What interventions could rewire the brain in mature adults, particularly those who grew up in less than ideal circumstances?
Are there ways to help restore or strengthen resilience?
One of my favorite neuroscientists is Dr. Bruce McEwen. He serves as Head of Neuroendocrinology Research at Rockefeller University in New York. To me, he’s a rock star. I find his work fascinating.
Dr. McEwen recently published a paper that provides an overview of some of the most recent developments to date in brain science. He was especially interested in the impact of childhood stress on brain development.
In essence, he wanted to know which evidence-based practices could rewire the brain in a way that might restore or strengthen resilience.
According to Dr. McEwen, strategies ranging from cognitive-behavioral therapy to mindfulness, as well as physical activity have all been shown to be effective in changing the brain’s structure and function. He was also interested in programs that promote social support, social integration, and developing meaning and purpose in life.
I was particularly interested in what McEwen had to say about increasing social integration and support as a way of decreasing the cumulative effect of stress (or allostatic load) on our bodies.
McEwen cites programs like the Experience Corps that create volunteer opportunities for people 50 years and older. These experiences provide cognitive challenges as well as increased physical activity, both of which have been shown to slow the decline of physical and mental health and to improve prefrontal cortical blood flow.
Dr. McEwen also highlighted several studies that, once again, emphasize the benefit of physical activity. For example, walking for 1 hour, 5 days a week can significantly change the size of the hippocampus (that’s the part of the brain that plays a role in connecting short-term and long-term memory).
All in all, the take home message is encouraging, due to the remarkable power of neuroplasticity in the brain.
You see, research continues to confirm the immense ability we have to promote brain growth and healing throughout our lives.
If you’d like to take a look at the paper in its entirety, you can find “Recognizing Resilience: Learning from the Effects of Stress on the Brain” in the January 2015 edition of Neurobiology of Stress.
Now I’d like to hear from you. What strategies have you found helpful in restoring or strengthening a client’s resilience? Please leave a comment below.
Great! Knowing there are evidence based ways to improve resilience is itself a contribution to resilience!
My son has been interested in Music therapy. N.I.C.A.B.M have not as yet dealt with that- although it clearly assists one with Mindful living. I also think that C.B.T. exercises help one to be mindfully present and thus just a little above the storms of life. This focus on self help C.B.T. as opposed to skilled C.B.T. therapy or M.B.C.B.T. is worth more consideration.
Promoting meaning and discovering purpose.
My attention deficit seems to be really bad right now I can’t read all those comments. But this is really a good web-site! just what I need. I have studied the brain in the past and am doing so now. I just need to put it all together and do it! I also have trouble typing on this tablet. I used to be a decent typist, but not a good speller. I am wondering now how I ever made it through college with a 3.5 average. That was 45 yrs ago.
I moved to New Mexico 10 yrs ago with my husband. He was sick for 8 yrs, then died. We had no one here, including consistant health care. I am alone now and have severe anxiety at times. I don’t have a car and I have limited resources. I am reading Budhhism and going to a cognitive therapist. but I only see him for 50 minutes once a week. I am trying yo meditate, but on top of everything else I have an attention deficit, which seems to haven’t gotten worse now that I am older.
I can relate to Brenda’s message. I was caregiver for my husband for 28 years. Now that I am alone, I have lost my identiy and confidence. I have been in cognitive behavioral theray for 5 years. Progress is painfully slow. I love the word resilience! I need that badly!
Hi Ruth. I am a student and teacher of Social Role Valorization (SRV) developed by Dr Wolf Wolfensberger of Syracuse University (he passed away in 2011) which is particularly applicable to people who are socially devalued and marginalized…itself a kind of prolonged trauma. SRV utilises much learning from role theory and suggests that amongst other things, obtaining or winning back an old valued role helps against descending and remaining captured by roles such as ‘victim’, ‘patient’, ‘client’ and even more negative roles such as menace, object of ridicule etc. Without the valued role its difficult for a person to gain a new identity and to be seen differently by others – such that they would get treated differently and better by others. For example, as someone who has positive prospects and hope for a better future. Of course a role (whether positive or negative) affects all aspects of ones life and largely determines everything that one does. Hence its usefulness in turning around events of the past. Ray Lemay has published some articles addressing resilience and SRV in particular.
Since I lost my husband I have noticed I have lost some of my identity too. I live in a low income large senior apt complex. The constantly want me to conform to their morays behavior etc. So I try to stay away form them but I have a friendly outgoing personality so they gravitate towards me and I naturelly respond. The problem is they irritate me and in the past I have gotten mad at them., which of course they don’t like and neither do I. I don’t. They are not bad people but very basic and not highly educated. Most of them are in their 80’s and in poor helth too, so they are not going to change. I am still stressed out from taking care of my husband so I am not able to cope with them. It is a catch 22 situation whitch frustrates me and hurts their feelings.
Thanks John! This is helpful for me to know about. Much appreciated!
I stress the importance of getting a good nights sleep. Sleep is critical for human functioning and flourishing. We may work on a sleep routine and stress reduction exercises as well as accepting the secondary insomnia and reading for a few minutes before trying to get back to sleep.
Physical activity is so important for my self-image and self-concept and especially as, now at 60 with a movement disorder described as a “conversion disorder” or more accurately a “functional neurological symptom disorder” by some neurologists/psychiatrists, this research makes a lot of sense. I love walking about 2-3 hours each day and do light weights and exercises. The social part and intellectual part ie. doing mind puzzles and all that stuff, isn’t nearly as important to me as keeping strength and memory which i have despite tremors and dystonic spasms that occur each day and pain in my lower legs that can make walking a tad difficult at times combined with some weird seizure like symptoms. Keep strong and keep resilient, love yourself and don’t get depressed. Being alone is great because, guess what, there isn’t anything such as lonlieness in our society, we are all connected on this little planet called Earth even if you think your alone. Everyone is around you and with you even if you think you are alone with no “friends” or “family”. We are all connected in a Jungian collective unconscious or cosmically conscious way as one universal mind. Enjoy!
I used to excerise a lot which was very benifical to ADHD as well as my body. Now I can’t do as much so am further frustrated.
Thumbs up! Mike F
Thank you for this. very illuminating.
Your information is fascinating. I have written an eBook about to be published called The Teacher Within for teachers to become more mindful. We are evaluating the results to see if teachers are more mindful, and better role models are students more successful. We are currently evaluating this program at Transylvania College in Cluj – Napoca, Romania. I hope to get it into schools globally. I live in the Washington DC area. I am also co-authoring a book with a law enforcement professional, hoping to help law enforcement become more mindful and more resilient. Your information on resiliency was exceptionally helpful.
Thank you.
With Respect,
Susan Shapiro
Might you provide a link to “Recognizing Resilience: Learning from the Effects of Stress on the Brain” in the January 2015 edition of Neurobiology of Stress?
Thanks!
I took a class for fear of flying called SOAR. Capt Tom Bunn, MSW, who has a therapy program which re-wires the brain to not release a stress hormone at any part of a flight, from making the reservation to landing. It worked for me after not flying for many years. My brain no longer automatically stresses out during flights, or even just thinking about flying. Brain successfully changed.
Ruth Rockstar,
Thanks for the tip. I use HRV in conjunction with simultaneous EEG monitoring. It is fascinating to see how improving HRV benefits SMR (12-15/16 Hz). Client’s are reporting some beneficial effects regarding
overcoming the residue of developmental trauma and/or trauma.
Are there any readers using this multi-modal biofeedback approach to increase resilience?
John R. Galaska, PsyD
BeCalmofOjai.com
I am a Recovery Coach, and have found the best way to increase resilience (and joy, for that matter) is with Kristin Neff and Chris Germer’s Mindful Self-Compassion. No matter the person (male, female, young, old) I watch them, over the 8-week course, transform themselves right in front of my eyes.
Replaying positive images of strength and coping. Retelling the stories of trauma to include coping, resilience and thriving. Instilling beliefs that we develop strength as a result of struggle. Stress becomes opportunity to grow and practice. Also physiological supports like deep breathing, magnesium, adrenal support formulas, rescue remedies and Bach remedies,self-administered acupressure and self-massage/tapping.
This is a fabulous list Denise. Thank you for providing such a comprehensive reply. I love that you’ve mentioned retelling (trauma) stories with the strength built into them. My gratitude. Jenni Australia
My adult children have no time to be caretakers. Too busy with work etc. Dutch society is stepping in somewhat, but that never equals the help my children did give in the past, let alone replace an intimate partner. 9 years ago 2 of my sons pushed me for 2 years to get a dog, for i was so alone. I did, knowing the therapeutic benefits of dogs. He just died. I never knew i could feel such deep intense pain about his imminent parting. Experiencing i was loosing it, spiralling into suicidal depression, knowing my adult children, with whom i just started up a new attempt to repair our family, did not deserve or need this, i decided to buy a new pup instantly. Knowing she would force me to go outside, to walk her, which has the bonus of meeting many dogowners who are mostly friendly, often having a chat, providing me with the necessary social contact, i otherwise would miss out on. Years ago i decided on no intimate relationship or even friendships, unless healed from CPTSD/DID as i kept repeating the same negative patterns. Where my deceased dog taught me i could be loved, showing me unconditional love every day, this one forces me to learn building attachment and is a challenging handful. Dogs can’t speak. Insecure about whether she loves or likes me. All kind of feelings traumarelated are surfacing, where normal people buying a dog do not suffer from. I optimized chances of success by putting her crate next to my bed. Early in the morning she wants to cuddle up in my bed. So i guess she is showing me we are both learning attachment skills. At 65 i may not have another chance at an intimate partner. Science recently proved that when with a partner with healthy attachment skills one can heal within 3-4 years. My changed brainwiring though is giving me more problems in daily tasks. Its functioning so complicated that i cannot keep it up, possibly Burnout, Adrenal Exhaustion, Chronic Stress or Dementia symptoms as people suffering from CPTSD stand a much higher chance to get. Social integration and support sounds nice. But when not with likeminded people/kindred spirits often an extra burden, which creates its own loneliness of not being able to talk about what interests and concerns me. Too shy, too insecure to form my own eatinggroup that would have debates on real topics. And although i found some organized they are costly to join. Too costly for my low sensitive budget. It would be great when psychologists/counsellors/therapists etc. would put in some more effort to connect certain clients to start up eating/debating groups. My feeling is there are enough clients/people who would like to join, but they just do not meet eachother in general society, if not joined to some church or other communitygroup.
I just discovered Meetups online and there is a wonderful list of groups from all walks of life. If you don’t see one you’d like to join, you can form a group. I am a 63 yr old woman dealing with a fractured marriage of 40 years and the stresses of caregiving for my mother who just went into a nursing facility, She is not adjusting well so she gives me s lot of grief over her placement there. I have few friends a am not a very traditional sort of woman so I have a hard time meeting people who are like minded. I have just joined my first group (haven’t met yet) so I’m hopeful that I can increase my social interactions in the near future.
Good luck with your resilient self that reaches out to connect with people. You are beginning and that is great . I also found support groups are a great way to feel connected as well as groups that meditate together.
I joined Meetups but didn’t like the activities but don’t know how to go to the site where you sign up to be a group coordinator. The present coordinator wasn’t helpful.
I am an integrative counsellor and psychotherapist. My own early years experience is a driving force within in my continuous search towards firstly my own inner healing and how this knowledge can assist and support the cliental with which I work. I have found mindfulness practice extremely helpful regarding the strengthening of my own resilience. Also creativity has been with me from childhood where it was a comforting source of calmness, I am an abstract artist and still gain comfort from this activity, Journal keeping and studying my own psychology has given me empowering insight and understanding of self. My journey has been a difficult one but these days I am the happiest I have ever been. I love my work, I have a loving family and I am learning to love myself as I love others. Your articles are inspiring and very encourageing, thank you for sharing.
I’m interested in this, is the damage wholly reversible? Can parents be taught how to help their children?
sorry… resilience can only be achieved through knowledge and integration of what our self truely is! until we shift from t he externally-vakidated false self all the rest is icing on the cake… not the cake!
iMind Psychology (Melbourne, Australia)
Possibly you have no clue about what building resilience in perspective to surviving trauma implies. It worked great for me. Speaking about true self or false self, when the other self in case of early childhood traumas concerns an unborn embryo/foetus/todler/child/adult is simply cruel. That part only needs love and belated parenting by whatever Self or Selves. Possibly you are referring to those who became masters at meditation, following gurus. Just lost a friend who took that path to death. Her last words the morning of her deathday were I have thousands of friends, yet go home alone. Telling me that her high energy, you refer to as true self, is the real fake, in denial of all the suppressed trauma, which got never integrated or processed/transformed, always lurking beneath that high energy of her Self. Whether that was her true Self or just another Fake, learned from New Age masters, i am not certain. Truth is i read things written by her after her death, showing me her mind was in fact quite messy. Again having adopted New Age teachings about LOA.To fragment selves of other people. to insult us who worked hard building resilience, it it just icing on the cake, especially on this site, which has been a lifesaver for me in the past, tks to all the free teleseminars, shows how untrue and unkind you truely are. Having built resilience i can handle it with ease.
Thank you, so much, Ruth, for introducing me to the work of Dr. Bruce McEwen. I will most certainly refer to the journal article you’ve cited + also hunt up more of Dr. McEwen’s work.
It is my own personal experience, nurturing, loving, moral support, solace & comfort can also drastically heal the brain + mind-body connection, following a stressful event; including extreme stress. In other words, love, compassion & empathy are very important healers of our brains, following even extreme allostatic load. The power of love & all its qualities cannot afford to be, should not be, dismissed by neuroscientists.
The numerous potential studies, using SPECT scans, fMRI’s & so on, that could be done to validate the importance of TLC & various demonstrations of love, to people who have suffered even extreme allopathic load, are far too numerous to give mention to, in this brief comment, today.
When I read “…connecting short-term & long-term memory”,… I instinctively freaked. Uh-uh. That is one reason I suspect I’ve fought sleep for so many years ..that’s when it happens.
I am a stress release practitioner and i help clients reduce stress and rewire the brain using meridian tapping emotional release techniques
Are you talking about EFT?
I am interested in ways to calm the body and mind
I am interested in ways to calm the system
I recommend Neurofeedback for the “lost boys”. Seburn Fisher argues that until there is some degree of self regulation for the fear driven brain then thereis no capacity for attachment. Love is not enough. Bessel van de Kolk’s book on trauma The Body Keeps the Score has a chapter on Neurofeedback as well as other methods of working with neglected and abused children.
I listened to her teleseminar. Wanted to try it out and had the bad luck to meet with a Neurofeedback practitioner working for a dutch university,treating ADD/ADHD, to find her theories contestetable. Costing me a lot of money, wanting to treat my brain at the opposite side then Sebern advises. My gut told me to run. That said i also find the theory that a feardriven brain has no capacity for attachment false. My 9 year old dog dying last september i am certain i attached. Animals are much safer to learn attachment later in life, then most humans are. I instantly bought a new pup. For therapeutic reasons. To force me to get out of the house, walking the dog, Which gives the added bonus of much social contact with other dogwalkers. And to not get lost to suicidal depression for loosing my mate of 9 years, who taught me unconditional love and that every day is a new day, a fresh day, even when the day before was bad, or i was emotionally unstable. Maybe this loss of cohesion should not just be put on the plate of those suffering childhoodtrauma, but one should look at how western societies choose to organize themselves. Dutch science showed a person can not work more then 25-30 hours a week, to leave time for connecting/caretaking of elders, children, hobbies, partners, society etc. etc. Churches are emptying out, which is another main reason for loss of cohesion, thus increase of unsafety within societies. Multiculturalism is not working or not working yet again increasing loss of cohesion. I guess i suffer the worst kind of attachment disorder/possibly RAD. With a repetition of being dumped after having been abused by male partners, at 65, i deem the chance of being able to attach within an intimate relationship not very likely, but not impossible. Again science proved that when choosing a partner with healthy attachment skills. one heals within 3-4 years. Had i know this when younger, i would have made wiser choices and counteracted by traumarelated caretaking/saviour complex. Many women though around me suffer the same loneliness, not having a partner and they do not have CPTSD/DID. Sadly society still does not choose to educate young people in how to maintain/form relationships, which last in good times as well as bad times. Sadly society makes young people into workslaves, often leading to Burnout around their twenties. Tks for the comment, for it made me realize how false it is as many scientific theories are. But to be determined to realize healthy attachment to my new pup is certainly challenging and not as normal as other dogowners will experience that. I really have to work hard at it. She sleeps next to my bed in a crate to optimize her chances. And when now she calls out early in the morning to lie next to me in bed, i know i am getting somewhere with our attachment. And when my granddaughter of 8, which i did not see for 2 years, after a breakup with my son/her father due to my traumasymptoms and history/his past of being raised by a mother with traumasymptoms, asks if she can stay for the weekend, i know somehow there is attachment. And still i also know i am not normal, not functional. Then again decades ago i read that children who are overprotected, loved too much, never had boundaries put to them, suffer the same dysfunctional symptoms as those qualifying for the ACE criteria.
You can only grow more resilient…. That is rewire your brain……. When you understand why you react to the world the way you do. When you know those reasons rewiring can begin. You need someone to open up those aha moments and then the process of building your resilience can begin.
Walking does not do it for me…. I need to run. CBT in the hands of a good psychologist has also helped me to build my resilience to one of life’s greatest challenges… The death of my beloved spouse.
I work at a residential treatment Center and we have many lost boys who need re-wiring. These boys come from abuse, neglect, and have behaviors that resist a normal childhood with a family. They need love but do not know how. Can we re-wire their cognitive abilities when they can’t sit still or listen at such a young age? It should be easier when they are young. I totally agree with mindfulness, CBT, and Yoga, these lost boys can not do it.
I am a yoga, mindfulness teacher specialising with children . In my experience they can do it but it is a very slow build up. Yoga and mindfulness needs to start with fun, concrete and short practices like carefully studying a flower like they are an alien from outter space or getting magnifying glasses and looking at bugs outside. Vigorous yoga with balancing poses are very effective in tuning over stimulated children and teens. It is important though that you have a signal to stop and breathe with no talking for just one or two breaths to help them to build self regulation so they can learn to bring themselves back to quiet when they need to. I sing a singing bowel to signal to come to child’s pose. As you probably already know, It also really helps to show them the basic neuro science of how the brain works so they can understand why they think the way they do and why it is so hard for them to sit still, listen and consentrate. It gives them a sense of powerment when they realise they can choose to respond rather than react. Video example of cartoons to illustrate flight, fright or freeze are great because they can detach themselves from the emotion of it and feel safer to discuss it. A bit like kids using puppets or drawings or play to play out their trauma in therapy. The paws.b and .b programs for school aged children created by The Mindfulness in Schools Project in the UK is an excellent way to introduce the concepts and practices of mindfulness to children. I am trained in both. Lots of councillors and psychs doing the training.
Laura- I am in Perth. If you want to collaborate, please email me: renaebedells@yahoo.com.au
Eft / Tft is an ” easy” effectful way of getting through to these boys, doimg fysikalsk platina, training surprises a lot of uptalking’ friendly quiz/ competition. Internasjonale with ” mindfulness. Hildegun Norway
Very respectfully, the work you do is so important, but I do not believe we “re-wire” the people we work with. We support people, create interventions that are specific for them, but they are the ones who do the real work, who change (although I would argue we all change in work done well).
They are not machines, they are integrated beings and neurophysiology is part of their bodies- down to the cellular level. Working with their bodies is the essence of working with their minds- especially for younger boys- this is where their brain/ nervous system, endocrine system is located- and this is where shifts in their cognition will begin. Please do not give up in your quest to find methods that meet these complex needs- somatic work, martial arts, meditative walking/ running, time in nature are some of the ideas that I would humbly suggest. Best wishes!
i used yoga and mindfulness
Dr. McEwen’s paper is a wonderful document to start the conversation on effective healing practices for those suffering from lives that experienced significant stress in childhood. My wife, Grace Banta, has published her autobiographical account, “Graciela No One’s Child” (Amazon ebook & print), of her triumph over a decade-and-a-half of constant abuse and stress from her abduction at six months from the sidewalks of Brooklyn’s waterfront to her life growing up in Mexico. We have been married forty-seven years and I still marvel at how she accomplished this. She first revealed this amazing story to me after we had been married thirty-nine years. She had previously told another story during our earlier years. I found out later that this was to avoid re-visiting the pain of the true story. Thank you Dr. McEwen and Ruth Buczynski for the work you do and for so effectively sharing what you learn as you go.
can you provide me with the cite for the McEwen publication?
thank you.
Here’s the citation:
Bruce S. McEwen, Jason D. Gray, Carla Nasca, Recognizing resilience: Learning from the effects of stress on the brain, Neurobiology of Stress, Volume 1, January 2015, Pages 1-11, ISSN 2352-2895
Keywords: Hippocampus; Early life stress; Epigenetics; Gene expression; Allostasis; Sex difference
Link to study.
Happy reading!
thanks
Thanks for the link. The article was really good and very informative.
Thx (◍•ᴗ•◍)❤
As an “mature” adult who is a survivor of an extremely diverse childhood that included almost all of the top stressor ‘s ,awareness of infidelity, divorce , alcoholism in the home, adult influence to enable and cover, self conflict , abandonment by one parent,abuse form the other, and incarceration at age 11 when i was turned over as a ward to the court system at age 11..lol, I have just really come to see at age 54, the deeper patterns of stress cycles that are reminiscent to me now of the same cycles i remembered as a child in my mother. and in myself.
I thought I was imagining it.
This, after almost thirty some-odd years of “running away” from anything stable or consistent by way of a life style.5 yrs ago I walked back into a “normal” life-style and in that mere time , I have become someone other than the strong willed, in-control, athletic woman I was. The difference is astounding and alarming.
While my other life style was bohemian at best, crossed the line of criminal regularly , and involved drugs, people of less han desirable character, and a reliable adrenaline pipeline ..lol… I laughed everyday, ran, walked. danced, socialized constantly..(I used to climb a huge old banyan tree laughing, in search of privacy there were so many people moving through my days..in my 30’s and forty’s.).And I loved it.
I had different stressor’s of course, but I was confident, strong, and optimistic. I have seemingly lost touch with that me, and I was seriously considering questioning my sanity, have put on 50 lbs, go no where, do nothing, and feel like I’m watching myself become one of the people who i used to term the living dead..lol..lately i have thought of returning to that wilder life style in moderation simply to “save” myself ..lol…save the quality of my time left for living.
Then I found your page and started reading. following links, questioning and researching further, coming back and re-reading..lol..
It’s my belief most of our personal mistakes come from our ignorance of what we are actually doing..and why we are actually doing it. Once we know that ,finding a way to apply that knowledge to a “cure”, or solution is a natural progression.
So I will end this lengthy dialogue..lol..with a thank you.
I have been my favorite on-going DIY self-improvement project since I can remember and nothing makes me feel more inspired than to be handed new sets of tools..LOL.
Thanks for sharing…. Ditto on the life long self help. It’s the best gift I ever gave my self.
Namaste
Possibly that earlier part DID/dissociation. Depletes the physical body, so ultimately a no win situation of you have people in your life you are responsible for until the 7th generation, as native americans say. Giving up that earlier part, missing it, sometimes desperately is a choice one makes. Not easy. But building resilience in standing it all, building a new self, more sustainable on this earth, has its own benefits. It can take many years though. In my case more then anticipated. But after having the family i created fall apart like a house of cards, i am not making an attempt to heal that family. I am also trying to maintain some relationship with my 2 oldests sisters. Yes it is hard. And yes there are bonuses. Most important though is that i believe myself as an adult to be responsible to clear up/to clean up this mess. For my children, for the world at large. Humanity cannot go on the way western societies steered it. Many or most families falling apart, children unable to take care of elders and the system failing to do so, due to rising healthcosts. Here in the Netherlands elders stay too long in hospitals for lack of caretakers, so that necessary operations cannot be done to others, elders are sent back to live by themselves because their criteria are not severe enough and Big Pharma is producing ever more costly medications, which will make it only worse. Here in the Netherlands when ill one can claim for help to clean one’s house. I understood that in the USA that help does not exist. We just survived a push to abdicate that help. Possibly due to american companies investing or buying our healthproviders insurance companies. If you are sincere about going the path, no matter what it takes, maybe find some FB support groups. Sometimes those suck too, not very good with bohemian style ladies or truthseekers, but i also had experiences in the past where they felt lifesaving. A kind word, especially from one who walks a similar path, knows the pain, can make all the difference. Either a bohemian fast flame or a courageous spiritual warrior. You are free to choose as long as you do not harm others.
I’m enjoying the series andhave been a viewer and supporter for many months.Thanks for all you do,Chuck
Walking in addition to every day walking? I walk at least an hour a day just in my normal life.
Ruth,
Thank you for the cutting edge topics. I teach psychiatric nursing in southern CA. My focus has been not only to teach students to work with patients using evidenced-based practices but also for the students to build resilience. In the general population about 9% of people are depressed. One study of 1,000 plus hospital nurses in the east showed that 18% were depressed. Nurses need to learn effective ways to build resilience. Thank you for the current course you are offering. I am learning so many practical ways that I can use to help the students! Thank you, thank you! Nancy
Wonderful series, even for a layperson like me. I think the answer to my question is probably obvious, but is this one hour TOTAL walking or one hour all at once? Part of my reason for asking is that, when weather is really extreme, sometimes the only way to get that hour in is indoors, which usually means piecemeal. Thanks! Wendy