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 that the brain is not a rigid organ, but is malleable, and changes throughout life, both in structure and function. This change happens through our experience. We actively change our brains by the way we respond to our 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 your brain is the tangible expression of your life history, the culmination of a lifetime of learning. Life experiences determine neural connection and creates a complex and integrated neural network that sometimes results in psychological rigidity, like depression or anxiety for example.
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 involves a certain amount of stress. Think of working out at a gym. In order to build muscles you need to apply stress in the form of resistance to the muscle in order for it to grow. Or think of learning Math. You have to wrestle with the problems in order to finally “get it” 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. It is important at the commencement of the therapeutic journey, that one be informed that 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 that lead to increased psychological flexibility and life satisfaction. Louis Cozolino, Ph.D., in his second edition of The Neuroscience of Psychotherapy, 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 a client wants help with anxiety. Anxiety is a rigid neural network and characterized by reactivity and opposition to experience. The therapist will promote safety and trust through mindful attunement to the client. The empathy and receptivity of the therapist will provide an environment in which the client may explore more flexibility in how she can relate to another human being. She will take some risks and learn how to be vulnerable without fear of rejection or abandonment. This will take some time, as all relationships do, for the rigidity of her neural networks to be challenged through risk taking, developing new perspectives toward her thoughts and feelings, and choosing new behaviors. She will be challenged to move toward and make space for her anxiety so she learns to experience it in a less reactive manner, with openness and acceptance. She will learn and practice a variety of mindfulness skills to orient her to the present moment, and out of rigid patterns of thinking that orient her in despair over the past or imagined future. She will develop openness and flexibility in dealing with her fears. She will be challenged to clarify her values and develop her emotional intelligence so that she can explore her thoughts and feelings and put them into words. And through this process she will develop a sense of herself in a new context, where she is no longer the victim of internalized threats or fear. This new context is literally manifested as a new construction of an interconnected neural network. She constructed it. She changed her own brain through the process of good therapy.