The Active Inference Model of Coherence Therapy.

Abstract

Coherence Therapy is an empirically derived experiential psychotherapy based on Psychological Constructivism. Symptoms are viewed as necessary output from an implicit model of the world. The therapist curates experiences and directs attention toward discovering the model. Rendered explicit, the model is juxtaposed with contradictory knowledge driving memory re-consolidation with resolution of the symptom. The Bayesian Brain views perception and action as inferential processes. Prior beliefs are combined in a generative model to explain the hidden causes of sensations through a process of Active Inference. Prior beliefs that are poor fits to the real world are suboptimal. Suboptimal priors with optimal inference produce Bayes Optimal Pathology with behavioral symptoms. The Active Inference Model of Coherence Therapy posits that Coherence Therapy is a dyadic act of therapist guided Active Inference that renders the (probable) hidden causes of a client's behavior conscious. The therapist's sustained attention on the goal of inference helps to overcome memory control bias against retrieval of the affectively charged suboptimal prior. Serial experiences cue memory retrieval and re-instantiation of the physiological/affective state that necessitates production of the symptom in a particular context. As this process continues there is a break in modularity with assimilation into broader networks of experience. Typically, the symptom produced by optimal inference with the suboptimal prior is experienced as unnecessary/inappropriate when taken out of the particular context. The implicit construct has been re-represented and rendered consciously accessible, by a more complex but more accurate model in which the symptom is necessary in some contexts but not others. There is an experience of agency and control in symptom creation, accompanied by the spontaneous production of context appropriate behavior. The capacity for inference has been restored. The Active Inference Model of Coherence Therapy provides a framework for Coherence Therapy as a computational process which can serve as the basis for new therapeutic interventions and experimental designs integrating biological, cognitive, behavioral, and environmental factors.