Reconsidering therapeutic action: Loewald, cognitive neuroscience and the integration of memory's duality

Both Loewald's relational theory of memory and the Self-Memory System (SMS) of cognitive neuroscience describe a dual memory system, one system that is experience-near sensory-perceptual, and the other, symbolic and conceptual. In contrast to perspectives that locate therapeutic action in either altering implicit procedural memories or interpreting explicit historical content, we argue that psychological health emerges from effective integration of both memory systems, achieved through a combination of transference dynamics and analytic insight. We support this position by elaborating four key assumptions of the loewaldian and SMS perspectives, followed by application to a clinical example. We highlight the power of certain integrative autobiographical memories called 'self-defining memories' in assisting an understanding of transference dynamics and providing metaphoric touchstones to guide subsequent treatment.