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.