Psychology Insider: Loving with the Brain in Mind—A Book Review

Oct 16, 2013 by Dr. Robert Weathers

Loving with the brain

By Dr. Barbara Grimes and Dr. Bob Weathers

A new book has just been published, one which is not only absorbing and highly innovative, but which also applies to recent changes to CalSouthern’s psychology curriculum. First, let’s summarize some of the key observations made in the book, written by couple therapy expert, Dr. Mona DeKoven Fishbane, and titled: Loving with the Brain in Mind: Neurobiology and Couple Therapy. (This 2013 publication represents the latest in the esteemed Norton Series on Interpersonal Neurobiology, edited by the two of the most well-known pioneers in the field, Drs. Daniel Siegel and Allan Schore, both of UCLA.)

One of the foundational premises of the book, indeed the whole sub-discipline of interpersonal neurobiology, is that our brains and behavior are formed by an individually unique combination of genetic proclivities and our cumulative life experiences, with particular weighting given to early, formative developmental experiences. So it is: both nature (genetics) and nurture (experience) are integrally woven together to form the essential fabric of our subjective senses of self, and our actions which follow.

The good news is that we are not somehow predestined to suffer the sole influence of our genetic heritage passed on by our forebears. One finding after another from the past 10 to 20 years in neuroscience has yielded truly revolutionary insights into the possibility of the fully formed adult brain being able to fundamentally change, grow, and develop across our entire lifespan. Both reviewers here recall that only 30 years ago, in their respective graduate school coursework in neuroanatomy and neurophysiology, the reigning paradigm of brain and cognitive development assumed that the human brain is basically done with any change or development by, at latest, age 25. How the conventional wisdom of yesteryear has been radically reversed!

The operative term here is “neuroplasticity.” That is, our brains are plastic, or malleable to environmental influence—forever. This single contribution, alone, provides a scientific, evidence-based foundation for both couple therapists, and those they treat, to find hope and realistic optimism for the future.

The book systematically and practically offers a whole range of options for helping couples to become co-authors of new patterns of relating, creating patterns which will ultimately set in motion brain changes for both, ultimately leading to the pleasure and sense of vitality which follow from healthy, genuine connection with one’s most intimate partner.

The author herself, Dr. Fishbane, supplies one example after another of couples who are stuck, and the misery that accompanies worn-out, dysfunctional ways of relating. Yet she also brings a new and profound understanding of alive and flourishing couples, with an analysis of what goes into making for health, both from a relational perspective and from the neurobiology which underlies true mutuality and satisfying intimacy.

One example of her pragmatic orientation: Dr. Fishbane grounds in neuroscientific insights exactly what makes up the common experience of running into a reactive collision—perhaps even a dead-end—in a relationship. What neuroscientists call “affective dysregulation” has its roots in the fear centers of the brain. It shows up accordingly in the brains of one or the other partner, but most often eventually both members of the relational dyad.

Of course, it’s one thing to gain deeper understanding of what may go wrong, including biologically, in any relationship; unfortunately, such cognitive insight is surely not sufficient to bring about resolving any particular dispute, much less the couple’s reconciling again to one another. It is here where Dr. Fishbane moves into her examination of the biology of empathy and mutual understanding, and more importantly, how they may be learned, leading ideally from emotional dysregulation back into a far more balanced, subjective state. She terms this “self-regulation.”

The ultimate implication of Dr. Fishbane’s incorporation of a neurobiological backdrop into successful treatment of relationships is that therapists, armed with the leading edge of such scientific insight, will be fortified and empowered to work more effectively than ever with couples on the brink. (Few couples arrive at therapy without being on the verge of separation.)

The influential social psychologist, Kurt Lewin, once observed: “There is nothing so practical as a good theory.” Contemporary best-selling author and social commentator, Malcolm Gladwell, notes similarly that most of us, including mental health professionals, are “experience-rich and theory-poor.” Applied to Dr. Fishbane’s book, our comprehension of what makes the brain tick can drive a much more effective and wide-reaching theory of relationships, including how they develop (functionally or dysfunctionally) and how they can most beneficially change. A therapist, with foundations in interpersonal neurobiology, can now educate client couples to better untangle and make sense of recurring emotional reactions, and the damage they evoke. Those same clients may also gain concrete tools for repairing relationship injuries and for rebuilding an even stronger, more flexible, more reliable sense of love and connectedness—through thick and thin.

This book artfully brings together two seemingly opposed perspectives from within psychology and psychotherapy. First, it is vital that our therapeutic interventions, including with distressed couples, be based in objective science. Advances in neurobiology clearly fit this bill. Second, and no less critical: it is imperative that the subjective individual, or in this case couple, not be lost in objective science, which risks reducing relationships down to nothing but neuronal connections and dopamine firing. How to simultaneously hold together both objective science and subjective personhood and human relatedness—that is the crux. Dr. Fishbane accomplishes this noble task and more, with obvious mastery and consistently accessible language.

One final note: at the outset of this review, we mentioned how the book mirrors or anticipates recent changes in CalSouthern’s curriculum. Just a few, quick examples come to mind. Our practicum courses, across both the master’s-level and doctoral programs, now incorporate attention to what was above called self-regulation—in this instance, that of the therapist-in-training. Mindfulness exercises and regular, self-reflective assignments to address the therapist’s own potential, subjective reactivity (or, countertransference) are but two examples of our integrating self-regulation—or the therapist-as-instrument—directly into this core, clinical curriculum.

In addition, we have created a new course designed exclusively to integrate Dr. Fishbane’s focus on interpersonal neurobiology, in addition to recent and related progress in attachment theory. It’s a course which is available to our graduate learners in elective form. Finally, our courses across all programs—from bachelor’s through master’s and doctoral levels—are constantly being updated to incorporate the latest findings and clinically relevant insights from neuroscience. This includes all addiction and recovery-oriented courses, from our undergraduate Certificate in Addiction Studies right up through graduate-level offerings on the same topic. It is just one more indication of CalSouthern’s commitment to keeping you, the learner, in the loop of innovative, cutting-edge developments across all of psychology.

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