Psychotherapy produces changes in the brain

The door is open to the design of psychological treatments based on neurobiological evidence.

The development and improvement of neuroimaging neuroimaging techniques over the last few decades has made it possible to understand the structures and functions of the brain in living subjects.

Before the appearance of these techniques, the study of the brain was considerably limited in such a way that it was difficult to identify the changes that occurred in the brain over time.

The emergence of neuroimaging techniques

Neuroimaging has opened up new lines of researchThe aim of the study was to identify abnormalities in the brain functioning of subjects with psychiatric pathologies, to determine the brain structures involved during the performance of a particular task (such as remembering a list of names), or to better understand the brain mechanisms involved in the flight response.

A way to objectively measure the effectiveness of psychological therapy

Psychological therapy produces changes in a patient's emotional state, belief system, and behavior. It is not surprising, therefore, that these changes are also measured in a patient's emotional state, belief system and behavior, it is not surprising that these changes also occur at the brain level.. One of the lines of research that has been developing with the advent of neuroimaging is the study of the brain changes that occur as a consequence of psychological therapy.

Before the advent of neuroimaging, the effectiveness of a psychological therapy was measured based on subjective measures such as patient and therapist assessment of the degree of improvement achieved or comparison of pre- and post-treatment test results. However, the neural substrate of this improvement was unknown. Hence, the brain was compared to a black box whose contents could not be known. The advent of neuroscience and, specifically, of neuroimaging, has made it possible to open this box and begin to understand the functioning of the body's most complex organ.

Changes in the mind produce changes in the brain

If we can now see how the brain functions and the transformations that take place in it, it becomes possible to measure them objectively, it becomes possible to objectively measure the changes that occur in the course of psychological treatment, as well as those that may occur during the course of treatment.and also those that may occur after the end of therapy. This advance makes it possible to identify those psychological treatments that are most effective for a given disorder. The brain, being a plastic organ, is shaped by the experiences of the subject and responds to psychological treatment through changes in its structure and functions.

Barsaglini et al. (2014) conducted a review of the main research that has analyzed the effects of psychological therapy in patients with mental disorder. In this review they observed that obsessive-compulsive disorder is characterized by hypermetabolism of different areas of the brain, including the caudate nucleus. Many studies suggest that cognitive-behavioral treatments in patients with obsessive-compulsive disorder produce a "normalization" of the metabolic levels of the caudate nucleus and that this "normalization" is accompanied by an improvement in symptomatology.

On the other hand, patients with specific phobias (such as, for example, spider phobia) experience a reduction in the activity of the limbic system involved in the fear response as a consequence of having participated in a cognitive-behavioral oriented psychological therapy. In the case of patients with schizophrenia, several studies collected in the review by Barsaglini et al. observe that psychological therapy produces a normalization of the activity pattern in the fronto-cortical areas and, therefore, an improvement in the symptomatology.

Towards the design of effective psychological treatments based on neurobiological evidence

In general terms, these results indicate that psychological therapy produces changes in the functioning of the brain and that these changes are associated with an improvement in the patient's symptomatology.. In this sense, although to different degrees depending on the disorder in question, both pharmacological and psychological therapy allow normalization or compensation of abnormal patterns of brain activity.

Although it is still too early to draw consistent conclusions (there are divergences in the scientific literature about which specific brain changes are produced by psychological therapy and also about which methodology is most suitable for the measurement of these changes), neuroimaging opens the door to a promising line of research: the design of effective psychological treatments based on neurobiological evidence.

Bilbiographical references:

• Barsaglini A, Sartori G, Benetti S, Pettersson-Yeo W y Mechelli A. (2014). The effects of psychotherapy on brain function: A systematic and critical review. Progress in Neurobiology, 1–14.