This Is Your Brain On Therapy.
Carolyn Spring in her fantastic account of recovery from Dissociative Identity Disorder, trauma and shame, describes therapy as “renting someone else’s nervous system” for an hour in order to calm the jagged body and mind.
The book, “Unshame” is a detailed and compelling description of what it’s like to sit in a room and be co-regulated (calmed down) and healed by the presence of someone else being with, noticing, listening, witnessing and reflecting what you’ve experienced in the past and what you’re experiencing now.
As a Cognitive Behavioural Therapist I was fascinated with the detailed and subtle ways the body showed up in the text, because CBT traditionally has not been great at considering this. The writer describes the way the therapist leans in to listen, or the way the therapist smiles, nods their head, holds the gaze of the eyes or “simply” radiates safety:
“It’s some silent communication between her nervous system and mine. It feels primitive. It is wordless. We sit.” (p.169)
These are somatic gestures that are almost beyond language and certainly feel poetic or mystical. With my hard nosed evidence-based perspective though, it got me to wondering exactly what’s going on between bodies and brains, when you sit in a room and tell someone else what happened to you.
Neuroscience as an Emerging Influence on Therapy.
Counsellor, writer and academic Bob Shehib argues that neuroscience (an emerging field of study focusing on the nervous system, and the way networks in the brain operate, along with how the brain can reshape and heal itself due to its neuroplasticity) is one of six forces that influence the practice of therapy. Those other forces are :
Psychoanalysis (for depth and insight),
Behaviourism (how and why we act the way we do - the “B” in CBT),
Humanism (the importance of the “necessary conditions” that make a good therapeutic relationship - empathy, unconditional positive regard and authenticity),
Multiculturalism (holding in mind the cultural context/s we exist in)
Social Justice (the awareness that problems arise in relation to external factors such as poverty, oppression and marginalisation, not individual deficits, despite what the medical model tries to tell us).
So, neuroscience is an important component of understanding ourselves and others.
The eminent trauma therapist Babette Rothschild has written extensively about the role of “mirror neurons” the biochemical information messengers in the brain which automatically and empathically connect our nervous system and brain to others.
This can sometimes be problematic though if our empathy response is activated in an unsafe way for example if (outside of therapy) someone shares trauma material with us without seeking our permission first. Rothschild recommends we make sure we know how to “apply the brakes” before venturing into our trauma material, so processing happens safely and slowly, minimising the risk of further trauma happening.
Neuroscientist Giacomo Rizzolatti first identified the presence of mirror neurons during research he and his team carried out in the 1990s. However, the exact function and mechanism of mirror neurons is contested.
What seems to be agreed though, is that our mirror neurons activate a form of echoing or copying as we interact with each other, and probably served an evolutionary purpose to help us identify who in our tribe was “safe” to be around and who wasn’t.
You may notice that sometimes your body posture is the same as the person you’re speaking to - this is one way the mirror neurons are embodied through action; we unconsciously copy the other person and this increases a sense of empathy, of the other person “getting” what we’re talking about.
Empathy then, has kept us alive.
How Therapy Repairs and Reshapes the Brain
New neurons can be generated in the brain through a process known as neurogenesis. Carolyn Spring refers to this as “rebuilding the substrates of the brain”. Therapy, along with exercise, diet, safe connection with others and mental stimulation will all aid the process of neurogenesis.
The famous phrase “neurons that fire together, (mostly) wire together” comes out of this line of neuropsychological research back in the late 1940s. We know now that some of the common tools used in CBT such as exposure therapy, imagery updating or behavioural experiments can help heal the amygdala and/or the hippocampus; the alarm and security systems of the brain which can knock out the regulating frontal cortex and cause havoc in our body, emotions and mind.
We can change the way the brain reacts by reshaping it, and this offers tremendous hope for those of us who have been afflicted by trauma, anxiety or depression.
We don’t have to live in the constant state of having a flipped lid, as Dr Dan Siegel, professor of clinical psychiatry and author of the neurobiological classic The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are, has put it. We can learn to calm and regulate ourselves. Carolyn Spring refers to this as the “activation of my green zone: the ventral vagal circuit of my social engagement system”. (P.2)
Your Brain On Therapy; the Drugs Do Work.
Biochemically, there’s a delicious cocktail of brain chemicals being mixed when we sit with someone who is empathically listening to us: dopamine is released when we’re heard and seen, which generates feelings of well-being.
Oxytocin (the hug drug as it’s sometimes called) is released when we feel that the therapist is right there with us, really present, holding us in mind, and has demonstrated their reliability and consistency by showing up over and over again in the same place at the same time with you.
Oxytocin helps us to attach to people/places/non-human animals that are important to us. This builds new neural connections in the brain, ones that enhance self-compassion and beef up the soothing system of the brain so that the threat and drive motivational systems are regulated. (Gilbert, 2022)
Mindfulness also helps us with the “working memory” which can get clogged up with difficult memories and slow down our thinking processes. Mindfulness helps clear the working memory and open up some space and take the pressure off. It also builds up areas of the brain that aid planning and emotional regulation. (Barnhofer et al 2019)
However, a not so delicious cocktail can be served up when we’re sitting with someone who doesn’t seem empathetic or who may be confrontational or threatening: cortisol, the main human stress hormone is released, along with adrenaline, norepinephrine and vasopressin, all of which create that on edge, spun out, stomach flipping experience of shakiness and the urge to run away, duke it out or simply collapse to the ground. If we stay in this “red zone” for too long it can have dire consequences for our physical and psychological health.
This is also why it’s important to find a therapist you like and feel safe with.
But wait! There’s more!
Your Body on Therapy; You Better Werk.
Polyvagal Theory, Sensorimotor therapy and other modalities also integrate ways of staying in the green safety zone (or the Window of Tolerance) with the lived experience of being in the body too. If we can find ways of becoming safely embodied as trauma researcher and therapist Deirdre Fay puts it, we can then create reparative feedback loops to the brain and nervous system which reduces the stress response and improves our sense of agency and control.
In CBT we will often explore ways of enhancing a sense of safety in the body and safety in the world. Tools such as cognitive restructuring, imagery practices, reframing or attention awareness exercises can help us “to understand the connections between thoughts, emotions, and behaviour, and … use such methods …. to modulate overly emotional or impulsive reactions, either of anxiety or of anger, associated with amygdala functions. Such overreactions are often thought to involve impaired connections between areas in the prefrontal cortex and the amygdala.” (Lavine, 2020)
CBT can also incorporate body based practices too, drawn from EMDR, Mindfulness, Compassion Focused Therapy and ACT. The body is there in CBT it’s just that not many CBT therapists pay attention to it. Here at Rhizome Towers thanks to our (ongoing) training in Somatic Trauma Therapy, we definitely bring the body and the mind, the body and the brain, the body and the nervous system, the body and the systems we live in, fully into the room and fully into therapy if that’s what the client needs.
Right on the cutting edge of all this are people like Dr Nick Walker (self-described queer, transgender, flamingly autistic author and educator), who along with many other activist-academics in Psychology and the Humanities are exploring neurofluidity and neuroqueerness by challenging neuronormativity and envisaging a postnormal future where:
“it would be commonplace for people to regard their own minds and embodiments as fluid and customizable, as canvases for ongoing creative experimentation, in much the same way that more and more people are doing with their genders.”
Phew!
Who knew there was so much going on while you’re talking to someone else about what ails you?
If you are interested in exploring ways to improve your wellbeing by investigating the brain, body and nervous system using the power of language, embodiment and evidence-based psychological therapy, feel free to get in touch with us at Rhizome Practice and book a session.
