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Healing The Social Brain

Louis Cozolino

From The Neruopsychotherapist, Issue 1, April-June 2013



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Psychotherapists are applied neuroscientists who create individually tailored enriched learning environments designed to enhance brain functioning and mental health. We are skilled at teaching clients to become aware of unconscious processing, take ownership of their projections, and risk anxiety in the service of emotional maturation (Holtforth et al., 2005). In our work, illusions, distortions, and defenses are exposed, explored, and tested or modified with understandings closer to reality. Implicit memory—in the form of attachment schemas, transference, and superego—are made conscious and explained as expressions of early experiences. We use a combination of empathy, affect, stories, and behavioral experiments to promote neural network growth and integration.

Through all of this work, subcortical networks that store memories of fears, phobias, and traumas are activated and made accessible for integration with cortical inhibitory circuitry. This essential integration allows for linkage among explicit and implicit circuits, conscious awareness, and the control of negative memories, sensations, and emotions. Regardless of the client’s particular problem, psychotherapy teaches a method to help us better understand and use our brains. And as the dialogue between psychotherapy and neuroscience continues to evolve, an increasing number of scientific findings will be applied to both theory and clinical practice.

Important factors in the therapeutic process have been identified as an empathic and supportive relationship, maintenance of moderate states of arousal, activation of both cognition and emotion, and co-construction of narratives. A safe and empathic relationship establishes an emotional and neurobiological context conducive to neural plasticity. It also serves as a scaffold within which a client can better tolerate the stress required for neural reorganization. We have already seen that birds are able to learn their songs after sensitive periods when exposed to other birds singing, but are unable to learn the same songs heard from a tape recorder (Baptista & Petrinovich, 1986). Under certain conditions, birds require positive social interactions and nurturance in order to learn (Eales, 1985). And the stronger the relationship between human trainers and their birds, the greater the learning will be for both (Pepperberg, 2008). These studies, combined with what we know about changes in biochemistry during interpersonal interactions, suggest that a positive and attuned relationship enhances neural plasticity and learning. The nearly insatiable drive of adolescents to be in constant contact with one another may reflect the underlying drive for neural stimulation during this crucial developmental period. Emotional expression and modulation have been incorporated into psychotherapy because of their impact on these underlying biological processes.
The importance of the activation of both emotion and cognition is recognized by most psychotherapists. Releasing emotions associated with painful memories, facing a feared situation, or experimenting with new interpersonal relationships all involve some sort of stress, anxiety, or fear. Although this way of thinking has been accepted clinically, we now have considerable evidence to support the idea that moderate levels of arousal optimize the production of neurotransmitters and neural growth hormones that enhance LTP, learning, and cortical reorganization (Cowan & Kandel, 2001; Zhu & Waite, 1998). Trauma undoubtedly changes us in many ways, from our startle response to our attachments and self-identity. Dissociation in reaction to trauma represents a breakdown of neural integration and plasticity. In therapy, we use moderate levels of arousal to access cortical mechanisms of plasticity in controlled ways with specific goals. The safe emergency of therapy provides both the psychological support and the biological stimulation necessary for rebuilding the brain. Much of neural integration and reorganization takes place in the association areas of the frontal, temporal, and parietal lobes serving to coordinate, regulate, and direct multiple neural circuits of memory and emotion.


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