Clinical Intuition in Psychotherapy: The Neurobiology of Embodied Response

Clinical Intuition in Psychotherapy: The Neurobiology of Embodied Response Terry Marks-Tarlow New York and London: W.W. Norton & Company, 2012. Contents, illustrations, diagrams, references, index. 278 pp. $35.00 cloth. ISBN: 9780393707038One in the Norton Series on Interpersonal Neurobiology, this book aims to "integrate the best of modern science with the heal- ing art of psychotherapy. "In the foreword to Clinical Intuition in Psychotherapy, Allan Schore hails "this groundbreaking book" as a contribution to the "paradigm shift that is occurring in psychotherapy" (p. xi), describing the wider context as an "interdisciplinary trend towards the integration of psychological and biological realms. " The paradigm shift, Schore suggests, has generated a deeper understanding of "the psychodynamics and neurodynamics of the change process embedded within psychotherapy" (p. xii). Author Terry Marks-Tarlow high- lights the problem with clinical intu- ition-its potential to seem either "magic" or "mysticism. " She notes that for this rea- son clinical intuition in psychotherapy has lacked "scientific legitimacy," suffered neglect, and been "avoided as a legitimate topic of scientific interest" (p. 51). But Marks-Tarlow remains convinced there exists "a firm scientific grounding to all acts of intuition," and her conviction underpins this admirably scientific inves- tigation of the phenomenon.Readers familiar with Marks-Tarlow's impressive and original Psyche's Veil: Psy- chotherapy, Fractals, and Complexity know she is grounded in nonlinear science and understands its implications for the work- ings of the mind and brain and of psy- chotherapy. And nonlinear science proves fundamental to Marks-Tarlow's insights into clinical intuition. Here, too, it is a unifying strand of her work. But she also draws on a wide range of scientific theory and an in-depth knowledge of research in psychology, psychoanalysis, attachment theory, neuroscience, biology, ethnology, and related areas of study.The introduction establishes the three premises about clinical intuition Marks- Tarlow interweaves through the book: clinical intuition "fills the gap between theory and practice"; it involves the "per- ception of relational patterns, both in self and other"; and it is "a necessary ingredi- ent for deep change during psychother- apy" (p. 3). The opening chapter, "Flashes, Hunches, and Gut Feelings," lays out the scientific and theoretical foundations of the author's understanding of intuition more generally and its relevance in psychotherapy. Marks-Tarlow discusses the differences between left hemisphere and right hemisphere; between top down, cortical, explicit, conscious, deliberating modes of processing experience and bottom up, subcortical, implicit, unconscious, embodied modes of processing experience. Intuition, she argues, is part of the implicit realm. She describes how, in psychotherapy, there exists "a never-ending kaleidoscope of ever-shifting self-states in patient and therapist," and she conceptualizes clinical intuition as that which enables moment-to-moment processing of these "continually changing contours of perception, motivation, and emotion" (p. 19). Chapter 2 gives a comprehensive scientific, psychoneurobiological account of "implicit processes" and the "origins of clinical intuition within the implicit realm" (p. 33). Marks-Tarlow identifies a number of key properties of intuition: It is nonverbal (or preverbal); It is "emergent" in the complexity theory sense, i.e. nonlinear, emerging out of dynamics and patterns of interaction that unfold over time and are not predetermined or explicable by fixed laws and chains of cause and effect; And it is holistic, in contrast to left hemisphere top-down reductionist thinking.Subsequent cha pters include "Empathic Roots," "Play," "Survival of the Wittiest," "Lighting the Way," "Navigating the Seas," and "In Pursuit of Wisdom. " These chapters elaborate the interconnectedness of intuition with human empathy, play in psychotherapy, humor, imagination, embodied and conceptual self-awareness, and, finally, wisdom. …