How the brain and therapy work together

The Brain's Job: Keeping You Alive Through Predictions

Our brains are essentially prediction machines with one primary job: keeping us alive. To do this, they rely on past experiences to predict future events. This is all based on what we've encoded in our memory.

When we encounter danger in the past but only manage to cope with it instead of solving it, those coping mechanisms get stored in our memory. Then, when we face something similar in the future, our brain automatically uses those past coping strategies. It's like if you taste a delicious cake and later encounter ingredients like eggs, flour, and butter. Your brain might label the new dish as cake, even if it isn’t.

This automatic process helps the brain save energy. It's unconscious and hard to recognize, let alone slow down to evaluate whether the past is truly repeating itself.

The Hose and the Snake

Imagine seeing a hose coiled up on the floor and for a moment thinking it's a snake. Your brain uses the shape of the hose to make a quick judgment to protect you. After a second, you realize it’s just a hose, and you can go about your gardening.

In relationships, these automatic assumptions are harder to recognize. We often mistake our gut feelings for objective truth. For example, if you grew up with parents who couldn’t handle big emotions like sadness, anger, or fear, you might have learned to suppress these feelings to cope. This coping strategy gets encoded in your brain.

Coping vs. Solving

As an adult, when you feel sad, scared, or angry in a romantic relationship, you might automatically suppress these emotions. You might feel anxious, irritable, or distracted but not recognize the underlying sadness, fear, or anger. This can lead you to stay in unhealthy relationships because your emotions, which are meant to guide you, are being ignored.

The Role of Therapy

Describing this unconscious process is challenging because it's designed to be unnoticed. This is where therapy comes in. Good psychotherapy helps you recognize the core issues behind your behaviors, like difficulty focusing, irritability, numbness, or getting overly upset. Therapy guides you in creating new, healthier responses that truly solve your problems rather than just coping with them.

By working through these issues in therapy, you can update your brain's prediction models with new data that reflects actual solutions, allowing you to live a more fulfilling life.

How Our Brain Learns and Adapts: The Magic of Memory Reconsolidation

When we’re born, our brains aren’t fully developed; they’re like houses with just the framing up. So, in the beginning, we heavily rely on our lower brain areas and start interacting with the world through our core emotions. These primal interactions happen through instinctive reactions to our sensory experiences. The feedback from these experiences gets stored and helps us learn. Over time, with repetition, these experiences turn into long-term, non-declarative memories, creating implicit prediction models (see our easy to read post on implicit prediction models).

Our brains learn through a method called prediction error. If a prediction is wrong, we update it; if it’s right, we stick with it. This process, which Freud called the Reality Principle, helps us use energy efficiently while adapting to survive. Memories and predictions guide our actions, from our posture to social strategies and facial expressions. These non-declarative memories are (like Tinactin) quick-acting and long-lasting, making them reliable for forming automated prediction models, even though updating them can be tough.

However, these memories can be updated through a process called memory reconsolidation. When we recall and viscerally feel these implicit memories, they become destabilized and open to new information before consolidating again. The provides a potential to change deeply held connections between emotions, events, and self-protective behaviors if new, powerful experiences contradict old expectations. Thus, memory is a constructive process, piecing together bits of the past to predict the future. We are still learning how and where this can apply clinically but any good effective psychotherapy will harness this mechanism in the brain.

Our subcortical systems, memories, and prediction models support the brain’s higher functions, like thinking and feeling. The cortex, allows us to learn and adapt. Unlike our primary instincts, learning involves creating predictions about what is adaptive at the moment (instincts are built in, we don’t have to learn them). What we learn as adaptive may therefore differ from instinctive reactions.

Memory Reconsolidation: A Deeper Dive

Karin Nader and Oliver Hardt’s groundbreaking work revolutionized our understanding of memory. Before their research, it was believed that memories formed linearly, transitioning from short-term in the hippocampus to long-term storage elsewhere. They showed that recalling long-term memories makes them unstable and requires reconsolidation to remain long-term. This means memories can change each time they're recalled, making memory a dynamic process.

Their research indicates that after a memory is reactivated, it stays open to new learning for about six hours before reconsolidating. This process doesn’t damage the brain and is specific to individual memories. Memory reconsolidation has since influenced psychotherapy, such as Bruce Ecker’s Coherence Therapy, by showing that old memories can be updated with new emotional experiences, facilitating growth and reducing anxiety.

This concept aligns with Frank Alexander’s idea of the corrective emotional experience, suggesting that updating old memories with new, positive experiences can help resolve long-standing emotional issues. Interestingly, Nader and Hardt were students of neuroscientist Joseph LeDoux, who initially doubted their hypothesis but changed his stance after they proved it correct.

Understanding how our brains learn, adapt, and change through memory reconsolidation not only gives us insight into our own behaviors but also opens up new possibilities for personal growth and therapeutic techniques. Whether we’re dealing with past traumas or looking to improve our adaptive strategies, the dynamic nature of memory offers hope for lasting change.

What Counseling Isn’t: Clearing Up Common Misunderstandings

It might seem odd to write about what counseling isn’t, but there's a lot of confusion about effective therapy. So, let’s clear up some misconceptions.

Counseling is Not Giving Advice

A friend once mentioned they were unsure if their loved one’s therapist was giving good advice. This is a common misunderstanding. People often think therapy is about being told what to do. But, imagine a therapist as an archeologist. They dig in areas where they believe they might find significant artifacts. When they find something, they carefully uncover and study it to understand the bigger picture.

Similarly, therapists help you explore your thoughts, feelings, sensations, and memories. They work with you to understand these elements and how they fit into the bigger picture of your life, often uncovering connections to past traumas. The goal isn’t to give advice, but to help you understand yourself better and develop strategies to create meaningful change in your life.

Counseling is Not Quick or Easy

Many people are surprised by how long therapy can take, as well as the time, effort, and cost involved. Changing your brain and breaking old habits is a delicate, slow process. While there are aids like medication or alternative methods that can support therapy, the core work is often gradual and requires patience.

Counseling is Not a Regular Conversation or Relationship

Therapy conversations are unique. They aim to access parts of you that don't typically come up in everyday interactions. This means the topics and the way you talk about them are different. You might be encouraged to express your true feelings, which can be challenging and make you feel vulnerable. Therapists aren’t interested in being politically correct or sticking to societal norms—they focus on what truly is. There’s no right or wrong, just what exists.

Moreover, the therapist-client relationship is different from a regular friendship. It’s a unique bond with emotional intimacy, where the therapist knows a lot about you, but you know less about them. This imbalance, however, creates a powerful connection essential for making progress. You might feel younger, more empowered, or different in other ways compared to your daily relationships. As trust builds, you’ll become more open to feelings you’ve previously hidden, allowing them to surface and be addressed, whether they stem from developmental stages or trauma.

Understanding these distinctions helps in appreciating what therapy is truly about: a journey of self-discovery, healing, and growth, rather than a quick fix or a series of friendly chats.

Rethinking Mental Health: Embracing the "Choose Your Own Adventure" Metaphor

In my last post, I touched on how viewing mental health through a strict medical lens can hold back progress. The medical model labels things as healthy or unhealthy, good or bad, and this binary thinking just doesn’t fit when it comes to mental health. (And yes, even the term "mental health" has its issues, but let’s tackle one thing at a time.) Today, I want to introduce a different metaphor: think of mental health as a "choose your own adventure" story.

Everything Tells a Story

Everything we do, feel, and think carries meaning. It might be a small detail or something significant, but it all contributes to the story we're living. It can be exhausting to stay on top of everything, and it’s tempting to dismiss some things as meaningless. But here’s the good news: we’re not trying to write a story or determine its meaning; we’re here to listen to the story being told.

The words we use, the tension in our muscles, the way we look or avoid looking, the emotions we feel or suppress, the intensity of those emotions, our behaviors, our thoughts, our levels of engagement—they all tell a story. Often, the real story isn’t just what's on the surface. In therapy, we’re trained to listen to everything, not just the spoken narrative. We call this "process vs. content." For example, you might say one thing, but your hand gestures might reveal something different.

Moving Beyond the Medical Model

Using the medical model can increase the risk of shame. Why? Because getting curious about something can trigger a fear that we’ll find something "faulty" or "unhealthy." But if we approach it like a psychotherapy model—where we listen for the story without judgment and assume everything that surfaces is normal given the context—there is no right or wrong. This frees us to remain curious and keep listening.

In Somatic Experiencing work, this might lead to noticing imagery, movements, or sensations. In psychotherapy, it might bring greater insight and clarity.

The Therapist as a Curious Companion

This isn’t a “gotcha” approach. The therapist isn’t an expert who sees what you can’t. They are a curious companion who might notice something and wonder about it with you. By listening to the story your body-mind is telling, without trying to force it into a specific framework, we can follow the adventure your system chooses. This is what ultimately leads to feeling better.

So, let’s ditch the rigid medical model and embrace the idea that mental health is like a choose your own adventure story. By listening to our stories and staying curious, we open up the path to genuine understanding and healing.

Two Common Misconceptions About Mental Health and How to Overcome Them

Hey there! Let's talk about two common misconceptions about mental health that can really get in the way of making real progress:

Misconception 1: Treating Symptoms Instead of the Root Cause

We often mistake the symptoms of mental health issues for the problem itself. So, we end up trying to manage these symptoms—like negative thoughts, anxiety, or depression—instead of digging deeper to understand what they actually represent. For example, these symptoms might be rooted in traumatic memories that have shaped how we respond to situations in the present. If we only focus on managing the symptoms, we're not addressing the underlying issues that cause them.

Misconception 2: Using Medical Metaphors for Mental Health

Another big misunderstanding comes from how we talk about mental health. You’ve probably heard people say, "I have anxiety" or "I have depression," like it’s something they’ve caught, similar to "I have a cold" or "I have a broken bone." This medical language implies that these mental states are static and abnormal, but that’s not really the case. Anxiety and depression are important and natural states that everyone experiences to some extent, and they fluctuate over time.

Even chronic states of suffering often indicate that the nervous system is responding exactly as it should, based on past trauma. The system is on high alert or shut down because it's unconsciously using old, trauma-based information to navigate current situations, which might not be helpful unless that same historical trauma is happening again.

The Bigger Picture

Of course, mental health is complex, and there are exceptions to these ideas. But generally speaking, shifting our focus from just managing symptoms to understanding and addressing their root causes, and rethinking how we conceptualize mental health, can make a big difference in our approach to healing and change.