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by Carol Kershaw and J. William Wade
W. W. Norton, 2012
Review by Diana Soeiro on Nov 6th 2012

Brain Change Therapy

Carol Kershaw, Ed.D. is a licensed psychologist in private practice and J. William Wade, PhD is a psychotherapist at Institute for Family Psychology. They are both members of the American Society of Clinical Hypnosis (founded by Milton H. Erickson, MD in 1957) and they both co-direct Milton Erickson Institute of Houston (TX/ USA).

Their therapeutic approach has its ground on a basic concept "neuroplasticity" that defends the idea that brain, and brain functions, are not fixed throughout life i.e., "individuals have the capacity to inhibit old networks and to condition those that lead toward positive states" (p. xii). William James (1842-1910) was the first to defend this (see Chapter 4: Habits -- The Principles for Psychology, Cambridge, MA/ London, England: HUP, 1983, 1890): "In the organic world (...) the habits are more variable than this. Even instincts vary from one individual to another of a kind; and are modified in the same individual, (...) to suit the exigencies of the case. The habits of an elementary particle of matter cannot change (on the principles of the atomistic philosophy), because the particle is itself an unchangeable thing; but those of a compound mass of matter can change, because they are in the last instance due to the structure of the compound, and either outward forces or inward tensions can, from one hour to another, turn that structure into something different from what it was. That is, they can do so if the body be plastic enough to maintain its integrity, and not be disrupted when its structure yields." (pp. 109, 110).

Starting in the 1960s, and mainly throughout the 70s, new therapeutic techniques stated being developed with a strong influence of Eastern thought, in particular Zen meditation practices. The work developed during the 70s by cardiologist Herbert Benson, from Harvard Medical School, was particularly relevant, supporting that sustained physiological benefits, like reduced heart, metabolic and breathing rates, came from meditation practice. His 1975 bestseller The Relaxation Response intended to validate this giving detailed description of several experiments conducted. Also that same year, another book was published in two volumes by Richard Bandler (b. 1950) and John Grinder (b. 1940), The Structure of Magic I: A Book About Language and Therapy and The Structure of Magic II: A Book About Communication and Change aiming to promote the ability to challenge distortion, generalization and deletion in a client's language -- influenced by the ideas of philosopher Noam Chomsky (b. 1928) -- something they defended it was a powerful element to promote a client's overcoming of a situation/ condition. Their work was also influenced by an older contemporary, Milton H. Erickson (1901-1980), an American psychiatrist specialized in medical hypnosis and family therapy. Bandler and Grinder developed a therapeutic method named Neuro-Linguistic Programing (known as NLP) combining meditation, hypnosis and language use, as a way to transform the brain (neuroplasticity) believing that creating new pathways in the brain (new habits) stimulates a different behavior in the client allowing him/ her to overcome his situation/ condition.

The recently published book, "Brain Change Therapy: Clinical Interventions for Self Transformation", could therefore be said to be an NLP book. Both authors (BTC) and NLP take Milton Erickson as a strong influence. Still, the authors make no mention of NLP and instead state that "BTC starts with the working assumption: Effective therapeutic change must inevitably include a repatterning of neural pathways" (p. 1) or further ahead, "BTC is a therapeutic approach based on neurological research demonstrating that learning alters the brain by changing the number and strength of synapses and that people have the ability to turn brain circuits on and off in a way that changes their psychophysiological states" (p. 61). I have some reservations on how different is NLP from BTC: is it any different? But moving ahead, what has this book to offer and who is its potential audience?

One of this book's achievements is that it can be read both by therapists and clients. And this is an achievement because it is hard to imagine how can a book communicate and relate to both, simultaneously. Any therapist in practice will benefit from reading this book, in the sense that it offers a very clear presentation of its principles and method, accompanied by questionnaires, charts and an up to date of complementary software and exams available. On the other hand, a therapist's client can also find it very helpful because the language is informative and clear, and along with a description of the method, a brief, and not over-explanatory, note is given on the neuropsychological processes' involved in each step.

Aside from a simple and clear language what it also helps to access information and ideas presented is the book structure. Each chapter has several sub-divisions, which helps the reader to follow, and focus, on the topic, while feeling guided.

Chapters 1-3 goes from description to diagnosis: how is the nervous system structure, which are its electrochemical process, anatomy and physiology; and what are the neural patterns and emotional circuits (seeking, rage, fear, lust, care/ nurturing, panic, pain). Here, we're reminded that BTC's goal it is not to eliminate an emotional state but to create flexibility, helping the client to observe the process and working with it, in order to be able to overcome it.

Chapters 4-7 approaches stress, explaining what is and how it manifests in the brain, identifying stress manifestations and possible strategies to deal with it (Ch.4); how Ericksonian hypnosis, through voice use and narrative can be used in BTC ("words change physiology", p. 103) (Ch.5); which brain technology equipment is available nowadays to help bring awareness both to therapist and client of the emotional pattern at stake (Ch.6), and how can both hypnosis and technology can be used together so that the client can observe how to generate alpha-theta brain waves that are believed to create states of in-betweeness, liminal states (p. 161) that are therapeutic gold, enabling brain pattern changes.

Chapters 8-10 approach BTC use in cases of fear (Ch.8); weight related issues (Ch.9) and life-threatening and chronic illnesses (Ch.10).

The last two chapters, show that BTC not only can help overcome a situation/ condition but it can also contribute to create a better self, a more aware one, which will make you have a better work performance (Ch.11) and also feel more balanced innerly (Ch.12), making you able to perceive "the true absence of all boundaries" (p. 310). Hence, "Using BTC, a therapist can assist an individual in developing a nonreactive mind and reconfiguring defensive patterns that have been blocking internal balance and connection with others" (p. 311).

Contrary to what sometimes happens in brain-related approaches of brain and mind interactions, the human side of BTC's exposure as a method prevails over the scientific one -- being no less accurate. This book will allow both therapist and client, to acknowledge what is at stake in BTC, allowing them to decide if the method is something they would like to try and further dwell on.


© 2012 Diana Soeiro


Diana Soeiro (b. 1978). Philosophy, PhD (2011). Postdoctoral Research Fellow at Institute for Philosophy of Language/ New University of Lisbon. Updated information:

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