Talk Therapy Linked to Changes in Brain Activity

Justin Karter
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Talk therapy has long been associated with symptom and behavioral changes, but new research shows that it may also lead to neural changes in the brain. The recently published research found that transference-focused psychotherapy (TFP) was linked to alterations in neural circuitry in women diagnosed with borderline personality disorder (BPD).

“These results advance our currently limited understanding of neural mechanisms associated with psychodynamically oriented psychotherapy,” wrote the researchers. “Activation in [certain parts of the brain] was associated with improvements in behavioral constraint, emotional regulation and aggression in patients with BPD.”

One of the researchers, Mark F. Lenzenweger, distinguished professor of psychology at Binghamton University said: “These findings represent the genuine frontier of clinical science in understanding the effects of psychotherapy.”  “Think of it — talk therapy that impacts neural or brain functioning.”

Psychotherapy is currently considered the predominant treatment for people diagnosed with BPD and transference-focused psychotherapy  (TFP)  is regarded as one evidence-based treatment  for improving symptoms of interpersonal aggression and impulsivity. TFP, developed by Kernberg and colleagues utilizes “techniques of clarification, confrontation, and interpretation of affect-laden themes that emerge within the transference relationship.”

The researchers recruited a small sample of 10 women who had been diagnosed with borderline personality disorder (BPD) from a New York City Hospital.  These patients were treated for one year with transference-focused psychotherapy (TFP) and given regular neuroimaging scans using functional magnetic resonance imaging (fMRI) methods.

According to the researchers, “treatment with TFP was associated with relative activation increases in cognitive control areas and relative decreases in areas associated with emotional reactivity.”

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Perez, D. L., Vago, D. R., Pan, H., Root, J., Tuescher, O., Fuchs, B. H., … & Lenzenweger, M. F. (2015). Frontolimbic neural circuit changes in emotional processing and inhibitory control associated with clinical improvement following transference‐focused psychotherapy in borderline personality disorder. Psychiatry and clinical neurosciences. (Full Text)

22 COMMENTS

    • Yes, it seems lame the way that this is being reported as though it is a surprising finding. But what is even more lame is that in many corners, it’s still taken for granted that if mental or behavioral issue is found to be related to a brain difference, that is being taken as proof that the issue is evidence of a “biological brain disease.” So anyone who thinks in that way would have to be “shocked” to find out that talk therapy can miraculously reverse this “brain disease.”

      John Read (an expert regarding the effects of childhood diversity on later mental/emotional problems) says when he goes to conferences with lots of “brain” people he sometimes finds himself getting up and asking questions like “what is the brain for?” and “Of what use would be a brain that did not change itself in response to the environment?” Because so many of them seem to talk and think about the brain as though it is an organ that exists in disconnection from its world.

      • It is pretty sad, Ron. Sometimes I wonder if the majority of biological psychiatristric researchers are aliens who have infiltrated our planet from some other galaxy where common sense and critical thinking do not exist. It’s hard to think of another explanation for why these so-called professionals are so unable to understand that trauma and environmental experience contribute heavily to emotional and relational problems…

      • Ron, do you really think there are that many of these type of people who think this way?

        Most psychologists or outpatient therapists I hear from do not seem to think in this way. It seems to me that it is primarily researchers who work in university settings or in hospitals but do not do intensive therapy with clients that think this way. In other words, researchers who are disconnected from real people. This allows them to maintain the non-awareness and denials that maintain the myth, for them, that behaviors represent brain diseases. I also think that outside of America this sort of thing is less common; America being the land with 4% of global population which consumes over 50% of psychiatric drugs, and thus the land where researchers are pressured by corporations into biological simplemindedness all too often.

        • I think there are lots of clinical people who think of “serious mental illness” as brain disease – it allows them to think they are doing the right thing when they focus all the efforts on getting the person to think of themselves as permanently defined as ill and keeping the person on drugs forever etc.
          At least that seems to be the way it works in the US! I have heard the US really stands out in that way, so I agree with you on that part.

      • My comment above has a typo, I meant to say John Read is an expert regarding the effects of “childhood adversity” not “diversity.”

        To BPDTransformation: yes, the alien explanation is a pretty good one! It’s so much simpler than trying to sort out all the complex politics and motivated blindness which might otherwise account for how otherwise intelligent and competent humans could overlook so much!

      • And the implications for the world of biological psychiatry are, of course, systematically ignored. If therapy can change brain chemistry, it stands to reason that brain chemistry is readily altered by environmental experiences. Logically, the idea that “mental illnesses” are uniformly caused by fixed problems in the brain is therefore completely disproven, and all those brain scans of the “ADHD brain” or the “depressed brain” can be completely dismissed as anything but evidence that different people are simply reacting to differing sets of circumstances. So why are we trying to drug brains into submission, when they appear to be responding to the survival needs of the environment? I know, I know, rhetorical question… as long as there are financial and social benefits to a certain “truth,” it will stay “true” regardless of the data.

        —- Steve

        • “As long as there are financial and social benefits to a certain ‘truth,’ it will stay ‘true’ regardless of the data.” This does seem to be the reality … but, society did eventually become disgusted by the powers-that-be’s former witch hunting theology … eventually.

          And since psychiatry basically just quietly took over the witch hunters’ role in society (unjustly defaming and murdering women and children to cover up the men’s sins), maybe society will some day also tire of today’s witch hunters, the psychiatrists.

  1. Scientific Fraud About Brain Scan Findings
    Psychiatrists wrongly assume that all brain scan differences are abnormalities.

    “Of course, they are comparing averages, so the left amydala in some BPD patients is larger than those of the average control. Notice also that the scientists only occasionally compare different diagnostic with each other.”

    https://www.psychologytoday.com/blog/matter-personality/201407/scientific-fraud-about-brain-scan-findings

    • Right, brain scan difference averages are understandable normal differences due to one group having more trauma, neglect, fear, stress, whatever than the other one; the crazy thing would be a brain that could experience trauma but not change relative to a brain that experienced a harmonious environment. That brain would not be functioning properly.

      As usual psychiatrists are unable to understand even the most basic cause and effect sequences.

    • I was interested by these words of David Allen (the author of the article you linked):

      “In this post I will not be talking about gross findings that affect the entire brain, like the shrinkage (cerebral atrophy) seen in advanced Alzheimer’s and in *some cases of severe advanced schizophrenia* (and yes, contrary to what the anti-psychiatry folks say, that was found in 30 studies of patients with schizophrenia who had never taken antipsychotic medications). Those findings are clearly indicative of disease.”

      Any replies or rebuttals?

      • In his writing this guy Allen asserted off-the-cuff that schizophrenia was definitely a brain disease caused by brain chemistry, but without citing any clear evidence, and in other articles he made negative comments about people labeled with Borderline Personality, implying that they are unlikely to get better. Very little credibility in my book. Maybe he’s just not a very good therapist.

        As Ron says below, severe psychotic states (characterized be extreme terror, rage, confusion, and a lack of secure loving relationships for years) clearly affect the brain and its limbic system, and do not at all require the explanation of being caused by a “disease process” if the brains of people who experience these things are different than the brains of people who are in much better past and present psychosocial situations.

        • While comparing brains of people can so easily lead to stigma, duality, marginalization, we do know that childhood abuse in the family does, without a doubt, lead to heart wounding, which will most likely lead to challenging relationships with one’s self and with others..

          The heart can heal, and when it does, than a pathway opens for core changes. Any adverse effect on the brain that occurs during any kind of stress can be reversed. Then, there is the matter of the environment being called to make changes in how it operates as a culture. That is often where we get stuck and extremely frustrated, but that can change, too, with diligence, focus, and a tremendous amount of faith.

  2. I think all this also boils down to the scientists’ persistent need to understand humans as brain driven machines (to understand the brain as a computer). They attach to this view so much that any evidence that goes against it is habitually ignored. Studies that have made direct observations of (changes in) neurons also show that acute and chronic stress induces structural changes in several brain areas such as shrinkage of neurons, simplification of dendrites and reduction of spine density as well as changes in brain circuits.
    See:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645314/
    http://www.nature.com/neuro/journal/v15/n5/full/nn.3093.html
    http://www.ncbi.nlm.nih.gov/pubmed/26320029
    http://www.ncbi.nlm.nih.gov/pubmed/25335852
    http://www.ncbi.nlm.nih.gov/pubmed/25348768
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181836/
    http://www.ncbi.nlm.nih.gov/pubmed/16095592
    http://www.ncbi.nlm.nih.gov/pubmed/12151561
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179117/pdf/pnas.201110444.pdf
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550735/
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893146/

  3. To me, it stands to reason that our brain chemistry responds to environments, as our chemistry is not fixed, but fluid and ever changing. It’s how we adapt (or not), biologically and emotionally, to circumstances and change, and we can feel this, physically, if we don’t dissociate, and stay attuned to our bodies during such changes.

    I’m fairly certain that our brain chemistry will more than likely respond one way to a violent, oppressive, judgmental, marginalizing environment, and respond quite differently to a calm, safe, grounded, lovingly supportive environment. The latter, I imagine, can lead to balance and clarity.

    Same goes with people, whether therapists or not–we can elicit divergent chemical (and emotional) responses from people, depending on our own energy and mindset.

    If we’re conflicted and struggling, the right kind of dialogue–engaged, respectful, open, focused, authentic, non-biased–can, indeed, heal our hearts, minds, and spirits via chemical shifts. It’s all part of the same unit, attempting to work in tandem.

  4. Hmm… So today, I went to the doc who said my brain needs fixing and suggested therapy to change my brain waves. I asked him if there were any alternatives that he would suggest. He said, “Oh no, you need this like a diabetic needs insulin.”

    I ran home, changing my brain radically while doing so. I ate lunch, choosing foods that affected my brain. I petted my dog and wow my brain felt terrific. I spent time knitting, (which in a study was shown to help people with eating disorders). Then, the sun went down, causing a radical brain shift. I went to meet my sweetheart. My pupils dilated, worthy of an EEG test. My sweetheart and I hopped into bed and had wild sex. Then, the biggest brain change of all: I slept.

    The next day, the doc called. He asked me if I’d been to the therapist. I said, “Don’t worry. I feel great, doc.”

  5. Hi Julie,

    I have always been extremely upset about doctors like yours using the diabetic analogy like most folks on this board. Since I have joined the pre-diabetic club, I find it even more offensive.

    Yeah, it is amazing by taking extra care of yourself as you did can change your brain waves without needing therapy. Kind of like if I pay attention to my diet, my chances of joining the diabetic club will be greatly diminished which will greatly decrease the chances of my needing insulin.

    It just seems like healthcare professionals are incapable of coaching people to engage in self care methods that have a great chance of working. Not putting therapy down as some people need it but to say there weren’t any alternatives when you asked your doctor is beyond absurd.

    • Hello AA, you know that scenario, though perhaps sounding like a realistic slice of life of the average human being’s day, was a bit of tongue in cheek on my part only to illustrate a point. And yes I think they stuck their feet straight into their mouths with that deliberate, intentional diabetes lie. Don’t they even feel the least twinge of guilt over such an atrocity? Like telling us the truth isn’t all that important. We’re subhuman, whatever percentage lesser than human, never quite rightful citizens deserving of respect and upfront honesty. We’re not worth it, we’re commodity, disposable, only one more negligible statistic easily swept under the rug should they screw up.