62nd Annual Symposium on Family Theory and Family Psychotherapy
The Annual Symposium on Family Theory and Family Psychotherapy is the most important meeting on Bowen theory and its applications. It brings together the liveliest minds in the Bowen network to present, question, and discuss their latest research and ideas. The Symposium also features a Distinguished Guest Lecturer from another scientific discipline whose research is relevant to Bowen theory.
Dr. Arnsten is a Yale neuroscientist who studies the prefrontal cortex—the part of the brain that helps us focus, reason, and reflect. Her work shows how stress can disrupt our ability to think clearly and stay steady in our relationships. This research brings fresh insight to Bowen theory's central concept: differentiation of self.
DR. Arnsten WILL BE SPEAKING ON THE FOLLOWING TOPICS AT THE SYMPOSIUM:
The Prefrontal Cortex and the Top-Down Regulation of Thought, Action, and Emotion
This first lecture will describe the functions, anatomy, and physiology of the prefrontal cortex. The prefrontal cortex has the remarkable ability to represent information without any sensory stimulation, the foundation for abstract thought, working memory, and the top-down control of attention, action, and emotion. The prefrontal cortex subserves the executive functions, e.g. planning and organization, and is critical for social cognition and appropriate social behavior, including metacognitive abilities such as Theory of Mind (knowing what someone else is thinking), empathy, insight about oneself and others, and remembering to remember. The prefrontal cortex in humans has hemispheric specialization, with the left hemisphere generating language in most people, and being our “cheerleader.” In contrast, the right hemisphere is specialized for inhibiting inappropriate actions, attention, and emotions.
In this presentation, we will review the anatomical networks and local circuits that create these remarkable functions, including how prefrontal neurons excite each other to keep information “in mind” through glutamate synapses on dendritic spines. We will also review the circuits and mechanisms that generate emotion, how these are regulated by higher prefrontal cortical circuits, and how the prefrontal cortex dysfunctions in most neuropsychiatric and cognitive disorders. We will briefly review the evolution and development of the prefrontal cortex. It is the last brain area to fully mature, making it especially vulnerable to insults, and yet the first to degrade with age, starting in middle age. There are also changes in adolescence that make the prefrontal cortex especially vulnerable to dysfunction with stress, the topic of our second lecture.
Prefrontal Cortical Function is Impaired by Fatigue, Stress, and Inflammation: Molecular Mechanisms and Targets for Treatment
Although the prefrontal cortex subserves remarkable cognitive and executive abilities, it is also remarkably fragile. Indeed, the very molecular mechanisms that it needs to keep information “in mind” render it vulnerable to dysfunction and degeneration when these molecular actions are not tightly regulated, e.g. due to inflammation. Although many biological functions have an inverted U relationship to arousal state, the prefrontal cortex has a uniquely narrow inverted U, where either fatigue or uncontrollable stress impairs its functioning, and there is a narrow window for optimal function. A key aspect of stress effects on prefrontal function is that the subject must feel they have no control over the situation to induce detrimental actions, an arena where cultural factors interact with biological mechanisms. Chronic stress actually causes loss of prefrontal connections that can be seen on MRI as a loss of gray matter, especially in the frontal pole needed for metacognitive abilities such as insight, and top-down control, including top-down control of emotion that can increase risk of depression. We have been learning about many of the molecular mechanisms that cause the prefrontal cortex to dysfunction with uncontrollable stress, down to the level of ion channels. This has allowed for the development of treatments for prefrontal disorders now in widespread use, e.g. prazosin and propranolol for the treatment of PTSD, and guanfacine (Intuniv) for the treatment of ADHD, trauma and a variety of related disorders, including new studies on “brain fog” from long-COVID and delirium.