Does psychotherapy affect the human brain?

The development and improvement of neuroimaging techniques over the past decades have made it possible to understand the structures and functions of the brain in living people.

Previously, the study of the brain was limited so that it was difficult to identify changes that occur in it over time.

Thanks to these techniques, we now know roughly how psychotherapy influences the brain, and we can understand the importance of psychological treatments in improving brain function.

    Neuroscience and psychotherapy

    Techniques such as functional magnetic resonance imaging (fMRI) or structural magnetic resonance imaging (MRI) have made it possible to identify abnormalities in the cerebral functioning of patients with mental disorders, to determine the involvement of different structures cerebral and, also, like psychotherapy and improving the mental health of the patient is reflected in the brain.

    It is a fact that psychotherapy improves the lives of many people, by producing changes in their emotional state, by changing their belief system and, consequently, their behavior and their relationship to others.

    In the past, it was not possible to know what the neural substrate for patient improvement was. The effectiveness of the therapies was established on the basis of how the patient said he had improved from his problem, assessing his subjective well-being and the degree of improvement the therapist saw in it, as is done today, but having no way of seeing what was happening to the patient’s brain during his lifetime.

    Assuming human behavior is based on the brain, it had to be assumed that psychotherapy changed the functioning of this organ, but how it was a big mystery. The brain was like a black box, the contents of which were impossible to know without opening the skull, a practice which was of course not common. With the advent of neuroscience, especially neuroimaging, it was possible to open this box that is the skull without really having to do it, and thus the functioning of the most complex organ of the human body could be known. .

      What does psychotherapy involve in the brain?

      In a common childhood, our parents and guardians act as sources of tranquility, calm and learning, providing their children with a safe environment so that they can develop, explore and learn not only knowledge and skills, but also deal with stress, fear and other negative emotions. .

      This way, in a healthy family neurological development is achieved allowing a healthy, flexible and efficient relationship among the most primitive part of our brain, the limbic system, with the most evolved, the cerebral cortex.

      The experience of chronic stress during childhood affects neurological growth, preventing its development. High levels of stress hormones end up affecting higher cognitive functions, such as memory or thinking, and can lead to difficulty regulating emotions. In adulthood, the person deals with problems in a dysfunctional way, to the extent that it can even lead to episodes of dissociation and inability to deal with their emotions.

      Psychotherapy can be used to reorganize the structure of the brain by providing a learning environment rich in everything the patient did not have as a child. While the adult brain is not as plastic as the child, what the patient learns through psychotherapy can correct hyperactivity and hypoactivity in various areas of the brain. Psychotherapy provides cognitive and emotional stimulation, improving brain connections.

      Stress and psychological activation (arousal) are double-edged weapons: at very low levels they do not motivate the subject to learn or change, while at high levels they make him overreact to problems. The intervention of a psychotherapist can promote change by bringing stress and psychological activation to medium and moderate levels, stress to healthy levels which activate the production of growth hormones and better learning at the neural level.

      The essential task of any good therapist is to accompany the patient in the process of regulating strong and negative emotions, such as stress or sadness.

        Brain changes associated with psychotherapy

        Psychotherapy produces physical changes in the brain that allow for better functioning, better integration and better regulation of neurological systems, which underpin better mental health, especially when we are in high stress situations. Specifically, the changes in the frontal and temporal cortex that are involved in the regulation of emotions, thinking and memory.

        We have an example with the case of obsessive-compulsive disorder (OCD). Research into this disorder suggests that in this psychiatric condition, there is hypermetabolism in different areas of the brain, including the caudate nucleus. Numerous studies point out that cognitive behavioral treatments in patients with OCD normalize the metabolic levels of the hollow nucleus and that this phenomenon leads to an improvement in symptoms.

        Another case is that of specific phobias, such as arachnophobia. Patients with phobias show a reduction in limbic system activity involved in the fear response after undergoing CBT-type psychological therapy. In patients with schizophrenia, psychological therapy has been shown to normalize the pattern of activity in the frontocortical areas, improving some of its symptoms.

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        We can also cite the case of people with a major depressive disorder. In this type of patient, being the subject of psychotherapy reduces the activity of areas of the brain associated with emotions such as sadness, as is the case with the amygdala and the limbic system in general. Psychotherapy also causes changes in the hippocampus, which regulates emotions and memory and the middle prefrontal cortex, associated with thinking and problem solving.

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