Enrico Moretto

Background/Objectives: The integration of psychotherapeutic theory with contemporary neuroscience represents one of the most productive frontiers of clinical research. The fundamental theoretical constructs of Gestalt therapy have been developed with considerable clinical depth, yet their neurobiological foundations remain largely unexplored. Confluence, one of the most debated mechanisms of contact disruption in Gestalt therapy, has recently been described as characterized by a three-dimensional conceptual structure: blurred boundaries, undifferentiation, and avoidance of contact. Methods: In this hypothesis article, we start from this structure and from neuroscientific evidence on thalamic filtering, thalamocortical synchronization, and salience attribution. Results: We propose an original theoretical framework—explicitly hypothesis-generating rather than empirically validated—for dysfunctional confluence, understood as a putative disruption of the transition from globally distributed somatosensory activation to the formation of differentiated figures in the salience network. Conclusions: The proposed correspondences are intended as heuristic mappings aimed at generating testable hypotheses and opening a productive dialogue between Gestalt theory, affective neuroscience, and clinical practice.

This paper introduces SNAP (Structure, Narrative, Activation, Process, Next), a multidimensional clinical reflection tool supporting psychotherapists in systematically attending to phenomenological, relational, and process-oriented dimensions. SNAP integrates Gestalt therapy, complex systems theory, and the Research Domain Criteria (RDoC) framework, comprising 73 items across five dimensions. A pilot acceptability and perceived utility study (N = 20 psychotherapists) used a retrospective pre-post design in which participants provided retrospective pre-exposure and post-exposure ratings for each item. Post-exposure ratings were higher overall than retrospective pre-exposure ratings (T2: M = 6.69, SD = 0.54 vs. T1: M = 6.02, SD = 0.70; mean difference +0.67; Hedges’ g = 0.28, Cohen’s d = 0.29; 15/73 items p < 0.05 uncorrected; 2/73 after Benjamini-Hochberg FDR correction). The largest descriptive contrasts were observed in phenomenological dimensions: Next (g = 0.61), Activation (g = 0.49), Narrative (g = 0.43), and Process-Therapist (g = 0.41). Structural bio-psycho-social dimensions showed minimal contrasts (d = −0.02 to 0.15). Absolute post-exposure ratings were high across items (89% rated 6/9 or above), supporting good acceptability and perceived usefulness within this sample. These preliminary findings support SNAP as a promising, positively perceived framework for clinical reflection. Larger-sample psychometric validation is warranted.

This paper introduces SNAP (Structure, Narrative, Activation, Process, Next), a multi-dimensional clinical reflection tool designed to support psychotherapists in systematically attending to phenomenological, relational, and process-oriented dimensions during therapeutic work. SNAP integrates Gestalt therapy's phenomenological foundations with complex systems theory and the Research Domain Criteria (RDoC) framework, com-prising 73 items organized across five dimensions: Structure, Narrative, Activation, Process, and Next. A preliminary validation study with 20 psychotherapists employed a retrospective pre-post design in which participants rated the utility of each SNAP item for clinical reflection before and after SNAP training. Results showed significantly higher perceived utility after training (T2: M = 6.69, SD = 0.54) compared to retrospective baseline (T1: M = 6.02, SD = 0.70), with mean increase of +0.67 points (Cohen's d = 0.29, p < 0.05 for 15/73 items). Greatest utility gains were observed in phenomenological dimensions: Next (d = 0.63), Activation (d = 0.51), Narrative (d = 0.45), and Process-Therapist (d = 0.43). Structural bio-psycho-social dimensions showed minimal gains (d = -0.02 to 0.15), sug-gesting these were already well-integrated in therapists' clinical thinking. Findings suggest SNAP enhances reflective capacity by systematically directing attention to phenomenological dimensions that are valued but inconsistently attended to. Further psychometric validation with larger samples is warranted.

A situational individual’s mental state contains the dynamic interaction between explicit, conscious cognitive processes and implicit automatisms that develop outside of consciousness. The influence of implicit and unaware processes, often underestimated, manifests itself in the speed with which we process information, in immediate emotional responses, and in the emergence of intentions even before they are accessible to awareness. The brain activity that precedes a decision manifests itself several milliseconds before the subject reports the conscious intention to act. This phenomenon highlights how awareness emerges after the decision-making process. The Quantum Cognition model proposes an alternative theoretical framework to classical logic to explain complex cognitive phenomena such as ambivalence, overlapping intentions, and sudden changes in perspective. The aim of this paper is to propose the QC model as a powerful formal strategy for describing the mind as a dynamic, probabilistic, and context-sensitive system.

A situational individual's mental state contains the dynamic interaction between explicit, conscious cognitive processes and implicit automatisms that develop outside of consciousness. The influence of implicit and unaware processes, often underestimated, manifests itself in the speed with which we process information, in immediate emotional responses, and in the emergence of intentions even before they are accessible to awareness. The brain activity that precedes a decision manifest itself several milliseconds before the subject reports the conscious intention to act. This phenomenon highlighting how awareness emerges after the decision-making process. The Quantum Cognition model proposing an alternative theoretical framework to classical logic to explain complex cognitive phenomena such as ambivalence, overlapping intentions, and sudden changes in perspective. The aim of this paper is to propose the QC model as a powerful formal strategy for describing the mind as a dynamic, probabilistic, and context-sensitive system.

This article proposes an integrative theoretical framework that explores the relationship between interoception and personality, linking neuroscientific evidence, psychological models, and phenomenological perspectives derived from Gestalt therapy. Building on contemporary neurobiological models of consciousness and arousal, the study highlights how the perception of internal bodily states—interoception—is a fundamental component in the development and modulation of personality traits. Through an integrative narrative review of recent literature (2000-2024), the theoretical convergences between interoceptive processes and the personality dimensions of introversion, extroversion, and neuroticism are outlined and reinterpreted in a Gestalt perspective as embodied and relational modes of contact with the environment.The article argues that personality should not be conceived as a static set of traits, but as a dynamic model of organismic self-regulation in which body and mind co-construct subjective and social experience. This integrative view has important implications for psychotherapy, education, and organizational contexts, where the cultivation of interoceptive awareness can improve empathy, emotional regulation, and relational well-being. The proposed framework aims to provide an interdisciplinary contribution that transcends the traditional mind-body dualism and offers new directions for empirical research on the embodied foundations of personality and their role in social behavior.

Background/Objectives: Gestalt therapy traditionally opposes categorical diagnostic labelling due to its fundamental inconsistency with phenomenological and process-oriented ontology. However, this epistemological rigour can limit integration with structured evidence-based interventions for complex personality organizations such as Borderline Personality Disorder (BPD). Despite the evidence base for DBT and Schema Therapy in treating BPD, these approaches may inadvertently minimize the lived phenomenological experience and organismic wisdom central to recovery. Meanwhile, Gestalt therapy’s anti-diagnostic stance limits its integration with structured evidence-based protocols. This paper proposes a hybrid theoretical model that addresses this gap by integrating the clinical epistemology of Gestalt therapy with Linehan’s biosocial theory of Dialectical Behaviour Therapy (DBT) and schema-focused interventions, while preserving the core principles of Gestalt. Methods: we present a model of theoretical integration that draws on Gestalt contact theory, the four modules of DBT (mindfulness, distress tolerance, emotional regulation, interpersonal effectiveness) and the experiential techniques of Schema Therapy. The integration focuses on the dialectic of acceptance and change, which mirrors Gestalt’s paradoxical theory of change. The proposed framework preserves the non-protocol dimension of Gestalt therapy while incorporating the pragmatic utility of DBT and Schema Therapy. Results: key conceptual contributions we propose include: (1) theorizing the “Draft Self” as the object and subject of therapeutic work, (2) integrating mindfulness and grounding as embodied processes within live Gestalt experiments, (3) activation techniques to explore the identity fragmentation endemic to BPD. Conclusions:his integration offers a coherent, embodied, and process-oriented framework for understanding and treating BPD that validates patients’ lived experience, mobilizes evidence-based interventions, and opens up meaningful intertheoretical dialogue.

Background/Objectives: The ability to improvise is one of the elements that characterize human action. However, improvisation has always been subjected to a lack of interpretation: it is considered an activity without rules and references and assimilated to an action that does not require skills, therefore completely unexpected and “surprising”. It is therefore clear that in this way it is contrasted with all those activities based on the rigorous analysis of data and scientific methodologies that would seem to be the only ones to guarantee ‘authority’ Methods: A scoping review, using PRISMA framework, was conducted about the neurophysiological correlates of creative improvisation. This investigation started from the study hypothesis that similar mental processes to those affecting the improvising musician occur in psychotherapeutic practice. Conclusions: The use of creative improvisation becomes a means by which all dimensions of psychotherapeutic work are realized more deeply and vividly. The parallelism between therapeutic and musical process rests on the underlying factor of both creative endeavors, which is embodied in the emerging non-linear dynamics: each relational encounter becomes a unique interpretation, which transforms both the performer and the listener.

Clinical supervision is crucial for the practice of psychotherapy and for training in it: it is a cornerstone of professional support, stimulating clinical reflection and the continuous development of skills. Recent studies explore the use of ChatGPT as a tool to support supervision: the crucial role of prompts in optimizing the effectiveness of Artificial Intelligence in this area emerges. This study has two main objectives: one is to develop a prompt framework by leveraging the evidence gathered in the two previous studies and testing its effectiveness. The other objective is to compare the performance of a free Large Language Model with that of other accessible paid models, with a view to inclusivity. The results show the surprising competitiveness of the free model and a significant improvement in the supervision feedback obtained, compared to that of previous studies, attributable to the characteristics of the new prompt, which includes precise instructions on the fundamental characteristics of good supervision. Artificial Intelligence can reduce professional hierarchies by democratizing expertise and represents a form of cognitive augmentation, as it extends the therapist's reflective abilities and promotes new forms of conversational supervision. The future ethical challenge will be to effectively combine technological innovation with the fundamental values of the caring professions.

Non-suicidal self-injurious behaviour (NSSI) is defined as any form of intentionally self-inflicted injury for the purpose of psychological benefit. This phenomenon has been exacerbated by the COVID-19 pandemic emergence of newpsychopathological outbreaks, particularly in the adolescent population.The aim of this review is to understand the extent to which, for the very young, NSSI acts represent an attempt at emotional self-regulation and a coping strategy to cope with unpleasant or barely tolerable emotional experiences and how the attachment bond may represent a predictive factor for the onset of this phenomenon.