Friday, 1 December 2017

Book Review: How People Change

The dust jacket of How People Change is a mirror image of two people; black and white on the left, and in color on the right. When I saw it, I thought about clients I’ve worked with who described the depths of depression as “all the color gone out of the world.” The colors began to return as the depression lessened.

The title also reminded me of the trans-theoretical model of change developed by James Prochaska and his colleagues. Their model describes the spiraling stages that people go through over the course of change.

But how does that change occur, and how does it occur in therapy?

In How People Change, editors Marion Solomon and Daniel J. Siegel sought to examine the question of how people change in the therapeutic relationship.

This book is a part of the Norton professional series on interpersonal neurobiology and is geared to helping clinicians learn and incorporate the latest in scientific research into their practices for helping people change.  You can hear Siegel’s introduction to the book here and his explanation of interpersonal neurobiology here.

This is a fascinating book whose thirteen contributors across eleven chapters talk about how people change in a range of therapies with differing approaches. There are approaches for individuals, for couples, and for group work.

One constant throughout the book is an emphasis on the relationship of those involved in therapy, including the therapist. The work of Allen Shore, Stephen Porges, William James, Donald Winnicott, J. H. Jackson, Hans Selye, and many others are cited and built upon. The approaches vary from psychoanalytic, to psychobiological, to attachment-focused. I found the somatic-based chapters particularly interesting.

“We still don’t understand the origins of mind, but it probably had something to do with groups of brains coming together to form the super-organisms we call tribes… At this current point in evolution, our best guess is that the human brain is a social organ and the mind is a product of many interacting brains,” write Louis Cozolino and Vanessa Davis in their chapter.

Philip Bromberg cites his own work and that of Allan Schore about the “phenomena of and concept of ‘state sharing’ — that is the right-brain to right-brain communication process through which each person’s states of mind are known to the other implicitly.”

In our relationships we have the potential to heal and be healed.

The chapters build upon each other, with the authors giving an overview of both the art and the science of their individual methods. Brain plasticity, epigenetic changes over generations, the role of our mutual emotion regulation, and even defining emotions are all addressed.

The changes that occur for all the persons involved in the therapeutic process and ways to effect change are also addressed. There is a welcome sense of flexibility.

“When presented as dogma, each perspective in psychotherapy is simultaneously right and wrong…Each works, or doesn’t, depending on the client and the quality of the therapeutic relationship,” Cozolino writes.

This is an excellent book not only for therapists, but also for those who study the philosophy of mind, for those looking at policy in societal change, insurance companies, and those who teach and practice body work such as yoga, tai chi, qigong, dance therapy, and more.

Pat Ogden’s chapter “Beyond Words,” and Peter Levine’s chapter “Emotion, the Body, and Change” are very enlightening, particularly if you have been focused inside your head and in the world of words. We are communicating to ourselves and to the world constantly, and mostly nonverbally.

I thought about the work of Wampold and Imel (2005) as I read this. In this age of forcing specific evidence-based practices in therapy, it has been refreshing to read the different ways that extremely competent therapists work and in a variety of ways. The common factors underlie the effectiveness of how people change.

This book supports the importance of paying attention to the therapeutic relationship, to what clients want, and their own theory of how change occurs for them (and your ability to work with that). This book is well worth your time. I continue to refer to it.

How People Change: Relationships and Neuroplasticity in Psychotherapy
Edited By Marion Solomon and Daniel Siegel
W. Norton and Company
320 Pages
Hardcover



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