This is a reflective article based on what is understood about our brains and how this understanding tracks with what I offer in Cognitive Analytic Therapy. I recall learning about the concept of neural plasticity during my psychology undergraduate degree many moons ago. Recently I read a substack post about why change is so difficult (ixcarus, 2026). This reflection is influenced by this post and some of my own musings. I will begin with an introduction to the electrical networks of the brain based on what I can recall of the top of my head from a couple of neuroscience modules at university!
The idea of plasticity explains how new connections are created between neurons. Established networks in the brain are comprised of neurons which are covered with fatty layers. These layers are highly conductive of electricity and are called myelin sheaths. Neurons transmit electrical impulses via this myelin. The more myelin on a neural connection, the faster the signal, the more established the habit – such as an automatic behaviour. Synaptic plasticity is the process of generating new connections between neurons. With this principle, new behaviours are like treading on fresh snow and require more effort to sustain because of the lack of myelin. The connections are possible, there is synaptic potential, but this requires conscious, consistent effort – such as dedication and clarity of intent with pursuing something new.
It costs a lot of energy to invest in new connections, even if they are better for us.
The brain does not discriminate between good and bad habits, it is equipped for efficiency and follows the path of least resistance. I remember coming across the phrase ‘neurons that fire together, wire together’. And revisiting this topic again today, the word repetition is around.
How come some parts of the brain are associated with different functions?
It has been established through some kooky experiments on people and animals, that neurons in different parts of the brain perform different functions. So, if you add an electrical current to the part of the brain associated with word production (Wernicke’s area) you would stimulate the neurons here and speech would come out. There were also cases of people who had parts of their brain damaged or removed and the resulting impact on their change of function was used to deduce what that area was responsible for. One of the most famous was the case of Phineas Gage. He was involved in an explosion where a pipe went through his eye and out the other side of his head. His frontal lobe was affected. This is the area we associate with executive functions like impulse control and planning. This area is typically under construction when we are adolescents which could explain the typical mood swings and inability to comprehend consequences or make healthy choices during this stage of development.
However I used to wonder about case examples like Phineas. I wondered how you could clearly create a causal link between a physical injury and a type of behaviour, a personality. Then I also wonder whether there are unseen factors that scientists neglect to consider. For example, the experience of having a big piece of metal explode into your face. This would be bound to be a traumatic experience and this in itself could explain a change in behaviour.
The whole cause and effect idea of the brain, with regions associated with functions seems like a modern version of phrenology. In reality the really exciting aspect of our brains is how the individual neural networks operate together. Modern imaging like Diffusion Tensor Imaging reveals beautiful examples of this. Different zones interact with each other during a task - it is more about connection between the so called lobes as opposed to the function of a lobe in isolation. This is hopeful because it demonstrates the brain’s capacity to evolve, to create different connections beyond a preconceived idea of maturation, outside of a typical idea of reaching a stage of maturation and neurological development of around 25 years old.
Anecdotally, I have come to learn that this rigid idea is not evidenced in my experiences with people. For one thing, many influences can delay the process of brain maturation (Arain et al. 2013). I am not sure why but it seems sometimes the mind continues to be under construction and ways of being, still being formed, like in a state of flux. Ever-evolving, primed for newness. This is what brought me to write this article. How helpful is it to hold rigid views of development or the capacity for change, where does our neural wiring come into this, how might this feed into the hopelessness people express when they sit in the client chair with me and say ‘it is too late for me’?
There might be such hope and optimism for children, especially as when we are born we generate so many new neurons; there is so much potential for growth and change. The main reason for this is because we need to adapt to a new environment for survival. We can create new neurons as adults too, just less prolifically but still, when we exercise or do something nourishing for our brains, new neurons can be generated and new connections consolidated.
More possibilities for new connections do exist.
In therapy, my task is to help someone find this potential within themselves, to generate new ways to thrive. Our shared task is beyond survival, potentially life-changing but oh so effortful and oftentimes painfully slow. So how might the approach offered from Cognitive Analytic Therapy (CAT) overlap with established knowledge of how we train our brains to shape new pathways?
Recognition – ‘Knowing yourself is true wisdom, mastering yourself is true power’ (From a Yogi Teabag)
There is a focus early on in CAT to figure out what it is that we are working on together. My task is to hear what you want therapy to help you with and to arrive at a shared understanding of what happens when it seems something familiar yet interpersonally distressing occurs.
Our brains reinforce whatever we do repeatedly. Our brains are value neutral. Therefore what comes naturally to us may not be in the best interest of our and other’s wellbeing, we repeat whatever requires the least energy investment.
We need to become aware and notice what it is we have come to form as a habit in order to then appraise the value of this for ourselves and our loved ones.
The brain is a history organ which transfers what we have perceived before into the present. This is most apparent when it comes to new experiences. The anxiety associated with uncertainty is fertile breeding ground for old patterns and ways of being to transpose onto the present. I wonder if this is why there is the phrase ‘people, places and things’ in the Alcoholics Anonymous ethos. Just changing the people around us, the place we are situated in and the things we have or do is not enough. We need to take accountability to change internally too. Then this refers also to the serenity prayer, to discover the wisdom to recognise the things we cannot change.
Relationality – humanising connections, I to thou (Buber cited in Scott et al. 2009)
The concept of relational therapy refers to what happens between us. Relational healing is associated with concepts made popular by the philosopher Martin Buber (cited in Scott et al. 2009). I see this as recognising the mind of another and the contributions we make towards how we interact with each other. A bit like the idea that a problem is shared is halved only in this case it is more like thirds – you, me and the space between us. It is a bit of what I am contributing and a bit of what you contribute, in a shared space between us. In therapy this is usually referred to as the intersubjective space.
Building on what is said above, changing the cues for path-of-least-resistance old habits is only part of the solution. We also need to build in new ways of relating otherwise we just recycle old relational patterns in new contexts. This could potentially contribute towards a sense of hopelessness if we see no improvement despite investing in such drastic changes in our lives, such as ending relationships or moving countries.
Relating this concept to neural pathways, it is like changing the architecture of our minds by building an extension. First, we need a blueprint to help us consciously be aware of when we repeat new ways of being. What kind of structure is already built in our mind? In CAT this is the map, working towards the reformulation stage. We draw out established pathways and leave space for new ones to evolve. The map holds us to account for recognising the existing structure and creating space for the extension by changing our roles in maintaining interpersonal difficulties.
Reformulation – how else can we see this?
One step towards changing these networks and ways of being is to look at our sense of ‘I am’ and ‘you are’. Though certainty offer some kind of container for our anxiety, it can also create a trap and limit growth, concretsing the structure of our mind feels like being stuck between a rock and a hard place. Instead, in a therapeutic relationship the offer and invitation is to enter a less rocky, hard space, find softness, be curious to ask what is happening between us?
My understanding of Reformulation is this is a process of working towards a shared understanding of what has happened to us, how this has shaped our ways of being, especially when emotions seem to become all-consuming and overwhelming.
Usually we draft a letter and create space for conscious curiosity about where our work could take us and what else might be possible. Each letter is unique and I tend to write openly about how our understanding of your usual patterns might enter our therapeutic relationship. I hope to offer an opportunity for us to experience something more helpful for you.
Connecting with neural pathways and change, it is a bit like we are trying to lay down the foundation for new neural connections. First, we are acknowledging the familiar, efficient ones that led you to seek therapy in the first place. Then, instead of what usually happens when certain feelings are felt, how about we see what else is possible? What new neural connections might occur? I work from an integrative psychotherapy lens offering creative approaches for this unknown, unfolding process, so this is where we lean into just being open to possibilities. To offer the space to just be. Without a prescription or expectation.
Another possible pitfall to sustaining change is how we also tend to act in ways that are congruent with our personality. When we say ‘I am not a morning person’ but also set a goal of getting up early, we are working against our self-concept. This is another reason why it is helpful to hold space to just be. This way we appreciate the reality of our ever-evolving true nature as humans. This is one of the reasons therapy is difficult. We are going against the established paths of our minds, our nervous system is telling us this is effortful and there’s another way. However, if we are really motivated and feel safe enough, we can work through this resistance. These are good indicators of when we are ready for therapy and more likely to gain benefits from this process.
I wonder if because it feels hard and tiring to live with uncertainty that we create a tendency as people who like some degree of control and awareness to come up with values which hold us together or steer us in certain ways. In therapy, at times of difficulties, it helps to remember our values - why am I doing this?
For example, being someone who values their mental health and sees people as fundamentally good, then the behaviour of attending therapy and contributing towards a safe therapeutic relationship could be congruent with this value. Our brains like associations between how we see ourselves and what actions we take. Beliefs are not enough alone; we need to embody them in connection with others.
Revision – spot the difference
Making changes in CAT is referred to as revision. This is where we look over what has gone before and notice the difference. Change is more likely to occur when we are outside of our comfort zone. We need a certain amount of stress to move us towards action. Too much stress and we resort to avoidance. Too little and we take the path of least resistance and nothing changes. This is why effective therapy might feel uncomfortable.
I remember a yoga teacher describing this growth as moving towards ‘the soft edge’. Just that bit that feels uncomfortable, not painful, but just edgy enough to be challenging our limits, quite literally stretching ourselves.
When we are doing something challenging - like having a difficult conversation we might ordinarily brush under the rug - our brain releases norepinephrine and acetylcholine. This increases our focus. When this happens our brain is paying close attention and creating new neural connections, hopefully to be encoded as a new way of being. This is the plastic bit which is a step towards lasting change. Then the next time might feel less frightening to embark on a difficult conversation, it will still feel effortful though as the connection is new and less efficient than the brushing-it-under-the-rug way of relating.
This part of therapy is usually quite frightening for us all. It requires a leap of faith. Going away from what is comfort zone friendly yet self-limiting and moving towards what is outside of the known but might be more congruent to our hypothetical, aspirational, evolving new self-concept. It takes lots of energy, feels challenging and unfamiliar yet somehow it is where we want to be moving. This part of therapy sometimes results in the phrase ‘I don’t know who I am anymore’. It really helps if our loved ones adapt and support this new growth in us.
How long does it take to change something we don’t like about ourselves?
I think the focus needs to be on moving towards new ways of being rather than running away from what we appraise to be a bad habit or unhealthy way of relating. In CAT we consider all of how we are to have evolved from necessity, all ways of being are vital. We are products of a need to adapt in order to survive the circumstances we arrive in this world in. So perhaps a small part of us will be vulnerable to being a certain way under stressful conditions. However, the greater space we can create for new possibilities might allow for room to pause, reflect and respond as opposed to react.
Bringing this back to neural pathways, this is why meditation has so much value for our brains. It helps build focus and patience with ourselves. A meditative practice linked with spirituality or religion adds the element of possessing faith in a power greater than ourselves. What used to be a worry might melt into a niggle and then nothing when we can ground and centre in the moment when we can retain a bigger picture and accept ourselves wholy and truly.
I think the 'what ifs' and 'shoulds' arise from a need to be in control in response to a fear of the unknown or dread and foreboding of past problems repeating. When we face up to a reality of not knowing we allow space for something else to occur. Without facilitating past blueprints wired in our brains to automatically translate, fear might rise, but we can create new ways of connecting with emotions without resorting to old perceptions. This takes time and attention but it is possible thanks to the possibility for new connections within, thanks to our capacity for neural plasticity.
I wonder whether the new connection is also an internalised version of what we experience in the therapeutic relationship. If we are met with a grounding, co-regulating other, this might be a new experience for us to integrate within ourselves too? In CAT this fits around the zone of proximal development, what we can do with another today, we can do by ourselves in future.
We also all process in our own unique circumstances, in our own time and pace. CAT has a variety of session numbers to represent this varying capacity for the work.
As mentioned earlier on, the key to sustaining change is to commit. To make a commitment to yourself. As my current yoga teacher says, just aim to show up on the mat. Be in therapy even on days when you feel nothing, or worse than nothing.
It is about showing up to meet every version of yourself. To sustain change, choose consistency over intensity and striving for perfection. Tend to the basics – fluids, good foods and quality rest to nourish your brain. Just by adding a little bit of effort, you might just send a signal to your brain that you are taking care and being more present and let’s see what happens…
References
Arain, M., Haque, M., Johal, l., Mathur, P., Nel, W., Rais, A., Sandhu, R. and Sharma, S. (2013) 'Maturation of the adolescent brain' Neuropsychiatric Disease and Treatment, pp. 449-461, DOI: 10.2147/ndt.s39776
Ixcarus (2026) ‘Neuroplasticity: Rewiring your Brain to do Hard Things.’ The Forbidden Files (Available from Substack, last accessed on: Sunday 1st February 2026)
Scott, J. G., Scott, R. G., William L Miller, W. L., Stange, K. C. and Crabtree, B. F. (2009) ‘Healing Relationships and the Existential Philosophy of Martin Buber’. Philosophy, Ethics, and Humanities in Medicine, 4 (11), doi:10.1186/1747-5341-4-11
