Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
Department of Psychiatry, MacKay Memorial Hospital, No. 92, Section 2, Chung-Shan North Rd, Taipei, 10449, Taiwan.
J Neural Transm (Vienna). 2023 Aug;130(8):1077-1088. doi: 10.1007/s00702-023-02644-3. Epub 2023 May 5.
Psychotherapy is a learning process. Updating the prediction models of the brain may be the mechanism underlying psychotherapeutic changes. Although developed in different eras and cultures, dialectical behavior therapy (DBT) and Morita therapy are influenced by Zen principles, and both emphasize the acceptance of reality and suffering. This article reviews these two treatments, their common and distinct therapeutic factors, and their neuroscientific implications. Additionally, it proposes a framework that includes the predictive function of the mind, constructed emotions, mindfulness, therapeutic relationship, and changes enabled via reward predictions. Brain networks, including the Default Mode Network (DMN), amygdala, fear circuitry, and reward pathways, contribute to the constructive process of brain predictions. Both treatments target the assimilation of prediction errors, gradual reorganization of predictive models, and creation of a life with step-by-step constructive rewards. By elucidating the possible neurobiological mechanisms of these psychotherapeutic techniques, this article is expected to serve as the first step towards filling the cultural gap and creating more teaching methods based on these concepts.
心理治疗是一个学习的过程。更新大脑的预测模型可能是心理治疗变化的机制。辩证行为疗法（DBT）和森田疗法虽然是在不同的时代和文化中发展起来的，但都受到禅宗原则的影响，两者都强调接受现实和痛苦。本文综述了这两种治疗方法，它们共同的和独特的治疗因素，以及它们的神经科学意义。此外，还提出了一个包括思维的预测功能、建构性情绪、正念、治疗关系以及通过奖励预测实现的变化的框架。大脑网络，包括默认模式网络（DMN）、杏仁核、恐惧回路和奖励通路，有助于大脑预测的建构过程。这两种治疗方法都针对预测误差的同化、预测模型的逐步重组以及逐步构建奖励的生活。通过阐明这些心理治疗技术的可能神经生物学机制，本文有望成为填补文化差距和基于这些概念创造更多教学方法的第一步。
