One of the first clients I worked with as a counseling intern dealt with chronic depression and debilitating anxiety for over 20 years. Despite working with multiple counselors and psychiatrists and trying a gamut of different therapies and medications, her symptoms remained largely unchanged.  After struggling for so many years, she felt stuck in a place of hopelessness and self-blame. Previous clinicians tried to address this self-blame by reminding her that her depression and anxiety were the result of chemical imbalances within the brain and a complex trauma history. But this explanation didn’t seem to fully encompass the origin of her symptoms or explain why commonly used medications and therapies weren’t working for her. As a novice counselor-in-training, I lacked confidence in my ability to help her process these experiences from a different lens and reach her health goals. I felt driven to learn more about the neurobiological roots of mental health struggles and scientifically supported interventions to address those roots.

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The Problem

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The monoaminergic hypothesis on mood is without a doubt the most pervasive and widely held theory in mental health. It purports that a select group of neurotransmitters like serotonin, dopamine, and norepinephrine are responsible for many mental health disorders. But the production, transmission, and reuptake of these chemical messengers is only one small part of how the brain may impact psychological wellbeing. Our brain is one of the most important organs in our body. It is responsible for facilitating biological processes and manufacturing our sense of self and reality. Despite this fact, the brain remains the part of the body we know the least about in the scientific world. Developing a more integrated and inclusive understanding of the brain may be the key to both better understanding why and how mental health struggles exist, and to developing more effective ways to treat them. Beyond the medical level, counselors can also use integrative neuroscience as a tool in talk therapy to educate, engage, and empower clients to achieve this aim.

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Neurobiological Psychoeducation  

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Educating clients about the neurobiological and physiological foundations of their mental health challenges can be a game changer.  By unraveling the intricacies of how their nervous systems operate, clients gain a clearer perspective on their symptoms. This knowledge helps distance them from self-blame and empowers them to manage their health more effectively. With a deeper understanding of the brain’s functioning, clients can cultivate self-awareness and develop strategies to regulate their nervous systems and experience more balanced mental wellbeing. Outside of discussing neurochemical contributors to brain health and mood, it’s important to also consider other factors such as the function of different brain regions and the communication between them, electrical brain wave activity, and the connection between the central and peripheral nervous system.  

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Encourage Good Brain Hygiene

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Counselors can also help clients recognize the impact of their daily habits on the brain’s health, such as diet, water intake, breathing styles, movement, and sleep. For example, fatty acids are critical nutrients for brain wellness. Since 70% of the brain is made of fat, consuming omega 3 fatty acids is important to ensuring optimal brain functioning (Weinandy, 2018). Establishing healthy sleep routines is also vital for overall brain health and wellness. Anyone who has ever pulled an all-nighter or worked night shifts can attest to the impact of sleep deprivation on mood and cognitive ability. Clients can use smartwatches and phone apps to track their physiological data at night to gain insight into their sleep patterns. I also like to recommend the book, The Power of When (Breus, 2016) as it explains circadian rhythms and which sleep schedules and behaviors are best for each unique chronotype.

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Empower Them with Tools Backed by Neuroscience

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Equipping clients with tools and habits rooted in neuroscience empowers them to take an active role in their mental health journey. Most clients are likely to use therapeutic tools more when they understand the neurological mechanisms behind them. We set clients up for success by simply highlighting the neuroscientific evidence that supports the benefits of implementing and maintaining new habits. We can remind clients that when they engage in mindful activities, like meditation, there are observable changes in the electrical activity and communication of the brain. Brain imaging studies have shown that mindfulness treatment can cause a decrease in overactivity in brain areas associated with rumination and compulsive behavior. It can also help increase alpha waves, especially in the left prefrontal cortex, which is correlated with feelings of happiness and peace (Demos, 2005).  

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When we encourage clients to engage in deep breathing, we can also explain how low and slow breathing helps ensure they’re supplying the brain with sufficient blood flow and oxygen, which is critical for neurological functioning. The act of exhaling longer than the inhale also has scientific benefits. When we inhale our heart rates increase and then decrease with each exhale. By extending the exhale, the Vagus Nerve is stimulated, activating the parasympathetic nervous system, which sends a message to the brain that we’re safe and can relax (Berland, 2019).

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Putting Knowledge into Practice

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Years later I reconnected with the same client I worked with as an intern. I was practicing at a brain-body wellness center providing integrative neuro-psychotherapy and felt better equipped to offer a different perspective on her symptoms. We used brain imaging technology to learn which areas of her brain were over and under firing. We looked at the correlation between her heart activity and breathing as a measure of nervous system functioning. We also discussed her diet, movement, and sleep habits. The more she learned about how her body worked, the easier it was for her to step away from self-blame, step towards self-compassion, and become more consistent in developing healthier habits and tools.

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By integrating neuroscience with talk therapy, counselors can foster a collaborative therapeutic journey in which clients feel empowered to address their mental health challenges with greater self-awareness and skill. As clients understand the interplay between their experiences and the brain’s intricate processes, they can engage in targeted habits and techniques that contribute to their overall mental wellness. I hope that by arming ourselves and our clients with knowledge and resources, we can usher in a new era of therapeutic care in which the complexities of the brain are met with understanding, mental health is nurtured with intention, and hopelessness is replaced by a profound sense of empowerment.