Reply To: Neurobiology helps direct therapy.

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A neuroscience/neurobiological perspective and an empirical therapeutic process have enabled me to be more effective with patients for a number of years. However those perspectives and those methods have been most effective when training other therapists.

For example: Susan contacted me recently for a consultation because she was struggling with a patient whose trauma ruminations and very high anxiety were taking over their treatment process. She brought a video-recording of the most recent session for us to review.

Together we looked at the video using a neurobiological perspective through a variety of lenses. We focused on all four levels of her patient’s nervous system:
1] peripheral nervous system, [Voice, breathing, posture, etc.]
2] primary level: brainstem emotional systems [such as Care, Seeking etc.]
3] secondly level: basal nuclei, amygdala, hippocampus and thalamus emotional systems, [such as Fear, Shame, Salience etc]
4] tertiary level: neocortex and conscious emotional systems [such as Authority, Autonomy, etc]
Using these neurobiological perspectives enabled Susan to more precisely discern empirical distinctions between her patient’s present moment emotional strengths, resources [safe, care, connection emotional systems] and her traumatic emotional habit patterns, constraints [fear, shame emotional systems] from the past.
Based on these observations, Susan was able to propose some novel treatment opportunities to connect with her patient’s emotional brainstem resources of Care, and Play [Panksepp] in order to energize the therapeutic process and reduce her patient’s anxiety. We talked about how facilitating the Care and Play emotional systems would also strengthen their therapeutic attachment relationship.
Together we proposed a number of hypotheses Susan could empirically test in her subsequent therapy sessions with this patient. Her goals were to focus on her patient’s underlying emotional resources. Susan later reported that their sessions were much more productive and they each felt less drained each time they met. The patient’s conscious and verbal obsessions about the trauma took up much less of her mental energy both in and outside of her sessions.