Dr. Daniel J.

Siegel

a david van nuys interview

22 The Neuropsychotherapist issue 1 April-June 2013
“W
e can promote compassion, integration, and kindness.” So says my guest, Dr. Dan
Siegel, discussing his latest book Mindsight and the organization he has founded,
The Mindsight Institute. Daniel J. Siegel, MD, received his medical degree from
Harvard University and completed his post-graduate medical education at UCLA
with training in pediatrics and child, adolescent, and adult psychiatry. He served
as the National Institute of Mental Health Research Fellow at UCLA studying family interactions with an
emphasis on how attachment experiences influence emotions, behavior, autobiographical memory and
narrative.

Dr. Siegel is currently a clinical professor of psychiatry at the UCLA School of Medicine where he is also
on the faculty of the Center for Culture, Brain, and Development and the Co-Director of the Mindful Aware-
ness Research Center at UCLA. An award-winning educator, he is a Distinguished Fellow of the American
Psychiatric Association and recipient of several other honorary fellowships. Dr. Siegel is also the Executive
Director of the Mindsight Institute, an educational organization that focuses on how the development of
mindsight in individuals, families and communities can be enhanced by examining the interface of human
relationships and basic biological processes. His psychotherapy practice includes children, adolescents,
adults, couples, and families.

Dr. Siegel has published extensively for the professional audience. He is the co-editor of a handbook
of psychiatry and the author of numerous articles, chapters, and the internationally acclaimed text, The
Developing Mind: Toward a Neurobiology of Interpersonal Experience. This book introduces the ideas of in-
terpersonal neurobiology and has been of interest to and utilized by a number of organizations, including
the U.S. Department of Justice, The Vatican’s Pontifical Council for the Family, Microsoft and Google, early
intervention programs and a range of clinical and research departments worldwide. He has been invited to
lecture for the King of Thailand, Pope John Paul II, and His Holiness the Dalai Lama.

Dr. Siegel serves as the Founding Editor for the Norton Professional Series on Interpersonal Neurobiol-
ogy, which also includes more than 20 textbooks. His book with Mary Hartzell, Parenting from the Inside
Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive, expresses the application
of this newly emerging view of the mind, the brain, and human relationships. His professional book, The
Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being, explores the nature of mindful
awareness as a process that harnesses the social circuitry of the brain as it promotes mental, physical, and
relational health. His book Mindsight: The New Science of Personal Transformation offers the general reader
an in-depth exploration of the power of the mind to integrate the brain and promote well-being. His latest
professional text, The Mindful Therapist, explores the application of these ideas for the clinician’s own devel-
opment of mindsight and neural integration.

Dr. Dave: I am really happy Dr. Siegel: Well, I had been encountered [some] professors
to have this opportunity to meet a biochemistry major in college who had this really unfortunate
with you and to discuss your and also very interested in oth- trait, in which they treated peo-
work. As I was reading your lat- er things, like people, basically. ple as if they were bags of chemi-
est book, Mindsight, I appreci- And I had worked on a suicide cals rather than having a center
ated reading about some of your prevention service and was on a of subjective mental life—a core
personal struggles as a young dance team, and things like that. I aspect of the essence of their hu-
medical student at Harvard. You thought medical school would be manity. Instead they were treated
actually dropped out of medi- a great opportunity to blend the just like they were a bunch of en-
cal school for a time because of real passion I had about people zymes in need of surgery or medi-
what you felt was missing in the with my background in science. cal prescriptions or whatever.
curriculum at that time. Tell us a And the science was very useful, I was very young when I started
bit about what led to that disaf- of course, for learning the techni- school and I think my youth, and
fection and what you did during cal aspects of medicine, but when also my idealism, just made it so I
those intervening years before I was a young student in my first tried my best to do what I thought
returning to Harvard Med. and second year, unfortunately I you were supposed to do, which

www.Neuropsychotherapist.com The Neuropsychotherapist 23

 is to learn from your teachers. But the more tion that the mind was real. I could then use
and more I learned from these particular mindsight in my own inner world to—this
people who didn’t see the mind—a word I is back in 1981—say, “Look, some people
coined as mindsight—they seemed to lack don’t see the mind. They are my anti-role
this thing called mindsight; to see the mind. models, and if they’re my professors, I have
I got very depressed and disillusioned with to not be like that.”
the whole experience and ultimately came And then I saw with my medical pa-
to the Dean of Students after one particu- tients, when I saw their minds, when I could
larly horrendous interaction with a supervi- really relate to their feelings and ask them
sor during a final physical examination re- what they’re thinking, what they remem-
view. It’s a long story, but the bottom line bered, what had meaning for them, the sto-
was how very painful it was to see the way ries that emerged and the feelings that ac-
he treated the patient; not in a very kind companied them seemed to help them get
or empathic way. So I went to the Dean of better.
Students and I just basically said, “I can’t go Ironically, I finished medical school,
on anymore. I’m dropping out.” While in my went into pediatrics, went into psychiatry,
mind I was dropping out, she insisted that I went into child psychiatry, went into re-
just take a leave of absence, which I thought search psychiatry, become a scientist study-
would be a leave forever. ing narratives and emotion regulation and
I ended up spending a little under a ultimately I started teaching about that kind
year actually. I loved dancing in college, so of stuff and coming up with new ideas about
I thought of becoming a dancer and a cho- it. But years later, it was maybe 25 years af-
reographer. I pursued that for a while and ter the day I decided to drop out of school, in
then when I decided that wasn’t going to be the very room that I decided, a place called
my calling for all sorts of reasons I travelled the Ether Dome—I was back there giving a
across Canada to become a salmon fisher- lecture, invited to give the opening keynote
man, and that didn’t exactly work out for all address to Harvard on the importance of
sorts of reasons too. I came back and worked stories and emotion in the development of
in Los Angeles as a sound technician for a health.
film crew who were filming the performing
arts at Royce Hall, UCLA. During that time What a triumph!
I had surgery, and John Lennon was unfor-
tunately assassinated. I woke up out of the It was unbelievable. My son was there. It
anesthesia and heard this news report that was just incredible.
Lennon was killed and I couldn’t believe it.
In my mind, it was like, “why in the world To come full circle like that must have
would a person kill John Lennon?” And it been so gratifying?
kind of opened my mind to other things
that had been cooking during that time off It was.
of travel and dance and stuff: what is the
mind? What is in the mind of this murderer Now mindsight is a new term that you
that would get him to take such an incred- introduced into our therapeutic vocabu-
ibly benign and contributing member of our lary. What do you mean by mindsight?
society and kill him intentionally?
So that really opened up my own aware- Well, originally the word mindsight back
ness of the idea that you could try to figure in 1980-81 was just a little private term I
out what was going on in people’s minds made up, describing how you see the mind.
and try to help those minds get better. And then as I went through my training at
And through a series of different things I medical school, it helped me remain sane,
ultimately decided to go back to school basically. And then when I became a psychia-
because it was actually faster for me to be- try trainee I saw that there’s something very
come a psychiatrist than to become a psy- special about knowing how we as clinicians
chologist because I was halfway done with see the inner, subjective world of another
medical school. So I went back to Harvard person, the mental life of another person,
armed with this year off and the convic- to see inside. But when we teach them—our

24 The Neuropsychotherapist issue 1 April-June 2013

clients, our patients—how to
develop the skill of seeing the
“why in the world would
mind, perceiving the mental a person kill John Lennon?” And
world, they can then start to
work with that inner life in a it kind of opened my mind to other
very different way. So mind-
sight, then, became more than things - What is the mind? What is in
just insight into yourself or
empathy for another person. the mind of his murderer that would
Those are very, very impor-
tant, but it became also, how
get him to take such an incredibly be-
do you shape your own inter-
nal world, or help another per-
nign and contributing member of our
son shape their internal world
toward health? So now mind-
society and kill him intentionally?
sight is a term that means
how you perceive the inner is something that’s been around for thou-
world and then move that world towards sands of years. It’s been in the East, in the
something I call integration, which we can West, also used in contemporary practices,
talk about. Integration is basically a process in religion, in contemplative traditions. So in
where you link different elements to one Buddhism, for example, and Hinduism, and
another, and in the world I work in we con- the Islamic faith, and Judaism, and Christi-
sider integration as health. So mindsight al- anity, in Lakota tradition, in all sorts of tradi-
lows you not only to see the inner world of tions, there’s an effort to encourage mem-
yourself or others, it helps move that world bers of that culture to focus on the present
in yourself or others toward wellbeing be- moment, to not be swept up by judgments
cause it promotes integration. and expectations, and to then use this abil-
ity to focus your mind, your attention, on
Mindsight sounds a lot like mindfulness. the present moment sensory experience so
Is there a difference? that you’re not suffering. So it allows you
to distinguish, for example, between self-
Yes. The two words that people always created suffering and inevitable pain in life.
ask me about—and it’s a very important So suffering might be seen as coming from
question—one is mindfulness and the other saying, “Oh! I shouldn’t have hit my knee! I
is something called mentalization. I’ll start shouldn’t have hit my knee! What a clumsy
with the mentalization part. guy I am. I’m so clumsy! Look how I’ve done
Mentalization is a term [coined by] that to myself. Oh, I’m so bad! I’m so bad.”
Peter Fonagy and Mary Target and Howard All that negative talk would create suffer-
and Miriam Steele; these are fabulous re- ing, when instead I’ve just bumped my knee.
searchers in London. In the ‘90s and in the Mindfulness, just as a little example
last decade, the 2000s, they studied the way there, has you pay attention to the present
parents see the inner mental life of a child. moment, as Jon Kabat-Zinn has beautifully
And when parents reflect on that inner life described it: in a purposeful way without
for themselves—something called reflective being swept up by judgments. Other people
function for their child—they’re basically us- describe it as imbued with a feeling of kind-
ing mentalization; they’re seeing things in ness, an attitude of compassion toward the
mental terms. self and others. And that’s mindfulness.
So mindsight of course embraces Now mindsight, this term I made up
those fantastic studies on mentalization before I even knew there was a term called
and sees that seeing the mind is at the core mindfulness, embraces all those fantastic
of something called “secure attachment.” practices of mindfulness, but it’s not the
It’s really good for developing resilience same, because mindsight is the way we
and thriving, really. Mindsight overlaps with monitor energy and information flow in our
that, but it’s not the same—I’ll explore that relationships. So like we are sharing right
in a moment. Mindfulness, the next word, now between you and I, the way we’re shar-

www.Neuropsychotherapist.com The Neuropsychotherapist 25

 mindsight is the ability to perceive energy and information
flow in your subjective mental life, in the sharing of relationships,
in the mechanism of the body,
and then move that flow toward integration
ing with people who might listen to this in- distributed throughout the body.
terview—that’s a relationship, the sharing of
energy and information flow. Then there’s Exactly. So here’s what happened. The
the embodied part. There’s the mechanism thing that I brought together was actually
of energy and information flow that extends a think tank of forty scientists, and it was
from your toes to your nose. It’s basically a at UCLA back in 1992, the beginning of the
neural mechanism and you can learn to be- decade of the brain. Our task was to just ask
come sensitive so you perceive or monitor the question, “What is the connection be-
this flow. And then basically whether the tween the brain and the mind?” These were
flow is happening in your body—the em- anthropologists, sociologists, linguistics
bodied brain, I call it—or in your relation- people, these were people from neurosci-
ships (the sharing is the relationships and ence, one neurosurgeon was in the room,
the mechanism is the embodied part), you psychology, all sorts of groups were there
can then use the focus on energy and infor- —forty people from over a dozen different
mation flow to move that flow towards inte- disciplines of science. We could all agree on
gration. This is something that’s not talked what the word brain meant. No one knows
about in the mindfulness world, it’s not exactly how the brain works, but we knew
talked about in mentalization. You can look it was composed of basic cells distributed
at mindsight this way: if you took a triangle throughout the whole body, but many of
and said there’s relationships—one point of them in a spider web-like set of connections
the triangle; there’s the brain—the second in the skull itself. We were learning lots of
point; and there’s an emergent property new, exciting things back then in the be-
that we call the mind—the third point on ginning of the decade of the brain because
the triangle.. Basically what we are saying is technology had allowed us to look beneath
that mindsight is the ability to perceive en- the previously opaque skull and see what
ergy and information flow in your subjective the functioning of this stuff was, looking
mental life, in the sharing of relationships, at the skull part of the brain. I use the word
in the mechanism of the body, and then brain to mean the embodied nervous sys-
move that flow toward integration. And so tem, but brain is a lot easier to say.
that’s how mindsight is distinct from mind- So here we were, ready to turn to
fulness, which it embraces, and mentaliza- the mind, and these scientists could not find
tion, which it also embraces but it takes it any common ground on what to say about
into the realm of health and integration in what that word meant! And this was really,
body and in relationships. really frustrating, and the group was basi-
cally going to implode and disappear. So I
I was interested to read that you called took myself for a walk, as the person who in-
together a conference of peers, and that vited everyone into the group, and the next
you experienced some frustration looking time when the group got together I offered
for a definition of “mind” because nobody a definition, the one you quoted. Basically
had a good one, and you ended coming up that one part of the mind—not the whole
with your own, which you’ve alluded to mind (because of course the mind is con-
here, and I’ll quote: “The human mind is a sciousness and subjective experience and
relational and embodied process that regu- beauty and love and poetry and everything
lates the flow of energy and information.” is a part of mental life like that)—can be de-
One of the things I especially appreciated fined as the way energy and information
is your emphasis on the whole body, that flow is regulated. So we say it’s a relational
the mind is not just in the brain that’s in the and an embodied process that regulates
skull, but that the brain is in some sense the flow of energy and information. Now

26 The Neuropsychotherapist issue 1 April-June 2013

when you say it like that you need to under- a revolution, I just think it’s a natural evolu-
stand that at that moment, saying it to this tion—that we’ve had a field of mental health
group, every single one of the 40 scientists that didn’t define the mental, and now it’s
said, “Yes, this is a place we can begin our natural to just define it together. A working
discussion. This fits with everything I do.” definition.” When you say it’s relational and
Anthropologists would say, “Yes, I study the embodied, it honors the power of relation-
way energy and information flow is shared ships, and of course that makes people nerv-
in relationships across generations. That’s ous because then they don’t own their mind.
what culture is! So that’s fine with me.” A Of course anyone in a relationship knows
neuroscientist said, “Yeah, I put a person in you don’t, it’s dependent on everyone else
a scanner, I have energy flow (let’s say from in the relationship. And then the embodied
a picture) and the moment it has meaning part means every psychotherapist needs to
(information) I see what parts of the brain know about the nervous system, brain sci-
are activated. I’m looking for energy and in- ence and biology, which of course makes
formation flow in the brain itself. And that’s them nervous, but that’s what it means to
fine with me.” So the group with 100% con- be a professional. We need to know about
sensus went on to meet for four and a half relationships and the embodied brain also.
years. When you say it’s a regulatory pro-
cess—here’s the exciting thing—it means
Oh, that’s great! you have to monitor something, like when
you’re watching where you’re driving a car,
Yeah. Four and a half years, and you and modify that thing. And so the thing is
know the exciting thing was we could go energy and information flow, energy being
deeply with that working definition. Now, the capacity to do stuff is how a physicist
just so we’re on the same page about this, defines it. Information is a swirl of energy
what this means is that the process says that that has symbolic meaning, like these words
the mind—this core aspect of the mind—is we’re using with each other, and so when
a verb, it’s not a noun, and from a scien- you realize that, you have to monitor and
tific point of view we use the concept of an modify energy and information flow in your
emergent property. The emergent property relationships and in your body, and then we
is something you see by elements of a sys- put in the thing which we can talk about
tem interacting with each
other, give rise to a pro-
cess called an emergent
property, and that’s what
I’m suggesting the mind is The mind is a relational
and the group found that
very useful.
I’ve asked psycho-
and an embodied process that
therapists from every dis-
cipline of psychotherapy
regulates the flow of energy
you can imagine—social
work, nursing, psychol- and information
ogy, psychiatry, all of us
in mental health, “How
many of you have ever
had even one lecture, besides the one I next if you want, Dave, that we’re talking
gave, that defined the mind?” 2–5% say yes. about integration. We don’t just say, “Hey,
It’s always the same; way over 95% say, “I’ve regulate yourself.” We’re actually saying we
never been given even one lecture that de- can define mental health, or any other kind
fines the mind.” of health probably but let’s just stick with
So what people have told me, and I mental health—mental health is integra-
don’t know if it’s true, but they say, “Look, tion, and integration is the linkage of differ-
you’re proposing a revolution in the field of entiated parts. Amazingly, when you’re not
mental health.” And I say, “I don’t think it’s integrated you go to chaos or rigidity.

www.Neuropsychotherapist.com The Neuropsychotherapist 27

 Now when I first came across this of where we’re at in this field, this mindsight
and looked for the science, it blew my mind. approach.
I went to a mathematics book because I
could find no science that said why chaos You spell out functional areas of inte-
and rigidity would be the patterns I was gration, so can you take us through the
seeing in my patients in psychotherapy. highlights of integration?
So I found this book on the mathematics
of complex systems that said when a sys- Well, what happened to me back in the
tem is not linking differentiated parts and `90s, when all this was emerging in my own
maximizing complexity (like a choir singing explorations, was first of all an importance
harmony), when they’re not in this harmo- to stay really close to science. So everything
nious flow, this flexible adaptive, they go I’m saying has a scientific foundation that
to either chaos or rigidity. I opened up the comes from many different disciplines in
Diagnostic and Statistical Manual of Men- science. You won’t see it written anywhere
tal Disorders to any page and every single in one place, but the process is to look for
symptom of every syndrome in that book the common principles across separate dis-
(which has no conceptual framework), was ciplines, and that’s something Wilson calls
an example of chaos, rigidity, or both, and consilience.
I thought, “Oh, my God! This is a book de- The first thing to say is that these
signed not to have a framework,” but now ideas are built from science and then they’re
it can finally have a framework that not just applied in everyday life in parenting and in
says impaired integra- psychotherapy and in schools, in education-
tion leads to any of the al settings, so that there is a practical ben-
The first thing to psychiatric syndromes;
now we know it’s being
efit to these scientific and conceptual ideas.
People would ask me for a practical guide,
say is that these supported by new data
coming out by all sorts
and I would say, “Look, this approach, which
I call interpersonal neural biology, is about
ideas are built of people, to show that
developmental trauma
health, but it is a form of therapy. It informs
therapy, sure, but it’s really a way of bring-
from science and or schizophrenia or au-
tism or bipolar disorder
ing together all the different disciplines of
science and now contemplative practice,
then they’re shows evidence of im-
paired neural integra-
religion, art, music, dance—all these dif-
ferent ways of exploring the truth of being
applied in everyday tion, where the parts of
the brain that link dif-
human and being alive. They’re all welcome
into this conversation. When they said “get
life in parenting ferentiated parts aren’t
working well together.
practical,” then I had to really try to formu-
late what I was doing in my private therapy
and in You can also show suite. When I started teaching students the
that integration can more organized approach to it—these do-
psychotherapy and be promoted through mains you’re talking about—I started teach-
psychotherapy—and ing students and they started applying, for
in schools, in it works. People go example, in integrating consciousness. So
from chaos or rigidity
educational into more harmonious
you say, “What’s that?” Well that’s finding
ways to differentiate awareness from that

settings, so that states of being, which

we call wellbeing. So
which you are aware of and then linking
those. “What other kind of integration?”
there is a practical the framework has em-
bedded in it a definition
Well, there’s something called bilateral in-
tegration: the difference between the left
benefit to these of health, a pathway to
understand how inte-
hemisphere and the right. There’s a beauti-
ful book called The Master and his Emissary
scientific and gration is health, im-
pairments lead to cha-
by Iain McGilchrist that explores these dif-
ferences between left and right. What we’ve
conceptual ideas. os or rigidity, and a plan
for what you can do
been doing is exploring how you integrate.
To honor the differences, promote the dif-
about it. So that’s kind ferences, then cultivate connection. Here’s

28 The Neuropsychotherapist issue 1 April-June 2013

the thing: integration is not the same as Well, it’s so beautiful when I hear that be-
blending. It’s not like a smoothie, it’s more cause what we’re looking for is consilience.
like a fruit salad; you maintain your indi- The sages and wise elders, all of whose
vidual identities so that the whole is greater shoulders we stand upon, if this works then
than the sum of the parts. this framework should meet the criteria for
So that’s the key of integration. Jungian analysis, and psychoanalysis from
There’s bilateral integration, then there’s a Freudian point of view, cognitive behav-
vertical integration that is honoring these ior work, EMDR work, narrative therapy,
deep, deep processes in the body itself: the work therapy, group therapy; it should fit
muscles, the intestines, the heart, the brain- with contemplative practice. It turns out—it
stem, the sub cortical areas also like the lim- does!
bic area—and how you bring those up into I can’t tell you how exciting it is. I’m of-
cortically-mediated forms of awareness. ten asked to give addresses to each of these
Then there’s memory integration where groups, including the religious groups, and
you literally see how different elements of what people find is that it’s consilient with
synaptic shadows from past experiences their approach. So what I say is that inter-
are embedded in forms of memories, called personal neural biology, this mindset ap-
implicit memory, and you can literally pull proach, is really a place for all of us to come
them together; take the differentiated ele- together and collaborate, to try to bring
ments and link them together in something more kindness into the world.
called explicit memory. You can see how The next kind of integration, inter-
trauma is, in large part, an impediment to personal integration, is all about that. How
memory integration. do you honour differences and promote
If you have an integrated memory, then linkages?—which is basically kindness. Inte-
the next form of integration is narrative inte- gration is kindness.
gration. We are narrative creatures and you
need to have a way where you find mean- I have really been sensing this coming
ing by connecting the past, present, and fu- together. That some kind of “coming to-
ture. Now this connection of past, present, gether” has been happening and we can
and future is really the fundamental core all get under the same tent. It really does
of narrative. Narrative integration allows build on a lot of threads of thought, and
you to become not just a passive historian approaches that I have been articulating;
of what’s happened to you, but actually the ideas like mindfulness, the various func-
active constructor of your own life story. You tions of the brain, gaining a better under-
can be your own novelist. standing of the brain and so on, and the
Then there’s state integration, which role of memory—all of that. It’s beautiful.
is the brains’ capability of being in different One of the things I love about your book,
states. Like one state in me wants to be in too, is that you ground many of these ide-
solitude because I love just getting into the as in case histories. Early in the book you
present moment and going inward. Another relate a case history of Barbara, who suf-
part of me loves to be social. Well, with one fered from headaches. Perhaps you could
body, how do I take these two states and take us through that, because it effectively
give them both what they need? So that’s sets up many of the theoretical points that
just a simple example. State integration is you make.
honoring differences, promoting linkages;
not becoming the same. I don’t say, “Oh, Sure. Barbara suffered from a car ac-
I’ve gotta chose one or the other!” No. I cident, and unfortunately she had terrible
hold onto the opposites within awareness damage to the part of her brain just behind
and I intentionally find harmony by bringing the forehead, in the arc of the steering wheel
them together. because she unfortunately didn’t wear her
safety belt. What happened in taking care of
That sounds very Jungian in a way— her family was the family was falling apart
holding of the opposites is an essential Jun- after this brain damage. Her neurosurgeon
gian concept. lent me her scans and I took her scans to the
library and I looked up the parts of the brain

www.Neuropsychotherapist.com The Neuropsychotherapist 29

 that had been damaged and pursued a sci- did recover in a very deep and powerful way
entific review of what we knew at that time and could do the necessary healing. The les-
(it was a long, long time ago) from the sci- sons learned were profoundly important for
ence of the brain that could help us under- understanding the importance of integra-
stand what areas were damaged and what tion in our relational and mental and neural
the science would tell us about what those health.
areas were responsible for. So ultimately a
list of nine functions that emerged from this Thanks for taking us through that.
area behind the forehead came out, and I We now know that there is this recipro-
could help the family, the children and her cal integration between the brain and
husband, understand why Barbara was not our thoughts, that the brain shapes our
Barbara anymore. Even though she looked thoughts but our thoughts can also shape
similar, because she had plastic surgery, our brain. So what do you see as the deeper
the brain surgery had removed all sorts of implications of this neuro-plasticity?
things. She got better from a physical point
of view, but not from a mental point of view. Oh, it’s huge, Dave! I mean, here’s the
This area of the brain is one of the most power of it. The simplistic model that was
integrative regions; that is, it’s part of the running around a while ago was that the
cortex that links the cortex to areas below brain runs the show. Like they’ll say, “The
it: the limbic area, the brain stem, the body mind is just the activity of the brain, or the
proper. It even makes maps of the firing of side effect of brain activity or whatever.”
other nervous systems, called empathy, and But what we now know is that the brain is
these are mindsight maps of the self. I call constantly changing. Your mind, your men-
them me-maps, or mindsight maps of some- tal life, the process that regulates the flow
one else are called a you-map, and even a of energy and information in your relation-
mindsight map that makes an internal rep- ships and your body, including the stuff up
resentation of a sense of “we”, I call those in your skull, the way you focus energy and
mindsight we-maps. Barbara didn’t have information flow, which is basically how you
any of those maps anymore. The whole pay attention, drives your pattern of think-
family collapsed. ing; you can alter how you feel and it specifi-
These maps we make in our cortical cally activates the firing of certain circuits of
regions, these pre-frontal areas, are neces- neurons. When you make your neurons fire
sary for us to have social and emotional intel- by the energy of your mind and the focus
ligence. They’re necessary for other people of that flow, you can actually get the brain
to feel felt by us. All these ways that Barbara to change not only its firing in the moment,
used to be, unfortunately, sadly, she could but you can rewire it so that it changes its
no longer create because those areas of her synaptic connections. You can grow new
brain, the integrative areas, couldn’t pull all neurons, you can alter the myelin sheath
that stuff together. So the family was able that’s laid down connecting neurons in a cir-
to go through a grieving process when they cuit so that the effect of flow is 3000 times
could understand the truth. That insight, more potent! And now we’re learning—not
about the importance of knowing about in- only synapse formation, neuron formation
tegration in the brain and its role in creat- from new neurons from stem cells in the
ing wellbeing in our families, really started brain, myelin formation—about the cutting
me on a journey to honor relationships—I edge area of epigenesis. You can actually
was being trained as a relationship scien- change the regulation of gene expression,
tist—and to also look at narrative, because and molecules called epigenetic molecules.
we make meaning out of these experiences. The preliminary data is coming in that, for
And this is what the kids and husband had example, if you use mindfulness meditation,
to do to make meaning out of their loss. which is using the focus of your attention in
So I wanted to put together some a very specific way to pay attention to pre-
kind of view that tied relationships, narra- sent moment experience and letting go of
tive, psychotherapy, the brain, and inte- judgments, when you’re taught how to do
gration, all into one perspective. Barbara... that you can actually reduce the destruction
while her situation was so painful, the family of the part of the chromosome called telom-

30 The Neuropsychotherapist issue 1 April-June 2013

 Yakobchuk/Bigstock.com
mirror neurons constantly scan the movements
of other beings, living creatures,
and try to detect predictable patterns
eres. When the telomere destruction is re- it’s down.” We need to just start by saying
duced, you actually, conceptually, theoreti- that mirror neurons are extremely excit-
cally, are extending your life span—we have ing. I think they are an incredible discov-
these ends of chromosomes, and when you ery by some researchers in Italy, Rizzolatti
use them all up your body is ready to die—if and Gallese and others. They were discov-
you can slow down that telomere turnover ered and proven to be in human beings by
by increasing something called telomerase Marco Iacoboni and Itzahak Fried here at
through mindfulness meditation. UCLA, through neurosurgery they were do-
We now know the focus of your mind— ing. There are a lot of contributors to this
that’s all mindfulness meditation is, focusing field, but you need to know, some scientists
your mind in particular ways; it’s very pow- don’t believe they exist. I happen to believe
erful—can change not only the connections in them because I’ve read the research and I
in the brain, but even epigenetic control of really think it’s fantastic. Basically what this
gene expression. So we’re at this incredibly is, and there’s a long history to it but I’ll just
exciting time to empower ourselves to de- cut to the chase, are neurons that constant-
velop our mind with mental training to pro- ly scan the movements of other beings, liv-
mote wellbeing; in body, in relationships, in ing creatures, and try to detect predictable
mental life, in ways we could only dream of patterns. When these mirror neurons detect
before; and now we have the mechanisms a predictable pattern, they have a process
that are just being illuminated to support called the sensory implication of motor ac-
these important steps toward health. tion, and what that means is that, Dave, if
I see you moving your hand toward a glass
Now another factor, mirror neurons, of water and lifting the glass toward your
plays a key role in the interpersonal aspect mouth, I’m going to start predicting that
of your interpersonal neural biology. Take you’re going to drink water. Now my mirror
us through the role of mirror neurons in em- neurons predicting your actions work with
pathy and emotional contagion. an area called the superior temporal cortex
to create a map of your intentional state.
Well, like anything in science you can say So the first step that these mirror neurons
“up” and a bunch of people would say, “No, do is that they are looking for predictable

www.Neuropsychotherapist.com The Neuropsychotherapist 31

 sequences. The next thing they do is they then imagine what we ourselves are feeling
make a neural map of another being’s in- with insight, and then we project really that
tention, which is a mental state. So now I’ve insight into ourselves onto what we imagine
mapped out your intention, and then I can is going on in someone else, which we can
do two things with that mapping of your in- call empathy. That’s kind of the pathway,
tention. and this is how mirror neurons fit into the
The first thing I do is I drive that informa- whole exciting discovery about the nature
tion down into my subcortical areas; these of our relationships with each other.
are all cortical regions—superior temporal
cortex... mirror neurons are in the parietal Is there any final thought that you’d like
area and the anterior area, as well as the to leave us with?
cortical lobe as well as other areas besides
these frontal and parietal regions—and I I think if we do this together, then the
drive it down into my limbic area, and prob- sky’s the limit on what we can achieve. I
ably downward to my brain stem, and make know the world’s in a very painful place for
my body resonate with you. So I might start lots and lots of people all around the planet,
feeling thirsty, for example. We call this “in- but people can now, with all this new sci-
ternal simulation”. entific understanding and this framework
The second thing I’m doing is get- for understanding what wellbeing is, be
ting ready for behavioral imitation; that is, empowered to promote integration and
my hand may try to find a glass, or it may promote compassion and kindness. This is
even happen automatically, and I find a something we can do. We can help affect
glass and I start drinking when you’re drink- global change issues, which is an area I work
ing. Just like when someone yawns and you in. We can work with people in communities
yawn, or someone crosses their legs and that are really struggling to bring this kind
you cross your legs. These are behavioral of resilience from the inside out. And doing
imitations, and there’s also internal simu- this together, I think we can do incredible
lation. So the mirror neurons allow for be- things. So, I want to welcome everyone into
havioral imitation, and through the insula the mindsight community and I look for-
they go downwards—the sub-cortical area ward to meeting people in person.
is rising back up through the insula to the
prefrontal areas, especially the right inte- Dr. Dan Siegel, thanks for being my
rior insula...a twig of it goes over to the right guest today.
anterior cingulate—I just call this whole set
of prefrontal areas the resonance circuits. So Dave, thank you. It’s really been a pleas-
you can resonate with another person. I can ure; a great interview. Thank you.
resonate with you and I’ll feel thirsty. Or if
Van Nuys, D. (2013). Interview with Dr. Daniel
you’re in pain, I could feel your pain. Or if
Siegel. The Neuropsychotherapist, 1, 22-32
you’re joyful, I could feel joyful.
http://dx.doi.org/10.12744/tnpt(1)022-032
This is the modern conceptualization
of the neurobiology of empathy and com-
passion; that we move from internal simula- This interview is an
tion, then, in these middle pre-frontal areas, adaptation from the
that that patient Barbara unfortunately had Shrink Rap Radio show
severely damaged, and not only map out #255, “Mindsight with
our internal sub-cortical state in something Dr. Daniel Siegel”, as in-
called interoception, but then you take inter- terviewed by David Van
oception in these middle pre-frontal areas Nuys, Ph.D., aka “Dr.
and you make a map of what’s going on in Dave”. The interview
your own mental life. Like, “Oh, I’m feeling was originally transcribed by Erika Steeves
sad,” and then you take it a next step over before editing for this publication.
in an adjacent area of the middle pre-fron-
tal region and you say, “I wonder if Dave is Further interviews and transcriptions can
sad?” And so we draw on interoceptive abil- be found at www.ShrinkRapRadio.com
ity—the ability to perceive inward—and we

32 The Neuropsychotherapist issue 1 April-June 2013

 The International Journal of Neuropsychotherapy (IJNPT) is an open-access, online journal that con-
siders manuscripts on all aspects of integrative biopsychosocial issues related to psychotherapy. IJNPT
aims to explore the neurological and other biological underpinnings of mental states and disorders to
advance the therapeutic practice of psychotherapy.
Our mission is to provide researchers, educators and clinicians with the best research from around
the world to raise awareness of the neuropsychotherapy perspective on mental health interventions.

Visit www.neuropsychotherapist.com/submissionscall/
for more information on submitting articles, letters and research notes.

www.Neuropsychotherapist.com The Neuropsychotherapist 33