Can Therapy Change Your Brain?

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Exciting new research on anxious adolescents shows that successful therapy is associated with positive changes in the brain.

The American Journal of Psychiatry recently reported that after completing a course of cognitive behavior therapy (CBT) for anxiety, researchers observed improvement in adolescent brain functioning.

Sixty-nine participants in the study, who had an average age of 12.8 years, were diagnosed with generalized anxiety disorder, social anxiety, and/or separation anxiety disorder. Researchers scanned their brains with functional MRI before and after cognitive behavioral therapy (CBT). None of the participants were on medication. They were compared to a group of age-matched controls who did not experience anxiety.

Specifically, the researchers found that overactivity in the fronto-parietal areas of the participants’ brains normalized after treatment. However, they still experienced increased limbic system activity compared to the control group.

This article reminded me of another study from several years ago, which examined brain glucose metabolism after four weeks of intensive cognitive behavior therapy for OCD. Reduction in OCD symptoms after treatment corresponded with significant improvements in the brain after the treatment.

How Does CBT Help Anxiety?

Cognitive behavioral therapy addresses changing problematic thinking and behaviors that feed into the issue that the person wants to change.

Cognitive element: People learn to question catastrophic thoughts and have a more balanced and realistic way of viewing their fears. For example, suppose a teenager avoids raising her hand in class because she worries that there will be horrible consequences if she says the wrong answer. A therapist could help her examine her catastrophic fears and come up with realistic alternative outcomes if she did indeed say the incorrect thing.

Behavioral component: The behavioral aspect of CBT often involves exposures – confronting situations that people fear. This behavioral piece is critical because people learn from direct experience that their fears will not come true. In the example of the socially anxious teenager, she might work on practicing raising her hand in class to participate. As part of confronting her fear, she might even purposely give the wrong answer as an experiment to see what actually happens.

Why Is This Brain Imaging Study Important?

There are many reasons why this study is important.

• For one, having a better understanding of how the brain responds to treatment like CBT could help lead to advances in therapy. We might eventually better understand which aspects of treatment have the most significant impact on brain functioning.
• In addition, skeptics of therapy who see anxiety and other mental health issues as biological or neurochemical problems might appreciate the positive impact that non-medication treatment like CBT can have on a person’s functioning. Medication can also be helpful for many. However, those resistant to considering therapy because they view their anxiety issues as brain functioning problems might be open to exploring it as a treatment option.
• Finally, I hope that studies like this can give more credibility to treatments like CBT and lead to more mental health parity, in which insurance companies are willing to reimburse therapists and their clients at a higher level than they do currently.

The Mind-Body Connection

There is still so much more that we need to learn about how the brain impacts emotions and behavior and how therapy can change the brain. Studies like this one are a great step in elucidating this connection.

To find a therapist, visit the Psychology Today Therapy Directory.