Why Therapy Works: Interview with Louis Cozolino

This is part of the DR Book Collection.

Image result for why therapy worksI don’t think I’ve ever mentioned this before on here, but, as some of  you may have guessed, I go to therapy. I haven’t as of late for various reasons, but for a solid two years I went pretty much every other week. My interest in shame and vulnerability has been largely due to my personal work in therapy. This is why as soon as I heard of psychologist Louis Cozolino’s book Why Therapy Works: Using Our Minds to Change Our Brains, I immediately picked it up. Granted, like most of my books, it sat dormant for quite a while until I finally finished it up toward the end of last year.

Cozolino walks the reader through the findings of cognitive neuroscience, discussing the “fast” (i.e., “primitive systems, which are nonverbal and inaccessible to conscious reflection, [that] are referred to as implicit memory, the unconscious, or somatic memory”, pg. 5) and “slow” (i.e., “conscious awareness…[which] eventually gave rise to narratives, imagination, and abstract thought”, pg. 5) systems of the brain. Because of this “fast” system, we often have negative internalizations that we’re not even consciously aware of. This is what Cozolino calls “core shame”:

Core shame needs to be differentiated from appropriate shame and guilt that emerge later in childhood. Appropriate shame is an adaptation to social behavior required by the group. Core shame, on the other hand, is an instinctual judgment about the self, and it results in a sense of worthlessness, a fear of being found out, and a desperate striving for perfection. In essence, core shame is tied to our primitive instinct to be a worthy part of the tribe; it is a failure to internalize a deep sense of bonded belonging. As a result, people with core shame feel damaged, unlovable, and abandoned. Thus, core shame becomes a central factor in the perpetuation of insecure attachment and social status schema (pg. 10).

The brain, according to Cozolino, “is a social organ” and “we can leverage the power of human relationships to regulate anxiety and stimulate learning” (pg. xxii). This makes the relational nature of therapy all the more important and effective:

The reasons for our struggles often remain buried in networks of implicit memory, inaccessible to conscious reflection. Psychotherapy guides us in a safe exploration of our early experiences and helps us create a narrative that associates these early experiences with the ways in which our brains and minds distort our current lives. In the process, our symptoms come to be understood as forms of implicit memory instead of insanity, character pathology, or plain stupidity. This process can open the door to greater compassion for oneself, openness to others, and the possibility for healing (pg.9).

The book is comprehensive and excellent for both laypersons and scholars. You can see short interview clips with Cozolino below.