Here we go again, I thought.
Loretta and Jack were back in my office, dispirited and fed up. "I don't think I love him anymore," Loretta began, and what caught my attention was not what she said but the way she said it: quietly, flatly, as though she was beyond caring.
During our first round of couples therapy, one year earlier, 31-year-old Loretta hadn't said anything quietly. She'd been chronically pissed off at Jack and had let him know via frequent, name-calling outbursts. Jack, 33, prided himself on his levelheadedness and often responded with patronizing mini-lectures like "Try a little rationality, Loretta," which, of course, had only fueled her ire.
I had spent the first four months helping them defuse these automatic, self-protective reactions and coaching them to become more attuned to each other's feelings. Next, I helped them open up to one another about their deeper dreams and trepidations, nudging them toward an intimacy they hadn't enjoyed since their courtship days. Not long after that, they missed two appointments in a row and left me a voice-mail message saying goodbye and thanks for "saving our marriage."
Now they were back and worse off than before. When I first met Loretta and Jack, at least they'd been full of fight and feeling. Now they were curiously subdued and all but resigned, it seemed to me, to the death of their seven-year marriage.
"What happened?" I asked. Sighing, Loretta explained that after leaving therapy the first time, they'd felt practically reborn as a couple, filled with a new delight in each other. Then Jack, a software developer, had been promoted to a high-powered management position requiring 60-hour work weeks. Stressed and preoccupied, he'd begun to withdraw at home, playing computer games until far into the night. The more Loretta reached out to him, the more prickly and distant he became. "We've lost something. It feels like we're just going through the motions," Loretta said. I looked over at Jack; he shrugged wearily.
I had a hunch about what was going on, but I felt deeply sad that my earlier efforts had borne so little fruit. It helped a little to know that I wasn't the only therapist who'd ever encountered the "Teflon factor" in marital therapy. Controlled outcome studies show that only about half of couples improve with treatment. And even among those who do make progress, a disheartening chunk, 30 to 50 percent, relapse within two years.
Why doesn't our work have more staying power? Marriage researcher John Gottman proposes that therapists focus too much on helping couples eliminate fighting and not enough on promoting a steady flow of positive interactions, which, according to longitudinal studies, is a critical ingredient of long and rewarding marriages. Unless clinicians also help couples build up a robust "emotional bank account" of mutual intimacy, goodwill and respect, says Gottman, they'll be hard-pressed to buffer themselves against the inevitable stresses of married life.
That made perfect sense to me, but still I wondered: how can couples keep that bank account filled, once they leave therapy? Several years ago, frustrated to the max with my own regular influx of "boomerang couples" like Loretta and Jack, I began to look into new research on how our brains and hormones operate to promote and sometimes sabotage lasting intimacy. What I've discovered thus far has both humbled and inspired me.
I'm humbled by how thoroughly our emotional responses appear to be embedded in our brain circuitry and chemistry, which helps to explain why couples keep reverting to their habitual fight-or-flight patterns with each other. But I'm newly optimistic, too. My explorations into the neural underpinnings of emotion have also given me a window into the depth of our intrinsic urges to give comfort and pleasure to those we love. We may be physiologically set up for conflict, but we're just as surely wired for connection.
The New Anatomy of Emotion
Once upon a time, scientists believed that our emotions resided in a kind of undifferentiated jumble, deep in the subcortical reaches of the brain. While they were reasonably certain that this "limbic brain" was where the emotional action took place, they remained fairly clueless about how or why one particular feeling tended to arise or dominate others. Why grief instead of anger? Why fear instead of love? And why the troublesome penchant for getting mired in one mood or another, rather than moving fluidly from one emotional state to another?
Recently, using increasingly refined tools that can electrically and chemically stimulate the brain, as well as make images of our neural turbulence, scientists have begun to construct some persuasive hypotheses. They now propose the existence of seven discrete neural systems that we could roughly call brain "circuits," each of which activates a specific emotion along with its accompanying, self-perpetuating thoughts and behaviors. The seven primal networks are rage, fear, separation distress (which provokes loneliness and sorrow), nurture, play, lust, and what scientists call "seeking," the powerful hunting quality that propels us toward our goals.
Apparently, when we're confronted by a particular stimulus, a cascade of neurohormones prompts one or more of these "big seven" mood circuits to activate and commandeer the brain, causing us to feel, think, and behave according to the dictates of the lit- up circuit.
Putting Neural Know-How to Work
From my standpoint, it doesn't take a brain scientist to figure out that some of these "big seven" neural states are more apt to promote satisfying marriages than others. I remember my excitement upon first reading about these neuroemotional systems, wondering: what if we could teach couples not only to modulate their rage and fear systems, but also to build up their emotional bank accounts via strengthening access to "intimacy circuits"—those controlling nurture, separation distress (which spurs us to seek connection), play, and sexual attraction?
While couples are in therapy, good clinicians help them effectively calm their anger and fear circuits as well as stimulate the more vulnerable, connection-generating states. The therapist acts as a kind of neural chiropractor, making regular, finely tuned adjustments to each partner's out-of-sync brain.
Just as important, we need to give our clients the tools to shift from one brain state to another entirely on their own. If the new affective neuroscience shows therapists anything, it's the critical importance of our role as teachers of emotional literacy. Notwithstanding the clinical scenarios that many of us were schooled on, featuring therapy masters who transformed a couple or family with a single, brilliant directive, the new behavioral brain science suggests the profound improbability that such "aha" moments will have any staying power.
Born to Nurture
Back to Jack and Loretta, still slumped on my couch, their bodies angled away from each other and their voices utterly drained of energy or affection. But I had faith that their potential for intimate connection still lived. For like all humans, deep in their brains they possessed a neurochemical operating system that's specially designed to promote caring. Though this neural nurture circuit probably originally evolved to prepare adults to ensure the survival of helpless infants, it also spurs caregiving behaviors toward peers, especially family members.
But what jumpstarts this care circuit? What kind of stimuli might trigger the free flow of nurturant neurochemicals through brain pathways, prodding a person out of resentful indifference and spurring a genuine desire to tend and give? The short answer: a partner's cry for help.
It's a tribute to nature's wisdom that each of us is equipped with a brain operating system that controls separation distress, which can range from mild loneliness to all-out abandonment panic. When loneliness circuits are electrically stimulated in animals, they emit distress vocalizations that are virtually identical to those emitted by young animals that have been separated from their mothers. When other members of their species hear such a cry, they speedily come to the agitated animal's aid, for their caregiving circuits have been activated by their companion's distress. Jaak Panksepp and other neurobiologists believe that human beings do a similar, brain-mediated dance of need and nurture. Ideally, when we call for help, a loved one runs to our side.
Ideally, of course, is the operative word here. The separation-distress circuit may be particularly difficult to fully activate, since it puts us directly in touch with our vulnerability—a vulnerability that may have caused us great pain in the past. Sadly, by keeping that system partially closed down, we cheat ourselves of the nurture we might otherwise enjoy. Some of us may not even realize how lonely and isolated we are.
Retraining the Brain
This was certainly the case with Jack. The youngest of four children of an overworked, single mom, he'd learned from babyhood that his cries were likely to be ignored. Gradually, he'd shut down his separation-distress system and detached from his need for human closeness. By the time he and Loretta had gotten together, he rarely even knew he needed comfort and was proud of his manly self-reliance.
The consequences were devastating. Unable to recognize his own need for nurture, Jack truly couldn't understand his wife's loneliness and need for his attention. "You know I love you," he would say impatiently. "Why can't you just believe that and pull yourself together?" Of course, Loretta didn't make it any easier by communicating her hurt with a barrage of furious insults.
The problem, in a word, was me. Loretta and Jack had learned how to access their intimacy circuits, but only within the protective umbrella of weekly therapy, where I'd endlessly soothed, coached, and prodded them back into connection. They didn't know yet how to stimulate these neural nurture systems on their own. If they were to keep their marriage alive, I'd need to teach them to rewire their emotional brains.
First, though, I needed to help them reactivate the nurture circuits that had briefly lit up their marriage a year ago. "Jack, what's going on?" I asked after Loretta had wrapped up her summary of their troubles. "You seem sort of sad." He straightened up immediately. "No," he demurred, "I think Loretta's probably right. We're just too different to make a go of it." As I allowed these words to hang in the air for a moment, I noticed that his eyes looked unnaturally bright, a key sign that his separation-distress circuit was firing. "Jack," I asked softly, "how are you feeling right now?" His eyes filled and he remained silent for perhaps 20 seconds. Then, his voice wavering, he said: "I don't know what I'm going to do without her."
At this, Loretta spontaneously reached over and touched his hand. "I don't want to hurt you, Jack," she said gently. I imagine that her oxytocin had begun to flow, but she couldn't yet sustain it. "I'm not sure I can go on like this," she continued, her voice rising in irritation. "When you hang out with your damn computer every night of the week."
I stopped her short. "He needs you now, Loretta," I encouraged her. Following my lead, Jack added: "I know I didn't let you in, Loretta and I'm sorry." Loretta snapped: "Yeah, that and three bucks will get you a cup of coffee at Starbucks." Jack looked hopeless. "You're right, Loretta," I said. "Nothing will change until Jack learns how to let you in. And I can show him, if he wants." Jack bit his lip, then nodded. I pulled out my appointment book and scheduled a meeting with him.
Alone with Jack, I began with a bit of teaching, describing in simple terms how his brain is already set up for intimacy. I let him know that he could learn skills that would allow him to more readily get in touch with connection-promoting feelings such as sadness and disappointment. At this, Jack grinned and shook his head. "I can't believe I'm sitting here about to learn how to feel depressed. This is a good thing?" We shared a good laugh, and then I clarified. "A little bit of sadness is a good thing," I said. "It's not something to be afraid of." The first step would simply be getting into the habit of noticing everyday disappointments and allowing himself to fully feel them.
After Jack had faithfully practiced these new awareness skills for several weeks, I encouraged him to begin acting on them. With Loretta's permission, he began to call her whenever he felt lonely, sad, or disappointed. Then, during a joint session, he recounted an incident at work in which he'd inadvertently offended a client and lost an important account. In the middle of the story, he fell silent for a moment, and then told Loretta that he felt a kind of queasy, hollow sensation in his stomach. "I'm sorry, honey," responded Loretta quietly. "I can imagine how that feels."
Her care system activated by her husband's sadness, Loretta impulsively scooted toward Jack on the couch and put her arm around him. Instantly, his whole body tightened--an instinctive attempt to short-circuit his vulnerability, I guessed. I asked him to pay attention to the tension in his body, then to simply notice the softness of Loretta's hand on his neck. Closing his eyes, Jack visibly relaxed, resting his hand on Loretta's knee. After about 30 seconds, I asked him to check again how he was feeling. "Warm and calm," he reported, surprise edging his voice. Chuckling softly, he added: "I must be high on those opioids you were talking about!"
It was a pivotal moment. Before, Jack hadn't even noticed that he usually resisted the comfort Loretta offered. Afterward, he consciously began to allow himself to be soothed by Loretta's gentle support, and a few sessions later, he reported that he often missed his wife during his long workdays and looked forward to being with her in the evenings. Before long, he spontaneously began to ask Loretta about her own emotional ups and downs.
A year later, when I saw Loretta and Jack for a follow-up assessment, they scored high on most measures of marital satisfaction. But that wasn't what pleased me most. It was several months after that, when they sent me a holiday card that featured a photo of them, both grinning broadly as Loretta held up their new baby daughter. The note on the card, in Jack's handwriting, inquired: "Brent, how do you get to Carnegie Hall? Turn the card over!"
I already knew the answer, but I flipped over the card anyway and smiled at the single, scrawled word.
This blog is excerpted from by "Brain to Brain," by Brent Atkinson. The full version is available in the September/October 2002 issue, Brain Therapy: The Neuroscience Discoveries That Can Change Your Practice.
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