New research finds that cognitive behavioral therapy (CBT) actually changes key brain structures that are involved in processing and regulating emotions.
The finding helps to explain the success of CBT for anxiety disorders. Remediation of social anxiety is an important accomplishment as anxiety in social situations is not a rare problem.
Experts say that around one in 10 people are affected by social anxiety disorder during their lifetime. Social anxiety disorder is diagnosed if fears and anxiety in social situations significantly impair everyday life and cause intense suffering. A relatively common anxiety provoking experience is talking in front of a larger group — a situation that can provoke fear and extreme stress.
In the new study, researchers from the University of Zurich, Zurich University Hospital and the University Hospital of Psychiatry Zurich discovered that the successful treatment of an anxiety disorder alters key brain structures linked to emotions.
In patients suffering from social anxiety disorder, regulation of excessive anxiety by frontal and lateral brain areas is impaired. Strategies aimed at regulating emotions should restore the balance between cortical and subcortical brain areas.
These strategies are practiced in CBT, a central therapy for social anxiety disorder. In cognitive behavioral group therapy, patients learn and apply new strategies aimed at dealing with social anxiety disorder.
Based on specific examples, the group discusses explanatory models and identifies starting points for changes. Through self-observation, role plays, or video recordings, alternative viewpoints can be developed.
In the study, published online in the journal Molecular Psychiatry, researchers investigated structural brain changes in patients suffering from social anxiety disorder after a specific 10-week course of CBT. Using magnetic resonance imaging, the participants’ brains were examined before and after CBT.
“We were able to show that structural changes occur in brain areas linked to self-control and emotion regulation,” said Dr. Annette Brühl, head physician at the Center for Depression, Anxiety Disorders and Psychotherapy at the University Hospital of Psychiatry Zurich (PUK).
The more successful the treatment, the stronger the brain changes. The research group was also able to demonstrate that brain areas involved in processing emotions were more interconnected after the treatment.
“Psychotherapy normalizes brain changes associated with social anxiety disorder,” Brühl said.