Left brain – right brain: In therapy

In my previous post I outlined some of the key differences between the left and right hemispheres of the brain and touched on what that might mean for psychotherapy. I’ll now delve a little deeper into that mystery.

While my previous post was based on well established neuroscience, some of what follows is more speculative. That said, it’s all grounded in current scientific understanding.

As I explained last time, part of the role of the right brain is to keep us alert to danger. The right hemisphere is specialized for wide-angle sensory awareness that’s good for scanning for threats: We might say that the right brain is naturally suspicious. Perhaps it’s no surprise that research has found a correlation between depression, anxiety and increased activity in the right hemisphere. A lot of that activity is in the frontal lobe, a region concerned with reward, attention, planning, and motivation. There’s also a high level of right hemisphere activation in PTSD and when childhood abused adults recall unpleasant memories. Another strand of research suggests that PTSD is linked to poor communication between the hemispheres (Cozolino, 2017).

How might therapy help balance and integrate the two hemispheres? When I work with clients, I’m constantly monitoring several channels of communication. The most obvious strand to watch for is the difference what is said and the way it’s said. The structure of language, the way sentences are strung together, is largely a left brain activity, but our tone of voice is more involved with right brain processes. Body language and facial expressions are also more under right brain control. If, or rather, when, there’s some inconsistency between the simple content of what’s said and the wider context, I’ll need to make a judgement call. Suppose a client says “I’m fine about that”, but their facial expression, body language or tone say ‘I’m really not OK”. I might decide to reflect that back to them: It’s as if I’m acting as a mediator between the right and left hemispheres.

Peter Afford suggests that Experiential Focusing – the foundation of my therapeutic approach – may work by promoting the integration of the left and right hemispheres (Afford, 2014). Focusing invites us to drop our awareness into our physical bodies and check for a ‘felt sense’, a feeling in the body that carries meaning. We then sit with any felt senses that arise and gradually begin to engage with them through language. A felt sense is often just a vague sensation at first and I’ll be curious about where it is in my body, its size and shape, and whether it has a colour or a particular emotional tone. I’m initiating a dialogue between an emotional, bodily sensation, which are right brain processes, and the more left brain activities of labelling and seeking details. The next stage is to deepen that dialogue, literally asking the felt sense what it’s about. The linguistic right hemisphere is engaging in dialogue with the more embodied left.

I’ve been watching the therapeutic process over the last few months and I think I’m seeing lots of occasions where I’m helping my client with some left/right brain integration. I’m not saying this explains how therapy works; there are many parallel processes going on all the time, many of which we may currently be oblivious to. However, I believe the work of balancing and integrating the left and right hemispheres is a key part of therapy and having a greater awareness of how that might happen can enhance therapeutic practice.

Left brain – right brain: Beyond the myth

Back in the 70’s there was a lot of pop-science chatter about the left and right brain hemispheres. Right brained people, it claimed are creative, while left brained types are analytical. Pretty cool, huh? Cool, but inaccurate and misleading. We now know much more, and the research reveals something much more exciting!

While most systems are integrated across both brain hemispheres there are real differences between the two, but it’s not simply “emotion on the right, reason on the left”. When we talk about the right/left lateralization of the brain, we’re saying that some functions are carried out in one hemisphere more than the other; it’s about specialization. While there are differences between right handed, left handed and ambidextrous people, in general the specialization is as I describe it below.

Areas of the right hemisphere are specialized to deal with aspects of the physical and emotional self. Strong emotions like anxiety and terror activate the right brain. The right hemisphere has many more connections to the emotional heart of the brain, the limbic system. It’s also more connected to the rest of the body, notably the viscera – your gut.

The left hemisphere is specialized in organizing the conscious linguistic self. It’s better at problem solving and is inclined towards positive emotions. The left brain is the more social of the two halves: It’s engaged when someone approaches you and also when you’re angry with someone. The left brain thinks in a linear, sequential way and has less of a connection with the rest of the body than the right brain.

Graphic of the brain

We all have an instinctive ‘fight, flight, freeze’ response to danger, and the right brain is tied into that. Because it processes information in a holistic way, the right brain quickly gets the big picture, and it’s always checking; is that picture safe or possibly dangerous? Perhaps because we’re wired to look for danger, the right hemisphere is more concerned with negative emotions. When you look at a distressing image, the right hemisphere is activated and depression seems to be linked with increased right brain activity. Many right brain specializations are concerned with things outside our immediate awareness, so we can think of it as the home of the unconscious mind. As Louis Cozolino explains:

“When we are awake, the right hemisphere silently provides information to the left, which we experience as intuition, feelings, and visual images” (Cozolino, 2017).

Both halves of the brain have a vital role to play, and mental wellbeing requires a balance and integration between the two. All this has profound implications for psychotherapy. Anxiety, depression and psychosis have all been linked to poor integration between the left and right brain, so does therapy help integration? The short answer is yes, but a more thoughtful discussion will follow in my next blog post.

The cognitive iceberg

Every year the Edge website asks interesting people a provocative question. The Edge Question for 2011 was “What scientific concept would improve everybody’s cognitive toolkit?”

Adam Alter, a psychologist and Assistant Professor at Stern School of Business, NYU, responded with a short discussion of the idea that our minds are like an iceberg, such that we’re ignorant of many of the processes that shape our mental lives. This notion may be familiar – I’ve discussed my own model of the cognitive iceberg in this blog.

Alter explains that ”while we’re focusing on the business of daily life, our brains are processing multitudes of information below the surface of conscious awareness”. This “peripheral information subtly shapes our thoughts, feelings and actions, and crafts some of our most critical life outcomes”.

He gives a few interesting examples, noting what a powerful impact the weather can have. No surprise perhaps that “rainy weather makes us more introspective and thoughtful”, but less obvious that it also improves our memory. Apparently the electrical state of the atmosphere also has an influence on accidents, suicide, depression and irritability.

Alter mentions the power of embodied metaphor, citing studies showing that “people find strangers more likable when they form their first impressions while holding a cup of warm coffee”. Lakoff and Johnson have discussed this at length, claiming that most of our reasoning relies on such embodied metaphors. The way we use the metaphor ‘more is up’ provides a simple example: Because in health we stand up, while sickness brings us down, we tend to think of ‘more’ as being ‘up’ (‘price rises’) and less as down (‘stocks plummeting’) (Lakoff & Johnson, 1999).

“An interconnected whole”

Dr. Dan Siegel’s conclusions about the mind support the core theme of this blog: Mind is extended. But Siegel emphasises the importance of human relationships: 
“Mind is shared between people. It isn’t something you own; we are profoundly interconnected. We need to make maps of we because we is what me is!” (2010).

A rowing boat on a loch with mountains and forest background

Siegel is developing a new area of cognitive science called interpersonal neurobiology that’s focused on understanding the mind and mental health. Siegel’s ideas seem to me to be both intuitively true and radical. For example, he claims that “relationships, mind and brain aren’t different domains of reality—they are each about energy and information flow” (2010). That means that our relationships are an integral part of the bodymind.

To some extent this recaps what many others have already said – the mind “cannot be separated from the entire organism”  or the “outside environment” (Varela, 1999, authors emphasis), but Siegel develops this understanding and applies it to our mental health.

Although I very much like his emphasis on human relationships, we need to remember the other than human world. What do Siegel’s insights mean for our relationship with animals, forests, mountains and the rest? As Siegel himself says, “‘We’ are indeed a part of an interconnected whole”(2010).

Spirit of place: What lies beneath

Most of Uluru lies beneath the surface of the desert. Human cognition is like that too: Probably 95 percent of embodied thought lies below our everyday awareness.

Uluru sunset. Copyright AH

Our cognition is like an iceberg; the familiar self is just the tip that emerges from the sea, while the vast bulk of cognitive processing lies out of sight. But we can access that deeper level through ‘gut feelings’, those physically sensed intuitions that hint at other ways of knowing.

When anthropologists and adventurers write of how indigenous peoples can sense the spirit of a place, there’s an implication that no-one else can. But I’d hazard that we’ve all felt it; a soundless hum, an invisible haze, something about a specific place that hovers just outside comprehension.

We can all sense the spirit of place if we’re attentive enough. Just as the Aboriginal Dreaming lies hidden in the land, so does spiritual connection lie deep in what I call bodymind place.

On-line and off-line, or who ate my toast?

A mate gave me some home-made marmalade, so I slapped some on my toast and sat down to enjoy it with a cup of tea. Ten minutes later I looked forlornly at a crumb dusted plate and realised I’d eaten it but hadn’t tasted it.

I’d been pondering my blog and not paying attention to the here and now. This common experience – a side-effect of being conscious – has engaged spiritual teachers from (at least) Buddha to Eckhart Tolle as well as cognitive scientists. The latter make a useful distinction between on-line and off-line cognition. On-line cognition deals with live tasks that require fast moment-by-moment processing; eating toast, for example. We switch to slower, off-line cognition when we need to check on something odd or plan future behaviour. You’re probably using on-line cognition now. Watch your awareness as you read: “The old man the boats”.

I’d guess you used on-line cognition as you started to read that sentence (from Meyer and Rice, 1992), but had to re-read it off-line to get the meaning.

One of my key themes is the importance of place in cognition, but location is irrelevant for some off-line cognition. When you’re ‘in your head’, imagining some ‘what-if’ scenario, you’re off-line and place is fairly irrelevant. But on-line cognition is in the moment, so place is fundamental. Just remember that next time you eat some toast.

Brains, bodies and places

Neurons used to be compared to simple on/off switches, but they’re actually much more complex. Each one works like a little brain and is in conversation with thousands of cells via hundreds of chemical signals. Your cranial brain has about 23 billion neurons, so no wonder it’s often claimed as the most complex object in the known Universe!

Now let’s consider the rest of the body. As well as the billions of neurons in the spinal cord, there’s 100 million in the gut that form a kind of second brain. The heart has a nervous system too – again complex enough to be called a brain. All that is integrated with the endocrine system which communicates information body wide. That’s a very simple overview of the bodymind system, but it will serve my purpose.

So far we’ve only considered what philosopher Andy Clark calls the skin-bag body; what about place? At a cognitive level we are totally integrated with our environment. For Lakoff & Johnson – a double act comprising of a cognitive linguist and a philosopher – the environment “is part of our being” (1999). Anthropologist Tim Inhold concurs; organism (mindbody) and environment (place) are “one indivisible totality” (2000).

To compare this matrix of brain, body and place to a computer is like describing a neuron as like a light switch. Perhaps the metaphor of bodymind/place as an ecosystem will serve us better?