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The Fullness of Midlife

"We are intended for wholeness and redemption and healing."

by Dr. Barb DePree MD

Ann McKnight with Dr. Barb

Ann McKnightAnn McKnight has extensive experience in clinical social work and therapy. Methods and approaches she's learned about and shared to benefit her patients are the Enneagram, Cognitive Behavioral Therapy (CBT), Acceptance Commitment Therapy (ACT), mindfulness, centering prayer, mind-body research including sensory work, and Eye Movement Desensitization and Reprocessing (EMDR). She is certified in Brainspotting and Trauma Studies through Bessie VanderKolk's Trauma Center in Boston. In addition to her private practice, Ann speaks and teaches regarding a variety of topics, including Nonviolent Communications and this TEDx talk on Restorative Circles.


Dr. Barb: Our guest today, Ann McKnight, has more than two decades of experience in clinical social work and therapy. She looks for best practices and new therapeutic methods so her patients can flourish. In addition to her private practice, Ann speaks and teaches on a variety of subjects throughout the United States. I hope we’ll talk about several of those topics and therapies. Welcome Ann!

Ann: Thanks Barb, it’s great to be here.

Dr. Barb: You have been studying and applying a new treatment method, is my understanding, called brainspotting. And while you’ve been in this area of therapy for many many years, this sounds like a relatively new approach to training or addressing issues with your clients. Can you explain more about that?

Ann: Yes, I’m happy to do that. And probably the best way to explain it is to maybe go right into a real life example. We all as human beings, have those things that happen for us, like something that maybe happened to you recently where you think about it. When you think about it in this moment, you feel a little life in you, a little irritation, let’s say you had a conversation with someone that didn’t go well, or something happened that you can still bring up the experience of that inside yourself. Some people call it getting triggered. We all have those things. But if you could just think of somethingyou don’t even have to tell me what it is specificallybut just think of something that brings that up in yourself right at this moment. And just let me know when you come up with it. [pauses]

Dr. Barb: Yes, I have something very specific in mind.

Ann: Okay, great. If you want to say a word about that, that’s fine. If you don’t, that’s okay, too. That experience that you’re havingyou’re pulling something up that isn’t happening right now, but you’re experiencing it as if it is happening right now. And that is the kind of thing that brainspotting is addressing. So, if we look at the human brainand if we had a visual here, I have a brain model in my office and it’s just been really wonderful for helping people understand how their own brain operates, so my brain model, if I pulled it out right now, I’d split it in half, right down the midline.

There are three parts of the brain that are really important when this kind of experience that you just pulled up is happening.The first one is the brainstem. The brainstem is right at the base of our skull, the top of our spine. And it’s the part of the brain that we have in common with reptiles, and birds, and snakes, and lizards. It’s the part that has to do with basic protective functions and basic things like hunger, temperature regulation, our fight-flight-freeze reactions.

The next part of our brain, just above that, above the brainstem, is part of what’s called the subcortical layer of the brain. For our purposes in brainspotting, we name it the limbic system. It’s not just one thing, it has lots of parts: the hippocampus, the hypothalamus, the amygdalathose are things that people may have heard ofbut in general, I think about that part of our brain as sort of like our intestines. Our intestines are made to process and digest food that we take in. And they process it so that things that we need are absorbed and used for energy and nutrition and the rest of it moves on. When our digestive system is working well we don’t have food lingering in our system. It just kind of works efficiently. And in that same way, our limbic system is continually doing that work. Just as you and I are talking right now, there’s all kinds of things happening in the rooms around usthere’s shifting in the light, and there’s noises outsideand our limbic system is continually processing those kinds of things. I’ll come back to that in a minute, about things getting stuck in there.

The next part of our brain, the third part that’s relevant in brainspotting, is the neocortex. That’s that top part of the brain that we see when we look at the human brainkind of the wrinkly, crinkly partand that’s the last part of our brain to develop. It develops... it really comes into full development more after the age of two. The subcortical brain, the limbic system is getting more fully developed before we even have words to talk about our experience. So, the neocortex is the placeand your neocortex may be doing this about the experience I asked you to pull upyour neocortex may be saying things like, “I don’t know why this is still bothering me; that’s just silly.” Or, “You really need to get over this,” or “That doesn’t make any sense whatsoever!”

It’s that part of us that wants to make New Year's resolutions, and then chides us for not following through on them and says things like, “Why do people smoke? That’s just terrible.” There’s not a person on this planet that doesn’t know that smoking is not a great thing for your health, and yet there are so many people that do it. Right?

Our New Year’s resolutions get broken, and we all have things that we could be doing better. We like to think that this neocortical partthis rational part of our brainis 90 to 95 percent in charge of us. What is so fascinating about being in my line of work now is there’s so much more understanding of how our brain works. One of the things that we’re understanding is that the neocortex is not that much in charge of our behavior. In fact, I’ve even seen 20 to 30 percent influence over the things that we do, rather than control over it.

So, where is the action happening? The action is happening in those subcortical layers. Those subcortical layers are where things like loveyou know, I know you’re a mom and so am I, and if you really broke it down to give this rational explanation of why you love your children, or why you love your husband, it's really kind of a hard thing to describe. And in some ways you can say, gosh it doesn’t even make sense to have children, they are expensive, they’re a worry…. [laughs]

Dr. Barb: [laughs]

Ann: You know, why would people have children? And yet we do. And there’s this whole other place out of which we experience that. The place where we experience love and the place where we experience meaning is not the place of rationality; it's also a place where things can get stuck.

The place where we experience love and meaning is not the place of rationality.So let’s go back to the situation that you were thinking of. When you are bringing that up in yourself, we know that we are into the subcortical brain when you have a visceral reaction to it. Maybe some emotions that are not the most pleasant, and sometimes people talk about tightness that they feel in their belly or their chest or their musclessome kind of a constriction. That’s how we know we’re in those deeper regions of who we are as human beings.

So what does brainspotting do? Well brainspotting.... If we were going to brainspot you right now on this issue, what I would do is say to you, “Okay Barb, I want you—just look at the wall across from yourself as you're pulling up that experience. I want you to look at three different spots on the wall. (I’ll tell you where to look in a moment). But, what we’re looking for is, does one of those spots activate the intensity of what you are experiencing? It may or it may not. We’ll just check it out and see. So I want you to move your eyes to the left, not turning your head just moving your eyes. And just notice that... [pauses]

Then I want you to turn your eyes to the center, directly in front of you. And just notice that… [pauses]

Then you are going to move them to the right. And just notice... [pauses] if there were any differences in those three spots in terms of the intensity.

Dr. Barb: My response to that would be, when I looked to the left.

Ann: Ok, so you could feel something got a little bit more intense when you looked to the left. So what we would do with brainspotting is, sometimes you might have a pointer or you could see where your eyes naturally want to go. But, believe it or not, you would just leave your gaze right there. And it’s something, it’s such a funny thing because our neocortex wants to push back on it immediately, but there is something that happens when our ocular system stays in that fixed spot that allows things that get stuck in that place of meaningin that part of our limbic systemthings that have gotten stuck actually start to unwind and digest, and what’s fascinating about that! What a brainspotting session might look like is, it would be so boring to watch, it would be the most boring thing ever, because all you’re doing is just sitting with your gaze fixed, and you might be totally silent the whole time. Sometimes people speak, sometimes they don’t, yeah.

Dr. Barb: And while my gaze in this case is fixed to the left, so while I’m looking to the left, am I processing and recalling and reliving the vignette that I’m working through?

Ann: Yes! But it’s coming about in a way that is not our typical way of doing things, which is neocortically driven. You’re not saying to yourself, “Okay, I’m not thinking about this now. Now I need to analyze and figure it out.”

You're letting your mind go wherever it needs to go.What you’re doing is very much like in mindfulness. You are letting your thoughts… if you picture like a comet and the tail of a comet, where the images and thoughts in your mind are going is the comet, and your will or your intention is just following those. So you’re not directing it in any kind of way. You’re just literally letting your mind go wherever it needs to go. What I say to people is, you might be thinking about your grocery list or something mundane from three days agothings that make absolutely no any sense. Your mind is just all over the place and that is totally fine. So it’s such a different way to look at how we process things when it’s driven from this other space. 

I want to go back and talk about why. Why vision? I don’t know about you, but anytime I walk into an elementary school, that smell of crayons and sharpened pencils, there’s this amalgam that takes me right back to my own kindergarten experience. I have these flashes and I can remember Mrs. Thomas, my teacher, and some of the kids, and the early 1970’s outfits we were all wearing. And so it’s just the smell triggers all kinds of memories, in a way, that if I would have said to myself, “Okay, I want to think about my kindergarten experience," that’s a different way to approach it, and different things are going to come up than when it’s just unfolding.

Smell triggers things in our limbic systems. And in that same way, our vision also does that. So think about a gazelle standing out in a fieldyou know those National Geographic showsit’s just eating in a relaxed way, and it hears a noise, and then it’s head goes up, and it’s eyes go right to where that sound came from. You and I do the same thing. If either of us heard a loud noise where we are, our heads would turn immediately. So our visual system is intimately connected with our survival mechanism. We get to those nonconscious places in ourselves through our vision.

That’s really what we’re leveraging in brainspotting. We’re leveraging the ability to access the point at which that upsetting thing that you were thinking about, the point at which that has been kind of lodged or encapsulated in that limbic system, so you think about this experience you had as a piece of undigested food that hasn’t broken down yet. We can use the visual point where it’s more activated to get in there and help it break down.

Dr. Barb: And so I think what I hear you saying is, my cortexwhich I would think about as an important tool of processingis telling me what I should be doing, really doesn’t play a role. So, as you say, I could be thinking about my grocery list. I shouldn’t be thinking about what I should have said, how I should be moving on. That’s not really going to be beneficial to the process, it’s just the positioning of the eyes and incorporating that sense of vision.

Ann: It’s the position of the eyes; it’s having a full connection with that visceral activation, so you’re pulling something up; and it also is about, believe it or not, this is a really relational process. People have said, and I’ve tried it, “Can I try this on my own?”

Yes, you can, but what will happen is, you are not able to go as deeply into those subcortical places. There is something in our relational brains that can step back and relax a little when we are with another person who is present with us. So that’s also an ingredient here in allowing that metabolizing of experience to happen.

You know what you just said with your question is so perfect because, this is such a paradigm shift for how we do therapy, for understanding how our brains work. That instead of this idea of “top down,”I have people who come into my office and on the first day we talk about, what would you love to have, what are you hoping for? Lots of times people will say, I want tools, I need tools, or I need advice. So this idea that psychotherapy or the way we heal or the way we move through things is, if we talk about it and understand it, then somehow that’s going to sink down and trickle through and make us feel better. And that’s not to say that talking therapy is not important, it totally totally is. And there’s this other way to get to certain things that aren’t going to be addressed through that neocortical kind of way.

Dr. Barb: So can this technique be used in other ways? The way we’ve just referenced it, I’m seeing it as kind of repairing and healing. But what about those who want to aspire to something, and it’s not recovery/healing, it’s more moving forward, motivational? How can I reach a different place to achieve something? Can you apply brainspotting to a situation such as that?

What does it look like to be a fully flourishing human being?Ann: Yes! That is such a greatI’m so glad you bring that up! A couple of the people, I think about what I do is really more about how do I overcome my pathology. It’s really about, what does it look like to be a fully flourishing human being? And doingI have a few Division One athletes and athletes at Hope College who have improved their performance. People who have pieces in their work that they want to do better with. Brainspotting is enormously helpful.

There was just an article in the Denver Post about an Olympic bronze medalist in snowboarding who used brainspotting. She started it in October. She had an injuryit doesn’t talk about brainspotting specifically in the articlebut she started using it in October, and had really overcome a lot of mentally problematic obstacles that were getting in her way and went on to win the bronze. And the feedback in the article wasI think it was from her coachhe said that this was the fastest turnaround he’d ever seen. I loved reading that article because that is what I see in my office. I just saw someone this morning before starting this conversation with you, who said to me, “I cannot believe how fast and how deep this healing has happened.”

So really there’s something very amazing about it, yeah. The other piece about all of this, that I think flies in the face of our cultural ideas about who we are, we often have the sense that we’re either broken or lacking and we need something from the outside. There’s someone else who’s smarter who knows better what I need for my life than I do or, what was it someone said to me yesterday? “Life sucks and then you die.” And that’s the most we can expect. You know, life sucks and then you die. [laughs]

When people get underneath the pain they have and are able to move through it...Doing this process with people, for me has been so life-affirming and in my own faith life, just affirming that, we really are made with this incredible capacity for resilience, for restoration, for moving toward wholeness, for longing for forgiveness, and that really is who we are at our core. And I see that when people get underneath the pain they have, or are move through it, that’s what is there, and it’s really beautiful. I think about it you; you’ve have spent a lot of your life watching babies be born, you know, and all of the complexities of that. But at the end of the day, you’re just watching life emerge right before your eyes, is miraculous.

We are intended for wholeness and redemption and healing.Dr. Barb: It is! So, it’s really encouraging to hear about a technique like this, and in a way, when I first became acquainted with it just recently, it was hard to imagine how it could make a difference. On the other hand, I think your analogy of emotion and the origin of emotion and how difficult it is to understand and really cognitively place it. There is this deeper, intricate place that so much arises and emerges from that I think, individually, we don’t know how to access that. So to think that there might be tools and individuals like you to guide us there I think is really exciting and interesting. Because, it’s uplifting to hear you talk about, really we are intended for wholeness and redemption and healing. I think for so many people they’ve been so discouraged for so long, or can’t find their way out, or have done talk therapy in a variety of ways that, to think there could be some, a different approach that really is a deeper, more meaningful approach.

I guess my next question about, as a clinician, could this tool be used for any physical healing?

Ann: Yes. I can’t make any blanket statements about the world in general and what everyone needs. But I can tell you what I have seen in my office. I have seen some people who have chronic pain where the pain has been lessened. I have seen people who have symptoms of chronic fatigue that have lessened. I have seen people who are living withwhat is the word?disease that is going to take their life. It’s known. They will die from what they have, and they can feel physically more comfortable in the midst of that. I think that’s really important. You know, I want to make sure that I say that the span that brainspotting can be useful for. I see people who have been impacted by suicide, directly, in their immediate family. People who have had the death of a child. These horrible terrible painful life experiences that really are grievous. There is no way that we are going to walk through these kinds of life experiences without grief, but there is often an added layer of suffering on top of the grief that we all take on when our minds are trying to figure out what happened so we can blame ourselves or we have regrets about what we did or didn’t say or do, and that adds to our experience of pain. And it also can prevent us from moving through the grieving process. Brainspotting can be really helpful in just working with that additional layer of suffering that gets overlaid on grief.

Dr. Barb: Interesting, could this be a technique used in children as well?

Ann: Yes, there are people who do use this with children. I don’t work with children, but yes.

Dr. Barb: Interesting.

Ann: Well, one of the best things about it for children and also adolescent and college aged boys, who don’t, who are not that keen on being verbal. When they know that they don’t have to talk about things to be able to process them through in a way that’s meaningful and lasting, makes it so much easier for them to get the help and support that they need.

Dr. Barb: Yeah, I can imagine that. There are probably many individuals who would see that as a benefit of this approach, as a matter of fact.

I know over your career you’ve also been involved in a number of approaches; nonviolent communication, restorative circles. This feels like add on, expansion. Is that how you would see this added tool?

Ann: Exactly, that’s exactly how I would see it. It’s just really an expansion of the same core pieces. For me those pieces seem so interwoven with each other and they just happen to be working at different levels of who we are. So brainspotting kind of works at this subcortical level. Nonviolent communication is how we think about ourselves with our neocortex and how we use words and hear other people. And then restorative circles kind of taking that capacity out, so how do we live together better within our communities and our neighborhoods and our families and the groups that we are a part of.

Dr. Barb: Well thanks, Ann. I feel like there’s a whole lot more we could talk about, but with our time limitation, I think we’ll kind of close it at that. But, I’m sure that it leaves individuals with the desire to want to explore this idea. At least for me, it’s fascinating and I’m excited that this seems to be a breakthrough treatment option.

Are there many individuals who have the training to provide this therapy?

Ann: Well, I think we are going to see a lot of growth in it. I have been doing this for about a year and a half. At the moment, there are two of us in the State of Michigan who are certified. There are my partner, Lynn is working towards her certification now, there are some other people who have had a little bit of training, but I really… the demand is increasing. There’s a very high demand right now as people come into my office or come into Lynn’s office and are having very powerful and impactful results. They’re talking to people so I have more people coming my way than I am able to see right now. So it’s my hope that other therapists in our area are going to see the value in this and get training in it.

There are trainings that go on all over the US. I think at the moment that there are still more people trained in Europe and Central and South America than there are in the United States. But, I think that’s going to change pretty quickly.

Dr. Barb: Good. I often will close our time together by asking where do you find fullness at this stage of your life, Ann?

My work, for sure, feels so life-giving.

Ann: That’s such a good question. My work, for sure feels so lifegiving. Fullness also in being with my family, watching our kids who are in the launching stage. It’s such a blast to see our son and daughter developing their own interests and questioning life. It’s very inspiring. Nature is huge for me, yeah. And curiosity in general. [laughs]

Dr. Barb: Yeah, I can tell just with your tone of sharing that this is life-giving to you. And I think that’s really exciting. It’s a gift to be in a career that you feel you can be making a difference in people’s lives. I think that’s one thing you and I probably both share in our professions, and I’m very thankful for that. And I know you are too.

Ann: That’s for sure.

Dr. Barb: Thanks for your time today Ann, I appreciate it!

Ann: Thank you so much. Keep doing the great work you’re have been doing of spreading the word to women on topics that they need to know about, and for helping bring conversations to our community to things that haven’t been discussed before. [laughs] And giving good information about sexuality and the middle of life. That’s a big gift!

Dr. Barb: We’ll both carry on. 


1 comment

  • Barb,
    This was an amazing transcript for me to read. I really enjoyed this conversation. There are so many students in the classroom living in trauma learning to self regulate. When these places in their brains are interrupting their learning, it is important for me to give them time to work things through. Sometimes this looks like a two year old tantrum. It’s amazing to understand how the brain is trying to process these experiences. What a fabulous site you are developing. I’m so grateful you are making your investigating and discoveries transparent so others can benefit from this work!

    Sarah E Parker on

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