Transcript Wilkinson Handout 2014

A Jungian whole person
approach to dynamic
psychotherapy
Margaret Wilkinson
Edinburgh 2014
Psychological Therapies
• enable the well-being of the whole person of a client while engaging
primarily with mind
• ‘to cope with the privileged access to the mind of the client a split
has been made that excludes the body’ (Sinason 2006)
• Therapies that focus only on the mind will continue to promote the
now out-dated Cartesian split.
We cannot ignore the body
• ‘traumatic events of the earliest years of infancy are not lost but, like
a child’s foot prints in the wet cement, are often preserved lifelong’
• ‘time does not heal the wounds that occur in those earliest years;
time conceals them. They are not lost; they are embodied’
• if we do not explore how to work with this we ignore ‘ that which is
actually the somatic inscription of life experience on to the human
body and brain’ Felitti in Lanius et al, 2010 xiii-xiv
Schore’s seminal work
• Enables a creative approach to dynamic psychotherapy
• Teaches us how to explore research from the fields of neurobiology,
attachment and trauma
• Offers a basis for the development of a therapeutic approach to the
whole person
Plasticity enables change
• we make new neurons and new connections when we are stimulated
by change, newness and difference.
• ‘Enriched environment living….enhances the survival of newly
generated cells in the hippocampus’ (Gould and Gross 2002)
• the emotional and intellectual engagement that occurs between
subject and another subject in psychotherapy is just the kind of
enriched environment that can bring about change
Right hemisphere and attachment
• The right hemisphere is ‘preferentially involved in sympathetic
activation’ whereas the left’ is preferentially involved in
parasympathetic activity associated with reduced tension or calming
responses (Allman et al 2010)
• The VEN- containing areas of the right hemisphere have extended
their homeostatic regulatory functions to ‘the regulation of social
relationships and the homeostasis of interpersonal relationships’
(Allman et al 2010)
Learned Secure Attachment
• A sustained experience, such as that provided by longer term
counselling or psychotherapy, that is experience over time of a
different kind of relating enables a different kind of attachment to be
learned.
• Outcomes: ‘a state of neural integration and more complex cortical
development and capacity for self-regulated affect’ (Wilkinson 2010)
Systems neuroscience
• Studies of ‘intrinsic connectivity networks’ (ICNs) in individuals
(Seeley et al 2007, p.2349) have led to our understanding the brain as
being composed of multiple, distinct and interacting networks that
support complex cognitive and emotional processing and the
complex interactions that occur between our mind, brain and body.
The salience network
• The salience network consists of ‘the dorsal anterior cingulate
(dACC), and orbital frontoinsular cortices with robust connectivity to
subcortical and limbic structures’ (Seeley et al 2007)
• the network for meaning-making concerning cognitive, emotional
and bodily aspects of experience.
The insula
• An integral hub
• mediates ‘dynamic interactions between other large-scale brain
networks involved in externally oriented attention and internallyoriented or self-related cognition’ (Menon & Uddin 2010)
• facilitates the processing of ‘the physiological condition of the body’
and the development of ‘subjective feelings from the body’ (Craig
2010)
Gaze as a window to the mind
• a strong association between the right anterior insula in and ‘the
perception of one’s own bodily states and the experience of emotion’
Menon & Uddin 2010, p.658
• In health direct gaze activates a cortical route that enhances
evaluative ‘top-down’ processes underlying social interactions.
• In PTSD direct gaze leads to sustained activation of a sub-cortical
route of eye-contact processing that is an innate alarm system
Steuwe et al 2012
The dissociative defence
• ‘the emotional significance of the experience remains hidden all
along from the patient so that not reaching consciousness, the
emotion never wears itself out, it is never used up’
Jung 1912: para. 224
Three interacting systems
control the gut
• one in the gut itself with hormonal and neuronal mechanisms and
memory for coordinating ingestion and digestion
• One in the hypothalamus for automatic homeostatic control
integrating gut functioning with the rest of the body
• One in the insular and related cortices and linked to self-awareness
and decision-making
The insula as a switching agent
• Activates chief executive function when thinking is required, CEN is
vital for cognitive decision-making, for working memory and for
initiating and sustaining goal-directed behaviour.
• Switches to default mode network which enables self-referential
processing when the functions of the CEN are no longer necessary
A secure attachment style affected by major
early loss
• A retreat from mind into body
• Whole being and life patterns are affected
• Behaviour and symptoms expresses the patient’s dilemma
Conclusion
• The interaction between overwhelming and unmanageable
emotional experience and bodily response, may be modulated by
careful processing of traumatic experience within a secure and
empathic relationship
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