3 MIN READ | Psychotherapy

Brain-Based Psychotherapy Integration: Clinical Biopsychology (Part 2)

Robert Moss, Ph.D., ABN, ABPP

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Robert Moss, Ph.D., ABN, ABPP, (2016, September 21). Brain-Based Psychotherapy Integration: Clinical Biopsychology (Part 2). Psychreg on Psychotherapy. https://www.psychreg.org/brain-based-psychotherapy-integration-clinical-biopsychology-part-2/
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Editor’s note: This article is part of a series. You can read Part 1 here

Conscious versus Unconscious

I originally referred to the left hemisphere being involved with all verbal-thinking, including one’s internal verbal dialogue. Michael Gazzaniga similarly described the “interpreter” of the left hemisphere. I now use the term verbal interpreter to refer to the ventral lateral frontal region which includes “Broca’s area” (considered the speech motor planning area). Although the receptive language memories are located in the posterior lobes, the columns allowing us to actively use language are theoretically in the frontal lobe. If accurate, our internal verbal dialogue, which has often been considered synonymous with “consciousness” or self-awareness, involves only a limited area of the left frontal cortex. Therefore, if there are no direct cortical connections to allow the verbal interpreter to be aware of specific cortical activity located elsewhere, the other activity is “unconscious” relative to verbal awareness.     

A major question is what is connected to the verbal interpreter’s location? Obviously, left cortical functions are the most likely to be accessible by the interpreter, particularly in the lateral cortex that processes information from the world around us. Columns in the medial cortex process internal and self-referential information and these are less likely to connect to the verbal interpreter circuitry. This is based on the expectation that medial receptive columns are connected to their respective medial frontal columns. Additionally, right cortical connections to the verbal interpreter are very limited. It appears that frontal connections from one hemisphere connect only to the corresponding location of the opposing hemisphere. The same is true of the posterior cortical regions. This suggests that most right hemisphere processing is not directly connected with the verbal interpreter. The result is that there is inaccurate awareness of, and an inability to control, right posterior hemisphere activities by the verbal interpreter. As previously stated, non-verbal emotional processing involves the right hemisphere.

A clinical example will help illustrate these concepts. I used (Moss, 2015; 2016) the example of a woman who is forcefully held by her wrists during a sexual assault. At a later time, she was grabbed by the wrist by someone she trusts and experiences a panic/fear response. Based on my theory the tactile columns for the wrist lead to the activation of the column circuits where the various right cortical non-detailed (e.g., contextual aspects, voice intonations of the perpetrator, general body size and facial features of the perpetrator) sensory and emotional aspects are represented.

The victim is able to verbally state (from the left verbal interpreter) she had a panic attack that logically makes no sense based on the identity of the person who held her wrist. She is unable to describe all of the right hemisphere column circuits that were activated. In fact, the psychological treatment in which the patient verbally describes what occurred with every possible detail recalled over three to four repetitions results in her being able to recall many more specific details in the latter descriptions. As those details are discussed, the verbal interpreter circuit becomes aware as she visualizes those in her right cortex. Thus, she had the memories present cortically with the verbal interpreter circuit remaining unaware. Obviously, there can be other memories present that the victim fails to recall even during the treatment process. The point is that these are clearly episodic memories, but without consciousness as defined by the verbal interpreter being initially involved.

Dr Robert Moss, a former associate professor in clinical psychology, is currently with North Mississippi Medical Centre’s Regional Pain Consultants. He is the founding editor-in-chief of AIMS Neuroscience. He originated the Clinical Biopsychological Model of psychotherapy integration. He is board certified in clinical psychology (ABPP) and neuropsychology (ABN). You can engage with him on Twitter @drbobmoss



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