The virtues of Lane et al. are many: I will name three that seem especially compelling. First, the authors offer a serious integrative framework through which to study common mechanisms of change across a range of psychotherapies. Second, the authors place emotional processing front and center in their conceptualization of change in therapy. The third virtue is the foundation of the first two: A neuropsychological explanation that illuminates both the basis for psychological difficulties and the process by which these difficulties can be changed in therapy.
What an elementary neuropsychological account offers is a sort of machete with which to cut away some of the tangled underbrush of competing theories that have proliferated in psychotherapy. Clearly, similar processes underlie all therapies at a neuropsychological level. We have known for some time that theoretically different approaches to therapy have roughly equivalent effects (Wampold Reference Wampold2001), and Lane et al. help to illuminate why that is the case.
The authors posit as the core mechanism of change in psychotherapy the reconsolidation of prior emotional memories through new emotional experience. I would suggest that as memories change in therapy what is ultimately changing is the self, and that the self rather than memory is a more helpful and fruitful construct around which to build psychotherapy integration. I will clarify this idea briefly in this commentary. In order to achieve a clear model, the authors have at times been overly schematic. It is true that many therapies view emotion as important to the process of change. However, Lane et al. downplay substantial differences in the functions accorded to emotion in each of these therapies. Some therapies (e.g., emotion-focused) view emotion generally as a very healthy and essential source of motivation, value, and meaning. Other therapies (e.g., cognitive) view emotion primarily as a signal of distress requiring a cognitive solution. One of the contributions of recent advances in neuropsychology (e.g., Damasio Reference Damasio1999; Lane & Garfield Reference Lane and Garfield2005; Ozier & Westbury Reference Ozier and Westbury2013) has been to represent cognition as fully embodied and to convey the relation between emotion and cognition in some of its enormous complexity.
A disadvantage of trying to present emotion and memory as explanatory mechanisms at such a level of abstraction is that we are left with a limited sense of what is most basic in psychotherapy: a complex, healing encounter between two people. To paraphrase Rollo May in a different context, whose memory and emotions are we talking about? That is a slight misnomer because the self does not exist over and against memory and emotions but rather, to a degree, is constituted by memory and emotions. The reconsolidation of memory traces and resulting changes in behavior can be construed as necessary elements in the reorganization of the self. It seems to me that the construct of the self is a more promising foundation for psychotherapy integration. The self allows for a better understanding of autobiographical memory, a place for agency in the integration of changes to memory, and an appreciation of why a positive therapeutic relationship is crucial for change. Let us look at each in turn.
It is difficult to make much sense of autobiographical memory without reference to the self. Some leading researchers on autobiographical memory view it as inextricably linked to the self. In Conway's (Reference Conway2005) model, memory is understood to be highly motivated in relation to enduring goals and the maintenance of a coherent self. The working self plays a crucial function in organizing goals, creating and organizing memories, and controlling their accessibility. Another recent model (Prebble et al. Reference Prebble, Addis and Tippett2013) also provides a framework for tracking the relation between memory and self, underlining subjective versus objective and present versus time-extended representations. Two conclusions can be drawn: the complexity of memory is best analyzed in the framework of its relation to self; and much of the self, like memory, is implicit.
One of the core ideas of Lane et al. is that emotion and memory processes are very often implicit, they require no conscious awareness of feeling anything, and they are based on an unconscious “conceptualized as an extensive set of processing resources that execute complex computations, evaluations, and responses without requiring intention or effort” (sect. 2, para. 2). The self can also be viewed as a self-organizing system, and it is best conceptualized as constructed dialectically from the interaction of many subsystems, some of which are unconscious, including many aspects of memory (Pascual-Leone Reference Pascual-Leone1987). With his concept of the proto-self, Damasio (Reference Damasio1999) strengthened the idea that the conscious self is built up from the synthesis of implicit processes. Agency and intention are integral to every aspect of the therapy context; even unconscious change will need to be absorbed and integrated into a concomitantly changing conscious self. There is engagement, motivation, and agency involved in the integration into memory and self of new emotional experiences.
The self is born in relationship and is inherently relational (Bowlby Reference Bowlby1988; Schore Reference Schore1994). Human flourishing is ultimately about the capacity for a loving relationship with others and with oneself. Difficulties in the interpersonal domain provoke much of the pain, conflict, and loneliness that lead people to engage in psychotherapy. The emotional memories that need changing almost always involve others and new emotional experiences stem at least initially from the safety, understanding, and care proffered by the therapist, which compose a key piece of the corrective emotional experience. Important recent work on psychotherapy process underlines the ways in which implicit process can rupture the alliance, and how the articulation and repair of what is happening in the therapeutic relationship can be profoundly healing (Safran & Muran Reference Safran and Muran2000). As even implicit memories change, the self adapts and reorganizes as it integrates the change. The self as agent in therapy is both being changed by internal and interpersonal processes, and seeking to understand and integrate this change experience. The self is the construct at the crossroads of all these processes and is the best focus for psychotherapy integration.
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The virtues of Lane et al. are many: I will name three that seem especially compelling. First, the authors offer a serious integrative framework through which to study common mechanisms of change across a range of psychotherapies. Second, the authors place emotional processing front and center in their conceptualization of change in therapy. The third virtue is the foundation of the first two: A neuropsychological explanation that illuminates both the basis for psychological difficulties and the process by which these difficulties can be changed in therapy.
What an elementary neuropsychological account offers is a sort of machete with which to cut away some of the tangled underbrush of competing theories that have proliferated in psychotherapy. Clearly, similar processes underlie all therapies at a neuropsychological level. We have known for some time that theoretically different approaches to therapy have roughly equivalent effects (Wampold Reference Wampold2001), and Lane et al. help to illuminate why that is the case.
The authors posit as the core mechanism of change in psychotherapy the reconsolidation of prior emotional memories through new emotional experience. I would suggest that as memories change in therapy what is ultimately changing is the self, and that the self rather than memory is a more helpful and fruitful construct around which to build psychotherapy integration. I will clarify this idea briefly in this commentary. In order to achieve a clear model, the authors have at times been overly schematic. It is true that many therapies view emotion as important to the process of change. However, Lane et al. downplay substantial differences in the functions accorded to emotion in each of these therapies. Some therapies (e.g., emotion-focused) view emotion generally as a very healthy and essential source of motivation, value, and meaning. Other therapies (e.g., cognitive) view emotion primarily as a signal of distress requiring a cognitive solution. One of the contributions of recent advances in neuropsychology (e.g., Damasio Reference Damasio1999; Lane & Garfield Reference Lane and Garfield2005; Ozier & Westbury Reference Ozier and Westbury2013) has been to represent cognition as fully embodied and to convey the relation between emotion and cognition in some of its enormous complexity.
A disadvantage of trying to present emotion and memory as explanatory mechanisms at such a level of abstraction is that we are left with a limited sense of what is most basic in psychotherapy: a complex, healing encounter between two people. To paraphrase Rollo May in a different context, whose memory and emotions are we talking about? That is a slight misnomer because the self does not exist over and against memory and emotions but rather, to a degree, is constituted by memory and emotions. The reconsolidation of memory traces and resulting changes in behavior can be construed as necessary elements in the reorganization of the self. It seems to me that the construct of the self is a more promising foundation for psychotherapy integration. The self allows for a better understanding of autobiographical memory, a place for agency in the integration of changes to memory, and an appreciation of why a positive therapeutic relationship is crucial for change. Let us look at each in turn.
It is difficult to make much sense of autobiographical memory without reference to the self. Some leading researchers on autobiographical memory view it as inextricably linked to the self. In Conway's (Reference Conway2005) model, memory is understood to be highly motivated in relation to enduring goals and the maintenance of a coherent self. The working self plays a crucial function in organizing goals, creating and organizing memories, and controlling their accessibility. Another recent model (Prebble et al. Reference Prebble, Addis and Tippett2013) also provides a framework for tracking the relation between memory and self, underlining subjective versus objective and present versus time-extended representations. Two conclusions can be drawn: the complexity of memory is best analyzed in the framework of its relation to self; and much of the self, like memory, is implicit.
One of the core ideas of Lane et al. is that emotion and memory processes are very often implicit, they require no conscious awareness of feeling anything, and they are based on an unconscious “conceptualized as an extensive set of processing resources that execute complex computations, evaluations, and responses without requiring intention or effort” (sect. 2, para. 2). The self can also be viewed as a self-organizing system, and it is best conceptualized as constructed dialectically from the interaction of many subsystems, some of which are unconscious, including many aspects of memory (Pascual-Leone Reference Pascual-Leone1987). With his concept of the proto-self, Damasio (Reference Damasio1999) strengthened the idea that the conscious self is built up from the synthesis of implicit processes. Agency and intention are integral to every aspect of the therapy context; even unconscious change will need to be absorbed and integrated into a concomitantly changing conscious self. There is engagement, motivation, and agency involved in the integration into memory and self of new emotional experiences.
The self is born in relationship and is inherently relational (Bowlby Reference Bowlby1988; Schore Reference Schore1994). Human flourishing is ultimately about the capacity for a loving relationship with others and with oneself. Difficulties in the interpersonal domain provoke much of the pain, conflict, and loneliness that lead people to engage in psychotherapy. The emotional memories that need changing almost always involve others and new emotional experiences stem at least initially from the safety, understanding, and care proffered by the therapist, which compose a key piece of the corrective emotional experience. Important recent work on psychotherapy process underlines the ways in which implicit process can rupture the alliance, and how the articulation and repair of what is happening in the therapeutic relationship can be profoundly healing (Safran & Muran Reference Safran and Muran2000). As even implicit memories change, the self adapts and reorganizes as it integrates the change. The self as agent in therapy is both being changed by internal and interpersonal processes, and seeking to understand and integrate this change experience. The self is the construct at the crossroads of all these processes and is the best focus for psychotherapy integration.