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Top-down and bottom-up approaches to mental health.

Writer's picture: Sam StoneSam Stone



Our ability to change our brains and help our mental health is amazing.


Neuroplasticity is inevitable and our capacity to heal is enormous. Here, I will outline the two different approaches which work on the same overall goal. Using both is so powerful for us to feel fully integrated.


Top-down

In top-down approaches, the mind is recruited to change your mental health. This will strengthen the pre-frontal cortex and cingulate, which are our thinking and emotion regulation areas. Top-down approaches are less effective at helping the lower brain and nervous system structures such as the amygdala and vagus nerve, because the stress experienced in these areas, override the ability to think clearly, so influence in the opposite direction is similar. Top-down approaches are used in cognitive behavioural therapy and other talking therapies. Thought challenging, gratitude lists, visualizations and meditations can all be great top-down approaches.


Bottom-up approaches

In bottom-up approaches, the body changes the brain, often outside of our conscious awareness. It does this by down-regulating the amygdala (the fight/flight part of the brain), and strengthens the insula (centre for interoception – awareness of inner experiences). Bottom up approaches are less effective at changing our thinking, per say, but they can alter our mindset. Breathing exercises, body scanning techniques, yoga, progressive muscle relaxation, stretching and other body movement are all excellent bottom-up approaches (Sweeton, 2019).


References


Sweeton, J. (2019). Trauma treatment toolbox. Eau Claire: PESI Publishing and Media.

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