Psychopathology: Theory and Practice

Brain mechanisms of emotional consciousness: implications for clinical technique

Most forms of psychoanalytical psychotherapy conceptualize therapeutic change as a process whereby the unconscious parts of the mind are rendered conscious. Classically this involves a clinical technique which endeavors to attach words to preverbal and nonverbal mental processes. This is the essence of the ‘talking cure’. In this presentation, new findings regarding the brain mechanisms of consciousness will be reported which require us to turn the classical conceptualization of talking therapy on its head. The parts of the brain that generate ‘instinctual’ ways of thinking and behaving are the same parts of the brain that generate all consciousness. The parts of the brain that are associated with verbal cognition, by contrast, are intrinsically unconscious and are only capable of generating conscious thinking to the extent that they are activated by the more primitive, instinctual-emotional parts of the brain. Some implications of these findings for psychotherapeutic technique will be discussed.