Nerves that fire together wire together

How does psychotherapy work? People who come to see a psychologist hope and expect that they will change from the process. I ask all new clients “what do you hope to get out of therapy?” Most people hope and expect that they will change perspective or habits or both. But what does this change mean? What is happening in the brain when change occurs?

The human brain is the most complex of organs. The brain is a bundle of 100 billion nerve cells. Imagine a city of 100,000,000,000 people, each of whom have many, many links to other people. All those people are organised into various organisations/employers/families. These individuals and larger groups are associated with other individuals and groups in complicated ways.

These associations are what makes the city (and the brain) work together as a team. But some associations are not helpful. In a city, a political party that is associated with a criminal organisation will probably lead to the city becoming weaker, less effective. In a brain, an unhelpful association might occur between the fear centre (let’s call this the amygdala), and the mental network associated with something safe. Take Hannah as an example.

Hannah* was a second-year university student. She had always been stressed at exam time, but this fear had gotten out of control. She experienced panic attacks before some of her exams. She had missed one Semester-1 exam because of this and had now deferred Semester 2. She was fearful of resuming university the following year.

We might think that something like this has occurred in Hannah’s brain:

The idea of study or university

has become associated with


It is important to realise that all of this has happened in the brain. Even when not at university, or studying, the thought alone of university or exams was associated with fear and anxiety. Because this is all happening in the mind, it would be a mistake to think that Hannah could solve her fear by just avoiding university. Hannah had tried this by deferring the semester. Now she wasn’t just fearful of exams, but now university in general.

Psychotherapy addresses the problem of unhelpful associations two ways: 1. By weakening the unhelpful association and 2. By forming a new helpful association. In Hannah’s case this meant firstly to convince her mind that university and exams were safe. She visited uni and attended lectures to start to feel safe again in that environment.

Secondly, Hannah started to recognise and challenge negative thoughts about failure and her ability to think on her feet in exams. She changed her perspective. She started to practice new, more realistic ways of thinking about study, Uni and exams. She formed new connections:

The idea of study or university

forms a new association with

Safety or Reward

When we change a habit, we change our brain. Nerves that fire together, wire together. No matter who we are, we have a habit that holds us back. Unhelpful neural wiring telling us that safe things are unsafe. Telling us that we are not good enough when we are. These unhelpful associations are not life sentences. Brains change every day! What mental habit is holding you back?

* names and key details changed to protect anonymity

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