A
short paper given at the 7th UKCP Professional Conference on
‘Revolutionary Connections: Psychotherapy and Neuroscience
9th September 2001. Notes and a bibliography
have been added.
This
talk formed the basis for a longer chapter in Revolutionary Connections:
Psychotherapy and Neuroscience,(2002) ed. Corrigall, J & Wilkinson,
H. (Karnac, London)
“At the border
between chaos and order”; what psychotherapy and neuroscience have
in common
“Understandings
that are derived at the border between chaos
and order where, according to some, many of the problems of
nature lie, may not provide exact solutions but rather those which
can allow application and understanding to emerge.” (Coveney xiii)
I
want to start by putting both neuroscience and psychotherapy in a
larger context , and suggest that we are undergoing a shift in our
cultural and scientific paradigm. The cutting edge of neuroscience
represented here this weekend offers us more than fragments of interesting
information and alternative models of the mind. It highlights a new
way of thinking in science which - I am going to argue – is not just
a familiar way of thinking for psychotherapy but actually is fundamental
to its inception. This new scientific paradigm goes by various names
– catastrophe, chaos or complexity theory, or non-linear dynamic systems
theory. Its radical principles have significantly extended research
methods and processes and have lead to tremendous advances in fields
such as neuroscience.
I’ve
done a very crude sketch of the evolution of scientific thinking.
These stages I’ve outlined – pre-rational, classical and new science
– overlap. Sometimes they are in apparently irreconcilable conflict
but also potentially they can integrate at another level. It is a
dialectical progression. (see Wilber) For example, we can talk about
human relationship from any of these perspectives, and we can acknowledge
the truth of each.(Footnote: For a concise and vivid account of the
shift towards New Science and its key ideas, see Capra. For a more
overarching theoretical view of the evolution of ‘matter – life –
mind’ with a strong consciousness/spirituality perspective, see Wilber.
Also relevant: Coveney,Sardar)
(Pre-rational
science – intuitive, magical, mythical, traditional, folk)
Classical
science
Causality
Linear
Objective
Isolates events
Matter
Focuses on stability
Logic
Closed system
Reductive
Predictability
Explicit/observable
Time is uniform
Cause-effect
Sequential
Mechanistic
Fixed relations
Objects
Particulate |
New Science
emergent properties
non-linear
includes subjectivity
emphasises
context
process
focuses
on sensitivity
deeper
pattern
open
system
complex
chaos
implicit/hidden
sensitive critical periods
feedback loops
experience-dependent
self-regulating
network interconnections
fields
parallel
|
Classical
science explains closed systems. New Science was born from the attempt
to understand dynamic, complex, open systems, such as the ecosystem,
the weather system,and the behaviour of living creatures. In these
systems, change is a matter of complex interconnected events, where
there can be an extraordinary sensitivity to timing and minute changes
in the environment. Highfield and Coveney describe the brain as “organised
by chaos – a complex non-linear feedback system.” (286) As you will
have gathered from the speakers this weekend the characteristics of
the brain cannot be reduced to the function of its different parts
but to very dynamic complex interactivity. Consciousness, feelings,
ego functions are emergent properties of the system. (“Within science,
complexity is a watchword for a new way of thinking about the collective
behaviour of many basic but interacting units [….] their interactions
lead to coherent collective phenomena, so-called emergent properties
that can be described only at higher levels than those of the individual
units.” (Coveney, 7)
Psychotherapy
has always sought to work with the apparently irrational, the quirky
uniqueness of each individual or group. Its key thinkers have been
gifted in seeing through the veil of madness to a deeper pattern,
which takes account of the context and dynamic from which it emerged.
Freud said of the unconscious: “we call it a chaos…” (1933) and
he described it as a dynamic system. Winnicott and Bion recognised
that development and psychotherapy involved negotiations with catastrophe.
Reich and Jung perceived the re-establishment of self-regulation
– one of the core tenets identified by New Science – as the basis
of healing in psychotherapy.
In
contemporary psychotherapy, the use of the countertransference across
a broad spectrum of therapies, epitomises a chaos or complexity oriented
style of work. Countertransference is an emergent property of the
therapeutic encounter – its manifestations are inherently non-linear,
it is unpredictable, we may notice it first in a very subtle detail
of our own process; it is characterised by an extreme sensitivity
to relational cues; its meaning has to be derived from the context;
it relies on an objective use of subjectivity.
The
point I want to make is that psychotherapy already has a relationship
with chaos and complexity even if its principles are not an explicit
part of our theory and practice. It is precisely because neuroscience
at the cutting edge is informed by these principles that there is
a new basis for dialogue. (footnote: the parallel between psychotherapy
and chaos/complexity/catastrophe has been considered by several writers,
including: Field, Eigen, Postle ; and in passing by Samuels. I also
find Christopher Bollas evocation of psychotherapy imbued with the
metaphor and resonance of this paradigm, though he does not explicitly
make the connection. Schore (1994) quotes studies of psychotherapy
which analyse the client’s autonomic state changes from a chaos perspective.
And in a paper on ‘Early organisation of the nonlinear right brain
‘ uses non linear dynamics theory and self-organisation theory to
explicate the complex process of brain development through interaction
with the environment)
Neuroscience
has helped us, for example, to re-define and differentiate trauma,
particularly by illuminating how trauma is internalised on a structural
level throughout the brain and the body. But it is not just the establishment
of more intricate neuroscientific detail about the function of the
brain but the actual principles they illustrate which are of major
importance to psychotherapy. This is because the mind is not a thing
but a process. The embodied brain is the dynamic structure through
which this process operates.
Neuroscience
confirms that the earliest years of a child’s life are intensively
and extensively formative: the interactions between infant and primary
caregivers strongly influence the developing structure of the brain.
(Schore, 1974) Whilst such concentrated change cannot occur in the
adult brain – because the sensitive ‘windows’ of development have
passed and with it the young brains neural plasticity - the adult
brain continues to evolve according to the principles of self-organisation.
(Schore 1994, 473)
Psychotherapy
offers a particular opportunity for intensifying the normal self-organising
process of life. ‘Self’-organisation is a bit of a misnomer in a way
since the process it describes is intrinsically bound up with relationship
and environment which impinge directly as feedback. Self-organisation
is a term which can describe any system which is changed structurally
by its dynamic interactions with the environment. In the case of humans,
self-organisation is perpetuated via multiple interconnected feedback
loops which continually modify the micro-structure of the brain-body.
This process parallels and is a direct corollary of socialisation,
both individual and large-scale. (Schore interview) Psychotherapy
is painful precisely because it involves a conflict between established
structures and an emergent process.
Self-organisation
through and in psychotherapy depends on three interrelated aspects
of feedback: re-presenting, relating and feeling.
Re-presentation
of the client to him or herself happens in numerous ways. Psychotherapies
vary most obviously in the way in which they implicitly and explicitly
manage this feedback process: verbal intervention, eye contact, non-verbal
attunement, movement, touch, and other strategic interventions, such
as maintaining boundaries. All these interventions are to one degree
or another interpretative within a framework. Every therapist imparts
a set of principles and concepts which, whatever their intrinsic value,
reframes the client’s experience , and therefore represents it.
Re-presentation
is complex, conflicted and multi-levelled: conscious and unconscious,
triggered self-reflexively and directly and indirectly in relation
to the therapist. And it is holistic: affecting many systems of the
brain and the body, producing images, sensations, fantasies, feelings
and thoughts. The nature of the brain makes this inevitable – for
representation of the self is distributed through many systems of
the brain, from the brain stem to the cortex. Creative activity, dreaming
and play share some of these characteristics of re-representing– hence
their therapeutic (in the broadest sense) value. Metaphor in particular
is a highly integrative form of re-representation.
What
is interesting about neuroscience is that its emphasis on the highly
distributed nature of brain functions does not exclude the intuitive
structural models grasped at by therapy. Our psychic structure – grounded
in the structure of the brain and the body– is labyrinthine, with
re-transcriptions occurring on all planes. Ascending and descending
from brain stem to cortex, with higher and lower functions, as Freud
envisioned. Working cross-laterally from right to left and left to
right brain, whose functions clearly differentiate in ways reminiscent
of the Jungians idea of feminine and masculine principles. And this
is not to mention the circuits in the brain which are familiar via
the all too human tendency to go round in circles! The ongoing process
of re-presenting in therapy helps sort, strengthen and modify the
connections on which self and self-other representations are based.
(Footnote: for a clear introduction to current neuroscientific thought
on processing, the concept of ‘re-entry’ and ‘distribution’, see Pally)
In
essence the therapeutic relationship is a cultivated form of mutual
feedback – particular attention is paid to subtle changes and nuances
that hint at hidden dynamics. When a behaviour, phrase or gesture
– or all three together – are noted, even if not verbalised, awareness
is amplified. Empathy in the therapist, and the client’s attachment
to the therapist, and curiosity in them both will increase the potential
for resonance. The structure of therapy itself re-inforces the propensity
to heightened engagement which Schore describes as “synchronised energy
exchanges” (1997, 595). The Process Oriented Psychologist Mindell
suggests that the varieties of psychotherapy are “spontaneous creations
which arise by amplifying events in given channels of the client therapist
interaction”. (Mindell, 8)
In
science two kinds of feedback are recognised: amplifying or (+ve)
feedback which expands and intensifies patterns; and dampening or
(-ve) feedback which has the opposite effect. The tension between
these forms of feedback are at the crux of psychotherapy. Through
amplification subtle transactions are magnified and experienced in
their intensity as pain, excitement, fear etc. This positive feedback
will alternate or even oscillate with negative feedback which operates
psychologically as a defense, an attempt to limit the catastrophe
and chaos of experiencing intensity. With an imbalance of negative
feedback, the individual/system becomes static and closed. Too much
positive feedback dysregulates in the other direction – there is chronic
instability.
At
the risk of over-generalising, we could say that the humanistic tradition
has been characterised by its emphasis on positive feedback, ‘letting
it happen’ expression etc. Its raison d’etre was the encouraging of
growth. By contrast some psychoanalytic psychotherapies have focussed
on naming and interpreting defences, in order to modify the effect
of negative feedback. In practice all therapies probably use a mixture
of both. We work with the dynamic tension between safety and not being
too safe, between conscious insight and disinhibition, between structuring
and disrupting.
The
paradox of therapy is that when the client can bear what is unbearable
to think and feel, their experience changes – the self re-organises.
The critical factor here is sponteneity which is equivalent to chaos,
in the sense that scientists are using the term. Chaos, in this context,
represents “a lifting of constraints on information processing”. (Schore
1997) Of course, client and therapist naturally fear that chaos –
in the ordinary sense – may be unleashed. Both neuroscience and psychotherapy
would agree that change is not linear but rather a continual process
of organisation, disorganisation, and re-organisation.
It
is widely agreed now that the client needs to experience feelings in the relationship
with the therapist. This makes sense because, as Doug Watt has argued,
“emotion binds together virtually every type of information that the
brain can encode”. (Watt, 5)Intensity of feeling, transitions between
feelings, and the identifying of unfamiliar feelings, all feed self-organisation.
These
are bodily relational processes. Allan Schore has detailed the transformations
in the infant’s psychobiological state as it regulates and is regulated
by the attachment relationship. There is a direct parallel with the
therapeutic relationship which has the added complexity and inherent
conflict of being both a more and
less equal relationship. In the talk given as the overture to this
Conference he suggested that the process of therapy can utilize right
brain to right brain communication to work with projective identification.
The complex interactions he describes ultimately come down to a developed
capacity for empathy, for allowing the client to affect the therapist
and the therapist being able to tolerate that impact and feed it back
to the client in a useful way. In other words to work “on the border
between chaos and order”.
The
fears of the Neurosceptics are that the findings of neuroscience will
diminish the subtlety and complexity of psychotherapy. But its not
a matter of giving up the sterling of our evolved and involved practice,
or handing over our authority to the equivalent of Brussels
bureacracy. Its about being willing to cross the channel which has
divided the two disciplines for over a Century and get stuck into
dialogue
Any
theory – no matter how brilliant, how robust – can be misapplied
One
danger is that Neuroscience could be funnelled into a medical system
in a way which exacerbates its tendency to think in terms of damage.
That
would be an example of positive feedback (in the negative sense, if
you see what I mean) . But New Science theory of life is actually
one of extraordinary creativity rather than bleak determinism.
In
conclusion, I suggest that neuroscience can nourish psychotherapy
in two ways. By providing a description of human processes from a
different perspective, it offers us feedback for us to chew over.
Secondly, developmental neuroscience is accumulating further evidence
that we cannot isolate human psychological function from its somatic
foundation and from the network of relationships in which it has been
formed and is embedded. I believe that neuroscience can be on our
side in the argument that people need people, that psychotherapy needs
due time for its process and that simple statistical facts cannot
adequately represent complex effects of psychotherapy.
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