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Art and Science of Therapy: Why It Works

  “Some people feel the rain,  
    Other people just get wet.”
Bob Dylan


“Broadly, it appears that bringing conscious awareness to  bear on particular facets of our experience triggers neural firing in areas of the brain associated with those experiences.  When awareness is repeatedly focused on such experiences, new synaptic connections are generated, eventually resulting in “cortical remodeling”.  The clinical implication here is that by repeatedly focusing on, and linking, different aspects of the patient’s experience – somatic, emotional, representational, and so on – we can establish new connection in the patient’s brain.  Such connectivity is the neural equivalent of the psychological integration we hope to facilitate for the patient through a relationship that is more inclusive and collaborative than those that originally shaped him."        David Wallin, Attachment in Psychotherapy

Incorporating what we have learned from evidenced based research in attachment, relationship and neuroscience studies has been an exciting challenge.  Integrating the wisdom of the nonverbal body and our emotions with intellectual insight has been the answer.

Fully understanding the fundamental connection between mind and body is critical and has important clinical implications.  Neurobiological evidence argues convincingly for the inseparability of mind and body, asserting that feelings are essentially the mind’s readings of bodily states – that all emotions have a neural and biochemical corollary.

Being anchored in the emotional signals that issue from the body can result in the experience of “embodied mind”.    Integrating the various dimensions of the self (somatic, emotional, sensory, motor,  representational, analytical, reflective, mindful) and establishing interconnectivity between the separate domains of the brain (left and right, cortical and subcortical) are two sides of the same coin and make possible the most coordinated use of all of the brain’s potential resources.

The good news is the break-through finding of “NEURAL PLASTICITY”: the brain can be reshaped by current experience that not only establishes new neural connections but also alters the actual physical structure of the brain.

Psychological integration – that links differing states of mind as well as mind and body, thought and feeling, self-definition and relatedness – ensures that we can have access to the depth and breadth of the whole of our experience.  Such integration allows us to develop and harmonize the multiple dimensions of the self rather than feel the necessity to deny or disown parts of ourselves.  


With a mind that is embodied, we feel grounded, our actions directed from within.  We have useful, psychologically enriching access to our somatic sensations and our emotions.   The mindful body is an awareness that not only can be sensed and known but can sense and know.  There actually are “hearfelt feelings” and “gut reactions” which can give us access to a depth of self-awareness and awareness of others that is otherwise unavailable.  When inhabited by a mind informed and enlivened by the body we can feel more fully present and vital.

"...clinical implications of some recent neuroscience findings (Damasio, 2003; Siegel et al., 2006) are those suggesting that in both evolution and individual development "higher" (cortical/left hemisphere) structures in the brain are built upon - and often dominated by - "lower" (subcortical/right hemisphere) ones.  In keeping with this pattern of influence, neural "traffic" is much heavier from the bottom up - from the amygdala (fear response) to the cortex (fear management) - than from the top down (LeDoux, 1996).  These facts argue for a correspondingly bottom-up approach in psychotherapy that consistently grounds clinical work in the bodily sensations and emotions that underpin behavior and thought.  They also argue for including a focus on the nonverbal, primarily right brain-dominated dimension of the therapeutic relationship that is expressed through what is sensed, felt, and done, rather than said (van der Kolk, 2006; ogden, Pain, Minton, & Fisher, 2005; Schore, 2005).                                                                                                                                                                                                                                                       David Wallin, Attachment in Psychotherapy



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