Louis Cozolino, PhD is a professor of psychology at Pepperdine University and a therapist in private practice in Los Angeles. He is the author of five books The Neuroscience of Psychotherapy, The Social Neuroscience of Education, The Neuroscience of Human Relationships, The Healthy Aging Brain and The Making of a Therapist. He has also authored and co-authored research articles and book chapters on child abuse, schizophrenia, language and cognition including the chapter on Sensation, Perception and Cognition for the current edition of The Comprehensive Textbook of Psychiatry. You can find all of these books on his Norton site by clicking here.
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Another excellent interview!
I had a few thoughts on your disappointment with Cozolino’s response. I think at the heart of this is an issue of what constitutes knowledge and what can neuroscience offer to our knowledge base when it comes to psychotherapy. Cozolino mentioned that psychotherapists need to have no knowledge of the brain to be very effective. I would refute this. Traditional psychotherapists had to have deep knowledge about the brain to be effective. But this has typically been experiential knowledge (aquired through guess work and lived experience), not scientific knowledge. You yourself refer to shamanism, which is also (when authentic) a form of deep experiential and cultural knowledge. Neuroscience (when it is of high quality) offers scientific knowledge (through the accumulation of verifiable data accumulated through use of the scientific method). This knowledge can very much refine our practice of psychotherapy in the ways that Cozolino eloquently described. However it does not substitute for experiential knowledge. Your previous guest Dr Arden gave some more basic examples of how neuroscience can be used to dress up fairly basic psychoeducation, and Cozolino and your previous guest Ecker gave much more profound examples of how neuroscience can inform psychological interventions. Neuroscience will never replace experiential knowledge however. Science must always be partnered with creativity and implicit skill before it achieves results. Despite this, I share your ongoing enthusiasm however of how it will continue to refine and guide the experiential and creative practice that is psychotherapy.
Your new fan,
Dr. Michael Ocana
I thought the conversation with Lou, prompted by the email you received questioning the validity of neuroscience to psychotherapy, was interesting. I think that regarding neuroscience as a ‘fad’ in the world of psychotherapy is rather like saying muscular/skeletal research is just a ‘fad’ to the physiotherapist, or that some detailed knowledge of an FA-18 hydraulics systems is superfluous to the fighter pilot. No one expects the fighter pilot to be a hydraulics engineer, just like we are not expecting the therapist to be a neurologist (nor a neurologist to be a therapist), but a more detailed knowledge of what you are operating has to pay dividends in the long run. It is surprising to me that a therapist wouldn’t want to know about the latest findings of the brain – the main thing modulating thought, affect and behaviour. I see this neurological awareness as just a natural progression of the discipline of talking therapy. As Lou pointed out in your interview, there can be surprising answers arise for a therapeutic problem because of a more intimate knowledge of what’s happening ‘under the hood’ so to speak.
I think there is also a lot of validity in the ability to separate the patient from the pathology by explaining in simple terms that it’s their over active amygdala that’s the source of this difficulty (for example) and there are ways we can get this part of their anatomy to work in a more functional and healthy way. The patient can then step back from themselves and see “Oh, OK, I thought I was crazy but it’s just this little bit of my anatomy that’s playing up and it’s just a matter of getting this under control. I can handle that.”
I see neuroscience, and other biological and social sciences, as a welcome addition to what we are doing as therapists, regardless of the school we are grounded in, and it can only improve our care if we are willing to be flexible and accept the new information and integrate it into our approach. I suspect that more and more therapists are becoming eclectic in their therapeutic interventions, and adding neuroscience research to the rich banquet of knowledge available to us today can only be positive for therapist and client alike. I agree with what Dr Michael Ocana has said – neuroscience will not replace the experiential knowledge of the psychotherapist, but it certainly will refine the creative practice of psychotherapy.
Thanks for a great interview.
Dr Cozolino is, without doubt, deeply rooted in the development of both psychotherapy and neuroscience over the past few decades. The argument of the need for neuroscience knowledge in the ability to practice psychotherapy is a curious one. All information is of value to both specific knowledge and also our capacity to intuit the wider picture. Stephen Pinker once commented (I paraphrase) on counter-intuitive thinking – the more I know the less counter-intuitive my thinking is. Lou has created a wonderful chapter in the 2nd edition regarding epigenetics and this may prove to be as exciting and informative as was the understanding of the malleability of the synapse. I also recommend that people read his books – and there are a number of them.
Looking forward to your next interview!
Richard Hill
If the findings of neuroscience can help some people approach therapy with less fear that’s great. To externalize the problem can be helpful but it’s also equally important that we don’t use neuroscience findings to rid us of our personal agency, or to make scientific our human struggles and experience because it could rob us of the opportunity to change and to understand each other.
Does it really help me to say “ I’m not/am hard wired for …” instead of “I struggle with/to….”, keeping in mind that change is always an ongoing work not a destination. Neuroplasticity likewise is a potential not a means to an end.
For me neuroscience is exciting because it’s facts speak to my yearning to put an end to uncertainty. Yet the promising uplifting language of neuroscience should be tempered with a grain of salt. The term rewiring in particular is seductively mechanistic.
Having had psychotherapeutic help over the years, it’s an ongoing work and struggle to grasp and apply understanding, to continue to learn. Sometimes I forget what I learned. It’s not a linear path or a quick-fix – if only. For this reason I don’t in any way regard the therapy I had as a biological invention. Saying that psychotherapy is a biological invention implies that somehow my brain has been rewired and reconfigured, and by inference, permanently changed for the better, that I cease to struggle to make sense of my experience, to understand my behavior, my feelings. Everyday, my experience tells me that this is not true.
The findings of neuroscience can tell us what happens biologically in our brains but what kind of understanding of the mind and our personal experience does this knowledge constitute? You can’t have a mind without a brain that’s certain but it doesn’t follow logically that brain and mind are same thing. They aren’t.
What an awesome interview. It was refreshing to hear Dr. Cozolino’s combination of deep expertise and openness/humility. It lessened my resistance to the neuroscience craze!
I’m not sure I have much to add that hasn’t already been mentioned in the excellent and thought provoking comments above, although I’m not sure Louis meant his statement about neuroscience quite the way Michael interpreted it.
Anyway, I loved a particular point that Louis made about certain teachers seeming very much like people trying to convert you to a particular way, and Louis having no intent on becoming a ‘disciple’. I see this all too often and I’m reminded of something we were taught in Psych 101: “Study many, love several, marry none”.
I thought Louis’s thought about a neuroscientific explanation sitting with certain people better than perhaps something like a pscyhodynamic explanation was particularly canny (as he said, you don’t need to explain to women the need to feel!). I can think of three people immediately in my life for whom explaining neuroscientific processes in the course of therapy would drop their guard and resistances to what they would see as some kind of stereotypical ‘touchy-feely’ psychotherapy! 😉
I thoroughly enjoyed this interview with Dr. Louis Cozolino. In regards to questioning the usefulness of neuroscience and it’s ability to inform psychotherapy, I wholeheartedly agree with Matthew Dahlitz analogy when he says “Its rather like saying muscular/skeletal research is just a ‘fad’ to the physiotherapist, or that some detailed knowledge of an FA-18 hydraulics systems is superfluous to the fighter pilot”. Babette Rothschild’s book “The Body Remembers” is an excellent example of the way in which a psychotherapist can integrate knowledge of the brain and the ANS into an informed and practical approach to treating PTSD.