The Neuroscience of Psychotherapy

BOOK REVIEW

The Neuroscience of Psychotherapy: Healing the Social Brain, Second Edition

 

Reviewed by Bernadette Grosjean – Dr Grosjean is assistant professor in the department of psychiatry and behavioral sciences in the David Geffen School of Medicine at the University of California Los Angeles.

 

In his book In Search of Memory, author Eric Kandel states, “Understanding the human mind in biological terms has emerged as the central challenge for science in the 21st century.” Louis Cozolino’s remarkable book The Neuroscience of Psychotherapy: Healing the Social Brain is certainly up to this challenge.
 
If Kandel brought the viewpoint of a Nobel Prize neuroscientist, Cozolino delivers the informed perspective and integrative thinking of a master clinician in this updated edition (the first was published in 2002). Throughout this humbling and empowering narrative about the plasticity of our brains and the influence of human relationships on the mind, Cozolino shows how recent discoveries in neuroscience help us make sense of some of the oldest principles in healing. In a very convincing argument, Cozolino reveals how the core of the success of these practices—various combinations of empathy, affect regulation, construction of narrative, and behavioral experiments—results in the development and healthy integration of multiple neural networks. It is not magic; it is neuroscience and it is quite extraordinary.
 
After recounting how neuroscience and psychotherapy intertwine, the author describes the construction and organization of the brain and its interdependence with the environment. His careful examination of complex neurological functions (eg, memory, language, introspection) sheds a crucial light on what can go wrong and how neurological healing may occur. As a clinician who has spent endless hours listening to, observing, and caring for patients, Cozolino skillfully shares with us his minute observations of brain anatomy with the humanistic perspective of a psychotherapist. Through the use of multiple clinical vignettes, he reveals what he has learned and how his experiences have informed his daily practice.
 
In simple yet elegant language that combines a pathologist’s rigor with a poet’s creativity, Cozolino excels in filling our imaginations with splendid metaphors, such as the “amygdala whisperer” and the “cortisol’s motto.” Cozolino exemplifies how art and symbolism are powerful vehicles of human communication. The author reminds us of challenges in public health, such as the deleterious effects of war and child neglect. In an era when “doctors have become far too impressed with their technologies,” Cozolino’s research demonstrates how time, trust, and reliability are indispensable when teaching a patient with a wounded brain how to recover. Pharmacology may help, and is at times an indispensable ally, but it in no way replaces the value of a human relationship.
 
Cozolino regrets that “all of the ‘givens’ of classical healing and psychotherapy have been squeezed out of modern Western medicine.” He reveals how much those “givens” have strong scientific underpinnings and underlines the urgency of re-integrating them into the training and the minds of 21st century therapists. This beautifully written book is indispensable for anyone involved in the fields of mental health or public policy. It is replete with insights into the basic principles of human experience, including the impact of society on the psyche from conception to death.