on February 14, 2013
Book Review: A General Theory of Love
February 14, 2013
In their book A General Theory of Love (2000), Thomas Lewis, Fari Amini and Richard Lannon, psychiatry professors at the University of California, San Francisco, examined the phenomenon of love and attachment by synthesizing the previously separate fields of cognitive psychology, art, neuroscience, culture, and evolutionary biology. The style of the book lies within a happy medium between stagnant scientific journals and accessible self-help books. The book effortlessly sways back and forth from romantic sentiment to cutting-edge scientific research. In this way, this book appeals to academics and non-academics alike, and its popularity is evidenced by it having been translated into Spanish, Chinese, Japanese, Portuguese, Korean, Latvian, Croatian, and Farsi.
The Main Points
The four main points of the book are: 1) our brains are affected by those closest to us, particularly during childhood; 2) within intimate relationships, our limbic systems synchronize with one another; 3) our brains can be changed for the better through long-term therapy; and 4) American society often frustrates our efforts to satisfy our biological need for connection.
The authors begin by educating us in biological fundamentals, explaining the triune brain (reptilian with its basic functions, limbic with its emotional function, and neocortical with its facility to reason) and explaining how evolution led to our illogically-structured brain. As ancestor animals adapted to their environment, each evolutionary solution was solved by modifying already-established structures, including the nervous system. Thus, over the eons, evolution's twists and turns led to a quirkily designed brain. Structures of the brain evolved incrementally and without and end goal (p. 21).
The authors take us further down the road toward love by describing the evolved functions of the brain structures involved in early relationships. Throughout the ages, instincts have evolved. For example, infants have an instinctual attraction to faces and a pre-programmed understanding of facial expressions (p. 61). This multitude of inborn brain structures encourages survival by fostering a bond between parent and child, so the child may be protected and taught by the parent. Along these lines, research has found that a lack of nurturing love will damage the human brain forever (p. 89). Grim evidence of this can be found within findings that extreme emotional deprivation can even cause infant death (p. 87). Human children are pre-designed for attachment and they need it for biological and practical survival.
Neurons and Neurotransmitters
The authors continue by explaining that the brain is a network of neurons. Through chemistry (neurotransmitters), neurons send signals to each other. By altering the chemistry in the brain, one can alter the functioning of the mind. Caffeine can cause alertness, SSRI's can alleviate depression, Ritalin can increase focus, and so on. In theory, all aspects of the mind are modulated by chemistry, including love.
The authors briefly discuss the neurotransmitters involved in experiences of love. They point out that current biological investigations of love focus on three crucial chemicals: serotonin, opiates, and oxytocin (p. 92). For instance, oxytocin levels have been found to surge in human mothers around birth which stimulates labor and also facilitates bonding between mother and neonate. Also, oxytocin gushes at puberty which motivates crushes and romantic love (p. 97).
Early animals evolved a mechanism to detect bodily damage: the neurotransmitters involved in the sensation of pain. And since the body needs a way to restore balance, opiates evolved to assuage that pain. When mammals evolved the limbic brain to facilitate the dependence on each other for survival, evolution recruited this primitive pain/opiate system to motivate mammalian social behavior. This is why relationships are both pleasurable and agonizing. For example, most people say that nothing is more painful that losing a loved one (p. 95).
Cutting. As a particularly poignant application of this theory, the authors attempt to explain cutting behaviors. Life is rife with tiny and not-so-tiny rejections - a disagreement, an apathetic look, a break-up. These social experiences produce emotional pain, which in some ways is indistinguishable from physical pain. When a teen cuts her skin, pain fibers send pain signals to her brain. Eventually, the brain releases pain's counterweight: the soothing, numbing opiates. In effect, she caused a physical pain to trick her nervous system into eventually numbing both her physical pain and her emotional pain (p. 96).
The authors dedicate a significant portion of the book to describing research in cognitive psychology that demonstrates that much of our motivations, memories, and processing occurs outside of our awareness or control. With this empirical foundation, the authors assert that the limbic brain contains emotional Attractors, encoded early in life (p. 140). These Attractors compel bias when viewing emotions and relationships. They influence our experience of romantic relationships. Since these templates were established within the mostly-unconscious limbic brain, these Attractors are nearly impossible to modulate by the conscious mind (p. 142).
Parenting and the Development of Self
In the first few years of life, the over-abundant neural pathways are whittled down to a select set of frequently-used circuits. Through repeated experience with caregivers, the brain becomes imprinted with what love feels like to the child. This collection of experiences and their neural consequences tell the child what relationships are, how they function, what to anticipate, and how to conduct them. If parents love children healthily, wherein mistakes are forgiven, children's needs are paramount, and hurts are soothed, then that is how the children will feel about themselves and relate others later in life (p. 160).
The target audience of the book seems to be people who have had a troubled romantic life in that the authors are often attempting to explain why so many of us have dysfunctional relationship patterns.
Early experiences establish particular neural pathways that set the stage of adult romantic relationships and how they feel to us. If a child is not given a steady limbic resonance, that child will have difficulty empathizing with others. Whereas if a child experiences a steady limbic connection, that child will develop the ability to empathize, to look inside someone else, and to respond accordingly. And when two healthy limbic systems join, limbic attunement allows these lovers to regulate each other's emotions, neurophysiology, hormonal status, immune system, and other functions (p. 207).
The authors go on to assert that the human limbic system is stabilized through relatedness. In the short-term, when people are hurting and out of balance, they turn to others for support - this returns them to limbic homeostasis (p. 170). In the long-term, people can permanently fine tune their limbic systems through prolonged contact with a caring, wise, responsive person who, over time, can bolster their healthy neural networks that will lead to increased self-soothing and relationship satisfaction. Many people leave therapy sessions (regardless of the theoretical orientation of the therapist) feeling calmer, stronger, safer and often they don't know why (p. 171). This is the result of limbic resonance, which is outside of conscious awareness.
When a client comes in to therapy suffering from unfulfilling relationships or low self-esteem, the therapist, through long-term limbic attendance, alters the microanatomy of the client's brain. Long-term, relationship-oriented psychotherapy strengthens or weakens particular neural pathways (p. 176). Short-term self-help solutions are ineffective because they propose that a strong-willed client should be able to change how they think and feel. But the psychophysiology of emotional life cannot be changed so easily. It took a limbic connection to create the problem and it will take a lived limbic connection to repair it (p. 177).
The authors make a compelling argument that American individualism, materialism and capitalism are frustrating our emotional and physical health. Americans are encouraged to achieve and not to attach (p. 206). For example, we disparage "needy" people, but we glorify self-made individuals. Since our culture promotes self-sufficiency which leads to isolation, we suffer needlessly from anxiety, depression, narcissism and other such maladies of the 21st century. Therefore the authors advise that we should not only privilege our cortex/cognitive mind, but we should also pay attention to our limbic/emotional selves (p. 229). To this end, the authors also advise that couples should spend time together if they want to maintain their bond.
Mainstream medicine has responded to external and internal economic pressures by paying less attention to patients' limbic system. The authors claim American patients have deserted mainstream medicine for the warm embrace of practitioners who attend to patients' limbic system: massage therapists, chiropractors, acupuncturists, and a host of others (p. 222). They recommend mainstream medicine change their systems and practices to the way things were before, when kindly doctors attended to the patients' limbic systems.
The authors wisely admit that even though love emanates from the physical brain and science provides a valuable tool for exploring the brain, human beings come equipped with an older means of discerning the nature of emotion: subjectivity (p. 12). This is a welcomed admission for those readers who are skeptical of the broad and reductionistic claims often made within science today.
Brief Therapy. The authors disparage brief therapy as a universally unfortunate development since it denies clients' need for long-term limbic attendance. As a relational therapist, I agree with the authors' assertion that some therapeutic goals are best met through an ongoing attuned therapeutic relationship. In support of this, there is a growing body of empirical evidence supporting the efficacy of long-term, psychodynamic therapy (Town et al., 2012). However, many of my clients also come to therapy for issues that are not suited for long-term therapies. Some clients' goals are best met in short-term therapy. Furthermore, brief therapies have a much larger body of evidence supporting their efficacy. As one of many examples, a 2012 meta-analysis of 15 randomized controlled trials found brief psychotherapies to be more efficacious than control (Nieuwsma, Trivedi, Mcduffie, Kronish, Benjamin, & Williams, 2012).
No Credit Given. Much of the book is common wisdom: love feels good, childhood experiences affect adult relationships, parents should pay attention to children's needs, society pressures us to move too fast for our own good, etc. These are good messages, and the authors provide an inspiring new angle on these old wisdoms. However, since the authors do not credit the giants upon which they stand, many readers might attribute these wisdoms to the authors themselves. It is common for self-help authors to write as if they were the first to put forth their ideas, but academic psychiatrists should know better. One might defend the authors by pointing out that this book is meant for the lay audience who don't care about citations. However, these are adept writers who could have woven in a few references to satisfy the academic audience.
The title of book could have been The Recent Biological Science that Supports the Long-Established Bowlby/Ainsworth Attachment Theory. But I suppose that title would have spoiled the book's marketing efforts. Attachment theory was mentioned only briefly in the book. The authors did not credit Bowlby, Ainsworth, and the many other theorists who had similar if not identical claims - this is like writing a book about gravity and not mentioning Newton.
Myths and Truths. As an example, after a somewhat long, circuitous discussion regarding cognitive research findings, the authors arrive at one of their main concepts: Limbic Attractors, or biases developed early in life that affect one's view of adult relationships. During this discussion, the authors mention that Freud's concept of transference is similar to their concept of Limbic Attractors. This exhibits responsible writing: give credit where credit is due. However, in the next paragraph, they write "Science has a way of supplanting myths with no less fantastic truths: transference exists because the brain remembers with neurons" (p. 141). The key words are "myths" and "truths." Transference is a myth while Attractors is a truth.
Limbic Resonance. (I am not a biologist, so my opinion on the following matter should be taken with a grain salt.) Throughout the book, the authors claim that our limbic brains synchronize, resonate, regulate, and revise. However, in my humble opinion, they did not provide any direct empirical evidence of this claim. Perhaps they merely omitted the research for the sake of readability. Or perhaps such supporting evidence does not exist. Their claims make intuitive sense, but without biological evidence, the authors are merely repackaging long-established psychological philosophy within biological terminology.
Perhaps the authors did not want to bore the lay audience with research and jargon. Or perhaps the authors wanted to make it seem as though they were truly inventing a new General Theory of Love. Rather than speculating, I wrote the authors and asked them. They have yet to reply.
This book added to my understanding of attachment. It has illuminated connections I had not seen previously. For example, I have worked with many clients who cut. The authors' explanation of the involved neurochemistry (i.e., opiates) was the missing puzzle piece in my formulation of self-abuse.
Also, this book helped me to understand the biological effects of love and the biological effects of a lack of love. The authors have bolstered and inspired my efforts to foster more love in the world. After reading this book, I found myself focusing more attention on my clients' "limbic" selves. Are they getting enough love in their lives? Could they give more love to others? I have always recommended cuddle time for couples but now I can make connections between cuddling and their brain chemistry, which in turn affects other areas in the lives (e.g., sleep quality, mood, immune system), which in turn affects their cuddle time, creating a recursive cycle.
A reviewer on Amazon.com wrote (retrieved on 2/8/13): "This book was an eye-opening experience for me. Since my early teens, I've established a pattern of being in relationships that start out on a high and then eventually deteriorate and fail. I've never understood why I involve myself-a successful, intelligent, generally happy person-with people who leave me dissatisfied, feeling worthless, and convinced that I should just give up and relegate myself to a lonely Siberian outpost. A General Theory of Love enlightened me. Not in some namby-pamby, self-help, touchy-feely kind of way-but by explaining the science of brain development and the associated outcomes in our personal lives using accessible, easy to understand language that borders on lyric prose. Thank you Dr. Lewis for introducing me to myself!"
There are many more reviews like this one. Regardless of the critique, this book has helped people to understand themselves and to forgive themselves for their relationship foibles. I suppose that benefit far outweighs any shortcoming.
Lewis, T., Amini, F., & Lannon, R. (2000). A general theory of love. New York: Random House.
Nieuwsma, J., Trivedi, R., Mcduffie, J., Kronish, I., Benjamin, D., & Williams J. (2012). Brief psychotherapy for depression: A systematic review and meta-analysis. International Journal of Psychiatry in Medicine, 43(2), 129-51.
Town, J.M., Diener, M.J., Abbass, A., Leichsenring, F., Driessen, E., & Rabung, S. (2012). A meta-analysis of psychodynamic psychotherapy outcomes: evaluating the effects of research-specific procedures. Psychotherapy, 49(3), 276-290.