Neurobiological Essentials for Clinicians

What Every Therapist Needs to Know

Arlene Montgomery

Review by Matthew Dahlitz

From a neuropsychotherapy point of view, the title and subtitle of a new book by Arlene Montgomery, Neurobiology Essentials for Clinicians: What Every Therapist Needs to Know, ring true. It is a masterful and pragmatic exposition of pertinent neurobiology that informs psychotherapy. Montgomery is herself a skilled psychodynamic psychotherapist who has been teaching interpersonal neurobiology to students at the University of Texas for many years. Thanks to this book, we too can sit under her tutelage and discover what is really going on in the neurobiology of our clients.

Grounded in regulation theory and its developmental variant, modern attachment theory, Montgomery covers the fundamentals of neuroscience for the practising psychotherapist in a detailed, yet clear and concise manner. The book’s content relating to the theory is extensively referenced, which is a testament to the author’s knowledge of the subject. But what I so love about Montgomery’s approach is the way she weaves this knowledge into case-study perspectives—throughout the book the reader is taken inside the therapy room, where she then demonstrates the theory, as therapist and client engage one another in familiar scenarios.

Dr Allan Schore, a leading researcher in the field of neuropsychology, has contributed a Foreward to this useful textbook. If you are familiar with the work of Allan Schore, then you will be a step ahead when diving into the theoretical aspects of this book. However, if you have not read Schore, Montgomery does a fine job of getting you immediately up to speed in the first chapter, “Affect Regulation and the Autonomic Nervous System”, while introducing a case study to pin down the theory to real world application.

Dr Montgomery’s book is not just about the brain—it is also about the body, especially the increasing appreciation for bodily-based autonomic arousal and its importance both in development and in therapy that we now are beginning to have. She presents a neuropsychobiological awareness of our clients—and ourselves—in a holistic clinical model that, for me, “connects all the dots” in a very satisfying way.

I should warn therapists—for whom biology and neurology may not be a strong point—that this book may not be an easy read. Nevertheless, I would also suggest that Neurobiology Essentials for Clinicians: What Every Therapist Needs to Know is an essential read for the psychotherapist who wants to get a sound grasp of brain/nervous system functionality in the interests of advancing their therapeutic career. Here Montgomery is a therapist talking to therapists, and I feel her pragmatic style of case presentations and thorough referencing of the theory underpinning good clinical practice has resulted in a fine text book for any aspiring psychotherapist.

The book is organised into two sections and eight chapters which cover the following topics:

Part I. Neurobiological Underpinnings of Selected Clinical Experiences

1. Affect Regulation and the Autonomic Nervous System

2. Defense Mechanisms and the Limbic System

3. Threat Management and the Amygdala

4. Therapeutic Engagement Issues and the Vagal System

5. Personality Disorders as Affect Management Strategies

Part II. Special Populations and Topics

6. Neurobiological Considerations in Working with Adolescents

7. Working with Groups: How Selected Principles of Regulation Theory can be Applied to Group Work

8. Integrating Selected Neurobiological Concepts into the Supervisory Process

The 360-page book is in a large format (8 x 9.9 in) and type-set in a very readable manner, which is something I very much appreciated as an editor, and which made the learning journey all the more enjoyable.