What does therapy actually do? How does it work? Does anyone really ever change?
The field of neuroscience has exploded in recent years, revealing a number of findings about the human brain: how it develops, how it operates, and how it changes. Neuroplasticity explains how the brain is not a rigid organ, but is malleable and changes throughout life, both in structure and function. This change happens through experience. Humans actively change their brains by the way they respond to their environment.
The brain and nervous system are made up of millions of neurons and hold the capacity to connect in a multitude of possible combinations. The architecture of the brain is the tangible expression of life history, the culmination of a lifetime of learning. Life experiences determine neural connection and create a complex and integrated neural network that sometimes results in psychological rigidity, such as depression or anxiety.
Therapy is essentially a laboratory for developing, reshaping, and strengthening new neural connections that promote psychological flexibility and life satisfaction. The restructuring and strengthening of neural networks involve a certain amount of stress.
Think of working out at a gym. In order to build muscle, you need to apply stress in the form of resistance for the muscle to grow. Think of learning math. You have to wrestle with the problems to understand them and move onto higher functions. Therapy is the same way.Therapy is not supposed to be easy. If it is, not enough stress is being applied to the neural “muscle,” and psychological growth may be less likely. At the commencement of the therapeutic journey, it is important to be informed therapy may get tough, because it will—and this is a good thing.
The goal of psychotherapy, from a neuroscientific perspective, can be summed up as promoting growth and integration of neural networks, leading to increased psychological flexibility and life satisfaction. In his second edition of The Neuroscience of Psychotherapy, Louis Cozolino, PhD, suggests four areas in which psychotherapy enhances neural growth and integration:
- The establishment of a safe and trusting relationship
- Mild to moderate levels of stress
- Activating both emotion and cognition
- The co-construction of new personal narratives
So what does this look like? Let’s say someone wants help with anxiety. Anxiety is a rigid neural network characterized by reactivity and opposition to experience. The therapist will promote safety and trust through mindful attunement to the person. The empathy and receptivity of the therapist will provide a comfortable environment to explore more flexibility in relating to another human being. The therapist will encourage taking risks and learning how to be vulnerable without fear of rejection or abandonment.
It will take time, as all relationships do, for the rigidity of neural networks to be challenged through risk taking, developing new perspectives toward personal thoughts and feelings, and choosing new behaviors. The therapist will challenge the person to move toward and make space for anxiety in an effort to learn to experience it in a less reactive manner, with openness and acceptance. The therapist will teach the person to practice a variety of mindfulness skills to become more present and to stop rigid patterns of thinking that result in despair over the past or imagined future.
The therapist will encourage openness and flexibility in dealing with fears, challenging the person to clarify values and develop emotional intelligence to translate thoughts and feelings into words. Through this process, the person will develop a sense of self in a new context, no longer the victim of internalized threats or fear. This new context is manifested as a new self construction of an interconnected neural network. The person’s brain is changed through the process of good therapy.
References:
- American Psychological Association. APA concise dictionary of psychology. Washington, DC: American Psychological Association, 2009. Print.
- Cozolino, L. (2010). The Neuroscience of Psychotherapy: Healing the Social Brain (2nd ed.). New York: W.W. Norton &.

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