Emerging Support of Psychodynamic Treatment from  Brain Research
In parallel with the increasing empirical validation of psychodynamic psychotherapy, there is another expanding area of research addressing changes in the brain that correlate with psychotherapeutic benefits.   More specifically, the emerging field of neuropsychoanalysis is confirming what we intuitively understand about our patients’ emotional lives and the healing power of the therapeutic relationship. This convergence between the study of neurology and psychotherapy is emerging in two different ways:  (1) studies that directly examine changes in the brain via imaging techniques in correlation with psychotherapy, and (2) developmental studies inferring a link between the brain systems responsible for key psychological capacities (affect regulation, self-reflection) and functional changes associated with the positive changes produced by psychodynamic psychotherapy.

The first line of evidence is a growing number of imaging studies that document positive changes in brain metabolism attributed to the effects of psychotherapy.  Eric Kandel, Nobel prize laureate in neuroscience, described two such studies of patients with OCD and with depression in which pre-treatment abnormalities in the metabolic activity of relevant brain structures (the basal ganglia, limbic region, for OCD, and different parts of the prefrontal cortex for depression) were reversed over a course of psychotherapy (2006).  Other major contributors to the field, Mark Solms (Solms and Turnbull, 2002) and Alan Schore (2003), both discuss imaging studies focusing on the prefrontal cortex in which there are not only positive changes in metabolic activity over a course of psychotherapy, but these changes are correlated with symptom relief.

All of the studies referred to here use imaging techniques (fMRI, PET scans) to examine brain functioning, and used CBT as the psychotherapeutic technique.  Kandel, Solms and Schore all extrapolate these findings to psychodynamic psychotherapy as well. As Shedler (2010) reported, the “active ingredients” in both CBT and psychodynamic therapy (and other therapies as well) are psychodynamic elements (therapeutic alliance and experiencing) – the variables shown to be most predictive of positive outcomes in treatment.  This consistency suggests that it is reasonable to infer similar brain changes in psychodynamic therapy as those documented using CBT.  Shedler also notes that the common use of CBT in outcomes studies results from a “mismatch” between the often subjective aims of psychodynamic treatment and the typical experimental variables used in research design.  With greater awareness of these nuances in assessing the effectiveness of psychotherapy, the availability of psychodynamic research is increasing. Neuroimaging studies that directly involve psychodynamic psychotherapy are beginning to appear in the literature, and will reveal more about mind/brain and functional changes as well.