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Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony

McParlin, Z; Cerritelli, F; Friston, KJ; Esteves, JE; (2022) Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony. Frontiers in Psychology , 13 , Article 783694. 10.3389/fpsyg.2022.783694. Green open access

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Abstract

Recognizing and aligning individuals’ unique adaptive beliefs or “priors” through cooperative communication is critical to establishing a therapeutic relationship and alliance. Using active inference, we present an empirical integrative account of the biobehavioral mechanisms that underwrite therapeutic relationships. A significant mode of establishing cooperative alliances—and potential synchrony relationships—is through ostensive cues generated by repetitive coupling during dynamic touch. Established models speak to the unique role of affectionate touch in developing communication, interpersonal interactions, and a wide variety of therapeutic benefits for patients of all ages; both neurophysiologically and behaviorally. The purpose of this article is to argue for the importance of therapeutic touch in establishing a therapeutic alliance and, ultimately, synchrony between practitioner and patient. We briefly overview the importance and role of therapeutic alliance in prosocial and clinical interactions. We then discuss how cooperative communication and mental state alignment—in intentional communication—are accomplished using active inference. We argue that alignment through active inference facilitates synchrony and communication. The ensuing account is extended to include the role of (C-) tactile afferents in realizing the beneficial effect of therapeutic synchrony. We conclude by proposing a method for synchronizing the effects of touch using the concept of active inference.

Type: Article
Title: Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fpsyg.2022.783694
Publisher version: https://doi.org/10.3389/fpsyg.2022.783694
Language: English
Additional information: © 2022 McParlin, Cerritelli, Friston and Esteves. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords: therapeutic alliance, active inference, affective touch, synchrony, predictive processing, allostasis, free-energy principle, perinatal care
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Imaging Neuroscience
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/10146088
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