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NPT:   How has an understanding of neurobiology helped you in your practice and with writing your book?

 

KO:    After more than twenty years working as a psychologist in public schools, I moved to a private middle high school for students with special needs. Talented educators in other schools had tried to teach these fascinating kids, but all the usual techniques and some really creative ones had come to naught. The students needed and deserved different and effective approaches to their learning. It was a daunting challenge because if our attempts failed then the private nature of the school meant the school would also fail. We needed a reliable source of information and inspiration to meet the challenge, and it quickly became evident this lay with neurobiology. It followed that the more I could discover and teach teachers about interpersonal neurobiology, the more we could use that knowledge to develop new solutions to help our students with their learning and emotional struggles. Similarly, the more the staff learned, the easier it became to build on their knowledge and develop new approaches. With every success our passion for learning and applying interpersonal neurobiology grew. It has become a positive feedback loop, and we continue to learn and find creative practical solutions for difficult problems.

I wanted to pass on these solutions and this way of thinking beyond our small school so I began writing for the GAINS Quarterly, which in turn led to publication of The Invisible Classroom: Relationships, Neuroscience and Mindfulness in School (Norton Series on the Social Neuroscience of Education, 2014). I could go on to describe in detail how neuroscience is helpful in my practice, or how I apply the concepts in the book, but I believe it is best summarized in a real-life example.

Just a few weeks ago, I was alerted by a teacher that a boy was hiding under a pile of coats in the entryway of the school. I was surprised to discover that he had bolted from his favorite music class. His baffled music teacher guessed it had something to do with a girl’s choice of a song for the band to learn. The girl had passionately explained to the class that the song was important to her because it had soothed her when she was in hospital recovering from a suicide attempt. The teacher played a recording of the somber song to the class and decided the chord structure was easy enough for them to learn. When the boy objected, the teacher gently said, “Let’s all learn this song and you can choose the next one.” That was when he fled the room and disappeared under the coats. When I joined the boy in that freezing cold entryway he did not respond to anything I said. I even began to doubt that the pile of clothes contained a human boy. I felt the familiar sense of doubt and helplessness rise within me. Embarrassment was added when a visitor passed through and gave me a questioning look while I sat on the floor staring at the pile.

I was grateful when Stephen Porges’s polyvagal theory came to mind and along with it a rough outline of a plan. I realized I was probably in the company of a boy in the state of dorsal vagal collapse. What had happened to cause the collapse? I did not know; but I did know that I needed to try to reactivate his sympathetic nervous system and his ventral vagal social engagement circuits. Yet how could I do that without triggering a fight–flight response that might cause him to run out the door into the nearby forest, as he had done before? I knew the boy trusted his music teacher and that this teacher had some training in the polyvagal theory from our student problem-solving in the past. I also knew he was passionate about and currently studying the effects of music on the brain. I explained to the boy I was going to leave for a moment and ask his music teacher to join us. I got the predictable non-response.

When the teacher and I returned, we talked to each other without expecting a response from beneath the coats. He spoke about how surprised he was that the girl had revealed her suicide attempt and hospitalization in such detail and with such emotion. He also commented how the song made him feel sad, and how the minor chords in some music are designed to make everyone feel sad. We both agreed that we did not know why people would ever like a sad song, but we also knew that many did. I described how suddenly experiencing all those sad emotions at once can make the brain, which is always trying to protect us, just shut down. (The brain is always trying to protect us is a theme the boy would have heard many times, because we often use it to normalize students’ anxiety.) Then the music teacher surprised me when he carefully, softly, and gently pondered aloud that what had happened might have reminded the boy of his uncle’s suicide. And the coats began to shake as the boy underneath quietly sobbed. My eyes filled with tears as I felt him move out of dorsal collapse into sympathetic arousal toward ventral vagal social engagement. My feelings were confirmed as he started to talk about the girl, the song, and his uncle. Again, the music teacher and I talked to each other, describing how anyone would be overwhelmed by the combination of the girl’s emotional account of her experience, the sad song, and the sad memory. We agreed, “It was just the brain doing what it is supposed to do. It shut down everything, because it was overloaded. Nothing is wrong or bad, and lying under the coats probably felt safe and warm.” As the boy’s disheveled hair and eventually his full being emerged from under the pile, we carefully planned a face-saving strategy for rejoining the kids during the upcoming lunch period.

As we were parting, the music teacher mused out loud that forcing the boy to learn the song might be too much at this point. He offered to teach the girl the song individually, while the whole class learned a different one. He warned that the boy would likely hear the song when she was practicing it, and with a wan smile he agreed that probably it would be fine. Then he left and joined his friends for lunch.

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NPT:   What does the title of your book The Invisible Classroom mean?

KO:    I’ve worked for four decades as a psychologist in public and private schools—roles that place me in the classroom every day. As my knowledge of neuroscience, relationship science, positive psychology, and mindfulness grew, I began to see things that were invisible to my educator colleagues. Where they saw important issues such as content, curriculum, and accountability, I saw connection, collaboration, and neural integration. When in the classroom, I see an invisible web of relationships among the students, and between the teacher and the students, as well as the web of brain cells firing in their embodied brains and even the functions of their vagus nerve. This experience was the seed of the book’s title. The book itself began as a disconnected collection of stories arising from my attempts to apply these concepts in schools. When Bonnie Badenoch, the GAINS editor, introduced me to her publisher at W. W. Norton, I found myself trying to explain the book’s theme, and the title The Invisible Classroom popped into my mind unbidden. Perhaps it was a real-life example of an emergent property, but I’ll leave that to others to decide. For me the title captured my experience, and the publisher agreed.

NPT:   You also run The Positivity Company. How do you integrate these theories and philosophies into that work?

KO:    The Positivity Company (http://thepositivitycompany.com/) applies neuroscience, positive psychology, and mindfulness, because we believe that human well-being and flourishing rests at the intersection of these fields. My wife, Sher Kamman, and I started it in 2001 after we began to feel something was missing in our work, Sher with trauma survivors and me with families and children. While we felt that it was certainly helpful and rewarding to assist people to heal, it did not seem to be enough. Something was missing. These seeds of discontent led us to the work of Martin Seligman, who was beginning with positive psychology, and Dan Siegel, who was developing interpersonal neurobiology. We fell in love with their work then and continue to absorb whatever we can. We pass on their and others’ research through workshops to the public, but primarily we train therapists, educators, and physicians. We know from neuroscience that one-time training events and conferences, while inspiring, are not as effective as one- or two-hour trainings given over time. We offer monthly trainings in a series, similar to a college course. They have been quite popular, and one series has continued for nine years with many members attending every year for the full nine years.

NPT:   If there was one thing you would like to impart to a new psychotherapist or a new teacher, what would it be?

KO:    I would stress the vital importance of the relationship. It may seem obvious, but the more we learn about the brain, the more we realize the biological importance of authentic relationships. We learn everything through a relationship with someone. Try a brief thought experiment: think about anything you learned, anything, from the letters of the alphabet to neuropsychotherapy. Regardless of the topic, someone taught you via the spoken or written word. You learned it all through your relationship with the teacher or the author. (You, dear reader, and I are in relationship through my words on this page.)

Humans must trust the teacher/author in order to accept and learn the content. For example, you and I don’t know each other, but you likely trust my words because you trust The Neuropsychotherapist. If you did not trust it, you probably would have stopped reading long ago. The neural mechanisms involved in trusting another human are complex, but likely include mirror neurons, the vagus nerve, the amygdala and the prefrontal cortex, as well as the visual and auditory systems. Many of these systems and processes are nonconscious. We all nonconsciously broadcast and receive immense amounts of information when we are in relationship with others, whether it is in the classroom or the consulting room.

What is especially challenging for the budding teacher and psychotherapist is the realization that all these aspects of a relationship are vitally important and cannot be faked. Teaching and therapeutic techniques, while important, must work within the invisible web of authentic relationship. It can be simultaneously terrifying and comforting, but the budding teacher or psychotherapist must learn about the neurobiological importance of the relationship and experience it.

NPT:   What’s ahead for you in the next 12 months?

KO:    I’m excited to be starting a pilot training that is part of the Family Doctor Residency program at Dartmouth Medical School. It’s small scale, but it fits our model of short trainings given repeatedly over time, and if the residents and faculty see it as helpful it will be adopted. My hope is that it will have a positive impact on those highly stressed, unappreciated new physicians. Also, I have been enjoying writing instructive vignettes about the day-to-day application of interpersonal neurobiology, which has led my friends, colleagues, and especially my wife, to ask me if I’m working on another book. Apparently they miss me when I’m huddled in my garret, gnashing my teeth, trying to explain the intricacies of neuroscience. The best I can say is maybe, not to be coy, but I’m writing what I know and experience. Possibly like The Invisible Classroom it will morph into a book.

 

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