Minding my brain: Fourteen neuroscience‐based principles to enhance psychotherapy responsiveness

Abstract

Intersections between psychotherapy and neurosciences are at its dawn. The quest to understand the neural underpinnings of psychological processes has led several generations of scientists to explore neural correlates between mind, brain and behaviour. Neuroscience methods and research have given psychology new perspectives and insights about the structure and function of complex neural pathways that underlie human functioning (cognition, emotion, motivation, somatic reactions and interpersonal behaviour). By translating neuroscientific findings into psychotherapeutic principles of change, it is possible to promote responsiveness towards brain dysfunction that underlies patients' psychological malfunctioning. In psychotherapy, responsiveness is a core aspect of the therapeutic change process, especially to adapt psychological interventions to patients' motivational stages and preferences, coping styles, neurobehavioural modes and emotional needs. Within a transtheoretical and translational approach, contemporary neuroscientific findings are revised, discussed and used to attempt to build on 14 theoretical brain‐based principles that may be applied to psychotherapy. Translating these empirical findings into practical principles, clinical strategies and tasks is expected to enhance psychotherapy responsiveness grounded on a science‐based knowledge of brain functioning.

Neuroscience-based psychotherapy: A position paper

“…Neural areas, including the medial prefrontal cortex, the midline regions of the posterior cingulate cortex, and the precuneus region of the parietal cortex that turned on/off only to self-related task engaging of an individual, have been recently shown to support the DMN (Raichle and Snyder, 2007;Mak et al, 2017;Buckner and DiNicola, 2019). These findings have sustained the hypothesis that it may be the neuronal basis of the Self (i.e., personal and social awareness and ability in differentiated cognition and perception) (Faustino, 2022). Moreover, the dorsolateral prefrontal cortex, which is considered the neural circuit of working memory, also enables us to pay attention to something in the here-and-now (Siegel, 2006).…”

“…According to previous attempts to point out neuroscience-based psychotherapy principles (Cappas et al, 2005 ; Faustino, 2021 ), the traditional dualism between brain and mind is no longer tenable. In the near future, we wish that neuroscience-based psychotherapy can contribute to the unification of its fragmented field, given that each specific school approach explains only 8% of the variance of the results and the most important common factor called into question to explain the patient's change after treatment is the therapeutic alliance (Wampold and Imel, 2015 ).…”

“…The patient has an innate and programmed capacity to internalize, embody, and imitate the state of another person, and through psychotherapy, he/she can discover himself/herself in the other's mind (Janiri et al, 2009 ). Accordingly, proximity to the patient (i.e., proxemics), bodily movements (i.e., kinesics), and paralanguage (i.e., a no-lexical component of speech) are fundamental dimensions in the therapeutic setting (Cappas et al, 2005 ) that have to be correctly managed by psychotherapists prior to discuss about feelings and emotions (Faustino, 2021 ).…”

“…Specifically, research in mindfulness currently integrates theory and methods from eastern contemplative traditions, western psychology, and neuroscience and is based on neuroimaging techniques, physiological measures, and behavioral tests (Tang et al, 2015 ). In addition to this, complementary emotion-focused techniques, such as experiential focusing, systematic evocative unfolding, evocative experiential states, and relaxation techniques (e.g., diaphragmatic breathing and progressive muscle relaxation) can contribute to enhancing emotional soothing by a “bottom-up regulation” of the subcortical network, too (Faustino, 2022 ). In light of this, we highlight that a top-down and bottom-up integrated approach to the treatment of anxious or depressive symptoms is necessary to counteract the symptomatology reported by the patient.…”

Assessing the patient’s affective perception of their psychotherapist: validation of the in-Session Patient Affective Reactions Questionnaire

“…Research on emotional expression in psychotherapy provides evidence that emotions substantially contribute to therapy outcomes at both the session and treatment levels ( 23 – 25 ). Furthermore, emotions are an element of both therapy-specific and nonspecific therapeutic processes related to clinical efficacy ( 26 , 27 ). Helping patients become aware of their emotions and make constructive use of them appears to be important in therapeutic change ( 28 , 29 ).…”