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The Neuropsychology of the Unconscious: Integrating Brain & Mind in Psychotherapy

What makes a person stubbornly repeat harmful behavioral patterns over and over again, seemingly unaware of past outcomes? After more than thirty years of clinical and supervisory practice, Efrat Ginot is convinced that the answer lies in the unconscious mind. “[U]nconscious systems are resistant to change,” Ginot writes, and “the resistance is built into the machinery of the brain/mind.”

Despite research advances on mind and behavior, the unconscious remains one of the most elusive features in the psychological repertoire. Many psychological scientists view it as the shadow of the real, though research out of Yale from 2008 suggests the unconscious is not nearly as rigid and deliberative as we once thought. Contemporary cognitive science holds that our unconscious mind processes information through subliminal means, which implies a lack of conscious awareness and a lower range of sophistication.

Perhaps the most influential notion for the Western understanding of the unconscious comes from Sigmund Freud. Although Freud’s investigation of it came from individual case study examinations and was devoid of the scientific rigor we are accustomed to today, it remains the historic foundation upon which Western theories of consciousness are frequently based. Ginot’s book, The Neuropsychology of the Unconscious: Integrating Brain and Mind in Psychotherapy, is no exception.

At first I took this to be yet another book in a long line of reductionist treatises — treatises that espouse the superiority of neuroscience and all things material over that of the qualitative and intuitive nuances required for effective therapeutic intervention. But a closer look showed that my initial notions were, at best, skewed.

Ginot’s book, while at times thickly reductionist, achieves balance. Ginot shows how having a deeper understanding of brain mechanics can improve our work with clients — and how it can enhance our understanding of the unconscious in general. Hers is not a linear argument by any means. Rather, Ginot’s brilliantly researched book comes from a place of genuine sincerity. Her goal is to shed light upon an otherwise dark arena of the brain/mind. Her method of revelation comes not from laboratory trials, but from a reputable career of working with clients and experiencing, through those sessions, how the human mind works within its varied environments.

“There exists a very delicate and shifting balance between the power of repetition and the genuine wish to change,” Ginot writes. What she refers to here may correlate with the “plastic paradox.” Neuroplasticity, as researcher and author Norman Doidge writes in a recent paper, promotes flexibility and change within the neural pathways, demonstrating that the brain remains malleable — despite the rigidity of our conditioned behaviors.

In fact, because of our behavioral rigidity, we tend to project the notion of inflexibility onto the brain. We tend to assume that it, like our unwanted habits/patterns, is also unable to change. Despite our limited thinking, however, the brain itself, as a living organ, remains flexible and capable of change, whether or not we permit our behaviors to exploit those new pathways.

It all sounds very science fiction, to be sure, almost to the point of imagining our lives as composed of many selves, controlled, at times, by the sociocultural patterns we are conditioned to, and at other times by involuntary brain-body mechanisms. But that is precisely what neuroscience has shown our brain/mind experience to be!

Although Ginot treads lightly around the concept of neuroplasticity, she tacitly invokes its presence when she discusses the influence of the unconscious, and the techniques therapists can use to help reprogram behavioral patterns. Hers is an important book because it focuses on how to help the client in practical terms. She looks at how we can apply the revelations from neuroscience to improve lives in clinical practice. (When she speaks of “self-narratives” and the “unconscious” she means it in psychodynamic terms, but her examples can just as easily serve as evidence for plasticity and rigidity and perhaps a multi-layered mind theory.)

But for all the brilliance of Ginot’s research and her years of reputable clinical practice, her book is not very accessible. Part of a professional series from Norton, it may not appeal to the lay reader unless that reader is equipped with a stellar understanding of neuroscientific and psychodynamic concepts. Ginot does offer some explanation of the terminology, but the writing style itself is more akin to scholarly journal-speak than to the fluid, lively, and easy-to-understand prose found in fellow neuropsychology writers like Antonio Damasio and V.S. Ramachandran.

As long as a reader is not intimidated or distracted by Ginot’s expository style, this is a book worth referring to time and again as a guide for turning theory into practice.

The Neuropsychology of the Unconscious: Integrating Brain and Mind in Psychotherapy

W. W. Norton & Company, June 2015

Hardcover, 336 pages


The Neuropsychology of the Unconscious: Integrating Brain & Mind in Psychotherapy

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K.M. McCann, PhD

APA Reference
McCann, K. (2016). The Neuropsychology of the Unconscious: Integrating Brain & Mind in Psychotherapy. Psych Central. Retrieved on September 29, 2020, from
Scientifically Reviewed
Last updated: 17 May 2016
Last reviewed: By a member of our scientific advisory board on 17 May 2016
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