If you can change the way you think, you can change your brain.
That’s the conclusion of a new study, which finds that challenging unhealthy thought patterns with the help of a therapist can lead to measurable changes in brain activity.
In the study, psychologists at King’s College London show that Cognitive Behavioral Therapy strengthens certain healthy brain connections in patients with psychosis. This heightened connectivity was associated with long-term reductions in psychotic symptoms and recovery eight years later, according to the findings, which were published online Tuesday in the journal Translational Psychiatry.
“Over six months of therapy, we found that connections between certain key brain regions became stronger,” Dr. Liam Mason, a clinical psychologist at King’s College and the study’s lead author, told The Huffington Post in an email. “What we are really excited about here is that these stronger connections lead to long-term improvements in people’s symptoms and overall recovery across the eight years that we followed them up.”
Cognitive Behavioral Therapy, or CBT is a psychotherapy technique that was developed in the ‘70s and is commonly practiced today. CBT targets depression, anxiety and other mental illnesses by helping patients to identify dysfunctional thought patterns and beliefs, and ultimately to replace them with healthy ones.
In the case of schizophrenia and psychosis, CBT can help patients reframe their thinking around unusual perceptions or paranoid thoughts ― for instance, the belief that others are out to get them.
“CBT helps people learn new ways of thinking about and responding to their difficulties,” Mason said. “What we think makes it effective is that people can take the tools they have learned and practiced in therapy, and then continue to use them long after the therapy has ended.”
Rewriting Beliefs, Rewiring The Brain
In rewriting their deeply-ingrained thought patterns, it seems that patients also quite literally rewire their brains.
In a previous study, Mason and his team showed in a previous study that psychosis patients who received CBT had stronger connections between brain regions involved in accurate processing of social threats. The new findings reveal that these changes are enduring, and they may be critical to long-term recovery.
In the original study, patients with psychosis underwent brain imaging both before and after three months of CBT. The patients’ brains were scanned while they looked at images of faces expressing different emotions. After undergoing CBT, the patients showed marked increases in brain activity. Specifically, the brain scans showed heightened connections between the amygdala, the brain region involved in fear and threat processing, and the prefrontal cortex, which is responsible for reasoning and thinking rationally ― suggesting that the patients had an improved ability to accurately perceive social threats.
“We think that this change may be important in allowing people to consciously re-think immediate emotional reactions,” Mason said.
For their new research, Mason and his colleagues followed 15 of the original study participants, tracking their health over the course of eight years using medical records. At the end of the eight years, the participants also answered questions about their overall recovery and well-being.
The researchers found that heightened connectivity between the amygdala and prefrontal cortex was associated with long-term recovery from psychosis. The exciting finding marks the first time scientists have been able to demonstrate that brain changes resulting from psychotherapy may be responsible for long-term recovery from mental illness.
Overcoming Psychiatry’s “Brain Bias”
There’s a good chance that similar brain changes also occur in CBT patients being treated for anxiety and depression, Mason said.
“There is research showing that some of the same connections may also be strengthened by CBT for anxiety disorders,” he explained.
The findings challenge the “brain bias” in psychiatry, an institutional focus on physical brain differences over psychological factors in mental illness. Thanks to this common bias, many psychiatrists are prone to recommending medication to their clients rather than psychological treatments such as CBT.
“Psychological therapy can lead to changes in the mechanics of the brain,” Mason said. “This is especially important for conditions like psychosis which have traditionally been viewed as ‘brain diseases’ that require medication or even surgery.”
“This research challenges the notion that the existence of physical brain differences in mental health disorders somehow makes psychological factors or treatments less important,” Mason added in a statement.
CORRECTION: This article previously described Liam Mason as a psychiatrist; he is a clinical psychologist.