The People's Therapist

How does psychotherapy actually work?

Good question.  The answer is interesting and has to do with how your brain works.

The basic idea of psychotherapy is that you take emotional content from a primitive part of the brain and bring it to another more sophisticated, thinking part, where it can be examined and understood.

Here’s a quick primer on the design of your brain.

Due to quirks of evolutionary history, the human brain contains three distinct parts, which evolved separately.

In the center, there’s a small, rather rudimentary brain.  It resembles the brain of a lizard.

Wrapped around that, a second brain evolved much later – the paleo-mammalian brain.  It resembles the brain of a dachshund, or any other warm-blooded animal.

Sitting atop these two brains, there is the cortex.  That’s the grey, wrinkly stuff that you probably think of when you think of a brain.  It’s much larger than the other two brains, and is unique to humans, having evolved only very recently.

Like all higher animals, you have five basic emotions:  anger, fear, caring, hurt and happiness.  They exist entirely in the two more primitive parts of your brain – the lizard and dachshund parts.

Your thoughts – and your sense of awareness – exist only in the outer, sophisticated brain – the cortex.

There’s a reason for this.  All animals feel some emotions, but only humans have higher consciousness.  We alone think. (Actually, it could be argued that dolphins and some higher apes do too, but I’ll set that debate aside for now.)

Anger and fear reside in the innermost, lizard brain, because they reflect the primitive fight or flight instinct.  Faced with a ferocious predator, a tiny lizard needed to reflexively know whether to get angry and fight, or get scared and flee for its life.

The other three emotions are located in the paleo-mammalian brain.  That’s because they relate specifically to childcare instincts.

A lizard lays eggs – lots of eggs, and it doesn’t invest much time in caring for its young.  But a mammal bears only a small number of live young, and its off-spring are helpless for a period after birth.  So while a lizard might ignore its own large brood of young (or even dine upon a few of them), a mammal, with its small number of helpless off-spring, developed three important emotions related to childcare:  caring, hurt and happiness.

These emotions, located in the paleo-mammalian brain, lead the parent to care for its young, love them, and find happiness in caring for them, or hurt if they leave before the parental bonds are detached.

That’s your emotions, explained.  Now for psychotherapy.

Speech, and communication in general, including non-verbal communication like art and dance and music, are located in the cortex.  Psychotherapy is talk therapy.  A therapist’s goal is to get you to put your feelings into words.  In neurobiological terms, the idea is to take emotional material from the two inner, primitive parts of the brain – the lizard and dachshund parts – and translate them into speech – forcing them through the neural passageways of the cortex.

In essence, the thinking you is forced to process material from the feeling you.

In Freudian terminology, the two inner brains are the “unconscious” (the superego and the Id) and the outer cortex is the “conscious self” (the ego).  By funneling primitive brain activity into communication, therapy forces the unconscious into consciousness, integrating the self.

It’s a bit like an intellectual holding a conversation with a lizard and a dachshund, which is why the process isn’t always easy, and can take a while.

In any case, it’s better than living unconsciously – walking around thinking you know what’s going on while a lizard and a dachshund are secretly operating the controls.