Neurobiology and its Applications to Psychotherapy

In this presentation, Child and Adolescent Psychoanalyst Lucy Biven explains her fascination with neuroscience and the research findings she has found most useful in her therapy practice. She cites the work of Panksepp, LeDoux, Antonia Damasio and Gazzaniga, emphasising the finding that people make decisions on the basis of emotions that are beneath conscious awareness and which stem from lower areas of the brain and nervous system. These are automatic biological responses that we can effectively work with psychotherapeutically if recognised. She further elaborates Panksepp’s 7 emotional systems (SEEKING, RAGE, FEAR, LUST, CARE, PANIC/GRIEF, and PLAY) and draws on findings that suggest how we can most effectively treat depression and anxiety by placing a neurobiological framework at the centre of assessment.

Video of lecture – 43 mins

In this presentation, Dr Mona Fishbane discusses ways to integrate the wisdom of interpersonal neurobiology in couple therapy. She explores the neurobiology of passionate love and the challenges of nurturing long-term love; the health consequences of happy and unhappy relationships; what makes for relationship satisfaction; the dynamics of our automatic, emotional brain; how to bring prefrontal thoughtfulness to couple interactions; the dynamics of couple reactivity; emotion and emotion regulation; the neurobiology of empathy. Mona offers interventions informed by neurobiology, focusing on emotion regulation and empathy. The goal of therapy is to help couples become more relationally empowered, becoming their best selves, and co-constructing the “we” of their relationship. Mona shares how she helps the couple “get meta” to their own dance, co-authoring their interactions and building an intentional relationship. She explores the neurobiology of habits and change, and ways to facilitate change in therapy. In contrast to the reactive stance of unhappy couples, Mona offers ways to facilitate a “proactive” approach to loving.

Video of lecture – 1 hr 8 mins

Vittorio Gallese explains how the discovery of a mirror mechanism reveals an embodied approach to understanding the other. He terms this Embodied Simulation (ES). ES provides a new empirically-based notion of inter-subjectivity viewed first and foremost as intercorporeity – the main source of knowledge we directly gather about others is embodied. By means of ES we do not just “see” an action, an emotion, or a sensation and then understand it through an inference by analogy. We map others’ actions by re-using our own motor representations. ES provides an original and unitary account of basic aspects of intersubjectivity, demonstrating how deeply our making sense of others’ living and acting bodies is rooted in the power of re-using our own motor, emotional and somatosensory resources.

Video of lecture – 43 mins

The minimal bodily self: behavioral and neuroscientific evidence

From a phenomenological perspective, three levels of selfhood have been identified. First, there is the implicit awareness that this is ‘my’ experience. Second, there is the more explicit awareness of self as an invariant subject of experience and action. Finally, there is the social or narrative self, which refers to personality, habits, style and other characteristics of an individual. The concept of minimal, pre-reflective, or core self is currently under debate. It is not clear which empirical features such a self is presumed to possess and which kind of experience occurs in shaping it. This lecture proposes that besides searching for the neural correlates of a pre-defined, explicit and reflective self-knowledge, empirical research should first investigate which kind of experience allows implicit, pre-reflective self-knowledge to emerge. Vittorio Gallese presents behavioural and neuroscientific evidence showing the crucial role of the motor system in enabling the distinction between our bodily self and the bodily self of others. The bearing of such implicit distinction on psychoanalysis and psychopathology is also discussed.

Video of lecture – 1 hr 9 mins

Dr Jean Knox suggests that mirror neuron research offers valuable scientific insights into the mind-body dichotomy. She proposes that it challenges the model that privileges mind and thought over bodily enactment as the essence of what makes us human. She suggests that intersubjectivity is increasingly recognised as the embodied relational matrix out of which each individual emerges. The mirror neuron mechanism automatically prompts the observer to resonate with the emotional state of another individual, with the observer copying the motor, autonomic and somatic responses. Dr Knox sees this is the basis for both empathy and emotional contagion, ‘concordant countertransference’ (Racker) and introjection. The therapist often has to relate to states of mind activated by mirror neurons that are unbearable. This may lead the therapist to retreat from embodied inter-subjectivity into defensive positions such as intellectually-based, theoretical stances to the detriment of the therapy, while an understanding of the mirror-neuron mechanism may help therapists to tolerate embodied emotional discomfort.

Video lecture with slides – 32 mins

In this presentation, Ruth Lanius outlines an effective combination of therapies for trauma-related disorders that has been successfully piloted at the Traumatic Stress Service in the University of Western Ontario. The study is based on both clinical work and neuro-imaging observations of brain functioning in people with PTSD. The function and anatomy of the intrinsic brain networks (central executive, salience and default-modes) is explained with particular reference to the importance of connections and moving flexibly between these. These key-functions are often impaired in stress-related disorders, particularly to shift from active to resting brain-states. Dr Lanius explains how we can successfully reverse problems with connectivity and thus greatly increase the mental functioning of PTSD patients by offering EEG feedback combined with a range of psychotherapies including DBT, sensorimotor, exposure-based approaches, EMDR, narrative work and cognitive processing therapy.

Audio with images – 35 mins

In this video presentation, Dr Terry Marks-Tarlow suggests that clinical intuition is central to deep, embodied change in psychotherapy. Interpersonal intuition is linked to implicit processes of learning, memory, and imagination. These originate subcortically, beneath conscious thought. Clinical intuition is also related to parental instincts as guided by emotional/motivational circuits found in all social mammals. Finally, a play model of growth and healing during psychotherapy is offered, which counterbalances the trauma perspective currently in vogue.

Video of lecture – 1 hr 25 mins

We now know that each hemisphere plays a role in everything the brain does. Iain McGilchrist suggests that there is a Darwinian advantage to this division, originating in the need to pay two quite different types of attention to the world simultaneously: one enabling effective manipulation of pieces within the environment, the other enabling us to be aware of the whole. In human consciousness, these two modes of attention give rise to two different versions of the world, with different qualities, as well as different sets of preoccupations and values. He believes that an understanding of the implications of this attentional divide may cast light on some important questions, such as the nature of our selves, our minds and bodies, and of the world that we are in danger of destroying. These understandings will be elucidated to set a framework for understanding some of the most important aspects of the psychotherapy relationship and our lives in general.

Video of lecture – 1 hr 3 mins

The Divided Brain: the nature of our selves, our minds and our bodies – Part II

Video of lecture – 42 mins

The Divided Brain: the nature of our selves, our minds and our bodies – Part III

An understanding of hemisphere differences casts light on the nature of language and our relationships. In this second presentation, Iain McGilchrist will explore how the purpose of language is far from straightforward and that each hemisphere has a different way of engaging with language, to different ends. These insights cast light on what empathy is and is not, the importance of boundaries, and the nature of our relationships with one another and the world. The relevance of this knowledge to the task of psychotherapy will be explored.

Video of lecture – 36 mins

The Divided Brain: the nature of our selves, our minds and our bodies – Part IV

Video of lecture – 46 mins

In this lecture for psychotherapists, Professor Jaak Panksepp provides a working understanding of how emotions are created in the brain and how this provides a new understanding of the foundations of consciousness. He focuses on the nature of basic emotional processes as revealed through the study of neuroscience. This provides an effective framework for a better understanding of how feelings of sadness/grief and playfulness/joy are created, and their impact on our understanding of the mind and its disorders. Panksepp proposes that the complex social brain can be categorised into 7 emotional systems (SEEKING, RAGE, FEAR, LUST, CARE, PANIC/GRIEF, and PLAY) that are essential for wellbeing and survival. He relates the functioning of these systems to the skills of psychotherapy, for example, in engaging the CARE system. He further emphasises the importance of connecting with affect before cognition in creating therapeutic change. Panksepp proposes that every emotional system can be changed at its core via our adaptive capacity for neuroplasticity.

Video of lecture – 37 mins

The Brain-Mind mechanisms of SEEKING: depression, aliveness, and the location of the core self with clinical implications

Panksepp continues to explain emotional primary processes as the (sub-cortical) origin of feelings. He suggests that psychotherapy can be more effective if drugs are used to dampen the effects of primary emotional systems, and discusses psychotropic treatments for depression. It is proposed that depression is a disorder of the SEEKING system, and by seeing it in this way we have the opportunity to create more effective treatments. Panksepp proposes that psychotherapy clients are often dealing with primitive emotions that have taken over the higher mind and that we therefore need to work in the domain of emotional primary processes. Pharmacological therapies focus on biological similarities; psychotherapeutic approaches focus on the unique experience that each patient brings. Panksepp is a passionate critic of “ruthless reductionism” and asserts that scientific facts are not useful unless combined with concepts. He emphasises the plasticity of the brain – a key concept for understanding psychotherapeutic change.

Video of lecture – 38 mins

Here Steven Porges explains the human biological responses to stress through an elaboration of the primitive emotional response rooted in the functions of the vagal nerve. The branches of the vagal nerve serve different evolutionary stress responses in mammals: the more primitive branch produces immobilisation behaviours (e.g. freeze or feigning death), whereas the more evolved branch is linked to social engagement and self-soothing behaviours. These functions follow a hierarchical structure, where the most primitive systems are activated only when the more evolved structures fail to deal with threat. In this presentation, Dr Porges considers how we can learn to manage affective disorders and over-activation of evolutionary stress responses by engaging higher functions.

Audio with images – 47 mins

In this lecture, recorded in 2013, Allan Schore first discusses classical conceptions of mutual love by Darwin, Freud, Winnicott, Bowlby, Fromm, Stern, and Harlow. He frames an interpersonal neurobiological perspective of both low arousal “quiet” and high arousal “excited” mother-infant love, focusing on the role of right brain-to-right brain communications. This lecture integrates current neuroscience research with developmental psychodynamic models in order to propose that the earliest emergence of mutual love occurs at 2-3 months, and that the right amygdala acts as a deep unconscious system in mother-infant relationship.

Video of lecture – 1 hr

The Early Bonds of Mutual Love: a neuroscientific exploration PART 2

This lecture provides an overview of current neuroimaging research studies of parental, and specifically maternal love, which highlights the essential roles of the right amygdala, cingulate, and orbitofrontal cortex in both mother and infant. Schore describes the initial emergence of mutual love at 2-3 months, drawing on the work of Stern, Fogel, and Trevarthen. A detailed analysis of developmental psychological studies of facial expressions the loving mother directs towards her infant in this critical period is followed by an exposition of the neurobiological and neurophysiological mechanisms that underlie mother-infant mutual love.

Video of lecture – 1 hr 5 mins

The Early Bonds of Mutual Love: a neuroscientific exploration PART 3

In this session, Schore elaborates the role of the right amygdala, an essential structural system that is activated in all later adult forms of mutual love. The co-creation of mother-infant mutual love, a bond of “deep affection, strong emotional attachment” represents the expression of an instinctual evolutionary mechanism that is continually activated over the stages of human development. Offering a neurobiological update of Freud’s topographic theory he suggests that the right amygdala, the “deep unconscious,” is essential to all later forms of mutual love.

Video of lecture – 59 mins

The Early Bonds of Mutual Love: a neuroscientific exploration PART 4

Presenting current neuroimaging studies of adult romantic love, Schore here suggests that subcortical limbic-autonomic areas of the right brain, especially the right amygdala, generate the most intense nonverbal embodied expressions of the human heart.

Video of lecture – 55 mins

Dr Daniel Siegel explains the concept of interpersonal neurobiology as a discipline which seeks to understand the mind through the consilience of knowledge from a range of scientific disciplines. Siegel explains the healthy mind as an integrated system which has adaptability and flexibility in responding to external stimuli. This, he proposes, is at the root of self-regulation. Dr Siegel suggests that all self-regulation emerges from integration, defined here as the linkage of differentiated parts. When this integration is impaired, chaos and rigidity (in the nervous system’s response to external stimuli) lead to dysregulation and ultimately to psychopathology. He proposes that psychotherapists can become skilled in identifying the areas of chaos and rigidity in their patient’s life, and in promoting self-regulation via interventions that specifically promote integration at psychological and neurological levels. Effective psychotherapy improves the integrative growth of fibres in the brain (long-term neuroplasticity).

Audio with images – 23 mins

In this interview, Mark Solms elaborates his concept of neuropsychoanalysis as a systematic attempt to reconcile psychoanalysis and neuroscience by drawing one’s understanding from both disciplines simultaneously. He places this discussion into an historical framework, considering, among other works, Freud’s understandings of the human drives. Solms suggests that the subjective psychoanalytic method can be combined with the objective stance of the neuroscientific approach in order to provide us with a much more complete understanding of the mind. Rather than seeing the scientific and conceptual frameworks as dichotomous, he proposes that neuroscience gives us a series of methods whereby we can test psychoanalytic hypotheses. (Interviewer, Jane Ryan)

Audio with images – 1 hr 6 mins

In this brief video, Alan Watkins outlines the skill of affect regulation via conscious breathing techniques which impact on the feedback loop between breath, heart rate variability and emotional experience. He proposes that it is possible to master one’s emotions in this way, even if one has experienced considerable trauma. Watkins draws on an integrated theory of the mind-body, demonstrating how some simple neurobiological knowledge can be applied to enhance the emotional well-being of our patients/clients and ourselves as therapists.

Audio with images – 11 mins

In this lecture, Felicity de Zulueta focuses on the psychobiology of post-traumatic stress disorders. She suggests how these scientific insights can be applied to the best clinical technique for helping patients suffering from PTSD or dissociative disorders.

Video of lecture with notes and diagrams – 49 mins