Why Therapy Works: Using Our Minds to Change Our Brains

Written by Louis Cozolino

Reviewed by Kimberly Wang, New York University

With remarkable candor, Louis Cozolino opens with an anecdote about the client who first challenged his unquestioning faith in psychotherapeutic efficacy and shook his confidence as a clinician. Needless to say, psychotherapy is in the business of dealing with the intangible, making sense of the amorphous feelings that give rise to suffering, and, thus, this story perfectly captures the doubt that often dispirits both clients and clinicians in the healing process. That said, Why Therapy Works underscores the importance of understanding psychotherapy’s mechanisms of action beyond the conventional therapeutic philosophies and metaphors.

Cozolino’s three guiding principles are: 1) the brain is a social organ, shaped by evolution to connect with and change through interpersonal interactions; 2) neuroplastic, structural changes underlie therapeutic transformation; and 3) humans are natural story-tellers; therefore, the creation of narratives is critical in enhancing the self-reflectivity needed to heal from past traumas. Why Therapy Works reinforces these concepts with “Neurological Corners” and “Definitions,” easy-to-digest portions of key information that are separated from the main text for extra emphasis. While many of these explanations would not feel radically new to the experienced reader, Cozolino adds an interesting perspective to already familiar principles by offering insight from his personal life experiences.

Of particular interest to the reader questioning his or her faith in psychotherapy is the book’s philosophical approach to the ontology of suffering, which offers a vital element of reassurance. “Evolution is a problem-creating as well as a problem-solving process,” quotes Cozolino from Jonas Salk’s 1985 Open Mind Interview. Why Therapy Works treats this seemingly paradoxical duality as a focal point – “Our deep evolutionary history accounts for the profound connections among our bodies, minds, and the nature and quality of our relationships. It has also provided us with the ability to heal others in psychotherapy” (pg. 3). According to Cozolino, humans need not feel helpless to their suffering – understanding and harnessing these evolutionary artifacts is the key to control.

With his rich, personalized commentaries, unassuming analyses, and purposeful characterization of evidence-based science as “another metaphor” (one that offers the best “nonshaming explanation” for human struggle), Cozolino has redeemed the young, inexperienced therapist of his past and achieved a thorough, bottom-up explanation of the mechanisms of psychotherapeutic change.

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Why Therapy Works CozolinoCozolino, L. (2016). Why Therapy Works: Using Our Minds to Change Our Brains. New York, NY: W.W. Norton & Company. 271 pages. ISBN: 978-0-393-70905-6. Hardcover. 271 pages. Includes bibliographical references and index.

Keywords: psychotherapy, evidence-based medicine, self-regulation, social brain

Categories: Reviews

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