Clinical Biopsychology: Could A Grand Theory Actually Exist To Allow True Psychotherapy Integration? - Robert A. Moss a 42 year old gentleman, was involved in an accident the preceding February, during which his propane truck was struck by a car with the other driving being killed. His truck was overturned and he had immediate concerns over a possible tank rupture and explosion. He was referred by the insur- ance adjuster handling his worker's compensation case. When initially assessed on 4/3, he recounted details ·with noticeable anxiety. He reported crying spells, increased nausea and frequent nightmares. He noted one particu- lar situation in which he became startled, scared and angry, when his wife unexpectedly applied the brakes. He said his reaction v.ras very much out of character for him. He reported another accident that had occurred 5 years previously in which others had been injured and killed. He was not the driver, but was riding in the truck cab when the car swerved into the truck. He sustained no physical injury in either accident. Shortly after the accident, he saw his family physician who diagnosed PTSD and started him on Zoloft. He was instructed not to do any driving. The client devel- oped nausea and discontinued the medication. He was then prescribed Paxil with his noting improved sleep, reduced nightmares, and decreased crying spells. He had no crying spells in the week prior to the psychologi- cal evaluation. He also noted he was beginning to find some enjoyment in activities. Unfortunately, he was experiencing the side effect of inhibited orgasms. During his initial evaluation, he reported a normal appetite and low energy level. He denied suicidal thoughts and hallucinations. He reported dysphoric mood only if he thought about the accident. He reported increased startle response and hypervigilance. He noted increased irritability. He indicated he had always been an organized, detail-oriented, and perfechonishc individual. He denied the use of alcohol and drugs. He had no history of mental health treatment. He was reared by both parents. His mother demon- strated physical affection, used fair punishment, and was not verbally abusive. She drank no alcohol. His father demonstrated no physical affection. He was physically and verbally abusive. He was an alcoholic. This client had a brother that had been shot and killed 5 years previously, with his indicating his brother's death had been quite difficult for him to personally resolve. The client had left school in the tenth grade due to his desire to leave home. He was a C + student. He ·was out- going and denied being picked on. He got in little trouble in school. He denied any history of work problems. He had 3 marriages. His first ended because she tired of it. His admitted the end of his second marriage was difficult for him to resolve. His present marriage had gone well. Before discussing the case conceptualization and treat- ment for Jim, let's first discuss a new psychotherapy model. Clinical Biopsychology The past two decades have witnessed an explosion in applied brain research. This has been largely related to the development of new technologies, including com- puter generated algorithms, which allow for measures of brain activities. Obviously, any new psychotherapy grand theory would have to be one based on a model of brain functioning. This realization has led to some speculation as to specific brain areas (e.g., amygdala, anterior cingulate, etc.) being involved in the experi- ence of psychological problems, though there is no real suggestion as to how such activity explains the subjec- tive and objective symptoms. A comprehensive new model was reported by Moss (2006) based on the cortical macrocolumn being the binary unit, or bit, by which all higher cognitive func- tions exist. The Dimensional Systems Model goes on to discuss how the macrocolurnns interact in feed for- ward and feed backward patterns with other columns and other structures in the brain. This model actu- ally emerged in 1984, but was rejected by journal peer reviewers for being too speculative and untestable at that time. Over the past 26 years, the model has been applied to a deeper understanding of both the develop- ment and treatment of psychological problems. The new applied approach of Clinical Biopsychology was described in a treatment manual (Moss, 2001), with the first professional article following 6 years later (Moss, 2007). The Clinical Biopsychology model is consistent with the psychodynamic views of two semi-independent minds, though these are both considered conscious. The left