We know counseling works. Increasingly, our field can benefit from neuroscience to better understand why and how. Evidence-based treatments and use of research to inform practice supports ethically sound and effective practice. With advances in neuroscience, the counseling field can use what we know about the brain to inform practice.
We know that counseling builds new neural networks in our brains. A frontier in the field of counseling is to identify ways we can incorporate neuroscience into our practice in practical ways.
Concepts to Consider (Ivey, Ivey, Zalaquett, & Quirk, 2009):
The brain can change, responds to its environment, and new connections and neural networks are born throughout the course of an entire human life. The brain, in fact, can “rewire” itself.
The brain can develop new pathways at any time over the course of development in response to new situations or experiences. Exercise is important to encourage this process.
Attention and Focus
Increasingly, the counseling field is using meditation and mindfulness as therapeutic interventions. These interventions support attention and focus that is required for learning.
Clarifying our Understanding of Emotions
Basic emotions that can be viewed in brain imaging include: sad, mad, glad, fear, disgust and surprise. Brain imaging reveals that each fires a different part of the brain. The Amygdala is where sad, mad, and fear live, but also where we absorb new input and memories. Thinking and feeling are positively influenced by improvements in executive cognition.
Neuroscience and Stress
It is important to note the effects of chronic stress on the brain. Families who have lived in poverty may be experiencing chronic stress, which can impair neural development. Additionally, racism, sexism and oppression can increase cortisol. It is important for counselors to recognize the effects of an oppressive system on an individual rather than seeing an issue within the individual who is living in an impoverished or oppressive system. Understanding this, counselors may choose to engage in social justice and advocacy to fight against the perpetuation of these systems. (Ivey, Ivey, Zalaquett, & Quirk, 2009)
Integration of Left and Right Brain in Counseling
Thomas Field, in “Integrating Left-Brain and Right Brain,” posits that counseling interventions and practice should deliberately activate both the left and right brain. According to Field, counseling often focuses most on the left side of the brain, which is responsible for logic, rational thought and abstract cognition. The right brain is associated with unconscious social and emotional learning, which includes empathy, creativity and flexibility. A focus on the therapeutic relationship activates right side brain functions. Field advocates for using creativity in the counseling process, which can help to activate right brain functions. The importance of the therapeutic alliance is continuously validated by neuroscientific literature, so it may be helpful for counselors to consider how to utilize this relationship in the therapeutic setting.
For a counselor who is interested in using neuroscience research in his/her practice, it may be interesting to learn about how interventions may speak to different functions in the brain.
A National Institutes of Health study found that by using scans of brain activity, we can potentially predict if depressed patients would best achieve remission with antidepressants or psychotherapy (McGrath et al., 2013). Now, this process is based on trial and error. Using a PET scan, researchers compared brain activity of patients who achieved remission following treatment with those who did not improve. They found that if a patient’s pre-treatment brain activity was low in the front part of the brain, this signaled higher likelihood of remission with CBT, but a poor response to escitalopram. Hyperactivity in the same part of the brain predicted remission with escitalopram and poor response to CBT. The field has a long way to go still to be able to use this technology functionally, but it is promising.
In 2016, the NIH announced it would continue to support the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative. Projects include computer programs to help detect and diagnose autism and Alzheimer’s Disease, a way to wirelessly record brain activity, a project to improve rehabilitation for stroke patients and a study more about how we read and speak.
Resources and References
Field, T.A. (n.d.) Integrating left-brain and right brain: The neuroscience of effective counseling. The Professional Counselor. Retrieved from http://tpcjournal.nbcc.org/integrating-left-brain-and-right-brain-the-neuroscience-of-effective-counseling/
Ivey, A., Ivey, M.B., Zalaquett, C., & Quirk, K. (2009). Counseling and neuroscience: The cutting edge of the coming decade. Counseling Today. Retrieved from http://ct.counseling.org/2009/12/reader-viewpoint-counseling-and-neuroscience-the-cutting-edge-of-the-coming-decade/
McGrath, C. L., Kelley, M. E., Holtzheimer, P. I., Dunlop, B. W., Craighead, W. E., Franco, A. R., & ... Mayberg, H. S. (2013). Toward a neuroimaging treatment selection biomarker for major depressive disorder. JAMA Psychiatry, 70(8), 821-829. doi:10.1001/jamapsychiatry.2013.143