By Susan Morse
Washington Post Staff Writer
Tuesday, March 23, 2004; Page HE04

The next time you lock horns with your boss, your friend or your spouse and she tells you to leave emotion out of it, tell her that science proves that's a lousy idea. Block that emotion and all you're likely to produce are bad decisions.

That heretical insight is at the heart of a revolution today in neuroscience and psychotherapy. More on that below. But the story, as told at the conference by Chicago-area marital therapist Brent Atkinson, starts with a 19th-century medical patient.

Phineas Gage was a railway worker who in 1848 had a 31/2 -foot iron rod blown through his skull in an explosion. To the surprise of doctors, he survived. Though he recovered physically with his intellectual faculties and motor skills intact, he was a changed man. He swore constantly, appeared fitful and abandoned plans as fast as he made them. Not until the 1990s -- when scientists produced computerized brain models based on photos of his skull -- was the reason for his character change confirmed: damage to the prefrontal cortex, a brain region that processes emotions governing social behavior.

Since then, similar behavior has been observed in some patients with brain damage from stroke, seizure or surgery. In each case, researchers have traced behavioral problems to the loss or malfunction of an emotion-processing center.

"If that [neural connection to emotional memories] is broken down," says University of Iowa neuroscientist Antonio DaMasio about one such case, "you're at the mercy of facts and logic, and that just is not enough."

What does any of this have to do with psychotherapy practice today? Simply this: If emotion is so central to our behavior that we can't bypass it without cost, then therapeutic approaches that appeal principally to logic and reason are bound to fail.

At least that's the conclusion of Atkinson, who told fellow counselors this month how this idea has transformed his practice.

For 15 years or so, Atkinson has been introducing his clients in The Couples Clinic to a simplified lesson in affective neuroscience, borrowing heavily from research pioneer Jaak Panksepp.

Through his studies, Panksepp, distinguished research professor emeritus of psychology at the Medical College of Ohio at Toledo, has shown evidence for what he calls seven "executive operating systems" powered by emotional centers in the brain. These systems include: goal-seeking (a state linked to productivity and creativity), rage, fear, lust, care, sorrow and play. Panksepp has shown that these states, and their characteristic behaviors, can be triggered by stimulating different brain regions with an electrical impulse.

At The Couples Clinic, Atkinson doesn't emphasize conventional marital therapy strategies, like encouraging partners to listen more attentively and make only "I statements" (as in "When I hear you say that, I feel hurt"). Instead, he trains partners to recognize their own emotional states -- often tricky, he says, given that "we're driven by neural states our brains are not set up to make us aware of." Then he teaches them to shift out of some of these states -- those less conducive to listening or responding fairly, like rage or fear -- before they rejoin the fray.

If emotion is a critical faculty, why the need to shift? Because while bypassing emotion is problematic, being ruled by it is no good either, neuroscience shows.

In his lecture this month, Atkinson showed videotaped portions of a session with one couple, identified as Steve and Kristi, who'd argued on their way to therapy and arrived in full feather, barely speaking to one another.

While Kristi took herself to another room to try to "self-soothe," following written guidelines, Atkinson talked to her more visibly angry partner. "What does it feel like?" he asked Steve more than once. As Steve worked to describe his body's response, down to the knot in his stomach, his manner began to change, his anger (rage state, says Atkinson) to subside.

By the time Steve met with Kristi again, he spoke to her sadly, with tears in his eyes (read: sorrow state). It wasn't that easy, of course, and Atkinson says learning to self-soothe and change states takes regular practice. The more intelligent clients are, he says, the more they think they can do it without practice. Says Atkinson, "That's baloney." •