Discovering Self and Other:

Neuroscience and Interpersonal Processes

 

 

What is the Self?

      The most widely used term and most elusive concept in psychology

      William James (1890) said that its the fundamental concept in psychology around which all else revolves.

      In psychotherapy we talk about self-esteem, self-actualization, self-activation, self-concept, self-image, self-regulation.

      The Self has many facets;  In my fathers house are many rooms (John 14:2)

      Both psychologists and philosophers have made clear, the self is an elusive concept at best.

      As Joseph Campbell said about God, its difficult to use language to describe something that is indescribable.

      Perhaps the Self suffers from the same limitation.  Something so complex that simple descriptions dont do it justice. 

      Exploring the Self requires us to step outside our comfort zone.

       Who is the I who knows the bodily me, he asked, who has an image of myself and sense of identity over time, who knows that I have propriate strivings? (Allport, 1961, p. 61).

      William James suggested that the universal conscious fact is not feelings and thoughts but I feel and I think.

      Social neuroscience has sought to find the neural representation of the self in the brain—or at least identify the brain modules, or systems, or networks that generate self-representations or mediate self-referential processing. But unlike vision, what and where appear to be independent questions, it appears that, with regard to the self, the what question has to be answered before the where question. Without some sense of how the self and self-referential processes are represented mentally, at the psychological level of analysis, efforts to find the self in the brain will likely prove fruitless (Kihlstrom, 2010).

 

The Whole is Greater

      Than the sum of its parts – The mind is the expression of the brain in relation to the body (and possibly other brains/bodies/minds).

      Two way street – changes in the brain affects the mind; and changing the mind changes the brain.

      However, a brain is not the only game in town.  Even singled celled organisms can have a very rudimentary sense of self.  They even show primitive emotions (moving toward or away from a stimulus).  Plants also show fairly complex Self behavior without a brain.  However, our ancestors took a different route, developing a more and more complex brain, and as a result concepts of the Self are equally complex(Damasio, Self Comes Into Mind, 2011)

 

Why Understand the Brain?

      Many of the areas therapists target in their work involves, cognition, emotion, memory, behavior, which are all regulated within the brain.

      Advances in neuroscience have resulted in a more nuanced understanding of the brain and its functioning, and therefore we can now better hypothesize the neurological correlates to our work as psychotherapists.

      Many descriptions of psychotherapy and the change process have been supported by neuroscience findings.

      Many aspects of our theories have been updated or replaced based on brain science.

 

The Triune Brain

      Described by McLean in the 1970s

      Organized the brain from an evolutionary perspective

      Reptilian Brain

o   Activation, arousal, homeostatis and reproduction

      Paleo-Mammalian Brain (Limbic System)

o   Learning, memory and emotion

      Neo-Mammalian Brain (Cerebral Cortex)

o   Conscious thought, problem solving and self-awareness

 

Contemporary Neuroscience

      The Structure of the Brain in Your Hand by Dan Siegel, MD. (https://youtu.be/gm9CIJ74Oxw)

      Frontal: Executive functions /

      Temporal: Auditory

      Parietal: Sensory Motor

      Occipital: Visual Visual

      Brain Stem: Automatic life-sustaining functions

 

Nature or Nurture?

      Much of who we are is handed down to us via our genetic history.  Many psychiatric illnesses have a genetic basis (depression, anxiety, schizophrenia, etc.)

      However genes not only have a template function (information to be passed on to next generation), but they also have a transcription function (synthesis of proteins).

      Transcription is directly influenced by experience.  Experience effects the expression of genetic programing

      Born with complete set brain structures, but not the connections – Experienced Based Development

      Psychopaths: Require both specific genes and environmental factors (eg, abuse, neglect)

      GABA and Anxiety: Recent study showing that domestic violence during pregnancy results in methylation of GABA receptor genes which causes dysfunction of GABA processes in brain.  This has been correlated with increased anxiety and risk for violence.  These genetic changes have been documented 15 years after birth.

 

Specific Brain Structures

      Orbitofrontal Cortex: Executive Functions – Modulator and integrator between affective and cognitive processes

      Limbic System: Emotion centers of brain

      Amygdala: Threats

      Hippocampus: Explicit memory (encoding and retrieval)

      Anterior Cingulate: Attachment, attention, reward-based learning, autonomic arousal

      Insula: Integration of inner & outer experience, empathy, compassion

      Corpus Callosum: L/R hemisphere communication

      Cingulate Gyrus: Control of emotions and attention

 

Brain-Based Psychotherapy

      Understanding that psychotherapy involves changing cognition, emotional functioning, behaviors, and this involves a concomitant change in neural functioning.

      Psychotherapy changes the brain - Neuroplasticity

      Brains are inherently social.

      Target interventions to specific neural capacities.

      Brain is constantly changing throughout life.

      Social connections lead to new or changed neural connections.

      We cant not affect one another.

 

Neuroplasticity

      The ability to continue to develop new neural pathways throughout the lifespan – allows genetics and the environment to interact in brain development; the specific experiences an infant encounters will trigger a cascade of specific neuro-biochemical reactions that can enhance or block gene expression; thus, experience continues to change the structure of the brain across the lifespan, making every human brain unique (Davino & Moore, 2010).

 

Neural Capacities & Psychotherapy

      Emotion

o   Affect and affect regulation

      Memory

o   Implicit versus explicit memory

      Mirror Neurons

o   Social cognition, empathy and interpersonal processes

      Prefrontal Cortex

o   Executive functions and interpersonal relationships

      Von Economo Neurons

o   Knowing self and other.

 

Emotion

      Old View of Brain

o   Emotion Interrupts thinking

o   Thinking was superior to emotion

o   Cognition and emotion were separate processes

      New View of Brain

o   Cognition and emotion are inextricably linked

o   Emotion informs decision-making

o   Cant have one without the other

      Sometimes we need more than one than the other to constructively problem-solve.

      Which one that is will vary from situation to situation

      Flexibility is key

      One of the capacities of the Prefrontal Cortex is Cognitive Flexibility – The ability to move off of set and apply different strategies to changing demands.

 

Presuppositions about Emotion

      Emotion and feeling are two different processes

      Emotion occurs in the body, feeling in the prefrontal cortex

      Emotions are generally unlearned reactions to events that cause a change in the state of the body

      Emotions help us solve problems or endorse opportunities

      Emotions promote survival and state of well-being

      Strong/weak, activating/calming, approach /withdraw

      Three types: Primary, background and social

 

Presuppositions about Feeling

      Feeling occurs when we are consciously aware that we are having an emotion

      Feelings allow us to make thoughtful decisions about how to respond to emotion – they allow choice

      Feeling allows us to consciously connect the stimulus with the emotion

      Feelings have the possibility of revealing good for life and not good for life states

      Feelings allow for control of the expression or response to emotion

 

Emotion Process

      Sensory input or attention (can be external or internal)

      Appraisal or evaluation (Is this good for life or bad for life?) – Thinking Fast and Slow

      Source Point in the brain (eg, amygdala, ventral medial frontal cortex)

      Behavioral response (eg, change in facial expression, language, other behaviors)

      Automatic – No Choice – Not Conscious

 

Different Types of Emotion

      Primary

o   Fear, Anger, Disgust, Surprise, Sadness and Happiness

      Background

o   Good or bad and everything in between

      Social

o   Shame, Compassion, Gratitude, Guilt, Pride, Awe, Love

      Background continual

      Primary more sporadic

      Social within the context of social relationships

      One type can affect the other - Layering

 

Feeling

      Feeling requires an awareness of a change in the body.

      Feelings reveal to us this change

      Feelings involve labeling that change into emotional terms (anger versus hunger)

      Feelings allow us to identify the stimulus or reason for the emotion

      Inhibit reaction long enough to decide the best way to respond (PFC – Inhibition Control)

      Tolerate emotion long enough to reflect – rather needing to act right away (PFC – Self-Reflection)

 

Affect Regulation

      The process of moving from an activated state to one of calm – well-being

      Its the solution to the emotion – either solving a problem or taking advantage of an opportunity

      Generally two types of affect regulation

o   Antecedent-focused

o   Response Focused

 

Antecedent-Focused Regulation

      Example: Visiting the Family for the Holidays

      Situation Selection

o   To go or not to go, that is the question

      Situation Modulation

o   Do we sleep at your mothers or at a hotel?

      Redirecting Attention

o   I cant talk to your father, hes angry all the time!

      Shift Perspective

o   He cant help himself, he was traumatized as a child.

 

Response Focused Regulation

      Adaptive responding to the affect

o   Walk away

o   Seek help or support

o   Breathing

o   Talking versus showing

o   Medication (both antecedent and response focused)

o   Meditation and mindfulness

      Maladaptive responses

o   Denial, blaming, eating, drugs, alcohol, aggression, violence, withdrawal, devaluing verbally, etc.

 

Working with Emotion in Therapy

      Depending on your own relationship to emotion, you may either welcome it or move away from it.

      Reflecting on emotion from the past is not as robust an agent of change as working with emotion in the present.

      Some didactic material about the difference between emotion and feeling may be helpful, but not critical.

      In the present, working with emotion is less predictable, less safe and more real and personal.

      Its the kind of interaction that clients remember.

 

Memory

      Everything in life is memory; save for the thin edge of the present.  Michael Gazzaniga, 2000 (The Minds Past)

       

      Short Term Memory

o   Sensory Memory

o   Working Memory

      Long Term Memory

o   Semantic Memory

o   Episodic Memory

o   Procedural Memory

 

Making & Retrieving Memories

      Hippocampus and surrounding cortex of the mdial temporal lobes is essential to making and retrieving memories.

      During learning, the hippocampus links together information from other parts of the brain – visual, auditory, sensory, etc. – into a memory trace (biochemical/structural change). 

      During retrieval, the hippocampus triggers these memory traces; so starts the process of recall; usually with a part of the memory.  The rest of the memory gets reactivated in time.  This process involves a reactivation of a distributed network of representations in the cortex.

      Some memories are easier to recall because of co-occurring emotion or important to sustaining life.  These neural traces become more consolidated over time, especially the more they are recalled. 

      Cortical memory traces may overlap with each other.  That way we can make generalizations from one circumstance to another. For example, mother-son memories may generalize to woman-male intimate memory.  If you learned how to drive in a 50 Chevy Bel Air, you dont want to start all over when you get into 1955 Ford Thunderbird.  This overlap allows for knowledge and associations to bridge across different domains. 

      Practice remembering strengthens memory.  Some researchers suggest that this can lead to confabulation. 

      Context is critical to remembering (barista on the bus).  Going home for the holidays is likely to trigger memories rather than going on a trip to a foreign country (unless the country is family related – Ukraine). 

 

Implicit & Explicit Memory

      Explicit Memory: Involves conscious awareness, at the time of remembering, of the information, experience or situation being remembered.

      Implicit Memory: Where behavior, feelings or thoughts are influenced as a result of prior experience, but which is recalled or manifests without conscious recollection of the original events.

      With implicit memory, there isnt a sense of remembering, just experiencing.

      Much of therapy involves the recollection and experiencing of both types of memory.

 

Priming

      Priming is a form of implicit memory; the exposure to an earlier stimulus/event increases the probability of a response to a later similar stimulus/event.

      Table - Complete a word Tab

      Childhood experiences include priming – response patterns that become automatic, without thought.

      Secure base priming – A form of priming that facilitates an insecure to secure-like responses to stimuli

      Anger and negative reactions to individual and group differences.

 

Priming Techniques

      Priming Techniques (experimentally)

      Exposing people (subliminally or supraliminally) to security-related words (e.g., love, hug, affection, and support) or the names of an individuals security-providing attachment figures;

      Exposing people (subliminally or supraliminally) to pictures representing attachment security; and

      Asking participants to recall memories of being loved and supported by attachment figures, or asking people toimagine such scenarios.

      Subliminal and Supraliminal priming even overrides the effects of negative self-esteem.

      Subliminal: primed without awareness

      Supraliminal: primed with awareness

      Repetition is Key

      Repetition thickens that neural pathways and makes the new behaviour easier to maintain.

      Parental priming: interactions between parents and between parent and child.

      Therapy is a form of priming

      Helping the brain respond to emotions

      Experience relationships differently

      Anticipating positive outcomes

      Subliminal processes from therapist

      Supraliminal processes: through narratives

      Taking in love, caring and support

 

Finding Truth

      Many studies have consistently documented the inaccuracy of memory.  We are prone to confabulation (filling in the blanks) and simply making up facts in order to make sense of the past.

      So when clients talk about their past, you need to take it with a grain of salt as to the truth of the facts. 

      However, attachment researchers have an interesting spin on this dynamic.

      The Adult Attachment Interview is an interview questionnaire that is utilized to assess attachment status.

 

Adult Attachment Interview

      The questions involve the subjects childhood relationship and experiences with caregivers.  But the actual fact of the relationships and experiences are not that important.  What matters is the coherence of the narrative.

      a coherent interview is both believable and true to the listener; in a coherent interview, the events and affects intrinsic to early relationships are conveyed without distortion, contradiction or derailment of discourse. The subject collaborates with the interviewer, clarifying his or her meaning, and working to make sure he or she is understood.  Such an subject is thinking as the interview proceeds, and is aware of thinking with and communicating to another; thus coherence and collaboration are inherently inter-twinned and interrelated.

 

Creating a Coherent Life Story

      From a neurobiological perspective, coherence involves both thinking (cognition) and feeling (emotion); seeing the situation from your point of view (self reflection), but also seeing it from others point of view (social cognition).

      Therefore truth is not as important as making sense of what a person does remember or believes happened to him or her.

      Many memories are not readily available so how do we even begin to construct a narrative?

      Extrapolation - Patterns usually persist, so what is remembered can give insight into earlier experiences.

      Talking with siblings, other relatives and friends.

      Family photos and other memorabilia

      Letters and other writings from family members

      Current behavior patterns with partners (priming)

      Current parenting behaviors (priming)

 

Mirror Neurons: Overview

      First described as visual-motor neurons that fire when an action is performed, and when a similar or identical action is observed (Rizzolatti and Craighero, 2004).

      Associated to cognitive functions of imitation and action understanding to social cognition. 

      Been associated with MS, schizophrenia, autism and spectrum disorders and alexithymia (deficiency in understanding, processing, or describing emotions). 

 

An Example of Mirroring

      You are on a bus from Reno to Lake Tahoe (Highway 50) and you notice the person next to you all of a sudden looking pale.  They start retching and filling a paper bag with clumps of undigested food.  What do you feel?  You feel a sense of nausea that one feels with motion sickness. 

      When we witness such experiences we activate;

      Mirror neurons in the insula that would be active if we were experiencing such feelings, and

      Mirror neurons in our premotor and parietal lobe that would be active if were were performing those physical actions (throwing up).

 

Are they real?

      Still controversial

      Meta analytic study by Molenburghs, et al (2011)

      300 published studies and 125 that met their strict inclusion

      A core network of human brain regions do in fact possess mirror properties that not only include action and observation but non-motor activities auditory, somatosensory and affect. 

 

Are MNs relevant to our work?

      We are in the business of watching, listening and feeling others. 

      Understanding others intentions in relationships

      Emotion regulation issues.

      Transference – Countertransference

      Understanding behavior and motivation

      Child development - Attachment

 

Theodore Lipps

      Philosopher Theodor Lipps (1851-1914) is remembered as the father of the first scientific theory of Einfhlung (feeling into, or  empathy).

      Unlike his predecessors, he used the notion of Einfhlung to explain not only how people experience inanimate objects, but also how they understand the mental states of other people.

      In 1903 he suggested the perception of an emotional gesture in another directly activates the same emotion in the perceiver, without any intervening labeling, associative, or cognitive perspective-taking processes.  He called this inner imitation.

      Although his ideas were eclipsed by experimental psychology and behaviorism, his ideas have found reflection in present day theories of imitation and mirroring.

 

Whats your intention?

      Emotion and intention closely linked.  Intention can also be mirrored between client and therapist.

      Clients come into therapy with not only not-conscious emotions, but also not-conscious intentions.

      Is the client distancing or withdrawing?  Is the client looking to the therapist to think for him or her or inappropriate caretaking?

      The client not going to talk about this if its not conscious; they are going to show their intentions.

      Mirroring can help to identify these intentions.

      Whats going on when the therapists mind begins to wander? What about when the therapist starts to talk a lot in the session? What about when the therapist starts to feel sleepy?

 

Mind and Body

      Mirror neurons are closely linked to motor neurons.

      Our bodies play a crucial role in emotional, cognitive and motivational processes. 

      Without our bodies, its difficult to experience emotion

      Its a two-way street – changing the state of our body changes our brain (meditation) – becoming aware of our bodies (mindfulness) changes our experience of self and other.

 

Emotion and Motivation

      Emotion is derived from the French word, emouvoir, which is based on the Latin word emovere, where e means out and movere means move

      Interestingly, the word motivation is also derived from movere

      So emotion and motivation are rooted in a term that means to move (toward or away).

       And our bodies rarely act without movement.

      Our bodies dont experience emotion without movement.

 

Emotion & Neuroscience

      And this is exactly what emotions are from a social neuro-scientific point of view: an inner state of another individual that comes out through her or his movements and can be perceived by another.

      There are always two aspects to our perception of the emotions of others (top down):

      The perception of bodily movements and behaviors that signal the emotion and,

      The cognitive deduction of the perceiver deduces or hypothesizes the inner state of the other. 

 

The Process of Mirroring

      Mirroring is a bottom-up process

      Mirror neurons that activate emotional centers in the brain as if we are experiencing similar emotional states and,

      Motor neurons that are activated as if we would perform the actions that signaled that emotion (i.e., facial and bodily movements).

 

Why is this important to us?

      As therapists we are trying to get into the minds of our clients.  

      If asking our clients about their inner states was all that was necessary to do that, then our jobs would be much easier.  

      Unfortunately, many of the people who seek psychotherapy services have had experiences that resulted in difficulty identifying, constructively regulating and understanding their emotions and expressing intentions, which often results in their showing their emotions and intentions rather than talking about them (alexithymia).  

      Acting Out – Showing rather than telling.

      Although many intentions and expression of emotions are fairly evident (even to the untrained eye), some are not so obvious.

      We are taught to pay attention to non-verbal cues in order to understand our clients mental states.

      Mirroring is another way to understand those states. 

      A bottom-up process (experiencing which leads to understanding) rather than a top-down process (recognizing which leads to understanding)

 

The Prefrontal Cortex

      Orbital Frontal Cortex (OFC) also called the Ventral Medial Cortex located in the prefrontal lobe behind the forehead and above the eyes

      Anterior Cingulate (front part of Cingulate Gyrus) located at the bottom of the Neo-Cortex on the top of the Limbic system

      The above two comprise the Medial Prefrontal Cortex

      These areas regulate functions that are critical to healthy interpersonal relationships.

 

Orbital Frontal Cortex

      Location, location, location

      One synapse away from limbic system, cortex and brain-stem.

      Has more direct access to the emotional centers of the brain than any other part of the neo-cortex

      Plays a role in integrating emotion, thought and behavior

      Not fully wired until 25 years of age (18-voting, 21-drinking and 25-renting a car)

      Critical in long-term planning and impulse control

 

Anterior Cingulate

      The Cingulate Gyrus (folds) just below the neo-cortex and along the top of the limbic system.

      The front of this area is called the Anterior Cingulate

      Doesnt fully come online until 9-12 months of age

      Determines what goes where – in that it regulates attention, inhibition control, involved in attachment behaviors, nursing and play, regulates aggressive impulses, has facial recognition cells, empathy, physical pain, social ridicule and rejection.

 

Orbital Prefrontal Cortex + Anterior Cingulate =

      Medial Prefrontal Cortex which regulates:

      Body regulation – Autonomic Nervous System – the accelerator and brakes of our body; and the hypothalamus and its release of hormones

      Attuned communication between parent and child, as well as between adults

      Affect regulation – balancing thought, feeling and action

 

The Nine Functions of MPC

      Daniel Siegel, author of numerous books on neuro-science, mindfulness, parenting describes the 9 functions of the MPC:

      Body regulation

      Attuned communication

      Affect regulation

      Response flexibility

      Empathy

      Autonoetic consciousness

      Fear reduction

      Intuition

      Morality

 

Strengthening the MPC

      Early childhood attachment experiences affect the development of all these capacities

      Clients with emotional difficulties are usually needing strengthening in one or more of these areas

      Neuroscience-based psychotherapy involves formulating interventions to strengthen one or more of these capacities, while attending the customary process of building and strengthening the therapeutic alliance/relationship.

 

Von Economo Neurons

      Constantin von Economo (1876-1931): Organized the cortex by cytoarchitecture (structure of cells).

       Divided the cortex into 7 lobes and each lobe with subdivisions (frontal-35; superior limbic-13; inferior limbic-14, etc.).

      Identified a specific type of neuron in the anterior cingulate and fronto-insular cortex (von Economo neurons).

      Both areas are particularly active when we experience emotion and self monitoring.

      The anterior cingulate seems broadly involved in nearly every mental or physical effort.

      The frontal insula may play a more specific role in generating social emotions such as empathy, trust, guilt, embarrassment, love—even a sense of humor.

      Only recently have received attention because of their identification in macaque which allows greater study.

      VENs thought to be the neural mechanism for fast social intuitions in uncertain situations – I like, I dont like.

      Rare at birth.  Start to increase during the first 8 months post birth.  Significantly greater numbers in the right hemisphere than the left, which suggest their function in attunement.

      Associated with dementia, autism, schizophrenia & depression

      Deficiency: deficits in empathy, social awareness & self-control

      Over-abundance: schizophrenia and suicidal-depression

      Produce proteins that are involved in immune response and digestion, suggests their role in monitoring of a body-loop that incorporates visceral states and emotions in the awareness of self and others (mirroring).

 

Von Economo Neurons & Consciousness

      Awareness of ones own mind and awareness of the minds of others are two separate but important processes necessary for successful interpersonal functioning.  Both require a form of consciousness.

      Theories of consciousness: Antonio Damasio – Proto, core and extended

      Proto: non-conscious, related to the bodys homeostatic mechanisms

      Core: awareness of self, self-states and others, other-states

      Extended:  autonoetic – past, present and future

      Von Economo neurons seem to be most related to core consciousness – knowing self and other

 

Core and Extended Consciousness in Psychotherapy

      Psychotherapy is a process of strengthening core (CC) and extended consciousness (EC)

      Core Consciousness

      Knowing self (emotion, thoughts, behaviors)

      Knowing/awareness of others

      Empathy and social cognition

      Mirroring

      Extended Consciousness

      Connecting past and present

      Implicit memory and its effect on the present

      Intention to change

 

Strengthening Economo Neurons

      Interventions that Strengthen Self

      Identifying thoughts and beliefs

      Identifying emotions and feelings

      Awareness of behaviors

      Emotion regulation skills

      Theory of mind - Self

      Interventions that Encourage Social Awareness

      Emotional Empathy

      Cognitive Empathy

      Sympathy

      Theory of mind - Others

 

Neuroscience of Self-Other Differentiation

      Damage to right hemisphere (temporo-parietal region) interferes with self-recognition (face).

      Patients with right fronto-parietal damage often suffer from asomatognosia: the failure to recognize part of ones body.

      Right ventral prefrontal damage can result in loss of autobiographical memory.

      Right medial prefrontal cortex involved in differentiating self-other mental states.

      Insula active when differentiating self-other (VENs?)

      Inhibition seems critical to the process.

 

Separating Self and Other

      Too Dichotomous: disconnected, estranged from others, oblivious to others minds, indifference.

      Too Entangled:  emotionally over-reactive, merging of minds, difficulty tolerating differences.

      Mirror neurons allow for a shared experience and may contribute to entanglement.

      In general, Mirror Neurons can be said to allow for a shared experience with others (feeling others emotions or intentions). Von Economo neurons allow for a sense of separation from others (knowing that self is separate from other – that others have their own minds and intentions).

      Self-reflection (theory of mind) can help to create separation (self-other differentiation) without losing the shared experience.

 

Thank you for completing my online CEU program.  If you have any questions or comments, please feel free to contact me at any time.

 

If you are interested in further readings on these and other topics, visit my Additional Reading page.  This page is continually being updated.

 

To receive your certificate of completion, please complete the Online Evaluation Form.  As soon as I receive your answers, Ill post your certificate of completion and send you an email with that link.

 

Thank you again for your participating in my continuing education program.

 

Daniel Sonkin