NeuroAffective-CBT or NA-CBT is a transdiagnostic model developed by Daniel Mirea in response to a growing subclinical population of undiagnosed affective disorders that fall under the umbrella of shame and self-disgust.

NA-CBT proposes that emotional dysfunction, chronic feelings of shame and low-self esteem are closely related and can be maintained over time by individual’s inability to self-regulate during states of hyper- or hypo-arousal (i.e. highs and lows in mood).  Underlying neural mechanisms include a loss of top-down prefrontal regulation of amygdala, aberrant cortical processing in the salience network, and an over activation of the ‘physiological’ part of the threat system (i.e. the Autonomous Nervous System). This means that individuals can feel emotionally fragile, moody, unpredictable and lack in motivation. Shame, self-disgust and low self-esteem could be found in a range of mental disorders.

Since the treatment of such phenomenon crosses the boundaries of a specific diagnostic criteria, the therapeutic approach has to be both comprehensive and strategic. NA-CBT therefore, relies on a clearly prescribed modular toolkit that aims to disrupt all mechanisms that predispose, perpetuate and precipitate shame, guilt, self-disgust or indeed chronic low self-esteem.

Treatment modules:

(1) Psychoeducation and motivation,
(2) Physical Strengthening,
(3) The integrated-Self,
(4) Coping Skills Training (including Self-Regulation) and
(5) Skills Consolidation & Problems Prevention

In a 2018 interview with Psychotherapy Expert Talks, Donald Meichenbaum pointed out that the field of neuroscience (including gene expression) is not only ‘cutting edge but highly relevant’ with the potential to further tailor interventions for patients suffering from very specific psychopathology. Research coming out of this field certainly adds value to psychological therapies and stays at the basis of models such as NA-CBT. It is my subjective view that in the near future, schools of psychotherapy will adapt and learn to focus on the body as well as the mind, which would imply a deeper understanding of bodily functions not only mind functions for all psychotherapists and psychologists. The fields of neuroscience, clinical hypnosis, psychosomatic medicine and biological treatments are only just starting to come together. NA-CBT is only one example of what could be achieved under the umbrella of Cognitive & Behavioural Therapies, an integrative school of psychology that remains best positioned, because of its empirical base, to oversee attempts to treat mental illness holistically.