Mona DeKoven Fishbane - Loving with the Brain in Mind

LOVING WITH THE
BRAIN IN MIND

Neurobiology and
Couple Therapy

MONA DEKOVEN FISHBANE

Foreword by Daniel J. Siegel

W. W. Norton & Company

New York London

For Buzzy, with love

CONTENTS

How do we combine science with the practice of psychotherapy in a manner that is both rigorous and useful? In this masterful book, Mona Fishbane offers a fabulous example of how the synthesis of a broad range of scientific discoveries can be woven together seamlessly with clinical compassion and expertise to form an important way of approaching therapeutic work with couples. Written to be of benefit to clinicians both new and experienced in the practice of psychotherapy, Loving With the Brain in Mind provides you with a wealth of research findings and practical suggestions that will enrich your learning no matter your level of prior exposure to this field.

The book has two parts, each with unique contributions to the goal of making science accessible and practical for you as the reader. The first half provides a fascinating summary of a wide range of findings, from the neuroscience of gender differencesor lack of themto the science of trust within intimate relationships. Youll discover how our hormonal responses to hugs can shape how we perceive our partners, and youll learn how our patterns of interacting are shaped by our temperament and our attachment history. Using a single couple as an example in this part of the book, youll explore in depth how these scientific findings can illuminate the way the individuals interact and how personal history, culture, social context, and brain functioning shape their internal worlds and ways of connecting with each other.

In the second half of the book, our able guide Dr. Fishbane reveals the many ways in which the study of science informs her own clinical practice. Youll read about how practical applications of the science create novel approaches to her clients/patients, and how you can use these in your own clinical work. With this background, youll meet some new couples as well as further your understanding of the work with Erik and Lisa, the couple from the first half. By understanding some of the basics of neuroscience, youll see how providing neuroeducation for couples can help how they get along. For example, when individuals become stuck in what in interpersonal neurobiology we call nonintegrated low-road states, couples can become filled with implicit memories that shape how they are perceiving the actions and interpreting the intentions of their partners. Learning about these ways in which the more integrative prefrontal area can temporarily stop functioning to coordinate and balance the lower regions of the brain, and the body as a whole, can help people gain perspective on these disorienting and sometimes frightening states of mind that can affect any of us. Overall, these practical approaches allow people to strengthen their minds and bring more self-compassion and other-directed compassion into their lives through a deeper understanding of the neuroscience of living.

As a part of this Norton Professional Series on Interpersonal Neurobiology, Mona Fishbanes book fits in well with our efforts to weave science with practical clinical application. If you are familiar with our other books in the series, youll know that Lou Cozolinos book The Neuroscience of Relationships and Marion Solomon and Stan Tatkins book Love and War in Intimate Relationships have similar topics. As the founding editor of our series, let me make a clarification regarding how these three books are complementary. In The Neuroscience of Relationships , youll find an introduction to basic ideas about attachment and the brain and their implications for how people in therapy change. In Love and War in Intimate Relationships , youll see some very specific case examples that show how affect regulation and the notion of neural integration inform what a therapist does. Here in Loving With the Brain in Mind , youll find a couple therapists primer on a very different set of information. In this book youll find new and important knowledge about what we know about how couples function that has emerged from recent technological advances in brain scanning techniques as well as the reviews of cutting-edge discoveries in a range of fields. Youll learn how to apply, in a broad range of couples situations, these new findings to enrich your own clinical practice.

Our work in psychotherapy has been transformed by synthesizing science with the art of the therapeutic relationship and the mechanisms of change. Interpersonal neurobiology combines the various disciplines of science, from anthropology to neuroscience, to help create a consilient view of the human mind, healthy development, and the cultivation of well-being. Im proud to introduce you to this new contribution to our professional series and invite you to pour a cup of tea, sit back, and soak in the wisdom of the elegant and illuminating synthesis youre about to experience.

Daniel J. Siegel, MD

Founding Editor

Norton Series on Interpersonal Neurobiology

One morning some years ago as I was walking on the treadmill, I called my 86-year-old mother-in-law, Nana, to say helloa daily ritual we both cherished. She told me that she was reading a book she was sure I would love: Erik Kandels (2006) In Search of Memory . I was astonished. I was halfway through reading this book myself, and while it is part autobiography, it is also a serious presentation of Kandels neuroscience research that led to his receiving a Nobel Prizenot typical reading for an 86-year-old woman! I reflected on how Nana had transformed herself in the second half of her life into an intellectually curious, voracious student, who would rise at 4 A.M. to prepare for her classes, reading Talmud, Levinas, stoic philosophy, and neuroscience.

Kandels insights offer the key to Nanas transformation. His research showed how learning changes the brain. While his brain of choice was that of a sea slug (its simplicity was advantageous for his purposes), the implications of his findings apply to the human brain. Kandel and his colleagues have also identified the ways in which psychotherapy changes the brain. The mechanism for these changesand for Nanas transformationis neuroplasticity, the ability of the human brain to change in response to new learning. This is the basis for the change we seek in all psychotherapy, including couple therapy.

NEUROPLASTICITY

Neuroplasticity is the reason therapists are in business, and it is the basis for behavioral change; yet as recently as a decade ago, it was considered impossible in the adult human brain. Neuroplasticity was for kids. The assumption was that after young adulthood, there was no chance for new connections to develop between neurons (brain cells). It was basically downhill from our twenties, as we lost neurons and brain capacity into old age. But the discoveries of the last 10 years have provided a much more optimisticand revolutionaryview of adult brain function: Neuroplasticity (new connections between neurons) and even neurogenesis (the creation of new neurons from stem cells) can continue into old age. While many adults fall into rigidity and hardening of the categories (Cozolino, 2002), neuroscience gives us hope to support those who seek change and renewal in their lives.