Brief Literature Review of CMI

Critical Memory Integration (CMI) is an experiential psychotherapy that facilitates therapeutic redress of impairment and distress brought on by past experiences. This is primarily accomplished by guiding individuals through the internal experience of bodily sensations and emotions. CMI also moves beyond conventional reliance on verbal or written narratives, instead using internal signals to uncover and access the underlying critical memories that shape perception, meaning-making, and responses. CMI theorizes that three tenets determine when a Critical Memory is most effectively integrated with existing neural networks, which comprise the individual’s sense of self or CORE Self. First, the individual must be in a calm and connected state; Second, in a titrated manner, the individual approaches the experiential content related to the critical memory with personal agency; Third, the individual persists in engaging with the increasingly difficult sensory-emotion experience of the Critical Memory while also maintaining their calm and connected state and agentic capacity.

Leveraging the neurobiological process of the social engagement system and memory reconsolidation, CMI aims to update these foundational memories and integrate them with the individual’s CORE Self, fostering a more resilient and expansive sense of self and promoting lasting change. CMI is grounded in contemporary neurophysiological science and informed by evidence-based practices. The therapeutic process unfolds through sessions combining psychoeducation with embodied experiential invitations to deepen interoceptive awareness, emotion expansion, emotion-based learning, relational learning, and narrative coherence. CMI therapists guide clients through exploring and integrating sensations, emotions, and, ultimately, critical memories. This process is supported by the therapist’s attunement and co-regulation skills.

The development of CMI is underpinned by contemporary neuroscientific theory and evidence for mechanisms of action and change. These sources substantiate CMI’s basis as a neurobiologically informed experiential psychotherapy.

• Defense and safety in therapeutic relationships (Geller & Porges, 2014)
• Social engagement theory (Porges, 2022)
• Attachment theory (Bretherton, 2013)
• Agency and the construction of the self (Bandura, 2001a; Moore, 2016)
• Self-determination theory (Ryan et al., 2021)
• Affective Neuroscience and theories of emotion (Panksepp, 2010)
• Processes of emotions (Greenberg, 2023)
• Role of oxytocin in neurogenesis (Ottoson, 2021; Pekarek et al., 2022)
• Memory reconsolidation (Lane et al., 2015; Ecker et al., 2013)

The psychoeducational and psychotherapeutic components of CMI are based on contemporary neurological approaches to nervous system regulation. These approaches involve building interoceptive awareness and working with somatic, affective, and emotional phenomena and established processes found across various psychotherapies, many of which have a robust evidence base.

• Mindful awareness, mindsight, and neural integration (Siegal, 2009)
• Focusing-Oriented Psychotherapy (Ikemi, 2014)
• Integrative Emotion Regulation (Roth et al., 2019)
• Emotionally focused individual therapy ([Book] Johnson & Campbell, 2021),
• Emotion-focused therapy (Greenberg, 2004)
• Coherence Therapy ([Book] Ecker et al., 2022)
• Somatic-based therapies (Payne et al., 2015)
• Meaning-making focused narrative-oriented therapies (Ghavibazou et al., 2022)

The clinical development team at Arise Alliance Institute has built CMI as an evidence-informed approach that grounds itself in first principles drawn from conventional neuroscience, such as the applied neurological research on human development, memory, and emotion, memory reconsolidation theory, and the understanding of emotional arousal, as well as established psychosocial theories, including polyvagal theory, attachment theory, and self-determination theory. A core tenet of CMI is its emphasis on optimizing the capacity of the therapist’s attunement and fostering the client’s capacities for attachment and connection, recognizing that feeling safe and connected in the therapeutic relationship is a necessary prerequisite for effective work and lasting change, facilitating the repair of attachment injuries and promoting neural growth. CMI leverages mechanisms of action such as emotion expansion and memory reconsolidation that are validated across many other therapies of transformational change, including experiential therapies like Coherence Therapy and Emotion-Focused Therapy (EFT), acknowledging that these fundamental processes are inherent in the brain and are facilitated by diverse therapeutic approaches. This emphasis on evidence will instill confidence in its effectiveness among mental health professionals, researchers, and students interested in learning more about CMI as an approach for promoting well-being with the individuals they serve.

References

Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52(1), 1–26. https://doi.org/10.1146/annurev.psych.52.1.1

Bretherton, I. (2013). The origins of attachment theory: John Bowlby and Mary Ainsworth. In Attachment theory (pp. 45–84). Routledge.

Ecker, B., Ticic, R., & Hulley, L. A. (2012). Primer on memory reconsolidation and its psychotherapeutic use as a core process of profound change. The Neuropsychotherapist, 1, 82–99.

Geller, S. M., & Porges, S. W. (2014). Therapeutic presence: Neurophysiological mechanisms mediating feeling safe in therapeutic relationships. Journal of Psychotherapy Integration, 24(3), 178–192. https://doi.org/10.1037/a0037511

Ghavibazou, E., Hosseinian, S., & Ale Ebrahim, N. (2022). Narrative therapy, applications, and outcomes: A systematic review. Preventive Counseling, 2(4). http://dx.doi.org/10.2139/ssrn.4119920

Greenberg, L. S., & Pascual-Leone, A. (2024). Changing emotion with emotion. In Change in emotion and mental health (pp. 325–344). Academic Press. https://doi.org/10.1016/B978-0-323-95604-8.00012-5

Greenberg, L. S. (2004). Emotion-focused therapy. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 11(1), 3–16. https://doi.org/10.1002/cpp.388

Ikemi, A. (2014). A theory of focusing-oriented psychotherapy. In Theory and practice of focusing-oriented psychotherapy: Beyond the talking cure (pp. 22–35).

Lane, R. D., Ryan, L., Nadel, L., & Greenberg, L. (2015). Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: New insights from brain science. Behavioral and Brain Sciences, 38, e1. https://doi.org/10.1017/S0140525X14000041

Moore, J. W. (2016). What is the sense of agency and why does it matter? Frontiers in Psychology, 7, 1272. https://doi.org/10.3389/fpsyg.2016.01272

Panksepp, J. (2010). Affective neuroscience of the emotional BrainMind: Evolutionary perspectives and implications for understanding depression. Dialogues in Clinical Neuroscience, 12(4), 533–545. https://doi.org/10.31887/DCNS.2010.12.4/jpanksepp

Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 93. https://doi.org/10.3389/fpsyg.2015.00093

Porges, S. W. (2022). Polyvagal theory: A science of safety. Frontiers in integrative neuroscience, 16, 871227. https://doi.org/10.3389/fnint.2022.871227

Roth, G., Vansteenkiste, M., & Ryan, R. M. (2019). Integrative emotion regulation: Process and development from a self-determination theory perspective. Development and Psychopathology, 31(3), 945–956. https://doi.org/10.1017/S0954579419000403

Ryan, R. M., Deci, E. L., Vansteenkiste, M., & Soenens, B. (2021). Building a science of motivated persons: Self-determination theory’s empirical approach to human experience and the regulation of behavior. Motivation science, 7(2), 97. https://doi.org/10.1037/mot0000194

Siegel, D. J. (2009). Mindful awareness, mindsight, and neural integration. The Humanistic Psychologist, 37(2), 137–158. https://doi.org/10.1080/08873260902892220