Jeffrey S. Applegate - Neurobiology for Clinical Social Work: Theory and Practice

The Norton Series on Interpersonal Neurobiology

The field of mental health is in a tremendously exciting period of growth and conceptual reorganization. Independent findings from a variety of scientific endeavors are converging in an interdisciplinary view of the mind and mental well-being. An interpersonal neurobiology of human development enables us to understand that the structure and function of the mind and brain are shaped by experiences, especially those involving emotional relationships.

The Norton Series on Interpersonal Neurobiology will provide cutting-edge, multidisciplinary views that further our understanding of the complex neurobiology of the human mind. By drawing on a wide range of traditionally-independent fields of researchsuch as neurobiology, and evolutionary psychologythese texts will offer mental health professionals a review and synthesis of scientific findings often inaccessible to clinicians. These books aim to advance our understanding of human experience by finding the unity of knowledge, or consilience, that emerges with the translation of findings from numerous domains of study into a common language and conceptual framework. The series will integrate the best of modern science with the healing art of psychotherapy.

A NORTON PROFESSIONAL BOOK

Neurobiology for
Clinical Social Work

Theory and Practice

Jeffrey S. Applegate
Janet R. Shapiro

W. W. Norton & Company
New YorkLondon

Figure 1.1 and 1.3 from Cognitive Neuroscience: The Biology of the Mind, Second Edition, by Michael S. Gazzaniga, Richard B. Ivy, and George R. Mangun. Copyright 2002 by W. W. Norton & Company, Inc. Used by permission of W. W. Norton & Company, Inc.

Figure 1.2 Reprinted with permission from the American Journal of Psychiatry, Copyright 1965. American Psychiatric Association.

Copyright 2005 by Jeffrey S. Applegate and Janet R. Shapiro

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First Edition

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The Library of Congress has cataloged the printed edition as follows:

Applegate, Jeffrey S.

Neurobiology for clinical social work : theory and practice /Jeffrey S. Applegate,

Janet R. Shapiro.

p. cm.

A Norton professional book. Includes bibliographical references and index.

ISBN 0-393-70420-3

1. Neurobiology. 2. Neuropsychology. 3. Clinical sociology. I. Shapiro, Janet R.

II. Title.

QP355.2.A65 2005

612.8dc22 2005045082

ISBN 978-0-393-70420-4 (e-book)

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Dedication

To Joan, with love and gratitude
Jeffrey Applegate

With love, to Steve, Jacob, and Sophia
Janet Shapiro

WE GRATEFULY acknowledge the assistance of many people in the preparation of this book. We would like to thank our colleagues at Bryn Mawr College for their support. In particular, the sabbatical we each received was critical to our ability to engage new ideas. We would also like to thank our editor at Norton Professional Books, Deborah Malmud, and her associate, Michael McGandy, for their careful attention to detail, their understanding of our perspective, and their consistent encouragement. Finally, we are grateful to our families for their ongoing patience and support.

OUR PURPOSE IN WRITING this book is to inform clinical social workers and social work educators about new findings from research on the neurobiology of attachment and their implications for knowledge building and clinical practice. These findings contribute to the understanding of how individuals regulate emotion and its affective expression, termed affect regulation. There is increasing consensus among scholars of human development that this self-regulatory capacity is central to well-being throughout the lifespan, and that affect dysregulation is a central risk factor in a wide range of psychosocial difficulties.

The last 15 years have produced a virtual explosion of research on the neurobiology of attachment and the ways in which modes of affect regulation play a key role in determining the structure and function of the developing brain and mind. Psychoanalytically informed scholars have taken leadership in reporting these findings in terms of their relevance for clinical theory and practice. Although the resulting literature comprises an impressive compendium, it is aimed primarily toward a psychoanalytic audience. To date no book intended for social workers exists; yet, by virtue of their work with at-risk children and families whose capacity for affect regulation is challenged by such factors as poverty, environmental deprivation, oppression, and societal violence, social workers occupy a unique position from which to employ this new knowledge in prevention and intervention.

The research we report offers new insights about the crucial role that relationships play in human development and in professional helping efforts. By describing the specific biopsychosocial processes that constitute the relationship, we hope to contribute to longstanding inquiry of the social work field into its mysteries.

RELATIONSHIP: THE ELUSIVE CONCEPT

From its inception, the social work profession has placed the helping relationship at the center of its theorizing and practice. Enduringly focused on the person-in-environment in the wide variety of settings and modalities in which they practice, social workers across the decades have extolled the importance of the web of relationships in their clients lives and the mutative power of the therapeutic relationship in their work with these clients. Whether working with individuals, families, groups, or communities, social workers have long recognized that it is the clients experience of the helping relationship, as much as or more than the workers resource provision, clever interpretations, or other technical interventions, that facilitates change.

Although implicit in the writing of late 19th- and early 20th-century social work scholars, the earliest use of the term relationship in the professional literature can be traced to Virginia Robinsons book, A Changing Psychology in Social Casework, published in 1930 (as cited in Biestek, 1957). Since then, scores of social work scholars have worked toward a definition of this intuitively accessible but conceptually elusive term. Authors have cited warmth, caring, acceptance, genuineness, a nonjudgmental attitude, responsiveness, empathy, attentiveness, support, concern, and understanding as core components of helpful relationships. The relationship has been characterized as the heart of the helping process (Perlman, 1979) and the soul of [social] casework (Biestek, 1957). Such efforts to convey the essence of relationship notwithstanding, the concept continues to elude efforts to capture in words its complexity and the skill it takes to employ it effectively.

PSYCHOANALYTIC PERSPECTIVES ON THE RELATIONSHIP

Early on, social workers began to look beyond their own professional boundaries for assistance in articulating the central role of the relationship in their work. Beginning in the 1920s, many social workers engaged in direct practice discovered in Freuds psychoanalytic theory a more thoroughly elaborated vocabulary with which to describe their practice. Terms such as