Instinctual Refinement Therapy: A Predictive Coding and Memory Reconsolidation Framework for Psychotherapy Integration

This article introduces Instinctual Refinement Therapy (IRT) , a structured transdiagnostic protocol that bridges the divide between psychodynamic therapy's etiological depth and cognitive-behavioral therapy's empirical rigor. Integrating psychodynamic therapy's etiological depth with cognitive-behavioral therapy's empirical rigor constitutes a fundamental challenge for psychotherapy science. IRT conceptualizes psychopathology as instinctual dysregulation—maladaptive calibration of evolutionarily conserved motivational systems (Security, Attachment, Agency, Orexis) through entrenched pathological priors. Adverse childhood experiences generate these pathological priors, which subsequently distort perception, emotion, and behavior via predictive coding processes. The IRT protocol systematically targets these computational mechanisms through sequential phases including Thematic Writing, Systematic Belief Challenging, and Belief Destabilization, deliberately inducing prediction error to collapse dysfunctional generative models and facilitate belief updating via memory reconsolidation. By integrating developmental etiology with structured methodology within a neuro-computational framework, IRT offers a unified, testable approach to transformational change while generating specific hypotheses for computational psychiatry research.