We now know that the brain is a system of complex interconnected neural networks. These networks are exquisitely responsive to an individual’s social environment, so that repeated or intense experiences constantly reinforce patterns of learned behaviour, thoughts and feelings.
This sensitivity also allows for the potential to change those patterns when new, intense or repeated experiences create and strengthen new neural pathways that facilitate alternate patterns of behaviours, thoughts and feelings.
Dr Pieter Rossouw has been using this research to train mental health practitioners around Australia in how to apply this new knowledge to the treatment of anxiety and depression. Dr Rossouw is based at the University of Queensland and is Director of the Master of Counselling Program, the Director of the Unit for Neuropsychotherapy and the Director of Mediros Clinical Solutions.
Counselling for Depression
Rossouw’s work is showing how the expanding knowledge of the workings of the mind supports the “talking therapies” or counselling, as more often the preferred first line of treatment – before medication is prescribed. When successful, the “talking therapies” are more likely to maintain mental wellness over time.
Vulnerability to mood disorders can have a genetic component but it is our experience of life, the people and situations we encounter that “wire” our brains to respond to perceived threats either with uncontrollable emotions (such as fear and avoidance, or anger and aggression), or with a more reasoned, calmer and resilient response.
If negative life experiences have taught a person that safety, social support and optimism are unrealisable states for him/her, then their brain is “wired” to see threat all around, and their response will most likely be with emotions such as alarm and despair.
Brains where experiences of safety, positive support and generally, success in dealing with manageable challenges, have been wired more strongly to use the higher levels of the brain (the cortex or “grey matter”) to “down-regulate” emotional responses to stressful situations.
The differing responses can be compared to the default setting on a computer. For those whose experiences and learning may have reinforced genetic vulnerabilities that their world is not a safe or emotionally nourishing place, the brain’s wiring takes them automatically to the “default” position of perceiving threat or hopelessness in even mildly stressful situations.
For individuals who have experienced mostly positive events and people in their lives from an early age, and suffered no prolonged trauma, their “default” position is usually resilience, as neural pathways in their brain have developed most strongly away from the emotional and instinctive centres of the brain to the “higher” levels of the brain that have the capacity to control emotions.
The therapist’s task is to help the client strengthen neural connectivity to the cortex where rationality and the ability to reflect more realistically, through language and logical thought processes on one’s experience, helps to “down-regulate” the threat response – and consequently assist the client to learn new ways of thinking, that will prevent them from being overwhelmed by negative emotional responses.
Can the brain’s default setting really be changed by talking therapy? Absolutely, according to Dr. Rossouw and research findings in neuroanatomy.
Because the brain exists in relation to its environment, the talking interaction between a skilled and empathic practitioner who fosters a sense of safety in the therapeutic setting, can teach the individual new ways of responding to life experiences.
Emphasising verbal communication and encouraging the recording of thoughts and experiences (in writing or on voice memos) over time, repeatedly engages the rational, reflective, language centres of the brain, strengthening connections between the cortex and the limbic systems (the brain’s emotional centre) while diminishing the neural wiring that keeps activating and strengthening negative emotional responses to environmental triggers, large and small.
The other very important factor in changing neural structures that reinforce negative emotional responses and continual distress, is practice. Traditionally, psychologists have given worksheets and readings to allow clients to practise new skills between sessions. Learning new habits takes time and repetition to establish and maintain new neural pathways to override the old ones.
I have also found internet sites like Mood Gym (run by the Australian National University) and apps such as Cognitus DBT, very useful in encouraging younger people particularly, to practise at home the skills learned in therapy.
However, Dr Rossouw points out that such internet-based therapies have been shown to be ineffective without client-counsellor face-to-face sessions to maintain motivation and to model and provide the sense of safety, emotional control and social connectivity, which the study of neuroanatomy is proving to be vital to developing neurostructures that promote mental health.
The University of Queensland in conjunction with the Queensland Brain Institute and neuroscientists around the world, are working to develop internet-based activities that will facilitate positive neural changes with regular interventions from the therapist. Therapists across Australia will be introduced to these models soon, which promise to greatly enhance treatment programs for a range of mood disorders such as anxiety and depression.
The simple message for clients to take from this, is that a positive relationship with a counsellor, well-informed by the latest research in applied neuroscience, and a client committed to practising the skills learned in their therapy sessions, is the key to success in managing wellbeing for the long term.
Susanne Gilmour is a Registered Psychologist with a keen interest in neuropsychotherapy. She has nearly 20 years’ experience as a psychologist working with children, adolescents and their families.
Bookings and Fees: To make an appointment with Susanne Gilmour, try Online Booking – Loganholme or call M1 Psychology (Loganholme) on (07) 3067 9129.