There is an inherent challenge in understanding the role of the brain in human experience. The English language leads us to think of the brain, mind, body, relationships, and culture as distinct and discrete concepts, which has spawned many dissociated fields of study. This suggests that each can be studied independently and understood without reference to the others. As you will learn in the following pages, understanding the human brain requires a synthesis of all of these disciplines. For biopsychosocial organisms like ourselves, to discuss one is, by necessity, to invoke the others.
fundamental assumption of my work is that each client’s presenting problems, cognitive and emotional styles, and defenses have been shaped through an interaction of genetics, temperament, and prior experiences. The way I conceptualize clients is also informed by developmental, systems, and attachment theory, with some Buddhist philosophy mixed in. I sometimes use techniques from cognitive-behavioral therapy (CBT), Gestalt, eye movement desensitization and reprocessing (EMDR), mindfulness, or play therapy in the context of a general psychodynamic conceptualization and a Rogerian approach
the shells of memory contain the unconscious memories of our attachment histories, how our bodies learned to experience and express emotions early in life, and what we absorbed from our parents’ childhoods. We also have memories carried by genetic programming formed by the experiences of our grandparents, great-grandparents—all the way back to our primate ancestors.
An appreciation of our snail-like qualities requires an understanding of how memory, consciousness, and all human experience have emerged from the deep history of our species. It includes knowledge of evolution, neuroanatomy, and how the systems of our brains work together to give rise to who we are, how we thrive, and why we suffer
The newer notion of the brain as a social organ emerged only in the last few decades, and with it, the field of social neuroscience
The consistent message of recent research is that minds are always embodied, encultured, and embedded within the context of relationships
Research in physiology has shown that our internal organs are automatically linked to our facial expressions to give others a real-time readout of our internal biological state
We now know that we are born with both genetic input that guides the basic organization of our brains and also that many brain systems are highly dependent on postnatal experience, especially those involved in social relating
The complex wiring of our brain is shaped to adapt to the particular relationships in which we grow up. As social animals, this adaptation strategy most likely maximizes the survival of both the individual and the tribe. Of course, this is not without its problems. The brains of many children are shaped to people and situations that are not good models for survival outside the family and thus, are poorly suited to long-term adaptation
We both experience surges of oxytocin, dopamine, and serotonin triggered by our mutual enjoyment, making us feel good and making us want to do it again. (Again! Again!
Brains connect to one another, regulate one another, and attune to one another in ways that enhance emotional resonance and support coordinated group behavior
By utilizing the basic Rogerian principles of warmth, congruence, and positive regard, therapists leverage their connection with their clients’ social brain networks in support of neuroplasticity and positive change
Nurturing connections have been shaped by evolution to create a state of brain and mind that opens us to learning, self-reflection, experimentation, and exploration
The social synapse is the space between us, the medium through which we communicate with and link to one another. When we smile, wave, and say hello, our behaviors are transferred across the social synapse to the sense organs of others—their cell surface, if you will. Receptors in the sense organs of the other convert these electrical and mechanical messages into electrochemical impulses within their brains. These signals stimulate internal biochemical changes, new behaviors, and the sending of messages back across the social synapse. From the moment we are born, our survival depends upon connecting to those around us through touch, smell, sights, and sounds. If we are able to connect with available and nurturing others, we will bond, attach, and survive.
Referred to as “the peptides that bind,” oxytocin and vasopressin modulate bonding, social behavior, and anxiety in a wide range of species. They are primarily produced in the hypothalamus and sent down into the pituitary gland and up into the limbic system and cortex. Oxytocin has also been found to be generated and released in the amygdala and the heart, reflecting their central role in both anxiety and attachment. At its core, attachment is the regulation of anxiety via proximity to others. The effects of oxytocin are to direct a child’s attention toward its mother while driving maternal behavior and inhibiting her irritability and aggressiveness. For example, when an infant suckles at its mother’s breast, the nipple triggers the hypothalamus to release oxytocin into the bloodstream, triggering a sense of well-being in the mother as well as contractions of the muscles of her breasts to force milk to the nipples.
Oxytocin, and it male equivalent Vasopressin, facilitating pair bonding, attachment, and the maintenance of monogamy in a number of mammalian species
evolution has used multiple reward systems to keep us focused on staying close and taking care of one another
In the context of psychotherapy, these systems can all be tapped into via a warm and supportive therapeutic relationship. The good news for all of us is that attachment circuits remain plastic throughout life, as evidenced by the intense love that grandparents often experience for their grandchildren. These neural hubs and the biochemistry that drives them are key levers of psychotherapeutic change. Techniques, clinical knowledge, and experience are all important, but it is the relationship that creates the state of mind and brain that allows a client to benefit from them.
There are many ways in which psychotherapy parallels good-enough parenting. Through the therapeutic relationship, we are attempting to modify the same circuits of attachment, emotional regulation, and autobiographical memory that were shaped during childhood. We also use the same attentive and nurturing sociostatic processes to help our clients regulate their anxiety, provide them with challenges at the edge of their capabilities, and help them to articulate their thoughts, feelings, and experiences. All of these aspects of psychotherapy are central to positive parenting, secure attachment, and building resilience.
From the perspective of neuroscience, what we see as resistance is the reflection of a complex network of implicit emotional, somatic, motor, and sensory memories. It is the brain-mind’s best guess about what is necessary to survive today based on what happened long ago.
The more stressed or frightened we become, the more likely we will regress to familiar patterns of interacting with the world
Therefore, resistance isn’t something that we have to wait out in order to start the real therapy. Coming to understand and work with a client’s resistance is a central component of therapy
Autism and Williams syndrome clearly point out that abilities like emotional attunement and arithmetic computation are organized in separate and dissociable neural networks subject to independent genetic, gestational, and developmental disruptions
Each of our neural systems has a deep history that reflects its survival value either now or at some point in our evolutionary past
One of evolution’s key strategies is the maximization of diversity through sexual reproduction, where the genetic diversity of two unrelated individuals maximizes the probability of healthy offspring
The two simultaneous evolutionary mandates, taking care of ourselves and taking care of others, are likely the biological origins of our morals, ethics, and laws. The dynamic tension between individual and group survival drives conflict both within and between tribes, countries, ethnicities, and religions
good example of neurodynamics central to psychotherapy is the relationship between the amygdala and the region of the prefrontal cortex just above the eyes called the orbital-medial prefrontal cortex (OMPFC). The amygdala, the primitive executive and the center of our fear circuitry, is fully mature at birth while the systems in the OMPFC that regulate it are not developed. Early relationships with caretakers shape the circuits between the amygdala and OMPFC, which stores the memories of how well others are able to regulate our anxiety. The implicit memories stored in this network manifest as what are called secure and insecure patterns of attachment. Although there is more to the neuroscience of attachment than this one circuit, the neurodynamics within this particular system have a powerful and lasting impact on how we relate to others.
Our brains (like our gut) remain essentially Paleolithic in nature and are more in sync with the life course of our hunter-gatherer ancestors than our current technological society. What this means is that much of how our brain develops only makes sense in light of our evolutionary and social histories. Put in a slightly different way, brain development is linked to the traditional demands of tribal life of thousands of years
Brain development is full of strategies that seem to contradict everyday common sense. One was to vastly overproduce neurons during gestation and have them compete for survival after birth. Neurons compete to connect with other neurons to become part of a functional system sustained and expanded through continued stimulation. The lack of stimulation to the shunned neurons causes them to die—a process called apoptosis—while the surviving neurons expand in size and connectivity. The brain grows larger during childhood because of the growth of new dendrites of the surviving neurons as the overall number of neurons decreases. During the first years of life, quantity is systematically replaced by patterns of connectivity and complexity. Like us, neurons survive because they connect with others and exchange energy and information.
The bundles that connect different regions of the brain are primarily made of myelinated axons and are called white matter because of the color of the myelin
Compare, for example, the fear circuits of the amygdala that are fully mature by birth with the cortical systems dedicated to regulating fear that take years to develop. During infancy and childhood, we rely on our caretakers to serve this yet-to-develop regulatory function. The way in which our caretakers help us to deal with fear and anxiety shapes our own developing circuitry between our amygdala and prefrontal cortex. How this circuit becomes organized is reflected in how we relate to others and our ability to regulate our emotions. As our brains develop, our experiences shape the architecture of our neural circuitry, making our brains a living expression of our learning histories.
abstract thinking, emotional regulation, attachment, and reward. This sensitive period is driven by the social expectations that traditionally came along with adolescence to reorganize attachments in line with peer groups and mating, and take on the responsibilities of adulthood. Because modern Western society has postponed the timing of these challenges, many adolescents are a poor fit for the ongoing dependency they must adapt to. They may gravitate to violent video games, challenging sports activities, and promiscuous sexual behavior in an attempt to fulfill their genetic mandates. If this could be fully recognized by society, perhaps the timing of education could be modified and supplemented with activities and adventures more in line with the developing brain.
As a social organ of adaptation, our brains’ first job is to join the web of relationships into which we are born. The newborn brain lacks perspective and experience, so it accepts the demands of its environment as a given, and invests in figuring out what is needed to survive. When we sit across from a client, years or decades later, we are relating to the totality of their developmental history. An appreciation of this deep complexity helps us to avoid accepting simplistic and prepackaged solutions for the human dilemma. A one-size-fits-all approach will never have a high frequency of success with such a diverse and complex species as our own
early experiences shape the wetware of our brains and program the algorithms organizing our minds
autobiographical and working memory. It is not an evolutionary instilled process triggered by a gene into a critical period, but rather an outgrowth of social relating whereby others see you as a separate and integrated being. They assume you have your own experience and ask you to articulate and share it.
As small pieces of her sense of a separate self began to coalesce, we had something to build a boundary around. We then used some meditation and guided imagery techniques to help her build an imaginary inner space for her to retreat to. We then used the resulting state of mind to practice being with Winston without monitoring his feelings, worrying about his needs, or obsessing about how she was failing him. She gradually worked her way out of living in his head and inhabiting her own. It takes time to build a self, just as it does during the long turbulent years of the transition from childhood to adulthood. It’s always important to remind our clients that this is a slow process; otherwise they start to attack themselves for being behind schedule and can be hit with the same shame they felt as a child for not being worthy of the attention they needed in the first place. All things in due time.
What is referred to as the unconscious by psychoanalysts, and implicit processing by neuroscientists, is mediated via a set of early evolving and early developing “fast” neural systems. These fast systems are driven via our senses, motor experiences, and bodily processes, all of which are nonverbal and inaccessible to conscious reflection. Evidence of the activity of these fast systems is all around us every day. If we touch a hot stove, get cut off while driving, or are able to return a fast tennis serve, our bodies react faster than our conscious awareness. These fast systems are likely all that our ancestors had for millions of years until the recent emergence of what we call conscious awareness.
In this chapter, I will attempt to create a broad map of what happens in the brain during the half second it takes the brain to construct the components of our conscious experience
the feedback systems in our brains work forward and backward in time, making neural processing more similar to the complex interactive systems like those which create oceans currents, tornadoes, and shape those interesting patterns in your cup as cold milk mixes with hot coffee. Simple linear models of cause and effect just don’t suffice
Because we are unconscious of the half-second gap between brain activation and conscious awareness, we assume it doesn’t exist. This leads to genuinely honest confusion in our clients when they ask, “How could things that happened decades ago still affect me?”
Just like the other members of the Justice League stuck in the standard flow of time, we only witness the results of our fast systems. Bullets don’t go off course, but emotions are triggered, information distorted, and perceptions reshaped within the fast layers of implicit processing. We just experience the results of all this activity, which we interpret as our objective perception of the world.
With the goal of adaptation through the prediction and control of our environments, our speed force allows us to make rapid decisions based on the smallest amount of information. Our brains use memory as their main predictive tool, especially for threatening situations. Although it seems to us that we are responding to the outside world, 90% of the brain’s activity is in response to other activity within the brain. This is where our brains are comparing our sensations to past experiences in an attempt to perform a preemptive action in the service of survival. This is as true for withdrawing our hand from a hot stove as for reacting with avoidance to the offer of attention from others if this has been a source of pain in the past. This is likely why past behavior is the best predictor of future behavior.
The nervous system evolved to monitor, assess, and trigger appropriate adaptive responses.
A third system, referred to as the smart vagus, operates in parallel to the parasympathetic branch of the ANS and is dedicated to fine-tuning bodily reactions in the service of social engagement.
As the human brain has become increasingly complex, the amygdala has remained at the core of input and output circuits to appraise moment-to-moment experience. When we are faced with danger, the amygdala exerts its veto power over the other two cortical executive systems and takes control of our actions and reactions. It sits at the nexus between descending information from the cortex and information sent up from the viscera and bodily senses. It is also at the apex of descending circuits to the brain stem and body in response to threat and attraction. All of these reasons explain why the amygdala appears to serve as a fulcrum of neural processing
The amygdala is best known for its role in assessing for danger and triggering the fight-flight-freeze response but also becomes active in response to positive stimuli. In the complex and delicate dance of relationships, it plays a central role (in collaboration with the OMPFC) in the evaluation of the dos and don’ts of day-to-day social interactions. In fact, while the size of the hippocampus correlates with the complexity of the demands of navigating physical space, the amygdala’s size correlates with the size of our social networks. Making all of these rapid appraisals requires constant feedback from memory networks that store salient learning experiences, making the amygdala also the hub of input from both implicit and explicit memory
A central physiological manifestation of secure attachment is a higher threshold of amygdala activation for anxiety than those with an insecure attachment schema.
Just as our immunological systems have to differentiate between familiar and foreign substances that enter our bodies, our social brains have to be able to identify how to safely navigate the social environment. In addition to distinguishing friend from foe, and kin from stranger, evolution also faced the challenge of better regulating emotions in close, sustained contact. As bigger brains led to children being born earlier in development to enhance survival of the mother, mothers needed to be able to read the increasingly primitive communication from their babies in order to care for them.
While basic approach-avoidance defensive strategies suffice for nonsocial animals, caretaking, cooperation, and group coherence require subtle and continuous emotional self-regulation. Mammals have to know not only whom to approach, but when, how, and for what purpose
An important contribution to our understanding of implicit processing has come from the neurophysiologist Steven Porges. His notions of polyvagal theory, the social engagement system, and neuroception add to our understanding of how brains connect, communicate, and regulate one another.
The third system, which is the focus of Porges’s social engagement system, relies on the later-evolving myelinated branch of the vagal system, which modulates sympathetic arousal.
Where the main ANS works like an on/off switch, the smart vagus provides us with a volume control on our arousal and social interactions.
Information from the social engagement system, which Porges refers to as neuroception, is fed to the amygdala and cortex to provide input for social engagement, such as recognizing and reading facial expressions and other forms of social input.
Good-enough parenting not only teaches appropriate responses in challenging interpersonal situations, it also builds the neural circuitry required to successfully carry them out.
system of neural processing. It is likely that intuition consists of a combination of multiple data streams appraised by the amygdala to have an overall positive or negative valence. The neuroscientist Antonio Damasio found that individuals with damage to the OMPFC, amygdala, or somatosensory cortex had difficulty making good choices in complex situations. He believed that this was because subliminal bodily and emotional input to the amygdala had been cut off. The core of the theory is that we evolved to use information from our bodies, such as muscle tone, heart rate, endocrine activity, and so on, to make rapid decisions about how to navigate the physical and social worlds. Through these somatic markers, we unwittingly rely on primitive appraisal networks to guide our conscious decision-making process.
Somatic markers are an excellent example of conservation in evolution, where older systems are retained and interwoven with later-evolving ones to enhance survival
Western psychotherapists tend to focus on the differences among the conceptual schools rather than appreciating their similarities. This is likely because we are so desperate to feel like we have an understanding of the mind instead of being in awe of its complexity.
Most forms of psychotherapy rely upon the expansion of self-awareness in the service of being freed from self-destructive patterns of thought, emotion, and behavior. The core beliefs of CBT, the unconscious determinants from early childhood experience used in psychoanalysis, and the existential dilemmas of the humanistic therapies are all present in the teachings of Buddhism
Suffering is a result of the dissatisfaction created by our minds, no matter how much we have or how well we are doing
Psychotherapy, in all of its forms, attempts to address and sometimes unpack the architecture of the fast system to discern how our experience is biased prior to conscious awareness.
The first step is awareness—transition from unconscious acting-out to learning to observe what is happening. Don’t expect not to do it; just add conscious awareness to the mix. Say you want to drink less alcohol yet find yourself regularly drinking to excess. Instead of just drinking as a reflex, be aware that you have the impulse to have a drink, find out what feelings are driving the behavior, and pay attention to the consequences
When I took my initial steps into the study of neuroscience in the 1970s, attachment and brain research lived in separate universes
What do early nurturance, maternal care, and attachment schema have to do with neuroscience and the human brain? The answer turned out to be just about everything.
As humans became increasingly social, the period of childhood dependency expanded well beyond those of most other species. Our brains develop slowly as they adapt to the behaviors, beliefs, and rituals of those around us. Through countless interactions, we learn how to have relationships, navigate the environment, and become a full member of our tribe. Our early interactions stimulate neural growth, establish our neurochemical set points, and determine how well or poorly our neural networks develop and integrate—all this in addition to shaping our attachment schema, affect regulation, and self-identity. Through this process, both the wetware of our brains and the organization of our minds are always an encultured reflection of experience
Neurofluency Principle 17: At its core, attachment is the regulation of arousal via proximity
At the same time, relational experiences are being translated (via epigenetics) into the wetware of the social brain
Both the OMPFC and amygdala are in the business of appraising the value of what is around us and trigger our bodies to avoid spiders and snakes and to approach children in distress and piles of cash.
While the OMPFC evolved from the amygdala, a major difference between the two in contemporary humans is that the amygdala makes very broad, black-and-white approach-avoidance decisions while the OMPFC is more nuanced in its evaluations
Given that it is such an evolutionarily primitive structure, the amygdala is fully developed even before birth. In general, the parts of our nervous system that evolved earlier develop earlier during our life. What this means is that even before we are born, our amygdala is capable of triggering the body’s fight-flight mechanisms and the cascade of biochemicals that cause panic attacks and compromise the body’s immunological defenses. Young children are therefore totally dependent upon a parent’s ability to regulate their anxiety for them by appearing when they are distressed, figuring out what they need
and returning the child to a state of calm and bodily equilibrium. If these experiences are largely positive and successful, the child tends to feel safer and more secure in the world, experience others as sources of comfort, and eventually learn to regulate their own fear through self-talk, memory of positive outcomes, and proactive problem solving.
When therapists talk of an inner mother, a major biological component is the shaping of the amygdala-prefrontal system to modulate our arousal and emotions
The ANS is a primitive system that works as a kind of on-off switch for activation or restoration. As we evolved into increasingly social creatures, this on-off switch became inadequate for dealing with the complexities of close and sustained relationships. A second network that is shaped by early experience has been called the social engagement system. Steven Porges has proposed that the vagus, or the 10th cranial nerve complex, has evolved in humans as an integrator and regulator of physiological arousal and social connection. The vagal system extends from multiple points within the body including the heart, lungs, throat, and digestive system and is involved in the regulation of their activity.
The second contribution of the social engagement system is to provide information from our internal organs to the muscles in our face. This system allows parents to watch the facial expressions of their preverbal children and get a real-time readout of their internal state. Think of the vagal system as a volume control that allows us to stay in proximity, deal with emotionally arousing situations, and dial in an appropriate level of relationship-sustaining arousal, activation, and emotion. If the polyvagal regulation of the social engagement system is underdeveloped due to insecure attachment, we may depend on the utilization of more primitive autonomic regulation (fight-flight-freeze) in relationships
The growth of oxytocin receptors is stimulated through epigenetic processes triggered by maternal attention
Dopamine is a key reward biochemical that motivates bonding, attachment, and social interactions. It is produced in the brain stem, travels up through the thalamus, amygdala, and OMPFC, and back down again
Oxytocin has been found to block dopamine receptors, which prevents habituation (and eventual disinterest) to those we love. The metaphor of being addicted to love may not be a metaphor
We literally build our children’s brains in positive and negative ways as epigenetic processes convert our interactions into the neuroanatomy and neurochemistry of their brains
Neurofluency Principle 19: Secure attachment reflects the ability to use others to successfully regulate arousal
A little morphine will even get a puppy’s tail to wag in the same way as it does when another dog or familiar human approaches. Playful contact with our dogs provides us the added benefits of reduced heart rates, lower cortisol levels, and increased immunological functioning, not to mention the cardiac value of taking them for walks—a beautiful example of cross-species sociostasis
we leverage the sociostatic abilities of the therapeutic relationship to modulate the biochemistry of attachment, affect regulation, and well-being.
What Freud called a repetition compulsion may simply be the brain’s way of keeping old habit patterns alive
if we could simultaneously activate the deep and surface narratives in the safer context of our relationship, he might be able to engage more cortical involvement, allowing for insight and positive change
Just a few decades ago, most psychotherapists practiced within a single theoretical orientation and only interacted with like-minded others. Therapists organized more like religious sects than professional guilds, and teachers competed to convert students to their personal belief system. As the years have passed, the practice of psychotherapy has become increasingly eclectic and open to new theories and treatment models
From a neuroscientific perspective, when any therapy works, it is because the therapist has managed to stimulate plasticity and positive change in a client’s brain.
I also want to develop an idea of how a client’s brain was shaped early in life, how this client processes information, and get a general sense of the nature of his or her neural development and integration.
the brain, as a social organ of adaptation, is built through experience, and all human experiences occur in the context of a specific culture. Knowledge
Additionally, sharing with my clients how our brains work and how we can use this knowledge in assessment and treatment provides us with a nonshaming way to explain their symptoms and how to work together to develop strategies to change them
Neuroscience can also serve as a common language among health care providers from different disciplines who may not work within a psychological framework. The key here is to be open to new ways of thinking, different ways of understanding, and new strategies for healing.
As the biologist Theodosius Dobzhansky wrote, “Nothing in biology makes sense except in the light of evolution.
Consilience is a countermovement to the traditional segregation of academic disciples. It’s based on the belief that the sciences have an underlying unity and consistency that can be explored and comprehended through many perspectives and strategies.
Again and again, I’ve been impressed by how much research in biology and animal behavior affords us deeper insights into human experience. It can help us see some of the blind spots that are embedded in our language, culture, and egos
One of my favorite examples has to do with the parallel between the growth of neurons and individual social animals. Just like people, individual neurons are involved in a Darwinian struggle for survival. It is the core evolutionary strategy of diversity, overproduction, and adaptation through natural selection that shapes the brain to adapt to its social environment as species to adapt to their natural habitats. The brain is its own ecosystem, with millions of neurons that struggle to survive just like animals in a jungle or on the savannah.
We are born with far more neurons than we need, and those which are able to communicate, coordinate, and form a bond around some function—finding our mouth with our thumb, learning a new word, or associating the sound of footsteps with the appearance of a familiar face—are stimulated by one another and survive
It may sound like a paradox, but as our brains enlarge, the actual number of neurons decreases. The space cleared by the removal of dead neurons allows for the growth and increased connectivity of those that survive. Our brains grow larger because those neurons that survive grow larger and larger
If you watch a neuron under an electron microscope, you see it expending its energy reaching out its dendritic arms in what appears to be a desperate search for connection. Neurons are social creatures, and connection is their first order of business
Although they may manifest as depression, anxiety, fears, and phobias, most human problems result from difficulties in bonding, attachment, and sustaining connection, During
Spitz called this catastrophic reaction to abandonment “anaclitic depression,” and a similar process is now described as reactive attachment disorder.
Early learning shapes implicit memory systems that guide all subsequent conscious thought, feelings, and behavior.
Just like neurons, infants rely on their ability to attach first to their caretakers and subsequently to the social world around them. Humans, like neurons, are social creatures who strive to become a part of a functional unit called a family
The brain is not a unitary structure but a complex system of systems, each with its own evolutionary histories, developmental trajectories, and functional responsibilities.
the amygdala can function either integrated with or dissociated from conscious awareness. When our brains are dissociated and the amygdala becomes activated, we become terrified, but we don’t know why
One of the amygdala’s many jobs is to generalize from frightening experiences in the past to situations in the present it interprets as similar
A clear lesson from neuroscience, as well as the fields of social psychology, political science, and economics, is that our brain and mind have not evolved to perceive the world accurately
our brain and mind have been shaped to organize reality in ways that help us adapt to the world. This is why we tend to think of our friends as better than others, why we blame others for our own mistakes, and why all of our children are above average
As we peer deeper into the brain-mind, we learn that an increasing amount of what we do, feel, and think is the result of reflexive and highly automatic processing. We learn from both the psychoanalysts and the neuroscientists that our experience of and behaviors in the world are heavily influenced by early childhood experiences. Attachment research teaches us that early relationships establish unconscious schemata in implicit memory that determine how to behave in intimate relationships. Social psychology has empirically demonstrated thousands of ways in which our perceptions and decision making can be influenced by subliminal messages, while thousands of cases in the neurology literature have shown how the loss of a group of neurons in a specific brain region can lead a man to mistake his wife for a hat.
our freedom to make choices depends on our awareness of the biases embedded in our implicit programming
Saddled with Paleolithic brains better suited for tribal life on the savannah than a diverse and pressure-filled city, we need to take more responsibility for how we use them. We have to be smarter than to think we know the correct answers for everything and that what our brains and minds reflexively dish up into consciousness is either accurate or to the benefit of ourselves and those we live with. It is this skeptical and curious stance from which psychotherapy can be most effective.
Because the social synapse has a broad bandwidth including many unspoken and unconscious levels of communication, we are able to both receive and send messages that assist mutual sociostatic regulation. In the same way that different clients lead us to feel very differently from one session to the next, we also can create a state of brain and mind in our clients that can influence therapy in both positive and negative ways. Our posture, tone of voice, facial expressions, hand gestures, the pace of our breathing—to name but a few elements—are automatically transmitted across the social synapse. These signals are processed and interpreted by our clients’ mirror neuron, autonomic, vagal, and attachment systems—to name another few—that are unconsciously processing their experience in the session. If we are aware of the signals we are sending, we can use them in ways that can impact our clients’ ability to regulate their affect, experience trust and vulnerability, and listen and benefit from the relationship.
Benefiting from psychotherapy requires considerable emotional regulation in client and therapist. The modulation of arousal in both parties is necessary for optimal connection, attunement, neural plasticity, and positive change. I have had clients who are so agitated that they can’t remain seated, stay focused on one thought, or keep track of our conversation. Many have suffered with such high levels of arousal for so long that they have learned to hide it from others and are no longer aware of it themselves. The only visible clues for the therapist might be distractibility, physical agitation, or reports that they are unable to sleep or focus on their work. We can’t necessarily rely on their reports of anxiety because they may no longer label it as such.
Assessing and understanding your clients’ level of arousal and their ability to modulate it is central to all forms of psychotherapy.
A helpful way to assess (and potentially treat) a client’s ability to regulate arousal is to use a simple biofeedback device that measures galvanic skin response (GSR). You can buy one online for around $75. It looks like an old computer mouse with two silver strips on top and measures subtle changes in secretions of the sweat glands tied to autonomic arousal. The basic idea of biofeedback is for clients to use the tone to learn to recognize their tension and more easily achieve relaxed states of body and mind. Use it yourself to get comfortable with how it works, the experience of the tone, and changes you are able to achieve in your own arousal. You can do the relaxation techniques that work for you and monitor how well your physiological arousal matches your conscious experience of relaxation.
The ability to attain and sustain a moderate level of arousal is necessary for neuroplasticity, learning, and positive therapeutic change
By assessing your client’s ability or inability to benefit from the GSR device, you are learning about the neurodynamics of their executive systems. Most specifically, you are learning whether they are able to leverage their second and third executive systems to downregulate and inhibit the first (amygdala) executive system