Therapeutic Free Association Is a Unique Cognitive, Affective, and Verbal Action Warranting Further Psychoanalytic and Neural Investigation

Abstract

The research presented in the target article is a valuable first fMRI study of free association, using an externally paced, five-word model. Although Freud’s instructions to patients seemed to be solely cognitive, contiguously connected statements suggested that there are automatically connected feelings and emotional conflicts. The noteworthy complexity of experimental vocal free association (VFA) is demonstrated by very widespread left dorsal, lateral, and inferior prefrontal fMRI signal activations. The investigation focuses on cognitive features only, yet it quotes some of the subject’s five-word groupings of coherent, evocative, emotional themes. No psychological operation can be solely cognitive, since psychologically, during waking life cognition, affect, and some degree of emotional conflict are always present. Correspondingly, cognitive and affective neural operations are always cotemporally functioning and integrated in the whole brain. The research model of free association suggests features of simple forms of spontaneity, thematic confluence, and affective expressiveness. Therapeutic free association is more complex and is inextricably part of the ebb and flow of the psychoanalytic treatment process. It has at least seven more features, including narratives of immediately lived experience; expressions of emotional conflict; memories, fantasies, and dreams; experiences of the therapist and treatment situation; self-esteem; and awareness of one’s own problems. It is, uncertainly, speculated here that free association may bring and transform less symbolic and less conscious mental formations, which may correspond to subcortical, paralimbic, and secondary cortical neural processing, into more symbolic and more conscious mental formations, which correspond to the highest levels of cortical neural processing. It seems important to study therapeutic free association to further psychoanalytic, and neural, understanding of thought, language, and consciousness.