The Psychotherapist’s Essential Guide to the Brain is a 147 page full-colour illustrated guide for psychotherapists describing the most relevant brain science for today’s mental health professionals. Taken from the best of the series published in The Neuropsychotherapist, and completely revised, this book represents an easy to read guide for anyone working in the mental health arena.
This book presents a thorough and clear introduction to the neuroscience that’s essential to today’s psychotherapist. Matt Dahlitz has done so much with The Neuropsychotherapist journal and this book takes a next step. It is an excellent resource. It truly is exactly what it says on the cover and provides engaging discussion on the pathology of oft-encountered disorders and their brain basis together with insights into how awareness of the neuroscience underpinning effective therapy can guide a therapist.
– Amazon UK Reviewer
Table of Contents
Introduction: An overview of major brain divisions, the complexity of
networks and functions of neurons.
Deep Systems: The function of the limbic system including the thalamus, amygdala, hippocampus and hypothalamus.
The Neocortex: Major divisions and functions of the neocortex. In particular the function of the prefrontal cortex in cognition and higher order processing.
Neurochemicals: An overview of the types and functions of neurotransmitters utilized by the brain including the neurochemistry of stress.
Epigenetics: How environmental factors influence gene expression both within and through heritable changes in DNA that can be transient or lifelong.
Motivation: How the striatum and the belief that we have some control over our environment motivates us.
Mirror Neurons: Mirror neurons respond to acts that are perceived to carry purpose or intention and form an important part of learning and being empathic.
Default Mode: The activity of the brain when it’s not doing anything in
particular and the very social nature of this state.
Obsessive-compulsive: The neural mechanisms behind obsessive-compulsive disorder including the neurochemistry and therapeutic interventions.
Fear & Anxiety: The neural underpinnings of fear anxiety, how it develops and is maintained and what to do about it.
Pain: The nature of pain from a neurobiological perspective and the close correlation between physical and social/emotional pain.
Depression: The nature of depression, the brain regions and
neurochemcials involved in this complex disorder.
Brain-Body: The brain-gut and brain-heart connection that modulates our mental life in surprising ways.
Memory: How memory works, both implicit and explicit memories and from short-term to long-term, as well as the reliability of recall.
Psychological Needs: Consideration of basic psychological needs from a brain based perspective to tie together neuropsychological knowledge with clinical practice.
I expected a low-quality book with the same old scans that I’ve seen in nearly every book on the brain. I was pleasantly surprised at the quality of the book. I’ve only read a few dozen pages but so far I’m pleased with the writing and colorful illustrations. I really appreciate the blend of neuroscience and psychotherapy. I hope this is just one of many as there isn’t this type of information readily available.
– Amazon.com Reviewer
In February 2016, The Neuropsychotherapist, a magazine devoted to informing mental health professionals about the neuroscience of psychotherapy, introduced a regular column on the brain for the practising clinician. The column proved popular because it interpreted relevant facts from a large body of technical knowledge in language accessible to the non-scientist. In view of the positive readership response, it was decided to compile all instalments of The Psychotherapist’s Essential Guide to the Brain together with new material into a stand-alone volume that might become a handy addition to the psychotherapist’s bookshelf.
Why learn about the brain? Surely a therapist has a range of therapies and techniques at his or her disposal that can be effectively implemented without a degree in neurobiology. Certainly some would argue that the application of techniques and the experiential learning of what works and what doesn’t is the path to take. But is this the best approach, in light of the knowledge that is now available to us? Does a medical doctor familiarize him or herself with only the symptoms and not the cause and mechanisms of an illness?
There is, I believe, much to be gained by understanding at least the fundamentals of brain function that play a critical role in our mental well-being. Freud, some will be surprised to learn, began his career as a neurobiologist, studying the nerves of crayfish with a view to forming an objective science of mental states based on neuroscientific research. Later he altered direction into psychoanalysis—research was not paying the bills, and the neuroscience of the day avoided the difficult subject of subjective experience and focused on the “nuts and bolts” of brain function. Now, with a greater understanding of both the subjective experience of the mind and the objective activities of the brain, the two disciplines of psychoanalysis and neuroscience can not only inform one another but integrate to provide a more mature and holistic understanding of mental well-being. The International Neuropsychoanalysis Society and our own efforts at The Neuropsychotherapist are just two examples of this attempt to integrate the best of both subjective and objective knowledge in mental health.
Consider the case of anxiety. If a therapist understood that chronic cortisol release due to anxiety can damage negative feedback loops that would normally attenuate the stress response (because excessive amounts of glucocorticoids damage activated glutamate synapses and pyramidal cells in the hippocampus and destabilize previously formed neural connections and neural/mental function in the hippocampus—see p, 25), he or she would not only have greater empathy for the struggling client, who finds it so difficult to relax or suffers from flashbacks or nightmares, but would also know that cognitive techniques are likely to prove ineffective until the underlying mechanisms are dealt with. The neurobiologically informed therapist would know that a “bottom up” approach, involving techniques that may be more physiological than psychological, is imperative to down-regulate a runaway stress response before cognitive approaches can have the desired effect.
Neuroscience can be a complicated subject, with its own academic terminology, often out of the grasp of the working therapist whose professional time is divided between clients, paperwork, and continuing education in his or her own niche of practice. There is often little time or desire to attempt to decipher the latest research from the Journal of Neuroscience—as I write this preface I note that the latest article in this journal is entitled “Densin-180 Controls the Trafficking and Signalling of L-Type Voltage-Gated Cav1.2 Ca2+ Channels at Excitatory Synapses”, a subject that probably wouldn’t get many psychotherapists motivated to give up a weekend to ponder how the discoveries of mice lacking densin could help their Monday-morning client with depression. This is where The Neuropsychotherapist, and this book, can help form a bridge between the world of neuroscience and the practical needs of the psychotherapist.
As an example, and not to dismiss the abovementioned article out of hand, there would be little point in my attempting to excite a counsellor about voltage-gated Cav1.2 channels playing a vital role in plasticity—that subject is too fine-grained, too full of mysterious jargon, and for the most part just plain tedious. But if I were to inform you there is a protein that helps signalling in the brain and contributes to the regulation of cognition and mood, and that it is part of a bigger puzzle of the molecular mechanism for a number of psychopathologies, then you may be more interested. What if there are ways to protect or enhance this protein and its pathway that are easy for anyone to grasp? The fine-grained science may sound like foreign gibberish, but the practical application of such knowledge may be just what your client needs.
Because our brain is an organ, like any other organ in our body, it is dependent on blood flow, oxygenation, nutrients, and signalling from other parts of the body. So the brain should be studied in context—the context of the whole body—just as the study of the mind entails the context of others and the environment. For this reason we also consider the influences of diet, gut microbes, the activity of the heart, inflammation, physical pain, gene expression, and other modulators of central-nervous-system activity. Most psychotherapists are aware of the importance of social systems and their impact on mental well-being; on a physiological level, the brain also functions in a systems context.
Does this mean the psychotherapist needs to be an expert in every area of neurobiology in order to understand clients effectively? No, but in addition to enhancing your own perspective and practise, awareness of what may be influencing the mental health of a client beyond the psychodynamic will help you identify needs that can be best met by the input of other specialists. There may be pathology that has resulted from a head injury, so that a neuropsychologist or neurologist is required. There may be a problem with a deficiency or overabundance of vitamins, minerals, or other chemicals in the client’s system that requires the attention of a naturopath or medical doctor. Having an idea of what is going on “under the hood” will give you an edge in identifying problem areas that are beyond your area of expertise and greatly improving outcomes for your client by pointing them in the right direction.
As an illustration, I remember learning about the different ways inflammation can cause depression: as the immune system activates an inflammatory response, it can deplete the body of the serotonin precursor tryptophan. Inflammation can also influence noradrenergic activity, stimulating the hypothalamic–pituitary–adrenal (HPA) axis. One client who approached me for help was depressed and also suffering from a number of severe allergies. Knowing that the inflammatory response to the allergens was likely disrupting her serotonin production and activating her stress response through the HPA axis, I referred her to a naturopath for testing and treatment. When she returned about a month later, her symptoms of inflammation were significantly reduced—along with her symptoms of depression. This reprieve gave us the opportunity to work on deep-seated emotional issues, unhampered by a brain in a state of emergency due to allergy-induced inflammation. The client had not made the connection between her allergies and depression, but the inflammatory response was clearly a major factor. She still had psychotherapy work to do, but my knowledge of her neurobiology gave me enough insight to direct her to the right help. Having her inflammation under control gave her the energy and motivation to continue with effective psychotherapy.
It is my hope that this book will open your mind and encourage you to take a more holistic perspective than ever before. As therapists we are privileged to live in a time when breakthroughs in the neurobiological sciences are both confirming and informing vital aspects of psychotherapeutic practice, breaking down traditional barriers and stimulating multidisciplinary approaches that will ultimately revolutionize how we think about mental health. For the sake of those we seek to help, may this book form one step along the way to acquiring the best tools and knowledge available in the quest for real change and lasting well-being.