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Therapy Isn't Brain Science - Page 2

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The neuroscience information that’s currently in vogue seems primarily useful in convincing clients that we’re “experts”—that we have hard scientific knowledge about what’s actually happening inside their skulls. Telling them about the impact of brain function on their emotional lives can certainly help normalize their problems and convince them that they can take steps to change how their brains operate, though “brain talk” may also convince them that the solution is to take medications. Another danger inherent in this fascination with the brain is that therapists will use neuroscience to convince themselves that they know more than they really do, and thus must be practicing effective therapy.

Many of our clients’ problems are far simpler than most people realize, and the therapeutic interventions needed to resolve them are often equally simple. Current neuroscience is irrelevant to our understanding of both the problems and their solutions. After all, therapists were doing helpful, healing work long before neuroscience made its official debut at psychotherapy workshops and conferences and the field developed a collective case of “brain fever.”

Good therapists have always known that to help people change the way they feel and behave, we have to help them change the way they use their brains every day, not tell them about their neural processes. By actively creating vivid, impactful therapeutic experiences, we can transform our clients’ perceptions of their own reality, shifting the way they think and feel about themselves and their capacity for change. Some of the most effective techniques for creating this shift, like the two described below, were in use long before neuroscience was even a distant speck on psychotherapy’s horizon.

Becoming a Bystander

John was a drug and alcohol counselor and a Vietnam vet. His worst experience during the war occurred in the marketplace in Pleiku while waiting to join his troops. When a teenage boy reached for the wallet in John’s hip pocket, he grabbed the boy’s arm. Suddenly, he heard someone shout, “Grenade!” and felt something push hard against his back. When he regained consciousness, he was leaning against a tree, still holding the boy’s arm. “But that’s all I was holding,” he said, “because the rest of him was gone.”

After returning home, John had all the symptoms of post-traumatic stress disorder (PTSD). He regularly woke from nightmares of being back in Vietnam, thrashing and screaming. Sometimes his wife had to sleep in another room to avoid being hit. After this kind of night, John would be 10 times as tired the next day as he’d been when he’d gone to bed. Once, at an outdoor flea market, he’d had a waking nightmare that started when he heard people speaking Vietnamese. When he looked up, he saw a large Vietnamese family walking toward him. This sight, he said, “clicked me right back to the most violent incident that occurred to me in Vietnam. Then, suddenly, everyone around me was Vietnamese.” He’d panicked and run back to his car. Since returning from Vietnam, he’d found himself increasingly avoiding all people and things Asian. And he had an exaggerated startle response: if anyone unexpectedly touched or spoke to him from behind, he’d jump and have to restrain himself from hitting them.

John had struggled with these symptoms for years and had tried every kind of therapy he could find, yet after a single session with my wife, Connirae, he experienced immediate relief from his symptoms after going through a simple process that taught him how to view his worst memory as if he were a distant bystander. A one-trial learning, not a treatment based on some complex neurological insight, transformed his life.

In brief, Connirae asked John to imagine being in a movie theater sitting way back from the screen and then to float out of his body and up to the projection booth, from which he could see both the movie screen and himself sitting in the theater below. From this position, she told him to watch a black-and-white movie of himself that spanned the incident in that marketplace in Pleiku but ended later, giving him a longer perspective. Finally, she instructed him to leave the projection booth, step inside the movie at the end, and run it backward in color very quickly, in about a second and a half. This step reverses the cause-and-effect stimulus–response sequence, so that the feeling responses come before the triggers for them, changing their meaning.

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15 comments

  • Comment Link Friday, 13 September 2013 23:45 posted by harpreet bhatia

    Really a wonderful article - exactly my sentiments!! Although I am also very interested in neurosciences, I agree that it is not a requirement to be a good therapist!!

  • Comment Link Wednesday, 11 September 2013 13:02 posted by paul tsakeres

    It's nice to know Steve, that you, your work is out there for us to model and utilize. Elegant in it's simplicity, the way you set up the change is impeccable. Thanx.

  • Comment Link Tuesday, 03 September 2013 18:53 posted by John Warren

    I notice that you don't mention Neurofeedback or biofeedback based approaches such as capnometry/heart rate variability and so forth and how they might be utilised. Neurofeedback has several hundred papers testifying to it's usefullness whereas NLP has, as far as I'm aware, only single case studies with no mention of failures. I presume you do have failures, or would they be reframed in some way? There are many approaches other than NLP. Can't you acknowledge their input?

  • Comment Link Sunday, 01 September 2013 15:10 posted by Edward

    Very interesting article. This is what I do on a daily basis, NLP, hypnosis, EMT, etc ...

  • Comment Link Saturday, 31 August 2013 21:12 posted by Dr Martin Russell

    "...so far, I haven’t seen any persuasive direct application of neuroscience to the practice of therapy."

    Steve does address the idea of using neuroscience findings / theories, for the purpose of "normalizing" people's experience.

    But beyond that, I too would be interested in identifying a concrete decription of a method, technique or application developed from neuroscience, or even a whole list of them.

    This would be really valuable.

    I look forward to people commenting here coming up to the challenge of providing the actionable specifics for this list.

  • Comment Link Friday, 30 August 2013 15:10 posted by Reza Venili

    Thank you dear Steve for choosing a topic which is pervasive among the practitioners nowadays and doing so shows just how much observant you are of the intellectual market of the FoNLP.

    As your student, I wanted to communicate a few things that came to my mind, regarding the article. I really enjoy your writings for many reasons amongst which is how you avoid cliches avoid regurgitated stuff. So to read that paragraph in which you mention 'the DSM-V and the 900 pages of description' seemed a bit out of character to me. Firstly it is a 'Diagnostic' manual and secondly there is a section named 'course' for every disorder in the book which proposes the course of treatment. These treatments may not be aligned with the kind of treatments that we hope for or the book might lack treatments for some of the disorders but still, to frame it as a '900 pages of problems' is to descend to the level of 'the word on the street' which you specifically invite us, the readers, to avoid.

    The other point was 'the moral of the article' or 'the conclusion' which was not clear to me. Since in NLP and specially in this article you are inviting the readers to pay attention to the spirit of NLP which is 'Do what works', are you actually inviting the reader 'do not study neuroscience'? Surely you haven't written this relatively long article as a way of expressing 'I think Neuroscience is irrelevant' without any practical purpose in mind, have you? and even if it is just about that (expressing a concern), don't you think that this sort of 'expressions' would invite heavy & unnecessary criticisms from outside the field? I mean, at the moment, do we need to be known as people who 'argue for ignorance'? This probably comes from people who don't know you are a member of the board of an active group who rigorously study NLP.

    Also, I'm a bit confused about the structure of the article and mainly about the relevancy of the 2 examples you presented (although I enjoyed them profoundly). If I understood it correctly, you first introduced your topic and then your claim and then you brought up 2 examples to show that no neuroscience was involved in these effective techniques. was that it? That is akin to saying "I believe wheels can not be used in an airplane. Now, to illustrate my point, let me give you examples of planes which do fine without wheels!" which is logically unnecessary and irrelevant to the argument, considering that they constitute almost 2/3 of the article. In fact, as you know it far better than me, we can not prove one method ineffective by telling anecdotes about the effectiveness of other methods. So, I couldn't find the point.

    Anyways, I hope the feedback proves useful. I use the opportunity to sincerely thank you for everything positive you've done for NLP over the years, Steve.
    All the best,

  • Comment Link Friday, 30 August 2013 13:01 posted by Mark Ryan

    Nice article Steve!

    I think a lot of the knowledge of the effective "How" to helping people has been available for years.

    Why work backwards from Neuro-science to a "how" when you could use the present working "Hows" to align with the new discoveries in Neuro-science?

    Seems like a more efficient path.

    Personally i think the "How" that has been learned in NLP - Hypnosis - Metaphor work and Bruce Ecker's Reconsolidation Coherence Therapy.... would be a great start to any new Therapists toolbox.

    Enough to have a long and successful career that will align perfectly with the discoveries of the new Neuro-science.

  • Comment Link Friday, 30 August 2013 10:39 posted by Nick Kemp

    Good observations! Any therapist or practitioner working with clients week in week out would IMO probably agree. In the internet age so often folks forget that what actually creates genuine results for people trumps all the academic theory every time. That's not to say such research has not value, rather that real life substantive change is more useful...

  • Comment Link Friday, 30 August 2013 03:27 posted by Holistic Hypnosis Hypnotherapy Los Angeles.

    I agree with knowledge verses pragmatic ability to help. Why I became a Hypnotherapist. 25 years of reading psychotherapy left me frustrated. I knew more and more about people's difficulties with no greater ability to assist in their resolution. Neuro- science is part of the pursuit of curing emotional problems via Chemical means. Years ago I wrote a line in a poem, "Might as well to find a thought, dissect a brain." which was my attempt to debunk this kind pseudo rationality. I was incidentally a scientist in my orientation as a youth.

  • Comment Link Friday, 30 August 2013 01:34 posted by Samuel Skierski

    It's not always what you think, it's how you think of what you think about. Brief therapy creates fast and lasting change.
    Kudos, Steve Andeas

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