Conscious, Explicit Memory, Implicit Memory, and Instincts as the Four-Component Mind for the Mental Origins of Psychotherapy and Personality

This paper proposes that conscious, explicit memory, implicit memory, and instincts constitute the four-component mind for the mental origins of psychotherapy and personality. The mental origin of the personality theories including the big five personality traits, the MBTI, the social style model, the Hofstede’s cultural dimensions, and the Schwartz’s theory of basic human values is from the unconscious instincts (the six social and three mental protective instincts). The three mental protective instincts that contain the three instinctive countermeasures against the three adversities are hyperactivity countermeasure against danger, phobia countermeasure against unfamiliarity-uncertainty, and comforter countermeasure against hardship. Each countermeasure is regulated (moderated) by a regulator to minimize overactive countermeasure as physical regulator to minimize overactive immunity in physical immune system. Severe adversities and ineffective regulators over-activate protective countermeasures to generate overactive countermeasures as overactive hyperactivity, overactive phobia, and overactive comforter, corresponding to dramatic-impulsive cluster, anxious-fearful cluster, and odd-eccentric cluster, respectively for personality-mental disorders in the DSM-5. Such disordered behavioral habits are stored in unconscious implicit memory which generates disordered thought patterns in pre-conscious explicit memory. For psychotherapy, cognitive behavioral therapy (CBT) normalizes disordered thought patterns in explicit memory to normalize disordered behavioral habit memory in implicit memory through the repetitive training in normalizing thought patterns, feelings, and behaviors. For psychotherapy, mindfulness meditation strengthens conscious attention (working memory) to normalize disordered behavioral habit memory through the repetitive training in directing conscious attention to the breath or body. In conclusion, the mental origin of personality-mental disorders is from the overactive mental protective instincts. The mental origin of psychotherapy is from therapeutic implicit memory and conscious attention for CBT and mindfulness meditation, respectively. The mental origin of personality is from the unconscious instincts. Therefore, the four-component mind of conscious, explicit memory, implicit memory, and instincts explains the origin, the storage, and the normalization of personality-mental disorders for psychotherapy, and provides the mental origin of personality.

Awareness during emergence from anesthesia: Features and future research directions

The anesthesia awareness with recall(AAWR) phenomenon represents a complication of general anesthesia consisting of memorization of intraoperative events reported by the patient immediately after the end of surgery or at a variable distance from it. Approximately 20% of AAWR cases occur during emergence from anesthesia. Clinically, these unexpected experiences are often associated with distress especially due to a sense of paralysis. Indeed, although AAWR at the emergence has multiple causes, in the majority of cases the complication develops when the anesthesia plan is too early lightened at the end of anesthesia and there is a lack of use, or misuse, of neuromuscular monitoring with improper management of the neuromuscular block. Because the distress caused by the sense of paralysis represents an important predictor for the development of severe psychological complications, the knowledge of the phenomenon, and the possible strategies for its prophylaxis are aspects of considerable importance. Nevertheless, a limited percentage of episodes of AAWR cannot be prevented. This paradox holds also during the emergence phase of anesthesia which represents a very complex neurophysiological process with many aspects yet to be clarified.