The Neuroscience Of Psychotherapy: Building and Rebuilding the Human Brain

It’s been a long time since I graduated from medical school and there has been an explosion of information about how the brain functions. I chose to review this book in an attempt to get up to date, and because I was curious about whether there were more things that I could do in my psychotherapy practice to improve the functioning of my patients in a lasting way. In some respects, I was disappointed, as I don’t think we are much wiser about the ways the brain functions when we conduct psychotherapy, or as Cozolino says “we are only at the dawn of understanding the brain” (p319). Yet, it appears that the field is at the brink of exciting findings and we now have specific technologies that can aid us in our work. The development of non-invasive ways of studying the function of the brain has made this increasingly possible. Dr. Cozolino’s fundamental premise was “that any form of psychotherapy is successful to the degree to which it enhances positive experiential change and underlying neural networks, growth and integration” (p315). All forms of psychotherapy are successful to the extent they enhance change in the relevant neural circuits. The brain is an organ of adaptation and built by experience during development and rebuilt during psychotherapy. The book was divided into five sections. Part one looked at the tangled history of psychotherapy and the theories of how the brain develops and works. Part two zoomed in more closely on how the brain actually works - from neurons to neural net works and the role of memory systems and the stories we tell ourselves. In part three, the organization of the healthy brain, was considered along with the construction of narratives dealing with the distortions in thinking that are much of the focus of psychotherapy. “Therapy is not just the rewriting of the client’s story; it is the teaching of a method, a process of integration - and a set of principles for future organization” (170). He made an elegant amalgamation of narrative psychotherapy with cognitive behavioural approaches. Part four looked more specifically at psychopathology and the role of the various parts of the brain and neurotransmitters. In particular, he focussed on the role of trauma as an example of how the past (memory) informed the present and the bridge between science and psychotherapy. The final section integrated what has been found and talked to the need of the psychotherapist to have an understanding of neuroscience, that the mind and the brain are one and the same, and that nature and nurture are two sides of the same coin with each informing the other. Language is the process by which the brain (memory) is accessed and through which the stories can be modified and new neuronal connections made. In spite of my rather naive disappointment that there was no specific magic or lasting spell to change the brain to cure man’s ills, I already had the answer. The way is to access the right brain (memory and emotions) through language (and psychopharmacology) and get into the open the distortion of thoughts and feelings and the meaning attributions so that they can be examined (left brain) and experiments done, to sort out what is valuable and true and should be retained, and what false or untrue and can be discarded. Then integration can take place. I found the book fascinating. It brought me more up to speed regarding the neurophysiology of the brain and gave me more confidence that what I was doing had a valid physiological base. For those curious about the place of neuroscience in psychotherapy or for those who just want to get more up-to-date, I would highly recommend this book.