talk therapy and drug therapy

How Talk Therapy Works

At PPSC, we are not just analytic therapists; we are educators as well. A significant part of what we do involves training the next generation of therapists to give patients the best possible chance at a satisfying and fulfilling life. As educators, we are constantly auditing the practices we teach, and investigating what researchers have discovered about the mechanisms of psychoanalytic therapy. This article caught our eye for precisely this reason: it concerns a study that looked at the differences and similarities between drug therapy and talk therapy on the brain’s anatomy.

First, a caveat: nobody knows anything about how the brain works. The vanguard in neurobiological circles is to announce which parts of the brain “light up” under imaging, but there our insight sadly runs aground. Those “lit up” areas hide a trillion secrets about the actual mechanical work of thinking and feeling which science has yet to decode. Still, as a blunt instrument, neurobiology can at least show us where the brain is developing, which brings us to this passage:

Drug treatments tended to be associated with increases in brain activity in the limbic system and other sub-cortical structures, including in the insula. These areas are broadly associated with emotional processing, and the insula in particular is involved in representing our internal bodily states. [...]

In contrast, psychotherapy appeared to lead to changes to activation patterns in parts of the frontal cortex and temporal cortex — brain areas known to be associated with thinking about ourselves and to storing and processing memories.

In other words, talk therapy confers a more cerebral and “executive” benefit than drug therapy, but both may ultimately lead to similar results.

If you’d like to explore how talk therapy can help you with depression, anxiety and relationship difficulties, please contact the New York psychotherapists at PPSC today.