For Siegel, aligning with the patient's state--direct right-brain to right-brain communication--and then expressing that affective state in fairly straightforward terms can be helpful to many patients. "I find myself saying things that I would never consciously think of saying like ýOh, that was too much.' These sorts of clarifying and attuned statements of feeling emerge unconsciously and can be the most helpful." Of course, right-brain to right-brain communication alone does not constitute psychotherapy. For Siegel, coconstructing a more linear narrative that integrates left- and right-brain functions is also essential.

But numerous psychotherapy outcome studies have shown that when patients recount what was most helpful about psychotherapy, they don't often recall specific interpretations or insights. What they remember is the quality of the relationship, the way it felt to be in the room with the therapist or to share a mutual gaze--experiences reminiscent of early attunement. Whether such experiences actually promote new neural connections in the patient's right hemisphere and better coordination between right and left hemispheres is an open question.

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