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TRANSCRIPT
Allostatic Load
Laurel Mellin, PhDAssociate Clinical Professor of Family and Community Medicine, UCSF
Stress Dominant Area
Mitrovic, I., Fish, L., Frassetto, L., Mellin, L. Rewiring the Stress Response: A New Paradigm in Health Care Hypothesis 2011.
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State Cognitive Emotional Relational Behavioral Physiologic
1 Abstract Joyous Intimate Optimal Regulation
2 Concrete Balanced Companionable Healthy Regulation
3 Rigid Mixed Social Moderate Regulation
4 Reactive Unbalanced Needy/Distant Unhealthy Dysregulation
5 Irrational Extreme Merged/ Addictive Dysregulation
Disengaged
Mitrovic, I., Fish, L., Frassetto, L., Mellin, L. Rewiring the Stress Response: A New Paradigm in Health Care Hypothesis 2011.
Emotional Brain StatesA
llost
ati
c
H
om
eost
ati
c
Repeated episodes of allostasis increase allostatic load
McEwen, B. S. Protective and Damaging Effects of Stress Mediators. New England Journal of Medicine. 338: 171-179, 1998.
Allostatic load represents an insult (stressor) in its own right.
McEwen, B. S. Protective and Damaging Effects of Stress Mediators. New England Journal of Medicine. 338: 171-179, 1998.
Koob, G. Alcoholism: Allostasis and Beyond. Alcoholism: Clinical & Experimental Research. Vol 27, No 2 (2003): 232-243.
Brain Set Point Declines
Brain adopts an allostatic state:fixed state of stress.
McEwen, B. S. Protective and Damaging Effects of Stress Mediators. New England Journal of Medicine. 338: 171-179, 1998.
Brain Set Point• Homeostatic State or Allostatic State?• Brain State # What is mode? • Set Point & Intervention Planning Concepts 1 – 3 Vagal brake engaged, PFC on line
Self-study programs/short-term training Primary reliance on endogenous chemicals
4 Vagal brake disengaged, PFC on line with co-regulation Group training and support/long-term training primary reliance on endogenous chemicals
5 Vagal brake disengaged, PFC on line with dyadic co-regulation and use of exogenous chemicals,
procedures and devices. Individual training until set point at Brain State 4.