Relational Neuropsychology: How It Shapes My Therapy Approach
“Love” by Ukrainian sculptor Alexander Milov, Burning Man, 2015. Image credit Alec Kondush
I’ve been putting a lot of thought lately into the ideas of relationship, attachment, and connection. As a parent whose children are starting to leave the nest, and as someone with a Peruvian wife who lives on another continent much of the year, I am confronted frequently with challenges to my own deep need for connection, closeness, and attunement with those I love. And as someone with complex relational trauma and autism, I am especially sensitive to any strain on my connectedness with others.
In psychological, therapeutic, and spiritual senses, I hold the firm conviction that our closest relationships – with our romantic partners, children, family members, and/or closest friends – hold the potential to be the most powerful engines for healing available to us. There is nothing like an intimate relationship to bring up our deepest, rawest emotions and unhealed wounds. These eruptions of subconscious material into our everyday lives provide invaluable opportunities for reflection and growth. Even the relationship between therapist and client can serve in this capacity, since it inevitably brings up similar experiences of rupture and repair, abandonment and connection, attunement and misattunement, throughout the process.
I’ve expressed this philosophy to clients many times in therapy and experienced it countless times in my own life. This conviction has had a profound impact on how I approach my work as a therapist. And yet, I’ve never really provided much explanation for where this belief comes from or how it has informed my personal and professional journey.
Understanding the Science of Connection
Over the years, both personally and professionally, I have sought to understand the ways in which relationships—both early and ongoing—shape our emotional and nervous system responses. My lived experience, combined with extensive study and clinical practice, has led me to develop a therapy approach grounded, in part, in relational neuropsychology.
Relational neuropsychology has its roots in attachment theory and neuroscience, with key contributions from researchers such as John Bowlby and Mary Ainsworth, who pioneered attachment theory, Allan Schore, who explored the role of early attachment in right-brain development and affect regulation, and Stephen Porges, who developed Polyvagal Theory to explain how the nervous system responds to social engagement and threat. Daniel Siegel and Louis Cozolino expanded this work by integrating neuroscience with psychotherapy, emphasizing the importance of interpersonal neurobiology. Jaak Panksepp, a pioneer in affective neuroscience, identified core emotional circuits in the brain that underlie our relational and emotional responses. (See the “Further Reading” suggestions at the end of this article if you would like to learn more.)
The collective research of these pioneers demonstrates that early relationships shape neural pathways that influence emotional regulation, stress responses, and the ability to form and maintain relationships. These insights have profoundly shaped modern therapy, emphasizing the importance of safety, co-regulation, and relational healing in mental health treatment. This, in turn, has impacted how I approach therapy – as well as how I have pursued healing in my own personal journey.
Comparing Relational and Family Systems Approaches to Traditional Psychotherapy
Traditional individual psychotherapy, such as psychoanalysis, cognitive-behavioral therapy (CBT), and depth psychology, often focuses on internal thought patterns, unconscious processes, and cognitive restructuring to address psychological distress. While these approaches can be valuable, they often emphasize individual insight and change without fully addressing the relational and systemic contexts that shape emotional and nervous system regulation. In my personal experience as a client and as someone with both complex trauma and autism, I found that 35 years of off-and-on therapy using these techniques helped me understand the roots of my struggles better and better… and did very little to change what was actually happening. This was because the issues I was having were arising from parts of the brain that are deeper than, and not directly connected to or under the control of, the areas of the prefrontal cortex that are involved in insight, talk therapy, or analysis.
In contrast, relational neuropsychology and family systems approaches recognize that healing occurs in the context of relationships. These modalities emphasize co-regulation, attachment dynamics, and systemic influences on emotional well-being. Rather than focusing solely on individual cognition or past unconscious processes, relational approaches integrate body-based regulation strategies, interpersonal neurobiology, and real-time relational experiences to foster healing. This shift is especially relevant for neurodivergent individuals and trauma survivors, whose nervous systems are deeply shaped by relational experiences and who may benefit more from embodied, experiential therapies rather than purely cognitive approaches.
In particular, these approaches – and others that directly impact subcortical parts of the brain, such as meditation, mindful movement (yoga, tai chi, qi gong, etc.), Brainspotting, and psychedelic-assisted therapy – can actually begin to rewire the limbic system and other brain regions that are altered by neurodivergence and complex trauma.
How Relational Neuropsychology Informs My Therapy
Not all of my work is based on relational or attachment-oriented models. When I work with individuals, I draw from a wide range of therapy methods including Cognitive-Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Internal Family Systems (IFS), existential and humanistic psychology, and Solution-Focused Therapy.
However, throughout my career I’ve been drawn to therapy practices and traditions that recognize and honor the fact that humans are wired for connection from the moment we begin forming in the womb, and that our relationships continue to shape and affect us throughout our lifespan. Perhaps this is due to my early focus on childhood trauma and interpersonal violence, going back to graduate school. Or perhaps it goes back even farther, to my pre-therapy career as a management consultant, where I worked with teams and entire organizations to manage complex change processes involving ever-shifting human dynamics.
My philosophy was certainly greatly influenced by the years I spent as a school-based child and family therapist, working with families, teachers, and other important individuals in a child’s life to help that child go from struggling to thriving. In that context, I developed a strong conviction that if you are working with a child (especially under the age of 12 or 13) in therapy and you are not involving the system of care around that child in some way in therapy, you are doing a disservice to that child – because no child can out-regulate the environment in which they operate. They are both shaped by, and in turn impact, the family and classroom and other situations in which they live. I hold the perhaps radical belief that this continues to be true, although not as dramatically as in childhood, throughout a person’s life – and that to ignore this in therapy is to severely handicap the therapy process. This is especially true, I think, when working with clients who are neurodivergent and/or who have experienced complex trauma, and in particular relational trauma.
Over the years, I’ve developed an eclectic, integrative approach to my work which brings together a variety of evidence-based and neurodiversity-affirming therapies that align with the principles of relational neuropsychology, including:
Polyvagal Theory and Sensory-Based Regulation: Understanding how the autonomic nervous system regulates safety and connection is crucial, especially for those with trauma histories or neurodivergence. I help clients develop tools for co-regulation and self-regulation using body-based interventions, breathwork, movement, and sensory grounding techniques.
Attachment-Based and Trauma-Informed Therapy: Early attachment experiences shape how we connect with others and regulate emotions. Whether using Emotionally Focused Therapy (EFT) or Internal Family Systems (IFS), I work with clients to identify attachment wounds and develop secure, stable internal and external relationships.
Mindfulness and Meditation: Research in relational neuropsychology has shown that mindfulness supports nervous system regulation and emotional awareness. By incorporating mindfulness techniques, I help clients build a stronger connection with their present-moment experiences.
Brainspotting and Somatic Processing: Trauma is stored in the body, and healing must often begin at a sensory level. Brainspotting allows us to access and release deep-seated trauma responses by working with eye positions that activate subcortical brain regions where trauma is held.
Implications for Individuals with Complex Trauma, Autism, and ADHD
People with complex trauma, autism, and/or ADHD often experience heightened nervous system sensitivity, difficulties with emotional regulation, and unique relational challenges. Relational neuropsychology helps explain why these difficulties arise and how therapy can be tailored to meet individual needs.
For those with complex trauma, past relational wounds can lead to hypervigilance, difficulty trusting others, and a dysregulated nervous system. Therapy focused on co-regulation, attachment repair, and trauma-informed body-based techniques can help rewire the nervous system for greater resilience and connection.
Autistic individuals often experience sensory sensitivities, difficulties with implicit social learning, and increased stress responses in unpredictable environments. Using sensory-friendly interventions, explicit relational strategies, and nervous system regulation techniques, therapy can create more stability and ease in relationships.
For individuals with ADHD, challenges with executive function, impulsivity, and emotional dysregulation often stem from nervous system imbalances. Therapy can support structured emotional regulation strategies, mindfulness practices, and nervous system regulation exercises to foster self-awareness and connection.
By tailoring therapy interventions to the unique ways the brain processes relationships and regulation, individuals can develop tools that help them feel safer in their bodies and more connected in their relationships.
Bringing Theory Into Practice: Real-Life Applications
To illustrate how relational neuropsychology informs my work, consider the story of “Sam” (a composite, fictional example not based on any particular client). Sam, a 30-year-old autistic man, struggled with social overwhelm and shutdowns, especially in unpredictable environments. With Sam, an approach including polyvagal-informed breathwork, body-based mindfulness, and sensory accommodations would help him feel more in control of his nervous system responses. Over time, he would learn to recognize early signs of dysregulation and use these strategies to prevent full shutdowns, improving his ability to engage in relationships more comfortably. Neurodiversity-affirming therapy, psychoeducation, and guided investigation into how his unique nervous system works could help him gain insight into how best to stay regulated and make the most of his strengths, while minimizing his challenges.
Similarly, “Kate,” who had experienced complex trauma, often felt stuck in cycles of hypervigilance and emotional numbness. Using Brainspotting, IFS, and attachment repair techniques, we worked together to process unintegrated trauma responses and to find ways to help keep her nervous system more regulated, so she was within her “Window of Tolerance” more of the time. Through this work, she began to experience emotions more fully and developed deeper connections with those around her.
Practical Tools You Can Use Today
While therapy provides a structured space for healing, there are several techniques you can practice on your own to support nervous system regulation:
Grounding with Sensory Input: Identify which sensory inputs help you feel safe and present (e.g., weighted blankets, essential oils, calming music) and use them regularly to ground yourself.
Breathwork for Regulation: Engage in slow, rhythmic breathing (such as 4-7-8 breathing or box breathing) to activate the parasympathetic nervous system and promote relaxation.
Mindful Body Awareness: Spend a few moments each day checking in with how your body feels. Where do you feel tension? What emotions arise? Simply noticing can begin the process of regulation.
Co-Regulation with Safe People: Spend time with people who feel emotionally safe and regulating for you, whether that’s a friend, partner, or therapist.
Movement-Based Regulation: Engage in activities that move energy through your body, like gentle stretching, walking, or rocking, to discharge built-up stress and promote nervous system flexibility.
As you likely know if you have worked with me, I have a wide variety of handouts and resources on these topics which I would be happy to share with you if you would like further detail. Feel free to reach out and ask if you would like more information.
Final Thoughts
Relational neuropsychology has shaped not only my understanding of mental health but also how I approach therapy. By integrating research-backed methods with deep personal insight, I strive to create a space that is both scientifically informed and deeply compassionate. Whether you are exploring therapy for the first time or are already engaged in this work, I hope these insights help you feel more empowered in understanding and regulating your nervous system.
If you’re interested in exploring how this approach might support your personal journey, I welcome you to reach out. Healing is possible, and together, we can create a path toward greater connection, regulation, and well-being.
Further Reading
For those interested in exploring relational neuropsychology further, here are some recommended books, websites, and podcasts:
Books:
The Polyvagal Theory – Stephen Porges
Affect Regulation and the Origin of the Self – Allan Schore
The Developing Mind – Daniel Siegel
The Neuroscience of Human Relationships – Louis Cozolino
The Body Keeps the Score – Bessel van der Kolk
How Emotions Are Made – Lisa Feldman Barrett
Attached – Amir Levine & Rachel Heller
Hold Me Tight – Dr. Sue Johnson
Websites:
Polyvagal Institute – www.polyvagalinstitute.org
NICABM – www.nicabm.com
The Trauma Research Foundation – www.traumaresearchfoundation.org
Neurodivergent Insights – www.neurodivergentinsights.com
Brainspotting – https://brainspotting.com
Podcasts:
The Trauma Therapist Podcast – Guy Macpherson, PhD
Being Well with Dr. Rick Hanson
