Like Drugs, Talk Therapy Can Change Brain Chemistry




After six years of twice-weekly psychotherapy sessions, Eric had plenty of insight, but his anxiety level had barely changed.

He was still bedeviled by a ceaseless urge to wash his hands and shameful and repetitive violent thoughts. Out of desperation and against the wishes of his therapist, he visited my office to discuss the possibility of medication.

"I thought I could understand my way out of my obsessive compulsive disorder," he recalled recently. "I wanted to be able to do it on my own, without medication."

What he did not remember was his vehement opposition to psychotropic medication on the ground that it was not natural and would change his brain chemistry.

He was right. Like Eric, many patients and therapists share the view that psychotherapy is preferable to pharmacotherapy because it is more "natural" and because it supposedly gets to the root of the patient's problem. They are convinced that self-understanding will bring relief, whether the problem is anxiety, depression or obsessional thinking.

Insight is a prerequisite of happiness, the theory goes, and well-being achieved without the hard work of psychotherapy is artificial and inauthentic.

But new evidence suggests that the talking cure and psychotropic medication have much more in common than had been thought. In fact, both produce surprisingly similar changes in the brain.

Take Eric's obsessive compulsive disorder. It hobbles patients with unwanted thoughts, often violent or sexual, that play in the mind like a broken record. Owing to the sometimes lurid nature of the thoughts, the treatment mainstay had for years been psychoanalytically oriented therapy to unlock the sexual and aggressive conflicts presumed to underlie the symptoms.

There was just one problem. That form of psychotherapy rarely, if ever, worked for those patients, a point now widely accepted by most psychoanalysts themselves.

But two seemingly different treatments can be highly effective: a form of talk therapy called cognitive-behavior therapy and a class of antidepressants called selective serotonin reuptake inhibitor antidepressants, or SSRIs, drugs like Prozac and Zoloft. It is well known that patients with the disorder have altered serotonin function compared with normal controls.

Brain imaging that uses PET scans, or positron emission topography, has shown that the disorder is associated with functional hyperactivity of the caudate nucleus, a structure buried beneath the cerebral cortex. Some researchers hypothesize that the caudate is part of a subcortical circuit that acts as a kind of filter, sifting out extraneous thoughts and impulses.

In obsessive compulsive disorder, they theorize, the subcortical filter malfunctions, allowing the unwanted thoughts to reach the cortex and then on to consciousness.

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SOURCE:- Harvard Medical School
Consumer Health Information

Yes, interesting reading. I am seeing a psychotherapist and he somewhat got into this topic. It has been proven that talk therapy EFT, CBT etc can bring about the same changes as the meds we take, but unfortunately not fast enough. When you go to the doctor in the depths of despair not able to see past today, you don't want to leave with an appointment to see a psychiatrist do you? You want help there and then. Medications are the best they (the doctors) can do at that time. It would be better if the patient could 'hang on in there' for therapy to retrain the brain, but in practice it doesn't work.