes anxious and/or depressed, deep breathing can help dispel hyperarousal and the fight or flight response when paired with positive words such as “I am safe” or other calming thoughts. When done in an effortful way and with determination, new, healthier tracks can be laid down in the brain, enabling them to become more resilient and emotionally balanced.

This is actually what we do when we learn a new habit, skill or sport, for example. Old negative tracks, or “tapes,” degrade and disappear.

Furthermore, scientists have discovered that activities such as meditation, spiritual practice, including prayer, regular exercise and healthy eating and sleeping practices, as well as massage, yoga, tai chi, etc., go a long way toward dispelling anxiety and depression with only positive side effects. Thus, psychotherapists really need to know more about these areas in order to educate clients.

Psychotherapists also need to be especially mindful about their own inner thoughts and feelings and those of their clients. Scientists have discovered what they call “mirror neurons” on each side of the brain. Put simply, these mirror neurons make it possible for us to know our own emotional and physical states and thus know those of others, leading to empathy. A high degree of empathy and attention to the facial and bodily expressions of their clients helps psychotherapists know them and mirror back to them the true selves they see beyond the emotional issues.

Other methods based upon neurological as well as integration of emotional pain and trauma, are eye movement desensitization and reprocessing, especially helpful for PTSD, and a somewhat newer one, EFT tapping, in which a statement of the issue is made and meridian (acupuncture) points are repeatedly tapped to facilitate neurological changes.

It is very good news that we can change our brains to become more positive and calm so we can live fuller, happier lives with greater inner peace and physical health.

Lucille Barish is a licensed clinical social worker. For further information, contact her at 212-362-7146.

Donna Greenstein knew something was wrong with her son, but no one believed her. The mother of four first had two daughters and went through the usual pediatric milestones with them. Then her son was born and began to grow up.

“He would have tantrums that would last for hours and went above and beyond the normal realm of the terrible twos,” said Greenstein, a nurse. “He would rip wallpaper off walls, urinate on walls and throw feces at his sisters.”

Preschool and kindergarten teachers kept saying, “Boys will be boys. It’s nothing. He’s immature, he’ll catch up; this is typical boy behavior.”

When he started first grade, she received a call from his teacher, who told her, “‘We need to have a meeting; something is wrong.’ Finally someone was listening to me. Before, everyone told me I was crazy,” she recalled.

Her son was tested and diagnosed with attention deficit hyperactive disorder (ADHD), obsessive-compulsive disorder and bipolar disorder. Now 16, he is active in school and sports and is preparing for college. Without intervention, therapy and medication, his story would have had a different outcome.

ADHD is a chronic condition that affects millions of children in this country, and it affects boys four times more often than girls. There are three types of the disorder: inattentive, hyperactive-impulsive and combined ADHD, the most common, which involves all symptoms.

With the inattention type, a child has difficulty paying attention to details, is easily distracted, procrastinates and fails to complete homework or chores. These symptoms are often missed until a child faces the challenge of a structured classroom.

Hyperactivity symptoms present themselves in very young preschoolers. They include talking excessively, always being on the go, fidgeting, running or climbing excessively. Impulsivity symptoms involve inappropriate behavior, conversations, blurting out answers before questions are asked, interrupting others in social situations, knocking over objects or banging into people.

Dr. Lenard Adler, professor of psychiatry and child and adolescent psychiatry at NYU Langone Medical Center, said, “Girls are less likely to be diagnosed in childhood because they carry a higher load of the inattentive symptoms. So in a classroom, if you are daydreaming and not paying attention and distracted, you may be seen as underperforming, as compared to a boy, let’s say, who is behaviorally disruptive, in and out of his chair, interrupting his teacher.

“That doesn’t mean that girls don’t have any hyperactive impulses and boys don’t have any inattentive. But the balance is different,” he explained.

The causes of the disorder remain a mystery.

” We think the lion’s share of the transmission of ADHD—probably about 80 percent—is familiar,” said Adler. “It’s a disorder that tends to run in families.

“That being said, we also look for environmental causes that might be contributing; certainly it has been shown that maternal smoking during pregnancy may raise the risk for ADHD,” he said. “Another environmental factor that has been shown has been maternal abandonment.”

Other possible causes linked to the disorder are lead exposure, certain food additives and, possibly, gluten.

Children with ADHD without proper intervention often struggle in the classroom, tend to have more accidents and injuries, are more likely to have trouble interacting with peers and adults and are at increased risk for alcohol, drug abuse and delinquent behavior.

Making the diagnosis of ADHD is not always easy, since there is no one specific test such as a blood test or CAT scan that can make the definitive diagnosis. Instead, it is usually made by gathering the child’s history, first with the parents and later from the observations of teachers, before the child is brought in for evaluation.

Standard treatments for ADHD include medications and counseling. Often, children can go on to lead productive lives. Typical medications include stimulants such as Ritalin, Adderall and Dexedrine, but there is no one perfect medicine, and it is often a trial to see which one or combination of them will be the most effective.

The stimulants help boost and balance the neurotransmitters, or brain chemicals, that help improve inattention, impulsivity and hyperactivity.

There are side effects to all meds; some may include decreased appetite, weight loss, insomnia and irritability. It may take several rounds of fine-tuning to find the perfect combination. Nonstimulant medications, along with antidepressants and clonidine, have also been used successfully.

Greenstein advises parents like her to seek treatment early.

“A lot of parents, I have found, are afraid of medications, so they allow their children to suffer for so many years because ‘I don’t want to put my son or daughter on medication,’” she said. “I think they do more harm than good, because the child’s self-esteem takes a major blow when they are not able to function in a classroom with other children.

“Once you medicate them and get them under control, their self-esteem starts to blossom, they learn, they start to feel better about themselves.”

Her son had difficulty maintaining friendships his first years in school. Now as a teenager, he has friends, is active and is looking forward to college.

“I have him burn off energy so he does mixed martial arts and track,” Greenstein said. “You have to keep all of that energy focused in a positive direction.”