Archive for June, 2012

Does Psychotherapy Change the Brain?

Posted on: June 4th, 2012 by admin No Comments

Toronto Psychologist Dr. Mishy Elmpak, C. Psych.


Does psychotherapy change the brain? Toronto psychotherapist Dr. Mishy ElmpakResearch in the area of neuroscience shows increasingly that the mind and body are intricately intertwined. Many brain imaging studies show that psychotherapy can actually lead to structural and functional changes in the brain. Beliefs that the brain stops growing are nowadays refuted and we know that there is actual growth of new cells well into the 60s and that experiences and the environment have an effect on the brain structure. Psychotherapy does actually alter the structure of the brain, just as exercises and other environmental factors have an influence on the brain. Helen Mayberg of Emory University, for example, has done studies comparing antidepressants with cognitive behavioral therapy (CBT) and found that CBT affects the frontal lobes–the “higher” part of the brain responsible for cognition–while fluoxetine (Prozac) goes to work on the amygdala–the “bottom,” emotional part of the brain.

It’s not just CBT that causes changes in the brain; studies by psychiatrist Hasse Karlsson have found that short-term psychodynamic therapy does the same in people with depression, as do studies by Schnell and Herpertz using dialectical behavioral therapy.

But critics of brain imaging studies note that the instruments have been too crude to really tell us much of anything. Brain imaging works primarily by measuring increases and decreases in blood flow to relatively large areas of the brain—a sign of neural activation or de-activation—and, critics say, drawing conclusions from this is roughly equivalent to studying the Earth’s geology by using photographs from the Hubble telescope.

But reviewing 20 years of studies of neuroimaging and psychotherapy in the August 11, 2011 Psychiatric Times, Karlsson points out that continuing refinements and new techniques of neuroimaging now enable us to study the brain at a much more precise level—down to a molecular level. We can now look at the synapses that control the flow of neurotransmitters like serotonin and dopamine. Karlsson cites a study by Lehto that finds that after a year of psychodynamic therapy, the brains of patients with atypical depression had developed denser connections in the synapses controlling serotonin; this is roughly equivalent to taking an SSRI antidepressant such as fluoxetine.

In one of his own studies, Karlsson administered fluoxetine to one group of depressed patients and short-term psychodynamic therapy to the other. Both groups showed clinically significant reductions in depression symptoms, but only the group receiving the psychotherapy showed greater density in the synapses. Karlsson speculates that the change in neural structure found in this study may account for the well-known fact that depressed people treated with psychotherapy are less likely to suffer recurrence than are people treated with only antidepressants.

Of course, these recent studies are still preliminary. The Lehto study had a small number of participants, lacked a control group, and found synaptic changes only in patients with atypical depression, a puzzling finding with no clear explanation as yet. Both Lehto’s and Karlsson’s studies need replication before the findings can be considered more important. But taken with two decades of other brain scans, the evidence is growing that psychotherapy can induce restructuring of the brain.

Karlsson’s article, “How Psychotherapy Changes the Brain,” may be found in the August 11, 2011 Psychiatric Times, 28(8).

Psychotherapy is for others

Posted on: June 4th, 2012 by admin No Comments

Toronto Psychologist Dr. Mishy Elmpak, C. Psych.

Some people believe that psychotherapy is for those with significant disturbances in their lives, or even worse for those who are ‘crazy’! Those individuals need to be fixed and told how to live their lives. But these people ignore the fact that psychotherapy has changed over time, and is not stuck in the times of asylums as it was more than 100 years ago. Indeed, psychotherapy like most fields has evolved over time, and is still evolving. Today there are so many techniques, strategies and directions of therapy that it is becoming increasingly more difficult to decide which type of therapy to go for. Furthermore, one has to decide, if medication is another route to go, or if that venue is a definite no. Some individuals prefer to pop some pills and go about their ways as usual, and some individuals do actually want to get to the bottom of their issues. Those who do want to tackle their issues and look into that what stops them from becoming who they want to be, for those individuals psychotherapy can be an important venue.

These people are motivated to grow, become gradually more and more like `themselves`, become more confident and willing to change their lives. This change is accomplished gradually, step by step, in small and consistent steps, on a daily basis in real life. These individuals do actively participate in their therapy, seeing it as a collaborative process, willing to risk mistakes in the process, and yet not giving up. These individuals are motivated to look at their own lives in a creative and explorative manner and implement solutions that may be out of the box, and different than what they have always done. These individuals are from any walks of life, business people, stay at home mothers, people in transitions in their lives, employees who are seriously looking at making some changes in their lives, couples who want to sincerely talk their conflicts over. These individuals experience empathy, genuine constructive feedback and an increase in their awareness and understanding of themselves and their processes during psychotherapy. This in itself can lead to a growth experience and self-realization process.

This process in itself can be experienced with humor and does not always have to be a stern and sinister endeavor. Humor does not take away from sincerity, and does not make fun of pain and hurt. A good dose of humor testifies of heart, wisdom and insight. The therapeutic process is not easy, and indeed, can sometimes be quite a difficult and strenuous endeavor. After all it is usually much easier to bury the head into the sand, then face one`s issues straight in the eye, with the heart of a warrior and the courage of an hero. It is not easy, but it is safe and can be experienced as a breakthrough and eye opener. It can be productive in many ways.

Despite all these explanations, of what psychotherapy can be like, it is definitely not for everyone, and sometimes, it really is just for others.

Overcoming Traumatic Experiences

Posted on: June 4th, 2012 by admin No Comments

Toronto Psychologist Dr. Mishy Elmpak, C. Psych.

If you are like many people then there must have been some form of trauma at some point in your life. Now don`t get me wrong, trauma as I use it, is not necessarily an event that is so terrible and awful, that it can never be overcome, and has to stick to you for the rest of your life. But a traumatic experience, if not resolved and overcome, can show up again and again in various forms throughout one`s life. That negative experience that once or many times happened, perhaps even many, many years ago, can still follow and haunt one`s life, and show up in the most undesirable manners.

It can suddenly show up in form of strong emotions, when you are reaching for important goals and for success, such as trying to grow your business, entering into that special relationship, shedding those many unwanted pounds, giving an important public presentation, or making that final decision for that important transition in your life.

But somehow, somewhere, you are not moving in the direction of your desire, your aspirations or those goals which you have set for yourself. Those emotions, those fears, panic and worry are coming up, and you feel stuck, unable to move, decide, or use your skills and knowledge, unable to problem-solve, and get yourself into the right lane of action. You seem to tread water over and over again, in that same spot, and not go anywhere close to where you would like to be. You still seem to somehow experience the same sights, sounds, smells and feelings that you once had, and those old feelings of self and identity come up, almost automatic and by themselves and no matter how hard you try to escape or get out of it, it just does not cut it.

It seems almost as if that old trauma is downloaded in your subconscious, and can be triggered again and again. Small experiences of the past when you felt humiliated, shamed, insignificant or even rejected, surface from nowhere, as if there are no triggers, and have never been present. You experience again those moments, as if your feelings do not matter, do not count and you are unlovable, and unwanted. You still go into hiding, do not ask for anything anymore, do not show others anymore who you really are, and what you really feel and think. And now, every time you want to be more intimate, or more disclosing about yourself, or reach for more success, or something more extraordinary in your life, you feel those same blocking emotions come up. It is almost as if you are stuck in that child, that age, that person that you once were, and things have not moved away from the time of that original event.

Or worse yet, may be you have not even noticed a trigger, you feel this does not apply to you, and the fact that you can`t succeed in your business, overcome your overeating, your gambling, your promiscuity, your procrastination etc. has nothing to do with your past life and/or your experiences. It just has to be forced, and done, and all will be well. Well, the point is exactly, that this sort of thinking has not worked in the past, and will not work in future either.

Today, you are simply not accessing all the potential that you have, the potential of your

Wired for Success

Posted on: June 4th, 2012 by admin No Comments

Toronto Psychologist Dr. Mishy Elmpak, C. Psych.

If you are like most people, you know what it is like to set a goal, promise yourself that this time you are really determined to reach this goal, and then just to realize again, that it seems somehow beyond reach. Again! Have you ever asked yourself – what it is that stops you from succeeding?

What is it about those people who are more likely than others to reach what they set their mind to? What information about success and succeeding do those people have which is missing in many lives?

Can success be learned? Or do you have to be lucky to live the life you would like for yourself? What is stopping you from reaching your goals? Something is holding you back, and if you could just figure out what this is, would you not love to put a stop to that what is holding you back?

How many times did it happen that you set your goals and then just find yourself not meeting them? Do you feel overwhelmed, stressed, discouraged or resigned when this happens again for the x-time? You want to reach that goal in your diet, you want to quit smoking, take the step to build your own business, get that relationship you like! But somehow, somehow, it does not come to it…..

What is that blocks your success? Have you ever looked at a brain to see how it works?

There are often strong emotions such as fear, irritability, nervousness, anxiety, or anger which interfere with those parts in the brain that are rational, planning and goal setting. That rational, goal setting part of the brain is overpowered by the emotional part of the brain which often seems so much stronger, more oriented to the moment and instant gratification. It appears that the resources, abilities, knowledge and skills of the rational brain are almost inferior to those of the biased, opinionated, distorted and whining emotional brain, and unless practiced and rehearsed and learned, the rational brain usually just loses the battle.

Accessing the resources and abilities of the rational brain means to re-structure your mind including your thoughts, feelings and skill sets so you are re-aligned with the emotional or subconscious brain and you can actually manifest the power and strength of the entire brain. It is possible to access the resources and capabilities that are inside you, but it just needs to be brought out into the open and put to action. There are many stories of people who changed their mental processes and achieved the desired success in their lives in a much faster and easier manner.

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