Abnormality and neuroscience

communication were the means by which working models were generated, maintained and transmitted to the next generation. This aspect of Bowlby’s theory provides a theoretical backdrop to the process of change evidenced in psychotherapy – a talking cure amidst an empathic, sensitive relationship. This issue will be expanded upon in the next chapter (‘Model of Psychotherapy’).

Accounts of health and pathology which are centred around the issue of needy dependence on ‘the other’, such as those of Bowlby and Fairbairn, resonate well with an approach like the Waverley Model. It proposes that a mature dependence is a virtue, not a sign of immaturity as in the autonomous self of hyper-modernity. In addition, the concept that we internalise our relationships, ie that external experiences become part of our inner world, corresponds with biblical ideas of marriage (two become one); the body of Christ (1 Cor. 12), and that God in-dwells us.

I have sought to affirm the value of a relational emphasis within modern psychological theories, especially via object relations and attachment theory as they began to deviate from Freud’s focus on biological drives. I have argued, however, that all three approaches can be complementary regarding explanations of motivation, rather than in opposition to each other. These theories give contemporary psychological credence to the relational emphasis of the traditional Waverley Model and are made more explicit in the adaptations of it for which this book argues. I have also outlined that from a biblical world-view, all three secular theories (even when regarded as complementing each other to form a broader notion of motivation) are limited by concepts that omit the benefit provided by a God relationship. This latter focus is distinctive of the Waverley Model in articulating the necessary specific ‘object’ (God) of mature dependency which thus defines ultimate health and pathology; normality and abnormality.

In recent years neuroscientific research has added objective weight to the idea that relationality needs to be understood in embodied terms.

Over the past thirty years, technological advances have made it

possible to observe brain maturation via the use of Magnetic Resonance Imaging (MRI). In general, findings show that the brain develops over the whole life span, but that these developments over the first few years are especially important for shaping patterns of relating both in the present and the future. This is because the developing organisation of the brain is a function of both genetic and environmental factors. According to Schore, seventy percent of the structure of the social/emotional part of the human brain is added after birth and is adaptive to early experience. Schore outlines how the social/emotional brain (prefrontal cortex) in particular develops over the first eighteen months in response to our attachment environment. Gerhardt, in relation to emotional regulation (a key issue in pathology), concludes that the scientific evidence shows that babyhood is a crucial time. This is because several systems that manage emotion (stress response, responsiveness of neurotransmitters and neural pathways which encode our assumptions as to how close relationships work) are not fully present at birth. Schore describes the process of neural connection, which is crucial to learning as a ‘use it or lose it’ mechanism. This is evidenced starkly by research carried out on Romanian orphans. Left in their cots all day due to lack of available carers, and thereby deprived of significant relational connection, these children ‘had virtual black holes where their orbito frontal cortex should be’.166 In short, our brains develop in part as a ‘mirror’ of our earliest and most significant carers, and that this ‘plasticity’ has a survival function. Where this environment is intrinsically hostile, either by direct abuse (‘sins of commission’) or neglect (‘sins of omission’), the experience is embodied, encoded in orbito cortical structures which become our temperamental self – deeply set patterns of mistrust, alarm, hyper-arousal etc which form the basis of later pathological patterns if not corrected.

How is correction possible if these patterns are rooted in brain structures? The possibility of correction is biblically founded upon the vocation given to humanity in the creation account of Genesis. Green defines it as:

individuality within community and the human capacity for self-transcendence and morality – that is, the capacity to make decisions on the basis of self–deliberation, planning and action on the basis of that decision, and responsibility for these decisions and actions.167

As Green notes, the concrete outworking of the creation call to be different (holy), when compared to other creatures (animals), finds expression elsewhere in Scripture covering varied aspects of life that may impact upon our mental wellbeing. For example, Leviticus 19 – family and community respect (vv3,32); religious loyalty (vv4–8,25–31); economic relationships (vv9–10); workers’ rights (v13); social compassion (v14); judicial integrity (v15); neighbourly attitudes and conduct (vv16–18); distinctiveness (v19); sexual integrity (vv20–22); exclusion of idols and the occult (vv26–31); racial equality (vv33–34); and commercial honesty (vv35–36). Hope of transformation beyond historically shaped pathological patterns is, as Brueggemann asserts, ultimately rooted in God’s holiness. The possibility exists of not being confined by our history but shaped by the hope of ‘end times’ fullness – restoration of His holy image with which we were originally created.

It can be seen therefore that in aligning our relational patterns to God’s created design (imaging God), we become truly human. In addition, the adapted Waverley Model proposed in this book visually portrays the connection between the external world and our core identity (spiritual area). Furthermore, this identity cannot be separated from our body which may have been impaired due to the impact of non-optimal relational conditions earlier in our development. However, despite these limitations, the Bible offers hope that amidst a God relationship we are still able to transcend such limitations and image God as holy – what Green calls our ‘unassailable vocation’.

Given the evidence outlined in this chapter, it would be expected that in any individual case of abnormality, causal explanations could relate to any or all of the following domains – physical, psychological, social, environmental and spiritual. Consequently, a method of counselling