How talking therapy changes your brain

A study from Massachusetts General Hospital (MGH) investigators has identified for the first time changes in the metabolic activity of a key brain region in patients successfully treated for depression with psychodynamic psychotherapy, suggesting a mechanism of action behind one of the most historically important and widely practiced forms of therapy. They also found evidence that pretreatment metabolism in a different brain structure might predict which patients are likely to respond to that form of therapy. Their report will appear in the journal Psychotherapy and Psychosomatics and has been issued online.

“Psychodynamic psychotherapy might be considered the original form of ‘personalized medicine,’ since it draws directly from a patient’s unique experiences to shape the course of treatment,” says Joshua Roffman, MD, MGH Department of Psychiatry, lead author of the report. “While it has been a core part of psychiatric training for decades and continues to be widely practiced, psychodynamic psychotherapy hasn’t been studied as broadly as have other approaches for a number of reasons, including its greater subjectivity and treatment-by-treatment variability. We do know that psychodynamic treatments are effective for some patients, and this study examined whether differences in neural activity could predict which patients would complete the course of therapy and which would drop out, a common occurrence for any type of therapy.”