Tag Archives: brain

Clinical Interviewing, Counseling and Psychotherapy Theory and Practice, Writing

Neurogenesis and Ideas for Training Your Brain to Listen with Empathy

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To start, I should say that I generally dislike pop-psych articles and promotional efforts that include cute sayings like, you can “Train (or re-wire) your Brain.” Most of you know this about me, partly because I like to make pithy comments about how, in fact, our brains actually don’t have any wires.

Despite overuse of the “wiring” analogy, I’m all-in on the principle that our behavior influences our brain structure, function, including a vast array of neurochemicals, hormones, and yada, yada, yada. In the following excerpt from our forthcoming Clinical Interviewing text, we provide a brief scientific commentary and recommendations for what we might oversimplify as “empathy training.”

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Neurogenesis refers to the birth of neurons and is one of the biggest revelations in brain research. Although neurogenesis primarily occurs during prenatal brain development, humans and other mammals generate new neurons (brain cells) throughout the life span (Jenkins et al., 1990). When adult neurogenesis occurs, new neurons are integrated into existing neurocircuitry.

Over 30 years ago, researchers demonstrated that repeated tactile experiences produced functional reorganization in the primary somatosensory cortex of adult owl monkeys (Jenkins et al., 1990). This finding and subsequent research supporting neurogenesis underscore a commonsense principle: Whatever behavior you practice or repeat is likely to stimulate neural growth and strengthen skills in that area. This is our explanation and prescription for how you can become more like Carl Rogers.

Multiple brain regions are activated during an empathic experience. Kim and colleagues (2020) summarized the complexity of what’s happening in the brain during empathic or compassionate responding, “Our analysis of sixteen fMRI studies revealed activation across seven broad regions, with the largest peaks localized to the Periaqueductal Grey, Anterior Insula, Anterior Cingulate, and Inferior Frontal Gyrus” (p. 112). In a similar review, Sezer and colleagues (2022) wrote:

Mindfulness-mediated functional connectivity changes include (1) increased connectivity between posterior cingulate cortex (DMN) and dorsolateral prefrontal cortex (FPN), which may relate to attention control; (2) decreased connectivity between cuneus and SN, which may relate to self-awareness; (3) increased connectivity between rostral anterior cingulate cortex region and dorsomedial prefrontal cortex (DMN) and decreased connectivity between rostral anterior cingulate cortex region and amygdala region, both of which may relate to emotion regulation; and lastly, (4) increased connectivity between dorsal anterior cingulate cortex (SN) and anterior insula (SN) which may relate to pain relief. (https://doi.org/10.1016/j.neubiorev.2022.104583)

If we focus in (somewhat inappropriately) on a particular brain structure, the anterior insula or insular cortex, a small structure residing deep within the fissure that separates the temporal lobe from the frontal and parietal lobes, seems particularly linked to empathy experiences, self-regulation, and other compassionate counseling-type responses (Chen et al., 2022).

Compassion meditation (aka lovingkindness meditation) is also associated with neural activity and structural development (or thickening) of the insula. Individuals who engage in regular compassion meditation have thicker insula, and when they view or hear someone in distress, they show more insula-related neural activity than individuals without compassion meditation experience (Hölzel et al., 2011). Other researchers have conducted meta-analyses and written reviews indicating that several brain structures are activated during cognitive-emotional perception, regulation, and response, and the relationships among them are highly complex (Kim et al., 2020; Pernet et al., 2021).

To oversimplify a complex neurological process, it appears generally safe to conclude that compassion meditation and other human activities related to empathy may contribute in some way to the thickening of the insula and development of other brain processes that enhance empathic responsiveness.

Although our knowledge about what’s actually happening in the brain is limited, these findings imply that you should engage in rigorous training to strengthen and grow your insula—as well as some of its empathic and self-regulating buddies like the posterior cingulate cortex, dorsolateral prefrontal cortex, rostral anterior cingulate cortex region, and dorsomedial prefrontal cortex (Sezer et al., 2022). This “training regimen” might contribute to you becoming more empathic and therefore, more therapeutic. In addition to practicing mindfulness or lovingkindness meditation, such a regimen could include:

  1. Committing to the intention of becoming a person who listens to others in ways that are accepting, empathic, and respectful.
  2. Developing an empathic listening practice. This would involve regular interpersonal experiences where you devote time to using active listening skills described in this chapter. As you practice, it’s important to have listening with compassion as your primary goal.
  3. Engaging in the active listening, multicultural, and empathy development activities sprinkled throughout this text, offered in your classes, and obtained from additional outside readings.
  4. When watching videos/television/movies, reading literature, and obtaining information via technology, lingering on and experiencing emotions that these normal daily activities trigger.
  5. Reflecting on these experiences and then… repeating… repeating… and repeating them over time and across situations

Rogers wrote in personal ways about his core conditions for counseling and psychotherapy. Contemplating his perspective is part of our prescription for developing an empathic orientation toward the variety of individuals with whom you will work.

“I come now to a central learning which has had a great deal of significance for me. I can state this learning as follows: I have found it of enormous value when I can permit myself to understand another person. The way in which I have worded this statement may seem strange to you. Is it necessary to permit oneself to understand another? I think that it is. Our first reaction to most of the statements which we hear from other people is an immediate evaluation or judgment, rather than an understanding of it. When someone expresses some feeling or attitude or belief, our tendency is, almost immediately, to feel “That’s right”; or “That’s stupid”; “That’s abnormal”; “That’s unreasonable”; “That’s incorrect”; “That’s not nice.” Very rarely do we permit ourselves to understand precisely what the meaning of [the] statement is to him [or her or them]. I believe this is because understanding is risky. If I let myself really understand another person, I might be changed by that understanding.” (Rogers, 1961, p. 18; italics in original)

As always, send me your thoughts on this content, as well as any ideas for improvement. Thanks and happy Friday!

Counseling and Psychotherapy Theory and Practice, Happiness, Personal Reflections, Writing

Four Questions to Help Keep Your Focus on the Positive

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Brain Image

Everyone agrees that the human brain is amazing. Perhaps the most amazing quality of human brains is the ability to shift focus. In an instant and at will, you can shift your focus from a current life conundrum, to the big toe on your left foot, to your dreams for the future, and to a memory from 1st grade. You can explore all these things—at least superficially—and then move on to the meaning of existence and the possibility of life on Mars all in less than one minute. In fact, as you were reading this, I’ll bet you were able to touch on all those thoughts.

Although shifting attention can feel random, it’s a power that most of us should learn to use more intentionally.

We’re using several methods for helping students intentionally harness their attentional focus in the Art and Science of Happiness course at the University of Montana. One method involves homework. Another method involves in-class and happiness lab activities. A third method (and the one featured here), is intentional and regular use of self-reflection. To accomplish this, we ask students to answer four reflection questions every two weeks.

Here are the questions, along with a small sampling of anonymized student responses:

  1. Over the past two weeks, what lecture content stood out to you as most important to you in your life?
  • “The sleep lecture and what you can do to sleep better, and what causes nightmares and night terrors”
  • “Happiness doesn’t have to ALWAYS be present in order to be happy.”
  • “I really enjoyed the lecture about the three steps to cure nightmares.”
  1. Over the past two weeks, what classroom or lab activities do you recall as most important to you in your life?
  • “All of them have been influential . . . and hope to continue these assignments into the future.”
  • “Having a happy song playing at the beginning of class is such a great way to start class.”
  • “The hand-pushing activity about how we should go into a situation with a plan.”
  1. Over the past two weeks, what positive changes have you noticed in yourself or in your life?
  • “After doing the 3 good things activity at night I felt relaxed and in a better mood.”
  • “I’m working on my sleep schedule which has felt good.”
  • “I found the sleeping tips to be really helpful in my own life and help me to improve my sleep.”
  1. Over the past two weeks, what activities, interactions, or thoughts have you experienced (outside of class) that were especially meaningful to you?
  • “Finding something inspirational.”
  • “More positive outlook on life.”
  • “I experienced being able to change my thoughts on a negative day by looking at three good things and able to remember that even on bad days there are still good things to remember.”

As I look over the students’ responses to these questions and the homework assignments, I feel like I’m catching some positive psychology contagion. I’m grateful to be able to teach this course and inspired by the students’ efforts to apply positive psychology principles to their lives.

Counseling and Psychotherapy Theory and Practice, Personal Reflections, Writing

Memories of Memorial Day: How to Use Memory Re-consolidation to Cope with Pain from the Past

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Green Shadow II

Back in the 1970s, I remember singing the lyrics to, The Way We Were, along with Barbra Streisand. Using my best falsetto, Barbra and I crooned, “Memories, light the corners of my mind.”

These lyrics aren’t technically correct. But then Barbra and the song’s lyricists, Alan and Marilyn Bergman, didn’t have access to modern brain scans. Based on neuroscience research, it would have been more accurate for Barbra and I to sing, “Memories, light the center of my mind.”

Memories live deep within the brain. If you could magically poke your index finger down through the top center of your skull, you still couldn’t quite reach your brain’s memory structures, the hippocampus and amygdala.

Memories are a fascinating electrical, molecular, cellular, and inter-structural phenomenon. I won’t be providing scientific details about memory, because then I’d have to write something about how the interaction of glucocorticoids and noradrenaline in the basolateral region of the amygdala can modulate the strength of memories in the hippocampus and other brain areas . . . and by then our fascination with memory would doubtless give way to boredom and sleepiness.

Speaking of sleepiness, it’s metaphorically accurate to say that most of our memories typically just lay around dozing in their hippocampal bed until awakened. Not surprisingly, some memories are lighter sleepers than others; they can be easily awakened. Sometimes, when sleeping memories are rudely awakened (triggered) they tend to be rather grumpy and unpleasant.

Here are three examples:

Say you’re creeping around on Facebook. You see an old high school photo from 25 years ago. The visual stimulus of the photo is a memory trigger; several related images and narratives pop into your mind. These images and narratives aren’t grumpy or unpleasant. Instead, you feel warmly nostalgic. This is an example of a visual trigger that activates a mildly pleasant set of associated memories.

In contrast, if you’re a veteran who has experienced war trauma and you hear firecrackers on the 4th of July, your consciousness may flood with vivid, multisensory memories. These memories could link to deep emotional pain. This is an example of an auditory trigger that awakens or activates disturbing memories—memories that you might prefer to put back to sleep.

Now, think of the smell of coffee in the morning. For me, the scent of coffee is neutral. No clear memories are activated. But, when coffee smells are combined with the aroma of bacon on the griddle, I have instant flashbacks to my Grandma Lucy making breakfast. This is an olfactory stimulus triggering a pleasant memory. I see my grandma’s grey hair, pulled back with bobby pins. I can see my own small hands touching and feeling the textured floral pattern on her white milk glass china as I wait for breakfast, watching her. I hear the pop of bacon sizzling. I can imagine the pain I might feel if I get too close to grandma’s griddle. I instantly know the past and future of this memory. First, Grandma Lucy peeled the bacon apart, dangling each piece before laying them on the griddle. Later, she’ll save the bacon grease, for another purpose. She was like that. Another emotion emerges. I feel sad. I miss her.

In honor of memory science, it’s important to note that each of the preceding memories may be more or less historically accurate. Even more important is the likelihood that these memories, like all memories, have changed, shifted, and evolved over time.

How can memories change? Isn’t it true that humans have an experience and then store a record of it in their brain, ready for later retrieval? Not exactly.

As it turns out, new memories are more fluid than solid. Following a memorable experience, memories stay unstable for somewhere between a few minutes and a few hours. New memories are in flux and shaped or degraded by additional new experiences that immediately follow. More remarkable is the fact that, even after storage, every time memories are pulled out (or retrieved) they return to an unstable or vulnerable state, until they re-stabilize or reconsolidate. And when they reconsolidate (a process that involves cellular protein synthesis), they can include new, different, or less information. This is how and why memories change over time.

For many Americans, Memorial Day is an intentional memory day. For example, yesterday there were flowers, speeches, and flag waving. Yesterday, you were probably in the company of family, possibly kneeling at a gravesite, perhaps celebrating the life of someone whom you loved and lost.

Memorial Day is a memory trigger. It’s a time set aside to honor the lives of men and women who died in service of our country. It’s natural and good to engage in this honoring ritual. People also honor non-military family members with flowers and graveside visits. But, amidst the celebrations, as is often the case, the emotional side of life gets short shrift. Typically, we celebrate and move on, despite the fact that it’s equally natural and good to honor the grief that we feel in response to Memorial Day celebratory rituals.

It might have been the 21 gun salute or the color of the flowers or the taste of the potato salad or the smell of your uncle’s cologne. Whatever the case, yesterday you probably had old memories awaken and stroll past you in an internal memory parade. Some of these memories may have been neutral. Others may have been pleasant. Still others, felt angry, sad, guilty, or lonely.

But memories are open to change, and that fact begs for intentionality. What I mean is that we should all have a plan for Memorial Day (and then a plan for Memorial Night). Not only do we need plans for how to celebrate, we need plans for dealing with the raw emotions that Memorial Day can trigger.

I wish I could offer up a simple method for helping you to deal effectively with Memorial Day memory activation and reconsolidation. But you (and everyone) are a unique entity with layers of fantastic idiosyncrasy. Nevertheless, here’s a quick glimpse into the emerging science of memory reconsolidation.

In one research study, participants were exposed to negative emotional memories from watching a trauma film. The next day, these memories were re-activated using a trauma-photo from the film. Then, after a 10 minute-break some participants played a game of Tetris, while others didn’t. The results: Over the next seven days, the participants who played Tetris after having traumatic memories re-activated, experienced significantly fewer intrusive trauma-related memories. The implications? Maybe the Memorial Night solution is to establish a Tetris-playing ritual.

But painful memories are complex and unique. What works for one person, might not work for another. As Drexler and Wolf (authors of a 2018 scholarly review) were inspired to write, “Indeed, when the activation of selective L-type voltage-gated calcium channels or GluN2B-containing NMDA receptors in the hippocampus was prevented before retrieval, thus blocking memory destabilization . . . the interfering air puff had no effect” (p. 15). Reading this led me to conclude that reading more of Drexler and Wolf’s article might serve as another possible memory disrupting intervention to employ during the reconsolidation period. I’m guessing, if you’ve made it to this point in this blog, that you’re inclined to agree.

From a practical perspective, it’s good to know that, generally, memory reconsolidation can take up to six hours. And so, in addition to Tetris and reading intellectual research papers, there are other reasonable strategies you can use to facilitate healthy memory reconsolidation, not just on Memorial Day (or Night), but any time of the year—as long as you’re within the six hour memory consolidation window.

  • Talk with a trusted friend or counselor about the emotions you’re experiencing. Even better, don’t just talk about your emotional pain, but also talk about and focus on the strengths you have for coping with your challenging emotions.
  • Engage in a physically strenuous activity. This could involve some sort of strenuous physical activity like cycling, running, yoga, or weight-lifting.
  • Ritual is good. This could involve a culturally appropriate spiritual activity like going to a sweat lodge or attending a religious service.
  • Writing is a common and effective method for expressing emotions. In particular, writing about your loss in ways that are meaningful to you can be therapeutic.
  • There may be no better way to deal with problematic emotions than engaging in positive helping behavior. Alfred Adler called this social interest. When you’re triggered, consider ways in which you can shift the spotlight away from yourself and toward fostering wellness in others.

Memorial Day is an intentional memory day. We created it and we celebrate it. But you can have other, self-created memory days. And what we know about memory and the disturbing emotions that can accompany memories, is that they present us with an opportunity. Some researchers call this an opportunity for “updating.” Recognizing this opportunity and intentionally engaging in healthy and soothing behaviors when difficult memories are activated is good guidance. This might be Tetris. It might even involve singing along with Barbra Streisand in your best falsetto. The point is that we have power, albeit limited, to update our activated memories . . . and so I wish you the best in finding intentional and healthy ways to soften your painful memories. It’s the honorable thing to do.

Parenting

Brain Equity: Grandpa Pancake’s Tips for Healthy Children’s Brains

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Rainbow 2017

These are the opening comments from a speech I made, along with speeches from Mike Halligan and Deb Halliday, for the Montana Young Child Conference in Helena . . . The powerpoints with the “Brain Equity Tips” are toward the bottom of this blog.

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Yesterday, today, and tomorrow have and will include many huge and tragic things happening in the world. There’s been hurricanes, shootings, and many other tragic events that are obviously important and that capture our attention.

But it’s also important for us not to become too preoccupied or obsessed with world events, partly because we have obligations and responsibilities right in front of us that also are immensely important. One of these things is parenting. Another is the formal and informal education of young children. We need to make sure that we’re not too distracted to do these things well.

Also, more than ever, local and national and global tragedies tend to divide us into sides. I’m tired of that divisiveness. That’s one great thing about tonight. We’re all on the same page. We can be together in our commitment to children’s education and well-being. For tonight, let’s bracket some of the huge world events and national events that divide us and may occupy a lot of our psyches, and bring our focus back to the very personal, immediate, and interpersonal process of raising and educating healthy, happy, ethical, and successful children

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I had my own, tiny little miniature, difficult experience yesterday. It was very hard. And I’d like to start this talk by sharing it with you.

I turned 60 years-old.

Don’t get me wrong. It was also a wonderful experience. But like lots of things in life: There was joy and there was horror.

Yesterday morning, I had to say, outloud, “I am 60-years-old.” It was painful. I was with my group of 8 doc students. They brought me pastries. Then, one of them asked, “Is it okay if we ask you your age? How polite. I hemmed and hawed. “Very old,” I said. “It’s big number.” It’s a difficult birthday. I’m 60.”

There were gasps. Seriously. Audible gasps in the room. One student acted VERY surprised. She said. “Oh! I was off 10 years! You don’t look . . . I didn’t think . . . I thought you were 70.”

A few minutes later, another one of them asked if they can call me grandpa pancake.

But we all have our limits. I said, NO. It’s Professor Pancake to you.

Being 60 and being Grandpa pancake, I decided it would be okay for me to begin this talk with an old painful memory

At some point in 1983 I got a new girlfriend. I know you might be thinking, what’s up? Now that John is 60 is he just going to ramble from one personal story to another? Maybe so. Someone gave me this microphone and so now I’m just talking.

Anyway, I got a new girlfriend. The point is that she had a 6-year-old daughter. At the time, I was on the verge of thinking I was pretty darn smart and clever. I was getting my doctorate in psychology. I could do Chi Square statistics in-my-head. Life was good.

My girlfriend invited me over for dinner. She lived at Aber Hall at UM because she was the Head Resident. And her daughter will be there. Kind of a big deal.

Dinner was served. Chelsea, my wife’s daughter, wrote our names in crayon, so we’d know where to sit. John, Rita, Chelsea. So sweet. Then, partway through dinner, I noticed Chelsea had a piece of lettuce sticking to her front teeth. Now, in my family of origin, we had this super-funny joke. Whenever someone got food on their lip or teeth, we’d say, “Hey, you’ve got food in your teeth and it’s making me sick.”

That’s pretty hilarious, don’t you think. So, in the moment of being a spontaneous cool boyfriend, I decided to share my family of origin humor with Chelsea. I looked at her and said, “You’ve got food in your teeth and it’s making me sick.”

You can probably guess how well that worked.

Chelsea started crying. She crawled up on her mom’s lap. Seeing the error of my ways, I got down on my knees and apologized.

This is a prime example of what makes parenting so darn difficult. There are an infinite number of multiple and rapidly shifting scenarios. That makes it impossible to be completely prepared for what happens next. It’s like Alfie Kohn wrote:

Even before I had children, I knew that being a parent was going to be challenging as well as rewarding. But I didn’t really know.

I didn’t know how exhausted it was possible to become, or how clueless it was possible to feel, or how, each time I reached the end of my rope, I would somehow have to find more rope.

The multiple and rapidly shifting scenarios that parents face include everything and anything. When I was the Executive Director for Families First in Missoula, I remember a mom who told me her daughter was pooping in the potted plants in the house. There was the mom whose daughter was afraid of the things that came out of toilets. There was a set of parents whose 10-year-old daughter was running the household. The parents whose children wouldn’t wear socks with seams . . . or eat any food that wasn’t white or yellow . . . or who first began using the F word at age five . . . in church.  Grocery store meltdowns, bad report cards, biting at daycare, not reading well, being too bossy with friends, forgetting homework, resisting homework, becoming school phobic, not cleaning their room, cleaning their room too much . . . you know what I mean, the challenging situations parent face are endless.

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For those of you interested and those of you who were at the Montana Young Child event and requested access to my powerpoints, click on this link: Montana Young Child Helena Keynote 2017

Thanks for reading and thanks for your commitment to the education and well-being of all children.

Counseling and Psychotherapy Theory and Practice, Personal Reflections, Research

Boy Brains, Girl Brains, and Neurosexism

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Black White Bikes

Sorry to say, I’ve been irritable the past couple days. If you don’t believe me, just ask my internet provider . . . or my editor . . . or ask me about my upcoming book deadline. There’s evidence everywhere for my irritability and impatience. You might even see evidence for it in this short excerpt from our forthcoming Theories of Counseling and Psychotherapy textbook. In fact, you should read this now, because I’m pretty sure it will get censored before appearing in our text.

Here you go.

You may be aware of popular books describing and delighting in the differences between female and male brains. Here’s a short list, along with my snarky comments:

  1. The essential difference: Male and female brains and the truth about autism (Baron-Cohen, 2003). Baron-Cohen is an autism researcher. His book allegedly, “. . . proves that female-type brains are better at empathizing and communicating, while male brains are stronger at understanding and building systems-not just computers and machinery, but abstract systems such as politics and music.” Comment: It’s so good to finally understand why most of our politicians are smirky White males who look like Baron-Cohen (heads up, this statement is sarcasm).
  2. The female brain (Brizendine, 2006): Brizendine is a neuropsychiatrist. Her book is touted as bringing “. . . together the latest findings to show how the unique structure of the female brain determines how women think, what they value, how they communicate, and who they love.” Comment: In Delusions of gender (2011), Cordelia Fine reduces Brizendine’s arguments to rubble. Nuff said.
  3. Teaching the female brain: How girls learn math and science (James, 2009). Comment: It’s hard to know how this book could be more than two pages given that there’s extremely sparse scientific evidence to support what this book’s title implies.
  4. Female brain gone insane: An emergency guide for women who feel like they are falling apart (Lundin, 2009). No comment. I couldn’t bring myself to read beyond this book’s title.
  5. The male brain: A breakthrough understanding of how men and boys think (Brizendine, 2011). Comment: The main breakthrough finding is that when you sell a million+ copies of your first book, a sequel, with similar drama, but equally slim scientific support, is essential.
  6. Unleash the power of the female brain: Supercharging yours for better health, energy, mood, focus, and sex (Amen, 2014). Comment: Better health, energy, mood, focus, and sex? I want a female brain!

The dangers of over-stating what’s known about the brain is significant, but nowhere are the dangers bigger than when you’re talking about sex and gender. Over time, physical differences between females and males have nearly always been used to justify systemic mistreatment of females (and limitations for males, as well). Some examples:

Plato didn’t think women were created directly by God and so they didn’t have had souls.

Aristotle thought women were deficient in natural heat and therefore unable to cook their menstrual fluids into semen.

Gustav Le Bon (1979) concluded that women’s intellectual inferiority was so obvious that no one could contest it. He wrote: “All psychologists who have studied the intelligence of women, as well as poets and novelists, recognize today that they represent the most inferior forms of human evolution and that they are closer to children and savages than to an adult, civilized man” (see Women’s Brains by S. J. Gould). Le Bon purportedly based his ideas on Broca’s measurements of 6 female and 7 male skulls. Not surprisingly, Le Bon strongly opposed the whole idea of educating women.

More recently, over the past 30 years, I’ve seen and heard and read many different descriptions and explanations about female and male brain differences. Nearly always, there’s the same old story: Women are more “right brained” and intuitive and less “left brained” and rational. Of course the actual brain hemisphere research is sketchy, but the take home messages are much like Baron-Cohen’s and Brizendine, which happen to be much like the philosophy of the Nazi Third Reich, which is that girls and women are well-suited for working in the kitchen and the church, and especially good at caring for children, but that women had best leave politics and the corporate world – where steady rationality is essential – to the men.

All this reminds me of the time my daughter, then a senior in high school, was shown a film in her science class depicting the female brain as structurally less capable of science and math. She came home in distress. We showed up at school the next day. What do you suppose happened next? We’ll leave that story to your imagination.

Genderizing the brain marginalizes and limits females, but it can also do the same for males. Take, for example, this quotation from “Dr.” Kevin Leman.

“Did you know that scientific studies prove why a woman tends to be more ‘relational’ than her male counterpart? A woman actually has more connecting fibers than a man does between the verbal and the emotional side of her brain. That means a woman’s feelings and thoughts zip along quickly, like they’re on an expressway, but a man’s tend to poke slowly as if he’s walking and dragging his feet on a dirt road.” (pp. 5-6).

Just FYI, even though my emotional quotient is just barely dragging along Leman’s dirt road, I can quickly intuit that what he wrote is sheer drivel. It’s not partial drivel because . . . as Cordelia Fine might say, “He just made that shit up.”

Seriously? Am I making the claim that male and female brains are relatively equivalent in terms of empathic processing? Yes. I. am.

Using the best and most rigorous laboratory empathy measure available, empathy researcher William Ickes found no differences between males and females in seven consecutive studies. However, based on a larger group of studies, he and his colleagues acknowledged that there may be small sex-based differences favoring women on empathy tasks. It should be noted that he and his research team (which includes females who may be more limited in their scientific skills than Baron-Cohen) offer at least two caveats. First, they believe that females being raised in social conditions that promote a communal orientation may account for some of the differences. Second, females are especially likely to be better at empathy when they’re primed, directly or indirectly, to recall that they (women) are better at emotional tasks than men. The converse is also true. When men are primed to think all men are empathic dullards, they tend to perform more like empathic dullards.

What all this boils down to is that females and males are generally quite similar in their empathic accuracy, not to mention their math and science and language abilities. It appears that the minor observable differences between females and males may be explained by various environmental factors. This means that if you want to stick with scientific evidence, you should be very cautious in making any conclusions about brain differences between females and males. To do otherwise is to create what has been eloquently termed, a neuromyth.

In summary, the safest empirically-based conclusions on sex- and gender-based brain differences are:

  1. The differences appear to be minimal
  2. When they exist, they may be largely caused by immediate environmental factors or longer-term educational opportunities
  3. To avoid mistakes from the past, we should be cautious in attributing female and male behavioral or performance differences to their brains
  4. If and when true neurological differences are discovered, it would be best if we viewed them using the Jungian concept of Gifts differing (Myers, 1995).
  5. Consistent with Cordelia Fine’s excellent recommendation in Delusions of Gender, we shouldn’t make things up—even if it means we get to sell more books.
Counseling and Psychotherapy Theory and Practice, Research

Feminist Theory and Interpersonal Neurobiology: A Natural Connection

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Woman Statue

This is a draft “Brain Box” for the feminist theory and therapy chapter from our forthcoming Theories of Counseling and Psychotherapy textbook.

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Feminist therapy is about connection.

So is neuroscience.

Neuroscience involves the study of synaptic interconnections, neural networks, brain structures and their electrochemical communications.

Feminist therapy involves egalitarian interconnection, empathy, mutual empathy, and empowerment of the oppressed, neglected, and marginalized.

As a highly sophisticated, interconnected entity, the human brain is metaphorical support for feminist theory and therapy. In the brain, cells don’t operate in isolation. In feminist therapy in general, and relational cultural therapy (RCT) in particular, isolation is unhealthy. Connection is healthy.

Healthy brains are connection-heavy. Whether humans are awake or asleep, brain cells are in constant communication; they problem-solve; they operate sensory and motor systems; they feedback information to and from the body, inhibiting, exciting, and forming a connected, communicating, community.

Using modern brain research as a foundation, Jordan (the developer of RCT) described how empathic relationships can change clients:

“Empathy is not just a means to better understand the client; in mutually empathic exchanges, the isolation of the client is altered. The client feels less alone, more joined with the therapist. It is likely that in these moments of empathy and resonance, there is active brain resonance between therapist and client (Schore, 1994), which can alter the landscape and functioning of the brain. Thus, those areas of the brain that register isolation and exclusion fire less and those areas that indicate empathic responsiveness begin to activate.”

Jordan is talking about how therapist-client interactions change the brain. Many others have made the same point: “It is the power of being with others that shapes our brain” (Cozolino, 2006, p. 9). In her review of RCT theory and outcomes, Frey (2013) emphasized that “research on mirror neurons, the facial recognition system, lifelong neuroplasticity and neurogenesis, and the social functions of brain structures” (p. 181) supports feminist theory and feminist therapy process.

Neuroscience research is supportive of feminist therapy in ways that are both real and metaphorical. There is unarguably great potential here. However, before we wax too positive, it’s important to heed a warning. Beginning with Plato (at least) and throughout the history of time, the main way in which physical (or brain) differences between the sexes have been used is to marginalize females and undercut their viability as equal partners in the human race (see Brain Box 10.2). With that caveat in mind, let’s respect feminism with some multitasking: Let’s celebrate the positive parallels between human neurology and feminist theory, while simultaneously keeping a watchful eye on how neuroscience is being used to limit or oppress girls and women.

Counseling and Psychotherapy Theory and Practice, Personal Reflections

Three Pounds of Theoretical Elegance in 888 Words

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Rita and Driftwood 2017

As you may or may not recall, we have several new features in our forthcoming Counseling and Psychotherapy Theories in Context and Practice (3rd ed.) text. Here’s a draft of what we’ve tentatively titled a “Brain Box” from Chapter One.

Brain Box 1.1

Three Pounds of Theoretical Elegance

John Sommers-Flanagan

This Brain Box is a brief, oversimplified, description of the brain. I apologize, in advance, to you and to brains everywhere for this oversimplification and likely misrepresentation. The problem is that even if I took a whole chapter or a whole book to describe these three pounds of elegance, it would still be an oversimplification. Such is the nature of the human brain.

You may already be familiar with the concepts described here. If so, it’s a review. You may be less familiar; then, it’s an introduction. For more information on neuroscience and therapy, we recommend Neuroscience for counselors and therapists: Integrating the sciences of mind and brain by Chad Luke.

Brain Structure: The human brain has indentations, folds, and fissures. It’s slick and slimy. Put simply, it’s not a pretty sight. But the brain’s form maximizes its function. One example: If you could lay out and spread its surface area onto a table, it would be about the size of two pages of a newspaper. The folds and fissures allow more surface area to fit within the human skull.

Scientists describe the brain as having four lobes: The frontal, parietal, occipital, and temporal (see Figure 1.2). The fissures or sulci of the brain demarcate the four lobes. At the bottom of the brain is the brainstem and cerebellum.

Each lobe is generally associated with different brain functions. I say generally because brains are specific and systemic. Although individuals have similar brain structures, individual brains are more unique than a fingerprint on a snowflake.

The frontal lobe is primarily associated with complex thought processes such as planning, reasoning, and decision-making (much, but not all, of what psychoanalysts refer to as ego functions). The frontal lobe also appears involved in expressive language and contains the motor cortex.

The parietal lobe includes the somatosensory cortex. This surface area involves sensory processing (including pain and touch). It also includes spatial or visual orientation.

The temporal lobes are located symmetrically on each side of the brain (just above the ears). They’re involved in auditory perception and processing. They contain the hippocampus and are involved in memory formation and storage.

The occipital lobe is located in the back of the brain and is the primary visual processing center.

I’m using all four lobes right now to type, read, edit, re-think, re-type, re-read, shift my position, and recall various relevant and irrelevant experiences. The idea that we only use 10% of our brains is a silly myth. They even busted it on the Mythbusters television show.

The brain includes two hemispheres. They’re separated by the longitudinal fissure and communicate with each other primarily via the corpus callosum. The hemispheres are nearly mirror images of each other in size and shape. However, their neurotransmitter quantities and receptor subtypes are quite different. The right hemisphere controls the left side of the body and is primarily involved in spatial, musical, and artistic/creative functions. In contrast, the left hemisphere controls the right side of the body, and is involved in language, logical thinking, and linear analysis. There are exceptions to these general descriptions and these exceptions are larger in brains of individuals who are left-handed. Woo-hoo for lefties.

The limbic system is located deep within the brain. It has several structures involved in memory and emotional experiencing. These include, but are not limited to the: amygdala, basal ganglia, cingulate gyrus, hippocampus, hypothalamus, and thalamus. The limbic system and its structural components are currently very popular; they’re like the Beyoncé of brain science.

Neurons and Neurotransmitters: Communication within the brain is electrical and chemical (aka electrochemical = supercool).

Neurons are nerve cells (aka brain cells) that communicate with one another. There are many neuron types. Of particular relevance to counseling and psychotherapy are mirror neurons. Mirror neurons fire when you engage in specific actions (e.g., when waving hello) and the same neurons fire as you observe others engaging in the same actions. These neurons are central to empathy and vicarious learning, but many other brain structures and systems are also involved in these complex behaviors (see Chapter 5).

Neurotransmitters are chemicals packed into synaptic vesicles. They’re released from an axon (a part of a neuron that sends neural transmissions), travel through the synaptic cleft (the space between neurons), and into a connecting dendrite (a part of a neuron that receives neural transmissions), with some “leftover” vesicles re-absorbed into the original axon (referred to as “reuptake,” as in serotonin-specific reuptake inhibitors).

There are somewhere between 30 and 100 (or more) neurotransmitters (NTs) in the brain, divided into three categories: (a) Small molecule NTs (e.g., acetylcholine, dopamine, GABA, Glutamate, histamine, noradrenaline, norepinephrine, serotonin, etc.); (b) neuropeptides (e.g., endorphins, oxytocin, etc.); and (c) “other” (e.g., adenosine, endocannadinoids, nitric oxide, etc.). Neurotransmitters are classified as excitatory or inhibitory or both. For example, norepinephrine is an excitatory neurotransmitter, dopamine is both excitatory and inhibitory, and serotonin is inhibitory. Although several chemical imbalance hypotheses regarding the etiology of mental disorders have been promoted (e.g., “low” serotonin at the synaptic cleft causes depression), when it comes to the brain, I caution you against enthusiastic acceptance of any simplistic explanations. A significant portion of the scientific community consider the dopamine and serotonin hypotheses to be mostly mythical (see Breggin, 2016; Edwards, Bacanu, Bigdeli, Moscati, & Kendler, 2016; Moncrieff, 2008, 2015).

Figure 1.2: A Look at the Brain — If the image was here, you would see it. In its absence, use your brain to imagine it. Yes. It’s beautiful. In the real textbook, we’ll have a real image of a brain and not my snarky suggestion that you use more than 10% of your brain to imagine a brain.

Counseling and Psychotherapy Theory and Practice

My Journey to Neuroscience

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For the revision of our Counseling and Psychotherapy text, Rita and I are contemplating how to integrate some neuroscience information in a balanced way. Each chapter would include a short section discussing neuroscience as it pertains to each theoretical perspective. This essay is one effort for beginning or framing the discussion.  Check it out (if you like this sort of thing) and let me know your thoughts (if you do that sort of thing).

From Biological Psychiatry to Interpersonal Neurobiology

In 1980, I (John) began my career in mental health services as a recreation therapist in a 22-bed psychiatric hospital. The patients were experiencing severe depression, manic episodes, and psychotic symptoms.

There was a large and intimidating psychiatrist (Dr. M) on the unit. Dr. M was a fan of biological psychiatry. He would smile as I engaged patients in the “Newly-Friend Game” (like the Newly-Wed Game, only better), relaxation groups, bowling nights, and ice cream socials. Occasionally Dr. M cornered me, explaining how my “cute” recreational programs had absolutely no influence on our hospitalized patients’ mental health. He waxed eloquent about brain chemistry. Never mind that the Thorazine and Haldol he prescribed had nasty side effects. Eventually, he claimed, there would be designer drugs that cured mental disorders from the inside out. Everything else was irrelevant.

I had a fresh, new bachelor’s degree in psychology. Dr. M had his M.D. He knew more than I did. Class dismissed. But it’s funny how encountering a condescending attitude can be motivating. I figured there must be a brain chemistry explanation for that too.

The chemical imbalance theory of mental disorders continued its dominance through the 1980s and 90s. Explanations for psychopathology focused on too much dopamine (causing schizophrenia) and not enough norepinephrine or serotonin (causing depression). No one really knew what caused these so-called imbalances, but biogenetic factors were the prime suspects. Although I kept silent with Dr. M, I held tight to my beliefs that social, psychological, and physical experience could be therapeutic.

Evidence slowly rolled in. While teaching a class on developmental counseling, I found a study showing that testosterone levels vary as a function of winning or losing tennis matches (Booth, Shelley, Mazur, Tharp, & Kittok, 1989). My brain (and the chemicals therein) loved this idea. If our testosterone levels could change based on competitive experiences, what other ways might human behavior influence the brain?

In 1998, while perusing research on serotonin and depression, I discovered that treadmill running increased brain serotonin in rats. The researcher described the complexity of the phenomenon:

Lipolysis-elicited release of free fatty acids displaces the binding of tryptophan to albumin and because exercise increases the ratio of circulating free tryptophan to the sum of the concentrations of the amino acids that compete with tryptophan for uptake at the blood-brain barrier level, tryptophan enters markedly in the brain compartment. (Chaoeloff, 1997, p. 58)

But my take-home message was simple: physical exercise might increase serotonin in human brains and also help alleviate depression.

Then neurogenesis came along. Neurogenesis is the creation of new brain cells. It has been long known that during fetal development, cells are created and migrate to specific places in the brain and body where they engage in their specific role and function. Cells that become rods and cones end up in the eyes, while other cells become bone, and still others end up in the cerebral cortex. In the 1980s and 1990s, everyone agreed that that neurogenesis continued during infancy, but most neuroscientists also believed that after early childhood the brain locked down and neurogenesis stopped. In other words, as adults, we only had neuronal pruning (cell death) in our future.

In the late 1980s, neuroscientists began conducting research that shook long-held assumptions about neurogenesis. For example, Jenkins and colleagues housed adult monkeys in cages where the monkeys had to use their middle finger to rotate a disc to get banana pellets. Even after a short time period (1 week) upon autopsy the monkeys had an enlarged region in their motor cortex. The conclusion: Even in adult monkeys, repeated physical behaviors stimulate neurogenesis in the motor cortex. This seemed like common sense. Not only do our brains shape our experiences, but our experiences shape the brain (literally).

As it turns out, neurogenesis slows with age, but it doesn’t stop. It continues throughout the lifespan. New learning stimulates cell birth and growth in the hippocampus (and other areas involving memory processing and storage). The “new brain research” left open the possibility that counseling and psychotherapy has the potential to stimulate neurochemical changes and cell birth in the human brain.

The evidence is no longer slowly rolling in—it’s popping like popcorn. Neuroscience research is as popular as Beyoncé. Whenever more evidence arrives showing how counseling and psychotherapy might be affecting brain functioning, non-medical mental health professionals get giddy. As you might suspect (or already know) occasionally we’re so excited that our statements about the implications and applications of neuroscience are way ahead of the actual scientific evidence. Counseling and psychotherapy practitioners have created new marketing terminology like “brain-based therapy” and “neurocounseling” and “interpersonal neurobiology” despite the lack of clear scientific evidence to support these terms. In some cases the birthing of this new terminology has caused lament within the neuroscience community (Satel & Lillienfeld, 2015).

Where does all this take us? As Dr. M would say, the brain is central to mood and behavior change. But now we know the reverse is also true: mood and behavior are central to brain development and change. If Dr. M were still alive, I might say, “touche” or “voila” or some other fancy and clever retort to show him that he had the directionality wrong—all these years.

But my retort would be incorrect too. The influence goes both directions at once. Even more importantly, we need to acknowledge that the relationships between and among brain structures, neurotransmitters, hormones, other chemicals, and human behaviors are still complex and mysterious. Even though journalists sometimes write with flourish about our ability to peer directly into the brain and see exactly what’s happening, that’s just not true. And to the extent we can “see” what’s happening, it appears that the brain is simultaneously functioning as a whole, as regions, as inter- and intra-cellular processes, and doing all these activities in particular sequences and all at once. Sure, as many mental health professionals will enthusiastically claim, we now know that meditation and interpersonal empathic experiences appear to stimulate the anterior insular cortex (AIC)! But it’s more complicated than that. The following excerpt from the neuroscience literature helps communicate this complexity (Mutschler, Reinbold, Wankerl, Seifritz, & Ball, 2013).

In summary, we argue that the dorsal AIC plays a pivotal role in empathy (similarly as during emotion processing and pain) by integrating sensory stimuli with its salience, possibly via connections to the cingulate cortex. This assumption is also supported by the fact that ALE-findings related to emotion and empathy for pain and also the DGR—which has been associated with cognition—overlap in the dorsal anterior insula, suggesting that these functions share a common neural substrate . . . . As mentioned above we assume that the overall role of the morphometrically identified area in the dorsal AIC related to individual differences in empathy which overlaps the DGR might be involved in integrating information which is relevant for socio-emotional and cognitive processing. Thus, we assume that empathy is not (only) related to a specific “socio-emotional” interaction area, but to a superordinate “domain-general” area, in line with concepts of empathy that include not only social and emotional, but also cognitive aspects . . . . Whether our findings in the dorsal AIC have also a relation to the “von Economo neurons” [VENs, . . .] remains to be determined. VENs have been hypothesized to play are role in social-emotional processing including empathy . . . .

This excerpt should inspire us all to pause with respect for the density and specificity of neuroscience. It should also inspire us to ramp down our expectations. If we just focus on empathy and the insula, we can see many sources of potential error: (a) much of the empathy research focuses on empathy for pain; (b) empathy is hard to measure; (c) it’s possible for a human brain to “light up” with empathy, but for the human to not express or show empathy toward someone else; (d) while empathy is generally considered a positive quality, some people use empathy to manipulate and hurt others; (e) there is brain structural and functional overlap; (f) the role of the VENs is unknown; and on and on. To use an inappropriate metaphor, it’s likely that the particular blend and balance of neurotransmitters (there may be up to 100) and hormones (there are about 50) and other cellular substances in each individual—along with structural variability—is more unique than a fingerprint on a snowflake.

In every chapter of this text Charles Luke (of Tennessee Tech) and I will share a highlight or update on neuroscience research. These highlights and updates will focus not only on the promise and potential of neuroscience to counseling and psychotherapy, but also on its limitations. A focus on limitations is needed because our ability to imagine what’s happening in the brain greatly outpaces neuroscience research. Although it’s tempting (and terribly fun), we shouldn’t let our imagination get too far in front of the science. As Dr. M might have said, “the brain offers us the greatest opportunity and potential to understand, explain, predict, and manage human behavior.” Of course it does; and it always will.

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Personal Reflections, Writing

What Brain Science Says about Becoming a Better Professional Writer

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This piece on professional writing is in anticipation of our upcoming John Wiley & Sons sponsored ACA presentation on April 1 in Montreal titled: Writing for Publication: Insights and Strategies

The “Decade of the Brain” started way back in 1990. It’s been over for more than 15 years. So you would think everyone could get over it and move on. But obviously that’s not how things pertaining to the brain work. Too many neuroscientists, journalists, and other people are happily riding along on the brain science bandwagon to just let it go. Most things would be perfectly satisfied with their own decade and the attention that goes with that, but the brain is a selfish organ and obviously interested in hogging all the decades. And so the brain discoveries just keep rolling in and eager journalists keep on writing and talking about the brain, which is why the popularity of neuroscience is now officially off the map. Neuroscience’s reach has far exceeded its grasp, but such is the nature of popular things. Just think about bell-bottoms.

We still know very little about the brain. That’s partly why neuroscience excites people. The excitement is more related to our collective brains collective imagination of what neuroscience might be than neuroscience reality. This has turned neuroscience into a projective test (think of the Rorschach Inkblots). There’s some vague information or structure out there and so everyone takes some of it in, blends it with their unique personality and past experiences, and then projects hypothetical possibilities about brain science onto the blank canvass of reality. Then voila, people start talking about ridiculous things like male brains and female brains and teen brains.

I say all this as a balancing introduction that will help me not sound completely trite and ridiculous when I write,

Coming up next: What brain science says about how you can become a better writer.

Let’s pause and self-reflect here. This statement is both bad writing and bad science. It’s bad writing because I’ve transformed (through grammatical magic) the inanimate field of brain science into an entity that has something to say. It’s bad science because the first rule of becoming a better writer, although supported by neuroscience, is such numbingly basic common sense that it’s inappropriate to gift it the charade of scientific authority.

Put another way, brain science can’t talk; people talk. But if brain science could talk, and you asked it, “What can I do to become a better writer?” it would likely respond with something like:

The first rule to good writing is WRITER’S WRITE. This is what literary and professional writers have said over and over for centuries and you didn’t need me, brain science, to tell you something you already knew. (see also: https://johnsommersflanagan.com/2013/09/04/professional-writing-for-us-professionals-who-may-not-quite-be-writers-yet/)

If there’s one thing we know from brain science (and common sense), it’s that practice leads to improvement. Neuroscientists might say it this way, “Your behavior directly influences your brain structure and chemistry; when you repeatedly practice something, you’re actually creating specific neurons and neural pathways to make that something easier.” Common sense (if it could talk) might say, “Repeated practice generally leads to skill development.” Speaking (apparently) on behalf of common sense, the renowned science fiction writer Ray Bradbury wrote:

Just write every day of your life. Read intensely. Then see what happens. Most of my friends who are put on that diet have very pleasant careers.

The take home message here is simple. If your goal is writing success, then you must make time to write.

There is, of course, a caveat to this general brain-based common sense rule. Yes, practice leads to improvement, but there are always exceptions.

Sometimes, even when you practice with great effort, consistency, and sincerity, you don’t improve much. The good news about this exception is that in the world of writing there are usually fascinating reasons for why diligent writers aren’t improving . . . and I’ll get to that important content at some point in the future. For now, remember this: The first step to becoming a successful professional writer involves taking Bradbury’s advice—which I repeat and elaborate on below:

  • Write every day
  • Read intensely
  • Get feedback
  • Engage in self-editing—produce a 2nd, 3rd, and 4th draft
  • Schedule more time to write
  • Identify your target audience and then learn more about them
  • Deal with multiple distractions
  • Reward yourself
  • Get more feedback so that you can be certain that you’re not rewarding yourself when you should be engaging in more self-reflection and scrutiny
  • Read your 4th draft aloud to yourself, then read it aloud to someone you trust to get even more feedback
  • Find somewhere to submit your precious manuscript
  • Hope for the best, but prepare for rejection
  • When you get your rejection, stay calm and integrate the feedback into your writer-identity
  • Revise your manuscript again, read it aloud again, get feedback again
  • After dealing with your neuroses, improving your manuscript, and gnashing your teeth, find the courage and strength to face your fears and resubmit your precious manuscript to somewhere that will recognize its greatness
  • Hope for the best, but prepare for rejection—again
  • Repetitively do all these things to help your brain structure and chemistry develop itself and you into a better writer who has a better chance of writing success

Before moving on I should say that I realize Bradbury was advising fiction writers and fiction writers fall within the literary writing domain. This is an important distinction. If you’re reading this blog, you’re probably busy juggling numerous professional activities. These activities might include a combination of teaching, research, service, attending classes, clinical practice, supervision, and more. Traditionally, writers with literary ambitions only juggle their daily writing and reading with a job delivering pizza or waiting tables. It’s likely that you have a more rigorous and full professional life. This is one good reason why your immediate goal shouldn’t be to publish your first novel or personal memoir. You probably don’t have time for those more ambitious goals; most human services professionals who write novels and memoirs do so during sabbatical or after retirement. For now, our goal for you and your goal for yourself should be to begin taking small steps toward becoming a professional writer. The best-selling novel will have to wait.

John hanging out with Robert Wubbolding

With Wubbolding