Journal of Psychotherapy Integration, Vol 35(4), Dec 2025, 256-271; doi:10.1037/int0000371
Fragmentation of the field of psychotherapy carries heavy costs to all stakeholders, yet reaching consensus on core science has remained challenging. The present article adds to existing efforts to consolidate theory by adopting the strategy of zooming in rather than out to identify the infrastructure and science underlying therapeutic action and to suggest how they connect with existing techniques across diverse orientations and therapies. The final targets of psychotherapy—products of information processing in subcortical “survival circuits”—are described as entrenched maladaptive patterns. These are repeatable response patterns that are entrenched (i.e., resistant to change), due in large part to nonconscious appraisal of the aims of psychotherapy as threatening to the maintenance and availability of survival circuits. The logic embodied in survival circuits is determined by schemas, widely recognized as targets of psychotherapy and based on autonomous, nonconscious “thinking fast” cognition. The final steps of psychotherapeutic action are explained by three low-level mechanisms: adding to available responses through new learning, inhibiting responses temporarily through extinction, and bringing about enduring change through memory reconsolidation. Primary requirements for the mechanism of memory reconsolidation are reactivation of maladaptive schemas juxtaposed with provision of disconfirming information in nonverbal form for processing within subcortical structures. These requirements are described as corresponding to techniques widely represented in diverse orientations and therapies. The article describes the art of psychotherapy as using connotative, experiential, and nonverbal communication to support “common factors” while shaping communication to reach subcortical structures where transformative change takes place. (PsycInfo Database Record (c) 2025 APA, all rights reserved)