Rethinking Mental Health

By Thomas L. Schwartz, MD

Psychotherapy, talk therapy, and counseling are all terms used when treatment revolves around a patient talking to a therapist every week. This series of blogs aims to evaluate some common myths about getting therapy for one’s mental or emotional symptoms. The first post in this series addressed the purpose of psychotherapy.

Myth: Talking about your issues is a psychological-only treatment in that it does not affect biological brain functioning.

Reality: This may be partially true. Talking about things often calms one down and lets one see several points of view and options for corrective actions in the future.

But psychotherapy is also a brain process. Talking things through likely strengthens the front part of the brain, making it stronger and better able to control the parts of the brain involved in drives and impulses (such as anger and sadness).

Imagine a depression study in which half of the patients only get psychotherapy, and the other half only get an antidepressant medication. Both groups of patients would get their brains scanned. (Such a study was published in the Archives of General Psychiatry in 2001.) Guess what? Those whose depression got better had the same changes in brain functioning, regardless of whether they took the medication or just talked in therapy. So talking in psychotherapy does create biological changes, just like some medications do.

Why is this important?  Some patients think psychotherapy is just talking and they want a more “biological” treatment that is studied and scientific.  Psychotherapy is both of these.