Depression, Anxiety and Stress Management

Cerebellar function goes beyond the long-understood role of muscular co-ordination. Each cerebellar hemisphere has a bidirectional relationship with the contralateral hippocampus. Spatial working memory has been shown to be lateralized, egocentric memory being held in the right cerebellar hemisphere and allocentric memory being held in the right. The right cerebellar left hippocampus (RCLH) deals with experiential memory forming a ‘street view’ and left cerebellar left hippocampus (LCRH) deals with understanding and forms a ‘map view’. Traumatic events are postulated to involve a sudden change to the “map view’ held in the LCRH. US combat veterans with PTSD (Post-traumatic Stress Disorder) have a right hippocampal volume that is 8% smaller than controls. Co-twins of PTSD patients also have smaller hippocampi, suggesting a genetic or developmental predisposition for PTSD. The anatomical connection between the two cerebellar hemispheres is via the middle cerebellar peduncles which are juxtaposed around the VIth cranial nerve nuclei. This juxtaposition is consistent with REM (Rapid eye movement) sleep representing middle cerebellar activity synchronising of egocentric and allocentric memories for encoding to long-term memory: this offers a theoretical mechanism by which EMDR (Eye movement desensitization and reprocessing) has its effect. We demonstrate a simple exercise to encourage subconscious allocentric and egocentric synchronisation by identifying the dominant lateral gaze and using alternate cerebellar stimulation, after which patients have reported improvement in mood. This technique can be used following trauma and offered as an on-going skill that the patient can continue by brief regular daily use. Ashworth and Dutton have been using this technique that they named ‘da Vinci Gaze’ to train professionals (doctors, paramedics and volunteer therapists) after noting the eye position of the Mona Lisa. This model using da Vinci Gaze offers promise both in short primary care situations and for provision of rapid and effective trauma first aid in mass casualty situations.