How does psychotherapy work? A cognitive neuroscience-based framework for understanding therapeutic change

Abstract

One of the key mechanisms by which psychotherapy facilitates positive change is by enhancing an individual's awareness of the internal and external factors that contribute to their problems. While this provides a conceptual understanding of psychotherapy, a more rigorous and precise mechanistic explanation is often lacking. In this thesis, I present a novel theoretical framework for understanding psychotherapy based on contemporary cognitive and computational neuroscience. I propose that enhancing awareness can be likened to mental navigation – the ability to navigate our representational space, which includes memories, concepts, ideas, images, etc. This navigation process involves exploring, identifying, and reconfiguring cognitive maps and schemas facilitated by neurobiological mechanisms similar to those involved in spatial navigation. The outcome of this thesis is an intuitively understandable conceptual framework and a biologically plausible mechanistic explanation of therapeutic change.