Abstract
Interactions between the client (Cl) and therapist (Th) evolve therapeutic relationships in psychotherapy. An interpersonal link or therapeutic space is implicitly developed, wherein certain important elements are expressed and shared. However, neural basis of psychotherapy, especially of non-verbal modalities, have scarcely been explored. Therefore, we examined the neural backgrounds of such therapeutic alliances during sandplay, a powerful art/play therapy technique. Real-time and simultaneous measurement of hemodynamics was conducted in the prefrontal cortex (PFC) of Cl-Th pairs participating in sandplay and subsequent interview sessions through multichannel near-infrared spectroscopy. As sandplay is highly individualized, and no two sessions and products (sandtrays) are the same, we expected variation in interactive patterns in the Cl–Th pairs. Nevertheless, we observed a statistically significant correlation between the spatio-temporal patterns in signals produced by the homologous regions of the brains. During the sandplay condition, significant correlations were obtained in the lateral PFC and frontopolar (FP) regions in the real Cl-Th pairs. Furthermore, a significant correlation was observed in the FP region for the interview condition. The correlations found in our study were explained as a “remote” synchronization (i.e., unconnected peripheral oscillators synchronizing through a hub maintaining free desynchronized dynamics) between two subjects in a pair, possibly representing the neural foundation of empathy, which arises commonly in sandplay therapy (ST).
Highlights
Psychotherapy is a unique form of communication among all types of social interactions between two individuals: a client (Cl) and a therapist (Th)
Cross-hemispheric synchronization between all possible combinations of pairs who separately participated in different sandplays: the control conditions (160 pairs)
The difference in the Spearman’s rank-order correlation coefficients between the Cl–Th pairs and the control pairs were statistically significant in the channels covering (1) lateral prefrontal cortex (PFC) (LPFC) and (2) FP regions [denoted as channel 7 and 10 in Figures 3A,B, respectively (q < 0.05, FDR)]
Summary
Psychotherapy is a unique form of communication among all types of social interactions between two individuals: a client (Cl) and a therapist (Th). An interpersonal link or therapeutic space is implicitly developed, wherein certain important elements are expressed and shared. This relationship is based on a therapeutic alliance, which is considered essential for positive change We investigated therapeutic alliances and their neural backgrounds in sandplay therapy (ST), a unique nonverbal therapeutic modality
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