Daniel Siegel is using his brain a lot more these days. But it's not the one in his skull that's got him so excited; it's the plastic one in his office.
The associate professor of psychiatry at UCLA and author of The Developing Mind (Guilford Press, 1999) is one of a new wave of psychotherapists who are discovering the power of neuro-biology in their everyday counseling work. 'I not only have a model of the brain that I . . . take out maybe three or four times a week with different patients, but I also have a chalkboard I constantly use to draw brain diagrams to help people see their problems in a different light,' Siegel tells Mary Sykes Wylie and Richard Simon in Psychotherapy Networker (March/April 2004).
The results, he says, have been eye-opening. 'Patients keep telling me things like, 'You know last week when you drew that picture of the brain? I finally understood my amygdala. It's changed my whole view of what's been going on with me all these years.''
Siegel and others are looking at new ways to read brain activity and apply that information to psychotherapy. Their recent embrace of neuroscience, argue Wylie and Simon, represents a fundamental shift in a profession that historically has been at odds with neuroscience and its tendency to see an individual's temperament and psychological health as ruled by genetics and seldom subject to change. But as scientists have learned more about the brain's innate 'plasticity,' psychotherapists have become more willing to use that knowledge to help their clients.
Contrary to earlier thinking, researchers now know that the brain produces new cells throughout a person's life and that its development is influenced by experience as well as genetics. Each stimulus we experience causes millions of neurons to fire together in the brain, creating neural maps or networks that add up to what Wylie and Simon call 'the architecture of all our experiences.' This new knowledge of the brain, combined with advances in technology to measure and interpret brain activity, have allowed therapists and their clients to consider how an individual's brain functions in a way that goes well beyond the word-bound techniques of traditional 'talking cure' therapy.
'Magnetic resonance imaging (MRI), positron emission tomography (PET), and CAT scans can now photo-graph the brain at work and play and even after therapy,' Wylie and Simon note. 'With electron microscopes, the nuclear tagging of living human molecules, and other biochemical investigative techniques, scientists can now see what happens in different parts of the brain when an alcoholic looks at a martini, or a schizophrenic has a hallucination, or a meditator experiences spiritual transcendence.'
This allows the therapist and the client to look at problems in a more focused, less emotional way. As psychologist Marcia Stern, author of Child-Friendly Therapy (Norton, 2002), puts it, clients experience the workings of their brain in a much more personal way than they experience even their own behavior patterns. Showing them how their brain processes information, for instance, gives them 'an incredibly compelling way of grasping the most intimate details of their moment-to-moment functioning,' she says. It helps them 'understand their own behavior and the behavior of other people in their families in a new way -- for example, how easily our thinking brains can become hijacked by our feeling brains -- while dramatically diminishing the amount of shame and blame that gets passed around.'
One of Stern's clients always described herself as picky and obsessive, to such a degree that at seminars she would have to beat everyone else into the room so she could get a seat in the front row. Her colleagues called her neurotic, but by looking at how the woman's brain worked, Stern helped her realize that she was simply compensating for the difficulty she had filtering out sensory information. 'Once she was able to do that, she went from a negative explanation of her behavior -- 'I am neurotically obsessive' -- to a compassionate view of how this behavior was a way of taking care of herself,' Stern says.
This approach allows therapist and client to move from digging into the past to the more manageable task of simply learning to live with one's brain, Wylie and Simon explain. It can be liberating for both parties as the focus shifts from figuring out why to deciding what's next.
To get there, however, will require that therapists ask different questions than they ask now, says Harvard associate psychiatry professor John Ratey, author of A User's Guide to the Brain (Pantheon, 2001). 'Instead of reflexively asking 'How do you feel?' therapists will increasingly try to find out about how clients perceive the world,' he explains. Therapists will 'tune in to clients' movement habits and other aspects of their behavior that show how their brains work and how to communicate with them.'
And while this marriage of neuroscience and traditional therapy is not without its critics -- many of whom worry that it could erode a century of therapeutic practice -- Stern, for one, is convinced that it's a positive development. 'Every clinician at one time or another realizes that words are not enough,' she says. 'So often the results you see in your office don't carry over when people go home. The challenge of therapy is always to get clients from intention to action. Helping people understand their own brains and the unique way they process information can help bridge that gap and make change stick.'