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Change Your Brain With Cognitive Therapy

Why you should do the corny, touchy-feely things recommended by your therapist.

If you’ve ever been in the market for a mental health provider, you’ve probably come across references to “cognitive behavioral therapy” or “cognitive therapy,” as these are common approaches for treating a variety of mental health conditions, including depression and anxiety. Broadly, cognitive therapies teach clients how to work with, manage, or change their thoughts in order to reduce symptoms such as depressed mood, worry, insomnia, etc. The idea here is that when you can manage or change your thoughts to be less distressing, you’ll feel better emotionally and engage in healthy behaviors.

This makes sense to most people, but a lot of clients complain to me that some of the methods recommended to them to shift their thoughts seem corny, superficial, or too touchy-feely. I’ll hear, “My last therapist told me to repeat these worthless affirmations…” Or, “I laughed when my therapist told me to write in red lipstick on my bathroom mirror what a lovable person I am…” Often, these “think positive” types of exercises are seen as a waste of time. Why would therapists recommend this stuff? What is going in the brain during cognitive therapy and, more specifically, why should we engage in the corny thought-shifting techniques promoted by some therapists and New Age thinkers?

The answer, put simply, is that when we engage in cognitive therapy, including all types of cognitive restructuring and thought-shifting techniques, we change critical neural networks that shape how we think, feel, and see the world, as well as what we believe to be possible.

The brain contains roughly 86 billion neurons, each of which is connected to about 10,000 others. The connections between these neurons organize themselves according to topics, or themes, and become neural networks over time. The result is that we have billions of neural networks dedicated to all kinds of thoughts, topics, emotions, and situations. For example, we all have a neural network called “dogs,” “the color white,” “coffee,” etc. If you’ve ever focused on it, you probably have a neural network for it. To understand why cognitive therapy can be so helpful, it’s useful to understand some basic rules about how neural networks work. Here are the three main rules of neural networks, in a nutshell…

The Three Rules of Neural Networks

1. The focus of your attention is the network you are in. If you are thinking about cleaning your toilet, you are in that network so long as you keep focusing on that topic. If you’re reflecting on what a good or terrible person you are, you are in the “good person” or “bad person” network so long as your mind is focused on that topic. Your attention tells you the neural network you are in. While it is common to find ourselves magically in the depths of some old network that may not be helpful, we can learn to practice mindful awareness in order to begin noticing where the mind wanders and lands. And, when needed, we can begin to shift attention to more helpful networks.

2. Neurons that fire together wire together. This is called Hebb’s Rule (1949), which basically says that repeated experience can strengthen or weaken neuronal bonds. The more neurons fire together, the faster and stronger they wire together, producing larger and stronger networks over time. What this means is that when you spend a lot of time in a particular network (meaning, you’re focusing your attention on one thing a lot), you grow it, and it becomes bigger and stronger.

There’s a New Age movement going on which tells us that what we think about can grow, and thoughts can become real. Some people even believe that with thoughts they can “manifest” certain outcomes in their lives. While this type of thinking invites eye rolls from some scientifically minded folks, these ideas are backed by neuroscience. It is in fact true that what you think of grows — quite literally — in the brain. And the more you focus on something, the more connections to that thing you make, which means that over time you begin to see the world more and more through that particular network/lens and the things that are connected to it. What you focus on, you get a lot more of. So engage with your thoughts wisely, and pay attention to which networks you spend a lot of time in!

3. Use it or lose it. Just as attending to a particular thought strengthens the neural network associated with that thought, neglecting neural networks results in a weakening of those networks over time. A great example of this is a neural map of a town. If you’ve ever lived in one place and then moved, you’ve noticed over time that you gradually get better at finding your way around the new town. It doesn’t happen immediately, but it does happen over a period of months, and the reason for this is that you build a neural network of that new town, which becomes stronger with time. As this neural network strengthens, however, you may notice that your memory of how to get around your old town becomes increasingly fuzzy. When you return to your old town years later, you realize you no longer can find your way around like you used to. This is because that network has atrophied over time as a result of neglect.

With neural networks, you either use them, or you lose them! This is really good news, because it means that if we can promote disintegration of old, negative, unhelpful networks, we can reduce the intensity and frequency with which we produce (and experience!) the distressing thoughts associated with those networks. Instead, we can build new, positive, helpful networks to spend time in, and reality shifts.

What These Rules Mean for Therapy

When a client is engaged in cognitive therapy, or cognitive behavioral therapy, the main goals are to: 1) help the client become aware of the network they are in by becoming aware of their thoughts (which can be difficult!), 2) recognize how being in that network/having that thought is helpful to them or not so helpful, 3) become aware of the consequences of spending time in that network/engaging with that thought, and 4) shift out of that network/thought into more helpful networks/thoughts when needed.

When we are mindful about where our attention goes, we are able to craft our neural networks to be more helpful, adaptive, and healthy. And when we shift away from the old, unhelpful networks that contain negative self-talk or beliefs, they actually begin to wither away as we cease to activate them. Thus, while gratitude exercises, thinking positive, or “manifestation” through thought manipulation may seem touchy-feely, they are very much in line with what we know leads to brain change, as they promote neural network alteration though thought shifting (or, in cognitive therapy language, “cognitive reappraisal”). So the next time your therapist tells you to repeat some affirmations or fill out a daily gratitude journal, remember that they are helping you change your brain for the better!

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