How does what we are learning about the brain influence the practice of psychotherapy?

There’s a revolution sweeping through the field of psychotherapy.  Over the last 10 years with the advent of high tech brain imaging techniques such as CAT scans, fMRI and PET scans researchers are now able to look into living, thinking brains and are learning things that are causing people to reevaluate what psychotherapy is and what is possible to accomplish in psychotherapy.

The conventional wisdom was,  that by the time a child reaches their 3rd or 4th birthday the brain that they have is the brain that they will have for the rest of their life.  Based on this assumption all a person could do was learn to make the most of the brain that they had.  Luckily, we now know that this is not true. The brain is now recognized as being plastic (changeable).  Our thoughts and experiences impact the brain by creating connections which over time and through repetition become stronger and stronger.  The Canadian neurologist Donald Hebbs stated it succinctly when he said that “Neurons that fire together wire together.” That’s what learning is all about.
Anyone who’s practiced a sport knows that the more one practices, the more automatic and quicker the response will be.  At first the behaviour starts out feeling awkward but over time it becomes so familiar that it feels natural and practically automatic.

This is true in every area of our lives.  We learn over time what to expect from ourselves and other people. It’s so automatic that we don’t even question these assumptions.  To take the analogy a bit further, imagine that the athlete, perhaps a tennis player has a flaw in her forehand.  Her coach identifies that this flaw prevents her from reaching her potential so he gets her to consciously slow down and practice doing it the right way.  It’s frustrating and while she’s relearning how to hit a forehand she’s playing worse.  Ultimately though, when the new motion becomes wired in she can play better than before. In this case her brain has rewired itself with the practice of the new motion.

This is what happens in therapy. A person may react in an automatic way that creates problems.  Perhaps the person over reacts in certain situations or fears situations that don’t warrant fear. The therapist’s job is to help her client to reevaluate her reactions and to practice feeling, thinking and behaving differently.  Over time the old reactions are replaced by new more appropriate responses.  This is one reason why effective  psychotherapy takes place over a period of time, perhaps months or years.  The term we use for brain change over time is neuroplasticity.