Posted by Pfinstegg on April 30, 2006, at 12:35:54
I went to a conference yesterday given by Dr. Douglas Watt of Boston University. It was enitled "Affective Neuroscience". Much of the first part had to do with which parts of the brain light up on fMRI's during various states of loss, attachment disruption and depression (in small primates mostly, but also in humans after various relationship losses). What was so amazing to me was how DEEP in the brain those parts were- they were about as far away from our rational, problem-solving cortexes as they could possibly be- in the basal ganglia, upper brain stem and nearby areas. Practically in our necks!
Then he talked about what implications this had for effective clinical practice. He had a simple model in mind- that depression equals attachment disruption. The primary model was an initial lack of secure attachment to a loving and responsive mother; all other things, such as physical or sexual abuse, were thought to cause depression. anxiety or panic- not too important which- because they cause a loss of trust and attachment also. He said that as evolution progressed towards larger and larger brains, social attachments became more and more important in order to protect our brains (100 billion neurons!) as they are growing. He said that the disruption of attachment and trust causes a lot of changes in brains- with the stress cascade (excessive cortisol) being the most well-known, but with other things, such as increased glutamate, increased Substance P, altered immune systems, etc. also being important although less well understood.
He said that the fact that attachment disruption causes unfavorable changes in such basic parts of our brains- the parts that we share with all animals who take care of their young- birds, reptiles. as well as all mammals- meant to him that it is often impossible in psychotherapy to use words and thinking in constructive ways to change something that is wordless. He feels that the best psychotherapy involves the development of the deepest possible attachment, which occurs through gaze, body language, a caring, comforting tone of voice, as well as the reliability of the therapist in committing to BE THERE, listening attentively and empathically. Complex interpretations involving a lot of cortex didn't seem to rate very high with him. He didn't seem to have a very high opinion of medications either, overall; he thought the three most important things were, first and foremost, the attachment to the therapist, and secondly, such things as aerobic exercise. play and meditation. He said that exercise raises BDNF at least as well as any of the AD's.
Aren't these the things which seem most important to us all, too? The intense search for a meaningful attachment to the right therapist seems to be the single most important underlying theme here. The people fortunate to find that KNOW that it is helping them tremendously. According to Dr. Watt, that's because the relationship is changing our brains in a healthy way. The people who get well enough to have the energy for exercise also find it very helpful. And regaining the ability to play seems to happen naturally when depression lessens. Not so many people mention meditation, but perhaps it's something we could consider more.
There's not really anything so new or startling here- except that it was said so clearly by such an eminent person, who had the fMRI slide documentation to back up what he was saying! I'd love to know what you all think.
poster:Pfinstegg
thread:638393
URL: http://www.dr-bob.org/babble/psycho/20060422/msgs/638393.html