08/10/2026
Great NYT article and additional commentary for consideration. There is no one size fits all therapy. The therapeutic relationship matters. And, there is so much more than talk therapy available for true healing work.
We welcome your thoughts.
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FOR CLINICIANS, this NYT article a 'must-read' IMHO. The Author left out one important piece about the Predictive Processing "model" and it's an important omission for those of us who work with the PP model and trauma 'treatment', both consciously and quite deliberately. One of the key issues to understand about healing trauma is first, that it's there for an extremely important reason - it helped you 'survive' (to protect yourself by developing various elaborate schemas, beliefs, 'complexes' which helped you to live after the experience(s) - the definition of 'trauma' is the wound that remains, not the 'events' themselves).
Predictive processing theory asserts that the brain must have salient 'disconfirming experiences' to upate beliefs, behaviors, emotional responses... the 'stickier' they are, the more disconfirming experiences we will need.
The definition: "Predictive processing is a computational neuroscience theory which proposes that the brain is an active prediction engine that constantly forecasts incoming sensory inputs and updates its internal models only when discrepancies arise. Instead of passively recording the world like a camera, the brain actively constructs perception by comparing what it expects to happen with what actually happens"
Normally PP works below consciousness, adjusting prediction errors/mismatches constantly, directing traffic as it were. Healing trauma symptoms permanently involves one ELEMENTAL process that is fundamental - and much more 'understandable' using the predictive processing model - it involves the process of 'memory reconsolidation' - not part of talk therapy in any direct way. So, you can choose to do this reconsolidation the slowwwww impartial way, (the baroque way), or you can do it the more direct, efficient way, with the necessary preparations, trainings, and 'resources' specific to your individual needs... like training for a marathon, which I'd say, healing often resembles. And, as the article elegantly points out, different people seem to prefer different ways of approaching their suffering (my phrase). This is also an inherently cultural and 'class' preference in many cases, and always has been in the case of psychoanalysis practice and training institutes for the most part since the beginning. I believe this last point about 'preference' may be the key in figuring out what a master therapist co-creates with a client (vs. a 'mechanic' who 'follows the protocols') to achieve results that are far more rich and resonant than any textbook can possible present.
In other words, you can talk for years without deeply and permanently correcting the prediction errors we call 'trauma symptoms' across many domains - and this is your choice (also, its your pocketbook). Only therapy that works directly with memory reconsolidation is working with the key element of the predictive processing model in its optimum sense, (and as Bruce Ecker points out), working more efficiently... at least as efficiently we how we currently apply the model to our work.
Is this "symptom relief" (a termed shunned by so many psychoanalysts, it befits a New Yorker cartoon)? Yes, it most definitely is. No shame there.
Is that important? Yes, very, to almost every human I've asked that question to.
But is it MORE than "symptoms relief" - the psychoanalysts love to ask this question, and rightly so. Well, here's where it "depends on the Therapist" (on their modalities, their own personal psychotherapy, how deep they went with it, and so much more). You can go to a 'mechanic' - and there are many - someone who can help with primarily symptom relief (again, NO shame there), or, you can go to an artist of sorts - a curious, creative Therapist who knows that there can be, and often is, so much more to trauma resolution than merely 'relieving symptoms', someone who understands at a fundamental level that our lives require MEANING to make any sense of our suffering, and our grief - both of which are guaranteed (not optional.) That may take you out of the realm of 'psychotherapy' and into another one that may be more creative, spiritual, enlivening.
It's your choice. And at this point in our history, it matters. Time matters. Economics matter. And those many years of "lost time" devoted to therapy that does absolutely nothing to heal trauma but gives you "insight" into how it all began - those years MATTER.
But I won't quibble. It's a good start.
Now lets continue to fill in the blanks for our clients and patients. They deserve NOTHING LESS.
If you want to understand memory reconsolidation - part of predictive processing, perhaps the crucial part that relates to therapy - look at Bruce Ecker's "Unlocking the Emotional Brain Memory Reconsolidation and the Psychotherapy of Transformational Change", recend edition.
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