Have you ever wondered why humans need therapy? I mean do we really need it? Does therapy work?

I wondered that very same questions for a number of years - long before I thought about going for therapy myself. In fact I remember clearly in my early 20's thinking with great relief " so much has happened to me its amazing I don't need therapy". We all have blind spots - and that was certainly mine!

Twenty years later living with the benefits of going into therapy - I decided to train as a therapist myself. But I still had that lingering question why do humans need therapy? And do we really need it? Does therapy work? Having a science background I needed some tangible proof of how therapy works and why humans need it.

Louis Cozolino – professor of Psychology at Pepperdine University and a clinician in private practice.

And low and behold someone else had had these very same thoughts. Cozolino found that when clients asked him why therapy works, he didn’t have a satisfactory answer (a bit like me).  Cozolino aimed to explain the mechanisms for psychotherapeutic change, by looking at how and why our brains evolved - examining the neuroscience of psychotherapy.

What are the levers of change in Therapy? Why does therapy work?

According to Cozolino there are 2 main levers of change in therapy

a) importance of connection - relationships and the power of relationships to regulate emotion and for the creation of new learning.

b) the other piece is the science of neuroplasticity, in other words the underlying mechanisms of action that allows the psychotherapeutic relationship to result in change. The mechanics of change.

Lets Blame Evolution For Us Needing Therapy.

First humans appeared on the planet 100,000 years ago, only 50,000 years ago did language and culture evolve. Evolution adapts to situations so we adapt to the environmental changes, both physical environment and the social environment. As a result  humans  have developed  incredibly large, complex brains that are problematic. Coordinating scores of neural networks from different evolutionary stages involves high complexity and is vulnerable to dysfunction. You could say its a bit like adding layer upon layer of new modern tube lines onto old rail networks - without checking if the old networks can cope.

Vital Half Second

Conscious and unconscious processing occur at different speeds. Older structures take 10-50 milliseconds to respond to stimuli. Newer structures take 500 – 600 milliseconds. During the half second processing delay, the brain constructs our present experience, based on template from the past.Our brains use our experience of past relationships to shape our perception of now.

Older structures - older brain, the right hemisphere,  the unconscious. 

The innermost structures of the brain, the parts nearest the spinal cord — are the oldest part of the brain, and these areas carry out the same functions they did for our ancestors.  The way the right hemisphere is organised is the way both hemispheres are organised in more primitive animals. It is dominated by fight- flight reactions, high states of emotion, fear, and low states of emotion like withdrawal, playing dead. The sympathetic/parasympathetic dominance. The “old brain” regulates basic survival functions, such as breathing, moving, resting, and feeding, and creates our experiences of emotion. The sympathetic nervous system prepares the body for the “fight or flight” response during any potential danger. 

Newer structures - newer brain, the left hemisphere,  the conscious. 

On the other hand, the parasympathetic nervous system inhibits the body from overworking and restores the body to a calm and composed state. According to Cozolino the left hemisphere is more of an "experiment that goes along with the evolution of sociality and humans becoming a fundamentally social species. The left hemisphere greases the social wheels". 

Task of Therapy 

Much of our conscious experience is based on unconscious processes, therefore, we are very vulnerable to misperception. We have these two fundamental brains (left/right, conscious/unconscious within our skulls that are programmed in different ways. Cozolino states

"the left hemisphere is in charge during the day, at least outwardly, with a lot of influence from the right. And the right hemisphere is in charge when we are sleeping—a gross simplification, but that’s sort of the general thing. A lot of us know what we should do—we should eat right, we shouldn’t cheat on our husbands or wives— yet we still eat the pepperoni pizza. Why? Well we are driven in a primitive way to do these things and our left hemisphere doesn’t always have the leverage to keep us from doing it

The task of therapy is to help make the unconscious processes, conscious. A therapist will attempt to address the processing bias created by the vital half a second.

During therapy bringing to the surface the unconscious is when you get those light bulb moments. This can be created from just talking in therapy - exploring whats going on, creative processes and psychoeducation.

I am further trained in Transactional Analysis and believe our relationship with attachment to be a fundamental factor in creating and holding on to fulfilling relationships.

Why Therapy Works

The task of therapy is multi-dimensional, as well as addressing evolution  it also addresses the following six factors that make therapy work.


The Power of Early Learning

Breaking the Power Of Illusion

The Power Of Core Shame

The Power of Self-Regulation

Anxiety Bias Suppression of speech

Neuro plasticity & Counselling