Can cognitive behavioural therapy really change our brains?

Cognitive behavioural therapy (CBT) is a type of talking therapy that’s used to treat a wide range of mental health problems, from depression and eating disorders to phobias and obsessive-compulsive disorder (OCD). It recommends looking at ourselves in a different way that might prove useful for all of us in everyday life. But what happens to our brains when we have CBT?

What is cognitive behavioural therapy?

CBT is based on the idea that problems aren’t caused by situations themselves, but by how we interpret them in our thoughts. These can then affect our feelings and actions.

Situation affects thoughts, which then affect feelings and actions
The way we think about a situation can affect how we feel and how we act

For example, if someone you know walks by without saying hello, what’s your reaction?

You might think that they ignored you because they don’t like you, which might make you feel rejected. So you might be tempted to avoid them the next time you meet. This could breed more bad feeling between you both and more “rejections”, until eventually you believe that you must be unlikeable. If this happened with enough people, you could start to withdraw socially.

But how well did you interpret the situation in the first place?

Common errors in thinking style

  • Emotional reasoning – e.g. I feel guilty so I must be guilty
  • Jumping to conclusions – e.g. if I go into work when I’m feeling low, I’ll only feel worse
  • All-or-nothing thinking – e.g. if I’ve not done it perfectly, then it’s absolutely useless
  • Mental filtering – e.g. noticing my failures more than my successes
  • Over generalising – e.g. nothing ever goes well in my life
  • Labelling – e.g. I’m a loser

CBT aims to break negative vicious cycles by identifying unhelpful ways of reacting that creep into our thinking.

“Emotional reasoning is a very common error in people’s thinking,” explains Dr Jennifer Wild, Consultant Clinical Psychologist from Kings College London. “That’s when you think something must be true because of how you feel.”

CBT tries to replace these negative thinking styles with more useful or realistic ones.

This can be a challenge for people with mental health disorders, as their thinking styles can be well-established.

How do we break negative thinking styles?

Some psychological theories suggest that we learn these negative thinking patterns through a process called negative reinforcement.

Graded exposure can help people confront their phobias

For example, if you have a fear of spiders, by avoiding them you learn that your anxiety levels can be reduced. So you’re rewarded in the short term with less anxiety but this reinforces the fear.

To unlearn these patterns, people with phobias and anxiety disorders often use a CBT technique called graded exposure. By gradually confronting what frightens them and observing that nothing bad actually happens, it’s possible to slowly retrain their brains to not fear it.

How does cognitive behavioural therapy work on the brain?

Primitive survival instincts like fear are processed in a part of the brain called the limbic system. This includes the amygdala, a region that processes emotion, and the hippocampus, a region involved in reliving traumatic memories.

Brain scan studies have shown that overactivity in these two regions returns to normal after a course of CBT in people with phobias.

What’s more, studies have found that CBT can also change the prefrontal cortex, the part of the brain responsible for higher-level thinking.

So it seems that CBT might be able to make real, physical changes to both our “emotional brain” (instincts) and our “logical brain” (thoughts).

Intriguingly, similar patterns of brain changes have been seen with CBT and with drug treatments, suggesting that psychotherapies and medications might work on the brain in parallel ways.

How effective is cognitive behavioural therapy?

Of all the talking therapies, CBT has the most clinical evidence to show that it works.

Studies have shown that it is at least as effective as medication for many types of depression and anxiety disorders.

But unlike many drugs, there are few side effects with CBT. After a relatively short course, people have often described long-lasting benefits.

“In the trials we’ve run with post-traumatic stress disorder [PTSD] and social anxiety disorder, we’ve seen that even when people stop the therapy, they continue improving because they have new tools in place and they’ve made behavioural and thinking style changes,” Dr Wild explains.

CBT may not be for everyone, however.

Since the focus is on tackling the here and now, people with more complicated roots to their mental problems which could stem from their childhood, for example, may need another type of longer-term therapy to explore this.

CBT also relies on commitment from the individual, including “homework” between therapy sessions. It can also involve confronting fears and anxieties, and this isn’t always easy to do.

Ultimately, as with many types of treatment, some people will benefit from CBT more than others and psychologists and neuroscientists are beginning to unravel the reasons behind this.

#RT via http://www.bbc.co.uk via Matthew


How to Train Your Brain to Alleviate Anxiety

By 
Our thoughts affect our brains. More specifically, “… what you pay attention to, what you think and feel and want, and how you work with your reactions to things sculpt your brain in multiple ways,” according to neuropsychologist Rick Hanson, Ph.D, in his newest book Just One Thing: Developing A Buddha Brain One Simple Practice at a Time. In other words, how you use your mind can change your brain.

According to Canadian scientist Donald Hebb, “Neurons that fire together, wire together.” If your thoughts focus on worrying and self-criticism, you’ll develop neural structures of anxiety and a negative sense of self, says Hanson.

For instance, individuals who are constantly stressed (such as acute or traumatic stress) release cortisol, which in another article Hanson says eats away at the memory-focused hippocampus. People with a history of stress have lost up to 25 percent of the volume of their hippocampus and have more difficulty forming new memories.

The opposite also is true. Engaging in relaxing activities regularly can wire your brain for calm. Research has shown that people who routinely relax have “improved expression of genes that calm down stress reactions, making them more resilient,” Hanson writes.

Also, over time, people who engage in mindfulness meditation develop thicker layers of neurons in the attention-focused parts of the prefrontal cortex and in the insula, an area that’s triggered when we tune into our feelings and bodies.

Other research has shown that being mindful boosts activation of the left prefrontal cortex, which suppresses negative emotions, and minimizes the activation of the amygdala, which Hanson refers to as the “alarm bell of the brain.”

Hanson’s book gives readers a variety of exercises to cultivate calm and self-confidence and to enjoy life. Here are three anxiety-alleviating practices to try.

1. “Notice you’re all right right now.” For many of us sitting still is a joke — as in, it’s impossible. According to Hanson, “To keep our ancestors alive, the brain evolved an ongoing internal trickle of unease. This little whisper of worry keeps you scanning your inner and outer world for signs of trouble.”

Being on high alert is adaptive. It’s meant to protect us. But this isn’t so helpful when we’re trying to soothe our stress and keep calm. Some of us — me included — even worry that if we relax for a few minutes, something bad will happen. (Of course, this isn’t true.)

Hanson encourages readers to focus on the present and to realize that right now in this moment, you’re probably OK. He says that focusing on the future forces us to worry and focusing on the past leads to regret. Whatever activity you’re engaged in, whether it’s driving, cooking dinner or replying to email, Hanson suggests saying, “I’m all right right now.”

Of course, there will be moments when you won’t be all right. In these times, Hanson suggests that after you ride out the storm, “… as soon as possible, notice that the core of your being is okay, like the quiet place fifty feet underwater, beneath a hurricane howling above the sea.”

2. “Feel safer.” “Evolution has given us an anxious brain,” Hanson writes. So, whether there’s a tiger in the bushes doesn’t matter, because staying away in both cases keeps us alive. But, again, this also keeps us hyper-focused on avoiding danger day to day. And depending on our temperaments and life experiences, we might be even more anxious.

Most people overestimate threats. This leads to excessive worrying, anxiety, stress-related aliments, less patience and generosity with others and a shorter fuse, according to Hanson.

Are you more guarded or anxious than you need to be? If so, Hanson suggests the following for feeling safer:

  • Think of how it feels to be with a person who cares about you and connect to those feelings and sensations.
  • Remember a time when you felt strong.
  • List some of the resources at your disposal to cope with life’s curveballs.
  • Take several long, deep breaths.
  • Become more in tune with what it feels like to feel safer. “Let those good feelings sink in, so you can remember them in your body and find your way back to them in the future.”

3. “Let go.” Letting go is hard. Even though clinging to clutter, regrets, resentment, unrealistic expectations or unfulfilling relationships is painful, we might be afraid that letting go makes us weak, shows we don’t care or lets someone off the hook. What holds you back in letting go?

Letting go is liberating. Hanson says that letting go might mean releasing pain or damaging thoughts or deeds or yielding instead of breaking. He offers a great analogy:

“When you let go, you’re like a supple and resilient willow tree that bends before the storm, still here in the morning — rather than a stiff oak that ends up broken and toppled over.”

Here are some of Hanson’s suggestions for letting go:

  • Be aware of how you let go naturally every day, whether it’s sending an email, taking out the trash, going from one thought or feeling to another or saying goodbye to a friend.
  • Let go of tension in your body. Take long and slow exhalations, and relax your shoulders, jaw and eyes.
  • Let go of things you don’t need or use.
  • Resolve to let go of a certain grudge or resentment. “This does not necessarily mean letting other people off the moral hook, just that you are letting yourself off the hotplate of staying upset about whatever happened,” Hanson writes. If you still feel hurt, he suggests recognizing your feelings, being kind to yourself and gently releasing them.
  • Let go of painful emotions. Hanson recommends several books on this topic: Focusing by Eugene Gendlin and What We May Beby Piero Ferrucci. In his book, Hanson summarizes his favorite methods: “relax your body;” “imagine that the feelings are flowing out of you like water’” express your feelings in a letter that you won’t send or vent aloud; talk to a good friend; and be open to positive feelings and let them replace the negative ones.

#RT via Bridget via http://psychcentral.com