How and Why Does Psychotherapy Work?

A better question might be, how does psychotherapy work?

Scientists, clinicians, researchers have wondered, for eons, how does psychotherapy facilitate change? The Greeks discussed thymos, the emotional spirit that seems to dwell within all of us; Descartes posited the pineal gland as the seat of the soul that connected mind and brain and enabled human consciousness. Some behaviorists, like BF Skinner, concerned themselves less with client’s and patient’s inner life and more with observable behavioral change. With the advent of MRIs and fMRIs (magnetic and functional magnetic resonance imaging studies) scientists have at last been able to peer, literally, into the human psyche to view the process of change. During the early years of development, again in the adolescent years, and then again during periods of concentrated change, such as intensely practicing a sport or playing an instrument, the human brain, through ‘neuronal growth and pruning,’ is able to prune out older, less helpful neuronal pathways while inducing the growth of newer, more adaptive neuronal circuitry. Psychoanalysts refer to this as “psychic metabolism.’ in psychotherapy, for example, as patients “abreact,” i.e., recover painful or traumatic memories or recollections, painful neuronal circuits dissipate and newer, healthier pathways are grown. The memories may well be intact, but the painful feelings and images are fewer and less painful.

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