What is talk therapy (or psychotherapy), really? To start, therapy isn’t magic, unfounded quackery, or anything like what you may have seen in movies and TV shows.

This article explains the foundational process used in the most common types of therapy. We’ll go over how the mental health benefits of therapy actually come from physical changes in the body. We’ll also explore how therapy can help you make meaningful, sustained changes in your life.

Talk therapy changes your mind — and brain

It seems obvious that physiological (physical) changes to the brain can cause psychological (mental) changes to how we feel, think, or behave. For example, medications can adjust the brain’s chemical imbalances to help people overcome symptoms of depression. It also seems obvious, then, that our feelings, thoughts, and behaviors are linked to the way the brain’s physical structure works. For example, mood and behavior changes are common in people who have a traumatic brain injury.

What isn’t obvious, though, is that the brain’s physical structure can change at any time — and we can use this to our advantage. When it takes in new information, the brain has the ability to naturally reorganize the physical connections between brain cells called neurons. This ability is known as neuroplasticity, and it’s how you learned everything you’ve ever learned.

So if we know:

  1. Neuroplasticity changes physical structures in the brain
  2. The way the mind works is linked to those structures

... then we should be able to use neuroplasticity to intentionally change our feelings, thoughts, and behaviors. Let’s go over how this process works in talk therapy.

You are what you learn

As you experience new things, neuroplasticity allows new connections to form between specific neurons. The more you experience something, the more those neurons are used and the stronger their connections become. The stronger the connections, the easier it is to remember information about an experience. A group of strongly connected neurons, called a neural circuit, is responsible for carrying out a specific function when activated. Neural circuits even connect with each other to form large-scale brain networks capable of performing complex functions — like remembering how it feels to hug your mom.

Before we get into why this is relevant to therapy, stop and think for a second. When you read “how it feels to hug your mom,” what happens in your head? No matter what your relationship with your mother is like, your brain almost certainly responded in one of the following ways:

  • Triggering a certain memory of hugging your mom
  • Starting a thought process about your relationship with your mom
  • Going through the emotions you have when you hug your mom
  • Making you miss your mom

This automatic response is an example of your brain’s neural connections in action. There is at this very moment a physical structure in your brain made of neurons devoted to the idea of hugging your mom. In fact, there’s a physical structure in your brain (or a relation between multiple structures) for everything you know.

While it’s a bit more complex in reality, we can think of the neural structures in your brain as places to store the lessons you’ve learned. Each structure was wired up as you experienced new things and learned new information from those experiences. Whenever you encounter a similar experience, the structures with relevant information activate to tell you what to feel, think, or do.

Now, if these structures can cause you to have a thought or emotional response simply by reading about hugging your mom, imagine what else they can do. Imagine what obvious and subtle things they’re doing in everyday life as you’re hit with the stress of work, family, health, and finances. And imagine how these automatic responses could affect not just your thoughts and feelings, but your behaviors, your relationships and, ultimately, your mental health.

"At a very basic level, I was aware of what I was doing. Whenever I got angry or anxious, I would shut down and distract myself on the internet. But I had no idea why I was doing this, or that I could react any other way. I had no idea how much I let my emotions control me."

You’ve learned helpful (and unhelpful) lessons

Since most new experiences happen in childhood, you learned a lot of big lessons growing up. These lessons helped you adapt your reactions so you could have an easier time getting along in life. For example, you may have learned lessons like:

  • Tantrums don’t work: When I don’t get what I want, I get upset and throw a tantrum. But throwing a tantrum doesn’t get me what I want, so I’ll try another strategy.
  • Don’t go too far: When I run away from mom and dad, they get mad and yell. That scares me, so I won’t run away from mom and dad.

Over time, a lesson you learned and the way you adapted might become less effective — or even have unintended consequences. When an adaptation malfunctions like this, we call it a maladaptive trait. Here are some examples of adaptations becoming maladaptive:

  • Social anxiety: As a kid, your awareness of others’ thoughts and opinions about you may have helped you adapt to fit in and make friends. As time went on, this awareness may have been so helpful socially that it became your default state — and riddled your mind with constant anxious thoughts.
  • Self-sacrifice: As a kid, you may have gained some big responsibilities early in life, like mediating arguments between loved ones or taking care of a relative. As time went on, you may have adapted to consider others’ needs before your own — and became so good at it you now effortlessly invalidate your personal feelings.

Bad news first: traits like these are even more invisible and harmful than you might think. Remember, maladaptive traits evolve from lessons you’ve learned — which are rooted in the brain’s neural circuits. Not only are these structures in your brain self-reinforcing (the more a neuron gets used, the stronger its connections), but they:  

  • May be further reinforced if you try to avoid them (the “Don’t think about elephants!” paradox)
  • Can feed into and activate each other (which might feel like an uncontrollable spiral of negative thoughts or behaviors)
  • Are often learned so early and are so well-reinforced that they’re a part of who you are — and nearly impossible to notice (without guidance)

Now, the good news: when we start to notice these traits and where they come from, we can change how we react to them and whatever’s causing them. And when we do that, we don’t just change the neural circuits in our brains — we change ourselves. This is the process therapy guides you through.

"Becoming aware of my emotions and working to understand them was a helpful practice on its own. But it was also fundamental to fully understanding my thoughts and behaviors. Most importantly, the three are linked — if I don’t have awareness of my emotions, thoughts, and behaviors, I don’t have awareness of myself. And if I don’t have that, I can’t change."

You can unlearn unhelpful lessons

Now we can answer the original question, “What is therapy?” Therapy is a process of identifying unhelpful traits, understanding how they affect you, and using tools to change how they make you feel, think, and behave. In other words, therapy is learning to unlearn unhelpful lessons.

Going back to how this works on a physiological level, therapy helps us identify malfunctioning neural structures, figure out how they work, and wire better ones to fit our needs. When we wire up better neural structures and keep using them, the old ones lose connections over time. Those parts of the brain get used less and less and we literally forget the information they held. Here’s the process, step by step:

  • You go to therapy to discuss how your traits may be unhelpful: The way you learned to navigate life experiences can have unintended consequences called maladaptive traits. You may benefit from getting help identifying and unlearning these traits.
  • You explore why your brain is wired the way it’s wired: It can be nearly impossible to see the root causes of certain maladaptive traits. Your therapist helps guide you.
  • You get tools to help you deal with how your brain is wired: Your therapist can provide new strategies for both short-term coping and long-term change.
  • Exploring and using these tools begins to wire up new areas of the brain: As you learn about your brain and how to deal with it, you’re making new, helpful neural circuits.
  • Over time, unhelpful parts of your brain are rewired: Now, when unhelpful neural circuits activate, the new, helpful ones do too. You’ve started to change for the better, and with continued practice your unhelpful circuits will weaken. Through this cycle of learning and unlearning, you may even one day fully rewire certain circuits and be free of their unhelpful lessons.

While your treatment will be unique to you (and different based on the type of therapy), the underlying process of learning to unlearn is the same. You’ll practice seeing foundational parts of yourself, understanding what built them, and then building new foundations.

"Two years after starting, I’m a completely different person. My anxiety is gone. My depression is gone. And I gained so much more than I thought I might, like self-worth and self-compassion."

Unlearning takes effort — and it’s worth it

Just like every skill you’ve ever learned, unlearning takes practice. Neuroplasticity means that it’s possible to make a change — not that it’s easy. All your brain knows is that its neural circuits have helped you survive until now, so it’s not going to just give them up. In most cases, you’re going to have to work hard over time (including outside of your therapy sessions) to physically rewire your brain.

Though challenging, there may be no pursuit so vital as coming to understand, accept, and better yourself. The path leads from personal growth into true wholeness — and beyond that, a greater capacity for compassion and service to others. While the best guide for you may be therapy, it could also be self-determined learning, your spirituality, or others who have walked the path. However you make the journey, we’ll be here to offer support when you need it.

Is therapy right for you? Learn when to consider therapy or other options in our next article.

“I don’t know that it’s possible to describe what therapy has given me. I had built walls around myself that I couldn’t even see. My therapists taught me how to see those walls, and how to tear them down. That gift is worth more than I can possibly know right now — I can say without exaggeration that it changed the course of my life.”

This article is for educational purposes only — the content on this page is not medical advice. If you or someone you know is experiencing a mental health crisis, immediate help and support is available from the Crisis Text Line.