Switch from distress to well-being by strong emotions: Speculations on three clinical vignettes

Starting from three clinical vignettes representing two mental disorders and different approaches to their treatment, we ask whether and how an unexpected event occurring at a particular time in a person's life could provoke such strong emotions as to determine a sudden transition from a state of severe distress to one of well-being. In this transition, we postulate that a major role is played by biological tendencies and brain plasticity under the influence of psychotherapy and positive emotions, emotions--especially trust, the sense of being cared for, and falling in love--that are awakened by openness to novelty and to the Other. Neurobiologically, a sudden improvement could be ascribed to an oxytocinergic action that, combined with dopaminergic circuits, can restore a state of well-being, safe attachment, and gratification.