What Cognitive Therapy does to your brain…

Cognitive Therapy is well known for being effective for depression (it’s twice as effective as medication in preventing relapse) and it’s also been shown to work for many other disorders — but why? How does it work?

A major clue to how Cognitive Therapy affects the brain came out in this study two years ago — researchers were interested in seeing how Cognitive Behavior Therapy affected the brains of depressed people as compared to medication. They hypothesized that since both CBT and medication were effective for depression, both treatments would affect the same part of the brain. Using brain imaging technology, they scanned participants’ brains before and after the course of treatment.

And they were in for a surprise. Researchers found that antidepressants affected one part of the brain among depressed patients, and CBT treatment affected another part altogether. Antidepressants dampened activity in the limbic system — the emotional center of the brain. Conversely, CBT calmed activity in the cortex — the brain’s seat of reason.

In other words, antidepressants reduced emotions, whereas CBT helped patients process their emotions in a healthier manner.

Which explains why those on antidepressants have a much higher likelihood of relapse if they go off of their meds — negative emotions can flood back in. But with CBT, patients gain the skills to respond to their emotions more effectively — for long-term benefits.

13 replies
  1. Susanna
    Susanna says:

    Isn’t CBT a bit like jogging – it feels as if when you don’t exercise you become unfit, ie your brain goes back to what it was before?

    Mindfulness or relaxation exercises slow down thinking and make the internal mental “buffer zone” bigger so you have more “space” and time to react to thoughts but if you don’t want to meditate, does any other kind of activity help to develop the same buffer?

    It is helpful being around people who put CT into practice – my therapist at the end of a session tried to print something off and his printer kept jamming. His down to earth and matter of fact attitude was proof that it is possible to choose not to lose your temper over a metal box full of plastic and cables.

  2. CT Today
    CT Today says:

    Susanna, thanks for your thoughts on this.

    As far as CBT being like jogging: You’re right that practice is helpful. We encourage people to practice their skills repeatedly, even after treatment is over, so that skills become automatic.

    About mindfullness/relaxation activities: Some people find a similar effect from exercise or through imagery techniques.

    And lastly, it’s always helpful to have good role models when you’re trying to develop new skills. In fact, some patients report that when they get upset, they think either, “What would my therapist [or another good role model] be thinking if he/she were in this situation?” or “What would my therapist say if he/she were here right now?”

  3. Jose Meras
    Jose Meras says:

    You write, “Mindfulness or relaxation exercises slow down thinking and make the internal mental “buffer zone” bigger so you have more “space” and time to react to thoughts…does any other kind of activity help to develop the same buffer?”

    There is a a therapeutic technique called Focusing that incorporates a step called “clearing a space” as part of the focusing process. It was developed by Dr. Gene Gendlin of the University of Chicago. You can find out more at http://www.focusing.org

  4. Mary Keane
    Mary Keane says:

    How many counselling sessions are required and how effective is CBT for mild bi-polar disorder in a young student who fails to take medication because of miserable side effects. Any information will be greatly appreciated

  5. CT Today
    CT Today says:

    The number of sessions depends on the individual in treatment. So although we can’t say exactly how many sessions would be involved, an average course of Cognitive Behavior Therapy runs about once a week for 12 weeks, but length of treatment is often shorter or longer depending on the individual’s needs (CBT is a relatively short-term form of treatment compared to other types of therapy though – especially since patients learn skills they can use themselves throughout their lives).

    We’d suggest looking at the Academy of Cognitive Therapy’s article on CBT for Bipolar Disorder, which includes an overview of how CBT for Bipolar Disorder works, and what research says about its effectiveness. If you are interested in looking into CBT treatment for the student mentioned, you can then find a Certified Cognitive Therapist through the Academy (you can search by zip code).

    We hope that helps!

  6. Susanna
    Susanna says:

    Jose – thank you for the suggestion and link.

    I wonder whether there are physical activities with this kind of effect because they might be more “grounding” and so possibly more helpful for some people who are a bit too much “in their heads” anyway.

    The gardener Monty Don in the UK has done a project to teach farming and gardening to young drug addicts to try to get them thinking about real and enjoyable “outside” things rather than focusing too much on imaginary “inside” things.

  7. Scott
    Scott says:

    I always felt the anti-depressants constricted my thoughts and feelings. Ignoring problems do not make them go away…processing however is far more effective

  8. Health Wizard
    Health Wizard says:

    My ten year old son is bipolar and adhd. He has been on medication since age 4. After several doctors and hospitals; and 19 different medications later he is still uncontrollable. WBR LeoP

  9. Paul Lyons
    Paul Lyons says:

    Very interesting observations. I’m living and working in England and very interested in training in CBT. Are there training possibilities in the UK along the lines of Aaron Beck’s progamme?
    Thank You
    Paul Lyons

  10. CT Today
    CT Today says:


    We’re glad to hear you’re interested in CBT training. We actually train mental health professionals from the UK and around the world through our Extramural Program for Long-Distance learners. This program includes supervision via phone or email, as well as two on-site workshops here in the U.S.

    Otherwise, you may want to look at training programs listed on the Academy of Cognitive Therapy website. There are two Cognitive Therapy training programs in the UK listed here.

  11. Roxana Duren
    Roxana Duren says:

    CBT aims to identify the specific assumptions that a depressed person can make about himself/herself and also CBT attemps to change the way this person values these assumptions and then substitutes these statements for a more positive and optimistic point of view. What can be said to a person that is hooked on medication battling depression to make him or her seek help through CBT? After reading the article above, the conclusion of the study indicates that antidepressants reduce emotions, but in time if one chooses to withdraw from these medication, the negative emotions can flow back in. Whereas, CBT seems to help patients process their emotions in a healthy manner and the benefit is longterm. I have a very close relative trying to come off of antidepressant medications and when the person lowers the dosage, the person returns to the same patterns of behavior, or even worse.



Trackbacks & Pingbacks

  1. […] This site takes a look at studies that have examined the effects that different types of treatments have on the human brain. According to researchers, antidepressants reduce emotions, while Cognitive Behavior Therapy helps people to process their emotions in a healthier manner. They found that those taking depression medication have a much higher relapse rate if they go off their meds because they are flooded with negative emotions. But Cognitive Behavior Therapy gives people the coping skills they need to deal with their feelings more effectively and thus, CBT may offer much more benefits in the long term. […]

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