Holmes Jeremy, Nolte Tobias
University College London, Anna Freud National Centre for Children and Families, London, United Kingdom.
Department of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.
Front Psychol. 2019 Mar 28;10:592. doi: 10.3389/fpsyg.2019.00592. eCollection 2019.
The free energy principle (FEP) has gained widespread interest and growing acceptance as a new paradigm of brain function, but has had little impact on the theory and practice of psychotherapy. The aim of this paper is to redress this. Brains rely on Bayesian inference during which "bottom-up" sensations are matched with "top-down" predictions. Discrepancies result in "prediction error." The brain abhors informational "surprise," which is minimized by (1) action enhancing the statistical likelihood of sensory samples, (2) revising inferences in the light of experience, updating "priors" to reality-aligned "posteriors," and (3) optimizing the complexity of our generative models of a capricious world. In all three, free energy is converted to bound energy. In psychopathology energy either remains unbound, as in trauma and inhibition of agency, or manifests restricted, anachronistic "top-down" narratives. Psychotherapy fosters client agency, linguistic and practical. Temporary uncoupling bottom-up from top-down automatism and fostering scrutinized simulations sets a number of salutary processes in train. enriches Bayesian inference, enabling experience and feeling states to be "metabolized" and assimilated. "Free association" enhances more inclusive sensory sampling, while dream analysis foregrounds salient emotional themes as "attractors." FEP parallels with psychoanalytic theory are outlined, including Freud's unpublished project, Bion's "contact barrier" concept, the Fonagy/Target model of sexuality, Laplanche's therapist as "enigmatic signifier," and the role of projective identification. The therapy stimulates patients to become aware of and revise the priors' they bring to interpersonal experience. In the therapeutic "duet for one," the energy binding skills and non-partisan stance of the analyst help sufferers face trauma without being overwhelmed by psychic entropy. Overall, the FEP provides a sound theoretical basis for psychotherapy practice, training, and research.
自由能原理（FEP）作为一种脑功能的新范式已引起广泛关注并得到越来越多的认可，但对心理治疗的理论和实践影响甚微。本文旨在纠正这一状况。大脑依赖贝叶斯推理，在此过程中“自下而上”的感觉与“自上而下”的预测相匹配。差异会导致“预测误差”。大脑厌恶信息“惊奇”，这可通过以下方式最小化：（1）采取行动提高感觉样本的统计可能性；（2）根据经验修正推理，将“先验”更新为与现实相符的“后验”；（3）优化我们对变幻莫测的世界的生成模型的复杂性。在这三种情况中，自由能都转化为束缚能。在精神病理学中，能量要么如在创伤和能动性抑制中那样保持未束缚状态，要么表现为受限的、不合时宜的“自上而下”叙述。心理治疗促进来访者在语言和实践方面的能动性。暂时将自下而上与自上而下的自动性解耦，并促进经过审视的模拟，会引发一系列有益的过程。丰富贝叶斯推理，使经验和情感状态得以“代谢”和同化。“自由联想”增强更具包容性的感觉采样，而梦的解析将突出的情感主题作为“吸引子”凸显出来。概述了FEP与精神分析理论的相似之处，包括弗洛伊德未发表的计划、比昂的“接触屏障”概念、费尔贝恩/塔杰特的性取向模型、拉康将治疗师视为“神秘能指”的观点以及投射性认同的作用。治疗促使患者意识到并修正他们带入人际经验的“先验”。在治疗性的“单人二重奏”中，分析师的能量束缚技巧和无党派立场帮助患者面对创伤而不被心理熵压垮。总体而言，FEP为心理治疗的实践、培训和研究提供了坚实的理论基础。
