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Adult Growth, Internalizations, and Synaptogenesis
February 2007, Vol. XXIV, No. 2
Clinicians, I believe, have little opportunity to learn about adult psychological growth other than that which results from psychotherapy. Almost by definition, patients who present for psychotherapy have not experienced major periods of growth arising out of other life experiences. A different picture emerges when one has the opportunity to interview nonclinical subjects in depth. Here, subjects' life narratives often contain major turning points that appear to usher in periods of psychological growth. During many decades I have had the opportunity to interview-usually in depth-more than 800 nonclinical subjects. Research volunteers, applicants for a psychiatric residency, and more recently, candidates for ordination in the Episcopal ministry came for interviews as one part of what was required to attain other goals. Some, but certainly far from all, described major life turning points.
These 3 much-abbreviated vignettes illustrate several of the most commonly heard turning points in the life narratives of nonclinical subjects. Healing marriages, religious/spiritual experiences, and psychotherapy all involve a new and transforming relationship either with another person or with God. Each of the new relationships is described as leading to changes in the self-changes that sound like manifestations of psychological growth. Some readers may react to these premises with skepticism-these are, after all, only stories. There are no careful before-and-after personality measurements documenting positive changes. I will not, for reasons of space, discuss the issues involved in how we know what we know, historical truth versus narrative truth, different forms of causal thinking (probabilistic and narrative), and other complexities. Rather, I ask the reader to assume, at least for the moment, that the narratives of turning points and psychological growth reflect substantial reality. Doing so allows me to move to the next issue-what are the mechanisms or processes that translate these life experiences into psychological growth?
Processes underlying growth
Throughout my career and until quite recently, the most common answer to questions about the underlying processes of psychological growth involved the idea of internalization. We are assumed to take into ourselves those persons (or certain characteristics of those persons) whom we love and who love us in return. The major problem with this concept is that it doesn't tell us much that we need to know. Although Vaillant's1 effort at distinguishing different types of internalization (and their relative maturity) has been helpful at the descriptive level, there remains the mystery of what he calls “metabolizing the internalized other.” What is involved in metabolizing? Is it just a convenient metaphor?
During the past few years, several new parameters have been added to the internalization-metabolism model of psychological growth. First, enduring changes in behavior must be associated with actual changes in brain structure and function. New synapses are formed (perhaps new neurons also) as the consequence of life experiences. Thus, psychological growth and brain growth are parallel processes. Second, for synaptogenesis to occur in response to life experiences, previously inactive genes must be “turned on” in order to produce the required proteins. Psychological growth, like psychopathology, is thus the product of gene-environment interactions-nothing very surprising about that. Further, we think we know a good deal about the relationship characteristics that are associated with psychological growth but we know very little about the actual genes involved. Although it is commonplace to read about “genes for closeness” and to see statements such as “connecting to others is hard-wired” and the like, there are no systematic data.
The relationship structure associated with individual psychological growth was described years ago by our research group at the Timberlawn Research Foundation in Dallas.2 A major task of relationship formation is establishing a balance of separateness (autonomy) and connectedness (intimacy) that is acceptable to both partners. In growth-facilitating relationships, the partners contribute more or less equally to the process of negotiating a balance suitable to each. Thus, shared power (in defining the relationship) is a crucial variable. This facilitates the development of exploratory conversations that over time produce psychological intimacy. Shared power also contributes to the development of the negotiation skills that are crucial for dealing with the inevitable differences. Thus, problem-solving skills come to be highly developed. In all this, however, each partner maintains a strong capacity for autonomous functioning. The strong interdependence does not erode individuality.
Thus, experiencing such a co-constructed relationship sets the stage for each partner to internalize desirable attributes of the other. The experience of such relationships and, perhaps as suggested by Siegel,3 in particular the exploratory, intimacy-producing conversations turns on those genes that are necessary for the production of new synapses.
Increasingly, we know more useful questions to ask. In this way, our understanding of how certain types of relationships appear to facilitate individual growth is gradually expanded.
Dr Lewis is chairman emeritus of the Timberlawn Psychiatric Research Foundation and clinical professor of psychiatry at the University of Texas Southwestern Medical School in Dallas. He is also in private practice of individual, marital, and family therapies in Dallas.
References1. Vaillant GE. The Wisdom of the Ego. Cambridge, Mass: Harvard University Press; 1993.
2. Lewis JM, Beavers WR, Gossett JT, Phillips VA. No Single Thread: Psychological Health in Family Systems. New York: Brunner-Routledge; 1976.
3. Siegel DJ. The Developing Mind: Toward a Neurobiology of Interpersonal Experience. New York: Guilford Press; 1999.