Is Talking Therapy a Waste of Time?

Is Talking Therapy a Waste of Time?


Is talking therapy a waste of time? I get it. You don’t want to sit and talk about your
fears and worries to a stranger for weeks, and on top of that, paying a large amount
of money in the process. After all, it is just talking, and you have
some biochemical alteration in your brain that needs to be addressed, well, biochemically. However, just as it does not make sense to
ask “do drugs work?”,it is important to note that not all therapies are created equally. We can say that different talking therapies
work for different conditions. And Cognitive Behavioral Therapy, or CBT,
is one of the most scientifically studied talking therapies. It can be helpful to people suffering from
mood disorders or schizophrenia, for instance, by helping them to identify abnormal beliefs
and thoughts, with the goal of replacing them with healthier ones. For people with schizophrenia, the therapy
involves learning to think differently about unusual experiences, such as distressing beliefs
that other people represent a threat. CBT also involves developing strategies to
reduce distress and improve wellbeing. But this is not merely advice-giving, because
CBT can change the structure and function of the brain. For example, when you see a face, the brain
fusiform gyrus sends this information to the amygdala, which plays a central role in the
perception and regulation of emotions, such as fear and anger. With this information, the amygdala interprets
the facial expression to determine which emotion the person is displaying. Then, it sends this information to the prefrontal
cortex, where you will have the conscious awareness of whether someone is happy or mad
at you, and decide how to behave accordingly. The brains of people with schizophrenia show
alterations in this circuitry, which may contribute to delusional beliefs, such as that someone
is plotting against them. Remarkably, after weeks of CBT, patients with
schizophrenia became better at discriminating emotions from faces. In addition, CBT improved the connectivity
between the amygdala and the prefrontal cortex while participants were shown faces, and the
more this connectivity was enhanced, the more the participants stated that their symptoms
have improved. CBT can be effective even when delivered via
the internet. For example, people suffering from social
anxiety disorder have excessive fear during everyday social interactions. A study from Sweden found that the more patients
with social anxiety disorder fear public speaking, the greater the volume of their amygdala. But after undergoing internet-delivered CBT
for 9 weeks, their amygdala shrunk, which also correlated with the degree of improvement
in the fear of public speaking. This study also revealed that when these patients
were criticized directly, their amygdala fired up intensely, more than the amygdala of people
without the disorder. But after the therapy, this activity decreased
to normal levels. Many other studies have shown that CBT can
change the brain, and understanding what kind of change is necessary for clinical improvements
following therapy is essential. Soon, neuroscience-informed psychotherapy
promises to personalize treatment, so that people can be prescribed specific therapies
depending on, for example, the size of their amygdala. But in the meantime, it is remarkable that
talking therapy with a professional can significantly change the brain for the better even when
delivered online.

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