THINKING ABOUT THINKING This book examines cognition with a broad and comprehensive approach. Draw- ing upon the work of many researchers, McDowell applies current scientific thinking to enhance the understanding of psychotherapy and other contemporary topics, including economics and health care. Through the use of practical exam- ples, his analysis is accessible to a wide range of readers. In particular, clinicians, physicians, and mental health professionals will learn more about the thought processes through which they and their patients assess information. Philip E. McDowell , LCSW, has a private practice in Lowville, New York. He earned a Lifetime Achievement Award from the New York State Office of Mental Health in 2002. This page intentionally left blank THINKING ABOUT THINKING Cognition, Science, and Psychotherapy Philip E. McDowell First published 2015 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 27 Church Road, Hove, East Sussex BN3 2FA Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 Taylor & Francis The right of Philip E. McDowell to be identified as author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data McDowell, Philip E., author. Thinking about thinking : cognition, science, and psychotherapy / Philip E. McDowell. p. ; cm. Includes bibliographical references and index. I. Title. [DNLM: 1. Mental Processes—physiology. 2. Brain— physiology. 3. Cognition. 4. Psychotherapy. WL 337] QP360.5 612.8′233—dc23 2014030932 ISBN: 978-1-138-82396-9 (hbk) ISBN: 978-1-138-82397-6 (pbk) ISBN: 978-1-315-74175-8 (ebk) Typeset in Bembo by Apex CoVantage, LLC After great inference, I came to the conclusion that I hadn’t the foggiest idea what cognition was. —Richard Powers Galatea 2.2 It’s disorienting to grasp that the world itself is neutral and that all the familiarity and unfamiliarity I feel is being carried around in my head. —Verlyn Klinkenborg New York Times June 3, 2009 We humans can tolerate suffering but we cannot tolerate meaninglessness. —Archbishop Desmond Tutu Sensation tells us a thing is. Thinking tells us what it is this thing is. Feeling tells us what this thing is to us. —Carl Gustav Jung Figures 1.1, 1.3, 2.2 and 2.6: Katherine McDowell Patterson Figures 4.5, 4.6 and 4.7: from On the Origin of the Human Mind by Dr. Andrey Vyshedskiy. Published by MobileReference. Copyrights MobileReference and Dr. Andrey Vyshedskiy Figure 4.1: adapted from How the Mind Works, Steven Pinker, Penguin Press, 1997, page 87. Figures 4.2 and 4.3: adapted from How the Mind Works, Steven Pinker, Penguin Press, 1997, page 103. CONTENTS List of Illustrations viii Introduction ix 1 Thinking about Psychology 1 2 Thinking about the Brain 42 3 Thinking about Emotions 68 4 Thinking about Thinking 90 5 Thinking about Our Selves 141 6 Thinking about Science and Contemporary Issues 174 7 Re-Thinking Psychotherapy 221 Bibliography 245 Index 255 ILLUSTRATIONS 1.1 Human Eye 22 1.2 Ponzo Illusion 23 1.3 Human Ear 24 2.1 Gross Brain Organization 45 2.2 Neuron 47 2.3 Brain Lobes 49 2.4 Brodmann’s Areas 50 2.5 Association Areas 50 2.6 Synapse 58 4.1 Knowledge Representation of “Cat” 95 4.2 Computer Model of “Cat” and “Squirrel” 97 4.3 Neural Model of “Cat” and “Squirrel” 98 4.4 Visual Illusion/Ambiguity 99 4.5 Triangular Representation of a Neuronal Ensemble 116 4.6 Pyramid Model of a Neuronal Ensemble 117 4.7 Polyhedron Model of a Neuronal Ensemble 117 5.1 Drawing by Adult Survivor of Childhood Abuse: Initial Presentation 158 5.2 Drawing by Adult Survivor of Childhood Abuse: Early in Therapy 159 5.3 Drawing by Adult Survivor of Childhood Abuse: After Therapeutic Rapport Is Established 159 6.1 Utility and Prospect Theories Psychological Model 180 INTRODUCTION I have been a practicing psychotherapist for over 40 years. The essence of psychotherapy—the art and science of using (primarily) verbal communication, which is one expression of cognition, to address problems of thinking, feeling, and behaving—is thinking about thinking. I received my graduate training in psychotherapy at the University of Michigan in the 1960s. The knowledge and skills I acquired were labeled social casework. The practice of psychotherapy was limited to psychiatrists and a small group of others who had undergone training at a recognized psychoanalytic institute in keeping with the teachings of Sigmund Freud and his followers. Since then, there has been a proliferation of research in the psychological and neurological sciences, due in part to new technologies and increased funding. The resulting findings have profound implications for the practice of psychotherapy, yet I am struck by the apparently immense gap between research and practice. This book is my modest attempt to bridge that gap. This book is not designed to be a complete exploration of the subject. My intended audience includes psychotherapists; students of neuroscience, philosophy, psychology, and psychotherapy; and general readers who desire a better grasp of how we try to understand ourselves and the environments in which we function. I have provided references in the manner accepted by scientific publications, as well as recommendations for further reading, in the bibliography. I also recommend that anyone interested in the latest thinking about psychology and neuroscience become a subscriber to Scientific American Mind magazine. An early scientific principle entitled Occam’s razor suggests that given alterna- tive explanations we should choose the simplest until the more complex provides more compelling evidence—a historical rendition of the modern acronym KISS: Keep It Simple, Stupid. This parsimony is congruent with my Scottish heritage, so x Introduction I have tried to apply it to the consideration of an obviously complex subject. In doing so, I also have had to contend with Einstein’s razor: “Everything should be made as simple as possible, but no simpler.” Here the great scientist warns that over- simplification can lead to false conclusions. I hope that I have had some success in conveying the depth and richness of cognition without rendering it unrecognizable to my intended audience. Research findings should lead to hypothesis formulation, testing, and replication. Reports in the popular press do not always make clear the degree to which findings have been supported by rigorous application of the scientific method, resulting in what has been referred to as “brain porn.” Neuroscientific explanations, even irrelevant ones, can imbue an argument with unwarranted credibility. I have tried to avoid this pitfall by citing esteemed science thinkers and researchers, while selec- tively referencing a few popular science writers, including Malcolm Gladwell, Sarah Begley, and Wray Herbert. The clinical vignettes are altered to protect the identities of the patients. Some have a kind of fairy tale quality to them due to my distilling a vast amount of clini- cal data to illustrate the utility of a specific intervention. All are anecdotal and do not represent scientific evidence of the effectiveness of a particular intervention. Any resemblance to actual persons or patients is coincidental. Ultimately, this book about thinking is about my thinking. It is my interpretation of the scientific data, combined with my professional and personal life experiences. I owe a great debt to the thousands of patients who over the years have trusted me with their most intimate thoughts and feelings. Many colleagues have enriched my understanding of how we think, especially those during my 29 years as director of the Lewis County (New York) Community Mental Health Center. Thanks to Ruth Spina for her thoughtful review of the first draft of this book and for her helpful comments on matters scientific. Joanne Freeman has been a delight to work with as an editor, smoothing my text so that even I could under- stand what I was trying to say. George Zimmar of Taylor and Francis has encour- aged and challenged me and deserves special gratitude for taking a chance on this first-time author. Finally, my beloved wife, Martie, and daughters, April and Kate, have been a constant source of support and inspiration, shaping the way I think in the most positive way. 1 THINKING ABOUT PSYCHOLOGY In the beginning of heaven and earth There were no words, Words came out of the womb of matter And whether a man dispassionately Sees to the core of life Or passionately sees the surface The core and the surface Are essentially the same, Words making them seem different Only to express appearance. If names be needed, wonder names them both: From wonder into wonder Existence opens. — Tao Te Ching (translated by Witter Bynner) As the blade of a sword cannot cut itself, As a fingertip cannot touch itself, So a thought cannot see itself. — Robert Allen, A Thousand Paths to Zen Featuring works made from the 1960s to today, “ Telling Secrets” centers on the par- ticipatory role of the viewer in contemporary art and the strategies that artists use to encourage multiple interpretations of their work. Prior to the twentieth century, most art aimed to tell familiar stories or reflect everyday life and accepted social mores.