Counselling and the Brain: Five Major Processes

The research in neuroscience is highly supportive of counselling’s emphasis on deep listening, empathic understanding, strength building, and wellness (Ivey, Ivey, Zalaquett, & Quirk, 2011). Counselling is shown to change the organisation of the brain: a learning process as the brain responds to stimuli and creates neural pathways to accommodate new information (Ivey, 2009). “Information” includes experiences, actions, thoughts, and cues: both those emanating from within ourselves and those from others and most especially including those stimuli arising within the therapeutic relationship. As John Ratey (2008, in Sullivan, 2012) said, “Experiences, thoughts, actions and emotions actually change the structure of our brains” (emphasis added).

In this article we’ll briefly overview five important processes that explain the impact of counselling on the brain structure. These are: Neuroplasticity, neurogenesis, the importance of attention and focus, understanding emotion and focusing on strengths and positives.

Process One: Neuroplasticity

Neuroplasticity addresses the increasingly evident truth that the brain is dynamic. It responds to external environmental events and to thoughts and actions initiated by the individual. Throughout our lifespan new connections – that is, new neural networks – are developed, regardless of age, background, or life experience (Ivey & Zalaquett, 2010). Neuroplasticity can result in large-scale re-modelling of a person’s neural networks, meaning that the brain can rewire itself. Here’s how it happens.

Action potentials: The ultimate motivators

When we think, “action potentials” fire across neurons that stimulate action potentials in other neurons. When we are learning or practicing something, the repeated firing (that is, use of the network) of neurons starts to strengthen dendrite connections. Let’s define the terms of those nerve cell parts to see why this is so helpful for growth. Neurons, or nerve cells, are the basic building blocks of the nervous system. These specialised cells are the information-processing units of the brain responsible for receiving and transmitting information; they do it through impulses sent via the release of neurotransmitters. The neuron has three main sections: the soma, the axon, and the dendrite. Each section plays a role in the communication of information throughout the body (Cherry, 2014a;; 2010).

Dendrites are treelike extensions at the beginning of a neuron that receive information from other neurons and transmit electrical stimulation to the soma in the centre of the nerve cell. Dendrites are covered with synapses, which use neurotransmitters to carry the signals across the synapse to other neurons (Cherry, 2014b). Synapses are the structural spaces between neurons in the nervous system that are the conduits for neurons to send chemical message signals to targeted neural cells; they are also called terminal buttons (, 2010).

Axons are the lengthy, thin, straight structures that are part of the neuron body (soma) that conducts nerve impulses away from the cell body to the neuron’s terminal buttons (synapses) (; 2010). Neurotransmitters are chemicals that are released from nerve cells which thereby transmit impulses from a nerve cell to another nerve, muscle, organ, or other tissue. A neurotransmitter is a messenger of neurologic information from one cell to another (, 2014).

As the dendrite connections strengthen, they up-regulate various neurotransmitter receptors and neural growth factors. Brain-derived neurotrophic factor, or BDNF, is a protein mainly located in the central nervous system but also present in the peripheral nervous system. It acts on brain nerve cells, causing them to survive and grow (Web definition, n.d.). BDNF stimulates dendrites to wire up in order to respond to learning demands and to code information for the development of new behaviours. This process has been likened to adding more memory to a computer as the program software requirements increase.

No action, less neuroplasticity

The neuroplasticity of the brain also means that underuse can reduce dendrite density and number, which down-regulates the receptors. Neuroplasticity works against us in the scenario in which we perceive a threat and become anxious; the areas of the brain which register the experiences of threat or anxiety strengthen, making expansion and growth more difficult. When there are mental health problems, the areas involved in thinking and memory get weaker. These occurrences are often marked by a down-regulation of neuroplasticity via neurotrophin pathways, as opposed to mere under – or overuse of specific parts of the brain.

Thinking activates the genes

All we have to do to create an action potential is to think! Simply thinking a thought activates a class of genes that Dr Matthew Bambling calls “immediate response genes” (Bambling, 2013). These influence the release of neurotrophins, secreted proteins which tell neurons to stay alive, change, or grow. Neurotrophins also encourage differentiation of cells to form neurons; they are important for neurogenesis (the next process). What’s becoming clear in neuroscience is the rule that language learners, personal exercise trainers, and virtually anyone using a skill have known for aeons, that is: use it or lose it. If we don’t use our neurons, they may not hang around. Thus BDNF and immediate response gene activity is integral to keeping neurons alive (Bambling, 2013).

Bambling notes that the degree of stimulation or mental activation (via action potentials) is read by the immediate response genes that literally switch on or off in response, signalling neurochemicals or other genes involved in brain growth and memory coding which are then activated. Thus immediate response genes operate as a class of signals or keys to activate a variety of processes in the brain; genes must either express or not express to bring about biological changes (the brain must be healthy to do this well). This is the basis of neuroplasticity: that our brains change in response to our positive or negative thoughts, learning, or social or physical environment (Bambling, 2013).

Process Two: Neurogenesis

Do you remember the old adage that you can’t teach old dogs new tricks? We’re not sure about the latest in canine research, but as far as humans go, that notion has definitely been discarded by modern neuroscience. Neurogenesis is the process by which new nerve cells are generated. Admittedly, many of the new cells are generated very early in life, but the active production of new neurons and other neural “products” from undifferentiated stem cells is a process that occurs through the lifespan in response to new situations or experiences in the environment. Obviously, counselling is a “new” situation for a client and it supports the building of neurons and neural networks!

Also, exercise is particularly important as a lifetime process to promote neurogenesis, ensuring brain health (and total physical health), because it increases blood flow and the release of positive neurotransmitters such as serotonin. The takeaway ideas here are that: (1) it is fortunate for clients’ brain health that they made it to your rooms for counselling, and (2) exercise needs to be part of the treatment regime, part of what you strongly advise them to do. If they are down, they should walk or run. Not only will they feel better, but as neurogenesis kicks in, their brains will be expanding as well (Ivey & Zalaquett, 2011;, 2012).

Process Three: The importance of attention and focus

Thanks to brain imaging techniques, we can now measure whether someone is paying attention. Focus and attending behaviour – on the part of both client and counsellor – are crucial for success in the learning process that is counselling. When client and counsellor attend to the story, the brains of both participants become involved. At the brain’s core is the reticular activating system, which transmits stimuli to the cortex and activates neurons firing throughout many areas. The direction of the attention – the focus – is determined by the executive frontal cortex of the brain. The counselling micro-skill of attending behaviour is integral to this process. Thus we are able to state that effective communication to the client of your attention with energy and interest results in the client seeing you as a positive resource. As we noted, each positive thought builds more neural receptors for positive thought, making the process a self-reinforcing one. An excellent treatment to facilitate client focus and attention is meditation. Benson and Proctor (2010, in Ivey & Zalaquett, 2011) suggest that relaxation and meditation help a person switch off or switch on gene activity associated with health and disease.

Process Four: Understanding emotion

As a therapist, you may always have had the sense that when the client is smiling or engaging in positive emotion, his or her brain is working differently than when the person is mad, sad, afraid, or even disgusted. Now neuroscience backs up this intuitive insight, showing through brain imaging that specific emotions fire different parts of the brain. The amygdala is the part that comes alive with negative emotions, and also is an energiser for learning and absorbing new input and memories. Numerous parts of the brain are activated by positive emotions. The prefrontal cortex and the hippocampus are clearly important, but also, the nucleus accumbens sends out signals to the dorsal cingulate cortex and prefrontal cortex, making it possible to focus on positive aspects. Feeling and thinking positively are heavily influenced by these executive cognition functions (Ivey & Zalaquett, 2011). A central understanding regarding emotion is the role of mirror neurons in creating the capacity for empathy.

Process Five: Focusing on strengths and positives

Here is a scenario you may be familiar with. The client has been coming for a number of sessions now, and the presenting issue is historical abuse. The client, a woman, has decided that she is ready to process it, and has chosen you to work with. She has been opening up about the abuse, amidst a torrent of powerful negative emotions; her anger, hurt, fear, and revulsion over what happened have come tumbling out in session. As a therapist, you are aware that it’s good for clients to get things out, and you are glad she has been releasing it. Yet you are beginning to have a sense of disquiet. She has been “waterfalling” with these negative disclosures for a number of sessions now, but when you try to steer the therapeutic conversation in the direction of positive aspects, she resists.

If you are worried that there is too much emphasis on the negative, then neuroscience would say you are onto it. Too much therapeutic focus on negative issues and problems builds a self-reinforcing circularity between the amygdala (as we just noted: the seat of most negative emotions) and the frontal cortex responsible for generating positive emotion. The result? Negative thinking, accompanied by negative feeling, which leads to depression: not what your client needs, especially if she has already been depressed by what happened and its aftermath.

Pessimism feeds on itself. Now neuroscience tells us that that an effective executive frontal cortex focusing on positives and strengths can overcome the negative. True, appropriate medication can enhance positive thinking through increasing the supply of serotonin. But so, too, can therapies such as CBT, positive psychology, the re-storying of narrative therapy, and transpersonal psychologies which continually reframe events and thoughts to focus on a greater sense of purpose and meaning.

As a therapist, you will also want to note that wellness activities such as exercise, solid interpersonal relationships, meditation, and leisure all facilitate our ability to control those amygdala-based demons of negative thinking and feeling (Ivey & Zalaquett, 2011).

This article was adapted from Mental Health Academy’s upcoming CPD course “Counselling and the Brain”. The purpose of this course is to give you an overview of the emerging connection between the human brain and counselling, with particular focus on the ways in which brain processes affect and are affected by the processes of counselling and psychotherapy. Click here to learn more about MHA.


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