Brain, Cognition, and Psychoanalysis: A Scoping Review

Cognitive functions and brain connectivity could be influenced by psychoanalytic psychotherapy (PP), thus representing neurobiological parameters for therapy-induced changes. This study searched empirical studies on cognition and the brain to evaluate which functions have been assessed, with which instruments, and what changes have been documented in brain connectivity after PP.

We used the guidelines and checklist of the Preferred Reporting Items of Systematic Reviews and Meta-analyses Extension for Scoping Reviews. The literature search was performed on the Medline-PubMed, American Psychological Association-PsycINFO, Elton Bryson Stephens Company, and Cochrane databases, and Google Scholar, including articles on patients with non-psychotic disturbances published from 1980 to September 2024.

Fifty-nine articles were collected. Five articles reported on cognitive outcomes. Abstraction and mentalization remained stable after individual PP in patients with adjustment disorders or anorexia nervosa. Executive functions, emotional intelligence, spatial short-term memory, attention, and balance between relatedness and self-definition improved after group PP applied alone or combined with individual PP. Twelve studies using functional magnetic resonance imaging, positron emission tomography, single-photon emission computerized tomography, or electroencephalography showed functional brain changes after different types of PP.

An empirical approach has rarely been used to evaluate the impact of PP on the brain and cognition. The results of selected studies on neurotic and depressive disorders suggest that PP can stimulate cognitive function and brain connectivity. Further literature reviews are needed to clarify these issues and provide an avenue for research studies targeting PP in different conditions. Communication between neurology and psychoanalysis is indispensable.