Right brain-to-right brain psychotherapy: recent scientific and clinical advances

Abstract

This article overviews my recent acceptance of a Lifetime Achievement Award from Sapienza University of Rome, in which I discussed three decades of my work on the right brain in development, psychopathogenesis, and psychotherapy. In the following, I offer current brain laterality and hemispheric asymmetry research indicating that right brain emotional and relational processes operate beneath conscious awareness not only in early human development, but over the lifespan. I discuss recent interdisciplinary studies on the central role of ultrarapid right brain-to-right brain intersubjective communications of face, voice, and gesture and the implicit regulation of emotion in nonverbal attachment dynamics. Special emphasis is on the fundamental psychobiological process of interpersonal synchrony, and on the evolutionary mechanism of attachment, the interactive regulation of biological synchrony within and between organisms. I then present some clinical applications, suggesting that effective therapeutic work with "primitive" nonverbal emotional attachment dynamics focuses not on conscious verbal insight but on the formation of an unconscious emotion-communicating and regulating bond within the therapeutic relationship. Lastly, I review recent hyperscanning research of the patient's and therapist's brains during a face-to-face, emotionally focused psychotherapy session that supports the right brain-to-right brain communication model. I end suggesting that the right brain is dominant in both short-term symptom-reducing and long-term growth-promoting deep psychotherapy.

Keywords: Affect regulation; Attachment; Hyperscanning neuroimaging; Intersubjectivity; Psychotherapy; Right brain; Right temporoparietal cortex; Synchrony; Unconscious.

Fig. 1

Unconscious processing of the “lower”, “bottom up” early developing implicit right brain and subsequent connections into the “higher”, “top down” later developing conscious explicit left brain. Note the vertical axis of the emotional right brain on the right side of the figure

Fig. 2

Channels of face-to-face communication in primary intersubjectivity. Protoconversation is mediated by synchronized eye-to-eye orientations, vocalization, and hand gestures all acting in coordination to express interpersonal awareness and emotions. From Trevarthen [16]

Fig. 3

Top-down view of right-lateralized interbrain synchronization of a spontaneous bidirectional nonverbal communication. Adapted from “Toward a Two-Body Neuroscience.” From Dumas [48]