What does therapy actually do? How does it work..." /> What does therapy actually do? How does it work..." />

Can Therapy Affect the Brain?

Illustration of brain in headWhat 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:

  1. The establishment of a safe and trusting relationship
  2. Mild to moderate levels of stress
  3. Activating both emotion and cognition
  4. 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.


  1. American Psychological Association. APA concise dictionary of psychology. Washington, DC: American Psychological Association, 2009. Print.
  2. Cozolino, L. (2010). The Neuroscience of Psychotherapy: Healing the Social Brain (2nd ed.). New York: W.W. Norton &.

© Copyright 2011 by By Jiovann Carrasco, MA, LPC-S. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Joye Chase

    August 29th, 2011 at 3:55 PM

    Gosh I would hope that therapy would effect the brain!
    Isn’t that what it is supposed to do?


    August 29th, 2011 at 7:08 PM

    The math and the gym examples helped me understand this..Now when I think about it-yes,the brain is not rigid for this very reason,we have the flexibility,the ability to change thugs and improve ourselves.

  • henry

    August 30th, 2011 at 8:17 AM

    wonderful article touching a topic that many wonder about from time to time.I know I sure have.it always feels good to read something like this with there being a cconnect between the things around us(including therapy) and what actually happens in our mind.

  • Jiovann

    September 8th, 2011 at 10:02 AM

    Thanks for the comments. I recommend Cozolino’s book, which goes into a LOT more detail. Especially interesting are the chapters on lateral and vertical integration of neural networking. Good stuff!

  • Nikko

    September 14th, 2011 at 5:32 PM

    Cool, Im giving you props where props r do. ure article has some good stuff 4 a project im writing in school. dont worry i cited yur site and everything so it all good! thx a lot 4 this, my teachers impressed cuz i got an A and had all good info that, i couldn’t find anywhere else but here. Youve helped me learn about what pyschology is and how it works with the brain. Even my teacher didnt no most of the stuff that you have here. I’ll make this my go to site in the future fo’ sho. Just keep it up, with those articles and remember that you have a hi school student countin on ya. Peace

  • Jiovann

    October 21st, 2011 at 7:22 PM

    Nikko! You’re awesome! Thank you so much for the props. I am so happy for you. Keep reading!

  • Kimberly

    April 7th, 2013 at 7:33 PM

    Great article. This approach and the research that supports it is beyond phenomenal. It has really helped me to integrate my understanding of attachment theory, brain science, interpersonal trauma, and psychotherapy and mindfulness. It just makes so much sense. Anyone interested should check out Lou Cozolino, Dan Siegel, and Ronald Siegel.

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