This article is an adaptation of our Fireside series video interview with Dr. Chad Luke, on the clinical applications of neuroscience.
Click here to watch the video recording.
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Introduction
This broad-ranging interview, featuring Dr. Chad Luke, explores how therapists can integrate neuroscience into clinical work. Topics covered include recent advances and future trends in neuroscientific research (and how they are relevant to your everyday clinical work), the importance of being neuro-informed, ethical considerations, psychoeducation, epigenetics, addictions, and much more.
About Dr. Chad Luke
Dr. Chad Luke is a well-established author, researcher, supervisor, educator, and clinical expert in the integration of neuroscience with mental health. He is an associate professor of counselor education at St. Bonaventure University, in the United States. Five of his seven books address the process of applying neuroscience research in clinical practice, including Neuroscience for Counselors and Therapists: Integrating the Sciences of Mind and Brain, now in its second edition, and Applying Neuroscience to Counseling Children and Adolescents: A Guide to Brain-Based, Experiential Interventions (with Christine J. Schimmel). Dr. Luke has been a clinician for over 20 years, a clinical supervisor for 10 of those years, and a graduate professor for the past 12 years. He is a prolific scholar, authoring or co-authoring over 50 journal articles, books, and book chapters. Dr. Luke is a regularly requested speaker both nationally and internationally, on topics related to neuroscience and clinical work. His trainings focus on the intersection of neuroscience and addictions, children and adolescents, career work, and theory, to name a few.
Dr. Luke is also the author of Mental Health Academy’s credential course: Clinical Applications of Neuroscience.
Clinical Applications of Neuroscience: Interview Transcript
Tell us a bit about your professional background and why you decided to become a mental health professional and researcher.
I think from early on, pretty overwhelmed with the condition of the world and the state of suffering that I experienced being around individuals, family, friends, community, and definitely feeling a sense of kind of powerlessness to know what to do to make sense of the world. You know, some a lot of mental health folks are kind of psychologically minded. We really want to know what’s going on behind the curtain, behind the scenes of people’s lives and experiences. And for a long time, I didn’t really find satisfactory answers. So pursued the psychology degree after a couple of different career starts.
Then that wasn’t enough, so did the master’s in counseling and really worked with some of the folks, populations that really struggle a lot, substance use individuals, those in unhoused situations, children and youth who had been neglected or abused and ended up in drug treatment centers. And so, I wanted to just continue my education, pursued the Ph.D. that allowed me to really study and broaden my experience. And so, a lot of clinical work with a lot of different populations and wanted to just continue. And that’s sort of led me to neurosciences. I still wasn’t getting the kind of answers that were satisfactory to me. And I was also then starting to see increasingly clinicians feeling kind of worn out and sometimes burned out and just really feeling like they were at kind of their wits end with how to help folks, especially resistant, you know, really stuck kind of situation. So, neuroscience has really been kind of a bright spot in my development.
So that’s the short version. The long version includes my mom and a pet. And I’ll spare you all that.
When and why did you start focusing on the intersection of neuroscience and therapy?
Like a lot of folks in my psychology program, we looked at brain and behavior, physiological psychology, and it just sort of ignited a little spark of interest on how – oh, this might be really what’s going on and how we can come to understand folks. And then the more I read and studied and then again was training students in a counseling program and then supervising folks who were just kind of running, feeling like they were running out of some options, just kept reading and designed a course around this topic. And just one thing led to another and couldn’t find the kind of bound together in one accessible platform. And so ended up serendipitously running into a publisher that I’d done some work for and brainstormed a book idea. And then that kind of took off. And it’s all been kind of a rollercoaster ride since then of trying to put together the pieces in a way that really makes sense for clinicians. So that’s why I’m so excited to get to talk about this. I feel like the more I talk about it and the more I study, the less competent I am to talk about it because it just opens up all these different avenues of knowledge that one could pursue to try to get mastery.
How does current neuroscience research inform your approach to mental health therapy?
I probably will want to preface this by saying that regardless of the question, I don’t know that I can ever give fully satisfactory responses in a brief amount of time. And so, just sort of naming that as we start, because everything needs further elaboration to get the full context. And so, a lot of times I feel a bit at a loss to be able to fully capture what people really care about when they ask some of these questions. So, but back to your question. So many of the responses you’ll get from me tend to start with, it depends. It depends on what we mean when we talk about informing our approach and what neuroscience is. A lot of times we as clinicians are struggling to understand maybe the difference between like basic neuroscience, translational neuroscience, and clinical neuroscience.
So basic being kind of in the lab where studying individual neurons in animal models of humans. And then translational is really starting to bridge certain animals to more primates. And then clinical is where we start looking at, okay, how is that working in a clinic setting? And often those are in controlled kind of situations. So I think Eric Beeson and I did some work together on a chapter, and I think the simplest way I can put it is that in terms of informing my counseling and my clinical work, neuroscience can, it validates, it extends, and it informs. So, I think it can feel really validating to our current theories and techniques and interventions. And I feel like that a lot of times folks want to know, you know, how do I know if what I’m doing is working? And it’s nice to see that there’s some evidence there. I think it also then can extend so we can go a little bit further in the theories and the techniques and kind of interventions that we’re doing. And I think we’re sort of in the phase of model building where we’re taking this and say, OK, can we build from the ground up a neuroscience-based treatment practice? And I think there’s yes and no there. So yeah, so there’s a lot of different ways I could answer that. But I think for the sake of time, I’ll just end here.
What ethical considerations arise when applying neuroscience findings to mental health therapy, particularly regarding privacy and consent?
Yeah, lots of opinions here. Some of our team’s research has looked at concerns that the field has about integrating neuroscience and the ways we integrate it. And the field being like counseling and counselor education is one of the branches. We’re speaking more generally here. I think that sort of the quality of the information is one of the biggest ethical concerns because I think in a free-market economy where novelty sells and innovation is really attractive, I think that there are a lot of things that maybe promise a little bit bigger outcomes than maybe the science supports. And so, trying to be a good consumer of that, I think, is pretty, it’s kind of our growth edge as clinicians, as multiple professions represented by clinicians, folks who would take courses here. And so, I think, on the one hand, you know, I mentioned basic science.
I think on the one hand, you have folks who are kind of scared of the, scared, intimidated, daunted by reading sort of this original basic, I mean, it takes me forever to get through one article when it’s using acronyms and shop talk that I don’t understand. That’s on one side. And then on the other side, you have basically if you look up neuroscience-based interventions on Google, any of the sponsored results can be kind of flashier oversimplifications of like, just do this therapy and it’s going to change your brain. And so, I think we’re really stuck as professionals trying to navigate this science that’s really accurate but really dense and hard to translate, all the way to folks who are kind of conducting research as a part of the product development that they’re working on to sell.
So, I think that’s a big thing. And so when it comes to informed consent and really bringing clients into this work, we have to know what we’re – what they’re – we have to help inform them of what they’re consenting to. And so, in order for them to be informed, we need to be informed. You’re seeing this a lot with alternative therapeutics around ketamine, psilocybin, MDMA (related article: Psychedelic-Assisted Therapies: Research Update). There’s a lot of risks and a lot of things we don’t know, even though there are some cool things that we do know.
Anyway, that’s not what this talk is about. But, yeah, so I think we still have a lot to learn. It also turns out that just because you tell somebody that what’s happening for them is rooted in their nervous system and the intention is to reduce stigma, it can actually rebound and have stigmatizing effects.
There’s a large body of literature that explores this. So, I think that’s a really unfortunate, unintended consequence. I’m just trying to help you see it’s not your fault. But then the research indicates that people are less likely to follow through on therapist interventions, which is not where we want to be, probably.
So great question. Thanks for putting that out there. It’s a good frame for what we’re doing.
How can neuroscience help us to combat racism, misinformation & disinformation?
It sounds like there’s some multiple dimensions to that question. So, I want to give it the respect it deserves, even though there’s a few layers to it. One of the – I think that there are some basic brain-based principles that we can operate from as clinicians that can help us understand kind of the course of bias and how to regulate it in ourselves and in our conduct with others. So, for example, our nervous system, our brain tends to be very gullible. We’ll believe anything we tell it.
And so, this is sort of a play on cognitive behavior therapy, but it is true that often we start with narratives and then look for evidence to support those narratives. And that’s related to the second principle of how our nervous system works. And that is, our nervous system prioritizes safety and survival over accuracy and over connection. So, if there’s room left, we’ll connect, but really what we’re trying to do is survive. And so, it’s a lot more, and so the third principle there is that we, our nervous system values efficiency over accuracy. So, we’ve got safety and survival over connection and speed over accuracy. So, we are designed to make snap judgments based on limited information for the sake of survival.
What happens, though, is when we do this, we start treating those snap judgments as if they’re based in reality when they’re really just based in biology. And so, I think neuroscience and the neuroscience of bias and in-group, out-group bias and stigma really inform how it’s really hard to get away from the way we’re biologically wired. And so, what that means in working with others is you can’t really fake being empathic or connected to people, even though there are beliefs out there, some people behave as if they can fake it, but the other person’s nervous system is always scanning for threats as well. So, I think once we know that it opens the door for us to have maybe more candid conversations, more room for some grace toward ourselves, grace toward others, and again, hopefully it moves toward more transparency in our communication. So, I think that’s just one dimension of the question that was asked. So, if there’s another layer, level that I need to address, I’m happy to circle back.
What is the state of play with Mirror Neurons these days?
That’s a great question. So yeah, and there’s a lot of noise around mirror neurons. We typically now call it the mirror system or the mirror neuron system because it’s not really like a handful of neurons that do this thing. It’s the importance of the research today, I think, is that we’re learning more from a biological basis how we form mental simulations related to someone else’s experience. So, if we’re sitting here and I scratch my nose and Peter goes, hmm, and starts scratching you first had to create a mental simulation of what I was doing and then compared it to your own experience of what was happening. And so now what comes next is the story you tell yourself. So, either you tell yourself the story, oh, Chad’s scratching his nose or, you know, depending on your knowledge of me, you might say, oh, he’s picking his nose. Or you might say, he’s trying to subtly tell me that there’s something on my nose, right? So, there’s not just the mental simulation.
There’s a story that we tell ourselves about that simulation. And the story is informed by our experience where we say, when I’m in situations and I do this, this is what is true for me. The issue is then we can go the next step and project that back on the other person and say, oh, that’s what that must have meant for them. And so, this mirror neuron system is really amazing, especially when we’re talking about culturally ethical practice and effective practice. Because I know that there are certain things, so let’s use a less silly example, a scratchy nose. Maybe it’s this gesture. So, in certain contexts, I’m trying to get your attention and then maybe in other, I’m trying to warn you of something, right?
So, there’s a few different ways that the context will tell you, at least make a guess of what that means and it has to do with our relationship with one another. And so the mirror system, mirror neuron system, is helping us create those simulations and then compare it to the stories that we’ve told ourselves based on our experience and then to then try to imagine which of those best fits the intention of the person that initially is doing the waving.
I hope I’m not making too much word salad out of that. But again, it helps us determine what action we need to take in relation to that other person by trying to form these simulations. The problem is if we’re coming from a background of trauma or neglect or other kinds of harm or situations that haven’t promoted our own development, we can project onto others stories that are not their stories. There are stories that we anticipate belong to them. And this really conflicts with what the neuroscience folks call theory of mind, which is how can I have an awareness of my experience when I’m with you? And still maintain that my experience is about me, not about you. And so, it’s where we’re training and empathy really comes in.
Does your work with Neuroscience encompass work with the body, somatics, or Polyvagal theory and whole-body integration?
Well, lots of layers to that one as well. I’ll right off the bat that polyvagal is a good example of kind of a self-contained model of neuroscience integration that is its own thing. And, you know, Stephen Porges has done great theoretical work. Deb Dana has come along and really operationalized a lot more of the concepts and applied it in a clinical setting and has done some really good work there. I leave the depth of discussion to those experts.
I think the question is amazing because what happens when we’re talking about neuroscience is we tend to, at least the bulk of the writing that I’ve seen in the mental health spaces especially, is we’re often just talking about the brain. And the brain is just part of the nervous system, and in particular, the central nervous system. But what we have to realize, I don’t have a diagram here, but you have the brain and spinal cord make up the central nervous system. But coming out from all of that is the peripheral nervous system. And the peripheral nervous system is then subdivided into body neurons and motor neurons, somatic neurons, and then further divided into autonomic nervous system, which is divided into the sympathetic and parasympathetic.
So, there’s this whole part of the nervous system that is all about attunement to the body. And if we, when we’re just talking about the central nervous system, we’re leaving out a lot of the sources of information that the brain and nervous system use to make sort of higher-order decisions. And so, all of the move toward, not all the move, but the flow of training and work in somatic sensory work and body work and breath work is, I think, a move in the right direction because it brings back into unity the body and the nervous system. They were never separate, but sometimes we treat them as separately. And, you know, popular book, The Body Keeps The Score, Van der Kolk, is good.
Also, I would go further, you know, the body is the first to know, in many cases, what is happening with the central nervous system or in the sympathetic nervous system, even. And, I mean, that’s the key messenger, is all those sympathetic processes are physical manifestations of what we might call anxiety or fear or depression. And so being able to tune into that, there are so many strategies now to help people learn about what’s going on in their nervous system by understanding the early warning system that is the body. And so, I think that’s a really exciting way to do that.
Again, I want to underscore that approaches like sensory motor psychotherapy and polyvagal are sort of self-contained approaches. And so, know that you can get fully trained on those. My work is focused in sort of more general integration across multiple different theories.
But I will say, the cool thing about polyvagal theory is it gets its name because the vagus nerve is the 10th cranial nerve and it’s the only one or only pair of the 12 pairs of cranial nerves that exit the brain and go all the way down to the gut. All the others terminate at the beginning of the spinal cord. And so, we talk about the gut-brain microbiome, and here’s where we start thinking about the enteric nervous system and kind of how our gut health really informs our overall wellness. So that’s where, that’s the cool thing about polyvagal theory. It just goes a little bit, well, a lot more detail about how you treat someone and their vagal nerve dysfunction or collapse, as they might say.
What role do social determinants of health play in the neuroscience of mental health, and how are these factors addressed in therapy?
So, the model that I’ve been developing for like 12 years, it’s not really that complicated, but it is grounded in both developmental psychopathology and social determinants of health (related article: Rethinking Wellness: A Holistic Perspective on Health). And all it means is that who we are today is the manifestation of all the social determinants in our history. So, I call it – well, today I call it the inheritance model. It’s gone by many names over the various iterations of my writing in understanding the research. But I’m going to say this as quickly as I can without leaving out too much of the important stuff. So, our origin story, it begins with a sociocultural world that we’re born into that we had no choice in joining. We didn’t make those decisions. The culture was the culture, the society was the society. And in that, our cultural norms, societal norms, the period in history, the part of the planet we’re born onto, the different economic forces and social issues, so forth. And in that context, our genetic blueprint is laid down.
So, we are given this sort of biological and hereditary inheritance, literally, that, again, will shake you. You and I were talking about this a little bit at the beginning before we logged on, before others logged on, about often we’re born with a nervous system that we’re born with and that, for me, that just means I’m pre-wired for anxiety and you might be a lot more chill.
But some of that is biological inheritance. As with health factors, like health conditions that we’re born with or not born with. And then the third is the early relationships. So, we didn’t choose our early caregivers. And yet they absolutely have a huge role to play in how our nervous system forms. and more and more research is coming out on the deleterious effects to the nervous systems of individuals in environmental exposed to environmental pollutants, dirty drinking water, air quality, other environmental toxins.
And so, and then the environment can also include the immediate environment, the intactness of the family or not. And then in that context, we have experiences and these experiences shape how we, how our nervous system is built. So, what am I saying with all that? Good question. So, in terms of thinking about social determinants of health, we have sort of these five stages of development in our early part of our life that form the foundation of our nervous system. And we didn’t have any choice in any of those. And yet, at a certain point in our life, didn’t we become responsible for living with that nervous system? That was the result of somebody else’s decisions. And so, for me, this is powerful because, as I mentioned to you a little bit before, I think step one is learning our nervous system and step two is making peace with the nervous system that we inherited. And so, this is a, this is just a drop in the bucket of the broader literature on social determinants of health.
But when you, I think, when we start to have a more sophisticated understanding of the origin story of individuals, it makes sense how those precursors, those inherited features of experience are manifested in thought patterns, feelings, behaviors, patterns of relating, and then general experiencing of the world. And so, I think that where we’re coming to with understanding integration of neuroscience into clinical practice is a more complete picture of the individual that’s sitting before us. So, it’s not about blaming our parents or our culture, and it’s not about taking away the responsibility of the individual to live their life as fully as they can.
But, wow, when we start connecting the dots, we have a lot of options for where we want to intervene in addressing some of those social determinants. Again, social determinants of health theory and practice is a lot richer than what I just described, but I wanted to give you a quick look at how I think about that today.
How does epigenetics influence mental health, and what does this mean for therapy?
As we think about using genograms or family trees to get further back in the origin story, like where some of the things that seem mysterious today that are popping up, maybe popped up in the past. I like thinking about epigenetics as really how the environment activates gene expression or leads to gene expression, which means things that were previously asleep are now awake. And now you’ve got to clean up after that. A parallel concept to epigenetics is experience-dependent plasticity. And all that means is that if the environment activates genes, experiences can activate nervous system adaptations. And
So, you have two forces acting on an individual that make modifications somewhat against their will. And so, one of the ways to work with this in session is again, so we’ll go back to addictions. When I work in addictions treatment, I do a lot of talking about sort of how their origin story makes sense that in many cases, there couldn’t be anything other than who they become. And so, there’s a place for them to be kind to themselves. But the question that I ask is, what if your substance use disorder is not your fault, but it is now your responsibility? And it typically comes from, you know, it sounds like the beginning of a joke, a bad joke. Two people walk into a bar, one walks out and the other has to be carried out. It’s really not a fair situation that two people go into a bar and have the same alcohol encounter, except genetically they have a very different encounter. And so, I think that’s really, I think there’s a lot of rage in addiction treatment that some people can use recreationally, and some people can’t.
And when they realize that second group of people, when they realize that they can’t, it often feels too late or at least for a certain type of behavior is a really upsetting experience to walk with people through. And I think it’s an important one. So, you see this so often with PTSD that, you know, statistically, 10 people could go through the same experience and only a couple of them are going to walk away with meeting the criteria for PTSD. Well, what did they do wrong to make that happen? They didn’t. They just inherited a vulnerability that they didn’t know about until it happened. Again, multiple opportunities to extend grace to individuals because, you know, if you struggle with something and kicking the crap out of yourself for struggling with it was effective, fewer people would have kind of psychological issues because we’re really good at beating ourselves up. I talked about that earlier, too. So that’s my little take on epigenetics. Again, just scratching the surface.
From a neuroscientific perspective, what distinguishes effective from ineffective mental health therapies?
Ultimately, what works is what works. And we still don’t have a blood test to see if people are – who with generalized anxiety disorder are in fact experiencing relief other than their self-report. And so I think that as, and I don’t know, so this is a, this is a U.S.-led thing through the National Institute of Health, which is the research domain criteria, which is really doing the biomarkers research, like, full blast, put hundreds and hundreds of millions of dollars into this to try to assess multiple levels of explanation for behavior so that people can—so that we can—well, part of this is precision medicine, being able to offer direct therapies that are custom-made for individuals. So that has an implication for what works. I think that many times, so this is purely Hebb’s rule, which is neurons that fire together, wire together, that the longer we’ve been thinking, feeling, acting, relating, and experiencing in similar ways, the more likely we are to continue, even in spite of contradictory evidence.
And so, I think as we develop better neurobiological assessments for understanding individual functioning, the better we will get at helping people track their progress. One of the things that the research domain criteria is really focused on is moving away from the ICD and the DSM where we collect a cluster of symptoms, many of which are self-reported. And we know that we’re not always that great at reporting out what’s happening to us, or at least there’s a lot of room for improvement. And so being able to move beyond that. Obviously, biomarkers and one primary is measuring cortisol in saliva and then precursors to cortisol and then also biomarkers of metabolites of cortisol. So, one of the things that we want to be able to help people do is say, okay, physiologically you are showing improvement. But again, the story that you’re telling yourself is that you’re not improving. And as clinicians, and, you know, a bunch of people around listening to this now, I think, can relate to making the observation, it seems like you’re making some improvement, and clients disagreeing with that. And so, I think having more objective measures of improvement data can really be encouraging to folks.
What are your thoughts on EMDR (Eye Movement Desensitization and Reprocessing) as a therapeutic intervention?
So, there are some strengths and some challenges with EMDR related to the research. The strengths are that there’s a growing body of literature supporting the practice of EMDR in alleviating symptoms related to trauma and stress. The jury still seems to be out about the eye movement part. There’s some really cool neuroscience research about what eye movements mean as they relate to their connection to the nervous system. Some have postulated that the retina is actually part of the extended central nervous system. And so, the movement of eyes are actually signaling neurobiological adjustments outside of the level of consciousness. That’s pretty cool. Others are not convinced by the research that that is an essential element.
What I will say is that as the conversation around trauma has intensified, so have the level of – so has the level of reporting by clients and awareness in the media. So, I think what – one of the things that’s happening is people are saying, wait, that is classified as trauma? I just thought that’s how parents treated their kids, for example. When you think about ACEs score – Adverse Childhood Experiences course. And so I think when we see an increase in reporting of trauma, it can mean both that there’s an increase in it happening, but also an increase in reporting because people didn’t know that you could talk about this and that there were solutions and treatments available.
So, when that happens, though, I think therapists and clinicians have become overwhelmed with needing something that works for their clients. And one of the things that is really powerful about EMDR is it trains clinicians in a very systematic method of addressing trauma. When you do that from the research, the research shows that when therapists operate from a coherent model that they believe in, their clients are more likely to believe in it and are more likely to follow through with the interventions prescribed. And so, you have multiple levels of things going on. You have the systemic approach that is gaining traction.
You have a belief by the therapist that this is gonna be effective. You have a buy-in from the client. And then you have, no offense to any EMDR practitioners who don’t like the word hypnosis, but you have sort of a, you introduce bilateral stimulation in a way that kind of bypasses the cognitive blocks people have to processing trauma. Essentially, remember, we our brain prioritizes survival and then efficiency and wants to survive as efficiently as possible. So, when we start bringing up trauma memories, our conscious mind or cognitive minds puts the brakes on and says, uh-uh, that is not how we survive and it’s certainly not how we survive efficiently. So, it puts the brakes on, and we are limited in our ability to work through that trauma. I’m giving you the broad strokes, there’s a lot more going on here. When we can pair a relaxed state with exposure to trauma, this is the behaviorists that have done this for decades, we can reduce the experience of the traumatic response.
So, if we can block the conscious brain from bailing out on us. If we can stop the emotional center of the nervous system from becoming dysregulated in the presence of traumatic re-experiencing, then we can think differently about – we have different ways of sorting that traumatic information. So that’s kind of what’s going on. So you have a lot of different factors happening simultaneously that really make it an effective form of treatment. But the exact mechanisms are still, I think, as my reading of the literature, is that they’re still a little bit opaque.
What are some neuroscience-based therapies for mental health disorders, and how do they differ from traditional psychotherapies?
So, again, it depends. There are the off-the-shelf kind of self-contained models that we mentioned earlier that are – they have specific language around describing dysfunction, and practitioners are trained on that specific language and the mechanisms of change that are – that operate within that frame. So, it – like, to be a CBT therapist, you have to understand all the CBT language and the mechanisms and be able to practice out of that model. Same is true for polyvagal, for example. More often than not, people are integrating at different levels.
So, the most common experience that I see is people using psychoeducation to—about neuroscience, about the nervous system—to integrate into their practice. Speaking of opacity, one of the things that’s really missing from brain-based psychoeducation or neuroscience-informed psychoeducation or whatever you call it is when it comes to psychoeducation, we as a field don’t know what the appropriate dose is, like when is the optimal amount and or when is the optimal time to introduce psychoeducation principles and then how much. You know, sometimes we all might have been to a therapist or two that use psychoeducation for 45 minutes out of 50 in a session and we would say that that’s less than optimal.
So, psychoeducation is probably the most common in the research that we’ve done and others have done, is when you ask people, what do you mean by integration? And we’re telling people about their brain, teaching them about how their brain works. And I think it’s definitely a sign of where that’s the starting point for where we are in the field, but I don’t think it’s where we want to ultimately land. So, brain-based psychoeducation is probably the most common. With regards to how they differ from “traditional” psychotherapies, I’m still more in the camp of what we talked about at the beginning, that neuroscience really enhances and can extend existing therapies. I’m not sure it reinvents the therapeutic wheel. And so, in terms of differences, I don’t think it should differ significantly from our tried-and-true thing. So, I used to say, you know, you’re reading about neuroscience and you read a study that says that empathy really isn’t that important to humans. You would not want to start integrating that into your therapy practice.
And so, yeah, I think that we want to be really careful that we don’t make it too different from our existing therapies. So, then what’s the value? I think the value is it does change, hopefully, first, the clinician. It gives us a greater appreciation for what we’re doing, why we’re doing it, and how it works in session. Again, it pulls back the curtain underlying, behind what we see on the surface as therapy and working. I think it can make us more empathic. I think it can make us more intentional. And I think it can make us more authentic. And again, that is underlying the, I’m saying the mechanisms underlying what we do and why we do it. And I think we’ve been, we’ve really needed that as a field.
It turns out that Freud got a lot of stuff right. Not necessarily the sexual stuff and some of his more outlandish claims, but he’s been kind of roasted for the last 50 years for being out of touch, but neuroscience has come back around to really validate a lot of this. So, I don’t think it should be a I’m either neuroscience-informed or I’m not, I think that the science is the science and we should all be science-informed. And neuroscience is really the, I think, the cutting edge of where therapy is going. So, hopefully people don’t say, oh, I’m going to be neuroscience informed, I’m going to do something totally different. Or that they think that they have to stop what they’re doing, to then somehow be more brain-based. I think it’s minor tweaks here and there.
Can you discuss any emerging neuroscience research that could revolutionize mental health therapy?
I think there are programs like the Research Domain Criteria where we’re looking at biomarkers, I think is going to be huge. Right now, mental health issues continue to be mysterious. So, I think that’s going to be a big, big part. I think that the intersection of AI (related article: Artificial Intelligence in Mental Health: Present, Promise and Peril) and neuroscience-related prompts and see where that takes us. I think that the intersection of the two are going to unlock possibilities in ways that we haven’t really quite imagined yet, because there’s going to be a lot of computing power that the human brain can’t do on its own that when we start recognizing, okay, so we have these neural systems and we’re trying to figure out how they function, and there’s a lot being written. You know, one of the things that we talk about often is it’s like impossible to keep up, keep current with neuroscience literature, and because it’s thousands of pieces that published a day or a week in this area and just don’t have the capacity. So being able to harness the power of technology to understand the broad strokes of the research is going to be really helpful.
I do think that we’re going to see vast improvements in understanding trauma as it relates to how the nervous system functions. That’s really my goal, is to understand how our nervous system functions in a practical way so that we can make peace with it and make alterations. I think psychedelics are going to be a big, big thing. I mean, when you look at MDMA for PTSD and the ways that certain pharmacotherapeutics can induce a safe state while people can then reprocess, I mean, there’s a lot of work left to be done. I think that’s going to be an exciting trend.
Sort of the dark side of AI that I really would love to mention as it relates to neuroscience is. As neuroscience is showing how important the real relationship we talked about, the real relationship is in the therapeutic encounter. Increasingly, neuroscience is able to mimic the basics of counseling interactions. If you’ve ever interacted with a chatbot online, you know that this is increasingly — I talked to somebody at work today at my job who said, oh yeah, I used the little chatbot with our healthcare provider to see what kind of counselor I might need.
And like, okay. So, on the one hand, we have neuroscience really highlighting the importance of the relationship and some of these really human-to-human connections. And we have AI rapidly developing sort of simulated human response at a very basic level. And so, I think that it’s going to be really important for us as clinicians, as a mental health field, to innovate and really understand this science well, because we don’t want to get in a situation where we’re doing work that can be replicated by chatbots. I’m not suggesting anybody out there is doing that, but I think we can’t just sit still. I think we really have to dive into this and be able to make a case for who we are as clinicians and why that type of work matters.
How do you stay updated with the rapidly evolving field of neuroscience as it applies to mental health therapy, and what resources would you recommend to other professionals?
Yeah, so I think about this a lot. I’ll just direct you to one way that you can know you’re staying current. If you have Google search bar, which most people do, and go to Google Scholar, you can do a search based on keywords, but on the left-hand panel of that you can click a box that says Review Articles. And so, you can, you’ll see that you can refine your search, but what you really want to be able to find in the literature are review articles, meta-analyses, scoping reviews. These are articles that summarize a lot of the literature that’s out there.
So that’s one way to keep current. I am a little bit nervous about science writers who take headlines from press releases from universities on single studies and make—I mean, it’s really interesting research, but it’s one study or set of studies. And so, one of the ways you kind of protect yourself against that is buying high-quality textbooks. And what I mean by that is Bayer, B-A-Y-E-R, has a core neuroscience textbook (Neuroscience: Exploring The Brain) that has really summarized a lot of the literature.
Augustine and colleagues is another one. I think it’s neuroscience exploring the brain is the bare article. And then the other one is just called Neuroscience. They just came out with a brand-new edition. And so, if you want to know what the thought leaders, the scientist leaders in this field think is the most important thing to immortalize in a textbook for the next 10 years, it’s that. So there are some ways to get some really credible sources. Be mindful of the stuff that you read that is really going to change the world in one study because we love to feel optimistic and hopeful, and so we can be seduced by some of these big, big claims.
So, stick with the basics. I think that’s one way to really move our field forward is stick with the basics.
Key takeaways
- Neuroscience is increasingly viewed as crucial for understanding and improving mental health interventions. It offers validation, extends existing theories, and informs new therapeutic practices, enhancing the effectiveness of mental health care.
- There are ethical concerns associated with integrating neuroscience into therapy, particularly regarding the quality of information, privacy, informed consent, and the commercialisation of neuroscience-based interventions.
- Social determinants of health and epigenetics are significant influencers on individual mental health. These factors shape individual experiences and are crucial in understanding and treating mental health issues.
- Neuroscience principles can be leveraged to combat biases, racism, and misinformation by understanding the biological bases of these behaviours, emphasising the brain’s tendency towards safety, efficiency, and snap judgments.
- Emerging trends in neuroscience research, such as the use of biomarkers and AI, could significantly advance the understanding and treatment of mental health disorders.
- The integration of technology in mental health, while promising, presents ethical challenges that need careful consideration to ensure that the therapeutic relationship remains central to practice.
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