Academic journal article International Journal of Psychoanalysis

The Predicting Brain: Unconscious Repetition, Conscious Reflection and Therapeutic Change

Academic journal article International Journal of Psychoanalysis

The Predicting Brain: Unconscious Repetition, Conscious Reflection and Therapeutic Change

Article excerpt

Neuroscience indicates that 'repetition' is fundamental to brain function. The brain non-consciously predicts what is most likely to happen and sets in motion perceptions, emotions, behaviors and interpersonal responses best adapted to what is expected-before events occur. Predictions enable individuals to be ready 'ahead of time' so reactions occur rapidly and smoothly when events occur. The brain uses past learning as the guide for what to expect in the future. Because of prediction, present experience and responses are shaped by the past. Predictions from early life can be deeply encoded and enduring. Predictions based on the past allow for more efficient brain function in the present, but can lead to mistakes. When what is predicted does not occur, consciousness can be engaged to monitor and correct the situation. But if a perception or emotion seems reasonable for the situation, a person might not notice an error, and a maladaptive 'repetition' may remain unchanged. The author discusses how predictions contribute to psychological defenses and transference repetition, and how conscious self-reflection facilitates therapeutic change. The neuroscience of prediction indicates why, in certain cases, active engagement by the analyst may be necessary. The author makes the argument for use of a 'neuroscience interpretation'.

Keywords: prediction, repetition, subjective reality, transference, consciousness, intentions, empathy, theory of mind

Introduction: 'What is past is prologue'1

According to neuroscience, even before events happen the brain has already made a prediction about what is most likely to happen, and sets in motion the perceptions, behaviors, emotions, physiologic responses and interpersonal ways of relating 'that best fit with what is predicted'. These predictions are continual, automatic and entirely non-conscious.2 Such predictions operate at all levels of brain processing (Engel et al., 2001; Fuster, 2002; Freeman, 2003; Graybiel, 1998; Llinas, 2001; Miller, 2000; Schultz, 2000). Prediction 'seems to be the ultimate and most general of all global functions of the brain' (Llinas, 1988, p. 340). To generate predictions the brain uses the present situation plus past experiences and learning, to 'anticipate' forthcoming events and 'prepare for them ahead of time' (Desimone and Duncan, 1995; Fuster, 2002; Grossberg, 1999; Miller and Cohen, 2001; Schall, 2001). Prediction enables individuals to respond more smoothly, efficiently and rapidly once an event does occur (Edelman, 1989; Freeman, 2000). From the evolutionary perspective, this is adaptive. Animals 'prepared' to react more quickly are more likely to survive and pass on their genes to their progeny.

Non-conscious predictions 'alter' the outcome, whereas conscious predictions do not. It does not rain because the weatherman predicts it will. But non-conscious predictions actually alter brain activity in the direction of what is expected. Since predictions incorporate past experience and learning, the past biases current experience. In a sense, we learn from the past what to predict for the future and then live the future we expect. Since predictions are not always correct, an oversight system exists. It is proposed that consciousness may have evolved to enhance the monitoring and correction of prediction errors (Posner and Rothbart, 1998).

Psychoanalysis is now a pluralistic treatment approach (Gabbard, 2005; Gabbard and Westen, 2003). Psychoanalysis has developed and benefited from an infusion of ideas from other fields, e.g. attachment theory, child development, research on temperament, and even psychopharmacology and neuroscience. To integrate psychoanalysis with neuroscience, in particular, poses difficulty, most notably because psychoanalysis studies the 'subjective and personal', whereas neuroscience aims to be 'objective and reproducible'. However, the benefits outweigh the limitations. For one thing, neuroscience and psychoanalysis share the common goal of trying to understand the mind. …

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