Crosstalk between Existential Phenomenological Psychotherapy and Neurological Sciences in Mood and Anxiety Disorders

Abstract

Psychotherapy is a comprehensive biological treatment modifying complex underlying cognitive, emotional, behavioral, and regulatory responses in the brain, leading patients with mental illness to a new interpretation of the sense of self and others. Psychotherapy is an art of science integrated with psychology and/or philosophy. Neurological sciences study the neurological basis of cognition, memory, and behavior as well as the impact of neurological damage and disease on these functions, and their treatment. Both psychotherapy and neurological sciences deal with the brain; nevertheless, they continue to stay polarized. Existential phenomenological psychotherapy (EPP) has been in the forefront of meaning-centered counseling for almost a century. The phenomenological approach in psychotherapy originated in the works of Martin Heidegger, Ludwig Binswanger, Medard Boss, and Viktor Frankl, and it has been committed to accounting for the existential possibilities and limitations of one's life. EPP provides philosophically rich interpretations and empowers counseling techniques to assist mentally suffering individuals by finding meaning and purpose to life. The approach has proven to be effective in treating mood and anxiety disorders. This narrative review article demonstrates the development of EPP, the therapeutic methodology, evidence-based accounts of its curative techniques, current understanding of mood and anxiety disorders in neurological sciences, and a possible converging path to translate and integrate meaning-centered psychotherapy and neuroscience, concluding that the EPP may potentially play a synergistic role with the currently prevailing medication-based approaches for the treatment of mood and anxiety disorders.

Keywords: Martin Heidegger; Viktor Frankl; anxiety disorders; biomarker; depression; existential psychotherapy; functional magnetic resonance imaging; kynurenines; logotherapy; meaning-centered psychotherapy.

Figure 1

Polarization of two fields of expertise: psychotherapy and neurological sciences. Both psychotherapy and neurological sciences explore the pathomechanism and interventional opportunity of psychiatric disorders. Translational studies are scarce, and each area of expertise stays polarized.

Figure 2

The milestones of philosophical phenomenology and philosophical existentialism. (a) The milestones of philosophical phenomenology. (b) The milestones of philosophical existentialism.

Figure 3

Main figures of early existential psychotherapy and later existential psychotherapy. (a) Main figures of early existential psychotherapy (Daseinsanalysis and Logotherapy). (b) Main figures of later existential psychotherapy (British and American).

Figure 4

Large-scale brain network including the default mode network, the executive control network, and the salience network. DMN: default mode network; ECN: executive control network; SN: salience network; ACC: anterior cingulate cortex; dlPFC: dorsolateral prefrontal cortex; INS: insular cortex; LPC: lateral parietal cortex; mPFC: medial prefrontal cortex; PPC: posterior parietal cortex.

Figure 5

Meaning-centered psychotherapy, its effective targets, and endpoints. Meaning in life is a predictor of psychological stress. Psychological stress causes depression, anxiety, and cognitive impairment. Depression is a measurable indicator which predicts diagnosis and/or treatment of depression with kynurenines (KYNs), chronic diseases with inflammation, disability and mortality of stroke and transient ischemic attack, and Alzheimer’s disease and dementia. Depression of Alzheimer’s diseases and dementia can be ameliorated by AAI (animal-assisted intervention) and pet-robot intervention (PRI).