Dan Siegel trained with me at UCLA in the late 1980s. By that I mean he was two years ahead of me on the long train of professional development. I followed him in my adult psychiatry residency and then I followed him in my child psychiatry fellowship, but by that time, he had graduated and entered into the “real world”. I always liked him and I always knew that one day Dan Siegel would become Dan Siegel. I knew, like many of my colleagues knew, that he would become a household name, at least in certain households. Dan had the constellation of qualities which are characteristic of leaders: high intelligence, charisma and thoughtfulness, along with a strong drive to contribute to the field of adult and child psychiatry.
“Mindsight”, the name of his latest book, is a word he coined to describe the observing ego, the part of the brain which observes other parts of the brain in action. The word feels like a combination of mindfulness and insight, which I think is what Dr. Siegel had in mind when he invented it. The book is part neuroanatomy lesson, part entry into the psychotherapists’ space (similar to this blog, I think) and part paving a new path towards the integration of psychotherapy, neurobiology and Hindu ideology.
The type of contribution that he is making is intriguing to me. He has studied neurobiology, psychiatry, child psychiatry and mindfulness. He has fused these fields together in a way in which the public can see how psychiatrists contribute to the world, above and beyond psychopharmacology. For that, I am grateful. He reminds his readers that psychiatry is a field of the brain in that the more we understand how the brain works, the better we can help people help themselves. I am grateful again. Dr. Siegel reminds us that the brain is a social organ. It is wired for connection. Many of us know that we feel better when we are part of a larger social structure, whether it is a family, a church or a political organization. Dan tells us that the reason for this is that our brain fires good feelings when it is around other brains with similar points of view. In other words, affiliation is a brain thing. We hunger for other people in a similar way that the stomach growls when it needs food. Our organs “yell” at us when needs are not being met. The brain is no different.
Dr. Siegel describes mirror neurons. A mirror neuron is a neuron that fires both when an animal acts and when the animal observes the same action performed by another. In humans, brain activity consistent with that of mirror neurons has been found in the premotor cortex and the inferior parietal cortex. Some people, including Dr. Siegel, speculate that mirror systems may simulate observed actions, and thus contribute to theory of mind skills. The idea is that we can experience joy when we see others experiencing joy because we have mirror neurons and we can imagine ourselves feeling what the other person is feeling. To put it another way, empathy is wired. Dr. Siegel argues that the more one is encouraged to empathize, the more extensive these neural connections will be, and so practicing empathy develops the mirror neurons in our brain. Neuronal firing means neuronal re-wiring.
Being present, learning to pay attention to the here and now, can be part of psychotherapy, can lead to more integrated, and hence better mental health, Dr. Siegel says. Dan takes us from thinking about interpersonal neurobiology to the Eastern teachings of observing oneself in a detached and attached way at the same time. That is, a psychotherapist can help a patient think about what is going on with his thought processes at the same time that the patient experiences his thought processes. As I read this part of the book, I thought about yoga, about focusing on the breath, about how this simple message is so helpful for so many ailments. I agree with Dr. Siegel that mindfulness adds to psychotherapy. I agree with him that incorporating mindfulness into treatment adds to the therapeutic process. I think most clinicians have done this for years. I salute Dan for bringing together psychiatry and Buddhist philosophy. The cooperation between these two fields is obvious, but it needed to be said. Dan knew this. He took a big step to bring his name together with these two fields to teach people that psychiatry is more than psychotropic medication and it is more than neurobiology.
As I read “Mindsight’ I appreciated Dan’s efforts to demystify the mental health profession. I continue to follow Dan on his path towards making psychotherapy a known entity. I follow him on his path to integrate the mind, the brain and relationships. Some relationships last a long time, even without words exchanged. In particular, there is the relationship of deep admiration and following. Dan and I have that kind of bond.