Exploring the Neural Impact of Hypnotherapy vs. Cognitive Behavioral Therapy in Treating Depression
With hypnotherapy, I often run up against scepticism about the efficacy and mechanisms behind this therapeutic mode. So I was interested to read a new study, in Frontiers in Psychology, which provides new insights into how hypnotherapy (HT) compares with Cognitive Behavioural Therapy (CBT) in treating depression, in particular focusing in effects on the brain’s default mode network (DMN).
These findings, in my opinion, carry significant implications for how hypnotherapy is understood and practiced.
What is the Default Mode Network?
The default mode network is a network of interacting brain regions that is most active when we are at rest and not focused on the outside world. It’s associated with a range of self-referential and introspective activities including thinking about ourselves, our emotions and our future and is commonly disrupted in depression.
The Study
The study involved 75 depressed patients who were randomly assigned to receive either HT or CBT. Both therapies were delivered over 20 sessions, and the patients' brain activity was measured using functional near-infrared spectroscopy (fNIRS) before and after the therapy sessions. The fNIRS technique, although limited to surface cortical measurements, provided valuable insights into changes within the DMN.
Main Findings
Both HT and CBT were effective in reducing depressive symptoms, as evidenced by significant improvements in the Patient Health Questionnaire Depression Scale (PHQ-9), a widely used tool for screening, monitoring, diagnosing and measuring the severity of depression. However, when it came to changes in the DMN, some interesting differences between the two therapy types emerged:
Reduction in DMN Activity
There was a general decrease in functional connectivity within the somatosensory association cortex (SAC) across both therapy groups. This decrease might suggest a normalisation of DMN activity, which is often hyperactive in depression.
Therapy-Specific Changes
The HT group showed a trend towards increased connectivity between the right angular gyrus (angG) and left supramarginal gyrus (supG). Although this finding did not remain statistically significant after correction for multiple testing, it hints at a unique impact of HT on interhemispheric brain connectivity.
Increased connectivity between the right angular gyrus (angG) and the left supramarginal gyrus (supG) could have several potential impacts, particularly in the context of cognitive and emotional processing. Some possible implications are:
Better Integration of Information: The angular gyrus is involved in various cognitive processes including language, number processing, spatial cognition, memory retrieval, attention, and theory of mind. Increased connectivity with the supramarginal gyrus, which is associated with perception, attention, and social cognition, might enhance the integration of different types of information, leading to improved overall cognitive function.
Improved Communication Skills: Both regions are part of the broader network involved in language processing. Enhanced connectivity may facilitate better language comprehension and production, as well as improved communication skills.
Better Emotional Regulation: The supramarginal gyrus plays a role in empathy and emotional regulation. Increased connectivity with the angular gyrus might improve an individual’s ability to understand and regulate their own emotions and those of others, which is crucial in social interactions.
Enhanced Theory of the Mind: Theory of mind, the ability to attribute mental states to oneself and others, involves both the angular gyrus and the supramarginal gyrus. Stronger connectivity could lead to better understanding of others' perspectives, intentions, and emotions, enhancing social relationships and reducing social misunderstandings.
In the context of depression, increased connectivity between these regions could be associated with changes in how patients process self-referential thoughts and emotions. This may contribute to more adaptive emotional processing and a reduction in depressive symptoms.
Implications for Hypnotherapy
These findings have important implications for hypnotherapists:
Firstly, it validates the efficacy of hypnotherapy in reducing depressive symptomsSuch validation is vital for gaining broader acceptance of hypnotherapy as a legitimate treatment within the medical and psychological communities.
Secondly, the potential changes in DMN connectivity specific to hypnotherapy suggests that hypnotherapy might engage the brain differently that’s CBT. This could be related to the altered state of consciousness induced by hypnosis, which may foster section and emotional processing in ways that traditional talk therapies may not.
Finally, the different effects observed in the study highlight the importance of individualised treatment plans. Hypnotherapists can take pride in the flexibility of HT to address specific neural patterns associated with depression, offering benefits to patients who might not respond as well to CBT alone.
Conclusion
The study's insights into the neural impact of hypnotherapy are both promising and encouraging. They affirm the effectiveness of HT in treating depression and suggest that hypnotherapy may engage the brain in unique and beneficial ways.
In a world where mental health issues are increasingly prevalent, having evidence-based, effective treatment options is more critical than ever. This study not only validates the work that hypnotherapists do but also inspires us to deepen our understanding and continue striving for excellence in helping our clients achieve mental well-being.
The full study can be read at https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1401946/full
Haipt A, Rosenbaum D, Fuhr K, Batra A Ellis A-C (2024) Differential effects of hypnotherapy and cognitive behavioral therapy on the default mode network of depressed patients. Frontiers in Psychology June 2024.