Neuroscience of Psychotherapy, Building and Rebuilding the Human Brain and Making of a Therapist, A Practical Guide for the Inner Journey

Freud started out as a neurologist and when he moved on to his talking therapy many questioned this decision. How could simply talking to people bring about healing in the mind, when scientific research showed that the brain operates as a result of a number of neurological processes? It has taken many years to provide sufficient evidence to confirm that Freud's assumptions was valid. During this process a clear split emerged between the two approaches to psychological healing. Not until the technical developments of recent year (which have offered real opportunities to study the active brain), have the two sides started to complement rather than oppose each other's theories. In Neuroscience of Psychotherapy, Cozolino is demostrating how this circle is closing by connecting evidence as to how the brain works with results of how successful psychotherapy can cause actual changes in these brain functions. The first part of this book offers a systematic overview of Neuroscience and Psychotherapy, its history and different approaches. The second part examines how the brain works. It deals with everything from basic neural units to complex aspects such as memory, language and organisation of experience. It also discusses if the two parts of the brain actually are one or two brains. The title of the third part is 'the organisation of experience and the healthy brain'. It deals with the executive brain, how we construct the narrative self and the interpersonal sculpting of the social brain. Common psychological problems such as anxiety, trauma and codepency are discussed in detail both from a scientific and clinical perspective. The fourth part deals with disorganisation of experience and psychopathology and the final part deals with 'the reorganisation of experience'. At the end of the book Cozolino points to the emerging paradigm of the psychotherapist as neuroscientist. From neuroscientific psychotherapy can get very valuable feedback both as regards how the brain works and how psychotherapy is able to correct 'malfunctioning'. His conclusion is that: "Although we are only at the dawn of understanding the brain, an appreciation of its evolutionary history, developmental sculpting, and design flaws can help us use it more wisely. Practical things – like understanding the neural damage resulting from drugs, stress, and early deprivation – should influence everything from personal decision making to public policy. Our tendencies to distort reality in the direction of personal experience and egocentric needs should lead us to examine our beliefs and opinions more carefully. I am convinced that understanding our brains will help us to better know our minds".

That is to say that with a two-sided approach and cooperation between neuroscience and psychotherapy we stand a much better chance of changing the world we live in, both in terms of preventing and healing psychological problems. This increased knowledge of how our brain and mind works also highlights the role of the therapist in the psychotherapeutic environment. Here, too, there's been an attitude change; away from the notion that the therapist is doing something to the client, toward the idea of working with the client, helping the client to gain insights and to real ways to change. Nobody is born a therapist and nobody has to be perfect before they can start working as one. Still, as Cozolino points out in much detail from his long personal experience, what the therapist says and does with the client makes the whole difference between good and bad psychotherapy. Much of this knowledge is unfortunately not available in books on 'how to become a psychotherapist'. Instead it is the result of the therapist's own inner journey, which in turn depends on the therapist's willingness and openness to deal with personal issues that are triggered by what happens in the interaction with the clients. The chapter headings of this book give a clear indication of the personal sharing that Cozolino contributes. In the first part, 'getting through your first session', the headings are 'What have I gotten myself into?', 'Getting Centred and Learning to Listen', 'Now What Do I Do?', 'Survival Strategies' and 'Beware of assumptions'. In the second part that deals with 'getting to know the client' he discussed issues such as 'challenges and strategies', 'the therapist's feelings', 'the paradoxy of client resistance' and 'turning weakness into strength'. The final part of the book really emphasises the aspect of the therapist's own inner journey. Under the heading 'getting to know yourself', Cozolino deals with issues such as 'countertransference', 'the underlying factors that draws people into becoming psychotherapists', 'how to build a satisfying and sane career', which can involve both selecting your clients and consistent self-care and knowing your limitations as a therapist. Above all Cozolino points to the importance of 'walking the walk, i.e. to practice mindfulness. Or in his own words: "I believe the key to being a successful therapist is self-awareness." That involves bringing mindfulness and the expansion of self-awareness into everyday life. Although both books deal with psychoanalysis, they also offer excellent advice for breathwork and other body-oriented therapies. Understanding how the brain works offers many insights into how and why breathwork and body-psychotherapy works. Learning about the sometimes rather difficult path to becoming a good-enough therapist (i.e. good enough to offer useful help rather than well-meaning bad advice to the client) is extremely useful. In particular for breathwork and body-oriented therapies where it is easy to focus too much on improving the actual technique rather than on what to do once the client's problems have been activated. After all, the activation part is only the 'getting there'. What the client does with what comes up during the session is what will eventually determine the outcome of the therapy. Or as Cozolino points out – to know/understand is the boobie price since real progress also requires a way out of the current situation, which is where the therapist can make a real difference.