Working Implicitly in Psychotherapy: Neuroscience Insights from Francine Lapides
On November 13th, 2015, SCV-CAMFT (a group of Bay Area therapists) gathered for a wonderful lunch and an exceptionally thoughtful presentation by Francine Lapides, LMFT. If you're just learning about Ms. Lapides, as I was in November, I highly recommend seeking out training with her—or perhaps therapy if you're in the Santa Cruz area. She has an upcoming training group in the new year focused on psychoneurology, designed to help therapists deeply explore how understanding the brain can enhance therapeutic practice. I am updating this blog in 2025.
One might call Francine our local Dan Siegel. She has studied with him for years and has been part of Allan Schore's Berkeley study group. A licensed MFT since 1974, she's a decades-long member of SCV-CAMFT and maintains a private practice in San Jose and Santa Cruz, California.
The Neuroscience of Early Development
In her presentation, "Working Implicitly in Psychotherapy: What Decades of Neuroscience Study Has Taught Me About Being a Psychotherapist," Ms. Lapides began by reminding us that infants are primarily right-brained, with this right brain development continuing through the first two to three years of life. Attachment templates are stored in the right brain—a critical insight that leads to an important takeaway: to heal trauma, we must address both unconscious and conscious areas of the brain.
As therapists, we witness firsthand how early traumas shape a person. Some traumas foster resiliency while others leave us more rigid. Francine guided us through fundamental neuroscience concepts during the first portion of her talk. This segment served as our "infancy" in neuroscience (for those without prior knowledge), and even for those familiar with the subject, her presentation offered an excellent review.
She shared Winnicott's profound quote: "There is no such thing as a baby... if you set out to describe a baby, you will find you are describing a baby and someone" (Winnicott, 1947). This highlights how the relationship heals because we are inherently relational beings. We can help our clients make meaning of early trauma, and this healing—rooted in the physiology of neuroscience—is more effective when approached from the bottom up (from body to head).
The limbic system and attachment theory dominated her discussion. As stated in Mrs. Lapides' slides: "Early life experiences create potent affective 'knowing' in implicit, non-verbal, unconscious memory which underlie and have a profound influence on personality, dominate mood, symptoms and relationships throughout life."
Experiential Learning in Action
As we transitioned to the second section of the talk, Mrs. Lapides invited someone to come to the front of the room and summarize what they had just learned about neuroscience. The room fell silent. We all sat as though glued to our seats. She allowed the perfect amount of silence to unfold before joking that she was merely getting our heart rates up so we could feel our prefrontal cortex at work.
As many therapists know, the prefrontal cortex helps regulate emotion. Francine's "experiment" was perfectly orchestrated as a process experiential learning exercise. We had absorbed the basics of neuroscience, were asked to present it publicly, and then—upon discovering we didn't actually have to—experienced the process of re-regulation.
This mirrors the therapeutic process where, week after week, we invite our clients to talk, draw, or move through their trauma. They might initially decline, but as the relationship and trust grows, we can begin to help them heal. This ability to manage activation helps clients access their unconscious beliefs.
Implicit Relational Schemas
There are, as Francine shared, "implicit relational schemas" or unconscious beliefs that all of us hold. For example, we may unconsciously believe that, "If I try to perform and fail, people will think less of me." These are precisely the thoughts and feelings we aim to address in therapy.
The question of how this can be done while integrating neuroscience will be explored in the intensive study group Francine will offer. She'll address clinical skills including: "trusting your intuition, somatic transference, intimacy and self-disclosure, rupture and repair," and much more. I wish I lived closer to Santa Cruz! This group will undoubtedly be valuable.
Right-Brain Approaches to Therapy
Francine noted, "While the overwhelming bias in western psychotherapy has been a top-down, primarily left-brain model of conscious and verbal attempts at change, neuroscience is increasingly confirming that we must work in this right-brain, unconscious, body-based arena as well."
When discussing the "bottom-up" approach to working with clients, she mentioned poetry because of its right-brain connection. She highlighted prosody—"the patterns of rhythm and sound used in poetry" according to Webster's online dictionary. Using poetry or other right-brain activities with our clients can help them access and heal their trauma.
I found the interventions Francine offered at the end of her talk particularly helpful. Instead of asking left-brained questions, we can shift statements to create more of a right-brain experience:
Instead of: "Your father's anger was uncontrolled and made you feel unsafe"
Try: "When your father exploded in rage, you felt terrified and small."Instead of: "It will be important for you to know I'm here"
Try: "Can you look at me, can you feel me here with you?"
If you attended the luncheon, you heard Francine's calm, seasoned voice. It was healing in a room of almost 100 colleagues. I hope you get a sense of her approach from this description.
For more information: www.francinelapides.com
And in case you are not familiar, this is Dan’s website:
https://drdansiegel.com/