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.

Example of Implicit Prediction Models: Riding a Bicycle

Implicit prediction models is an important concept to understand in order to understand mental health. When you first learn to ride a bike, it's a challenging process that involves a lot of trial and error. Here's how implicit prediction models play a role:

1. Initial Experience:

   • The first time you get on a bike, your brain has no experience or model to predict how to balance, pedal, and steer simultaneously.

   • You rely on basic instincts and sensory feedback. You might wobble and fall several times.

2. Feedback and Learning:

   • Each time you fall, your brain gets feedback about what didn’t work.

   • When you manage to ride a few feet without falling, your brain receives positive feedback, noting what you did correctly.

3. Formation of Implicit Prediction Models:

   • Over time, with repeated practice, your brain starts to form implicit prediction models. These are automatic, unconscious processes that predict how to balance, steer, and pedal based on past experiences.

   • These models help you make tiny adjustments to your balance and movements without consciously thinking about them.

4. Consolidation into Long-Term Memory:

   • As you continue to practice, these experiences consolidate into long-term, non-declarative memories.

   • Eventually, you can ride a bike smoothly without consciously thinking about balancing or steering. Your implicit prediction models handle these tasks automatically.

5. Automatic Adjustments:

   • When you encounter different terrains, like going uphill or downhill, your implicit prediction models adjust your body’s movements to maintain balance.

   • You don’t have to relearn how to ride every time; your brain uses the prediction models to adapt quickly.

This process shows how implicit prediction models allow us to perform complex tasks automatically, freeing up our conscious mind to focus on other things. It’s these models that make activities like riding a bike feel second nature after enough practice.

The basic problem that brings people to therapy: Part One

Emotional Conflicts, defenses and the dynamic unconscious

I would wager that most of what brings people to therapy are emotional conflicts. Emotional conflicts are the results of some kind of trauma experience. When emotional conflicts come from growing up they are considered symbols of what’s called, developmental trauma (sometimes called “small ’t’ trauma”). When they are in connection to a shocking or harrowing moment or event they are considered symbols of what’s called, shock trauma (sometimes called “large ’T’ trauma”). 

Here’s what I mean, at some point we have an emotion or set of emotions and are in need but when we express them or try to express them it doesn’t go well. Maybe they get us nothing of support, maybe they get us criticized or attacked maybe they get us ignored. When this happens the first thing we’ll feel is panic. If our panic response doesn’t result in people re-adjusting and supporting us then we feel helpless and alone (and still in need). Any of those ill tuned responses likely will also cause us to feel shame on top of the unrelieved stress we are already feeling. If that happens strong enough (i.e. shock trauma) or enough times (i.e. the “death by a thousand paper cuts” of developmental trauma) we remember it and adjust in the future. So we learn to feel alarmed when those emotions happen again because we fear getting hurt again and we also learn to automatically feel bad about ourselves when those feelings happen, as if there is something wrong with us (i.e. we re-experience the shame that we felt then). That is an emotional conflict. 

Coping with emotional conflict

So how does our body and mind deal with emotional conflict? Well, we can’t control what we feel but we can protect ourselves from feelings we fear get us hurt. We do this by using something called dissociation. This is basically a way to distract ourselves and not know what we’re feeling. Another word for these distractions or dissociation is defenses. 

Defenses

Defenses can be internal or external or both. When they are internal they involve a distortion of reality. We may feel that everything is our fault, or someone else’s fault, we may attribute our emotions to someone else (e.g. “I’m not angry, you’re angry”), we may feel paranoid, we may feel very helpless and just retreat and hide (this could include going numb emotionally), we may feel like someone or the situation is all good or all bad, we may under weigh the severity of the situation or over weight it, etc. External distractions may be the use of substances, shopping, eating, exercising, work, sex, creating drama, and of course the ever present phone in our pocket beckoning us to scroll just a little more, etc. Defenses correlate to what age we were when we first had to cope with this emotional conflict. Diagnostically, this is helpful because certain defenses can give clues to when a trauma may have happened in the lifespan. Think of it this way, if you are a baby you only have so many ways to protect yourself, you are pretty helpless, so things like denial of reality, rage, or extreme withdrawal or closing your eyes and hiding somehow are kind of the best you can do. Additionally, if you take on intense shame as a baby it really hinders your ability to grow healthy self esteem (e.g. you might develop a more fragile sense of self and be prone to addiction, deep humiliation and/or fits of rage when you feel too vulnerable). Likewise, if you experience something later in life you have more tools available to cope (both with the stress and the shame). For example, you might learn to tell jokes instead of feeling the emotions.

Summary

Basically, when you experience an emotional suffering you can’t solve you have to cope somehow to survive. That coping distracts you from the real needs you feel. In this way coping doesn’t really solve the issue but it does help you get through it. When that happens it’s that coping that gets recorded and remembered in the body and mind. So the next time you feel that way it is the coping that is used to get through it again (even if you’re not really in the same situation again). This becomes habit and eventually automatic and, over time, part of your personality. Another way to talk about things that are automatic (like defenses or coping) is that they are unconscious. So, defenses are automatic or unconscious. We don’t know when they are occurring. This is worth repeating. We don’t know when they are occurring. Our view of reality slips from in tune to a distortion based on past pains in the blink of an eye. We still think we are seeing clearly when we are actually seeing the past. No matter the current reality we see threat. This protects us from feeling the vulnerable emotions evoked that are marked as threatening because originally when we had those feelings we got hurt. This is the point of defenses, they help our system feel calm when we are experiencing upsetting emotions that we don’t know how to solve for. 

Navigating Conflict Beyond Trigger Warnings

Conflict is challenging. It becomes even more difficult when a trauma response is triggered. Imagine treating a minor issue like a major crisis—a "five-dollar problem" escalating to a "five-hundred-dollar problem." This often happens unconsciously, making it feel like a rational reaction. So, how can we address a problem that we can't directly perceive? Here are three steps to help navigate this issue:

Awareness

Trauma responses encompass physical, mental, emotional, and visceral layers. Although these responses are typically unconscious, we can bring them into our awareness. Increasing awareness reduces dissociation, allowing us to detect our feelings, thoughts, actions, and sensations when triggered. To practice this, think about a situation where past pain caused you to overreact in the present. Stay grounded in the present while asking yourself:

• What do I think when I'm triggered?

• What do I feel emotionally when I'm triggered?

• What do I do (both verbally and physically) when I'm triggered?

• What do I sense viscerally when I'm triggered?

Slow Down

Slowing down involves observing without acting. Notice your answers to the above questions, but resist the urge to act on them. This practice, known as mindfulness, creates a gap between your reaction and your actions. To activate your parasympathetic nervous system (the calming "brake pedal"), try the following techniques:

• Take a physiological sigh (two breaths in, one breath out)

• Drink some water

• Spend time in nature or with a beloved pet

• Practice orienting (check out our video on this technique)

• Reflective listening (repeat back what the other person said until they confirm you understood correctly)

Reflect

Reflection involves thinking about your thoughts, feelings, sensations, and desires. Assess whether your desires align with the situation and your values. Often, you'll need to find a compromise between your immediate impulses and your core values to achieve a beneficial outcome.

Decide and Act

Once you've reflected, consciously decide on the best course of action. Now, you're ready to address the situation appropriately, treating a five-dollar problem like a five-dollar problem.

By following these steps, you can navigate conflicts more effectively, reducing the impact of unconscious trauma responses and fostering healthier interactions.