Does psychotherapy influence the human brain?

The development and improvement of neuroimaging techniques over the last decades has 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 the changes that occurred in the brain over time.

Thanks to these techniques, today we know in an approximate way how psychotherapy influences the brain, and we can understand the importance of psychological treatments in improving brain functionality.

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Neurosciences and psychotherapy

Techniques such as functional magnetic resonance (fMRI) or structural (sMRI) have made it possible to identify abnormalities in brain function in patients with disorders to determine the involvement of different brain structures and, also, how psychotherapy and the improvement of the patient's mental health is reflected in the brain.

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

In the past, it was not possible to know what was the neural substrate for the improvement of patients. The effectiveness of the therapies was established based on how the patient claimed to have improved her problem, assessing his subjective well-being and the degree of improvement that the therapist saw in him, as is done today, but without having any way of seeing what was happening in the patient's brain while alive.

Assuming that human behavior is based on the brain, It was to be supposed that psychotherapy changed how this organ worked, but how it was a great mystery. The brain was like a black box, the content of which was impossible to know without opening the skull, a practice that was certainly not common. With the arrival of neuroscience, especially neuroimaging, it was possible to open this box, which is the skull without need to really do it, and thus you could know the functioning of the most complex organ of the body human.

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What does psychotherapy involve at the brain level?

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

In this way, in a healthy family neurological development takes place allowing a healthy, flexible and effective relationship among the most primitive part of our brain, the limbic system, with the most evolved, the cerebral cortex.

Experiencing 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 cause difficulties in regulating emotions. Upon reaching adulthood, the person manages problems in a dysfunctional way, so much so that it can even lead to episodes of dissociation and inability to manage their emotions.

Psychotherapy can serve to reorganize the brain structure by offering a learning environment rich in everything that the patient did not have when he was a child. Although the adult brain is not as plastic as the child's, what the patient learns in the context of psychotherapy can correct the hyperactivity and underactivity of various brain areas. Psychotherapy offers cognitive and emotional stimulation, improving brain connections.

Stress and psychological activation (arousal) are double-edged swords: at very low levels they do not motivate the subject to learn or change, while at high levels they cause them to respond in an exaggerated way to problems. The intervention of a psychotherapist can promote change by bringing stress and psychological activation to levels medium and moderate, stress at healthy levels that activate the production of growth hormones and better learning at the level neural.

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

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Brain changes associated with psychotherapy

Psychotherapy produces physical changes in the brain that allow better functioning, integration and regulation of the neurological systems, which underlie better mental health, especially when we are in situations of much stress. Specifically, changes in the frontal and temporal cortex that mediate the regulation of emotions, thought and memory.

An example we have with the case of Obsessive-Compulsive Disorder (OCD). Research on this disorder indicates that hypermetabolism occurs in different areas of the brain in this psychiatric condition, including the caudate nucleus. Many studies suggest that cognitive-behavioral treatments in patients with OCD normalize the metabolic levels of the caudate nucleus and that this phenomenon brings with it an improvement in the symptomatology.

Another case is that of specific phobias, such as arachnophobia. Patients with phobias present a reduction in the activity of the limbic system involved in the fear response after having undergone CBT-type psychological therapy. In schizophrenia patients it has been seen that psychological therapy normalizes the pattern of activity in the fronto-cortical areas, improving some of their symptoms.

We can also mention the case of people with major depressive disorder. In this type of patient, being subjects of psychotherapy reduces the activity of the areas associated with emotions such as sadness, such as the amygdala and 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.