The new wave of Comprehensive Cognitive-Behavioral, Emotionally-focused, Somatic Body and MInd Therapy.

 

The theory of SMART is based on the research that thoughts, emotions, and bodily sensations are interacting. SMART therapeutic perspective believes neurobiological linkage between behavior, thoughts, emotion, and sensation. SMART’s comprehensive perspective sees that the roots of a behavior start from the nervous system, which transmits neurons through synaptic space and send signals as a bodily sensation using neuromuscular (the meeting place of a nerve and a muscle fiber), which interprets into emotions, emotions generates thoughts and thoughts activate behaviors. SMART is an etiological treatment on the unbroken chain of humans’ behavior from intervening nerve system and neuromuscular using Static Movement treatment and it is part of “Third Wave” of Cognitive Behavioral Therapy(CBT).

Many aspects of the third wave of CBT are based on basic research in psychological mechanisms and reflect its current status better than classical cognitive therapy. For example, current research in the importance of metacognition, thought and emotion suppression, worry, rumination or experiential avoidance has deeply influenced MCT, ACT, MBCT, DBT and schema therapy. All third wave methods have strong roots in learning theory but not enough skill to treat bodily sensation level yet.

SMART aims to combine all aspects of holistic mind to create a comprehensive treatment for multi-layered symptoms in a multi-cultural environment. The SMART program adds a significant contribution to complete the development of a comprehensive Third wave of Cognitive Behavioral Therapy. Neuroscience revealed that MBCT helps to promote our nine middle prefrontal functions: bodily regulation, attunement, emotional balance, fear modulation flexibility of response, insight, empathy, morality, and intuition. Practicing mindfulness can be considered a form of brain fitness in that it stimulates the growth and presumably maintains the function of our integrative prefrontal circuits. (Lazar et al., 2005; Lauder et al., 2009)

The cause of the middle prefrontal malfunction is believed that neural misfiring at the insula and limbic regions. The main mental related cause of neural misfiring are increased stress, poor gut function, and poor neurotransmitter in addition to physical, chemical and hormone imbalances. The regulation of neural firing is the key to treating middle prefrontal functions.

A study using MRI found that the right anterior insula is significantly thicker in people that practice Mindfulness-based practices and increased gray matter concentrations in the insula and other areas of the brain. Coincidently, the PTSD brain imaging study by Dr. Van der Kolk, who is co-principal investigator in the PTSD field trials for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) shows that picturing the brain on trauma resulted heightened activation at right lower center of the brain, which is limbic area, or emotional brain. It was already well known that intense emotions activate the limbic system, in particular, an area within it called the amygdala. These two studies indicate that a Mindfulness-based practice can provide effective treatment for trauma-related symptoms.

 

Static Movement Therapy (SMT)

The SMART program introduces new integrated Mindfulness-based practice, Static Movement Practice (SMP). It is designed to combine two evidence-based Mindfulness-based practices. Based on evidence of parasympathetic activation, early studies defined meditation as a relaxation response. The later research attempted to categorize meditation as either involving focused or distributed attentional systems. Neither of these hypotheses received strong empirical support, and most of the studies investigated Theravada (Vipassana) style meditative practices. In the study funded by the National University of Singapore, they compared neurophysiologically (EEG, EKG) and cognitive correlates of meditative practices that are thought to utilize either focused or distributed attention, from both Theravada (Vipassana)  and Vajrayana traditions. In their conclusion, it may be more appropriate to categorize meditations in terms of relaxation versus arousal, whereas classification methods that rely on the focused vs. distributed attention dichotomy may need to be reexamined.

As previous research showed that Theravada (Vipassana) meditation, which is Hinayana school of Buddhism, is effective for relaxation because of parasympathetic activation and Vajrayana school of meditation is effective for arousal because of sympathetic activation. Static Movement Mindfulness Practice (SMP) is based on Zen techniques, which is a more sophisticated version of Mahayana school of Buddhism. More than 2500 years of the development history of Buddhism, there were three main branches of schools, Hinayana, Mahayana, and Vajrayana. In each school, there is a sophisticated form of meditation practices, such as Zen in Mahayana and Mahamudra in Vajrayana. We have been developing SMP based on Zen practice because it has sophisticated form, which has more than 1500 years of proven development history, and can cover both relaxation and arousal effect depends on the client’s need for sympathetic activation. Simply sophisticated form is easily adjustable for client’s state level and enables them to practice more frequently. SMP believes that this practice can influence neuromuscular level using Static Movement but this need to be researched scientifically to prove it’s effectiveness.

SMART principle believes that maladaptation of neurons occurs at a neuromuscular level as a muscle reflex, which leads to muscle antagonist co-contraction. A muscle antagonist co-contraction is involuntary coactivation that leads to problematic physical and psychological experience in the human body as symptoms and a sensation. The muscle co-contractions manifest as a tension in a shoulder or joint, poor circulation and oxygen, bodily sensations such as pains and tightness. A chronic co-contraction may be experienced as autoimmune issues such as neuromuscular disease and neurological disorders.

 

Promoting Neuroplasticity

One of the reasons that SMART program includes bodily sensation as a part of the neuromuscular level of symptom is that Static Movement can be utilized as a bridge to integrate motor neurons, neuromuscular junction, and muscle fibers to enhance the holistic promotion of health and well-beings. It is less focused on reducing psychological and emotional symptoms, although that wellness seems to be a “side-benefit.” The integration of the sensational level of mind activity, which is the reintegration of prefrontal cortex, insula and limbic regions in human’s brain, leads to the neuroplasticity, which is lasting change to the brain throughout an individual's life course. Neuroplasticity is involved in the development of sensory function. The brain is born immature and it adapts to sensory inputs after birth. The SMART program integrates thoughts, emotions, and sensations to create a bridge among with all parts of the brain. Fully integrated mind or brain is like  “Complete combustion” of oil lamps. There are no smokes and smells and it burns cleanly. The SMART program also sees that Mental disorders and even complaints, difficulties and relationship conflicts are deeply related to disowning some parts of the brain, which is resistant to own certain sensations and emotion consciously or unconsciously. It triggers misfiring of neurons, which results as a symptom. This is like “Imperfect combustion” of oil lamps, which produces dark smokes and smells. The presented methods include a diversity of new techniques and open up possibilities for new patient groups such as mental disorders, Neuromuscular disease, interpersonal and intrapersonal relationships, and Technology, Gambling and Sexual dependency that had received only little specific attention in the past. The available evidence now allows SMART treatment or Sensory-Grounded Behavioral Therapy to be considered as empirically supported.