The New ABCs

The New ABCs: A Neuroscience-Informed Cognitive-Behavioral Approach

The Waves model is a conceptual framework rooted in neuroscience and CBT. It explains how internal and external stimuli lead to emotions, thoughts, and behaviors, integrating bottom-up and top-down brain processes. The model is divided into two processes: Wave1 (bottom-up processing) and Wave2 (top-down processing).

Wave1: Bottom-Up Processing

  1. Overview

    • Focuses on efficiency and speed in information processing.
    • Operates automatically and outside of conscious awareness.

  2. Components of Wave1:

    • A1: Activating Event
      • External or internal stimuli trigger a response (e.g., people, places, memories).
      • Example: A client walking home recalls being mugged (implicit memory).
    • B1: Brain from the Bottom-Up
      • Sensory stimuli are processed in lower brain regions, bypassing the neocortex.
      • Triggers the release of stress hormones (epinephrine and cortisol).
      • Example: Anxiety builds as implicit memories of the mugging stimulate a threat response.
    • C1: Primary Consequences Throughout the Nervous System
      • The brain sends signals to the body, initiating physiological and behavioral responses.
      • Example: Increased heart rate, shallow breathing, sweating, or a freeze response.

Wave2: Top-Down Processing

  1. Overview

    • Adds conscious awareness, rational thought, and emotional evaluation to the automatic responses of Wave1.

  2. Components of Wave2:

    • A2: Awareness of Wave1
      • Conscious recognition of Wave1’s physiological and behavioral consequences.
      • Example: The client notices a racing heart, sweating, and fear of walking home.
    • B2: Brain from the Top-Down
      • Higher brain regions (e.g., prefrontal cortex) process new sensory input.
      • Reappraises the situation, critiques responses, and plans a course of action.
      • Example: The client chastises themselves for their inability to control physiological responses.
    • C2: Secondary Consequences Throughout the Nervous and Limbic Systems
      • Emotional responses are generated through the limbic system and cortex.
      • Messages are sent back down to the body, creating integrated physiological and emotional outcomes.
      • Example: The client feels shame and weeps after reflecting on their freeze response.

Key Takeaways

  • Wave1 represents rapid, automatic, survival-driven responses initiated in the brain’s lower regions.
  • Wave2 introduces conscious, rational processes to evaluate and manage Wave1 responses.
  • Both processes interact to shape a person’s emotional, behavioral, and physiological reactions.
  • Understanding the Waves can help practitioners and clients better address cognitive distortions and maladaptive behaviors.

By integrating neurobiological insights, this model enhances traditional CBT approaches, offering a deeper understanding of automatic and conscious processes in emotional and behavioral regulation.

Source

ChatGPT. (2024). The New ABCs: A neuroscience-informed cognitive-behavioral approach. OpenAI. Retrieved from a discussion with AI using the prompt: “Summarize and explain The New ABCs: A neuroscience-informed cognitive-behavioral approach in detail.”

Field, Thomas & Beeson, Eric & Jones, Laura. (2015). The New ABCs: A Practitioner’s Guide to Neuroscience-Informed Cognitive-Behavior Therapy. Journal of Mental Health Counseling. 37. 206-220. 10.17744/1040-2861-37.3.206.

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1. The New ABCs Model

  • Recent neuroscience-informed CBT introduces a two-wave model:
    • Wave1: Bottom-up processing that focuses on unconscious, automatic physiological responses to triggers (e.g., stress or threat).
    • Wave2: Top-down processing that emphasizes cognitive restructuring after physiological arousal is addressed.
    • (Clark & Beck, 2010; Makinson & Young, 2012)

2. Wave1: Bottom-Up Interventions

  • Focuses on physiological reactions (e.g., heart rate, emotional activation) and unconscious awareness during crisis.
  • Tools include:
    • Mindfulness: Encourages attunement to physical sensations and reduces threat sensitivity. (Brefczynski-Lewis et al., 2007; Siegel, 2007)
    • Biofeedback/Neurofeedback: Tracks physiological responses (e.g., using heart-rate monitors) to retrain regulatory processes. (Linden, 2008)
    • Grounding Techniques: Sensory experiences like holding ice or tactile objects (e.g., frozen water bottle) help regulate affect.
    • (Farb, Anderson, & Segal, 2012; Linehan, 1993)

3. Wave2: Top-Down Processing

  • Useful after Wave1 stabilization for cognitive reappraisal and restructuring of emotional distress.
  • Involves:
    • Systematic Desensitization: Gradual exposure to distressing stimuli while observing physiological responses.
    • Psychoeducation: Teaching clients about Wave1 and Wave2 processes.
    • Self-Talk: Encouraging rational thought patterns and lowering fear intensity during controlled exposure to triggering events.
    • (Clark & Beck, 2010)

4. Case Examples

  • Wave1: A client with social anxiety uses a frozen water bottle to manage anxiety during meetings. Over time, systematic desensitization reduces dependency on the object.
  • Wave2: A client mugged in the past learns to reappraise the likelihood of the event recurring using self-talk (“It’s unlikely to happen again”) and behavioral strategies like changing their walking route.

5. Phases of Treatment

  • Phase A: Attending to physiological reactions via mindfulness or biofeedback.
  • Phase B: Building new neural pathways through techniques like systematic desensitization.
  • Phase C: Connecting lower brain responses to conscious thought with acceptance and CBT strategies.
    • (Miller & Cohen, 2001; Porges, 2001)

Mindfulness, biofeedback, and neurofeedback are techniques that help people become more aware of their body’s reactions, especially during stressful situations.

  1. Mindfulness: This involves paying close attention to your body and feelings in the present moment without judgment. It helps people notice when they are stressed or anxious, which can help them calm down.

  2. Biofeedback: This technique uses special equipment to show you how your body reacts to stress, like how fast your heart is beating. By watching these signals, you can learn to control things like your heart rate or breathing to stay calm.

  3. Neurofeedback: This is a type of brain training where people get real-time feedback on their brain activity. It can help train the brain to respond in healthier ways, like reducing anxiety or improving focus.

  4. Systematic Desensitization: This is a process where people gradually face things that make them anxious, starting with less scary situations and slowly moving to more challenging ones. It helps people get used to their fears and learn to manage their reactions over time.

These techniques work together to help people understand and control their emotional and physical responses, especially during moments of stress or anxiety.

References

  1. Brefczynski-Lewis, J. A., Lutz, A., Schaefer, H. S., Levinson, D. B., & Davidson, R. J. (2007). Mindfulness training modifies subsystems of attention. Cognitive, Affective, & Behavioral Neuroscience, 7(2), 109–119.
  2. Clark, D. A., & Beck, A. T. (2010). Cognitive therapy of anxiety disorders: Science and practice. The Guilford Press.
  3. Farb, N. A. S., Anderson, A. K., & Segal, Z. V. (2012). The mindful brain and emotion regulation in mood disorders. Canadian Journal of Psychiatry, 57(2), 70–77.
  4. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. The Guilford Press.
  5. Linden, D. E. J. (2008). Neurofeedback and networks of the brain: Integrating psychophysiology and functional imaging. Biofeedback, 36(2), 71–73.
  6. Makinson, R. A., & Young, A. (2012). Neural mechanisms of regulation and emotion. Journal of Neuroscience Research, 90(6), 1227–1235.
  7. Miller, E. K., & Cohen, J. D. (2001). An integrative theory of prefrontal cortex function. Annual Review of Neuroscience, 24, 167–202.
  8. Siegel, D. J. (2007). The mindful brain: Reflection and attunement in the cultivation of well-being. W. W. Norton & Company.