How to retrain your amygdala
A short while ago I listened to a snippet on the BBC Today program. Dr Liam Mason was interviewed about the role of CBT in retraining the brain in sufferers of psychosis. It was shown that CBT physically changes the brain.
There is robust research using brain imaging techniques showing the change in brain structure connections following CBT. In serious mental health problems like depression and schizophrenia (psychosis) there is of evidence of functional disconnectivity between brain structures that process facial and social emotional signals. This means that people who suffer these problems are more likely to misinterpret faces expressions and social situations as threatening.
This may sound trivial but in Schizophrenia, depression and in many anxiety disorders there is convincing evidence that many people have a bias that over-interprets facial expressions and social situations as threatening leading to hypervigilance and difficulty in deciding what is a threat and what is not. Of course all of this is going on below conscious awareness. The sufferer is simply aware of feeling threatened and at risk, but without knowing why.
The brain system network that is responsible for this includes the amygdala. In normal circumstances the higher cognitive structures responsible for higher cognitive functions like self- awareness, decision making and judgement will send information about the world down into the lower parts of the brain including the amygdala so that they can be calibrated to the outside and external ‘reality’ (where normal life is not threatening).
In sufferers of psychosis these connections between the higher cognitive processing systems and the lower ones including the amygdala appear to be weaker. Meaning that it is much easier to misinterpret social situations as threatening and it is easier to develop self-referential ideas about what other people think of you and what they are saying about you. In CBT we call this ‘mind reading’. It is the belief that you know what other people are thinking, are saying and what their intentions are. We all do it by the way, but in psychosis it is just magnified to a substantial degree.
When there is poor connectivity between the higher brain structures and the lower ones the casualties are often your sense of empathy, your self-awareness and your insight. Hence it becomes harder to reflect on your own beliefs and to entertain those of others. And it is easier to develop unhelpful and unrealistic beliefs about yourself, others and the world.
After CBT there are stronger connections between the higher and lower brain structures meaning that the sense of reality is stronger and the sense of threat is lower.
Research has shown that CBT creates changes in the functional connectivity between the higher brain structures and the lower ones. For patients in the research study this led to a reduction in arousal which translates to feeling less threatened and less on edge. There is a reduction in the negative bias that leads patients to imagine that others are talking about them or plotting their downfall. There is a greater awareness that the sense of threat and need to be always vigilant is unnecessary and a waste of time and effort. This means that people can relax much more and simply get on with their life without having to be concerned that someone is out to get them. Psychotic symptoms go down and depression improves.
The functional magnetic resonance images of patients after CBT shows that there had been a significant strengthening of connections between a number of brain structures including the amygdala.
From my CBT clinic
In my work with clients, including those with psychosis I have seen that as CBT progresses there is a marked reduction in their sense of threat, (common in all anxiety and depressive disorders) this is correlated with an increase in self-awareness and the sense of being engaged in useful self-development work.
What is CBT?
In my clinical practice, CBT is the development of a knowledge base and a skills set that you can take with you on your life journey. It is a resource that always rewards your effort in acquiring it.
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