Being a Brain-Wise Therapist by Bonnie Badenoch

Author:Bonnie Badenoch
Language: eng
Format: epub
Publisher: W. W. Norton & Company
Published: 2008-05-04T16:00:00+00:00

Expanding the Therapist’s Mental Health

Throughout these chapters, there has been a continual nudge toward doing everything we possibly can to expand and solidify our own mental health: getting to know our inner community, finding areas where neural integration needs encouragement, and increasing our capacity for mindful awareness. Working to establish the internal space to welcome and then contain the pain, fear, and desolation our patients bring us is the most essential work. Although therapist sensitivity is partly a function of temperament, the far larger component is our ability to maintain neural integration under emotionally trying circumstances. As we forge inward ourselves in service of this goal, we find that at least three interwoven processes have a chance to unfold: (1) We heal what we can, widening our window of tolerance; (2) we become conscious of our implicit vulnerabilities, letting go of any belief that we can or must be perfect containers; and (3) we develop sufficient mindfulness to become aware in the moment when we are activated by our patients’ struggles. This last capacity allows us to minimize tendencies to replicate hurtful relational patterns, reinforcing the very neural nets we are seeking to change. However, when the inevitable ruptures do occur, mindful awareness allows us to repair them promptly and well.

This process begins with establishing and strengthening our vertical integration, especially in the right hemisphere, linking body, limbic region, and cortex. As we engage with our patients in the back-and-forth, microsecond, implicit-to-implicit interchanges that deeply connect people, vertical integration will give us a greater ability to sense the ebb and flow of empathic connection in our bodies. We will be able to make better use of our resonance circuits to enter as cleanly as possible into our patients’ emotional “house,” without undue perceptual bias distorting our sense of what they may be experiencing. We will more easily feel in our bodies when the doors to our hearts close, so that we can locate the limbic upset and remedy the rupture. Most of all, we need to have confidence that the process constantly unfolding within us, out of awareness, most often supports the kindness and understanding of our outer behavior.

What can happen when this nonconscious dance unfolds in all its beauty? When our middle prefrontal region is steadfast in its linkage with our limbic circuits and bodies, the flow of nonverbal information coming to us from our patients has a much greater chance of being held, with empathy as the most consistent underlying state. This linkage allows us to move in nonconscious synchrony a good part of the time. At the same time, the flow of warm regard from us can bathe our patients’ body–brain in the regulating care that was attenuated or absent in childhood. This broad capacity for holding the many forms of pain and fear works behind the scenes to rewire our patients’ often-tortured limbic world, linking it to the widely integrative prefrontal regions, first on the right, then flowing to the left. Such interpersonal richness encourages GABA-bearing fibers to grow from patients’ orbitofrontal cortex to the amygdala, calming old fears.

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