Reader Viewpoint

Simple therapeutic interventions for rewiring the maladaptive brain

Nicholette Leanza October 1, 2012

When taking my undergraduate and graduate classes many moons ago, my least favorite courses were Biopsychology and Cognitive Processes, during which our professors would lecture at great length about the structure and function of the brain. As a student embarking on a new career in mental health, I was aware I needed to know this important information, but I just couldn’t get into it. So, I skipped along in my career, content to understand the basics of the brain without really applying this knowledge in any useful manner.

But a few years ago, while researching ways to keep my counseling techniques fresh, I came across several articles that covered the most recent discoveries in neuroscience. That research ignited my current love affair with the most complex organ in the universe — the human brain — and helped me to understand how people really change their behaviors.

Let’s take a moment and ponder that question: What really causes an individual to change his or her behavior? You might answer that question in many ways depending on your theoretical perspective and on your specific observations and experiences dissecting human behavior. Regardless of how you answer, one fact is that change must first occur at the neurological level before we will see it at the behavioral level.

Understanding the biology of the human brain can also assist clinicians with understanding how and why people change. Clinicians are successful at their craft when they can produce a physical change in their clients’ brains. Obviously, they cannot get inside and rewire a brain, but they can set up conditions that favor this rewiring and create an environment that nurtures it (see The Art of Changing the Brain by James E. Zull). This article will explore how individuals change their behavior neurologically and examine some therapeutic techniques to stimulate this fascinating process.

Neural networks

The human brain is constructed of a vast amount of neural networks that form every thought or experience people have in their lives. Neuroscientists have found that these networks are interconnected as an intricate web of memories, thoughts and experiences. Hearing a special song can kick-start a flurry of recollections; a particular scent can guide an individual toward a memory of a particular person or place. This phenomenon indicates how the brain is circuited for memory.

For example, take the word teacher. Each person has a specific neural net that was created on the basis of experiences with the various teachers in his or her life. Another way to look at this is as a type of associative memory. Thoughts, ideas and feelings are constructed and interconnected in a neural net that may also have a potential relationship with another network of neurons. So, mention the word teacher, and one individual may automatically picture her lovely fifth-grade teacher, while another person might think of his difficult college math instructor.

Feelings and emotions are also entangled within neural networks. For example, the word love is stored in a vast neural net that is based on an individual’s experience with that term. Subsequently, the concept of love is also created from many other ideas. For some people, love may be connected to the memory of disappointment, pain or anger. Anger may be linked to hurt, which may be linked to a specific person, which then is connected back to love (for more on this, see What the Bleep Do We Know!? by William Arntz, Betsy Chasse and Mark Vicente). Therefore, when a person thinks of “love,” she may remember the person who broke her heart and still be angry about it. In essence, the enormous number of neural nets that each human possesses color all of his or her perceptions and interactions with other people.

Neurocounseling

Insights in the field of neuroscience reveal that many emotional and behavioral disorders previously believed to be the product of environment or experiences can be rooted in neurobiology. This is what synchronizes us to the idea of “neurocounseling,” the term I use to describe therapeutic interventions that assist people in changing their maladaptive neural connections. Other terms that also describe these types of techniques are “brain-based therapy” (John B. Arden and Lloyd Linford) and “neural pathway restructuring” (Debra Fentress).

When one thinks of his or her life experiences, what is being contemplated is really the experience of that person’s neurons. The experience cannot be predicted because it comes from the complex and random events of one’s life, and it cannot be programmed. Counselors strive for their clients to understand their maladaptive behaviors, and this is accomplished through the changing of the individual’s neural connections. Unless some change in these connections takes place, no progress or understanding will occur.

One important note is that counselors cannot remove specific neural nets that already have been established in a person’s brain. According to Zull, these nets actually leave a physical imprint on the brain. Instead, counselors must let clients use the neural nets they have already built — and which are related to clients’ own life experiences — and then use those as the foundation for motivating new neural nets to blossom. This is the only way a person learns new information and changes his or her behavior.

People must be able to relate to something before they can understand it, which is why the set neural nets are so important. If no established net exists, the individual has no reference point to understand or to change. Counselors may wish for clients to have more positive connections that cradle their self-esteem in the specific neural networks or fewer connections when it comes to their addiction to gambling, but unless some change takes place in these connections, no progress or change in behavior will occur.

Changing neural networks

The first step to facilitating change in neural nets is to identify them. One way to figure this out is simply to have clients talk about previous life experiences. The counselor’s job is merely to listen and pay attention to what clients say about themselves. Even in the first therapy session, as we build rapport and gather information about the client’s history, we can begin to identify his or her neural networks. By asking numerous questions, we generally get a feel for the individual’s overall issues such as difficulty trusting others, low self-esteem or poor anger control. As we identify the client’s established neural networks, we also can begin to work within the realm of the client’s experiences.

Identifying a client’s neural networks and inspiring a physical change in the client’s brain involves seeing counseling in a different light, which can likewise encourage new counseling techniques. Remembering how personal and individual a person’s neural nets can be allows counselors to experiment in different sensory avenues such as art therapy, music, therapeutic stories, psychodrama and other creative techniques. Each of these avenues can help facilitate the process of engagement and provide interesting ways to stimulate the senses. This type of sensory input will engage the networks to be active and open to learning new information. Neurons that are repeatedly used grow stronger. The more these neurons fire, the more they send out new branches looking for fresh and useful connections. Neural networks are also flexible, meaning new experiences can be added to old ones and old ones can be blended with the new. As new and different networks fire, the brain will form new connections and will physically begin to change.

One of the best approaches good clinicians can take is to help clients feel they are in control. One way to do this is to allow clients to draw from their own experiences. Clients often come to therapy with some positive networks already established, and once those networks are understood, clinicians can build on them. As previously mentioned, engaging clients’ senses through creative therapeutic techniques can be helpful in stimulating their interest in therapy and in generating new neural networks. Furthermore, cognitive behavior techniques such as “thought stopping” and “thought replacement” can be useful in creating the framework for new nets. When fresh neural nets bloom because of an insight gained into a situation or a behavior, the counselor can be assured that the client is on the path to healing.

Case example

I recently worked with a client who was referred with issues of anger and depression. She struggled with controlling her temper and often would have outbursts of anger toward others at her job, at home and at school. She also had a tendency to become easily frustrated. In gathering information about her background and experiences, I deduced that many of her neural networks were dedicated to anger over the physical and emotional abuse her mother had perpetrated on her as a child. As I began to understand her realm of experiences and relate them to the biology of her brain, I recognized that her brain was essentially wired for anger.

During one of our initial sessions, this client shared that her mother had also been a victim of physical and emotional abuse as a child. Because the client already had an established net for what it was like to be abused, I was able to guide her toward the insight that her mother was also most likely struggling with anger and depression stemming from her own abuse issues. The client was able to identify this insight because of her already established neural net and was able to begin to work on seeing her mother from a different perspective. She blended her old neural net — anger toward her mother — with a new neural net of being able to empathize with her mother.

Because networks grow stronger the more they are used, I knew it was important to keep the client seeing things from a new perspective. Building on the foundation of several important insights, I was able to help the client continue to change her thinking and reactions toward her mother, which in turn led to a decrease in her own anger. The biological change of her neurons directed the change in her thoughts, which ultimately changed the wiring in her brain. My role was to help her identify the neural net maintaining her anger, assist her to build a new neural net based on insight and empathy, help her to continually reinforce this healthier neural net and then help her to make the net stronger through use and application.

Conclusion

Teaming the fields of counseling and neuroscience demonstrates how these two disciplines can enhance each other. The human brain is a learning organ, and by exploring the biology of the brain, mental health professionals and neuroscientists can discover new and innovative approaches for the advancement of both fields. Mental health professionals who understand the biology of the brain will find it a valuable asset in also understanding how change occurs in human behavior. The practice of identifying established neural networks and then building on them to form positive connections will lead clients to change their maladaptive behaviors. In essence, a person’s neural nets are the building blocks that construct their thoughts, which ultimately create their reality and perceptions.

To increase the likelihood that new connections will form, it is important to work with clients’ current established neural nets, which will enable clients to gain greater insight into themselves or their situations. Therapy techniques that engage the sensory brain are often helpful in facilitating the neural creation process. Furthermore, cognitive behavior techniques can help clients use more effective and adaptive networks.

As neuroscience continues to unlock the mysteries of the human brain, it is imperative that mental health professionals pay attention to these revelations so that a more thorough understanding of the secrets to human behavior can be discovered.

Nicholette Leanza is a supervising professional clinical counselor and licensed psychotherapist with substantial experience working with children, adolescents and adults in a variety of treatment settings. She works as an adjunct instructor of psychology and sociology at the University of Phoenix, Cleveland Campus. Contact her at nleanza1@gmail.com.

Letters to the editor: ct@counseling.org

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