Saturday, April 10, 2010

GoodTherapy - Interpersonal Neurobiology – The Basics

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This is one of my favorite topics - and it's the future of psychotherapy in many ways. Christopher Diggins offers a nice introduction to the basic ideas.

Interpersonal Neurobiology – The Basics

April 7th, 2010

By Christopher Diggins, MA, LMHC, Interpersonal Neurobiology Topic Expert Contributor

Click here to contact Christopher and/or see his GoodTherapy.org Profile

It has only been in the past 10+ years that researchers have discovered “experience” changes the way neurons fire in our bodies. Just in the past few months, it has been revealed that the genes of infants are altered by trauma. This leads to the possibility that if trauma experience can change our neurons and genes, then why not “positive” experiences can restore our bodies to emotional and physical health. I know as an Interpersonal Neurobiology (IPNB) therapist that my clients, as a result of new emotional experiences, often make substantial changes in their feelings, moods, and behaviors.

Implicit Memory – Current situations trigger past emotional memories. ” When I sit in this big comfortable chair, it reminds me of when I was a kid and I would sit in my grandfather’s lap and feel safe and warm”. Or ” I get so angry when my wife and I fight it reminds me of when I would go to my room and hear my parents yelling at each other.”

Mirror Neurons – nerve cells activate in sympathy and in the same brain location as nerve cells of the person whose actions we are watching. These neurons help us to sense what others intend and help us connect with what the other feels…We resonate with their state.

Emotional Resonance – when two people experience deep feelings and can sense what the other feels. A mutual caring that is exchanged through words, expressions, or tones. One can feel what another is feeling.

What a IPNB therapist does:

1. Initiates and creates emotional safety along with the client.
2. Demonstrates vulnerability through transparency and self revealing.
3. Assists client in moving from “talking about” situations to being in emotional exchange with therapist in the “hear and now”.

Emotional Safety

“People disconnect from their emotional experience, afraid of being overwhelmed, humiliated, or revealed as inadequate by the force of feelings, only to pay the price later in depression, isolation, and anxiety. If affect-laden experiences can be made less frightening in the therapeutic environment–that is, if patients can be helped to feel safe enough to feel–then they can reap profound benefits, for within core affective states are powerful adaptive forces and processes with tremendous therapeutic potential” (Diana Fosha, The Transforming Power of Affect, p 13).

The basis of neurosis is this emotional disconnect where the child has to set herself apart from painful experience as a defensive measure. She cannot handle the pain on her own and so must defend against it. This measure sets up a life of emptiness and loneliness, and we all have this to various degrees. Therapists grow up in families with this emotional deprivation and are not immune to the painful consequences. We have a responsibility to ourselves and our clients to heal this internal deficiency. As a result of our familiy origins our neurons in brains and bodies are “wired” in a way where we also maintain this defensive posture, defending against painful implicit memories just as our clients do.

When we treat clients in our familiar ways of not recognizing and living in this emotional world it re-traumatizes them. I had a client years ago who reported to me that his former therapist had angrily directed him to leave the session if he did not stop being angry with her. He was angry because she was blaming him for his father’s shaming behavior saying, “What did you do to contribute to your father treating you that way”? This therapist treatment

We learn at an early age to cut ourselves off from this internal awareness. We do this in order to protect ourselves from experiencing both threats from external sources and pain from internal experiences. Because most children are treated in a way where their emotions are either discounted, ignored, humiliated, or even punished, the child learns very quickly that emotions are off-limits externally, and as a result emotions are off-limits internally. So in order to protect oneself from external threats and being overwhelmed from internal sources, the child constructs defenses. This is done strictly for protection.

The purpose of therapy is to create the emotional safety where the defenses are unnecessary and the client feels safe enough to reveal to the therapist and to herself the core feelings, the deep emotions that have been locked away probably since early childhood. Creating this safety can begin as early as the initial phone contact with the client. The therapist can accomplish this in the beginning by communicating caring, empathy, and respect. This is done by listening to the clients’ story, respectfully setting boundaries, and by acknowledging emotions as well as communicating confidence in the ability to help the client with the painful emotions. So even before the first meeting, the therapist has the ability or the possibility to benefit the client, to establish some trust, and to develop some minimal and yet beneficial connection. When this is accomplished in a substantial way, it sets the stage in the initial meeting to make great progress.

Fosha, internet trauma article: “In AEDP, the goal is to lead with (Fosha, 2000b) a corrective emotional experience (Alexander & French, 1946). The therapist seeks to create a safe and affect-friendly environment from the get-go, and to activate a patient-therapist relationship in which it is clear that the patient is deeply valued and will not be alone with emotional experiences. If this is accomplished, the patient will feel sufficiently safe to take the risks involved in doing deep and intensive emotional work (Fosha & Slowiaczek, 1997). We want to be able to explore self-at-worst functioning from within a self-at-best structuring of emotional experience activated by the here-and-now patient therapist relationship (see the case in Part 2, for an illustration of this principle at work)”.

With more and more safety, intimacy, and enjoyable and pleasant interactions a person learns to change expectations of interactions, even conflictual ones, from dread, failure, disappointment to closeness, confidence of good outcome, relaxation, and enjoyment.

©Copyright 2010 by Christopher Diggins, MA, LMHC. All Rights Reserved. Permission to publish granted to GoodTherapy.org. This article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about this article can be directed to the author or posted as a comment to this blog entry. Click here to contact Christopher and/or see his GoodTherapy.org Profile
Here is some more information:

Interpersonal Neurobiology


Interpersonal Neurobiology was Developed by: Dan Siegel, Allan Schore

Overview of Interpersonal Neurobiology: "Interpersonal Neurobiology, a term coined by Dr. Dan Siegel, studies the way the brain grows and is influenced by personal relationships. Recent studies have discovered that brain growth occurs throughout the lifespan. IPNB explores the potential for healing trauma by using positive and secure influences on the brain. Conditions once thought to be permanent now have the bright potential for healing and growth. IPNB has broad applications that are useful for parenting, mental health, addictions, education, health care, business professionals, and more." ~ Excerpt from Vanguard in Action

"Interpersonal Neurobiology, developed by Dr. Daniel Siegel, studies what occurs in the brain as a result of significant life experiences and how the therapeutic relationship can be used to actually change the brain and neurological system. It was once believed that neurological development ceased by late adolescence, but Dr Sigiel's research has determined that neurogenesis and neuroplasticity--the creation of new neurons and new neuronal connections--continue throughout our life spans. MRI's and PET scans, scientific devices that allow us to peer into the workings of the body and brain, verify that meditation, mindfulness, and emotional attachment significantly influence the body where new neuronal pathways are created. Experience alters the brain, even as we age. Whenever we learn something new, including new attitudes, perspectives, or behaviors, we are changing the physical structure of the brain." ~ Excerpt from Familyprocess.org

Resources Related to Interpersonal Neurobiology:

Global Association for Interpersonal Neurobiology Studies

The Developing Mind - Dr. Dan Siegel

Research Channel - Toward an Interpersonal Neurobiology of the Developing Mind; a video presentation by Dr. Siegel


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