For the science-minded only, some interesting new brain research below.  For the non science-minded, pass this post by quickly!

We knew that the avPFC was responsible for the ability to not engage in impulsive behavior which is rewarding in the short term but harmful in the long term.  But we now see that it is specifically the degree of the avPFC's interaction with the Nacc which accounts for this.

The real question, of course, is the degree to which avPFC-Nacc interaction can be increased through the creation and strengthening of neural pathways, as a result of cognitive therapy.  Can "talk therapy" and the resultant changes in thinking patterns cause physical changes in the brain?

Ultimately, third-party health care payers may look to measurable physiological changes in the brain as a measure of the efficacy of treatment.

In the meantime, don't let the little head get you into too much trouble!


J Neurosci. 2010 Jan 27;30(4):1488-93.
When desire collides with reason: functional interactions between anteroventral prefrontal cortex and nucleus accumbens underlie the human ability to resist impulsive desires.
Diekhof EK, Gruber O.
SourceCenter for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry, Georg August University, D-37075 Goettingen, Germany. [email protected]

Abstract
Human decisions are guided by "desire" or "reason," which control actions oriented toward either proximal or long-term goals. Here we used functional magnetic resonance imaging to assess how the human brain mediates the balance between proximal reward desiring and long-term goals, when actions promoting a superordinate goal preclude exploitation of an immediately available reward option. Consistent with the view that the reward system interacts with prefrontal circuits during action control, we found that behavior favoring the long-term goal, but counteracting immediate reward desiring, relied on a negative functional interaction of anteroventral prefrontal cortex (avPFC) with nucleus accumbens (Nacc) and ventral tegmental area. The degree of functional interaction between avPFC and Nacc further predicted behavioral success during pursuit of the distal goal, when confronted with a proximal reward option, and scaled with interindividual differences in trait impulsivity. These findings reveal how the human brain accomplishes voluntary action control guided by "reason," suggesting that inhibitory avPFC influences Nacc activity during actions requiring a restraint of immediate "desires."