It’s no secret that therapists have become enamored with brain science over the past 15 years. In fact, we’re so “brain-crazed” it seems you can’t go to a clinical workshop these days without having the presenter regularly use terms like amygdala, hippocampus, or neuroplasticity, once thought to be arcane. Many therapists even think that explaining clients’ brains to them is an essential feature of therapy, as if a basic understanding of brain science is enough to promote real change in their everyday lives. Ironically, this approach is contrary to the one clinical insight from brain research that’s most important to effective therapy: human behavior and motivation are driven mostly by the emotional brain—the brain centers that mediate “primitive” emotions and instincts and respond to sensory-rich experiences, not intellectual insights.
How many times have you surprised yourself by jumping at the scary part of a movie or shouting something hurtful at someone you love when you feel angry? You know the villain in the movie isn’t real and the insult to your loved one will only make things worse, but your emotional brain ignores this logic and leaps into action. In essence, the emotional brain is our unconscious mind, and scientists estimate that it controls about 95 percent of what we do, think, and feel at any given moment.
No matter how brilliantly our prefrontal cortex delivers insights and plans elegant coping strategies, the emotional brain is primed to override it all with neural patterns that persist until we intervene with something our emotional brain can understand---a compelling felt experience.
If people could simply think their way out of emotional problems, wouldn’t they do it? Instead, by the time they come to us, many intelligent clients have already spent hundreds of hours and thousands of dollars attending therapy sessions, taking medications, or pursuing other traditional routes for healing. They’re experts on their problems, yet they still get hijacked by their emotions. Should we decide that they subconsciously want to remain trapped and write them off as “resistant”? Or should we recognize that the treatment they’ve received hasn’t addressed the emotional brain, where most maladaptive patterns are stuck?
Take my client Saundra, for example. She was an attractive, talented surgeon with a Mensa-level IQ who’d graduated from an Ivy League school at the top of her class. She’d struggled most of her life with waves of severe depression and anxiety, but recently, her mood swings had become stormier and more frequent, affecting her personal life and threatening to wreck her career. She was consumed with the obsessive worry that working long hours prevented her from being an adequate mother; yet when she asked for time off to be with her children, she felt guilty for not working. Her intense feelings of anxiety and resentment resulted in angry outbursts toward her coworkers and daily arguments with her husband. Even worse, she couldn’t enjoy time with her children without bursting into guilt-ridden crying jags.
In our first session, she told me, “Intellectually, I understand what causes my depression and anxiety. Trust me. I’ve had years of therapy and tried dozens of medications. I realize my thoughts are irrational, and know I’ve developed these patterns because my family of origin was critical, abusive, and chaotic. But I’m 40 years old! When am I going to get over it?”
As we talked, I began to search for subjects that elicited a smile on her face, passion in her voice, or movement in her body, all of which I saw and heard when she talked about walking outside in nature, painting with acrylics, and watching her children play.
Assuming she was good at visualizing things, since she enjoyed painting, I asked her to recall something in nature, a place perhaps, that she’d experienced as “beyond beautiful.” When describing a sunrise she’d once witnessed by a lake in a wooded area near her home, she released a deep sigh, closed her eyes, and leaned back into the curve of the couch. Her jaw relaxed and her clenched fingers unfolded as she rested her hands on her lap. She took another deep breath and whispered, “I could linger there for hours.”
Because she was beginning to relax and indicated an interest in going further, I narrated the scene back to her, adjusting the pitch and tone of my voice so that it was melodic, soothing, and uplifting. I elaborated on her description of the sunrise, suggesting she could enjoy noticing how the crimson edges melted into pleasant pinks and vibrant golden oranges that glowed against the backdrop of a tranquil azure sky and the cool, calm lake.
When I asked Saundra what she was noticing within herself, she sighed as she murmured, “Feelings of serenity, peace, and joy.”
The Power of Play
Many of us were motivated to become therapists because of our emotional experiences with trauma, suffering, and adversity. We understand these things deeply, and I’d venture that most of us chose this profession for emotional rather than intellectual reasons. We didn’t just want to be smarter: we wanted to help people heal and make the world a better place.
It isn’t enough to be a kind, supportive guide on clients’ journeys. We have to be a provocative guide, creating experiences that trigger their curiosity and desire to know more. The experiences we create have to go beyond the intellect to reach a deeply human place, prompting clients to believe they can relate to themselves and the world in a new way. Following this approach, good therapy can often look like performance art, rather than a rational discussion. But let’s face it: to get the emotional brain to pay attention to what we’re saying and to keep clients coming back to our offices, the therapy experience has to be at least twice as interesting as the problem.
Professional Development |
depression and anxiety