Social Anxiety: Changing your brain with psychotherapy

Medication and psychotherapy have both been demonstrated to help people with an anxiety disorder. But research on the effects of psychotherapy on nerve cells has lagged far behind that on medication-induced changes in the brain. There have been preliminary studies which have demonstrated superior effects (from patient’s reports) from cognitive therapy over medication, in quelling unpleasant anxiety (and depressive) symptoms, and these improvements have lasted in research follow-ups. But did you know that scientists are now discovering physical evidence for these improved changes in research with social anxiety disorder?

Social anxiety is a syndrome whereby people experience overwhelming fears of interacting with others and describe high expectations of being harshly judged.Vladimir Miskovic, doctoral candidate, wanted to understand if it would be possible to ascertain physical changes in the brain following psychotherapy, within people with SAD. ‘We wanted to track the brain changes while people were going through psychotherapy,’ says McMaster University doctoral candidate and study co-author Miskovic.

Miskovic was part of a research team, led by David Moscovitch, Ph.D., of the University of Waterloo, collaborated with McMaster’s Louis Schmidt, Ph.D. and Diane Santesso, Ph.D. The researchers used electroencephalograms or EEGs, which measure brain electrical interactions in real time, to assess brain activity and change. The researchers focused on the amount of ‘delta-beta coupling’, which has been found to elevate with rising anxiety. They recruited a group of adults with social anxiety disorder for their study, and divide the groups into those who received treatment, and those who did not (two sets of controls).

The patients participated in twelve weeks of group cognitive behavior therapy, a structured method that helps people identify and challenge the thinking patterns that perpetuate their painful and self-destructive behaviours. For more information on cognitive therapy, please search my website for related links. Two control groups – students who tested extremely high or low for symptoms of social anxiety – underwent no psychotherapy.The patients were given four EEGs — two before treatment, one halfway through, and one two weeks after the final session. When the patients’ pre and post-therapy EEGs were compared with the control groups’, the results were revealing.Before therapy, the clinical group’s delta-beta correlations were similar to those of the high-anxiety control group and far higher than the low-anxiety groups. Midway through treatment, improvements in the patients’ brains of those receiving the cognitive therapy paralleled clinicians’ and patients’ own self-reports of easing symptoms. And at the completion of therapy and at the two week follow-up, the patients’ tests resembled those of the low-anxiety control group!

So now we have bonafide physical proof : cognitive therapy does produce positive, enduring (at least in the short-term), brain changes at the neural/physical level. I’m sure this is just the start of what’s to come, and what we therapists and our clients have known all along – psychotherapy works! More exciting research is sure to follow, that will enable us  to truly not only visualize or imagine, expect or believe, but actually “see” our improvements in our brains, as we move towards self-growth.


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