Oxytocin for Psychotherapy

Researchers in Australia will test whether sniffing oxytocin can make couples more open when they engage in psychotherapy, AKA couples counseling. Here's more information on the clinical trial.

According to this article from the Sydney Morning Herald,

The team leader, Adam Guastella, said research had shown the hormone could enhance trust and improve people's ability to interpret the emotions of others correctly. "These attributes are important for being open and honest with your partner during counseling."

The article goes on to quote Dr. Guastella as saying that the effectiveness of couples therapy hasn't improved in 20 years, and only about 30 percent of couples who undergo counseling report great improvement. Another third say they got some benefit.

The idea is that treating the couple with oxytocin right before a session could make them more open and able to communicate. Beate Ditzen, now in Zurich, did a study at Emory University showing that inhaling oxytocin made couples better at communicating. (See "Oxytocin Keeps the Lid on Spats.")

So, while this could work, there's an underlying assumption here that I find unhealthy: My therapy doesn't help people, so let's give them a drug.

According to my research for my book , therapy works when it creates changes in the brain by offering the client new and safe emotional experiences. The therapist must form a true relationship with the client, and then lead him -- emotionally, not intellectually -- into a healthier form for that relationship. It's emotional practice. In the case of someone who has been severely traumatized, this can actually change the structure of the brain and increase its ability to use oxytocin for bonding.

Certainly, some psychotherapists are better at this than others. In fact, it's likely that many people go into psychotherapy because they have their own relationship problems that they haven't worked out.

But therapy clearly can work; there have been a couple imaging studies that I can't locate right now that have shown differences in brain activity in schizophrenics and people with depression following psychotherapy.

So, instead of giving their clients drugs, maybe therapists should learn to do their job better.

Comments

[Ed Yong]

Susan, you'll know more about this than I do, but isn't oxytocin a fairly far-reaching chemical in terms of its effects? Is there any risk that sniffing some before a session will trigger a wide range of physiological changes, besides the desired effect of building trust?

[Susan Kuchinskas]

You are so right, Ed. Sue Carter, one of the top oxytocin researchers, has expressed concern about this very thing.

Most of the physiological changes produced by oxytocin occur when it's released by the pituitary in the bloodstream; the thinking, I believe, is that the inhalant produces most of its effects in the brain and central nervous system.

But even there, there's no telling what-all might be going on. A few fMRI studies have been done; recently, Evdokia Anagnostou, one of the members of Eric Hollander's autism research lab, did a scan showing activation of the prefrontal cortex when adults with ASD inhaled oxytocin. That's a good thing, because it could improve their ability to read facial expressions.

see: http://www.medscape.com/viewarticle/556321

The occasional sniff probably doesn't change physiology. However, it's possible, Carter thinks, that regular treatment could actually lower the body's natural production -- or have all sorts of other unforeseen effects.

[Paul Sunstone]

I share Ed's and Susan's concern about side-effects. I also wonder how many couples who don't trust each other enough to open up in therapy have legitimate reasons for not trusting each other?

[Susan Kuchinskas]

Whew. If a couple has legitimate reasons for not trusting each other ... well, it seems like they should definitely go into therapy so they can work it out -- or else break up, no?