Brain Based Therapy with Adults
By John B. Arden and Lloyd Linford
By Thomas Cohen, D.M.H.
Speaking as a Clinical Psychologist who has been practicing and teaching over 35 years, it is rare to find a book that conveys this much relevance, usefulness and non-dogmatic instruction.
Why would anyone want to read yet another textbook on psychotherapy? Because this book combines not only the most up to date research on psychotherapy outcome studies, but presents diagnosis and treatment in a sensible manner that follows from and is faithful to that research.
Is the book biased towards the approach of the authors and thus, like most accounts of therapy, relegated to describing solipsistic opinions? Yes, but those opinions are based more on solid research and cutting edge discoveries in neuro-science, than any other book I have ever seen. I am a psychoanalyst and thus feel the book leans too heavily towards CBT, but those accounts of CBT are dedicated to specific diagnostic conditions (e.g. anxiety disorder and OCD) that have extensive research to back up the claims. Also, the descriptions of treatment are concise and extremely informative about how CBT therapy works. CBT treatment is presented in a balanced context of its own limitations, contra-indications and the strengths of other treatments such as psychodynamic and relational/intersubjective approaches.
Considering that, as a field of study, brain science is only at its fledging beginnings, do we even know enough to create an approach that utilizes the rapidly growing body of information about how the brain works? I questioned how one could make the leap from the neuro-scientific laboratory to the consulting room. This book not only illuminates how brain studies can be applied to clinical work, but it beautifully simplifies the complexity of brain functioning into a language that can be effectively described to patients and therapeutically applied to relieve their suffering. It describes how clinicians can use brain studies to empathically bridge the gap between their own clinically distant theoretical explanations and the patient's need for understanding.
Is reading the book worth the effort? For me, the answer is a qualified yes. More than most psychotherapy books, this one created cognitive dissonance for me. For instance, I am biased towards psychoanalytic approaches to therapy and while this book does give ample weight to the psychodynamic, it emphasizes other approaches. However, its resounding emphasis is on what I would call the "intangible" aspects of therapy (what the authors describe as "common elements"). Arden and Linford state that one's method of therapy accounts for only 5% of the therapeutic success outcome measurements. Most of the variance is due to relational factors.
It is the non-verbal, emotional and interpersonal resonances that occur in the right brain-to-right brain, limbic system-to-limbic system interactions between patient and therapist that create the therapeutic relationship. This process is at the heart of the vivid and varied descriptions of the therapeutic process that this book portrays and, as such, makes it so worthwhile to read.
Finally, I imagine that many beginning, intermediate and even advanced level therapists could find this book a wealth of information for how to assess and treat the major diagnoses that confront us in our daily clinical practices: depression, anxiety, panic, OCD and PTSD. It is elegant in its succinct, innovative, practical and cutting edge approach to the challenges of psychotherapeutic practice.