Will New Brain Research Revolutionize Mental Health Care?

The development of brain imaging and machine learning technologies has allowed researchers to peer into the brain in real time, as well as discern hidden patterns in brain and behavioral data. For mental health professionals, these new technologies hold the promise that one day we will be able to ‘carve nature at the joints’: diagnose and evaluate the treatment of mental illnesses using objective neurological indicators of illness and improvement, rather than relying (as we do now) on observation and on clients’ subjective self reports.

This future vision however will not materialize easily, in part because research on the therapy-brain link is difficult to do well. For one, our current classification of psychological disorders (which is based mostly on reported symptoms) may not map well onto distinctly unique neurological patterns in the brain. Additionally, the link between brain neurology and mental illness is not simple. The brains of mentally ill people don’t usually reveal the corresponding, localized lesions seen in many neurological illnesses. Likewise, the inheritance patterns of mental illnesses are not straightforward. Most psychological disorders are caused by a combination of genetic predispositions, environmental conditions, and sociocultural factors, which is one reason for the dearth of useful animal models for most mental disorders.

Limitations notwithstanding, the new imaging and machine learning technologies have opened up intriguing lines of research into the complex ecology of mental health and illness. Much of this research has focused on three questions:

1: Does talk therapy cause changes in brain function and structure?

2: Can brain differences predict differences in client outcome?

3: Can differences in brains reliably diagnose specific psychological disorders?

Question 1: Does talk therapy cause changes in brain function and structure?

The notion that experience can affect the brain is not news. Some 70 years ago, Canadian researcher Donald Hebb proposed that brain neurology is plastic and responds to experience. As he famously put it: “The neurons that fire together wire together.” By the 1960s, research on rats had shown that enriched environments rewired the rats’ brains (see Rosenzweig & Bennett, 1996).

Accumulating data on humans have since converged to support this idea. For example, studying musicians, Gaser & Schlaug, (2003) found that, “gray matter volume differences in motor, auditory, and visual–spatial brain regions when comparing professional musicians…with a matched group of amateur musicians and non-musicians.” Studying London taxi drivers Maguire, Woollett & Spiers, (2006) found that, “compared with bus drivers, taxi drivers (who must pass a notoriously difficult street memorization exam in order to get licensed) had greater gray matter volume in mid-posterior hippocampi and less volume in anterior hippocampi. Furthermore, years of navigation experience correlated with hippocampal gray matter volume only in taxi drivers.” In a longitudinal study looking at the effects of mindfulness training on Parkinson’s Disease patients, Pickut et al., (2013) found a link between mindfulness based intervention and patients’ increased gray matter density in the neural networks postulated to play an important role in Parkinson’s Disease.

By Noam Shpancer Ph.D.