Articles

SCT From the Inside Out – the Brain of an SCT Therapist
an Interpersonal Neurobiology approach

Michael Robbins M.A., L.M.H.C.
Outline – presentation at the 2007 SCT Conference.

Major Take Home Messages:

An Integrated Brain, a Coherent Mind, and Empathic Relationships are equivalent to each other. By creating this state inside of ourselves, we isomorphically create an environment inside of which our clients can heal and integrate. A therapists most powerful tool to influence clients in the direction of mental health/ neural integration is the attunement of his/her presence.
Experience Shapes the Genetic Possibilities of the brain. Nature Needs Nurture. “Mind” is the flow of energy and information that happens at the interface of the genetic possibilities of our neurobiology and the environment.
The Brain and Mind develop through a process of differentiation and integration.

Neural Integration Defined

Neural Integration is the free flow of energy and information between the differentiated structures, and the associated functions of the brain and nervous system. By understanding the differentiated functions of brain structures we understand how an integrated brain, a coherent mind, and empathic relationships are equivalent.

Nature needs Nurture. Our genetic possibilities are constantly being sculpted by our interpersonal interactions, particularly our early attachment experiences. Neuroplasticity persists throughout our life times. Every significant, emotionally meaningful, attachment experience throughout a life time influences the development of new neural pathways and the structure of the brain. The work of Eric Kandell proved this. (He won a Nobel prize in 2001 for showing that experience activates genes which activate the growth of new neurons.) Hebbs Axiom “Neurons that fire together, wire together.”

Basic hypothesis regarding therapy (not proven, but makes sense from everything that we do know about brains and neuroplasticity.)

From a neurobiological perspective, therapy harnesses the reparative power of our interpersonal connections to create a higher level of neural integration and repair some of the damage done by early insecure attachment experiences.

Simplified Brain Anatomy: Demonstration: The brain in the palm of your hand

The Tripartite Brain

The brain stem. The most primitive, and oldest part of the brain. Controls and regulates the temperature of the body. the heart rate, basic reflexes such as breathing and coughing, grasping and sucking mechanisms (infants), basic survival mechanisms.
The limbic system. Involved with our basic emotional responses, attachment, memory, motivational, learning systems. The part of the brain that functions at “the intersection of the internal and external world where the primitive needs of the organism (brain stem) negotiate with the requirements of the outside world.” (Cozzolino)
The Cerebral Cortex – composed of left and right hemispheres as well as the corpus callosum, which connects the two hemispheres.
a. The right hemisphere. Develops earlier then the left hemisphere. It is holistic in its perceptions of the world, responsible for facial recognition, the appraisal of affect, the immediate sense of safety or danger, contains an internal map of the body, it is though the left hemisphere, in conjunction with the amygdala that we grasp the emotional, nonverbal part of communication. Involved with the processes of Implicit memory.

b. Left hemisphere. Linear, logical, language centers are here, as information travels across the corpus callosum, the left hemisphere helps us to integrate the non verbal, intuitive information into words. Involved with the processes of explicit memory.

c. Orbito-frontal Cortex. This is the part of the Cerebral-cortex that touches both the limbic and the brain stem. Located in the front of the brain behind the eyes. When this area is functioning well, it helps to regulate the following…

9 functions:

The balance and regulation of the body and the autonomic nervous system
Attuned communication
Emotional balance
Response flexibility – the capacity to pause and center before acting.
Empathy with others and insight into ones self (Mindsight – D. Siegal)
Auto-noesis, the capacity to know oneself
Fear extinction
Intuition
Moral judgment and a sense of Conscience

All of these except for fear extinction have been researched in humans, fear extinction only in animals so-far. (D. Siegal)

All of the systems of the brain are in constant communication with each other, so in a sense these distinctions are somewhat arbitrary, although it does seem that there are clear correlation’s between certain functions and certain areas of the brain. A healthy brain is also in constant communication with other brains and is constantly being shaped in this open process of sharing information and energy.

A Definition of Mental Health taken from Complexity Theory – “The River of Well Being”

Complexity theory is a mathematical way of looking at open systems that are capable of unpredictable or chaotic behavior. These systems naturally move toward complexity by balancing two forces: Differentiation and Integration. When systems are moving towards complexity by balancing differentiation and integration they are the most S.A.F.E. – Stable, Adaptive, Flexible and Energized. Dan Siegal uses this as a definition of Mental health and well-being.

Nine dimensions of Brain/Mind Integration from Dan Siegal

1. Consciousness Integration

A. There are two basic levels in the architecture of consciousness, the observer, and that which is observed. Siegal uses the metaphor of a bicycle wheel. The receptive hub of the mind is constantly discriminating and integrating the information from the rim. This is distinguished from the reactive mind whose attention is fixated on the rim and has lost its capacity to discriminate and integrate information. On the rim are our five senses which give us information about the outside world, the internal somato-sensory experience of our bodies which gives us intuitive information about our internal and external environment, and our awareness of the inner mental experiences of ourselves and others which form the foundation of our capacity for empathy and attunement.

B. Fundamentally the mind is ATTENTION. By directing the attention of the mind we discriminate and integrate information and link neural pathways together in progressively more complex ways.

C. some useful acronyms

1. S.I.F.T. At any given moment we can notice our sensations, images, feelings and thoughts to extract the information from the rim of our awareness.

2. S.O.C.K. The architecture of the mind is composed of different layers. We can notice the sensations themselves, our capacity to Observe the Sensations, the Concepts that the comprehensive mind constructs to make maps of our experience, and the non-conceptual ground of Knowing which is the foundation of consciousness itself.

3. Y.O.D.A. You Observe to Decouple automaticity.

4. C.O.A.L. The fundamental qualities of the receptive hub of the mind are that it is Curious, Open, Accepting and Loving.

2. Vertical Integration Integrating Body and Mind

A. You cannot look at the brain without also looking at the body. Anatomically the brain is integrated with the body. The brain is the entire nervous system, not simply what is in our skulls.

B. Inside the body, below the neck, there are huge neural networks that help us to process and integrate information at many different levels. These neural networks are particularly strong around the hollow organs of the heart the lungs and the intestines. These may literally be thought of as secondary brains. so we can literally ask ourselves, “How does my heart feel with this person? My lungs? My Intestines?” Contemplative practices have developed strategies to train and educate the capacities of the body to discriminate and integrate information for thousands of years. In Taoism, one literally refers to the “heart mind,” and the “brain in the belly.”

C. Affect happens in the body. See Dan Shore’s work on affect regulation.

D. When we are deep in the receptive hub of the mind we observe what The Body (as opposed to my body) is telling us without taking it personally.

3. Bilateral Integration – Integrate the left and right hemispheres of the brain.

A. The right side of the brain.

1. Develops first – the left doesn’t really become active until 18-24 months.
2. Contains a wordless knowledge of self and others – empathy, without words.
3. Modulates stress.
4. Early facial recognition and attachment systems.
5. Implicit, autobiographical memories.
6. Timeless, holistic, gestalt, in the moment.

B. The Left side of the brain.

1. Logical – asks “Why?”
2. Linguistic – language – when words become poetic and evocative they activate the right side as well.
3. Linear processing in time. Mathematical processing as well.
4. Literal concrete thinking, rather than wide, spatial, or holistic concepts.

C. Notice how these two primary modes of information processing are differentiated and integrated in ourselves and others. Pay attention to imbalances and use a variety of modalities to address these imbalances.

4. Memory Integration, Implicit and Explicit

A. Implicit memory develops first, well before 18-24 months and is associated with the amygdala and the Right Hemisphere of the brain. The right hemisphere develops before the left. Implicit memories provide a holistic, feeling tone, or a sense of a pervasive atmosphere. The imprints of these memories are like the background noise of our character and fundamental assumptions about life. Often these are held in the body language of a person, in their voice tone, and in the deep patterns of muscular tension and energy exchange in their internal organs. By making these imprints conscious, we may be able to modify the patterns that are no longer functional for our clients. When we have an implicit memory, we don’t have the feeling that we are remembering anything. Might be more like a mood in response to some triggering event.

B. Explicit Memories are associated with the hippocampus and the Left Hemisphere and involve a definite sense that we are remembering something. We can put explicit memories into words. Create narratives out of them. A coherent story involves aspects of both implicit and explicit memory. Hypothesis: If we are “exploring” in the SCT sense, we are using both sides of our brains and working with the processes of both Implicit and explicit memory.

C. When our Implicit and Explicit memory systems are integrated we are connected with both the facts and the feelings of our lives.

5. Narrative Integration

A. builds on memory Integration. This is our capacity to connect our internal and our external worlds over time in a way that is integrated, and connected.

B. Our narratives are the vehicles that carry the information and wisdom from one generation to the next. Stories are the fundamental fabric from which the cloth of culture is woven. We are all shaped by the cultural context and contribute to this context by the way we develop a narrative that integrates our experiences over time.

C. A parent’s capacity to tell a coherent, integrated narrative of his or her life is the best predictor of an infants future attachment status. A coherent narrative is open, emotionally connected, and embodied as opposed to a cohesive narrative which may make logical sense but feels disconnected.

1. See Una McCluskey’s work on attachment for an in depth exploration of secure and insecure attachment.

D. With few exceptions, SCT therapists do not work with the stories of our clients particularly in groups. The exceptions are when the stories actively contribute to sub-grouping and deepen the emotional resonance which is being shared. How does this affect the quality of the therapy that we do?

6. State Integration

A. the brain creates integrated clusters of neural firing patterns that are the manifestation of the mind’s organization around it’s basic needs and drives. These clusters are either linked with each other in an optimally permeable way or dissociated from each other. These “self-states” are the inner sub-groups inside of us or the sub-personalities that have different functions in different contexts. Jaak Panksepp has identified 7 emotional command systems as an example of how the mind organizes itself and its conflicting needs.

The “commander in chief” coordinates functions in relationship to dominance, control and power.
The “explorer” organizes our drive towards learning, searching and curiosity.
The Sensualist coordinates our drive towards sexual gratification and reproduction.
The energy czar is in charge of the care of the body making sure that we get enough rest exercise and nutrition.
The Jester looks out for our need to play, recreate and have fun.
The Sentry is in charge of our basic survival and often manifests in worry, fear, and vigilance.
The nest builder is in charge of our need for nurturance, affiliation, bonding, and secure attachment relationships.

B. How we manage the different conflictual needs of these different “Self States” has tremendous impact on our sense of balance and integration. Are some of these split off, more dominant, barely developed in you?

7. Temporal Integration

A. This is our capacity to remain open, flexible and adaptive at the edge of the Unknown and to manage unpredictability. This is the difference between exploring and explaining our experience. See Karl Lewins chart. If we do not create rigid stories about the past which create preconceptions about our possibilities for the future we stay in the river of well being – Flexible, Open, Adaptive, Coherent, Energized, and Stable (FACES). The brain as an anticipation machine.

8. Interpersonal Integration

A. Develop an in depth knowledge of our own unique attachment history and study the different defensive strategies that can become activated inside of us under stress. As we understand these automatic patterns or fixations we develop the capacity to return to the receptive hub of the mind which is the root of an attuned presence. Remember YODA. (You Observe to Decouple Automaticity)

B. An attuned presence draws on all of the previous dimensions of of Integration.

C. Develop your awareness of two layers of empathy. The Internal State of the Other (ISO) in the moment, and the Narrative Of The Other (NOTO) over time.

D. Create a state of resonance – an embodied joining of our energy and information (Mind) with the mind of another. We can only do this when we have developed our own state of integration.

9. Transpirational Integration

A. “Transpiration” means to “breathe across.” Siegal invented this term to refer to the linkage between the many different domains of life and our connection with something larger then our skin encased self. This connection with something larger then ourselves creates a fundamental shift in our center of gravity from seeing life only through the lens of “I, me and mine” to looking out for the good of the whole.

B. “Transpirational Integration” is equivalent to “Non-dual consciousness” that is developed in contemplative practice in which we realize in a very embodied way that we awareness itself, that we are both the differentiated functions of our brain and mind and the attention that chooses, we are the content and the ground the subject and the object simultaneously. At the very hub of the wheel of consciousness we disidentify with all of the content of the rim, including our own histories and identities and discover ourselves as emerging consciousness itself. From this pregnant-emptiness we then infuse ourselves into all of the content of our lives with great freedom, playfulness, engagement, vitality and compassion.

Bibliography:

This is a shortened bibliography of the resources that I found most useful in studying and preparing this presentation. I also looked at the work of Damasio, Schore, and Van De Kolk, three other seminal thinkers in this area, but I didn’t spend enough time with their work to have sufficiently mastered it, so I chose not to include them. The literature is truly vast and I have only scratched the surface of what is out there!

The Developing Mind; How relationships and the brain interact to shape who we are.
Dan Siegal
Guilford Press, N.Y., 1999

Parenting from the Inside Out
Dan Siegal

Healing Trauma; Attachment, Mind, Body and Brain
Edited by Marion Solomon and Dan Siegal
Norton & Co., N.Y. and London, 2003

The Neuroscience of Psychotherapy
Louis Cozolino
Norton and Co., New York and London, 2002

There were also several tele-courses that Daniel Siegal conducted that are available on tape that were invaluable to me in putting this all together. They are both available through the Psychotherapy Networker, www.psychotherapynetworker.org or call (800) 990-1066.

Audio Courses from Psychotherapy Networker:

The Clinical Applications of Interpersonal Neurobiology. Course # T101
Psychotherapy and the Integration of Consciousness. Course # T105
Psychotherapy from the Inside out, the Brain of the Mindful Therapist. Course # A-307

A. The brain is the social organ of the body. Shift from a single skull model to a multi skull model.

B. Nature needs Nurture. Our genetic possibilities are constantly being sculpted by our interpersonal interactions, particularly our early attachment experiences. Neuroplasticity persists throughout our life times. Every significant, emotionally meaningful, attachment experience throughout a life time influences the development of new neural pathways and the structure of the brain. The work of Eric Kandell proved this. (He won a Nobel prize in 2001 for showing that experience activates genes which activate the growth of new neurons.)

C. Hebbs Axiom “Neurons that fire together, wire together.”

Basic hypothesis regarding therapy (not proven, but makes sense from everything that we do know about brains and neuroplasticity.)

What is the Mind in Interpersonal Neurobiology?

Interpersonal Neurobiology defines the Mind as the “Flow of energy and information.” The experience of “Mind” is created at the intersection of our interpersonal relationships and the genetic possibilities of our neurobiology.

What is “Experience” from a Neurobiological perspective?

From a Neurobiological perspective Experience = the Firing of Neurons.

The firing of neurons triggers the growth of new neuronal pathways. Novel, new or different experiences (but not too different, like trauma) create a greater (positive) impact on the brain’s development. It can therefore be hypothesized that psychotherapeutic interventions that introduce difference at a rate that the brain can integrate create the optimal conditions for new neuronal growth. The major tool to create new synapses in the brain is “Attention.” By mindfully focusing our clients’ attention we are developing new pathways in the brain.

Mirror Neurons and the Neurobiology of Empathy

Mirror Neurons. This is the neurological structure that enables us to actually feel the experience of another person when we observe it. Our brains literally “mirror” the internal states of other people. This has tremendous implications for therapy and all relationships. Use our mirror neurons to track our clients. What happens when there is a deficit of mirror neurons? What promotes or impairs the function of our mirror neurons? All of these are fascinating questions that have yet to be answered.

Memory Systems, Implicit and Explicit

1. Implicit memory develops first, well before 18-24 months and is associated with the amygdala and the Right Hemisphere of the brain. The right hemisphere develops before the left. Implicit memories provide a holistic, feeling tone, or a sense of a pervasive atmosphere. The imprints of these memories are like the background noise of our character and fundamental assumptions about life. Often these are held in the body language of a person, in their voice tone, and in the deep patterns of muscular tension and energy exchange in their internal organs. By making these imprints conscious, we may be able to modify the patterns that are no longer functional for our clients. When we have an implicit memory, we don’t have the feeling that we are remembering anything. Might be more like a mood in response to some triggering event.

2. Explicit Memories are associated with the hippocampus and the Left Hemisphere and involve a definite sense that we are remembering something. We can put explicit memories into words. Create narratives out of them. A coherent story involves aspects of both implicit and explicit memory. Hypothesis: If we are “exploring” in the SCT sense, we are using both sides of our brains and working with the processes of both Implicit and explicit memory.

What is Mental Health? Look to Complexity Theory for an answer.

Complexity theory is a mathematical way of looking at open systems that are capable of unpredictable or chaotic behavior. These systems naturally move toward complexity by balancing two forces: Differentiation and Integration. When systems are moving towards complexity by balancing differentiation and integration they are the most S.A.F.E. – Stable, Adaptive, Flexible and Energized. Dan Siegal uses this as a definition of mental health and well-being.

The river of well being has two banks. If we get too close to either of these banks, we lose the current of well being. One bank is rigidity, redundancy, boredom. The other bank is chaos, flooding, cacophony. The example of a choir singing. This principal of the integration of differentiated parts is remarkably similar, if not the same as the SCT statement that “Human Systems survive develop and transform from simple to complex through the process of recognizing and integrating differences.”

What is “Emotion”

There is no fully agreed on definition for emotion in an interdisciplinary way, but this much can be said: Emotion involves an initial orientation and assessment in response to a stimulus. This arousal is first categorized as either positive, negative or neutral, the organism then orients itself in relationship to this stimulus based on this initial assessment. From these three “primary colors” of emotional response come all of the different gradations in our emotions.

Emotion also seems to have the goal of helping us to regulate and integrate experience. All the major theories of emotion talk about the capacity of emotion to integrate and regulate our experiences, neurobiologically, interpersonally, in relation to ourselves and in relation to the existential realities of life.

The neurobiology of “Fear and Anxiety.” Differentiate the “High” and the “Low” road.

The “Low” road is a “fast circuit” that bypasses the neocortex and goes straight from the amygdala to the motor centers so that the body has an immediate response. This has great survival value in the wild.

The “High” road is a “slow circuit” that includes the neo-cortex and involves some process of mental evaluation and assessment. This has great value in human, civilized interaction.

3 primary ways that therapy can help clients move towards neural integration

Contingent or attuned communication in the context of the present moment of the therapist-client communication. Contingent communication occurs when the communication is: 1) perceived; 2) made sense of in a way that matches the senders intention; 3) responded to in a timely and effective manner. Contingent communication is found in every culture in the planet which suggests that we are hard wired for it.
When contingent communication occurs in the present moment, the brain creates a model of a coherent sense of self. This is the process that is fundamental to a secure attachment experience. When this type of communication occurs in a consistent manner between the client and the therapist, the client develops a more permanent internal, self narrative that is S.A.F.E. i.e. Stable, Adaptable, Flexible and Energized. In the context of an attuned relationship the brain can naturally move to integrate experiences that it had difficulty integrating prior to that. An attuned relationship, a coherent harmonious mind, and an integrated brain are all manifestations of the same thing! (Siegal)
SNAG – Stimulate Neuronal Activation and Growth by strategically offering clients experiences that promote neural integration in the specific areas in which they are deficient. Use the principal of neuroplasticity across a lifetime and ones knowledge of the differentiated functions of a healthy brain to promote an optimal level of integration in the nervous system. Good therapy, contemplative practice, and secure attachment all have this same goal. Use a variety of different modalities (art, movement, music, talking, writing, poetry etc.) to promote holistic integration of all brain functions.

Self-regulation and self-soothing

Self-Regulation and Self-Soothing. The development of the capacity to regulate and soothe oneself in the face of difficult emotional experiences is one of the major goals of a healthy emotional development and involves integrating all of the major functions of the brain. Disturbances in our capacity to self-regulate in the context of our environments are the primary reasons that people come to therapy. These capacities are injured by difficult early attachment experiences, by current non-contingent or mis-attuned interpersonal relationships, and by genetic predispositions that make ones organism particularly vulnerable to disregulation (these tendencies can be ameliorated or made worse by interpersonal interactions.)

Summary: What is neural Integration? Be aware of these 7 domains and promoting integration in each of them:

The integration of these primary two levels of consciousness: the capacity to observe the experience in context and the focus on the here and now.
Bilateral integration of the Left and Right Hemispheres of the brain and all that this implies.
Vertical Integration of the body, the brain stem, the limbic system and the cerebral cortex and all that this implies in terms of function. Particularly note all of the nine functions that the orbital frontal cortex is a part of.
Memory Integration, Implicit and Explicit Memories in the service of creating a secure, coherent, flexible, adaptable model of the Self across time.
Integrating different states of mind or brain states. The reality is that we are a plurality of parts, create a sense of leadership of these parts from a coherent, centered place.
Interpersonal Integration. Creating a context that supports a SAFE pathway of development. Both inside the therapeutic context and in the clients life.
“Transpirational Integration.” The feeling that we are part of something larger then ourselves, something that is literally breathing through all of the dimensions of our being, through the manifest and unmanifest, through past present and future, known and unknown. Sense of compassion and service that naturally arises from the visceral experience of connection with this larger context.