Left brain – right brain: In therapy

In my previous post I outlined some of the key differences between the left and right hemispheres of the brain and touched on what that might mean for psychotherapy. I’ll now delve a little deeper into that mystery.

While my previous post was based on well established neuroscience, some of what follows is more speculative. That said, it’s all grounded in current scientific understanding.

As I explained last time, part of the role of the right brain is to keep us alert to danger. The right hemisphere is specialized for wide-angle sensory awareness that’s good for scanning for threats: We might say that the right brain is naturally suspicious. Perhaps it’s no surprise that research has found a correlation between depression, anxiety and increased activity in the right hemisphere. A lot of that activity is in the frontal lobe, a region concerned with reward, attention, planning, and motivation. There’s also a high level of right hemisphere activation in PTSD and when childhood abused adults recall unpleasant memories. Another strand of research suggests that PTSD is linked to poor communication between the hemispheres (Cozolino, 2017).

Brain scans

How might therapy help balance and integrate the two hemispheres? When I work with clients, I’m constantly monitoring several channels of communication. The most obvious strand to watch for is the difference what is said and the way it’s said. The structure of language, the way sentences are strung together, is largely a left brain activity, but our tone of voice is more involved with right brain processes. Body language and facial expressions are also more under right brain control. If, or rather, when, there’s some inconsistency between the simple content of what’s said and the wider context, I’ll need to make a judgement call. Suppose a client says “I’m fine about that”, but their facial expression, body language or tone say ‘I’m really not OK”. I might decide to reflect that back to them: It’s as if I’m acting as a mediator between the right and left hemispheres.

Peter Afford suggests that Experiential Focusing – the foundation of my therapeutic approach – may work by promoting the integration of the left and right hemispheres (Afford, 2014). Focusing invites us to drop our awareness into our physical bodies and check for a ‘felt sense’, a feeling in the body that carries meaning. We then sit with any felt senses that arise and gradually begin to engage with them through language. A felt sense is often just a vague sensation at first and I’ll be curious about where it is in my body, its size and shape, and whether it has a colour or a particular emotional tone. I’m initiating a dialogue between an emotional, bodily sensation, which are right brain processes, and the more left brain activities of labelling and seeking details. The next stage is to deepen that dialogue, literally asking the felt sense what it’s about. The linguistic right hemisphere is engaging in dialogue with the more embodied left.

I’ve been watching the therapeutic process over the last couple of weeks and I think I’m seeing lots of occasions where I’m helping my client with some left/right brain integration. I’m not saying this explains how therapy works; there are many parallel processes going on all the time, many of which we may currently be oblivious to. However, I believe the work of balancing and integrating the left and right hemispheres is a key part of therapy and having a greater awareness of how that might happen can enhance therapeutic practice.

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One Response to Left brain – right brain: In therapy

  1. This paper neatly sums up the research on depression and the right hemisphere.
    ‘Depression and the hyperactive right-hemisphere’, by DavidHechtab
    https://www.sciencedirect.com/science/article/pii/S0168010210001707

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