10 Ways Talking Therapy Improves Brain Structure and Function

Feb 03, 2020

The brain - neuroscience - is key to our psychological and emotional health
Therapist Rakhi Chand outlines 10 ways talking therapy can trigger helpful processes in the brain
If you are interested in starting therapy, we can help. Start your search here.

‘But how does talking help?’ is a question that I’m frequently faced with, and one that I frequently struggle to answer. A lady called Bonnie Badenoch is helping put an end to my opaque responses. Badenoch wrote a book called Being a Brain-Wise Therapist. Below I attempt to translate the basics so you may be a ‘brain-wise’ client, if you are not already.

It turns out that talking – and not just to a therapist - can change brain structure and function in positive ways. Should you be struggling with your feelings, sensations and/or symptoms, knowing what your brain is automatically doing to help you recover could be empowering and hope-inducing.

My intuitive understanding, before I learnt anything about the brain, was that making sense of our experiences, naming them, and our feelings in response to them, was necessary for mental wellbeing. As a professional, daily I witness that talking increases awareness. This awareness is new information – and however subtle, I see it facilitating people to make different choices.

Beneath our conscious awareness, however, there is a ridiculous amount going on that renders talking (and reflecting) helpful. Focussed attention on our experiences impacts brain structure and function. It also impacts our nervous system; and consequently – and directly – other internal organs such as the heart and gut, too.

Below are ten ways in which brain structure and function could improve - automatically - with talking therapy. Enter neuroscientist Claudia Civai, whom I consulted for her technical prowess (and to make extra sure I wasn’t inadvertently telling any porkies – it turns out the brain is pretty complex).

1) Naming emotions affects blood flow in the brain

When we name and differentiate emotions accurately, we move away from general and unknown fears. In this process, the amygdala region in the brain – that responds to the perception of fear - deactivates i.e. less blood flows there. At the same time, blood flow increases in the right prefrontal cortex, a part of the brain that contributes to emotional regulation (Badenoch, 2008).

2) The brain is able to change

Every act of recall is also an act of modification: the brain has an ongoing capacity for change. This is known as neuroplasticity. Badenoch describes it thus: ‘all aspects of an experience tend to gather into a neural net that encodes a representation of that event. When one strand of that net is touched by a current experience, there is some probability that the whole net will be activated. This is called remembering’.

One of the core memory areas is the hippocampus, which is part of the limbic system; an important system for emotional regulation. (I find it helpful to be able to visualise the brain – if you do too, think of the limbic system as being in the centre of the brain.) The amygdala is part of the system too; this is why certain emotional stimuli can trigger memories, and emotions and memories are tightly connected.

So, the empathy of a therapist in relation to a memory may well initiate the growth of new neural connections that will now become associated with and ease the suffering contained in the neural nets of previous difficult/painful events.

3) Reflection releases necessary hormones

During the process of remembering, the part of the brain known as the hypothalamus is activated; this controls the neuroendocrine system. Reflecting on experiences can thus release hormones, helping to create stability in the body.

4) We can consciously lower our stress levels

The hypothalamus will also be activated if we feel stressed; the hormone cortisol will be released, again with the aim of restoring stability. However, our cortisol levels may become too high if we feel chronic stress, leading to adverse effects such as anxiety and depression. When chronically stressed, we need to consciously help lower our cortisol levels.

5) Talking can give us access to important information

Therapy fosters neural integration i.e. the removal of blockages in communication and the blending of inputs from different areas (for example visual, emotional, and memory systems).

During times of stress it is common for communication pathways in the brain to become blocked or shut down. The prefrontal region in the brain (the area directly behind our eyes and forehead) is where rational and emotional cognitions are required to converge for healthy decision-making. Therapy typically helps to ensure that as much information as possible is accessible - neural integration - when making choices.

6) Chronic stress harms brain health

For a moment I considered leaving this out as it could sound mildly terrifying - but pertinent it is: chronic stress may lead to the death of brain cells. Chronic stress is rubbish! And may have longer term consequences - try not to wait to help yourself/get help.

7) Therapy can help us use our brains to their full capacity

Processing emotions and whole experiencing (including the non-verbal and bodily) utilises brain nets usually found in the right hemisphere of our brains – ‘integrative’ brain nets. Not attuning to this non-verbal part of our experiencing means we are not using our brains to their full capacity. We may become disadvantaged in relationships and social understanding in this case i.e. if we place premium on the strictly verbal and analytical left hemisphere brain nets.

Further, it is my experience that society in the Western world – and institutional patriarchy more generally - tends not to place particular value on an integrative approach. I thus witness in clients a bias towards the literal, when in fact it is also vital to process what is perceived and received non-verbally; to take in all information surrounding an experience at once. Clients and I often uncover that something is not that illogical when allowed to surface. Be aware of this bias if it exists in you; you may be missing useful information and underutilising your brain if so.

8) Talking can soothe physical symptoms of anxiety

The autonomic nervous system (ANS) links the brain to the body. The ‘autonomic’ bit just refers to the part of the nervous system that controls the internal organs, and is therefore outside our conscious control.

Several parts of the brain – including that to do with implicit/unconscious memory and emotional state - play a large role in the regulation of the ANS. As such, paying attention to our experiences/memories, such as in therapy, helps to bring our ANS into balance. If our ANS is not in balance, we feel crappy, with symptoms such as palpitations or stomach ache.

9) Face-to-face connection improves wellbeing

There is a direct connection in the brain between the nerves that control the heart (relating to our own actions and experiencing of emotions) and the face (relating to perceiving emotions and actions in others). For example, when we perceive another’s warmth or empathy via a gesture, this sets in motion calming communication via neural pathways in the brain and the ANS to our bodily feelings. Connectedness between two people has a transformative power: our brains dampen defensive strategies (Porges, 2017).

10) The H-bomb

Hope is something that I regularly see clients stumble upon. And, like a muscle, it can get a workout in a 50-minute session.

Chemically, hope impacts us: neurochemicals (endorphins and enkephalins) are released which actually mimic the effects of morphine (Small, 2019). Hope also stimulates the decision-making and problem-solving abilities governed by the frontal lobes according to Waldman (2015). He also states that it stimulates the immune system, motivates us to take action, and turns off the worry centres in our limbic system and right prefrontal cortex.

In sum, humans have the capacity to set off a series of unconscious events that can help direct us from mental illness to recovery. If you aren’t feeling tip-top mentally, I hope this brain-wisdom supports you to make a first step.

Porges, S. (2017). The Pocket Guide to Polyvagal Theory: The Transformative Power of Feeling, New York, W. W. Norton & Company

Small, T. (2019). The Science of Hope. January 2019. Brain Bulletin. [Online]. [Accessed 20 August 2019]. Available from: https://www.terrysmall.com/blog/brain-bulletin-47-the-science-of-hope

Waldman, M. R. (2015). Why Hope May be the Most Important Thing for Your Brain. 7 June 2015. MindFully Alive. [Online]. [Accessed 20 August 2019]. Available from http://www.mindfullyalive.com/blog/2015/6/7/why-hope-may-be-the-most-important-thing-for-your-brain