Deconstructive meditations and psychotherapy: Transforming the perception of the self

Abstract

Selfishness, understood as excessive focus on the self, appears to be a predominant feature of contemporary culture. While the degree of self-focus is adaptive for survival and decision-making, self-rigidity has been associated with significant psychological, interpersonal, and social costs. Throughout history, philosophers, religious leaders, and social activists have promoted a “hypo-egoic” way of being, characterized by reduced self-fixation and greater openness to others. However, a key question arises: How can one cultivate a more flexible and interdependent perspective on the self? Deconstructive meditations are a group of contemplative practices that aim to dismantle self-rigidity by exploring perception, cognition, and emotion. Their central mechanism is self-inquiry, an experiential process that involves directly observing patterns of the self, questioning the solidity of identity, and developing new ways to relate to experience. From the perspective of contemplative neuroscience, these practices have been shown to reduce self-narrative identification and promote psychological flexibility. Despite their potential, empirical research on deconstructive meditations remains limited and requires further investigation. This article reviews the essential findings on practices, their connection to psychotherapy, and their potential therapeutic applications. Finally, their clinical implications are discussed along with future research directions to validate their impact on mental health.

Key Words: Deconstructive meditations; Psychotherapy; Self-identity; Ego dissolution; Psychological flexibility; Enactive cognition; Buddhist psychology; Self-referential processing; Nondual awareness; Contemplative neuroscience

Core Tip: Deconstructive meditation practices are an innovative approach to reducing identity-based suffering by fostering self-flexibility and psychological adaptability. Despite their potential, there is limited empirical research on these practices. This paper highlights their mechanisms, current evidence, and interdisciplinary significance, underscoring the need for further studies to validate their clinical application.

INTRODUCTION

Throughout history, philosophers, religious leaders, and social activists have advocated a “hypo-egoic” way of being, characterized by a reduced focus on the self in favor of a disposition toward others[1]. Qualities linked to this function, such as compassion and prosociality, have shown benefits in terms of emotional regulation, and empathic and relational skills[1-3]. In contrast, selfishness, which is understood as an excessive fixation on the self, has been shown to impair subjective well-being[1,4]. These results demonstrate the importance of understanding the mechanisms underlying the self and its effects on mental health.

The self can be understood from a neuroscientific perspective through two modalities of self-awareness: The minimal self and the narrative self[5]. The former is pre-reflexive and transient, while the latter is extended in time and dependent on memory, language, and imagination. It involves introspection and self-referential processes and is linked to the cerebral default mode network (DMN)[6]. The relationship between the narrative self and DMN is the focus of research because of its role in rumination and self-evaluation, which are processes linked to various mental health problems[7]. Consequently, excessive activation of this network is related to health conditions such as depression and social anxiety[8,9], whereas a decrease in its activity has been linked to less rumination and greater psychological flexibility[10]. In this respect, evidence from contemplative neuroscience has shown that meditation can reduce identification with self-narratives and favor greater self-flexibility[6,11,12]. These findings suggest that modulation of their activities through contemplative practices, such as deconstructive meditations (DMs), aimed at developing a flexible perspective of the self, is an innovative approach for interventions in the clinical setting.

Current approaches in the field of mental health have argued that the self is not a fixed structure but a dynamic process shaped by cognitive, bodily, and contextual mechanisms[13], with transdiagnostic processes based on various psychopathologies[7]. Among these processes, self-rigidity has been described as a fixation on self-narratives that hinders adaptive capacity and underlies conditions such as depression and anxiety disorders, in which rumination and excessive self-referentiality play fundamental roles[7].

Both perspectives are consistent with the Buddhist notion of “anatta” (non-self), which does not imply the absence of the self but rather emphasizes its impermanent, dynamic, and interdependent nature, challenging the idea of a fixed and substantial identity[14]. This multidisciplinary view opens up the opportunity to design clinical and psychoeducational interventions aimed at reducing rumination and disidentification with self-beliefs, a focus shared by current proposals that highlight self-flexibility, understood as the ability to question and modify self-narratives, as a key factor in emotional regulation and the reduction of obsessive thinking[7,15,17]. Although most studies on DMs and self-boundary dissolution states are still in the incipient stage, and more rigorous clinical studies are required to evaluate their applicability in the therapeutic setting, recent research on advanced meditators has shown that these practices can dissolve self-rigidity narratives related to changes in the functional connectivity of the DMN, favoring plasticity in self-awareness and a positive impact on psychological well-being[6,11,12].

The main objective of this article is to integrate recent findings in neuroscience, psychology, and contemplative practices regarding DMs and self-boundary dissolution. This term refers to meditative experiences characterized by transient alterations in agency, body ownership, self-location, and first-person perspective[11]. Rather than implying the complete absence of self, these states reflect a temporary dissolution of the boundaries that sustain the sense of selfhood, particularly at the minimal level[11]. These experiences have also been associated with reduced identification with rigid self-narratives and greater self-flexibility[7]. This interpretation aligns with current neurophenomenological models, offering a scientifically grounded framework for understanding how DMs modulate self-perception and identity processes.

Understanding self-boundary dissolution states is essential not only for advancing contemplative neuroscience but also for exploring innovative therapeutic approaches to identity-related suffering. Accordingly, this review examines: (1) The theoretical and phenomenological foundations of DMs; (2) The neurocognitive mechanisms involved in self-boundary modulation; and (3) The clinical implications of these practices. Methodological challenges and future research directions are also discussed, to deepen the scientific understanding of self-related transformations.

DMS: FOUNDATIONS AND MECHANISMS

Self-deconstruction is the central focus of various contemplative traditions, which have developed specific techniques for this purpose in terms of their phenomenological and experiential perspectives, although they differ in their methods and philosophical foundations[17]. These types of practices have been described in the scientific literature as DMs; their main objective is to dismantle rigid cognitive patterns and question internal models of the self, others, and the world through the observation of direct experience. They differ from attentional practices, which focus on stabilizing cognition through self-regulation of attention, and constructive practices, which focus on developing positive psychological states such as loving-kindness or compassion[18].

One form of DM practice is Vipassana, which comes from the Buddhist contemplative tradition. This meditation trains the observation of impermanence in sensations, thoughts, and emotions, reducing identification with mental and physical phenomena[18]. Research in contemplative neuroscience has observed changes in the DMN of long-term meditators, suggesting a reconfiguration of self-referentiality and greater flexibility in self-perception[11,12,19,20]. This evidence is consistent with previous research on mindfulness meditation and its effects on neuroplasticity[21].

Other DMs, such as Dzogchen, Mahamudra, and self-inquiry in Advaita Vedanta, are categorized as non-dual practices that facilitate a transformation in the habitual dualistic subject/object experience. This change does not imply its disappearance or fusion, but rather its reconfiguration toward a more fluid and unified mode of experience[18,22]. Although these types of practices require further empirical validation in neuroscience and their clinical application, preliminary studies with expert meditators have observed that they can modulate the relationship between the brain networks involved in self-referentiality and external processing, reducing the polarization between the DMN and task-positive network[23]. This could suggest a decrease in self-experience fragmentation toward a more fluid relationship between internal and external processes. Another study reported that individuals with a greater propensity for non-dual states of consciousness showed increased prepulse inhibition, suggesting more efficient sensory filtering and less interference from irrelevant stimuli[20]. This evidence suggests possible implications for cognitive and emotional regulation in understanding transdiagnostic mechanisms in mental health. The previous sections described the foundations of the DMs. To understand how these practices influence self-dereification, the neurocognitive mechanisms involved in this process will be examined.

NEUROCOGNITIVE MECHANISMS IN CHANGES IN SELF-PERCEPTION

The following are the main processes described in the literature.

Self-inquiry and meta-awareness

Among the mechanisms linked to changes in self-perception, self-inquiry has been described as a central mechanism in DMs and refers to a process of exploring conscious experience that allows one to question beliefs and perceptions about the self, generating insights through discursive analysis and direct observation of mental phenomena[18]. On the other hand, meta-awareness involves becoming aware of one’s own cognitive and emotional processes, promoting self-regulation, and reducing experiential fusion with thoughts and emotions[24]. Both mechanisms would allow the identification of automated patterns that build personal identity, facilitate greater distance from identity narratives, and promote a more flexible relationship with internal experience[18]. Regarding the specific role of meta-awareness, an experimental study by De Oliveira et al[25] with 294 participants found that this mechanism played a crucial role in facilitating self-boundary dissolution states. Their observations indicated that the ability to observe thoughts and emotions without rigid identification mediates the relationship between meditative practice and reduction in self-reification[25]. From a neuroscientific approach, meta-awareness is associated with less activity in the posterior cingulate cortex and temporoparietal junction and is involved in self-referentiality[6].

Cognitive defusion

This is another mechanism mentioned as the basis of changes in self-perception and refers to the ability to distance oneself from internal experiences, such as thoughts and emotions, and see them as transient events of the mind rather than accurate reflections of reality, thus promoting greater self-flexibility and less emotional reactivity[26]. Some research in contemplative neuroscience shows evidence linked to this mechanism, such as the study by Nicolardi et al[27], which indicated that the posterior cingulate cortex, a central node of the DMN, is involved in the identification of pain that can be modulated through meditation. In contrast, Schweitzer et al[11] found that a reduction in beta activity in the posterior cingulate cortex and temporoparietal junction in advanced meditators is associated with reduced identification with mental content and greater self-flexibility. Kumari et al[20] showed that the benefits of meditation on mental health are mediated by an increase in meta-awareness and cognitive defusion (also referred to as decentering in other theoretical models), reinforcing the importance of this mechanism in non-dual meditative practices.

Modulation of the embodied self

The self is not only a cognitive construct but also an embodied experience related to the sense of body ownership, agency, and location in space[6]. This is why it has been pointed out by recent research as another mechanism linked to changes in the perception of the self. Trautwein et al[12] found that dissolution of the embodied self in advanced meditators was associated with decreased beta activity in the medial posterior cortex. This could be related to a lower fixation on self-referentiality. Furthermore, Schweitzer et al[11] found that self-flexibility in meditation is related to changes in the medial posterior cortex and temporoparietal junction, suggesting a transformation in multisensory integration of the self.

Based on these observations, recent theoretical and empirical models have provided a more integrated explanation of the neurocognitive mechanisms through which DMs can transform the perception of the self. These practices are associated with decreased DMN activity, which, as mentioned above, is linked to the narrative processing of the self and excessive self-referentiality[12,18]. Additionally, Dahl et al[18] described meta-awareness, cognitive defusion, and self-inquiry as the central mechanisms of DMs. These mechanisms enable practitioners to identify rigid self-schemas and enhance their cognitive-affective flexibility. Complementarily, the pattern theory of self conceptualizes the self as a dynamic and emergent pattern of embodied, affective, narrative, and cognitive processes[13], where deconstructive practices may promote a reorganization of this pattern through embodied meta- awareness and experiential decentering, leading to a more fluid and relational experience of the self[16].

At the neurobiological level, these transformations are hypothesized to involve interactions among attentional systems (frontoparietal networks), emotional regulation systems (limbic circuits), and networks supporting interoception and metacognition (the insula and anterior cingulate cortex)[12,16,18]. Empirical studies using magnetoencephalography, which records magnetic fields associated with neural oscillations, have demonstrated decreased high-beta activity in areas such as the posterior medial cortex during experiences of self-boundary dissolution[6,11,12], reinforcing the hypothesis that meditative states can mitigate the rigidity of self-related processing. In summary, these models support the notion that DMs not only reduce the narrative focus on the self but also actively reconfigure the processes that constitute the self. This shift can encourage a more flexible, embodied, and interconnected experience of self-transformation, with both clinical and existential relevance[7,15]. While grounded in current theoretical models and preliminary empirical findings, these mechanisms should be viewed as guiding hypotheses for future research rather than definitive explanatory pathways, as summarized in Table 1. While these findings on the mechanisms involved in changes in self-perception and their relationship with DMs represent a step forward in their understanding, further evidence is needed regarding their neurobiological basis, cognitive processes, and impact on mental health. The following section reviews recent studies analyzing the effects of this type of meditation and the challenges facing their incorporation into clinical interventions.

Table 1 Hypothesized experiential and neurocognitive mechanisms of self-perception transformation in deconstructive meditations.

Mechanism	Description	Transformation of self-perception
Sustained non-reactive awareness[17]	Sustained, non-reactive observation of present-moment experience that reduces conceptual elaboration and promotes direct awareness	The self is experienced as a dynamic and impermanent process, rather than as a fixed entity
Exploration of narratives and patterns[16,18]	Systematic self-inquiry into beliefs, emotional schemas, and bodily patterns of identification	Unveils the interdependence of narrative, emotion, and embodiment in constructing self-rigidity
Progressive disidentification[18]	Cognitive defusion and dereification processes that weaken habitual identification with thoughts, emotions, and sensations	Increases cognitive-affective flexibility and reduces experiential fusion with rigid self-schemas
Embodied meta-awareness[12,16]	Awareness of bodily, emotional, and cognitive processes as impermanent and constructed involves interoceptive and metacognitive networks	The self is experienced as an emergent, relational phenomenon embedded in context, rather than a core identity

CURRENT STATE OF RESEARCH

Self-boundary dissolution states through contemplative practices have sparked interest in the scientific community[16]. However, their study still requires the development of empirical research; it is still an incipient field compared with more established approaches such as mindfulness and compassion-based meditation[18,28]. Despite these limitations, research has begun on how these states influence self-reconfiguration, emotional regulation, and prosociality[15,29,30]. The following sections discuss the recent studies and their findings.

Impact on self-perception and emotional regulation

Among DMs, Vipassana has captured interest in the scientific community in psychology and contemplative neuroscience[31]. A study that recorded electroencephalographic patterns in meditators using this technique and compared them to those obtained from athletes found that the practice of Vipassana was associated with better response inhibition and lower emotional reactivity, translating into more efficient regulation of cognitive control[32]. In addition, two controlled studies conducted on addicted populations have reported improvements in self-awareness and impulse control. However, the results obtained for depression, empathy, and mindfulness were not significant[33,34]. In this field of research, the need for robust designs, randomized controlled trials, and long-term follow-up makes it difficult to draw conclusions regarding its effectiveness compared to other mindfulness-based approaches with empirical support[35]. Nevertheless, qualitative evidence indicates that Vipassana has the potential to transform cognitive and emotional patterns; therefore, its inclusion in therapeutic models could be of interest, highlighting the need to conduct research with greater methodological rigor[31].

As previously mentioned, neuroimaging research in advanced meditators has found that self-boundary dissolution states induced by meditation are associated with lower activity in the DMN, an area linked to self-referentiality[6,11,12] that can modulate the perception of the embodied self and affect regions of the brain involved in self-awareness and sensorimotor integration[12]. These results indicate that, although subjective experience in these states is fundamental, it may also be supported by specific brain mechanisms related to self-regulation and cognitive flexibility.

Neurophenomenology, a methodology proposed by Varela[36], seeks to integrate first-person phenomenological reports with neuroscientific data, bridging subjective experiences and neurophysiological measures. Using this approach, Nave et al[29] investigated the dissolution of the sense of self during meditation through phenomenological self-reports and neuroimaging, identifying both neural and experiential patterns associated with the loss of self-boundaries. Their findings indicate that this phenomenon involves changes in agency, attentional disposition, and bodily perception, also suggesting that meditators who adopted a non-reactive and surrendered attitude experienced a greater depth of self-boundary dissolution states. Furthermore, they proposed that deconstructing the self may promote greater self-flexibility, with applications in emotional regulation and interventions for mental health conditions characterized by self-rigidity.

Complementarily, a study on the impermanence of the embodied self[37] examined how meditation affects the neural mechanisms of death denial using magnetoencephalography to measure brain responses to self-associated death stimuli. The results showed that experienced meditators exhibited acceptance rather than denied response compared to non-meditators. Moreover, a higher degree of death acceptance predicted more positive experiences of self-boundary dissolution and well-being[37]. These findings suggest that death denial is not a fixed mechanism but a trainable one and that meditation can facilitate identity transformation processes with clinical applications in mental health. Lutz et al[38] developed a guide to understand how meditation dynamically modifies the subjective experience of the self, thereby providing new avenues for its study in clinical contexts. These developments highlight the need to integrate these findings into the clinical mental health context and their potential benefits.

Another study analyzed self-boundary dissolution states during meditation retreats and explored their impact on psychological well-being and self-perception[39]. The results indicated that participants experienced self-boundary dissolution states more frequently than the control group, suggesting that these states may facilitate transformations in identity and subjective experiences[39]. Although some of these experiences were challenging during the two-week follow-up, most participants reported that their impact was predominantly positive, reinforcing the ability of meditation to induce long-term beneficial changes in self-perception and emotional well-being[39].

Social implications and prosociality

Research has also focused on the social implications of DMs and their self-boundary dissolution state. Recent studies have explored how reducing self-reification can facilitate connections with others and decrease outgroup bias[11]. These findings align with those of Dambrun[30] in 2016, who found that reducing perceived bodily boundaries through meditation can induce greater happiness and less anxiety, suggesting that the self-boundary dissolution mode promotes better integration with the environment and others[30]. This research was based on the self-centeredness/selflessness happiness model[4], which suggests that a self-centered psychological mode tends to generate anxiety and emotional fluctuations. In contrast, a self-boundary dissolution mode promotes more stable happiness.

Clinical applications and integration approaches

The integration of Eastern philosophy into psychological interventions has already been presented in the field of mindfulness and its clinical applications[35]. Where DMs are concerned, a randomized controlled trial by Jarukasemthawee et al[40] measured the effectiveness of a methodology known as the Insight-Based Mindfulness Program. This Vipassana-based intervention focused on impermanence, suffering, and “non-self” (anatta) through the phenomenological exploration of experiences with contemporary psychological strategies, showing positive effects on emotional discomfort and cognitive flexibility[40]. The creation of these integrative approaches facilitates access to these types of practices in western clinical settings.

Risks and clinical considerations

An important topic to consider when implementing DMs in mental health is that their impact can vary depending on context and meditation experience. One study reported that these experiences of self-boundary dissolution can induce transient states of depersonalization in some cases, particularly in individuals without adequate training[41]. This highlights the importance of developing structured protocols that minimize adverse effects and optimize the application of these practices in therapeutic contexts. To achieve this, progressive support is essential, as it enables participants to integrate their experiences into their daily lives.

Even considering the above, it is relevant to highlight that these theoretical frameworks, including the pattern theory of selflessness[16], have begun to incorporate phenomena linked to self-perception within an explanatory framework that considers self-flexibility as an adaptive process in mental health. New approaches indicate that a rigid self can accentuate different pathologies in this area[7].

In addition, the interaction between pharmacological treatments and contemplative practices remains an underexplored but clinically relevant issue. Certain studies have suggested that mindfulness-based interventions, in combination with pharmacotherapy, may improve emotion regulation and depressive symptoms[42]. In the context of chronic pain, a protocol for a systematic scoping review has been proposed to evaluate how mindfulness-based interventions interact with pharmacological analgesic treatments, and whether their combined use may offer synergistic benefits or require clinical adjustments[43]. Although these studies did not directly address DMs, their findings may serve as a useful precedent for future research on how pharmacological treatments influence the neurocognitive and experiential processes involved in this specific type of meditative practice. Additionally, the physical effects associated with long-term pharmacological treatment, such as fatigue, chronic pain, and reduced mobility, may present challenges for sustained engagement in DMs and could require clinical adaptations in the way these techniques are implemented.

Beyond the traditional stillness in which deconstructive DMs are usually practiced, integrating low-intensity physical activity, such as mindful walking, may enhance engagement, embodiment, and emotional regulation, especially in clinical populations. A growing body of evidence suggests that combining physical activity with mindfulness can support mental health and adherence to contemplative routines and health-related behaviors[44,45]. Although these approaches have not yet been directly linked to deconstructive techniques, they may offer a valuable foundation for future adaptations of DMs that incorporate gentle movements, particularly for individuals with physical or motivational limitations.

Ongoing research and future directions

Concerning ongoing research and possible future directions, one of the most promising studies to understand the impact of DMs is the randomized clinical trial conducted by García-Campayo et al[28]. This study evaluated the effects of three deconstructive practices on well-being and the experience of non-duality, comparing them with mindful breathing as a control group. Using a mixed-methodological approach, this study analyzed changes in self-perception, mindfulness, compassion, and altered states of consciousness using quantitative and qualitative tools[28]. These findings open up new avenues for the clinical application of DMs in mental health research.

Another interesting project is Parola et al[46], who investigated how virtual reality (VR) can induce self-boundary dissolution states. Subjective experiences, physiological correlates, and clinical effects were assessed to offer a multidimensional perspective. This could represent a bridge between DMs and technological tools applied to psychotherapy and research in contemplative neuroscience[46]. While the above reflects the interest and advances in this area, core gaps remain in this field of research. Therefore, longitudinal studies are required to evaluate the long-term effects of DMs and changes in self-perception, in addition to greater integration of phenomenological, neuroscientific, and clinical methodologies into their study. Furthermore, population types and sample diversity in research remain limited; therefore, future studies should consider more representative populations to reflect the scope of these effects.

Nevertheless, current progress can promote the development of mental health interventions to facilitate access to self-boundary dissolution states for people without prior meditation experience. The implementation of evidence-based clinical approaches using DMs is promising in both research and therapeutic practice. The following section explores integrative frameworks that combine deconstructive and contemplative practices in therapeutic contexts, thus expanding their applications in mental health.

INTEGRATIVE FRAMEWORKS

Integrative proposals are emerging in both contemplative and psychological contexts, combining self-deconstruction with therapeutic strategies, constructive meditation practices, and technological innovation. The following section reviews these frameworks and their potential for advancing the understanding of the self and providing tools to support psychological and emotional transformations.

Constructive meditation practices and self-flexibility

Constructive meditation practices aid in a more integrated and sustainable process toward flexibility of the self[18]. Among the types of constructive meditation practices, the most widely studied are compassion or loving-kindness meditations, which have been described as facilitators of altruistic and prosocial behaviors[47,48]. Furthermore, regular compassion practice induces structural changes in the ventrolateral prefrontal cortex and anterior insula, areas involved in socio-affective regulation, and the generation of prosocial emotional states[49]. These results are also associated with a decrease in emotional distress and an increase in resilience through the activation of reward and emotional regulation circuits when exposed to the suffering of others[50]. Trautwein et al[48] showed that, unlike non-practitioners, long-term practitioners of loving-kindness meditation tend to perceive themselves and others in a more egalitarian way, with fewer cognitive biases of focusing on the self to others, which suggests a process of decentering identity and a better ability for interpersonal connection. A systematic review found that these meditations produce significant changes in empathy, compassion, and prosocial behaviors, which would occur through the activation of neural circuits related to emotional regulation and social connections[47]. It should be noted that the evidence indicates that constructive meditation practices would decrease the self-centered mode of functioning and increase disposition toward others, which could facilitate access to states of disidentification of the self. This raises the possibility that integrating constructive meditation and DMs into therapeutic interventions could enhance psychological well-being and self-flexibility, strengthen the processes of healthy change, and reduce the risk of significant adverse effects.

Buddhist psychology and the self as a dynamic process

Self-rigidity has been identified as a transdiagnostic factor in mental health, leading to growing interest in its flexibility as a therapeutic strategy[7]. In addition, Buddhist psychology has described the self as a dynamic and interdependent phenomenon, which is consistent with the self-pattern theory that considers self-rigidity as a factor in psychological distress[14]. In this respect, the integration of Buddhist psychology into research and clinical practice provides a theoretical framework with which to enrich the understanding of the self while also providing tools to promote flexibility to enable modulation of the self in their context, promote greater psychological adaptability, and reduce the suffering associated with self-rigidity[14].

Emerging therapeutic approaches

Among the emerging therapeutic proposals in this field, a contemplative practice named Feeding Your Demons[51], which is based on Tibetan Buddhism, specifically the ancient practice of Chöd, has been adapted to a secular and contemporary psychological framework. This intervention differentiates it from current contemplative approaches by incorporating elements of attention (mindfulness), constructive meditation (visualization and dialogue with emotional experience), and DM (exploration of the impermanence of the self and afflictive emotions)[52]. This process promotes the transformation of maladaptive emotional and cognitive patterns and provides a comprehensive framework for enhancing psychological well-being[52,53].

Studies of this contemplative practice require further validation in clinical trials with different populations. Preliminary research has found that meditators significantly improve psychological well-being, reduce stress levels, increase self-compassion, and facilitate self-integration[52,53]. Combining practices, such as “feeding your demons”, with broader clinical approaches could contribute to greater cognitive and emotional flexibility, promoting self-exploration without reinforcing patterns of self-rigidity. The authors of this article are currently examining this practice and its effects on women’s body image, self-deconstruction, and psychological well-being.

Another emerging proposal based on enaction, phenomenology, and contemplative neuroscience is a therapeutic model[54] that proposes a methodological framework that integrates attentional, deconstructive, and constructive practices in different progressive stages of identity exploration and emotional regulation in a therapeutic context. Based on the self-pattern theory, this perspective considers that psychological challenges do not stem from the absence of a healthy self but from self-rigidity, or the rigidity of its configuration[7,13]. Although it is at an initial stage for empirical study, this proposal has been registered as a model under exploration, with projections for future pilot studies[54].

VR and self-boundary dissolution states

Among the innovative technologies, VR has been explored as a potential tool for inducing self-boundary dissolution states. In a recent study, Kettner et al[55] evaluated a group VR program called Clear Light, which was specifically designed for people with life-threatening illnesses. This program includes an environment characterized by abstract visual representations that promote the dissolution of conventional perceptions of the self in favor of interpersonal connections. The findings indicated significant reductions in anxiety and depression as well as improvements in psychological well-being and connection with others[55]. However, the study was observational, with no control group, which did not allow for causal attribution of the observed effects[55].

Although this field shows considerable promise, research remains in its initial stages and faces notable methodological challenges. Preliminary evidence underscores the potential of VR in inducing self-boundary dissolution states and possible therapeutic applications. More broadly, the emerging approaches reviewed are conceptually innovative yet require further empirical validation before therapeutic implementation. The following section examines the challenges associated with its effective integration into clinical settings.

DISCUSSION AND CLINICAL IMPORTANCE

The integration of DMs into the clinical setting requires addressing fundamental challenges. Each of these is reviewed in detail below.

DMs and their impact on transdiagnostic processes

The incorporation of Buddhist philosophy and its contemplative methods into clinical settings, along with research in this field, has demonstrated that mindfulness plays a role as an intervention for various mental health issues[56]. This development has consolidated contemplative neuroscience as a field of research that extends beyond the study of mindfulness[57,58] to the incorporation of concepts and techniques based on contemplative traditions by different clinical intervention models such as mindfulness-based stress reduction[59] and mindfulness-based cognitive therapy (MBCT)[60]. Similarly, mental health approaches based on transdiagnostic processes identify cognitive and emotional rigidity as a central factor in psychopathology, contributing to the persistence of depressive states, anxiety disorders, and conditions related to self-dysfunction[7,61].

This approach requires intervention tools and models that more comprehensively address the processes that sustain and organize suffering[62]. While mindfulness and compassion-based interventions have shown benefits in mental health[35,47], DMs offer a unique approach to address the processes that organize patterns that sustain self-rigidity by directly probing them[7]. This would allow the field of research and mental health to expand the understanding of the self and deepen and broaden the approach to mindfulness[63]. Third-generation therapies focus on the relationship between cognitive and emotional processes[64] without directly questioning the foundations of the self that organize and structure our perceptions[62]. The integration of DMs has the potential to facilitate greater self-flexibility, generating a profound transformation in the perception of the self and dynamic adaptation with experience[38]. This coupling, in turn, strengthens cognitive and emotional flexibility, which is part of the processes that organize the pattern of the self, reducing the possibility of self-rigidity and sustaining long-term health changes[62]. However, for DMs to be effectively integrated, it is necessary to develop broader therapeutic approaches that recognize the interdependence between the mind and body environment and its dynamism[62]. Given the introspective depth and cognitive demand of DM practices, their clinical application may require a higher level of patient motivation and therapeutic support than standardized mindfulness-based interventions[35].

In this respect, approaches such as acceptance and commitment therapy (ACT)[65] have advanced the importance of psychological flexibility[61]. Nevertheless, they do not specifically address the mechanisms by which identity is constructed and rigidified. Therefore, it is possible to update such therapies along these lines with the incorporation of DMs or the development of new approaches that not only address the relationship with cognitive and emotional contents but are also directly applied to the phenomenological structure of the self, adding a value-based and functional direction to the process of self-flexibility[38].

Research gaps and methodological challenges

Notably, significant gaps remain in the scientific literature in this field. While these gaps offer opportunities for clinical research, further empirical evidence is required to advance their development. Although there has been a growing interest in integrating contemplative practices into psychotherapy since the development of mindfulness[38], essential methodological challenges are faced by the study of DMs in the clinical context[28]. So far, studies in this field have mainly been descriptive or correlational or involved populations of expert meditators, with a paucity of controlled clinical trials, longitudinal studies, and robust methodological designs[11,12]. This highlights the need to develop more rigorous experimental designs to evaluate their therapeutic and neurocognitive effects[18].

Some of the main challenges include: (1) Lack of clear operational definitions: One of the essential considerations for the development of the field is the greater clarity of the definitions and operability of DMs[18]. At this stage, there is a significant difference between mindfulness meditation, which has been standardized in interventions such as mindfulness-based stress reduction and MBCT[59,60], and a wide range of DM methods and practices that vary in their execution and expected effects[18]. Where these meditations are concerned, there is an absence of consensus regarding the different criteria that hinder the replicability of studies and comparisons between interventions[28]. One way forward is to learn from previous experiences with mindfulness[66] to develop more robust methodological frameworks for research on self-boundary dissolution states and these types of practices; (2) Scarcity of neurophenomenological measures: Integration of subjective experience with neurophysiological measures improves the understanding of phenomena and is essential for progress in this area[12]. The changes in self-perception and cognitive processes brought about by DMs cannot be fully captured using conventional scales of anxiety, depression, and psychological well-being[11]. An advanced approach is needed that incorporates neurophysiological measures and detailed phenomenological analyses of first-person experiences, going beyond traditional self-report methods[38]. Such an approach could offer a deeper and more nuanced understanding of the structure of conscious experiences during self-boundary dissolution states[67]; (3) Limited clinical designs: Very few clinical studies have reported the benefits of DMs[28]. Although there are preliminary reports of improvements in well-being and changes in the DMN of advanced meditators[6,11,12], there is a lack of randomized controlled studies in clinical populations, which hinders the assessment of their therapeutic use; and (4) Challenges in cultural and clinical adaptation: An important point regarding the integration of DMs into the clinical setting is the need for frameworks that are aligned with the biomedical model to facilitate their incorporation[28]. Possibilities are offered in this direction by theoretical work on enaction and its application to understanding the self[38,67].

Safety in clinical application: Joint integration of deconstructive and constructive practices

Safety is fundamental for identifying gaps and challenges in the integration of DMs into clinical settings. Although their therapeutic potential and how they could optimize mental health interventions have been previously reviewed, a question that opens up new avenues of research and describes a current challenge is how to implement them safely and effectively in diverse populations while minimizing their adverse effects[41]. This is particularly crucial when dealing with pre-existing psychological conditions, such as a history of trauma, severe anxiety, or dissociation[68]. Deconstruction of the self can generate experiences of existential emptiness, identity fragmentation, and loss of orientation if not accompanied by an appropriate framework[41].

To address this challenge, a promising approach is to explore the interplay between deconstructive and constructive practices that integrate the development of positive psychological patterns such as compassion, empathy, and value work[4,18]. Previous studies have shown that compassion and a sense of purpose can attenuate existential distress and improve emotional regulation in people undergoing identity transformation processes[69,70]. In this context, combining DMs with loving-kindness or compassion practices could facilitate a more stable and functional transition toward greater self-flexibility and value-based contextual approach[12,52].

ACT incorporates values in a stable direction during psychological changes, preventing cognitive flexibility from leading to disorientation[47,65]. This suggests that working with personal values as an experiential reference could help patients dismantle self-rigidity patterns without falling into uncertainty or existential emptiness[15]. Thus, the process of self-flexibilization would not be experienced as a loss but as a transition to a more dynamic and relational way of existing[12,48]. The previous sections reviewed key methodological challenges and potential strategies for addressing them. However, further research is required to fill the existing gaps and explore outstanding questions in this field.

Lines of future research

The challenges surrounding DMs and their clinical implementation, in addition to identifying obstacles to the advancement of the area, have provided a path for future research. The main conclusions are as follows.

Controlled clinical trials: In a clinical setting, the development of randomized controlled trials is fundamental for evaluating the effects of DMs[28]. Therefore, this type of design is required for different clinical populations, with long-term follow-up and comparison with established therapeutic approaches such as mindfulness-based interventions (MBCT and ACT) and cognitive behavioral therapy[61].

Development of specific measurement tools: Although there are existing instruments that measure self-boundary dissolution states[71,72], there is a need to expand and develop new clinical scales to assess self-flexibility, disidentification with self-narratives, and non-dual experiences that use standardized concepts and validate current ones[16]. This approach must be multidimensional and combine self-reporting, phenomenological interviews, and neuroscientific measures to capture changes in self-perception and their impact on mental health[38]. Furthermore, these tools should be integrated into therapeutic models to establish standardized criteria and enhance the efficacy and safety of DMs in clinical practice.

Exploration of VR and other immersive technologies: The use of health technology in clinical practice, specifically in association with mindfulness, has been reflected in online interventions[73], the creation of digital applications[74], and its use in VR[75]. As described in the previous sections of this paper, VR has also been used in studies of self-boundary dissolution states[55]. A recent study and ongoing project show that this is an option to be explored in this type of practice and could be seen as a new avenue to facilitate these types of states in clinical settings[46,55].

Studies on the combination of deconstructive and constructive meditations: It is crucial to explore hybrid models that integrate both forms of meditation to dismantle rigid self-patterns. Cultivating states, such as compassion and strengthening prosocial behaviors, can provide a secure psychological foundation, reduce the adverse effects of deconstruction, and reorient the self with positive ethical values[4,12,47,48,65]. The key questions include: Does the integration of constructive meditation practices improve emotional tolerance during deconstructive practices? What combinations are the most effective in different clinical populations? Does working with personal values help to maintain long-term identity changes? Clinical trials are required to evaluate these combinations, which could result in a more robust and adaptable therapeutic model, thereby consolidating DMs into contemporary psychotherapy[28,29]. The development of research on DMs and their incorporation into psychotherapy is an opportunity to transform the understanding of the self and its role in mental health, eventually allowing mind-body mechanisms that sustain self-rigidity to be directly addressed and dismantled[7,13,16]. For these reasons, this type of practice has the potential to work in mental health with deeper and more structural interventions than current approaches that focus on emotional changes or cognitive flexibility[61]. However, it should be noted that there is limited evidence to date, which means that significant challenges are still faced by the clinical implementation of DMs, ranging from the design of therapeutic models aligned with their objectives, lack of robust empirical evidence on their effects, and need to develop rigorous research methodologies[28,38]. To establish the clinical relevance of DMs, randomized controlled trials should be conducted in diverse clinical populations, ideally incorporating comparisons with mindfulness-based interventions and other established therapeutic models[61]. Moreover, it is crucial to use neurophysiological measures (functional magnetic resonance imaging and electroencephalography) and phenomenological methodologies to capture the effects of flexibility and reconfiguration of the self[38]. Therefore, future studies should standardize DM protocols, evaluate their effectiveness in well-designed clinical trials, develop multidimensional measurement tools, and explore the integration of these practices into contemporary therapeutic models. Addressing these challenges would allow for greater evidence of the efficacy of DMs and the possibility that they could play a major role in advances in contemplative psychotherapy, opening new avenues for self-transformation and reduction in psychological suffering.

CONCLUSION

New approaches to mental health focus on transdiagnostic processes to understand the cognitive mechanisms underlying various pathologies. From this perspective, DMs can be viewed as an innovative perspective in contemporary psychotherapy to address mind-body patterns that reinforce identity and psychological inflexibility. This opens up possibilities for developing interventions that profoundly and structurally focus on the mechanisms that sustain psychological suffering beyond emotional regulation and cognitive flexibility. However, implementing DMs in clinical settings presents significant challenges, which require the operationalization of these practices, the exploration of intervention models that incorporate these types of meditations, the design and implementation of controlled clinical trials, and the development of specific tools to measure changes in the perception of the self and its flexibility from a clinical perspective. Facing these challenges with rigor would allow such approaches to be consolidated, and these types of practices to be incorporated as important factors in the evolution of contemplative psychotherapy. Their potential to intervene in the dynamic construction of the self and reduce psychological suffering from its foundations makes them promising alternatives to the emergence of more integrative and effective interventions in the field of mental health.