Neuroscience–based Cognitive Therapy: New Methods for Assessment, Treatment, and Self–Regulation

Neuroscience is the most powerful emerging force in the contemporary landscape of psychotherapy. In Neuroscience–based Cognitive Therapy, Tullio Scrimali explores recent advances in neuroscience, showing how they can be applied in practice to improve the effectiveness of cognitive therapy for clients with a wide range of diagnoses, including mood disorders, anxiety disorders, eating disorders and schizophrenia.

Taking a hands–on approach to a topic that has previously been treated only theoretically, Scrimali provides a thorough evaluation of both old and new techniques. He introduces new technologies, including portable devices that allow clinicians for the first time to directly assess changes in brain activity within the clinical setting. He then explains how therapists can improve outcomes by using those neuroscientific findings in the ongoing therapeutic process.

With its wide–ranging explication of theories and their applications, Neuroscience–based Cognitive Therapy making cutting–edge developments accessible to clinicians in their practices, as well as providing valuable tools for further research

Foreword by Arthur Freeman xiii

Preface xix

Acknowledgments xxi

List of Abbreviations xxiii

Introduction 1

Part I Neuroscience in Context

1 Neuroscience, Clinical Psychology, and Cognitive Therapy 5

2 The Mind Brain Problem 11

3 Motor Theories of Mind and a Complex Biocybernetic Model in Neuroscience 20

4 Complexity, Chaos, and Dynamical Systems 27

4.1 Introduction 27

4.2 Complexity 27

4.3 Chaos Theory 29

4.4 Complex Systems 30

4.5 From Complexity to a Neuroscience–based Cognitive Therapy 32

5 Modular and Gradiental Brain, Coalitional Mind 35

5.1 Introduction 35

5.2 The Modular and Gradiental Brain 37

5.3 The Social Brain 41

5.4 The Central Nervous System, Neurovegetative Nervous System, and Visceral Brain 44

5.4.1 The Neurovegetative Nervous System 44

5.4.2 The Visceral Brain 46

5.5 Paleognosis and Neognosis in theMind of Homo sapiens 47

5.6 Memory 48

5.7 Internal Representational Systems 51

5.7.1 Imagery 52

5.7.2 Internal Dialog 54

5.8 Knowledge Processes 54

5.8.1 Introduction 54

5.8.2 The Unconscious and Tacit Dimension 55

5.8.3 Information Coding in the Human Brain 57

5.8.4 Tacit Knowledge: Experiencing 59

5.8.5 Explicit Knowledge: Explaining 59

5.8.6 Procedural Knowledge: Acting 60

5.8.7 Social or Machiavellian Intelligence: Relating 61

5.9 Coalitional Processes 62

5.9.1 The Self 62

5.9.2 Personal Identity 66

5.9.3 Narrative 67

6 Phylogenesis of the Brain and Ontogenesis of the Mind: Biological and Cultural Evolutionism 70

6.1 The Reptilian Brain: The Archipallium 76

6.2 The Limbic System: The Paleopallium 76

6.3 Brain Structures of Less Evolved Mammals: The Neopallium 77

6.4 Specialized Frontal Lobes 77

Part II Clinical Psychophysiology and its Parameters

7 Psychophysiology and Clinical Psychophysiology 83

8 Electroencephalography and Quantitative Electroencephalography 86

8.1 Electroencephalography 86

8.1.1 Frequency 87

8.1.2 Amplitude 88

8.1.3 Morphology 89

8.1.4 Symmetry 89

8.1.5 Coherence 89

8.1.6 Artifacts 90

8.2 Quantitative Electroencephalography 91

8.2.1 Technical and Methodological Aspects 92

9 Electrodermal Activity and Quantitative Electrodermal Activity 96

9.1 Electrodermal Activity and its Recording 96

9.2 Computer–Aided Analysis of Electrodermal Activity and Quantitative Electrodermal Activity 103

9.3 Reference Database 107

9.4 Evoked Electrodermal Responses 111

9.5 Effects of Psychoactive Drugs on Electrodermal Activity 111

9.5.1 Beta–Blockers 112

9.5.2 Benzodiazepines 113

9.5.3 Neuroleptics 114

9.5.4 Antidepressants 115

9.5.5 Anti–Epileptic Drugs, or Mood Stabilizers 115

10 Complex Psychological Diagnosis and Instrumental Psychodiagnostics 116

10.1 Introduction 116

10.2 Functional Diagnosis 118

10.3 Instrumental Psychodiagnostics 120

10.4 The Contribution of Neuroscience to a Complex Diagnosis 120

Part III Neuroscience–basedMethods in the Clinical Setting

11 Complex Psychological Diagnosis with Quantitative Electroencephalography 125

11.1 Introduction 125

11.2 Dementia 126

11.2.1 Materials 126

11.2.2 Method 127

11.2.3 Results 128

11.3 Schizophrenia 129

11.4 Depression 132

11.5 Mania 133

11.6 Attention Deficit Hyperactivity Disorder 133

11.7 Obsessive–Compulsive Disorder 133

12 Complex Psychological Diagnosis with Quantitative Electrodermal Activity 135

12.1 General Aspects 135

12.1.1 Setting 135

12.1.2 Advising the Patient 136

12.1.3 Testing 136

12.1.4 Assessing and Reviewing Results with the Patient 137

12.1.5 Planning Treatment 137

12.1.6 Use of Recorded Data for Constructing a Narrative on the Self–Regulation Process 139

12.2 Data Regarding Specific Clinical Disorders 139

12.2.1 Generalized Anxiety Disorder 139

12.2.2 Panic Attack Disorder 140

12.2.3 Post–Traumatic Stress Disorder 140

12.2.4 Phobias 140

12.2.5 Obsessive–Compulsive Disorder 140

12.2.6 Depression 140

12.2.7 Eating Disorders 141

12.2.8 Addictions 141

12.2.9 Schizophrenia 141

12.2.10 Mania 141

12.2.11 Attention Deficit Hyperactivity Disorder 141

12.2.12 Stuttering 142

12.2.13 Hypertension 142

12.2.14 Irritable Bowel Syndrome 143

12.2.15 Premenstrual Syndrome 143

12.2.16 Psychogenic Impotence 143

13 Sets and Settings when Applying a Neuroscience–based Clinical Methodology 145

14 Multimodal Assessment of Family Process and the Family Strange Situation 152

14.1 The Family Strange Situation Procedure 154

15 Biofeedback, Neurofeedback, and Psychofeedback 156

15.1 Theoretical Foundation and Historical Development 156

15.2 Physiological and Psychophysiological Biofeedback 163

15.3 Biofeedback and Cognitive Therapy 165

15.4 MindLAB Set–based Coping Skills Training 168

15.5 Relaxation, Self–Control, Self–Regulation 168

16 Meditation, Mindfulness, and Biofeedback–based Mindfulness (BBM) 171

16.1 Meditation 171

16.1.1 Types of Meditation 171

16.2 Mindfulness 175

16.3 Biofeedback–Based Mindfulness 177

17 Neurofeedback and Cognitive Therapy 180

17.1 Insomnia 180

17.2 Obsessive–Compulsive Disorder 183

17.3 Attention Deficit Hyperactivity Disorder 186

17.4 Depression 187

17.5 Mania 187

17.6 Drug Dependency 187

18 Psychofeedback and Cognitive Therapy 189

18.1 Mental Disorders 190

18.1.1 Panic Attack Disorder with or without Agoraphobia: Dedalo Protocol 190

18.1.2 Obsessive–Compulsive Disorder: Sisifo Protocol 190

18.1.3 Mood Disorders: Galatea and Eolo Protocols 191

18.1.4 Substance Addiction–Related Disorders: Baccheia Protocols 191

18.1.5 Eating Disorders: Fineo and Tantalo Protocols 191

18.1.6 Personality Disorders: Polifemo Protocol 191

18.1.7 Schizophrenia: Negative Entropy Protocol 191

18.1.8 Attention Deficit Hyperactivity Disorder 192

18.1.9 Stuttering 192

18.2 Psychosomatic Disorders 192

18.3 Meditation, Mindfulness, Music Therapy 193

19 Monitoring theWarning Signs of Relapse in Schizophrenia and Bipolar Disorder, and Coping with Them 194

19.1 Introduction 194

19.2 Schizophrenia 194

19.3 Bipolar Disorder 196

19.4 Coping with Prodromal Symptoms of Relapse in Psychosis 196

20 Get Started with Neuroscience–based Cognitive Therapy 197

References 199

Index 217

Professor Tullio Scrimali is a pioneer of clinical psychophysiology and cognitive therapy, recognized for his contribution to the discipline worldwide. He was a founding fellow of the Academy of Cognitive Therapy (ACT), and obtained the first Chair of Cognitive Therapyat the University of Catania, Sicily, where he currently directs the European School of Cognitive Therapy (ALETEIA International).