Therapy and Re-Parenting

There are many ways in which psychotherapy parallels re-parenting. Through the therapeutic relationship, we are attempting to modify the same circuits of attachment, emotional regulation, and autobiographical memory as those shaped during childhood. We also use the same attentive and nurturing sociostatic processes to help our clients regulate their anxiety, provide them with challenges at the edge of their capabilities, and help them to articulate their thoughts, feelings, and experiences. All of these aspects of psychotherapy are central to positive parenting, secure attachment, and building resilience. 

We also leverage the transference relationship to bring past struggles with parents into the present moment to make them available for conscious consideration and modification. Transference and attachment are always activated during therapy. Both are implicit memory systems based on early relationships triggered in the context of current relationships. Both attachment schema and transference reactions come in multiple forms. So always keep in mind that what we are seeing with any particular client is a particular reaction in a particular situation that may not be reflective of how they respond in other situations. We have to gather much information before we can have confidence in our conceptualization of attachment or transference with each client.

One way to think about the beginnings of therapy is a combination of two things; 1) an attempt to establish some kind of working relationship in the face of whatever resistances a client brings with them and, 2) discovering the deeper narrative below the surface story they disclose. A major challenge for the newer therapist is not getting stuck in the surface narrative. It is easy in the early years of our careers to mistake building a relationship with allowing the client to lead the sessions and taking everything they say as truth. The fact that we have two levels of narrative is embedded in the evolution of our social selves, the complexity of our brains, and the fact that our two hemispheres are capable of different ways of perceiving and navigating our experiences. 

From the perspective of neuroscience, what we see as resistance is the reflection of a complex network of implicit emotional, somatic, motor, and sensory memories. They are the brain-mind’s best guess about what is necessary to survive today based on what happened long ago. Our primitive brain works on a strict assumption that past experience is the best predictor of what we should do in the present. The more stressed or frightened we become, the more likely we will regress to tried and familiar patterns of interacting with the world. We see this all the time in children who develop new skills, only to see them disappear in the face of anxiety and trauma.

Therefore, resistance isn’t something that we have to wait out in order to start the “real” therapy. Coming to understand and work with a client’s resistance is a central component of therapy. From the perspective of neuroscience, these patterns of implicit memory that create the closed logic, emotional frailty, repetitive behaviors maintain suffering. A core aspect of successful therapy is embracing resistance as an accomplishment of the client that allowed them to survive stressful circumstances. By embracing resistance, you take away a client’s need to employ the resistance, which allows them to be less anxious, less defensive, and more open to change. This is the highest and best use of sociostasis in both parenting and psychotherapy.

This is an excerpt from Dr. Cozolino’s book The Pocket Guide to Neuroscience for Clinicians.