Is the default mode network a target neurophysiological substrate of psychodynamic psychotherapy?

The concept of default mode network (DMN) was introduced in the first PET and then fMRI literature after the serendipitous observation of constant, coherent, low frequency activity in rest states when the brain was thought to be involved in producing unstructured background noise activity (Raichle et al, 2001; Raichle & Snyder, 2007; Raichle, 2015). It consists of bilateral and symmetrical cortical areas, located in the mediolateral parietal, medial prefrontal, and medio-lateral temporal cortices. As a functional network the DMN is activated while the person is engaged in undirected mental activities such as day-dreaming, mind-wandering, or is thinking about oneself, about his or her own future plans and past recollections, or when laying undisturbed in the scan. Furthermore the DMN consistently decreases its activity when the brain is engaged in goal directed and focused attention tasks, and it has therefore been interpreted as a neural system expressing a kind of ‘give or take’ dynamics with respect to the system responsible for goal directed, attentions demanding tasks. In an attempt to bound classical psychodynamic constructs to neurophysiology, DMN has been recently recognized as a possible neurobiological substrate of the psychoanalytical concepts of the Ego and its functioning (Carhart-Harris et al, 2008; Rizzolatti et al., 2013) and as a relevant structure to assess during psychotherapy (Bucheim et al., 2013). Here we would like to propose a systematic review of the evidences which could imply an activation of the DMN as the target structure that is activated by the classical psychoanalytical method, that is articulated in triad of foundamental activities: free associations from the part of the patient, hovering attention from the part of the analyst, and suspension of moral judgement for both of them (Semi, 2011). Results could prompt future more focused empirical approaches in the domain of process and outcome research in dynamic psychotherapies.