Interpersonal Neurobiology: The Effects of Mirror Neurons in Therapy

A woman looks in a mirror and smiles at herself.The most important question concerning psychotherapy is: What has to happen in therapy for it to work, for it to be effective, and really help the person in treatment? The simple answer is: The person has to experience positive changes in the brain, in the neurological system. When we are in distress, anxious, depressed, or just plain unhappy, our neurons are firing in a certain way. In “fight, flight or freeze” mode, the limbic brain is engaged, and the body is producing hormones, cortisol, and adrenaline, in order to prepare the body to deal with the stressful situation. Sometimes we have these hormones pumping away for such long periods of time that they don’t stop, even during sleep. Effective therapy helps a person reduce the arousal levels and get to a place of relaxation where he or she is no longer reacting as if in danger. This means that cortisol and adrenaline have ceased or greatly diminished, and oxytocin and dopamine are being released into the body.

A therapist aware of interpersonal neurobiology (IPNB) would recognize the distress and resulting feelings, and know how to help the person get to this more relaxed state. When oxytocin and dopamine are present, the prefrontal cortex is involved and we are more aware and thinking clearly. In this composed frame of mind, the person is able to get a clear perspective of the situatio0n and make sound, reasonable decisions about how to proceed—without the need for a therapist’s advice or input.

The skilled IPNB therapist has the knowledge and ability to be in this relaxed state, even when with a person in distress. Then, the therapist’s mirror neurons influence and lead the person to match this more desirable state of mind.

The human brain has multiple mirror neuron systems that specialize in carrying out and understanding not just the actions of others but their intentions, the social meaning of their behavior and their emotion. Our survival depends on understanding the actions, intentions and emotions of others… Mirror neurons allow us to grasp the minds of others not through conceptual reasoning but through direct simulation. By feeling, not by thinking. (Blakeslee)

Mirror neurons come into play from the very beginning—when a person first hears about you from someone, when a person hears your voice in a voicemail, sees your website, or hears your live voice. So much happens here that can get the therapy off to a good start. If a person senses confidence, kindness, and consideration, then this will provide comfort, relaxation, and hopefulness for the therapy to come.

A person’s mirror neurons are sensitive to the therapist’s intentions and feelings. If the there is an attitude of respect, gentleness, confidence, directness, and responsiveness, the person will tend to feel safe and more open, emotionally. This emotional safety can be conveyed over the phone prior to first session, and allows for trust and hopefulness even before the first meeting. Of course, protective defenses are still in place and may hinder the opening up process, yet more revealing will occur if the person “knows” this is a safe emotional environment. This knowing, at the deepest level, may be for the first time. It helps the person feel kindness, appreciation, and caring, and not feel alone. What an impact!

Returning phone calls promptly is considerate, respectful, and often appreciated. Even if the person does not set an appointment, a pleasant conversation with this approach will benefit the inquiring person. Callers are relieved and relaxed when I treat them kindly and make every attempt to assist them, even if I can’t personally serve them. I might give them a referral or place them on a waiting list.

I always attempt to have them feel they are important and to make their search for a therapist as painless and successful as possible. When a person is seeking counseling for oneself or a family member, the person is often desperate and at the mercy of the health care system, an unfortunate position. So when the therapist is caring and genuinely attempting to help, the kindness has an impact on this person, even if there is no future contact.

A phone conversation where an appointment is set up may go like this, “I have just a little time right now and I would like for you to tell me, as briefly and clearly as possible, about your situation. I want to get a sense of you and see if I think it would be helpful for us to meet. And I think you will be able to tell if we might be a possible fit when we are done talking. Why don’t you start, and tell me of your reasons for seeking counseling?”

After the person has spoken, I  may continue with: “I think I now have a good sense of your situation and I would like to schedule a meeting, unless you are unsure, or if you have some questions for me.” Keep this conversation as brief as possible, making responses and caring comments to him/her. Let him/her know you are actively listening.) “I will see you on Monday at 2:00 PM. I appreciate your call and I have a good sense of your predicament. I have a sense of your situation and the hopelessness, distress, and despair you are feeling. Plus, I know that when we meet together we will be able to help you make the changes necessary to turn this around. This is a good start to our work. Take care.” Here there is appreciation, kindness, confidence and the person will likely be more relaxed and hopeful than before the call. Plus, he or she will look forward to getting started.

“Our kindness creates a field of power—a quality of genuine presence that grows from our intimacy with virtue. The more peaceful, cheerful, and generous we are, the more successful we are in attracting people to us…” (Mipham). This caring and confident approach does so much to help the client relax. Not only does the person feel more hopeful, but he or she also looks forward to meeting the therapist and getting started on beneficial, emotional work. This kindness will touch the heart on a deep level and create emotional safety, before even stepping into the office.


  1. Blakeslee, Sandra. (n.d. ). Mirror Neurons: Cells That Read Minds. Mind Power News. Retrieved from
  2. Mipham, Sakyong. (2005). Ruling Your World. New York, NY: Morgan Road Books.

© Copyright 2009 by Christopher Diggins, MA, LMHC. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Paige

    December 22nd, 2009 at 6:50 PM

    Thanks for the article, Christopher. I feel kindness isn’t often expressed or felt these days often. It’s a reflection on our society that people have to consciously think about being kind rather than it coming naturally to the majority. You don’t even hear the word much anymore. A kind word or soothing tone can be so healing too.

  • Belle

    December 22nd, 2009 at 7:56 PM

    In my experience, when you do attempt to be kind to another it can be met with suspicion more often than acceptance. People wonder what’s in it for you, as if you have to have a reason to be nice to them! I ignore that. I know my kindness will be accepted with good grace another day and that makes up for the awkward times when it’s not. Better to give and be rejected than not give of yourself at all. Nice article.

  • Wanderer

    December 22nd, 2009 at 8:11 PM

    “Be kind whenever possible. It is always possible.” – Dalai Lama

    Kindness is a viable option all the time and on every occasion. When you can’t see that, look harder.

  • Shane Watson

    December 22nd, 2009 at 10:07 PM

    Not everybody can calm down and help a person under stress to relax… I think in addition to the calming activity, you need to know a few more things to successfully help the person actually relax and calm down, and this is best done by a counselor.

  • Christopher Diggins

    January 4th, 2010 at 10:48 PM

    Yes, Paige, the power of kindness is even magical and it can happen over the phone with a stranger, in therapy, with family, anywhere. Even if it seems like it is not having an impact or if it seems like it is rejected, it still is so significant.

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