The Case of Yael by Louis Breger, Ph.D.
To what extent is Lou providing some of this care (in an appropriate manner) in his ongoing relationship with Yael? To what extent is Lou receiving a dose of oxytocin when he works with Yael? Is Yael’s early dependency on Lou a source of even greater “addiction” on Lou’s part to his work with Yael (and other patients he is seeing as a “workaholic”)? Perhaps, as their relationship matures, there is less of a need for (and less of a potential for) an oxytocin “fix” on Lou’s part. There might have even been a tempering of the “fix” when Lou was being supervised during his psychoanalytic training. Is a monitoring of the oxytocin fix, one of the reasons for the supervision of newly-minted psychoanalysts? While this monitoring of the fix might not be in handbooks on psychoanalytic training, it might reside “unconsciously” (or at least unacknowledged) in the actual training and supervision procedures of many psychoanalytic institutes.
Finally, we can turn to an even more controversial area of social neurobiology–the so-called “mirror neurons.” There is considerable evidence suggesting that there are a set of neurons in each of us that fires when we are observing another person engaged in a particular activity (such as playing tennis) or even experiencing a specific emotion (such as grief). These neurons, furthermore, tend to reside nearby the neurons that would fire if we would ourselves be engaged in this activity or would be experiencing this specific emotion. Some social neurobiologists go so far as to suggest that the human capacity for empathy requires the reciprocal firing of mirror neurons when we are with someone (about whom we care) that is experiencing a specific emotion. To what extent are mirror neurons in Lou firing when he is working with Yael–given that Yael describes Lou as “compassionate” (the very first characteristic on her list)? Furthermore, when Lou is disclosing something about his own divorce, would we find mirror neurons firing in Yael? Does she gain a new level of empathy when Lou does some disclosing? Could this empathy, in turn, help prepare Yael for her own future life as a partner and parent?
We might find that inter-subjectivity and the reality of a third entity in the therapeutic relationship is enforced by the mutual firing of mirror neurons. Mirror neurons might be providing a helpful hand in the establishment of a vital therapeutic alliance. Hopefully, we will know more in the coming years about this complex and often subtle interplay between brain, mind and interpersonal relationships. Thank you Lou and Yael for offering us some grist for the mill in our speculations about this interplay. We might be moving a bit closer to the truth about effective and caring psychotherapy.