“I’m a fish!” Deepening receptivity to neurodiversity: a neuroscientifically informed integration of psychoanalytic psychotherapy, reciprocal prediction, and mindfulness

Abstract

ABSTRACT Receptivity to our patients’ experience is a vital aspect of the psychoanalytic endeavor. As we receive incoming transmissions, we resonate with what is active in the patient. We hope to then jointly metabolize the experience. When we meet neurodiversity, realms of experience emerge that may elude us. Precipitously formulated ideas in the therapist, based on a neurotypical frame of reference, can impinge upon the discovery of our patients’ authentic world. How do we open ourselves to receive their true experience? This clinical narrative tracks the psychoanalytic travels of an individual who identifies as neurodivergent, who helped the therapist learn to deepen receptivity by dipping into a less differentiated place to follow the here-and-now experience from the bottom up. Throughout the journey, interweaving neuroscientific and psychoanalytic perspectives offered a powerful matrix from which an enriched understanding of our process could emerge. Psychoanalytic concepts including evenly suspended attention, unconscious-to-unconscious communication, alpha function, reverie, and negative capability are explored alongside neuroscientific insights into the stress response, mirror neurons, and the default mode network. A predictive coding lens introduced a view of the therapeutic exchange as a continuous reciprocal prediction, evoking the hypothesis that deepening receptivity required opening awareness to incoming signals and lessening the hold of prior predictions. To bring greater therapist awareness to the present moment and lessen the influence of self-referential evaluation, neuroscientifically-informed reflections also inspired the practice of mindfulness. Subsequent developments suggest that these approaches helped deepen receptivity to the experiences being communicated, leading to new understandings with transformative potential.