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.

Anterior limb lesions in bilateral internal capsules and memory function in patients with refractory obsessive-compulsive disorder

BACKGROUND： Previous studies have shown that lesions in the anterior limb of the internal capsule contribute to obsessive-compulsive symptoms in patients with refractory obsessive-compulsive disorder （OCD）. However, few reports have addressed the effects of lesions in the anterior limb of the internal capsule on cognition, learning, and memory functions in patients with refractory OCD. OBJECTIVE： To investigate the degree of damage to memory tasks in refractory OCD patients following lesions to the anterior limb of the internal capsule. DESIGN, TIME AND SETTING： A case-controlled, observational study was performed at the Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao-Tong University, China from May 2007 to March 2008. PARTICIPANTS： A total of 10 refractory OCD patients were admitted to the Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao-Tong University, China from May 2007 to March 2008 and were recruited for this study. The OCD patients were of equal gender, with an average age of （25.1 ± 9.6） years. An additional 10 healthy volunteers were enrolled from a community of Shanghai City as controls; they were of equal gender and aged （25.1 ± 8.6） years. METHODS： A total of 10 refractory OCD patients were subjected to lesions in the anterior limbs of the bilateral internal capsules. Wechsler Memory Scale-Chinese Revision （WMS-CR, as a task of explicit memory） and the Nissen Version （serial reaction time task） software （SRTT, as a task of implicit memory） were applied to determine memory functions and learning performance in pre- and post-operative OCD patients and controls. MAIN OUTCOME MEASURES： WMS scores, reaction time in SRTT, and Yale-Brown obsessive compulsive scale scores were measured in pre- and post-operative OCD patients and controls. RESULTS： Compared to controls, the pre-operative OCD patients exhibited reduced memory task scores （P = 0.005）, whereas scores for reciting numbers of backwards digits were greater （P = 0.000）. Figure recall and associative memory were less in OCD patients at 1 week following surgery than in the pre-operative OCD patients （P = 0.042, P = 0.002, respectively）. Reaction time in implicit SRTT was significantly longer in pre-operative OCD patients compared with controls and post-operative OCD patients （P = 0.01, P = 0.03, respectively）. These results suggested ameliorated SRTT following neurosurgery. Yale-Brown Obsessive Compulsive Scale results revealed significantly improved OCD following lesions in the internal capsule （P = 0.04）. Some post-operative OCD patients suffered from deficits in short-term memory and implicit memory. CONCLUSION： Lesions in anterior limbs of bilateral internal capsules improve obsessive- compulsive symptoms and implicit memory in OCD patients, but result in aggravated short-term memory deficits.