Discoveries from the Black Box: How the Neuro-Science Revolution Can Change Your Practice

Article excerpt

The human brain is a wet, coconut-sized, walnut-shaped organ, the color of raw liver and the consistency of an overripe peach. Comprised of billions of nerve cells, each connecting electrochemically with an average of 10 thousand others, it's the most complex biological entity known on earth. The number of possible interconnections among its neurons exceeds the estimated number of atoms in the universe. Just as remarkably, it can make such intricate and baffling self-transformations that many insist it will never be fully understood by its own kind. Because how it works is such a dumbfounding investigative riddle--the equivalent of studying a mirror with a mirror--therapists have preferred until recently to approach its actual functioning through the metaphor of the black box, rather than peel back the skin of the peach to discover what goes on inside.

Over the last couple of decades, however, technology has allowed us to open the black box, leading to what some have touted as the biological sequel to the Copernican revolution. Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and CAT scans can now photograph the brain at work and play and even after therapy. With electron microscopes, the nuclear tagging of living human molecules, and other biochemical investigative techniques, scientists can now see what happens in different parts of the brain when an alcoholic looks at a martini, or a schizophrenic has a hallucination, or a meditator experiences spiritual transcendence. Scientists have decoded the way memory and learning actully occur in the synaptic connections of a tiny sea slug--theoretically no different from what occurs in our own brains. Researchers have also identified individual "mirror neurons in monkeys," single neurons that fire both when a monkey performs a meaningful act--such as eating a peanut--and also when a monkey sees another monkey perform an act. Scientists think that this capacity for neural mirroring helps us interpret other people's actions and feelings, and may be the neurophysiological basis for empathy.

Increasingly, therapists are trying to make sense of the cavalcade of discoveries like these, regularly trumpeted in the research literature and the popular press. What will the rapidly expanding understanding of the brain mean for our traditionally low-tech profession? Already practitioners are applying unconventional therapeutic techniques, like Eye Movement Densensitization and Reprocessing (EMDR), Vagus Nerve Stimulation (VNS), and Thought Field Therapy (TFT), whose methods presumably rely on neurobiological healing processes not activated by mere words. Some believe that such approaches are just a preview of what's to come, as we continue to deepen and expand our understanding of how the brain works. They speculate that psychotherapy's most fundamental practices may increasingly be challenged by neuroscientific advances.

An exuberant, if somewhat tongue-in-cheek vision of the high-tech therapy of the future has been provided by prominent NIMH researcher Norman E. Rosenthal, in his recent book The Emotional Revolution. He imagines a not-so-distant clinical encounter of the future: "After relating your problems to your psychiatrist, she or he will ask you to put your head in a scanner. Watching while you talk, you will see how your amygdala guns into action when you discuss your obnoxious boss. Your right prefrontal lobe will glow with rage and despair, while the corresponding part on the left wilts, pale and lusterless." During the next few sessions, the therapist might "stimulate you electrically at various trigger points, . . . flash lights, massage you or help you reprogram your responses with a series of musical tones. On rescanning your brain, you and your doctor will be happy to see that the amygdala has settled down and your left prefrontal lobe has come into its own, reassuring you that everything is manageable and life is not so bad after all. …