Doing Neuropsychologically-informed Psychotherapy: How to Explain the Whole Brain to Clients

Top, Middle, Bottom: The Primary Areas of the Brain

I’d like to give you a new science-based perspective on the multi-level brain regions. I describe them as TOP, MIDDLE, and BOTTOM Brain. This vertical view of brain geography differs from all the information you’ve previously read about the right and left brain or split-in-half brain dichotomy.

That old dueling-hemispheric debate has resulted in misinformation as well as confusion. Neuroscientists recommend we consider our whole brain and use it to our advantage rather than focusing only on one part or side.

So I’d like to bring in neuroscience as a way to give you a new way to think of the brain. In this view, you view the brain from TOP to BOTTOM. Here’s the breakdown on this new science-based perspective on the multi-level brain regions. I call these regions TOP, MIDDLE and BOTTOM of the Brain. I refer to this as A Theory of the Whole Brain in Mind.

Top Brain

There’s a part of brain that makes you more fully human… more advanced than animals. It’s called the prefrontal cortex. It’s the TOP part of the brain. That’s the area that is the most-highly development or evolved.  Consider it uniquely human.  TOP represents the highest level of awareness, thought, intention, meaning, and executive functions. It involves parts making up the Prefrontal Cortex, the outer-bark or layer of the brain.  There is lots of soft tofu-like tissue in that region but not as many parts or structures as found on the inside or lower brain.

Middle Brain

The MIDDLE brain is right in the “middle” of the brain and looks like a Mohawk right above the structure that separates the right and left side of the brain. It’s been labeled the Default-Mode Network. This area is involved in attention and automatic thinking. When your brain isn’t focused on something specific or attending to a math problem or beautiful sunset it automatically defaults or goes into a kind of problem-solving, past-future-thinking, social comparison mode. Your brain begins reviewing old data, thoughts, past or future events, it’s a type of analysis paralysis.  The BOTTOM Brain gets confused and limited since data review of this sort of irrelevant information is not for purposeful or immediate action.

These sorts of thoughts would clearly limit or confuse a person if viewed as commands the BOTTOM brain can carry out or do.  Actually, the MIDDLE brain is just in planning and wondering mode. The MIDDLE Brain has been shown in brain scans to turn on automatically in about eight seconds when the brain’s attention systems are not focused. It’s the brain’s default mode instead of going into total resting state. And researchers estimate we normally spend about 30% of the day in this state. This mode becomes a problem when you get stuck in the MIDDLE and it plays your BOTTOM brain for confusing ancient primitive emotion-action systems.

When you work on clients’ thoughts that arise from this area, you’ll notice there’s a focus on past, future, and “what’s wrong with me” that seems like a broken record.  The data or information in the conversation hardly ever involves the present moment or “What can I do now?” type of thoughts.  I like to refer to it as Middle Me CD because it plays the brain rapidly and automatically into emotional pain and stuckness.

There are many new interventions, including meditation and mindfulness, that increase the flexibility to shift out of this painful, stuck and non-action mode characteristic of the MIDDLE Brain. These free your clients to the power of now.

Bottom Brain

The BOTTOM region of the brain is tasked with survival.  The more advanced brain areas we’ve reviewed thus far are built on the BOTTOM Brain functions. It’s been called the evolutionarily “ancient” or “primitive” brain, as we have it common with reptiles and mammals.  It’s also called the “emotional” brain because it regulates emotions, motivation, and habits. This area includes the amygdala and hippocampus and is involved in emotion and memory.  It’s also the part of the brain that controls our body’s physiology, such as breathing and automatic actions related to decision to approach or avoid.

Emotions such as fear, rage, and sadness turn on and play from this part of the brain and will include automatic physiological responses for survival actions, such as flight, fight, freeze, or flop. These also have been conceptualized as primitive emotion-action systems shared by all mammals.

Teaching clients about what their BOTTOM Brain is doing allows them to develop a new understanding, alliance with, or relationship to it and, most importantly, influence over it. Specifically, when they play the BOTTOM Brain for a change they actually perform interventions that tame and train the amygdala. They use neuroplasticity science to rewire their brains.

BOTTOM Brain Fosters Fast Transformation

Many people speak about the brain as having parts. In fact, it has specific areas—BOTTOM, MIDDLE, and TOP—that can be targeted to harness neuroplasticity. As a therapist, you want to influence a client’s BOTTOM brain. That’s how you create lasting change.

Most therapists use talk therapy, which works with the TOP brain. When you focus on the TOP brain in sessions, your clients will often tell you they understand how or why they need to change. They may make plans and decisions to change, but they won’t change. They think something is wrong with them rather when, in fact, there’s a problem with what the TOP brain has been doing.

The MIDDLE Keeps Clients Stuck

Without interventions that engage and influence the MIDDLE brain, however, transformation won’t happen either. This part of the brain has a unique signature or style of automatic or non-conscious thinking.

If you studied the content of Middle-brain thinking you’d find it’s totally irrelevant for creating and commanding useful right-now actions. It’s as if the Middle brain doesn’t recognize the present moment, and it focuses only on “what I should or could have done,” “what I hope I can do in the future,” and, of course, “what is wrong with me? Why do I feel and think this way?”

Interesting research has been done on the relationship between the activation of MIDDLE Brain region and rumination-stuckness problems as seen in PTSD, depression, chronic grief, and guilt.

BOTTOM Brain Inspires Action

The BOTTOM brain, on the other hand, can inspire enthusiasm and actions that cause change. By working with the BOTTOM brain in sessions, you help your clients create fast and lasting transformation.

That’s why it’s so important to understand the areas of the brain and keep them in mind when working with clients. This organ—the human brain—has a TOP, MIDDLE, and BOTTOM, you can “play this organ” more effectively in sessions and teach your clients to do so.  And when they walk out the door they’ll have acquired this new Theory of Whole Brain in Mind to guide them.  Not only will they come to form a new alliance or relationship with their organ they will develop new understanding of how they can and will change.

Conclusion

If you conceptualize the whole brain as multi-leveled in its capabilities, functions, processing, and responding you have a way of talking to clients about their problems that’s new and science based.

I’m passionate about spreading the good news about the whole brain as an amazing organ and showing psychotherapists the keys to how to use neuroscience to play the brain for change. Doing so is awesome and miraculous and illuminates our brains’ innate ability to change gradually and rapidly. Neuroscience ultimately will guide our best clinical practice as we seek successful outcomes for our clients. Once therapists understand the whole brain and how to promote neural change, they will play this essential organ and consistently get transformational results for clients. When you learn Emotional Pain Intervention (EPI®), you realize how important it is to focus your practices on brain science that promotes transformation.

Emotional Pain Intervention (EPI®)

If you want more specifics on how to talk to clients about their brain and emotional problems and a system for doing neuroplastic change, let me introduce you to a brain-interventional system for Emotional Pain Intervention (EPI®), which can help you to achieve better, more effective results with your clients. To learn more about EPI, I’m offering you an opportunity to join the teleconference to hear how others are using it in sessions to achieve the best outcomes and help more clients. This EPI system includes all of the key common factors involved in doing effective psychotherapy combined with neuroplasticity science interventions for a brain-changing conversation.  As you’ll discover, there are pre- and post-intervention assessments of emotional pain built right into the conversation.

On March 11, 2019 at 11am CST join a weekly Play the Brain for Change teleconference course that includes a bonus copy of my new book Play The Brain For Change: How to Activate the Vagus Nerve and Use Neuroplasticity for Quick and Lasting Change A Brain-Changing Conversation Guide for Psychotherapists. Space is limited, so reserve your seat now for what you’ll discover to be a fascinating, cutting-edge approach to treating your client’s cognitive and emotion-based problems and having more favorable outcomes in your clinical practice.

If you’re practicing neuropsychotherapy and keeping the whole brain in mind during your conversations with clients, I’d love to hear about it, please comment below.

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