Similarly, if a client discussing her memory of abuse says, “I feel frozen in that moment, and I need to get some distance from it,” she needs to allow her still image of the event to become a movie, so that it can change as time passes and then recede into the distance, becoming smaller, dimmer, and less disturbing. This approach isn’t rocket science, nor is it neuroscience. Instead, it’s a simple matter of finding out exactly what the structure of someone’s personal experience of a problem is—rather than the content within that structure—and then experimenting with useful ways to change it.

If you’re really listening to your clients, you’ll realize that they’re often being quite specific about what their problem is and what kind of solution would be useful. If a client speaking about his wife’s infidelity says, “It’s in my face, and I’d really like to put it behind me,” that isn’t just a metaphor: he’s telling you that the image of his wife enjoying sex with someone else is right in front of him, where he can’t possibly ignore it, and that if the same image were literally moved far behind him, where it would be less obtrusive, he’d pay less attention to it and respond less intensely.

As with John, the change David made is easily understood without any reference to the underlying neurological changes, and I don’t see how any application of current neuroscience could have improved the process or its outcome. Until neuroscience can tell us specifically what we should be doing differently in therapy, it’s about as relevant to our work as particle physics or the migration of butterflies.

Six weeks later, David said that he’d continued to feel comfortable interacting with young children. His sense was that the process had an across-the-board impact on his life, and his wife had noticed that he seemed calmer and more settled. He felt he could loosen up and have fun, whereas before the session, he’d been chronically serious and somber. About six months later, he reported that his wife was pregnant and they were both eagerly looking forward to the birth.

In a recorded interview two days later, David reported what had happened immediately following the session. “I was still processing, and I went off by myself to eat lunch at a restaurant. At the next table over, there was a family with a little baby. And I’m sitting there, and I’m looking over at it, and it dawned on me: I’m playing with this child! I’m playing the look-away game. And I got all excited.”

In the course of a single session, David learned how to take the image of his baby and see it straight in front of him, give it the same movement and other positive sensory qualities that the image of his professor had. Once he envisioned his baby this way—closer, life-size, and moving—his emotional response transformed spontaneously.

When Connirae next asked him to think of someone special he still felt connected to, but who was no longer alive or present in his life, he became more relaxed and animated as he said, “It’s an old college professor; he’s right in front of me—just, you know, life-size, in motion, outdoors, with cars and buildings in the background. I can talk to him and interact with him, and I feel a lot of warmth.” This image elicited a positive response of warmth and the felt presence of his professor, and proved to David that he could experience a person he’d lost as if he were physically present.

Resolving grief effectively requires reconnecting a client with the positive feelings of being with a lost loved one. To begin this process with David, Connirae elicited his experience of loss and grief by asking him what he saw when he thought of his child. He became tense as he responded, “I’ve got a picture of the grave, and a little closer to me is a transparent form of the way the baby would look now, if he’d lived. It’s located up and to my right, and it’s sort of like seeing the image through a tunnel. There’s black all around, and no sound.”

Most therapeutic approaches teach clients to get in touch with their feelings of grief and express them fully, which can result in uncontrollable, hysterical weeping. Although there’s a certain value in this kind of extended emotional outburst, it’s often deeply painful, and even if a client is willing to go through it, the process takes a long time. More importantly, fully expressing feelings of loss seldom resolves the loss.