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Neurobiology and psychotherapy: an emerging dialogue

Fuchs, Thomas

History and philosophy

Purpose of review The paper outlines the beginning dialogue of neuroscience and psychotherapy by reviewing neurobiological research relevant for therapeutic concepts, presenting recent neuroimaging studies on psychotherapy effects, and discussing some conceptual problems.

Recent findings Research into neuroplasticity, the role of explicit and implicit memory systems, early attachment processes, as well as the biological underpinnings of mental disorders has considerably influenced psychotherapeutic concepts, shifting the emphasis to implicit learning in the therapeutic relationship. Recent neuroimaging studies have also demonstrated that psychotherapy significantly changes functions and structures of the brain, in a manner that seems to be different from the effects of pharmacotherapy. These results as summarized in the paper give rise to some conceptual issues which are finally dealt with. It is argued that neurobiology may be helpful in assessment before therapy, but that psychotherapy is essentially based on its subjective and intersubjective dimension that cannot be turned into an ‘applied neuroscience’.

Summary The interplay between neuroscience and psychotherapy holds interesting prospects for the future, but also implies some pitfalls which are mainly due to reductionist approaches to the mind-body problem, suggesting caution about unrealistic expectations toward a ‘neuro-psychotherapy’.

Psychiatric Department, University of Heidelberg, Heidelberg, Germany

Correspondence to Thomas Fuchs MD PhD, Assistant Professor, Head of the Section Phenomenology, Psychopathology & Psychotherapy, Psychiatric Department, University of Heidelberg, Voss-Str. 4, D-69115 Heidelberg, Germany Tel: +49 6221 56 4422; fax: +49 6221 56 5998; e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.