Neurocounseling

Brain-Based Clinical Approaches

Thomas A. Field, Laura K. Jones, Lori A. Russell-Chapin, Thomas A. Field, Laura K. Jones, Lori A. Russell-Chapin

• Publisher: American Counseling Association
• Year: 2017
• ISBN:
  9781119375579
• Edition: 1
• Topic: Education
• Subtopic: Professional Development

This text presents current, accessible information on enhancing the counseling process using a brain-based paradigm. Leading experts provide guidelines and insights for becoming a skillful neuroscience-informed counselor, making direct connections between the material covered and clinical practice. In this much-needed resource—the first to address neurocounseling concepts across the counseling curriculum—chapters cover each of the eight common core areas in the 2016 CACREP Standards in addition to several specialty areas of the Standards. Detailed case studies, questions for reflection, quiz questions, and a glossary facilitate classroom use.

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Part I
Foundations of Case Conceptualization

The first section of the text reviews foundational knowledge needed to conceptualize client cases from a neurophysiological perspective. You will first be introduced to basic brain anatomy and systems before learning about neurophysiological development across the life cycle and the impact of neurophysiological marginality and traumatic stress on psychological health. This knowledge is considered fundamental to understanding the client's presenting problem from a neurophysiological perspective, leading to more effective counseling relationships, assessments, and interventions.

Chapter 1
Anatomy and Brain Development

Laura K. Jones

Learning about brain anatomy and the functioning of related systems may not be the first thing that comes to mind when you think about counselor education and training. Three facial expressions tend to emerge on counselors' faces when anatomy is mentioned: utter terror, complete boredom, or a smaller but growing contingency of expressions akin to fascination. If you are currently making one of the initial two expressions, perhaps you will find yourself, as you begin reading this and later chapters, becoming more engrossed and fascinated by the many wonders of the brain and how this information affects your work as a counselor.

Interest in the application of neuroanatomy to mental health has been long-standing. Sigmund Freud suggested in his classic 1914/2012 paper On Narcissism that “we must recollect that all of our provisional ideas in psychology will presumably one day be based on an organic substructure” (p. 78). Since Freud's early conjecture, limitations in technology have hampered understanding of the impact of the workings of the brain on mental health functioning. On April 2, 2013, a paradigm shift in mental health research began with the launch of the National Institute of Health's Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative. The mission of this initiative is to understand “the circuits and patterns of neural activity that give rise to mental experience and behavior” (National Institutes of Health, 2014, p. 12) and, in doing so, to cultivate an integrative understanding of brain–behavior processes. This chapter is a first step to introducing you to the inner workings of the brain in an effort to inform your case conceptualizations, treatment plans, and ultimately clinical effectiveness with clients.

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2016 CACREP Standards

This chapter addresses sections of the 2016 Council for Accreditation of Counseling and Related Educational Programs (CACREP) Standards pertinent to the common core area of Human Growth and Development (Standard II.F.3.):

• Theories of learning (Standard II.F.3.b.)
• Biological, neurological, and physiological factors that affect human development, functioning, and behavior (Standard II.F.3.e.)

This chapter also addresses the following Specialization Standard:

• Impact of biological and neurological mechanisms on mental health (Clinical Mental Health Counseling, Standard V.C.2.g.)

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Clinical Case Study: Rein

Rein is a 12-year-old female preadolescent of Native American descent. Her home environment is intact; she lives with both parents and a brother. Rein describes it as an attentive but conservative home with limited communication regarding emotions, physiological changes to the body, or interpersonal relationships. Her parents scheduled an appointment because of a marked decrease in Rein's grades at school'Rein previously having been a straight-A student'and a noticeable withdrawal from group activities during class. Rein reports feeling very sad and lonely and indicates that she has been feeling increasingly more distant from friends in the past 6 months. Rein denies feeling bullied or victimized, but she does not feel that anyone likes or understands her and has a hard time connecting with others. Her mother confirms that Rein often cries a lot and isolates herself from her family as well. Her mother also shared that Rein recently reached menarche and was concerned that Rein may feel embarrassed about this.

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The Brain: Structure, Function, and Systems

Despite incredible advances in science, the human brain in many ways remains a mystery. Part of its enigmatic nature rests in its complexity.

Not only are there various internal and external structures of the brain specified for certain functions, but those parts directly and indirectly influence one another by way of various chemical messengers. Further still, several areas of the brain can work in concert to govern other aspects of people's mental and physical functioning. Something seemingly as simple as reading the word counselor requires a remarkable succession of processes that involve virtually the entire brain.

In addition, researchers are now discovering more and more about how people's physical health and even the nature of the microbes in their gut influence the functioning of the brain. Some of the paradigms of mental health are now shifting as researchers begin to further investigate the reciprocal functioning of the body and brain, such as the role of inflammation (the process by which white blood cells help to protect people from infection) in depression (Miller & Raison, 2016). As such, I want to share some of what is known about the various parts and coordinated systems of the brain and body.

External Structures

What is your first thought when you hear the word brain? Most people think of a gray folded mass that sits inside the skull. This folded mass is the outer layer or lateral part of the brain, called the cerebral cortex, or cortex for short. You may also know that in the interior of this folded cortex, or more medial (toward the midline) and ventral (toward the base of the brain), are other exceedingly important parts of the brain. These internal and external structures control virtually everything about you. They allow you to think, feel, behave, breathe, and ultimately survive.

The cerebral cortex, or outermost part of the brain, is actually a 2- to 4.5-mm-thick mass of gelatinous tissue (Fischl & Dale, 2000). Even though it is often thought of as gray (and parts of it are called gray matter), it is actually pink when it is healthy living tissue, much like other tissue in the body. This folded mass includes the ridges of cortex known as gyri (singular, gyrus) and the shallower grooves between the gyri known as sulci (singular, sulcus). Fissures are similar to sulci but are deeper and more clearly divide regions of the brain. The gyri, sulci, and fissures help to demarcate different regions of the brain.

Hemispheres

The cortex is made up of two hemispheres, one on the left and one on the right. Connecting these two hemispheres is a thick band of nerve fibers known as the corpus callosum. It is the largest collection of nerve fibers in the entire nervous system, containing roughly 200 million interhemispheric connections (Luders, Thompson, & Toga, 2010). This band of fibers allows the two hemispheres to communicate back and forth and integrate the information being processed on either side of the brain. A common misperception in popular culture is that individuals are either left brained or right brained. It is accurate that certain functions may be predominantly controlled by brain regions in one hemisphere or another; for example, the area of the brain responsible for language production is typically located in the left hemisphere. However, the notion that a person can be either left brained or right brained is an overgeneralization and a misrepresentation of brain functioning. More often than not, both sides of the brain are working in coordinated action to allow people to more fully perceive, respond, and adapt to their internal and external environments.

Lobes

The cerebral cortex is further divided into four sets of primary lobes, with analogous lobes in each hemisphere. Each lobe is specialized for certain functions, such as sight, somesthesis (e.g., skin senses and proprioception), hearing and language comprehension, motor control, and executive functioning. The four lobes are as follows: occipital lobe, parietal lobe, temporal lobe, and frontal lobe. Figure 1.1 depicts the general location of the four lobes.

Figure 1.1 Lobes of the Brain

Note. From Anatomy of the Human Body (20th ed., Plate 728), by H. V. Carter, 1918, New York, NY: Lea & Febriger. In the public domain. Vectorized by Mysid, 2008, via Wikimedia Commons.

Occipital lobe. At the very back of the brain sits the occipital lobe, which is the smallest of the four lobes. This is the visual center of the brain. The occipital lobes piece together the visual components of the surrounding world. This allows people to interpret and understand what their eyes are seeing, such as shape, color, size, depth, and motion. However, visual processing is limited, meaning that people cannot process everything in the worl...