256: Brain Science & Attachment with Dr. Dan Siegel

Welcome back to The Couples Therapist Couch! This podcast is about the practice of Couples Therapy. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

In this episode, Shane talks with Dr. Dan Siegel about brain science & attachment. Listen to the episode on Apple Podcasts, Spotify, and your other favorite podcast spots, and watch it on YouTube – follow and leave a 5-star review.

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The Couples Therapist Couch 256: Brain Science & Attachment with Dr. Dan Siegel

This episode is brought to you by Alma. Visit HelloAlma.com/ATPP to learn more

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In this episode, Shane talks with Dr. Dan Siegel about brain science & attachment. Dan is the Clinical Professor of Psychiatry at the UCLA School of Medicine, Executive Director of the Mindsight Institute, and Author of numerous books & articles on mindfulness & neurobiology. Hear how interpersonal neurobiology applies to couples therapy, why our brain plays such a big part in our relationships, how much attachment influences the present, the benefits of mindfulness, and how to work on the emotional health of your clients. Here's a small sample of what you'll hear in this episode:

• What truly is the mind?
• Why is emotional communication is so valuable?
• Dr. Siegel's concept of mindsight
• How do you define relational health?
• Dr. Siegel's definition of integration in practice 

To learn more about Dr. Dan Siegel, his courses, and his books, visit:

DrDanSiegel.com

MindsightInstitute.com

Show Notes

• 256: Brain Science & Attachment with Dr. Dan Siegel
• This episode is brought to you by Alma. Visit HelloAlma.com/ATPP to learn more
• [0:38] Welcome to The Couples Therapist Couch 
• [1:34] Welcome to the show, Dr. Dan Siegel!
• [3:39] Does Dr. Siegel consider himself more of a researcher or a writer?
• [8:44] What truly is the mind?
• [12:42] How do we connect brain science with mental health therapy?
• [19:22] Why emotional communication is so valuable? 
• [21:23] Dr. Siegel's concept of mindsight
• [24:41] What if the mind is a self-organizing complex system?
• [27:57] This episode is brought to you by Alma. Visit HelloAlma.com/ATPP to learn more
• [28:56] How do you define relational health and how does attachment shape that definition?
• [33:21] Studying each person's structured narrative
• [38:29] Thinking of the mind as an inner part and and inter part
• [43:43] The neurobiological view of the health of a couple
• [48:11] Reacting to chaos and rigidity
• [50:48] Seeing the hope in any situation
• [52:09] Connect with Dr. Dan Siegel and check out the MindsightInstitute.com
• This episode is brought to you by Alma. Visit HelloAlma.com/ATPP to learn more

 

What is The Couples Therapist Couch?

This podcast is about the practice of Couples Therapy. Many of the episodes are interviews with leaders in the field of Relationships. The show is meant to help Therapists and Coaches learn how to help people to deepen their connection, but in the process it explores what is most needed for each of us to love, heal, and grow. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

Learn more about the Couples Therapy 101 course: https://www.couplestherapistcouch.com/

Find out more about the Couples Therapist Inner Circle: https://www.couplestherapistcouch.com/inner-circle-new

Transcript

Please note: this transcript is not 100% accurate.

00:00
Unbelievable things come up that have never been spoken ever that make the couple's dysfunction really clear why it's impairing integration now.

00:16
The Couples Therapist Couch, the podcast for couples therapists, marriage counselors, and relationship coaches to explore the practice of couples therapy. And now, your host, Shane Birkel.

00:31
Hey everybody. Welcome back to The Couples Therapist Couch. This is Shane Birkel, and this is the podcast that's all about the practice of couples therapy. Thank you so much for tuning in. I'm a licensed marriage and family therapist, and the goal of this podcast is to help you learn how to more effectively work with couples and possibly even learn how to have a better relationship. The episode this week is brought to you by Alma. They make it easy to get credentialed with major insurance plans at enhanced reimbursement rates.

01:01
Alma handles all of the paperwork and guarantees payment within two weeks. Visit HelloAlma.com/ATPP or click on the link in the show notes to learn more. Hey, everyone. Welcome back to The Couples Therapist Couch. This is Shane Birkel. And today I'm speaking with Dr. Dan Siegel, clinical professor of psychiatry at the UCLA school of medicine, executive director of the mind site Institute and author of numerous books and articles on mindfulness and neurobiology.

01:29
Hey, Dan, welcome to the show. Shane, thanks for having me. It's a pleasure to be here. Yeah, I'm really excited to talk to you today about brain science in relationships, particularly. But before we get into all that, why don't you tell everyone a little bit more about yourself? You know, I'm a human being on the planet, which is going through a lot of challenges these days. So we're all in this in a very incredible moment of human history. I'm a

01:57
husband and a father and a son and a friend to number of people and You know professionally I work in a field called interpersonal neurobiology, so we kind of bring all the fields of science together into one framework and and try to ask basic questions that are relevant for therapists of all kinds so questions like what is the mind and what is a healthy mind and

02:26
you know, how can we support the growth of resilience and wellbeing in people's lives? So, you know, that field is using something called consilience, where we try to find the common ground across different scientific disciplines. And now it's all sorts of disciplines. yeah, so we have a library through Norton of books that are available for therapists to read. And I've written a few of them myself. And I'm also, you know, I write for

02:55
parents a lot. So I do a number of parenting books, um, sometimes by myself, sometimes with colleagues. Now we're working on a number of issues related to identity and belonging and things like that in the community. have a kind of a public community that we're actively connecting with. Yeah, that's great. And I, I'm very, very grateful for your work. Uh, I know it's helped me as a parent a lot, particularly. And, uh, I'm, interested to learn more about, well, I was going to ask what,

03:25
What is interpersonal neurobiology? What I'm also just interested in for you is I know you've been a prolific writer over the years and I'm just curious, know, do you see yourself as sort of a researcher or do you see yourself at, you know, do you spend a lot of time just writing and thinking through ideas or how do you, what does your day to day look like? Yeah, well those are three great questions and let me try to order them in the sequence that you've,

03:55
ask them. The first is the field of interpersonal neurobiology. You know, what that is, is when I was training to be a therapist, when I was after pediatrics training, initially I transferred over to psychiatry and I became an adult psychiatrist and a child and adolescent psychiatrist. And I was taught to do couples therapy and family therapy and child therapy and teen therapy and adult therapy. And what I noticed was that there wasn't like a common like

04:24
conceptual framework across all those different approaches to helping people. So it was a little confusing and I decided I would become a researcher. This is the second part of your question. So I studied what's called attachment theory and research. You know, in the course of being a psychiatrist, being trained by psychologists to do research, I felt there was a need to sort of bridge across the academic world back into the clinical world. So I was doing at night a lot of therapy.

04:54
And then I became the training director in child and adolescent psychiatry, teaching basically people how to do family therapy and do therapy with their kids. so I really wanted to find a way, because I'm trained in science, to bring science into our work as therapists. And it was very frustrating, I'm just gonna say it straight, that even in psychiatry,

05:22
no one was saying what the mind was. So I kind of had like a, identity crisis, if you will, as a researcher, going back to train clinicians and being an active therapist and the identity crisis was I was board certified and everything, but I kind of felt like I knew nothing that I was taught nothing. I was taught a bunch of diagnostic labels and you know, standard approaches, but there wasn't a conceptual

05:50
foundation beneath the building of what was called the fields of mental health. So, you know, my wife, Caroline, well, she knew I was struggling with this and I was thinking of changing fields. So she said, you know, instead of changing fields again, because I had dropped out of medical school, came back, I started in pediatrics, switched to psychiatry. She said, instead of changing fields, why don't you change the field? And I said, wow, that

06:20
is really brilliant, which she is, know, and so I said, wow, okay, okay, what would that be? And so I just basically asked simple questions like, okay, if we're the field of mental health, cool, and we come from all different approaches, know, master's level folks and all sorts of things, social work, nursing, psychology, psychiatry, lots of us are in the field of mental health, okay, great, that's beautiful, that lots of diversity of professional backgrounds. So I started asking people, well, what were you told the mind is?

06:48
And like no one was told what the mind is, even in psychiatry, which is like the medical field of mental health. So I said, okay, well then the first changes that's gotta happen is if we have a field called mental health, we've gotta say what mental means. We've gotta do it. I mean, I know it sounds weird. It'd be like my wife, Caroline, she's a lawyer, right? And if I went out with her law friends to dinner and I said, hey you guys,

07:17
You know, did anyone ever tell you what a law was? I mean, they would think I was out of my mind. mean, and now that actually we have a definition of the mind, can use that phrase, but this, so this is what began in like 1990, 91, you know, the beginning of the decade of the brain. So I assembled all these folks together, you know, who were interested in the mind, but never defined it short of calling it brain activity, which is what Hippocrates said 2,500 years ago.

07:45
So for thousands of years, the field of medicine has said mind simply means brain activity. And William James, the grandfather of modern psychology, reaffirmed that in 1890 and his principles of the psychology. And, but I thought, well, you know, even though I'm trained as a physician and I, you know, I was trained in neuroscience and I think neuroscience is awesome, but is that all the mind is? It's just what happens inside your head. And so as an attachment researcher, didn't feel right.

08:15
And as a couples therapist or family therapist, it just didn't feel right. And I was working in schools, you can go into a classroom and feel the relational field that's there. And to say the mind is only in the people's heads, it just didn't feel right. So I assembled a bunch of scientists together. It's a long story. I write it up in a book called mind, but you know, the issue is I think we've been living with a limited narrative of just saying mind is brain activity and there's a lot more to it.

08:43
So ultimately, not gonna, I can talk about the specifics, but ultimately what came out in the early 90s was a definition of the mind that was a working definition that I proposed to these 40 scientists. And we dove deeply into that definition and that gave birth to the field of interpersonal neurobiology, which said the mind is broader than the brain and even bigger than the body. And it goes through some very specific things. So like the developing mind was a book that came from that journey with those scientists and

09:13
proposed the field and now it's in its third edition, which just came out. So it's exciting to see, and I had 18 interns work with me this time for the revision and I said, show that these ideas are wrong. And they go, you mean right? I said, no, I mean wrong. Give me one study anywhere in the world that shows all the principles of interpersonal neurobiology are wrong and then we'll throw it all away and we'll start again. It'll be so much fun. And they couldn't find for the most part anything.

09:43
that went against it and tons, literally thousands of studies to support the basic tenants that don't come out of any one particular field like genetics or neuroscience. But when you put it all together in what's called a conciliant way, you look for the common grounding across disciplines. So anyway, that's what gave birth to the framework of IP and B interpersonal neurobiology. Now, you know, I started this series at Norton and we have 75 textbooks for therapists. Oh, wow.

10:13
Yeah, so it's a big, you know, series now. And, you know, so if people say, well, what can I read about this? Well, you have 75 textbooks, you know, in addition to the other ones outside of the Norton series too, like the developing mind. That's what I've been doing on the sort of clinical academic side. And on the public side, there's a whole bunch of other things about what are we going to do with our human family and what we're doing to earth and what we're doing with racism and all that stuff. So that's a

10:39
That's another very active part of my life. But this gets to the final question. What is my day like? You know, I can go from, you know, having a wonderful opportunity to talk to you, Shane, to, you know, working with people on racism and trying to, you know, address, you know, do we do anti-racism or do we do eliminate racism? I mean, how do you phrase this for the public? And then I'll do work with people working on climate change. And now the West Coast burning, it's like, you know, literally the hot topic.

11:09
and hotter than most us want, but it's really pressing on us. And the pandemic, of course, has really raised to the front of our minds the reality of interconnection that humanity seems to have denied and acts as if you just live like as a solo self. So these ideas of interpersonal neurobiology relate to all those ways of addressing the crisis on the planet. And so we have this thing called PEP.

11:38
which initially was the personal experience of the planetary pandemic. And now it's this large community that's forming with a weekly meeting on Fridays, you know, where it's the personal exploration of planetary possibility. So that's, know, that, you know, each week I find new people to join me in the conversation. We have some really fascinating guests coming on, you know, really at the cutting edge of some of these things. Well, that's something that I appreciate so much about you. feel like,

12:07
you are grounded in the science as a scientist and, going to your trainings, that's something I appreciate so much is just the, the way that you're able to explain the science to someone who, like me, who's a therapist. But I, I feel like you're, know, you connected to the mindfulness, to the activism, to the, to our connection with the earth. And so I, you know, that's something that I'm just so grateful for about you. And I'm, and I'm curious. Yeah, absolutely.

12:36
I'm really curious from your perspective with that being said, I, cause I feel like what you're doing is so important because on one side you have scientists and people in the field of medicine who can tell us so much about what's going on in the brain from a scientific perspective. And then you have a, you know, so many therapists who are using models where it's like, yeah, I'm going to, you know, help these people process their emotions.

13:04
And it works really great, but I have no idea what's actually going on in the brain. so I'd love to hear you say more about that connection. Absolutely. Well, that's a great question, Shane. And, know, um, I appreciate how clearly you're articulating this and, know, we have a, just to start with the issue of trainings, you know, we have this 36 hour training program that we're, in the middle of now where, you know, therapists or others, you know, educators of various sorts, you know, come in and,

13:33
We spend, you know, six months going through with this 36 hour program with this experience of doing exactly what you're saying. So if you're a therapist saying, I want to help a couple do emotional processing, and let's say that question comes up in the course. Well, then you learn as you get, you know, basically trained in this field of interpersonal neurobiology, it's a comprehensive course in that area to say, okay, emotional communication, what does that actually mean?

14:03
You go, well, that's obvious, Dan. means you're communicating about emotions. What's the big deal? Well, for me as a scientist, that just isn't enough. Cause I'll say to you, you know, we don't have to do this here, but I do this, you know, in other settings, you know, but what is emotion? So someone said, well, an emotion is what happens when you have a feeling. go, cool. What does it mean to have a feeling? And they go, well, a feeling is what happens when you have an emotion. And it goes round and round these circles of

14:33
very understandable vocabulary, but no one's actually saying anything. It's the weirdest thing. It's almost like being Alice in Wonderland. know, like everything is like, same thing with the mind, by the way. People say, oh, his mind is disturbed. has an emotional problem. And they quickly equate mind with emotion or they'll say there's a brain imbalance. And I go, what do you mean? What does that mean? And even when I say that to my pharmacology colleagues, they get so agitated because

15:02
I always give this example, you know, when I'm starting out to help people see the distinction that even if, let's say emotions, let's talk about emotions. If you're a suicide prevention phone worker and a person calls on the line and let's say you're the listener, say, Shane, I don't see any hope in living. I have a gun in my hand. In my other hand is the phone. And all these terrible things have happened. I've lost my job.

15:31
My wife left me. My kids won't talk to me. I don't have any more income. I just can't see any way out. But I figure, because I saw this sign on the road for the suicide prevention service, so I'm calling you, but I'm at the end. I just can't see any way out of this. The gun is loaded.

15:57
And now the silence, right? Now this kind of thing is what I did when I was in college. I was trained to be on a suicide prevention service, right? And at the same time I was an biochemistry major. was learning about molecules and stuff like that of the body. So now if the mind is equivalent to brain activity, and I mean like it's a synonym, then you would say that emotional communication would be you saying, Dan,

16:25
I'm the caller, caller, go, Dan, I sense that your serotonin in your prefrontal region is probably a little bit imbalanced. It's probably low, boom, I would kill myself. Because the relationship is missing you identifying with and communicating about my internal subjective experience. Let's just call it that. The felt sense, the what's called first person experience.

16:54
I'm doing my best to tell you, I'm feeling hopeless. I feel despair. It's just a state of my mind that is mind, the first facet is subjective experience. Now, if you're instead say, Dan, I hear you're in a lot of pain. Yeah, I am. And I hear you sense that there's no way out and it feels like there's nowhere to turn but that gun in your hand. And I can sense how, you know, both

17:22
frightening that feels and almost liberating that feels to finally get out of the pain. Yeah, that's exactly how I feel. And you know, with your wife leaving everything, it just feels like it's too much. And a lot of people who feel like it's too much can't see any options. So I'm really glad you're calling because the benefit of that, we really understand what's going on is I can see all sorts of options for you because I've been here with people who've been there and

17:47
but let's stay with your pain for now, because that's what you're feeling right now. And I go, yeah, but you know, now it feels a little better or whatever like that. Now, when you realize emotion in a human being is almost identical to meaning, it's a state of mind, I think that's related to something called integration. And we can talk about what that means. But if you look at all the research on emotion, it relates to how differentiated things are being linked together. And let's just call that process

18:17
of linking different stuff, let's just call it integration. So this moment, Shane, with you accurately sensing my subjective experience, you are differentiating me from you because you're not feeling despair, but you're acknowledging mine. So you're acknowledging the differentiated way it is. And then with your compassion and kindness, you are then linking your bodily existence with my bodily existence.

18:45
So now I have just become part of a we, right? Because you're with my first facet of mind is subjective experience. The second facet is consciousness, which is absolutely awesome. And even if all these things depend on only the brain, it's not the same as the brain. See, this is the key thing. You know, if you tell, like look at a study on people with a common cold, if you tell a person, oh, you have a common cold, whatever, just drink a lot of fluids and get some rest.

19:15
Okay, fine. And then you compare it to a group that has the same amount of time with the physician, only the physician adds a few seconds of saying, God, Shane, you're a graduate student now and you have a cold. It must be so frustrating to have a cold while you're studying for exams. Okay, you know, drink a lot of fluids and take a lot of rest. You will get over your cold a day sooner. And when we test your blood, your immune system will be more robustly fighting that virus. Just with a 30 second empathic comment from your physician.

19:44
Right? This is incredible. Yeah. Incredible. So what I say when I teach physicians who basically have the empathy beaten out of them, seriously, the studies are really clear. And that was my experience. That's why I had to write this book. Mine was like, I had to just tell the story of what it's like to be in a socialization system that beats you up for being empathic and compassionate. Just beats you up. Right? So there's a whole chapter on that business, you know, and, but the point is that for us as therapists, you know,

20:14
Emotional communication means connecting with another person in an integrative way. And the mind is not just subjective experience, not just consciousness, it's information processing. by you identifying these terms like, Dan, it feels so hopeless, Dan, you feel the despair. You are actually processing information in a way that has us join. If you said to me, your serotonin levels are a little low in your prefrontal cortex.

20:44
you wouldn't be tuning into anything that had meaning for me. You might be exactly accurate, but it would be this cold way where I saw my professors of medicine do that. I'm sorry to tell you you're dying from X, Y, and Z. Goodbye. You know, I'm going, don't you want to like stay with them? Why? I told them what they're dying of. Well, because you just told them they're dying and there's nothing more I can do. And they'd walk away. could, I literally could not believe my eyes. And after dropping out of school, I realized eyesight.

21:14
is different from a word I had to make up called mindsight. You know, when you hear the person, the caller, and you sense their despair, you're using mindsight to make an image of their subjective experience. Whereas someone just says, your prefrontal cortex got low in serotonin. You know, you've studied something in books, know, suicide is associated with low serotonin, and then you just belt that out, you know.

21:41
from an intellectual wage like my professors would tell people they were dying. So emotional communication, let's say in couples therapy is a part of a larger frame where, you we talk about yes, information processing, yes, consciousness, what is the couple aware of? The first facet is you want people identifying subjective experience, fine. But none of those three facets really tell us what a healthy mind is. So then a fourth facet came up in this very room I'm in right now, because we're all at home, this is my home office.

22:10
you know, where if you say the mind is more than the brain and as an attachment researcher, you know, I study relationships. So I say, well, yeah, the mind sure is in the brain. I think the brain is cool. It's awesome. The whole body in fact is pretty fantastic and relationships are amazing. What is a relationship having common with the brain? And you know, in our 36 hour course, you kind of spend hours and hours and hours on this, but I'll just give it to you in a sentence. What they share in common is

22:40
energy and information flow. That's what happens in emotional communication. That's what happens in any kind of communication. And that's what happens inside the brain, believe it or not. The skull and the skin are not barriers that block the flow of energy and information. So when I realized that, know, walking on the beach, trying to figure out how to get those 40 scientists to work with each other and then where I assembled them to say, what is the relationship between mind and the brain?

23:09
You know, what the system is, and a couples therapist deals with the system of a couple, a family therapist deals with the system of a family, I do work in schools, we deal with the system of a classroom or the system of the school culture, or we have, you know, communities and now all the racism we're seeing, or we have a nation, or we have a whole world, these are all systems. So systems come in various sizes, the brain is a system.

23:37
Right? So once you start thinking about systems, you say, what's the stuff of the system? A system basically is like a cloud is a collection of stuff that's interacting with itself. And if it has the features of being open and chaos capable and being nonlinear, nonlinear means a small input at one point, like geese flying into a cloud. It's hard to predict the result. And the result is usually pretty big. So if you're an open influenced by other things other than the self or whatever the system itself and you're

24:06
capable of being chaotic and you're nonlinear, this large effect of a small input, then you're called a complex system. It turns out that complex systems have emergent properties that the interaction of the stuff of the system gives rise to something. And one of those emergent processes is called self-organization. So through a long line of reasoning that started in this office, I feel that these facets of the mind are probably all emergent properties of energy flow.

24:37
and that this fourth facet is called self-organization. It's the innate aspect of a complex system that regulates its own becoming. It's completely counterintuitive. It's just plain out weird, but it's just a fact in our universe. Complex systems organize their own unfolding. So then I thought, well, maybe the mind is the emergent self-organizing

25:07
and Biden relational process. So it's both in your whole body, not just your brain, but it's also in your relationships, like in a couples relationship. And amazingly self-organization basically creates this flow. can make an acronym FACES. It's flexible, adaptive, coherent in math terms means it's resilient over time, energized and stable. This FACES acronym, flexible, adaptive, coherent, energized and stable is really useful to couples therapists.

25:35
Because you can then ask the question, how does self organization, if that's what the mind is, a self organizing process, how does it create this faces flow and what happens when it doesn't? Well, fascinatingly, when it doesn't, you go to either, it's like a river, you go to either chaos on one bank of the river or rigidity on the other, which explains every couple I've ever worked with. You know, they get into chaos, you get into rigidity, but it turns out every diagnostic category that we have these names for.

26:03
depression, schizophrenia, know, dissociation, you know, all sorts of things. They all meet the criteria of chaos or rigidity. And so far, every study ever done, let's say on the brain of someone with a major psychiatric disorder, they have impaired, you'll see integration in the brain. Integration, the linking of differentiated parts is how a complex system maximizes or optimizes its self-organization, maximizes complexity is the term, but that freaks people out.

26:32
It creates harmony basically. The face's flow is created from integration. Let's just name the linking of differentiated parts as integration. So then I went, oh my God, then integration is health. So when I was working with couples, for example, I would try to sense how are they differentiating and then linking. So you can give me an example, Shane, of any couple you're working with and we can.

27:00
put it through the lens of differentiation and linkage, which is how we're defining the word integration. And you can see when a couple isn't honoring differences or promoting compassionate connections, the linkage, then they're going to tend towards chaos, explosions and temper tantrums and rages and all that stuff, or rigidity. They shut down, they stop having sex, they stop connecting with each other. There's this kind of malaise. Whereas if they are,

27:30
in an integrative flow, you're going to feel this vitality and fluidity. They're going to be in love with each other. And you can feel that, you know, when you go out to dinner with friends, you can feel that, God, you know, and, uh, and, so it became really quite exciting back in 92 to say a healthy mind is a mind that creates integration within and between period. Building a private practice can be challenging.

27:59
Filing all of the right paperwork is time consuming and tedious. And even after you're done, it can take months to get credentialed and start seeing clients. That's why Alma makes it easy and financially rewarding to accept insurance. When you join Alma, you can get credentialed within 45 days and access enhanced reimbursement rates with major payers. They also handle all of the paperwork from eligibility checks to claim submissions and guarantee payment within two weeks of each appointment.

28:27
Plus when you join Alma, you'll get access to time-saving tools for intakes, scheduling, treatment plans, progress notes, and more in their included platform. Alma helps you spend less time on administrative work and more time offering great care to your clients. Visit helloalma.com backslash a T P P or click the link in the show notes to learn more. You know, what's so interesting, I think when we're talking about someone

28:56
having a broken ankle, for example, in some ways it's very clear about how to fix that problem. And so I think what becomes very complicated for us as therapists, maybe even particularly couples therapists, is that how do you define relational health? You're talking about the integration, but even in the face of the fact that these two people are telling you what they want or need in their relationship.

29:24
or may not be aware of that. I mean, as part of it convincing them of the reality of what health looks like, you know, which I think can become such a challenge. And I know that, you know, I think another comment I just wanted to make really quick, I don't know if this is connected or it's making it more confusing, but how much you have that background in attachment, you know, and how much that the childhood or attachment experiences influence how we see the world in the present.

29:53
in our emotions and behavior and what's going on in the present? Yeah, well, that is such a great question. know, the, um, you know, whenever you think about your own perceptions and, you know, point of view, really, uh, we need to realize it's going to be filtered through your own experiences, what you learned, what you believe in stuff like that. So it's great that you're asking about attachment because it absolutely shapes and has shaped

30:20
you know, my role as well in everything, you know, my role as a therapist for sure, my understanding of the therapeutic process. Yes, I wrote a book called The Mindful Therapist, which kind of, you know, looks at something called part, you know, how we bring presence, attunement, resonance and trust as the beginning of the part we play as therapists. And my role is, you know, as a husband, as a father and you know, for sure.

30:46
So let's say a little bit about attachment. So attachment is this field from psychology that has a really exciting history of John Bowlby and Mary Ainsworth, a psychiatrist and psychologist, working collaboratively to create this field called attachment research or attachment theory. And it has people who push against it. There are people who believe genetics determines how you turn out and they get very upset about

31:16
some of the vocabulary that attachment researchers use. So it's important just to acknowledge that it's not like everyone accepts attachment theory and research as true. However, if you look at it as a scientist and try to challenge it as a scientist, you find it's incredibly solid as a science. And at least my experience is of my colleagues in this field, they are unbelievably bright, disciplined researchers who

31:45
Are really open to constantly challenging their own conclusions, you know, and so they're For me anyway, they're they're exactly what you want to see in a scientist someone who says this is what might be true Let's set up a paradigm and try to disprove it, you know but What we found basically we meaning the field of attachment researchers, you know what we found is that the best predictor of how a child's own security of attachment, which is

32:15
in turn, the best predictor of how they have resilience or not basically, and how they relate to other people. You know, the best predictor of that is not so much what happened to the parent, but how they've made sense of what happened to them. That was an amazing finding that came out in 1985. And when I heard that as a trainee in 85, I just said, I want to learn everything I can about that way of studying that. And it's something called the adult attachment interview.

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and the AAI. And so, you know, I got a research grant from the National Institute of Mental Health to study the AAI and studied with the person who created it, Mary Main and her husband colleague, Eric Hesse, and was just blown away by the power of using that as a, not just as a scientist in studies, but as a clinician, which I am, you know, where I would start giving all of my patients

33:12
Aai, so if I was doing couples therapy, for example, each member of the couple if there wasn't a lot of hostility, there was just a lot of difficulty each would get the aai with the other one listening in And that very process of doing a research established interview And having the other member of the couple here From kind of an objective stance. They they didn't have to do anything but sit there And then we'd reverse it the other person would then have their interview

33:42
And then when we could unpeel the layers, which basically go like this, it's an adult telling a narrative, a story about what they recall happening to them. Now that by itself, of course, isn't what happened to them. It's the story of what happened to them. And that's the amazing thing about the attachment researchers is they recognize that how are we going to know it's accurate? So the AI is not based on

34:10
Is this actually what happened? It's based on a narrative analysis. So I'm trained as a narrative scientist. I study the structure of story and its linguistic output, how you tell the story of the words. And so what you see, which is absolutely fabulous, is that's the best predictor. You can't go back 40, 50 years and say, is exactly what happened to you. No. So a person carries with them a narrative. And this is why I'm so fascinated in the biology of narrative, like for the brain.

34:40
Like how does the brain hold the memory? There are different layers of memory and then has it make sense of memory and make sense of experience. So people have essentially the experience that they had from birth on and then their way of adapting to that experience. So we can go through if we have time, but you know, there are very specific kind of patterns that emerge that then go forward.

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And Alan Shroff is a colleague who did the most extensive longitudinal studies now over 40 years. They've been studying people from before birth and now they're in their 40s and they see how they are in couples therapy, couples relationships, not therapy, couples, how they are in their romances. And so you can say that, yes, Nancy, your question, the things that happened to you, number one, how you adapted to it, number two. And the third is how you make sense of how you adapted and what happened to you.

35:39
Those are three different things that things that happened or didn't happen like neglect or abuse as just one example How you then try to do the best you could to survive and then how through adolescence and adulthood You've come to make sense of that So it isn't a fixed thing and this is the beautiful thing about attachment research It says you can always make sense of your life and in a book I wrote called mindsight I talk about a guy in his 90s, know who did the work of the adult attachment interview?

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made sense of his life in ways that you wouldn't believe a 90 year old would do. And his wife called me up. They'd been married for over 65 years. And she said, you know, Dr. Dan, you know, did you give Stuart a brain transplant? What happened? You know, he's he's like a whole different husband now, you know, and I said, no, he's just doing the work, you know, of making sense. Because when you make sense, what you're doing is you're integrating your brain and you're integrating your relationships. Whereas

36:38
suboptimal attachment, what's called insecure attachment. I don't really like that term or non-secure attachment. Because people aren't insecure. It's just they had a kind of non-optimal attachment. So that's one of the things people get mad about is that the researcher used the word insecure, but that's not to mean the person has insecurities and other nervous analysis. No, it's a non-ideal form of attachment. Anyway, so all that being said is in the attachment,

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interview in the couples therapy setting was so interesting about it and Stewart was about an individual case, but there's another example somewhere in the book of a couple I work with where you see the AAI of each member of the couple and these are all you know actual people I work with you see the AAI being given in couples therapy and then you see how within this three person system that is me the therapist the one partner and then the other partner

37:39
We then start looking at what happened. How did this person survive what happened and how have they made sense of it up to this point? And now how can they make sense of it in a more integrative way? And inevitably, know, the couples therapy I do, when you do it that way, unbelievable things come up that have never been spoken ever that make the couple's dysfunction really clear why it's impairing integration now.

38:09
And they get trapped in these kind of fixed ways that absolutely are echoes of their past adaptations and past experiences. Yeah, that's, that's incredible. And you know, it's like, I'm thinking, I think I'd probably learned this from your, from one of your books, the idea that if you grow up in a really chaotic family, you know, that you believe that the world is a chaotic place and you may live in fear. as an adult, if you're living in that adaptation, you're living with a lot of fear.

38:38
And so through the interview that you're talking about, they still went through those experiences, but they can begin to have a new understanding that I don't live in a world where I need to be fearful all the time, but there's a more nuanced perspective about who they are and the ability to be mindful and present, I suppose, as their adult self. Yeah, it's mindful and present for sure. And so that's kind of the if you think about the mind, this is maybe simple, but I think accurate way to think about it. Let's think about the mind as both

39:08
having an interior to it and also having a relational side to it. So you could call that exterior, but that makes it too kind of like your house, but it's more like, you know, there's an inner part and there's an inter, inter part. That's maybe a better way to say it. So for the inner part, a person's presence or a capacity to rest and receptive awareness. I talk about this in a book called aware, you know, how you cultivate that.

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but it really is letting go of your judgments, which is what mindfulness means. It's really being showing up, which is what presence means. And so now that's the interior part. And in addition to that, once a person has learned to become present, now they go from that interior work of building an interior resilience to a relational resilience where they can say,

40:05
I can join with you, my partner, in a way where I don't disappear as I become a we. Right? So a lot of the adaptations to non-secure attachment are ways of protecting you from being obliterated. You know, in all sorts of ways and there's, there are important distinctions across, you know, the ambivalent attachment, which gives rise to adult preoccupied attachment. There's avoidant attachment.

40:35
in a kid which gives rise to dismissing attachment and then there's disorganized attachment in a kid which gives rise to unresolved states in a parent and dissociation. So when you understand those basic patterns of attachment, then you realize, I see, know, those are really ways in which my capacity to be in a mutually rewarding relationship where I'm connected but not disappearing.

41:04
I retain my differentiated nature while I'm also fully engaged in joining. Right? Now that's a real art form, you know, and even if you thought about the brain aspect of it, I mean, we can go through the networks in the brain that do this, but it's a real beautiful capacity to stay grounded in your interior compass that allows you to guide yourself where you're going and also give in, in a sense.

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because you can't control the other to become part of a we, you know, and let go of the defensive way in which a lot of us want to cling to control and know exactly what's happening. And, you know, so, so there's a, in the aware book, uh, and actually in the new, new edition of the developing mind, you know, I talk about this three P framework of the mind, which is basically, um, this movement along a probability curve, which really, when you apply it, as I do in the developing mind to,

42:00
all these different aspects of attachment, you come to see that the mind as an emergent property of energy is actually moving along this spectrum of probability values. And when you drop into open awareness, it's maximal uncertainty, but that's equal to maximal freedom and possibility. So when a person learns to get used to that kind of presence, instead of clinging to these certainties, which we call peaks,

42:28
You know, I know this, this is the right way. I'm the expert in this. I'm gonna tell you what I want. I, I, I, I, me, me, me, me, me. All that stuff keeps you from joining, whether it's you're nervous about it or you're dismissing about it or you're dissociating about it. It's all kind of this effort to preserve your sanity really from your childhood experiences. But now joining is compromised. So when I do couples therapy, this just becomes part of our discussion.

42:58
Like how can I be a we without losing me? It's kind of that simple, but it's that hard. Yeah. And I think so many of the couples therapy models that I've studied, um, the people, you know, the listeners resonate with fit so well in everything that you're talking about the understanding, but you know, there there's not the brain science to sort of, or at least that's not part of what we are, what the depth of how we understand what we're doing.

43:26
But everything you're saying just fits so well, feel like with how we work so often with couples and it's just so, so helpful to have this light shed on the frameworks that we use to help people. Well, that's great. mean, that's great. Cause if you think about the emotional health of a couple, right? That's a term maybe you use or certainly can resonate with, you know, in our view in interpersonal neurobiology is what I mean by our, you know,

43:54
Emotional health means integrative health. How is this couple able to differentiate and simultaneously link to create that face's flow? So if we hear a couple's therapist say, oh, I'm really working on the emotional health of my couple that I'm working with, we would immediately start asking questions about, how is their differentiation and linkage? How is this integrative work happening?

44:19
And so in that sense, yes, you could look at the brain for sure. And you know, in the developing mind, you have like 500 pages of extensive review of all the networks and all this kind of stuff. But even if you don't want to go to the brain too much, it's fine. Cause you're really now becoming a systems thinker and you want to ask things, the system of the individual and the system of the couple. So there you would say, and this is why, you know, I like the word interpersonal because

44:48
The personal is very important. What's happening within the person, right? And the inter of interpersonal, it's what's happening in the betweenness. Well, it doesn't have to be a mystery because now we can say it's energy flow. And you can study literally what you can call a generative field that is promoting compassion and kindness and care and love, connection, a sense of vitality, emergence. You can feel it with a couple.

45:18
when it has this quality of being generative. They support each other. Someone stubs their toe, the other person's there to really help them, not saying, oh, you stupid bozo. And whereas other couples who are not in this integrative flow are so vulnerable to chaos and rigidity. Any couple can go there when you have your bad day, especially with the pandemic. There is incredible stress.

45:44
And as we know, domestic violence is up, substance abuse is up, suicide is up, anxiety is up, depression is up. This is a really, really hard time. So we are constantly bombarded with messages of death, you know, not just with the fires now, but I mean, with the murders, with the racist stuff going on that's being revealed in the United States. You know, we have constant reminders that the virus of, you know, this new coronavirus that's causing COVID-19 could kill you.

46:14
if you aren't vigilant for protecting your family, right? So it is an incredibly hard time. And even if you just look at the networks of the brain, when the networks of the brain that are involved in protecting you from death are constantly being active, it's exhausting. You're supposed to do that for a few minutes, maybe an hour. We're doing it for like half a year. Right.

46:39
You know, and so it's, it's, it's exhausting. So it's understandable. So couples need to really be kind with each other and figure out a way to say, yeah, this is really tough. I'm, I'm on massive alert all the time. So any kind of old attachment issues that I worked out in individual therapy, now we're going to work out, you know, come back to the four, you know, and present themselves as chaos and rigidity. So the message to have people remember is that

47:07
when there's rigidity that pops up or chaos, it's a sign integration is not happening. And rather than beat yourself up as a member of the couple, if you're doing couples therapy as the therapist, you know, supporting the couple and just say, yeah, let's just take a look at this. Cause life is a journey. It's an integrative journey. It's not like we've achieved integration, we're done. No, I mean, you're not done until you're dead. So integration is an unfolding journey.

47:36
that we're always moving toward in various ways. And sometimes you get a little close to the bank of rigidity, then you move back to the face's flow of that river. Sometimes you move more towards chaos, then you move back to the river. But if couples are getting stuck repeatedly in chaotic or rigid states, they probably need intervention because that can escalate very rapidly in these very destructive patterns. That patterns themselves,

48:04
can cause their own nonintegrated functioning. Because now you're reacting not just to your attachment history, or not just to what's going on with the pandemic. Now you're reacting to the chaos and rigidity that now becomes the issue with the couple's relationship. You said this yesterday, and you said that yesterday, and there's no forgiveness. So now it's this vicious cycle of deteriorating functioning that we see. I don't know how you do your couple's intake, but I know when I do an intake, I

48:34
some couples therapists I know don't do this, but I'll have the couple come in. We'll have a general feeling, whether it feels like it could be a fit. And then I'll meet with one of the members alone and I'll meet with the other member alone to get anything I need to know, you know, and I have been able to avoid wasting everybody's time when I find out one of the members of the couple is completely done. There's nothing, you know, this is not couples therapy. This is, know, breakup therapy, which can also be a good thing to do. But you know, no one's fooling under, but they just couldn't say it.

49:03
they're completely done. And that's even when there's not an affair going on, you know, so I just want to know that because if someone has, doesn't have a commitment to trying to make it work, you can be spinning your wheels as a therapist. Yeah, we've all probably been there. Oh yeah, for sure. So, and that's an interesting thing when someone, it isn't just, I'm felt falling out of love. It's like I've fallen out of love and I'm actually disgusted with this person. Right. Right. Right. mean,

49:32
A different kind of feel and you get that in those private moments. The person is hostile. You know, I forgot what the four things of the apocalypse are. Not horses of the... is it? Yeah, the four horsemen of the apocalypse. Yeah, John Gottman. What are those four? Do you remember what they are? There's contempt, criticism, stonewalling. Stonewalling and something else like lack of forgiveness or something. Maybe defensiveness.

49:59
Defensiveness, yeah. mean, so you can get that in the, you can get those four within the relationship, but you can also get some incredible contempt that you hear privately. like, oh wow. You know, cause at the, you know, couples, it's hard being in a couple because life is hard and any stuff from your own childhood starts popping up. And anyway, but it's also,

50:25
absolutely fabulous. So you've got this, it's like, you know, it's like raising kids is the hardest job in the world and the most rewarding job in the world. You don't, you don't get something for nothing. Yeah. And that's the great thing about, you know, to go back to when you were talking about the mind, this potential for shifting our perspective, for seeing the hope that exists in any situation that we encounter. Yeah, absolutely. And that hope is, I don't mean to go on and on about integration, but

50:54
In many ways, is what arises from integration. It's this feeling like right now, I might feel things are tough, but I can see there's a better way out. So I'm kind of linking present experiences, my interpretation of the past with the future. So it's really kind of a temporal, know, across time integration is where I think hope comes from. Yeah. Well, this is just so incredibly helpful. It's so clear what a great teacher you are.

51:24
And yeah, I'm just so grateful to be able to have this conversation with you. Are there any places you can point us for people who want to learn more? You know, you mentioned that all the trainings that you have available, maybe specific books or a book, you know, for people who want to go deeper. Yeah. Well, a couple of things. mean, the 36 hour training program is great. We're actually going to start pretty soon. Attachment in couples therapy, a very specific course just on that. Oh, wow.

51:53
I think that's coming up next. So check in with Christie at our, mind site Institute. So that's, we're going to have that with a live Q and a and stuff like that. And it's, it's, you'll hear the recorded content. So I know exactly what was said and it's pretty in depth. if there's, you want to see how to apply attachment research to, know, what goes on, there'll be, you'll have, you'll be able to watch it in your own time on the recorded thing, but then we'll have really fun Q and a's that are live. we'll have time to talk with each other. There's that, you know, in terms of,

52:23
I guess for a therapist, the books I would recommend, and I always have to be careful, because with 75 textbooks, I mention five of them, I'm going to get 70 other authors saying, why didn't you mention mine? So all I can say is, please look at the 75 textbooks and see which one resonates with you. But of the ones I wrote, and I know I can say those because I won't get mad at myself for not mentioning some versus others.

52:52
Mindsight is probably a good place to start. And then the mindful therapist is probably a good one too. And if you want just the in-depth science of relational science, I would look at the developing mind. know, John, John Gottman wrote something on the cover that was very sweet. So that would be a good book to do the developing mind. And if you just want to practice your own way of developing presence, I would look at the book aware. Great. And your, what your website, what's your website?

53:21
It's just my name with a D R in front of it. So Dr. D R and then D A N S I E G E L DrDanSiegel.com. Great. So I'll put all that in the show notes so people can find it really easily. And yeah, thank you again so much. This has been so great to talk to you. All right. Thanks Dan. Thank you, Shane. Great to see you. care. Yeah. Great to see you too. The episode this week is brought to you by Alma.

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They make it easy to get credentialed with major insurance plans at enhanced reimbursement rates. handles all of the paperwork and guarantees payment within two weeks. Visit HelloAlma.com/ATPP or click on the link in the show notes to learn more. And thank you again, everybody. This is Shane Birkel and this is The Couples Therapist Couch podcast. It's all about the practice of couples therapy. I hope you have a great week and we'll see you next time. Bye, everybody!