This Is What Happens to Your Brain When You Do Therapy

What you should know about neuroplasticity

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We’ve all been told that talk therapy can help you heal. Whether you’re dealing with a traumatic event, trying to combat stress and anxiety, or living with a serious mental illness, therapy is a go-to treatment. But how does therapy work? Specifically, what does therapy do to your brain to help you?

Read on to learn more about how therapy can actually change your brain in a way that will benefit you moving forward.

The Neuroscience Behind Therapy

We are actively building our brains from the moment we are born. As a child, what we experience helps our brain build connections and establish responses to outside stimuli—essentially, the “nurture” part of “nature vs. nurture.” (For the record, we now know each are important—we are also born with “natural” genetic predispositions that help our brains form, such as a historical susceptibility to mental illness or a bent towards certain reactions like anxiety or self-blame.) 

As we grow, the more times we experience certain things and use certain ways of thinking, the stronger those mental connections become. The neurons in our brain begin to form neural pathways, or well-traveled roads in our minds.

There’s a saying in the neuroscience world explaining this—”neurons that fire together, wire together.” 

Over time, these neural pathways determine the ways we will approach problems, react to stressful situations, and connect with others.

Sometimes, these pathways turn out to not be the best things for our mental health. Maybe we learned a way of interacting with our parents when we were young that gets us into trouble with our current relationships, or we have gotten so used to avoiding conflict that we can’t advocate for ourselves when necessary. This is where therapy can help.

Therapy can teach us to retrain our neural pathways to support behavior and ways of thinking that make our lives easier and better. This ability is known as neuroplasticity.

How Does Therapy Fit In?

A skillful therapist will be able to help you recognize the patterns you’ve developed in your brain and work to change those patterns.

Our neural pathways are affected by facing challenges and participating in new activities. A therapist can help you identify the challenges you need to face and present you with activities that directly correlate to those challenges.

For example, let’s imagine that when you were a child, you learned that arguing with or contradicting your parent resulted in severe punishment. This has taught you that being assertive and sticking up for yourself will always lead to something incredibly unpleasant. You’ve carried this association with you throughout your entire life and it is now affecting your work and your personal relationships—you fear the “inevitable” backlash that you’ve learned accompanies any attempt to voice your needs. 

Your brain created a neural pathway that reinforced this cause-and-effect; speaking up means punishment. You no longer have to consciously make this connection—it is a defined course in your mind.

In therapy, you can learn to recognize that this course exists. By examining your actions during times of perceived conflict—like when you need to express a need at work or with your partner—a therapist can help you understand that your automatic fear reaction is a direct result of the existence of this neural pathway that you’ve unconsciously developed. And by recognizing this, you can start to take steps to change it. 

The Research Behind Neuroplasticity in Therapy

There is an increasing amount of research about the possibility of neuroplasticity through therapy. 

One article in the Indian Journal of Psychiatry explains that, while psychiatric disorders might “debuild” the brain, therapy can “rebuild” it. This research team examined literature from many different previous research papers supporting the idea that therapeutic approaches can change the way the brain works by rewiring the neural networks that were previously enabling maladaptive thought patterns and behaviors.

Another paper, published in the renowned journal Nature, examined an experimental study of neuroplasticity in those with social anxiety disorder. In this study, participants with social anxiety and a group of control subjects (those without social anxiety) were given cognitive behavioral therapy.

Before this treatment, those with social anxiety exhibited high reactivity in the amygdala—a concrete illustration of the effects of anxiety in the brain.

After exposure to CBT, that reactivity in the brains of those with social anxiety had noticeably decreased.

A 2019 article in the Journal of Psychiatry and Neuroscience reported on adult neuroplasticity as a treatment for depression. It explains that, while mental illness can wire the brain to support depressive symptoms like rumination and anhedonia, “corrective” neuroplasticity through therapy techniques can reverse those neural connections and actually result in remission.

Therapeutic Techniques That Support Neuroplasticity

There are many different approaches you and your therapist can take to help you rewire your brain. In psychoanalysis, for example, the emphasis and focus are on your past experiences, the experiences that shaped you when you were growing up.

By examining the events of your childhood and other formative experiences, your therapist can help you build the skills to recognize these adverse events that shaped your cognition and to remind yourself of those events when you are falling into your predictable patterns.

Practicing conscious recognition of these patterns eventually leads to the ability to instinctively act differently in those situations. That’s neuroplasticity!

Neuroplasticity is also the goal of more here-and-now therapeutic approaches, such as cognitive behavioral therapy, or CBT. In CBT, the focus is on recognizing and acknowledging thought patterns that are negative, unhelpful, and hurtful.

Once you are able to see in the moment when you are acting out behavior that hinders or hurts you, you can work with your therapist to develop active responses to that behavior. Learning to change the way you think about and react to situations that previously caused you discomfort or pain—and having those changes become your first, natural responses to those situations—is a prime example of neuroplasticity.

Here’s a real-life example: Say you are afraid to be assertive at work because you fear a reprimand from your boss. In the past, if speaking up for yourself has resulted in punishment, now your brain automatically associates assertiveness with something detrimental.

Working with a therapist to identify this automatic response can help you realize why you are afraid to speak up at work; and role-playing with your therapist can help you feel more comfortable practicing using your voice and breaking that cycle of negative expectations.

You can then start taking small steps at work to bring in your opinions when appropriate, eventually realizing that, although in the past you have experienced negative outcomes when speaking up, that is not always the case.

This reroutes your previous neural network that taught you that assertiveness was bad, and replaces it with a new neural network that allows you to stand up for yourself when necessary.

Thus, working with a therapist to understand your responses, urges, and ways of thinking can ensure that you are building new neural networks that support your mental health and make your life easier.

Final Thoughts

We all have established patterns in our minds that guide our everyday behavior, but if some of those patterns are not helpful or are even hurtful, working with a therapist is a great way to address and change them.

Therapy can help you reform your neural pathways to make room for ways of thinking and behaving that are better for you and your mental health.

3 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Malhotra S, Sahoo S. Rebuilding the brain with psychotherapy. Indian J Psychiatry. 2017 Oct-Dec;59(4):411-419. doi: 10.4103/0019-5545.217299

  2. Månsson, K., Salami, A., Frick, A. et al. Neuroplasticity in response to cognitive behavior therapy for social anxiety disorder. Transl Psychiatry 6, e727 (2016). doi:10.1038/tp.2015.218

  3. Albert PR. Adult neuroplasticity: A new “cure” for major depression? J Psychiatry Neurosci. 2019 Mar 1;44(3):147-150. doi: 10.1503/jpn.190072

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By Hannah Owens, LMSW
Hannah Owens is the Mental Health/General Health Editor for Dotdash Meredith. She is a licensed social worker with clinical experience in community mental health.