AN INTERPERSONAL NEUROBIOLOGY PERSPECTIVE draws on a broad range of disciplines to create an integrated picture of human experience and the development of well-being. Using parallel findings from various fields of science, clinical practice, and the expressive and contemplative arts, this consilient approach to understanding “being human” attempts to weave a wide vision of our subjective experience. By bringing together often disparate ways of knowing, the aim of this endeavor is to expand our view of the mind and promote well-being in individuals, couples, families, communities, and our larger society.
Trauma has a huge impact on all aspects of our human civilization and individual lives. Yet, the reality of trauma is often overlooked in societal approaches to public policy, education, and the resources offered for the promotion of mental health. How can the pain of trauma be so often missed? When we write books or formulate approaches to an issue, we are often filled with concepts and words that distance us from the experiential reality of the topic at hand. Often we think in words, creating abstract ideas framed by linguistic packets of information, such as these you are reading right now. Such word-based theoretical frameworks are important in pulling us out of the immediacy of moment-to-moment experience, allowing us to gain a perspective on the larger picture than what direct sensation by itself allows. The benefit of this experiential distance is to give us a clearer vision of the whole by creating a wide perspective of a broad entity. But abstract ideas symbolized by words can also make it difficult for us to sense the “lived” details of our human experience. Such experiential knowing is often created best through direct sensation. Without the balance of the non-linguistic world of images, feelings, and sensations, the seduction of words and ideas can keep us from direct experience in our daily lives and professional work. On a societal level, such an imbalance can keep us in a state of denial. In a psychotherapeutic setting, focusing primarily on word-based thinking and narratives can keep therapy at a surface level and trauma may remain unresolved. An overemphasis on logical, linguistic, linear, and literal thinking may tilt the balance of our minds away from the important sensorimotor, holistic, autobiographical, stress-reducing, image-based self-regulatory functions of our non-verbal neural modes of processing. Linking these two very different but important ways of knowing is the essence of creating balance in our lives and in our understanding of complex human experiences such as trauma.
The central idea of interpersonal neurobiology is that integration is at the heart of well-being. Integration is the linking of differentiated elements into a functional whole. With an integrated system, our lives become flexible, adaptive, coherent, energized, and stable. Without this integration, the flow of our minds moves toward rigidity or chaos. In this way, trauma can be seen to fundamentally impair integration within an individual, dyad, family, or community. Posttraumatic states are filled with experiences of rigidity or chaos that continue the devastation of trauma long past the initial overwhelming events. By integrating many domains of our experience within a receptive form of awareness, we develop a more connected and harmonious flow in our lives. Such linkages include implicit with explicit memory, left-with right-hemisphere modes of processing, and mindful awareness with bodily sensation. Our minds have an innate movement toward integration and healing that may often be blocked after trauma. Releasing this drive toward well-being is a central goal of psychotherapy that enables the creation of integrated states that establish adaptive self-regulation. The therapist can utilize the view that neural integration, a coherent mind, and empathic relationships form three sides of a triangle of mental health that can be seen as the focus of healing in the process of psychotherapy.
Within an interpersonal neurobiology view of therapy, as we “sift” the mind, we attempt to integrate the sensations, images, feelings, and thoughts that comprise the flow of energy and information that defines our mental lives. Sensations include the non-verbal textures created by the body that involve the state of the muscles in our limbs and face, our internal organs, impulses to act, and actual movements. Sifting the mind with curiosity, openness, acceptance, and love—the “coal” that warms the heart of change—enables us to integrate these many elements of our mind in new ways that permit healing to emerge. As we focus on these many domains of the mind, the empathic communication within psychotherapy enables new states of coherence to develop as neural integration—the physiological linkage of the widely distributed neural patterns in the brain and body-proper—evolves and new forms of healthy, adaptive self-regulation are established.
In Trauma and the Body, Pat Ogden and her colleagues offer us deep experiential insights that can awaken our minds to the wisdom of the body. By turning toward the body with mindful awareness of here-and-now sensory experience, the pathways to integration are opened and healing becomes possible. This receptive awareness involves an accepting, loving, non-judg-mental attention that may be the essence of how the mind can move from chaos and rigidity in non-integrated states to the coherent functioning that emerges with integration. Mindful awareness of the body enables the individual to move directly into previously warded-off states of activation, which left the body out of the experience of mental life following acute or chronic traumatization.
With beautifully articulated applications of neurobiology extensively referencing state-of-the art scientific literature, the authors create an exquisite theoretical framework in the first half of the book. This framework sets the stage for the “whole forest” view that emphasizes why clinicians should intellectually and linguistically understand the central importance of the nonintellectual, non-linguistic neural and interpersonal processing of the individual. The mind, often unaware of these sensory and motoric states of the body, can finally achieve the integration that adaptations to trauma had blocked for so long.
The second half of the book offers a phase-oriented description of the “how-to” behind the practical aspects of these important therapeutic interactions. A sensorimotor approach to psychotherapy is more than just using the body as another frame of reference for rationalizing good psychotherapy. Rather, turning to the sensations, impulses, and movements of the body enables the therapist to open the crucial world of the non-verbal for direct processing within mindful awareness that is useful for a range of psychotherapeutic approaches.
Focusing on the body for the achievement of mental well-being is an approach spanning thousands of years of practice in the contemplative traditions. Somehow, in modern times, we have forgotten the hard-earned wisdom of these ancient traditions. Modern neural science clearly points to the central role of the body in the creation of emotion and meaning. Though some interpretations of neuroscience think of the “single skulled brain” as the source of all that is mental, this restricted view misses the scientifically established reality that most brains live in a body and are part of a social world of other brains. The brain is hard-wired to connect to other minds, to create images of others’ intentional states, affective expressions, and bodily states of arousal that, through our mirror neuron system’s fundamental capacity to create emotional resonance, serve as the gateway of empathy. In this way, we see that the mind is both relational and embodied. The authors of this wise text pay careful attention to the scientific reality of the embodied and relational mind in understanding the impact of trauma and in delineating a pathway toward healing. The interactions between therapist and client/patient seen through the light of this attachment-informed, somatic, and sensory-focused work enables clinicians of all persuasions to understand practical approaches to psychological growth and development in a new and useful light. While this perspective is based on extensive clinical practice, its theoretical framework is consistent with science. Bringing a sensorimotor focus to therapy pushes the envelope of our understanding of the interface between subjective experience and “objective” research findings into a wonderfully new realm: The authors have taken on the important challenge of putting words to a world without words. It is my pleasure to introduce you to their important contribution to understanding the relational and embodied mind in The Norton Series on Interpersonal Neurobiology. Let it bathe all the dimensions of your mind, and let us know your experience.