Growing up, I was fascinated by how mental health struggles, often dismissed or misunderstood, could be seen inside the human brain. Our society has improved in the last 15 years, but there used to be an abundance of dismissive messaging about mental health. Coming from a Middle Eastern background, the messaging was amplified tenfold: common stigmas included beliefs that mental health disorders were not “real.” Depression was seen as an excuse for being “lazy,” and anxiety symptoms were commonly thought to be “all in your head.” In such a disparaging time, it was intriguing to learn that there were distinguishable, tangible pieces of evidence that demonstrated the reality of mental illness through the use of brain imaging techniques.
Throughout university, I grew to love neuroscience classes because they provided a deeper dive into how our brains develop and take shape, as well as how they are affected by experiences in our lives. We were shown how every circumstance in our life integrates itself into the makeup of who we are, including, but not limited to, our everyday interactions, the way we are raised, the friends we have, the feelings we have, the cultural norms of our environments, and the major events in our lives. It was apparent that brain imaging techniques could not only reveal how our larger brain regions and structures were involved with, and respond to mental health issues, but when looking at our neurons, we could see from a cellular level that our brains have neural pathways that respond to our experiences. Our neural pathways are strengthened every time they are used, like when we think a specific way, or practice a certain task.
Researchers started to realize that even beyond childhood, our brains remained susceptible to shaping, and at any age, our brains were “plastic.” With this newfound knowledge, the idea of neural plasticity, or “neuroplasticity,” was created, and defined as the brain’s capability to alter its structure or function in response to exposure to new stimuli or environments (Van Ombergen, Laureys, Sunaert, et al., 2017). This being the core component, many forms of psychotherapy began to leverage the idea of neuroplasticity as a way to help treat mental health disorders, specifically maladaptive thoughts or behaviours. The idea that we tend to act based on the brain’s path most followed gave rise to the idea that with awareness, practice, and repetition, we can make way for new, healthier, and more adaptive pathways that will allow us to function in ways that align with our ideal selves.
Psychotherapy being thought of as solely “talking about your feelings” minimizes the total impact that every aspect of psychotherapy has on our brains. Dr. Eric Kandel, a renowned neuroscientist, explained that though we can’t “overcome” our DNA, we can compensate for it through learning. He noted that “psychotherapy is a biological treatment, as it can facilitate changes in gene expression, [and] can produce long-term changes in behavior” (Malhotra, & Sahoo, 2017). Studies have shown that neurologically, the relationship a client and therapist build is crucial to the effectiveness of treatment, accounting for nearly 30% of therapy success (Horvath, Re, Flückiger, & Symonds, 2011). A positive therapeutic alliance, meaning that the client feels safe, understood, and supported, allows the brain to let down its guard, and become receptive for change.
We can see a clear distinction in how our brains are adaptive and flexible to new information, repetition, and interpersonal support. With these things at play, we develop neuroplasticity, and create new pathways in our brains to help change thoughts, behaviours, or feelings that we often have. Interestingly, this sounds a lot like the foundation for many other health disciplines found at CARESPACE. An interesting metaphor I was taught to use as a psychotherapist was the idea that our brains are like muscles, and psychotherapy was like a personal training session at the gym. Technical language aside, this metaphor clearly demonstrates the point of psychotherapy as an intervention for behaviour change without the responsibility of success relying on the therapist, but that, just like having a personal trainer, if you aren’t working out, you aren’t building the muscles you need to. Doing “10 reps of positive affirmations” and “I feel statements” isn’t the cure all, but when clients are provided with psychoeducation and taught about why what we do in session is incremental to their bigger picture goal, this may open the door for deeper and more lasting change. We as psychotherapists do a lot of work to normalize people’s experiences, and foster understanding for our brains simply being biologically wired to function the way they do in response to our experiences, upbringings, etc.
Cognitive Behavioural Therapy (CBT) differs from other types of psychotherapy because it focuses on neuroplasticity at its core, and incorporates structured homework into the treatment. CBT helps clients identify recurring thoughts that are maladaptive or unhelpful to them, then focuses on training one’s brain to recognize when and how often these thoughts occur, such as through daily thought logs (see below). Throughout treatment, the goal would be to develop healthier, more constructive thoughts as an alternative to the initial unhelpful ones, essentially creating new neural pathways over time. Like Dr. Kandel said, we cannot overcome the pathways we already have, but we can open our brains up to the opportunity of alternative ones, and with time and practice, strengthen them.
In summary, our brains are like muscles that we need to consistently exercise to develop new thoughts, feelings, and behaviours. They possess an incredible capacity to change and adapt through neuroplasticity. Meaningful progress is always a possibility with the right support and environment. At CARESPACE, we all work towards the shared goal of fostering growth and healing. This serves as a reminder for both practitioners across health disciplines and clients that, while our approaches may vary, we all operate on the belief that we can trust our brains to do what they are designed to do: we just need to give them the space for that to happen.
References
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