How can talking about your problems help? A patient suffering from anxiety once asked psychiatrist Dr. Christopher W. T. Miller that very question. His answer led to an advice article in The Washington Post, where Miller offers three skills from psychotherapy that can change your brain – for the better.

This patient, battling a lifelong struggle with anxiety, had not found much help in medication, but he was of the confirmed belief that talk therapy was useless. He parroted the comments he had heard over the years: “No one does that anymore,” “Psychobabble doesn’t change anything,” and “You have friends you can talk to — how can a stranger have anything useful to say?”

However, the patient had a fourth, more pertinent question: “Is there evidence that therapy actually changes the brain?”

Let’s look at the evidence for various approaches to mental health treatment.

According to Miller, there’s evidence that medication can change the brain, as  “research has shown that antidepressants can change brain pathways and stress responses linked to depression, anxiety and impulsive behaviors, among other symptoms.”

Scientific data have shown that psychotherapy, exercise, mindfulness, yoga, and meditation are all beneficial for mental health.

Talk therapy can help improve self-esteem, optimism, and an understanding of who you are as a unique person. It can help you build stronger relationships, increasing your capacity for intimacy and reciprocity, “the healthy give-and-take we need to have when relating to others,” Miller noted.

Physiologically, psychotherapy has “also been shown to decrease biological markers of stress and inflammation,” he added.

Negative talk, psychotherapy, and the brain

The reluctant patient came armed to psychotherapy with a host of negative predictions: “This is pointless,” “You’re just going to tell me I can’t be helped,” and “We’ll talk and talk, and you’ll just prescribe me something anyway.”

Miller pointed out, “When we’re worked up, it can be hard to think, and often the same messages keep running through our heads like a broken record.”

He explained that if we were to look inside the patient’s brain during this harsh, negative self-talk, we would likely discover “an overfiring of areas responsible for strong emotions, including an almond-shaped region called the amygdala,” which “can lead to anxiety and unrest.”

To combat these repetitive negative messages, we need to activate “brain areas that help people think more flexibly, such as the ventromedial prefrontal cortex (VMPFC).”

This key region of the brain, located behind the forehead, is involved in communication, empathy, and “thinking through problems together.”

The VMPFC keeps the amygdala in check, preventing it from firing too much.

Significantly, in “psychiatric conditions such as depression, anxiety, and post-traumatic stress disorder, the VMPFC is not used enough — emotions remain high, and it is harder to change the tape that keeps negative thoughts going,” Miller explains.

How talk therapy affects certain areas of the brain

When we engage in talk therapy, the VMPFC and other brain areas involved with reasoning and problem-solving are increasingly activated, acting as a check on emotions and allowing us to reflect on situations, rather than simply reacting to them.

“Therapists help patients develop flexibility in thinking by offering space,” Miller explains. Therapists neither validate patients’ worst views of themselves nor offer solutions to solve all life’s problems. Instead, therapists invite patients to reflect. In the process, Miller says, “patients feel less trapped, broadening how they think of themselves and the world around them.”

How to use therapy skills in everyday life

Whether or not we are actively in therapy, we can all incorporate lessons from psychotherapy in day-to-day life. Miller explains that it all “comes down to how we treat our own thinking.” Here are a few tips:

• Choose reflection instead of reflex. To interfere with negative thinking patterns, step back to consider other points of view. Catch yourself in the act of entering a thought loop, and try to imagine other ways of looking at the situation.
• Bring softness instead of hostility. When we encounter someone who says something we do not agree with, we often assume the worst about them. It is helpful to look for the person behind those ideas – and the story behind their perspectives. Getting to know someone helps combat negative impressions, building empathy and connectedness
• Be curious instead of judgmental. Our minds are capable of continuous learning and growth, even in hard situations. “Although it is tempting to think our understanding of life is all there is to know, being open and inquisitive to things that are confusing and unsettling helps us stay flexible,” Miller urges. Just as it helps to hold off judgment toward others, we should do the same for ourselves. “If our mind goes to unpleasant and defeating places, instead of beating ourselves up over it, we should welcome the thought and reflect on what we can learn about ourselves by holding onto it, instead of throwing it away.” Responding to ourselves with curiosity rather than judgment can be the path to growth.

You can read the full article here.

Miller, Christopher W.T., MD. “3 skills from psychotherapy that can change your brain.” The Washington Post, 23 Feb 2023, https://www.washingtonpost.com/wellness/2023/02/23/psychotherapy-skills-mental-health/

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