Using cognitive neuroscience as a unifying

theoretical language in counselling psychology 

- the example of depression.

 

Tony Ward - University of the West of England

Arnaud Plagnol - Paris VIII Université

Oval:

Previous work on this topic by the authors.

Ward (2008) showed that a neural network model could be used to capture the principles of client centred therapy, and that properties such as transference would  emerge from this model.

 

Plagnol has written at length about how a cognitive neuroscience theory of representation can be used to explain classic defence mechanisms, and such explanations can then be used to understand and explain psychopathology.

Plagnol, A. (2004). Espaces de répresentation – théorie élémentaire et psychopathologie. CNRS Editions : Paris.

 

Plagnol, A, Mirabel-Saron, C. (2006). Depressogenic Schemas and Subjective Space. Annales Médico Psychologiques, 164, 24-33.

 

Ward, T.,  (2008).  Are connectionist models useful in counselling psychology?.  Counselling Psychology Review, 23, 97-102.

References.

Oval:

The case of Mme T. (Plagnol and Mirabel-Saron, 2004).

Mme T was treated for depression from the age of 40, initially using medication and psychodynamic psychotherapy.

 

After a number of years without making much progress, she was referred for cognitive therapy, using a schema focussed approach.

 

This proceeded with initial success and progressed through a number of stages:

 

1) Initially it was noted that the client had a number of schemas, of which the most prominent was hyper-control.  This was worked on successfully for some months, till a block developed.

2) After further reflection, the client came to recall some significant issues, in particular becoming aware of a scandal involving her father, which she found out about when she was 17. This was around the fact that her father had been married before. This recollection was helpful and helped the client recall other issues from her teenage years.

3) After further reflection, the client came to recall a similar scandal from her earlier years, involving her grandfather, who had apparently had a mistress.

4) It was speculated that the early family history may have led to a sense of insecurity for the client in her early years, leading to an all pervading sense of vulnerability, which later came to undermine the clients adult life and marital relationship.

 

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The case of Mme T shows how schematic coping mechanisms can break down in adult life, in this case possibly triggered by  the death of the father and subsequent disagreement over the estate by a number of siblings.

 

In therapy, these initial coping mechanisms are successfully dealt with, until an impasse is reached. After some further reflection, schemas related to a family scandal originating in the teenage years become apparent.

 

Eventually, this triggers further recollection, and a deeper, embedded vulnerability, probably going back to the client’s early years and  family environment.

 

It is hypothesised that this early vulnerability and pain caused the client to “split” their initial developing world view, with the bad part of the world being confined to a repressed part of the self schema. However, this repository of negative feelings and self worth continues to exist and can re-emerge to cause problems many years later.

The significance of this case.

The utility of a cognitive neuroscience approach to psychotherapy:

1) This approach has the potential to unify many different  perspectives on psychotherapy, through the language of cognitive neuroscience.

2) For example, in the case illustrated here, it demonstrates how aspects of a clients issues can be layered across different phases of their life, with fundamental issues relating back to their earliest years.

3) This view allows cognitive science theorists to capture classic defence mechanisms e.g. the notion of “splitting”.

4) The authors believe that the language of cognitive science will allow such classic phenomena as splitting, repression, projection, etc. to be captured with greater precision.

5) This precision may lead to more fine grained hypotheses around client issues, which can be followed up in further research.

6) For example, it may be possible to define the likely characteristics of treatment resistant depression, and thus make earlier decisions about when clients should be referred to specialist services instead of low intensity treatments.

To hear a summary by the authors on this topic, follow this link: https://youtu.be/_gNkWru-cJQ