#fMRI studies show #neurological changes & activity in patient's receiving #psychotherapy treatment #psychoanalysis #depression

fMRI studies show neurological changes & activity in patient's receiving psychotherapy treatment. Implicit in these findings are both neurogenesis and neuroplasticity, a byproduct of treatment.

Researchers Buchheim, Labek, Walter & Viviani (2013) designed an empirical research study to investigate the outcome of long-term psychotherapy from a neurobiological perspective. “In the present study, we attempted to integrate a clinical description of the psychoanalytic process with two empirical instruments…brain activity based on a functional neuroimaging probe”, (p. 9).

They wanted to create a study that would allow us to “see” the effects of psychotherapy on the brain. To accomplish this, the design included using clinical data, a standardized instrument of the psychotherapeutic process (Psychotherapy process Q-Set, PQS), and functional neuroimaging (fMRI). fMRI scans were administered after therapy sessions while the patient viewed the Adult Attachment Projective Picture System (AAP). This was done for 12-months.

In their research findings Buchheim, Viviani, Kessler, Kachele, Cierpka, Roth, George, Kernberg, Bruns, & Taubner (2012) show improvements in depressive symptoms and neural activity in regions of the brain. "This is the first study documenting neurobiological changes in circuits implicated in emotional reactivity and control after long-term psychodynamic psychotherapy". These scans showed neurological changes and activity in both patients receiving psychotherapy treatment.

In particular, the fMRI’s scans showed changes in the hippocampus, amygdala , subgenual cingulate, and medial prefrontal cortex after psychotherapy treatment. These findings documented neurobiological changes and a reduction of emotional reactivity after long-term psychotherapy. “The significant association of the changes in the subgenual cingulate and medial prefrontal cortex with symptom improvement supported the hypothesis of their relevance to the changes intervened during therapy”, (p. 5). 

They conducted a single-case study of a 42-year-old woman who received psychotherapy treatments for one year. The patient was described as having a disorganized attachment style with narcissistic traits, characterized by chronic fluctuating moods and self-esteem. The fMRI scans revealed neural activation in the ventrolateral and dorsolateral prefrontal cortex. This area is associated with controlling one’s focus and attention, and depression.

Other neural activation revealed from the fMRI scans included the pregenual portion of the medial prefrontal cortex, the posterior cingulate and precuneus, the middle temporal gyrus, and the anterior tip of the inferior temporal gyrus, and the occipital calcarine cortex. Buchheim, Labek, Walter & Viviani (2013) felt that these areas were most significant to this study because “The medial prefrontal cortex may also be associated with changes after the therapy of affective disorders…” (p. 9). They believe that observable neurological changes from therapy will be most visible in these brain regions.

The neurological response to psychotherapy allowed them to track this patient’s defensive characteristic via neural activity viewed in the scans. “Using functional neuroimaging, we were able to objectify the defensive structure of this patient during this phase of psychoanalytic treatment and the occurrence of difficult sessions”, (p. 11). 

While these research findings may not answer many important questions, they do show a distinct correlation between psychotherapy treatments and neurological activity. More research is needed in this area. “The relevance of these finding for future studies rests in the possibility of documenting specific mechanisms of action of depression therapy by systematically collating results from different studies and comparing different psychotherapeutic approaches…”, (p. 6). 

References
Buchheim A, Labek K, Walter S, & Viviani R. (2013). A clinical case study of a psychoanalytic psychotherapy monitored with functional neuroimaging. Frontiers in Human Neuroscience. Volume 7(677); pp. 1-13. Doi: 10.3389/fnhum.2013.00677.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805951/