Therapy in L.A.

  article of the month
January 2004
By Joyce Parker, Ph.D.

Neurobiological research on how the brain develops and works has made great strides in the last two decades with the advent of brain scans that can map brain activity and show precisely what areas of the brain are active when individuals react to various types of stimulation. From this research, we now know that human development is the study of interpersonal neurobiology. This means that the brain develops in interaction with significant others in our environment. We are social beings and human development occurs socially in interaction with the brain, as it becomes „the mindš. The entity we call the mind can be defined as „patterns of energy and information∑ Energy and information can flow within one brain or between two brains.š The ways energy and information flow within an individual and between two individuals creates the experience of mind. The processes of the mind come from the structure and function of the brain. The brain is connected by the central nervous system to the whole body. Thus the mind is inseparable from the internal and interpersonal experiences we have.

The brain is open to influences from the environment throughout our lives. It can create new synaptic connections among neurons as well as grow new neurons. This is a very exciting finding. It means that brains can change throughout the lifespan if the proper environmental influences exist. The brain appears to have a genetic predisposition to create the neurological foundation of the developing mind. The patterns of interaction between a child and caregiver are the keys to healthy development. Collaborative interpersonal interaction between the child and the caretaker are significant. In other words, how the mother reads the baby‚s signals and responds to them is particularly important. During the first year of life, brain circuits that are responsible for emotional and social functioning develop. The orbitofrontal region of the brain, which involves emotional regulation, empathy and autobiographical memory, is influenced most profoundly by the nature of interpersonal communication in the early years. The attunement of the caregiver to the child determines how this region of the brain will develop.

For healthy development, collaborative, attuned communication helps the child to regulate both positive and negative emotional states. These interactions are what regulate the child‚s emotions and are required for healthy maturation of the emotional and social brain. The mother‚s ability to calm and soothe her baby is crucial. The parents‚ pleasure in the child and their predisposition to be involved with the child are very important. Also important is the parents‚ ability to know when the child has had enough stimulation and needs time to regroup. Development shapes the brain by altering the strength of synaptic connections within the brain. Psychotherapy is also a collaborative attuned form of communication that can alter synaptic connections within the brain.

Self-knowledge and narrative coherence reveal the capacity of the mind to achieve integration of functioning. Accurate self-knowledge is a result of attuned and responsive caregiving, which helps the child learn about, accept and regulate their internal states. Narrative coherence is the understanding of how the past influences feelings and ideas in the present. These qualities of mind allow the individual to have „an internal sense of connection with the past, to live fully in the present and to prepare for the futureš. Psychotherapy also helps the individual develop a coherent narrative of their lives and emotions.

There are five basic elements of a healthy attachment that is fostered by caregivers. These same elements are crucial to the success of the therapeutic relationship. These factors indicate that interpersonal communication is central to how the brain creates neural maps of the self and others. They determine the specific experiences of reality.

  1. Collaboration: Healthy relationships are based on the sharing of mental states both verbally and nonverbally. Eye contact, facial expression, tone of voice, bodily gestures and intensity of response are all examples of nonverbal signals that can be responded to in an attuned way. This sharing is felt as very satisfying. A sense of connection with the other person emerges. This form of communication offers a feeling of closeness that supports the development of social, emotional and cognitive functioning.
  2. Reflective Dialogue: This is the verbal sharing of internal experiences of each partner in a dyad. This sharing can involve states of mind such as „emotions, perceptions, thought, intentions, memories, ideas, beliefs and attitudesš. The feeling is created that subjective experience is important and can be shared. These experiences help to create a capacity for empathy, „the capacity of the mind to create the representation of the mind of others and the selfš.
  3. Repair: Not all communication can be attuned and adequately responsive. When it is not, a disruption occurs. The repair of this disruption is an important learning experience. It reassures the child that misunderstandings can be rectified. It helps the child develop a cohesive sense of self that does not disintegrate when stress occurs.
  4. Coherent Narratives: Connecting the past, the present and the future in some comprehensible and relevant way is one of the central processes of the mind. It helps create an understanding of how the past influences feelings, thought and behaviors in the present. It provides a flexible capacity to integrate experience across time.
  5. Emotional Communication: Sharing in the positive, joyful experiences of life create the foundation for a positive attitude toward self and others. Also important is being able to remain connected to the child during times of painful or difficult emotions. These negative emotional states can be shared as the adult helps the child reduce the distress. The caregivers‚ sensitivity to a child‚s changing needs for connection and solitude is also significant. These forms of communication may be the core of how the interpersonal relationship helps to shape the emotional and social development of the child‚s growing mind.
Emotion is central to the regulation of energy and information flow in the brain. Emotion plays a central role in creating and regulating mental life. Therefore our emotional side is as important as our rational side in representing reality accurately. The sharing and amplification of positive emotional states and the sharing and reduction of negative emotional states are the heart of emotional interactions with the child. They help the child feel connected to the world. In psychotherapy, they help the patient feel connected to the therapist and the process of psychotherapy. In the child and the patient, this leads to healthier and more flexible capacities for emotional regulation.

Interpersonal communication is central to how the brain creates neural maps of the self and others. These maps determine how the individual experiences reality. Psychotherapy is a form of interpersonal communication that promotes neural integration, helps repair self-regulatory problems and improves narrative coherence and self-knowledge. Psychotherapy at its most effective enhances the mind‚s innate tendency to move toward integration. The healthy brain moves toward greater complexity. Complexity is the flow between differentiation and integration. Psychotherapy helps to develop a healthy balance between differentiation and integration. It helps to reduce the fears about things that are uncertain and increase the capacity of the person to make sense of their states and the states of others in the world.

The brain is open to change in response to experience throughout life. Thus the experience of a relationship with an attuned therapist can provide a collaborative joining that respects the individual‚s subjective states within an emotionally engaged and positive relationship. This relationship can facilitate the development of flexible self-regulation and a more integrated perception of self and others in the world. It can change the neural connections in the brain so that the mind is altered in essential ways that promote a healthier perspective on self and others. In this way, psychotherapy can change the brain and the mind.

Siegel, Daniel J., Toward an Interpersonal Neurobiology of the Developing Mind: Attachment Relationships, „Mindsight‚š and Neural Integration, in Infant Mental Health Journal, Vol. 22(1-2), 67-94 (2001).

All quotes within article were taken from this publication.

Dr. Parker is a psychotherapist in practice in Torrance. She is the editor of the Therapy in L.A. web site and a member of the Independent Psychotherapy Network.

The author of this article, and founder of the website, Joyce Parker, passed away in 2011. To honor her we are keeping her articles posted at this website.

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