The (In)flexible self: Psychopathology, mindfulness, and neuroscience

Authors

Fabio Giommi, NOUS-School of Specialization (PsyD) in Psychotherapy, Milano, Italy.
Prisca R. Bauer, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Aviva Berkovich-Ohana, Edmond Safra Brain Research Center, Faculty of Education, University of Haifa, Israel.
Henk Barendregt, Faculty of Science, Radboud University, Nijmegen, the Netherlands.
Kirk Warren Brown, Carnegie Mellon University, USA.
Shaun Gallagher, Department of Philosophy, University of Memphis, USA and SOLA, University of Wollongong, Australia.
Ivan Nyklíček, Department of Medical and Clinical Psychology, Tilburg University, the Netherlands.
Brian Ostafin, Department of Clinical Psychology, University of Groningen, the Netherlands.
Antonino Raffone, Department of Psychology, Sapienza University of Rome, Italy.
Heleen A. Slagter, Vrije Universiteit Amsterdam, the Netherlands.
Fynn-Mathis Trautwein, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
David R. Vago, Contemplative Sciences Center, University of Virginia.

Abstract

Clinical and neuroscientific evidence indicates that transdiagnostic processes contribute to the generation and maintenance of psychopathological symptoms and disorders. Rigidity (inflexibility) appears a core feature of most transdiagnostic pathological processes. Decreasing rigidity may prove important to restore and maintain mental health. One of the primary domains in which rigidity and flexibility plays a role concerns the self. We adopt the pattern theory of self (PTS) for a working definition of self. This incorporates the pluralist view on self as constituted by multiple aspects or processes, understood to constitute a self-pattern, i.e. processes organized in non-linear dynamical relations across a number of time scales. The use of mindfulness meditation in the format of Mindfulness Based Interventions (MBIs) has been developed over four decades in Clinical Psychology. MBIs are promising as evidence-based treatments, shown to be equivalent to gold-standard treatments and superior to specific active controls in several randomized controlled trials. Notably, MBIs have been shown to target transdiagnostic symptoms. Given the hypothesized central role of rigid, habitual self-patterns in psychopathology, PTS offers a useful frame to understand how mindfulness may be beneficial in decreasing inflexibility. We discuss the evidence that mindfulness can alter the psychological and behavioral expression of individual aspects of the self-pattern, as well as favour change in the self-pattern as a whole gestalt. We discuss neuroscientific research on how the phenomenology of the self (pattern) is reflected in associated cortical networks and meditation-related alterations in cortical networks. Creating a synergy between these two aspects can increase understanding of psychopathological processes and improve diagnostic and therapeutic options.

Publication Title

International journal of clinical and health psychology : IJCHP

Recommended Citation

Giommi, F., Bauer, P. R., Berkovich-Ohana, A., Barendregt, H., Brown, K. W., Gallagher, S., Nyklíček, I., Ostafin, B., Raffone, A., Slagter, H. A., Trautwein, F., & Vago, D. R. (2023). The (In)flexible self: Psychopathology, mindfulness, and neuroscience. International journal of clinical and health psychology : IJCHP, 23 (4), 100381. https://doi.org/10.1016/j.ijchp.2023.100381