Learning and habit change are accompanied by changes in the brain itself.

Neuroplasticity and Psychotherapy Generating alternative responses

Changing maladaptive habits, also known as neuroses, to more functional responses is a major feature of psychotherapy. Recently much has been written about neuroplasticity as a mechanism by which this change can occur. To put it simply, the field of neuroscience asserts that both the processes and the habits of emotion, behavior and cognition ride on the highways of the brain’s neuron system. Learning and habit change are accompanied by changes in the brain itself, both as road resurfacing and as changes in the pattern of traffic flow in the brain’s highways. These changes in the brain’s anatomy and function, visible during neuroimaging, are the physical correlates of changes in the mind. The ability of the brain to change structurally as part of learning is called neuroplasticity.

Although a complex phenomenon, key elements required when mindfulness meditation is the main stimulus for neuroplastic change are mindsight (awareness of how our brain/mind is currently working) and provision of an alternative response that our brain/mind can make. To be clear, it is not suggested that we need be or can be aware of the actual firing of individual neurons. Rather, we can be aware of our subjective experience of what such firing creates or codes for. For example, the precise neuron circuits activated when we are open to experience is presumably different than those firing when we are defended. Although it is unrealistic to think we will directly detect and characterize the neuronal paths of each state, we can be aware of the overall feeling of each state. If we are working in psychotherapy to become more available to others, it is very helpful to be able to identify the defended state, and to distinguish it from the open state.

As has been said in neurology for many decades, “what fires together wires together”. To continue with our example of defendedness/openness, we might find that we often enter the defended state when engaging in public speaking, being challenged by our spouse, or even when entering our place of work. In such a case, the old habit of becoming defended is triggered when we are exposed to these stimuli, which means neuronal circuits that code for defensiveness are firing. An associative link has been formed.

To further complicate matters, when we are defensive, we might speak harshly to others, fail to notice kindness extended to us, and make errors of judgement. This of course leads to poor communication, unsatisfactory relationships, emotional distress, and quite possibly hampers our career success.

In the simplified description presented above, perception of external stimuli, the defensive state itself, and maladaptive behaviors are represented by neuronal circuits that fire together, thus wiring together. In so doing, a neurotic habit has been formed. If we want to step outside this habit, and generate an alternative response, we must have mindsight, or awareness into the association among these three elements. If and only if we are aware of the feelings we have and can accurately observe the consequences of our actions can we intelligently choose alternatives to the old stressor that are more adaptive.

The first part of this process, becoming aware of the linkages among environment, emotion, and action, can be quite difficult. Often, our most deeply entrenched emotional/behavioral habits are not easily accessible to us. An event happens, and we only become aware of our response several steps down the chain of reactions, without being aware of our experience of the first moment. It is as if we black out in the face of feelings that are intolerable, and reawaken some moments later, in the midst of fending off the intolerable feelings with secondary and tertiary reactions. For example, we may be aware of our irritation or our snippy speech, but unaware of the fear that came earlier in the sequence of our reactions to the situation.

To the extent that the above is an accurate description of the human being, we might find ourselves addressing irritability when it would be more effective to target fear. But how are we to know, and how is a therapist to know, that the more primary reaction is, in this example, one of fear? The answer lies in clarifying our mindsight.

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