The link between depression and sense of self lies in the complexities of the right hemisphere of the brain. From the moment we are born, the development of a sense of self does not occur in isolation, but rather through the infant’s interaction with a mature right brain of an adult, predominantly that of the mother.

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Injurious experiences from childhood – separation, distress, fear and rage – affect the development of our brain and have an important impact of our sense of self that is at the heart of conditions such as depression or anxiety. Depression itself is clearly related to the client’s limited sense of himself and is usually triggered by interpersonal or relationship difficulties which unconsciously have resonance with the original attachment relationship.

Troublesome relational events, such as loss of or rejection by a parent, divorce, emotional neglect, parental depression or other absence (Schiffer, 1988), get “affectively burnt in” to our developing brain (particularly the right hemisphere). The negative effect these experiences have on affect regulation in the infant, curtail successful development of brain’s right hemisphere thereby interfering with the development of the self, this also endows the individual with a ‘right hemispheric advantage’ for processing negative emotion (Schore & Schore, 2008). Given the close connection between the right brain and the limbic ‘felt sense’, this will leave the affected person with more of a predisposition to negative feeling experiences and emotions, and may cause them to be more easily stuck in depressive interlock.

Damasio (1999) writes that depression, in its acute and severe stages, exhibits alterations in extended consciousness, causing the sense of (autobiographical) self to shrivel. Yet in the ‘something to be known’ of reactivated memories lies an opportunity for the client to re-experience and derive new meanings about his own identity and expand consciousness:

“Sets of memories which describe identity and person can be reactivated as a neural pattern and made explicit as images whenever needed. Each reactivated memory operates as a ‘something to be known’ and generates its own pulse of core consciousness.” (Damasio, 1999).


Resolving memory

The right type of psychotherapy (body-based, somatic) in a finely tuned, responsive therapist-client relationship can effect a rewiring of the client’s right brain by mind and body, in this respect therapy is not a talking cure but a limbic system ‘communicating cure’ composed not just of two minds but of two bodies. The therapist can work with a client to help them understand patterning from their past history, and help them to resolve memories particularly those associated with negative emotions such as anger, sadness, fear, hurt, guilt and shame. Clients can then safely re-present old traumatic or negative memories from much younger ages and take new insights and meanings that will reinforce a more resilient sense of self.


Mindfulness can help

Schwartz (2002) suggests that the mind can affect the brain in that neuronal connections in the brain can be remodelled by consciously strengthening certain pathways (in particular in the neo cortex and precuneus) and inhibiting the pathological ones (those between the frontal cortex and basal ganglia). Thereby the inherent plasticity in the adult brain can be utilized by drawing on the brain’s higher order functions to change its own neuronal structure. Shwartz refers to Teasdales et al’s work (Williams, Teasdale, et al, 2007), by using mindfulness-based practices to develop what is often called the ‘witness mind’, the mind can learn to experience negative thoughts ‘simply as events in the mind’ (Schwartz, 2002). This seems to serve a similar purpose to Korzybski’s ‘silence’ and ‘orders of abstraction’, thereby allowing the emergence of new meanings and a more complete map of the self.

Stopping the automatic patterns

Stopping the automatic patterns of pathways of ‘depressogenic thinking’ allows people to find new ways to

think about their feelings. The mindfulness model encourages people to ‘stay with’ the bodily sensations (felt sense) and allows the emergence of new understandings and meanings thereby changing their emotional responses to internal affective events and thoughts. This breaks the strong physical (somatic) connection between unhappy thoughts and memories which causes the ‘depressive interlock’, so that new understandings may be encoded from the somatic cues that triggered the depression (Schwartz, 2002).

Perhaps even more powerfully, “the empathetic therapist’s capacity to regulate the patient’s arousal state within the affectively charged non conscious transference and countertransference relationship is central to clinical effectiveness.” (Schore & Schore, 2008).


Therapy as a profound encounter to rebuild sense of self 

The therapist can use implicit non conscious, non-verbal communications in the therapist-client relationship to regulate the client’s limbic response and positively influence dysregulated affective states in a new ‘secure’ attachment. The therapist who has a ‘trained, practiced and disciplined sensitivity’ effectively has a right hemisphere that allows her to know the client “from the inside out” (Schore & schore, 2008) and will thus be able to use her own bodily-based reactions to the client’s communications to facilitate a ‘profound encounter’ (Corsini, 2000). Developed over time, this can allow for expression and re-expression of experiences that resonate with the original mother attachment experiences in the first two years of life to co-create a new secure attachment (Schore, 2008).

In such a deeply connected and sensitive relationship where the therapist is somatically attuned to the client’s right brain, the relationship serves to change the neuronal structure of the client’s right hemisphere so that psychotherapy becomes neurobiology in a right brain to right brain communicating cure (Lewis et al, 2001).

Implicit in this is the process of body-based communications (as in body-based psychotherapy), as Schore says:

 “The body is clearly an instrument of physical processes …. This sensitive instrument also has the ability to tune in to the psyche: to listen to its subtle voice, hear its silent music and search into its darkness for meaning.” (Schore, 2008)

For more information visit Embodied Counselling



Susan Tupling

I am a UKCP registered clinical psychotherapist, certified yoga and meditation teacher and a qualified therapeutic and executive coach. My specialist areas of expertise includes; Neurolinguistic Psychotherapy Pesso Boydon System of Body-Based psychotherapy Neuro linguistic programming Clinical Hypnotherapy Mindfulness and Meditation.