A study was conducted by researchers from Massachusetts General Hospital which found that those who benefited from traditional psychodynamic psychotherapy showed fundamental brain changes, as opposed to those who did not benefit from psychodynamic psychotherapy. Psychodynamic psychotherapy is a type of "talk therapy" where a patient relates past experiences, memories, emotional and/or physical traumas, and current thoughts and behaviors to a trained clinician in order to improve -- and eventually alleviate -- symptoms of depression. For example, one type of psychodynamic psychotherapy is known as cognitive behavioral therapy. Also called CBT, this type of therapy stresses using reason to overcome irrational impulses and emotions, until the process becomes nearly automatic -- an effective tool to change unwanted thoughts and behaviors.
In the study, researchers found increased metabolic activity in an area of the brain called the insula. The researchers enrolled 16 patients diagnosed with major depression in the clinical trial, who met with a clinician on a weekly basis. The patients were monitored to determine how much they felt they were benefitting from their psychodynamic psychotherapy. The psychotherapy sessions were fairly standardized so that the variability between patients was minimized (Evans & Fava, 2014, internet).
Much of psychodynamic psychotherapy is based upon the work of Sigmund Freud, an Austrian doctor whose theories revolutionized psychotherapy. It is thought that psychodynamic psychotherapy works (when it works) by a dynamic process. As Freud thought, our behavior is largely driven by unconscious motives. By talking about depression, it is theorized that these motives are revealed, and they lose their power over individual behavior. Thus, the individual becomes free of neuroticism, and his personality becomes more integrated. An important part of Freudian psychotherapy was predicated on the idea that all behavior is determined -- a forerunner of behaviorism (McLeod, 2007, internet). Much of the psychodynamic approach works because the individual is allowed the opportunity to establish a relationship with a therapist, and examine the way the patient interacts with other people in his life.
The study done at Massachusetts General Hospital is so important because, for the first time, the power of prediction is introduced into the psychodynamic equation. Up until now, there was not a lot of strong scientific evidence of how, why, and with whom, psychodynamic psychotherapy worked. Its lack of scientific validity has been one of the most consistent criticisms of this type of psychotherapy. With the information provided by PET Scans, clinicians are now able to predict with a high degree of certainty which patients will benefit from psychodynamic psychotherapy (Evans & Fava, 2014).
Again, those patients who completed the 16-week experiment, showed marked changes in the right precuneus, a structure which is found in the insula of the human brain. Not only does the study lend more scientific credibility to psychodynamic psychotherapy, it shows that it has the power to change neural structures. More research needs to conducted in order to determine how long those changes last, but there is a neural predisposition to successful psychodynamic psychotherapy patients. Those patients show increased glucose uptake in the aforementioned region of the brain.
This research has a great potential to impact society in a positive manner. For example, persons who are considering psychodynamic psychotherapy could receive a PET Scan to determine whether they would likely be able to complete a long course of psychotherapy, as it requires a unique neurological apparatus. Such a screening procedure could save patients -- and practitioners -- both time and money as those who would not benefit are weeded out by pre-treatment PET Scans. After more research is conducted, it is possible that, someday, PET Scans could be given throughout treatment to measure changes in glucose uptake -- thus ascertaining the efficacy of psychodynamic psychotherapy. The unique brain region -- the right precuneous -- will also unveil further mysteries about its neurological function in the brain, as those who suffer from untreated depression also exhibit changes in the area. Perhaps, special medications could be developed that pinpoint the region with high accuracy. In the long run, it is hard to say how this kind of research will affect society. However, it should have a positive effect as the technology becomes more refined. It will also help neurologists be able to map areas of the brain implicated in depression which have had a function hitherto unknown.
It is little wonder that researchers are excited about this kind of study, as it provides scientific backing to Freudian science that goes back more than 100 years. Also, the new methodology promises to save both time and money for practitioners, as well as insurers, clinics, and hospitals, and especially the patients.
References
Evans, K. & Fava, M. (2014). "Pet Scans Reveal How Psychodynamic Therapy for Depression May Change Brain Function." Retrieved on 11/12/14 from http://www.massgeneral.org/about/pressrelease.aspx?id=1756
McLeod, S. (2007). "Psychodynamic Approach." Retrieved on 11/12/14 from http://www.simplypsychology.org/psychodynamic.html
