Neuroscientific therapy for all

Psychotherapy can be quite helpful, as what the heart yearns for is a safe haven, a loving presence so that we feel seen, loved, and felt by another.

Yet the methods now in use were developed before the Age of the Emotional Brain, which started in 1980 and was in full form by 2000. Shared stress levels became so high that current stress resilience methods, which were cognitively based, were insufficient to process the influx of stressors. Rates of Chronic Physiologic Stress Overload (CPSO) began to rise.

As stress increased, cognitive control was not enough

Prior to 2000, most of us could "think our way" out of problems, but rising stress levels now cause the prefrontal cortex to function poorly and emotions to be extreme, triggering the brain to release control to the reflexive wires of stress overload stored in the emotional brain.

With increasing information overload, speed of change, and existential threats like climate change, our primitive, hunter-gatherer brains defaulted. More frequently, thoughts turned from comforting and wisdom-generating to their source of stress, with rumination, numbness, or cognitive meltdowns.

Prescribing medications without EBT can backfire

As the emotional brain is the social brain, we rely on the healthy brain states of others to buffer the inevitable down periods in life. However, with stress overload becoming a widespread experience and technology drawing us away from social experiences, a lowering of the set point of society exacerbated our stress.

Healthcare played a part in the stress overload, as talk therapy plus friends and family could not buffer the load. Pharmaceutical companies helped those in the most need, but all but the most vulnerable may have taken the pressure off our need to learn to cope in healthy ways. The protocols of the day have been to use therapy and pharmaceuticals more without addressing the basic problem: processing life cognitively without robust emotional tools and an abundance of human connection.

The cognitive paradox may cause self-blame

Researchers did their part to call our attention to the missing link – a way to process emotions that met the needs of our times, but it was largely ignored. New York University researchers studied the effectiveness of cognitive control of stress, showing the worst possible outcomes.

The cognitive methods worked when stress was low, and they did not need them but failed in even moderate stress when most needed. This "cognitive paradox" gives users the illusion of control, but then when stress surges, they discover that the brain does not work in the same way, and we find ourselves spinning out of control and blaming ourselves. Patients say, "It's all my fault," or, "There is something wrong with me." They do not know that the problem is not them but an emotional processing skill insufficiency.

We need to adjust to the Age of the Emotional Brain, specifically:

Adjustment #1.

Treat stress as foundational to psychotherapy.

Chronic stress causes the biochemical and electrical changes that underpin most health problems. In assessing patients, reframe presenting concerns as symptoms of stress wiring that they can change. Check-in with them to identify their current brain state (5-point scale) and, over time, monitor their chronic stress level or set point (5-point scale).

Adjustment #2.

Teach skills to combat stress overload and rewire circuits.

Foundational to psychotherapy is training in the root cause of the symptoms, which is not having the emotional tools to overcome today's extreme stress levels. All patients need the fundamental skills of EBT and to appreciate that they can use them to change their entire physiology in one to three minutes. If they have problems or issues, they are just wires, and in addition to therapy sessions, they need a circle of support and the tools to combat stress overload and rewire circuits between sessions. Instead of a therapist-centric treatment, arrange the therapy session, so it is the launch for the patient's week of using EBT solo, with friends and family, and with their EBT Support Group to interrupt the stress chemical cascade anytime, anywhere.

Adjustment #3.

Set the treatment goal as raising the brain's set point.

Instead of focusing on one issue after another, reframe all problems as a symptom of a brain set point in stress. Resolve their presenting concern by rewiring the circuit, causing immediate relief and contributing to the overall physiological goal of raising the set point.

With cognitive methods, the physiologic stress circuit is not rewired, and the "issue" is likely to return or be replaced by another. By raising the set point, rewired circuits are less likely to be reinstated, and the patient's overall mental and physical health improves.

With stress levels only rising, making EBT foundational to psychotherapy is inevitable, either with the demand coming from patients who want an actionable, physiologically-based therapy or therapists who sense something is missing in their methods. As EBT becomes integrated into healthcare, all the current methods will be apt to function better. Many problems will be prevented because the therapists are addressing the root cause: stress overload.