Becoming Aware Through Internal Exploration: Understanding Psychotherapy on Conceptual and Neurobiological Levels

Becoming aware of previously unrecognized aspects of one's psychological and behavioral challenges is one of the central mechanisms of positive psychotherapeutic change. Yet the specific neurocognitive processes that underlie new realizations remain poorly understood. What must occur in one's mind and brain for awareness to emerge? Here, we present a novel, detailed, process-based framework for understanding how new awareness arises during psychotherapeutic dialogue. Central to this framework are the concepts of "mental navigation" and "cognitive map expansion," which we explain at both the conceptual and neuroscientific levels. Namely, individuals construct internal world models in the form of cognitive maps. Mental-health difficulties may reflect maps that are overly rigid or narrow. Therapeutic change may thus involve expanding these maps by mentally navigating beyond their current boundaries and forming new trajectories in the conceptual and neural activity space. We conclude by exploring clinical-practice implications as well as offering directions for empirically validating this model.