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How People Change


When I read the flier announcing another edition edited by Marion Solomon and Daniel J. Siegel, I knew I needed to review it (hard not to give a nod to these two—they consistently offer quality material) but the list of contributors felt far too familiar— I’ve read many books and papers by many of the contributors, some I’ve even interviewed and written about for this magazine. One essay even acknowledged that a version of it was previously published in 2011.

Well, here’s to moving forward despite assumptions and preconceived notions and reading with receptivity and curiosity. Yes, I was pleasantly surprised by the newness of how established data was used to support creative and insightful ways to address change in psychotherapy.

How People Change offers 11 essays exploring growth and change, which are noted to be “at the heart of all successful psychotherapy”, and I will add at the heart of body psychotherapy and somatic psychology. The body and its place in our lives—our healing and overall health— is part of the process in many of these essays. A clear focus on mind-body dualism is supported as many of the authors write about the relationship between client and therapist and explore “the complexities of attachment, the brain, mind, and body as they aid change during psychotherapy.” Contributors include: Philip M. Bromberg, Louis Cozolino and Vanessa Davis, Margaret Wilkinson, Pat Ogden, Peter A. Levine, Russell Meares, Dan Hughes, Martha Stark, Stan Tatkin, Marion Solomon, and Daniel J. Siegel co-authoring with Bonnie Goldstein.

Each essay presents the author’s thoughts on how to induce, instigate, facilitate change in psychotherapy, how to be with the client in the change process, and what it means to be in relationship with a client’s mind, brain, body, and soul. While there is not time nor need to detail each essay, I offer small glimpses of some of them.

Philip M. Bromberg: Psychotherapy as the Growth of Wholeness: The Negotiation of Individuality and Otherness

Bromberg begins with an interesting discussion of the two epigraphs he selected to begin his chapter:
“My one regret in life is that I am not someone else.” (attributed to Woody Allen)
“We may still tremble, the fear of doing wretchedly may linger, but we grow. Flashes of inspiration come to guide the soul. In nature, there is no outside. When we are cast from a group or a condition we have still the companionship of all that is.” (Theordore Dreiser)

In an engaging first-person voice that addresses the reader directly to intimately share an insider’s perspective, Bromberg offers that his opening epigraphs not only guided the focus of his chapter but also demanded their own air time. He writes that while he normally picks one epigraph, two came to forefront, and while he usually selects them then forgets about them, while writing, these two kept coming to the page: “What I received was not a ‘meaning’ but a feeling of strangely pleasurable surrender to something new that was even more unbidden: The words of these two epigraphs, my reason for choosing them, kept changing experientially in unexpectedly personal ways while I was writing” (pg. 18).
His chapter continues to be a joyous read as he “introduces” us to how his mind works then begins what he calls the chapter proper. His work is strongly influenced by Allan Shore’s contributions to psychotherapy and neuroscience (affect regulation, dysregulation) with emphasis on the phenomenon and concept of “state-sharing”—“the right brain to right brain communication process through which each person’s states of mind are known to the other implicitly” (pg. 23).

“The interface between my own thinking and his (Schore), when linked to the centrality we each place of the mind-brain-body interface, provides the core context that I believe will allow psychoanalysis and psychotherapy to become most genuinely therapeutic” (pg. 23). His chapter thus focuses on how human relationships (specifically between therapist and client) enable the self to heal while simultaneously co-creating a dynamic link between healing and growth. While he dislikes the word change when applied to people, to address the theme of this book, he spends his time thinking about and thus writing about what makes psychotherapy possible (pg. 23). From his perspective, psychotherapy is a relational experience, shaped by two specific people. What makes it therapeutic is its uncertainty—what he calls safe surprises (pg. 23).
Later in this chapter, Bromberg underscores his “strong and lasting conviction that when perception organizes our way of relating, our patients are therapeutically freed (though not necessarily ‘free’) to actively ‘do’ unto us what we are ‘doing’ unto them” (pg. 33) to emphasize that “personal meaning is not birthed by the ‘right words,’ but by a two-way perceptual context that slowly includes the cognitive meaning provided by the personally negotiated affective physicality of its experiential meaning” (pg. 33). He then writes about the trauma of nonrecognition before sharing his case study involving those voices.

Louis Cozolino and Vanessa Davis: How People Change

These co-authors offer first a comparison between a rat and a human that involves tunnels and cheese. It seems that if a rat finds cheese at the end of a tunnel it will return to the same tunnel. But, if the cheese is no longer there, after a few disappointments, the rat will forage elsewhere. Meanwhile, a human will continue to haunt the same empty tunnel all the while believing that the cheese should be there. Their point is that the human brain is an organ of adaptation and survival. It is designed to do things as quickly, as efficiently as possible with the least amount of information (pg. 54). Our brain, they say, is inherently conservative—it wants to do what’s worked before. And it also a ‘social organ’ such that “its growth and organization is shaped and reshaped in the process of ongoing experience” (pg. 55). According to Cozolino and Davis, “The dynamic tension between habit and the need for adaptation lies at the heart of psychotherapy” (pg. 55).

There’s an interesting discussion about dogma and unconscious egocentric biases (on the part of the therapist) that lead one to believe his/her way is the right way. And another fascinating conversation on reflexive social language (RSL) defined as “a stream of words that appear to exist to grease the social wheels” that consist of “verbal reflexes, clichés, and acceptable reactions in social situations that establish a web of pleasantries with those around us” (pg. 65) as compared to what they call our internal narrator, which verbalizes internal language that is far different than we share with other people. RSL connects us to others with a positive intent, while the narrator is a private language, a single inner voice that is primarily negative, and driven by self-doubt, anxiety, fear, and shame. It also serves to turn against others via critical and hostile thoughts. They end the essay with a case study.


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About the Editors:

Marion Solomon, Ph.D., is a lecturer at the David Geffen School of Medicine, Department of Psychiatry at UCLA, and Senior Extension faculty at the Department of Humanities, Sciences and Social Sciences at UCLA. She is also director of clinical training at the Lifespan Learning Institute and author of Narcissism and Intimacy, co-author of Short Term Therapy For Long Term Change, and co-editor of Countertransference in Couples Therapy and Healing Trauma.




Daniel J. Siegel, MD is a graduate of Harvard Medical School and completed his postgraduate medical education at UCLA with training in pediatrics and child, adolescent, and adult psychiatry. He is currently a clinical professor of psychiatry at the UCLA School of Medicine, founding co-director of UCLA’s Mindful Awareness Research Center, founding co-investigator at the UCLA Center for Culture, Brain and Development, and executive director of the Mindsight Institute, an educational center devoted to promoting insight, compassion, and empathy in individuals, families, institutions, and communities. Dr. Siegel’s psychotherapy practice spans thirty years, and he has published extensively for the professional audience. He serves as the Founding Editor for the Norton Professional Series on Interpersonal Neurobiology which includes over three dozen textbooks. Dr. Siegel’s books include Mindsight, Pocket Guide to Interpersonal Neurobiology, The Developing Mind, Second Edition, The Mindful Therapist, The Mindful Brain, Parenting from the Inside Out (with Mary Hartzell, M.Ed.), and the three New York Times bestsellers: Brainstorm, The Whole-Brain Child (with Tina Payne Bryson, Ph.D.), and his latest No-Drama Discipline (with Tina Payne Bryson, Ph.D.). He has been invited to lecture for the King of Thailand, Pope John Paul II, His Holiness the Dalai Lama, Google University, and TEDx. For more information about his educational programs and resources, please visit: www.DrDanSiegel.com./