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Brain denial among therapists is rooted in mind-body dualism and discomfort with mortality.

Pseudoneuroscience in therapy ranges from well-intentioned missteps to marketing ploys.

TMS and brain monitoring tech are closing the gap between subjective and objective measurement.

One of the first courses in medical school is gross anatomy. We pay respect to the person who donated their body—someone with a life, loved ones, a history. We are grateful. It is also a complex emotional experience—existential, personally challenging, an abrupt shift from academics to life-and-death. At some point during that course, we dissect the head, and hold the brain, reflecting on the person’s life. For many physicians, that moment changes something. The mind, whatever else it is, has a brain. The brain has a mind. These two conceptualizations are much closer to one another than many people—including many therapists—would prefer to acknowledge.

Does the Brain Matter in Therapy?

In psychoanalytic circles, I’ve often observed a remarkable resistance to neuroscience—not healthy skepticism, but something closer to avoidance, though the discipline of neuropsychoanalysis, pioneered by Mark Solms and colleagues, represents an important counterpoint. I’ve been told flat-out by esteemed colleagues that they don’t care about neuroscience or think it has any relevance—an expression, perhaps, of personal philosophies, ways of coping with life’s travails, or inexperience with serious treatment-resistant conditions.

On the other side, a different faction of clinicians misuses or overuses neuroscience, deploying brain-talk as decoration, marketing, or pseudoscientific authority. At best, this is a well-intentioned misstep; at worst, a frank marketing ploy. Between these poles, patients are caught in the crossfire, denied a right-sized acknowledgment and application of what we actually know about how brains support minds.

The pattern might be described as brain denial, or denial of brain—a reluctance to confront what it means that minds emerge from physical organs, vulnerable, mortal, subject to aging and disease. Terror management theory offers a useful lens: mortality is, for most of us, the anxiety we manage least effectively, and the brain is a relentless reminder that we are biological systems with........

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