Foreword

As we move deeper into the 21st century, we carry with us a wealth of data, theoretical knowledge, and new technologies unimaginable just a few short years ago. As a result, we are moving past the linear logic and simplistic nature-nurture debates so prevalent during the 20th century. We now find ourselves thinking in terms of complexity, self-organizing systems, and the synergistic interactions of mind, brain, genes, and culture that create all living systems and give rise to human experience. These new discoveries are important scientific advancements that are leading us to a deeper and hopefully more accurate understanding of mental health and mental illness. It is my pleasure to welcome Mind–Brain–Gene into the Norton Series in Interpersonal Neurobiology as part of this important movement.

In this new book, John Arden takes a long stride forward in articulating an emerging model of clinical theory, case conceptualization, and therapeutic practice that attempts to integrate these new scientific findings into clinical practice. Multiple areas of research from genetics, epigenetics, and neuroscience, to attachment, development, and psychoneuroimmunology have demonstrated the complex interconnection taking place between our minds, brains, and genes during lifelong adaptation and change. While many are overwhelmed by the complexity of these multiple fields and retreat to narrow definitions of “how to” modes of therapy, Dr. Arden takes on these challenges with interest, enthusiasm, and compassion.

Mind–Brain–Gene is a wake-up call for those who think that knowing how to use a specific technique is enough to be an effective psychotherapist. Being a psychotherapist is far more than following a manual, assigning homework, or applying one technique. It is grounded in careful observation, active listening and learning to ask the right questions. It is knowing and being able to creatively utilize relevant information from an array of scientific disciplines. Finally, all of these things need to be grounded in an existential engagement with our clients fueled by curiosity, caring, and compassion. You will find all of these qualities embodied and expressed in Dr. Arden’s examples and case studies. You will notice that while his thinking is sophisticated, his interactions and interventions are straightforward and altogether human. Knowing how to communicate with clients is just as important as having the right answers.

This book is being published at an interesting time in our field. On the one hand, advances in neuroscience and epigenetics are making it clear that psychotherapy is a powerful intervention. We are learning that the nature and quality of relationships throughout life have the ability to trigger epigenetic processes that alter gene expression in ways that can both help and hurt us. We also know that brains are adaptational processes, hubs of energy and information that can be significantly altered within healing relationships. Psychotherapy is clearly a deeply biological intervention, as well as a social and emotional one, central to the fabric of the human life. Despite what many medical professionals believe and what insurance companies profess to support their bottom lines, psychotherapy is not a second class or subordinate form of treatment. It is relevant, powerful, and makes a difference in the lives of untold numbers of people.

On the other hand, the field of psychotherapy is moving in the direction of being “paraprofessionalized” and almost anti-intellectual. An ever-growing number of training programs march students through a list of antiquated academic courses, send them to practicums where they are undertrained, and socially promoted rather than rigorously evaluated. Our clients are people in need and psychotherapy is a powerful treatment modality that needs to be taken more seriously both by society and the field of mental health.

In Mind–Brain–Gene, Dr. Arden is challenging us to think more broadly, more deeply, and in a more complex manner about the factors that contribute to human health throughout life and across the generations. He is summoning us to open our eyes to the broader horizons of human experience in which we and our clients live and to bring this knowledge to bear in our thinking and work. Dr. Arden is also inviting us to consider new ways of thinking and to not be frightened by what we don’t know or find difficult to understand. My hope, and most likely his, is that this expanded knowledge and way of thinking will lead us to more inclusive case conceptualizations, accurate diagnoses, and efficacious treatments.

Louis Cozolino

Los Angeles, 2018