Does psychotherapy influence the human brain?

Does psychotherapy only affect people's behaviors, or also their brains?

The development and refinement 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 in such a way that it was difficult to identify the changes that occurred in the brain over time.

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

Neurosciences and psychotherapy

Techniques such as functional magnetic resonance imaging (fMRI) or structural magnetic resonance imaging (sMRI) have made it possible to identify abnormalities in the brain functioning of patients with mental 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 the neural substrate of the patients' improvement was. The effectiveness of the therapies was established on the basis of how the patient claimed to have improved his problems, assessing his subjective wellbeing and the degree of improvement that the therapist saw in him, just as it is done today, but without having any way of seeing what was happening in the patient's brain while he was alive.

Since human behavior is based in the brain, it was to be expected that psychotherapy would have to be based in the brain, it was to be assumed that psychotherapy changed how this organ functioned, but how it did so was a great mystery.. The brain was like a black box, whose contents were impossible to know without opening the skull, a practice that was certainly not common. With the advent of neuroscience, especially neuroimaging, it was possible to open this box that is the skull without actually doing it, and thus it was possible to know the functioning of the most complex organ of the human body.

What does psychotherapy involve at the brain level?

In an ordinary childhood our parents and caregivers act as sources of reassurance, calm and learning, offering their children a safe environment for them to develop, explore and learn not only knowledge and skills, but also to manage stress, fear and other negative emotions.

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

Experiencing chronic stress during childhood affects neurological growth, impeding its development. High levels of stress hormones eventually affect 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 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 infant brain, what the patient learns in the context of psychotherapy can correct hyperactivity and hypoactivity in various brain areas.. Psychotherapy offers cognitive and emotional stimulation, improving brain connections.

Stress and psychological arousal are double-edged swords.at very low levels they do not motivate the subject to learn or change, while at high levels they make him/her respond exaggeratedly to problems. The intervention of a psychotherapist can favor change by bringing stress and psychological activation to medium and moderate levels, stress to healthy levels that activate the production of growth hormones and better learning at the neural level.

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.

Brain changes associated with psychotherapy.

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

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

Another case is that of specific phobias, such as arachnophobia. Patients with phobias show a reduction in the activity of the limbic system involved in the fear response after having been subjected to 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 patients, being subject to psychotherapy reduces the activity of the brain areas associated with emotions such as sadness, as is the case of the amygdala and the limbic system in general. Psychotherapy also causes changes in the hippocampus, which regulates emotions and memory.which regulates emotions and memory, and the medial prefrontal cortex, associated with thinking and problem solving.