Prediction Error Minimisation (PEM) as a basis for therapeutic engagement

Malcolm Holmes

status: Under development

September 16, 2023

Note: This paper presents ideas that are in an early stage of development. Significant further research is required, both theoretical and practical.

Executive Summary

Scientific Background

Prediction Error Minimisation (PEM) is a theoretical framework of the brain that suggests the brain’s role is to make predictions as to the meaning of sensory inputs, using prior knowledge, and to minimise the chance of errors in predictions. ref

Errors in prediction occur when additional sensory information contradicts a prediction (think here of the conclusion of a magic trick). Here, this will be referred to as a Prediction Error event.

In her book How Emotions are Made, Lisa Feldman Barrett suggests that PEM applies not just to the external perceptual world, but also to emotions. Rather than there being emotion centres in the brain, that is, places where emotional processing can be located, evidence suggests that emotions too are constructed (the Theory of Constructed Emotion), following the same process of “predicting” that a set of interoceptive sensory inputs “are” a certain emotion. Here, interoception involves the perception of internal sensations, be it our heart beating, sensations in our toes, or emotions happening.

“Spiritual” Shifts

People, going back at least as far as 2,500 years to the Buddha, have described shifts in human experience that, when they occur, typically result in subjects reporting a reduction in suffering - in some cases an eradication of suffering. It is easy to consider such as spiritual ramblings or religious hyperbole. However, there is an increasing body of research that demonstrates that certain spiritual practices do lead to shifts in experience that follow observable patterns.

Spiritual Shifts and PEM

Prediction Error Minimisation theory provides a compelling explanation of these spiritual shifts. If prediction is taking place at all levels within the brain, a prediction error event at a low enough level could cause a major reorganisation that the individual can experience as a shift in perception, in which something that feels fundamental about the experience of life changes.

Not only does this observation explain spiritual shifts, it also offers some intriguing perspectives on how to triggering them. Thus, PEM can form the basis of a therapeutic technique.

Naming and Goal

This paper describes a secular approach to inducing these shifts. It has been named “The Odoki Method”, and is currently under active development.

This method requires language to describe its goal - ideally a name that is both appealing yet not too remote as to be disenfranchising. The name chosen to describe the goal is “Deep Wellbeing”. This name has been chosen on the basis that individuals are likely to be able to relate to “wellbeing”, whether they experience it or not.

It is further clarified as “A form of wellbeing that is independent of external circumstance”. That is, this sense of well is not disrupted by life’s events, however difficult or catastrophic. It is possible to experience significant, even traumatic life events, and still retain this deep sense of wellbeing throughout.

This name is also free of prior associations. Words such as Awakening or even Enlightenment have such varying definitions, some of them humanly impossible to achieve, making them problematic terms for communication. Hence, a new, simpler term is valuable, and “Deep Wellbeing” fits the bill nicely here.

Conceptual Background

Experiental Validation

When someone shows another person a bottle, and says it is a cup, they will likely be quickly corrected. With external objects, validation of predictions can be straightforward. Both individuals are using the same senses to engage with the object.

If an individual asks someone else, “What emotion am I experiencing?”, the process is entirely different. The individual speaking has access to interoception - the vast array of inner sensations relating to this emotion. The person to whom they are speaking only has access to their words, tone, facial expression, etc. Yet, still, validation still occurs. However, this validation will, by its nature, be far less accurate. When one person states that another is experiencing anxiety, for example, there is a far greater chance of them being wrong than would be the case with external objects.

When Prediction Stops

Once a prediction has been made, the brain does not need to put any more effort into further predictions. It is a cup. The brain typically stops paying attention to such things as its colour, shape, pattern, texture. The prediction “cup” allows it to be filled with water for drinking.

This process also happens internally. Once a prediction is reached, e.g. “I am experiencing anxiety”, the brain typically stops predicting. This one is sufficient. This also means no further attention is needed, as enough information is known to proceed. Experience can be described to others, “Hey, I’m feeling anxious”. So the prediction works.

Incorrect Predictions and Suffering

When a prediction is incorrect, it becomes less effective. In fact, this discrepancy can be identified as the cause of our suffering. Imagine trying to drink water with a book. It would be deeply frustrating.

Yet, due to the fact that prediction stops when a seemingly valid prediction has been identified, along with issues with validation described above, incorrect interoceptive predictions tend to persist. As does the suffering that derives from them.

This has a clear and obvious corollary to which we shall give attention later: if invalid predictions cause an individual to suffer, correcting these predictions will remove that suffering.

Prediction Stacks

As well as predictions drawing on sensory experience, predictions are also made on the basis of other predictions. Once a cup has been predicted, drinking can be predicted. Then a meal can be predicted, or a social event, and so on.

Internal predictions are made on the basis of interoceptive sensory experience. Here again, they can also be made upon other predictions. Interoceptive sensations may lead to a prediction of, say, “anxiety”. This may lead to a prediction of “an anxious person”, which leads to “I cannot do this job”, etc.

This stacking of predictions provides a basis for understanding the significant change in experience with spiritual shifts.

In witnessing a trick, laughter may happen, but that’s the full impact.

If, however, a prediction low down in a stack is seen through, this undermines all predictions that have been built upon it. The brain will have a lot of work to do to build fresh predictions, and the results of this refresh is likely to be a significantly different experience of life.

Therapeutic Use

Triggering Prediction Errors

If internal predictions are more likely to be incorrect and incorrect predictions cause us to suffer, it is only natural to think that correcting predictions will reduce suffering.

A natural assumption would be that it is best to prevent these incorrect predictions from happening in the first place. Of course, this does make sense when possible. However, many of the predictions that are at play have been established since childhood. Thus, correction explicitly requires the deliberate triggering of prediction error events. This is not in itself novel. Cognitive Behavioural Therapy takes this same approach, for example through helping patients recognise “cognitive distortions”.

Direct Experience

It is common for psychotherapeutic methodologies to encourage a person to think about their experience. However, the predictions that matter are typically deeper than thought alone can access. To trigger meaningful prediction error events, a person must learn to stay, at least for a short time, in what is described as “direct experience”.

This involves a person staying with sensations, be they physical, emotional or thought. In the case of thought, the person is aware that they are thinking rather than engrossed in the content of the thoughts.

Direct experience is not meditation, although they are very closely related. Meditation is a valuable tool that can help people stay in direct experience. However, it is also common to find meditators of some experience who cannot do it.

Thought Content

When using direct experience, contrary to many therapies, the content of thoughts is not considered relevant. In fact, it can be distracting. Therefore, a therapeutic relationship does not require the person to reveal anything of personal substance. They may share “I am anxious when I meet a friend”, but needn’t share who the friend is, nor anything about their history with this person.

Inquiry into Process

Thus, rather than the content of thought, the practitioner is far more interested in the processes that happen in a person. When a memory is invoked, what feelings occur in the body. How are these experiences labelled? Are those labels valid, or are there more useful ones? And so forth. The nature of the original memory is irrelevant as far as the process is concerned.

The Value of a Guide

Given the persuasive nature of the predictive mind, a practitioner’s role is to guide a person into their own direct experience, countering the person’s natural tendency to switch into thinking. Once there, the practitioner guides the person to attend to possible predictions. The practitioner is valuable here as, again, the persuasive nature of predictions makes it hard for a person to ask the right questions on their own.

The practitioner will typically help guide the person with some exercises, typically selecting exercises based upon what the person reports of their experience.


A hallmark of a prediction error event is surprise. This can come with laughter, or exclamations such as “wow”, or “I didn’t expect that”.

Example and Anatomy of an Exercise

The best way to provide further details of the method is with an example. In this section, commentary on the exercise will be provided in italics.

Imagine a practitioner meets a new person. They share that they would like help with their anxiety.

The practitioner asks them to bring to mind a scenario where they feel anxious. Dr David Burns talks about this as specificity. To be able to meaningfully engage with anxiety, the person needs to choose a specific issue to work with (i.e. in this case, anxiety), and a specific instance of that issue, to make it immediate and present for them.

They are asked to acknowledge when they have identified an occasion when they felt anxious. The practitioner only needs to know that one has been found. Details of it are not relevant as the real work will happen within their inner world.

The practitioner asks them to describe the bodily sensations that they notice when bringing this scenario to mind. It doesn’t matter what the they describes, it gives context to the practitioner allowing them to choose the best route to take.

If the person describes something thought based, the practitioner kindly guides them back to sensation - either physical or emotional. Stories are captivating, yet, thinking about an issue rarely brings about change. Yet, if they can start to notice everything happening in their body, they will likely learn something meaningful. Thus, starting with either physical or emotional sensation is a key starting point.

The practitioner then asks them whether these sensations are pleasant or unpleasant (or neutral). Even if they says something was excruciating, or that it was delightful, the practitioner still gives all options. This leads them to actually check with their experience. The practitioner is deliberately not prejudicing the situation.

Then, having found their physical and/or emotional experience, the practitioner asks them to imagine a scenario where the issue is resolved. When the issue is gone, over, never coming back. Then the practitioner asks how that might feel. Assuming someone can make this imaginative leap (most can), they typically respond with something like relief.

The practitioner then asks the them to further describe this experience, perhaps prompting them with questions about its colour, texture, size. Here, secretly, the practitioner is guiding them particularly towards size. Does this feel small, or large and expansive? People often find their way there. If they don’t, the practitioner may nudge them towards its expansive nature or alternatively adjust their guiding accordingly.

Similarly to before, the practitioner asks them whether this experience is pleasant, unpleasant or neutral. Again, the practitioner gives all options so as not to prejudice the answer. Occasionally, the answer will surprise the practitioner.

Once the person has found the expansive sense when the issue is resolved, they are asked to place the issue at the centre of this expansive space. Then they are asked how this feels. Firstly, asking someone to place one thing at the centre of another requires one to be smaller than the other - this is a subtle hint. People commonly (but again, not always) find that they experience the same difficult issue as being less important than before, even though nothing has been done to change it.

It is common for this exercise to illicit surprise. This would be a prediction error event. They did not expect the issue to become less weighty than it was previously.

At this point, the practitioner can explain to them how they can use this approach for themselves - pointing out the value of imagining what it feels like for an issue to be resolved. Simply being able to imagine an issue being resolved can reduce the magnitude of the issue. It brings a healing element into their life.

Deeper Guiding

The above describes an approach to shifting basic assumptions that can ease immediate suffering. This same approach can be used more deeply to explore more fundamental assumptions, particularly those that centre around various aspects of identity - these being a foundational root to human suffering. More will be written about this on another occasion.

The Odoki Method Toolbox

The Odoki Method has an increasing number of such exercises that can be found on the Odoki Method website under toolbox.


The work presented in this paper has drawn from a wide range of sources, spiritual, therapeutic and scientific.

Scientific Influences

Liberation Unleashed

Liberation Unleashed, was started in 2011. Using a practice described as “Direct Pointing”, it pioneered a web based form of textual guiding. A practitioner would commit to engaging with a practitioner at once per day. The guide would ask questions and set exercises aimed at helping someone see through their own sense of self view. Whilst not expressed in this way, direct pointing provides a valuable tool for triggering prediction error events.

Kevin Schanilec (The Ten Fetters)

the Ten Fetters is a traditional Buddhist teaching, described in the Pali Canon, the earliest of Buddhist scriptures. The sense of self view targeted by Liberation Unleashed maps straightforwardly to the first three of the Ten Fetters.

In 2013, Kevin Schanilec began using the Ten Fetters as a structure for guiding others, using direct pointing, in the same form as used by Liberation Unleashed, but guiding through the remaining seven fetters.

Practitioners of this approach have reported life changing impacts, including the erradication of anxiety; the cessation of fear of death; a deep seated stability and groundedness; a deep seated love for those around the practitioner.

Again, the Ten Fetters provide a suggestion of a set of predictions that people tend to make that, when seen through, reduce the suffering experienced by the practitioner.

Sedona Method

The Sedona Method was created by Lester Levenson in the 1950s, and formulated into a method in 1972. A man with a fascinating life history. His method involves “releasing”, which is a direct method for letting go of unnecessary predictions. He also made some valuable observations about the nature of experience once incorrect predictions have been released, noting that at that point, love is a natural way driving force.

And of course: The Buddha

This section cannot conclude without mentioning the Buddha. The Ten Fetters, as described above, are one formulation of the path to Enlightenment attributable to the Buddha. If the value of the Ten Fetters as a teaching can be explained through PEM, thus so can the Buddha’s path in general, without in any way diminishing its profundity.

Scientific Influences

Lisa Feldmann Barrett

In her book How Emotions are Made, Fedmann Barrett gives a masterful explanation of predictive processing and then applies this to emotion. This work was foundational to everything written in this paper.

Dr Shamil Chandaria

Dr Chandaria has spoken about The Bayesian Brain and Meditation in which he explains predictive processing in depth and how it can be used to explain meditation and spiritual states. This work was found after the material in this paper was prepared, however it provides a delightfully clear rendition of the power of predictive processing in explaining deep wellbeing.

Dr Chandaria focuses on meditation. In this presentation he does not talk about the application of predictive processing in a therapeutic context (i.e. without a client having a meditative background).

Dr Jeffery A Martin

In attempting to study happiness, Martin found himself interviewing 1,200 people with experience of what he described as Persistent Non-Symbolic Experience (PNSE). His book, Finders summarises a lot of his research and provides a captivating framing of what in this paper is described as deep wellbeing.

Whilst Martin’s maps are outstanding, he does not publish the methods he has subsequently used to help people find these shifts - firstly offered with his Finders Course, and after that with his 45 Days to Awakening course.

Therapeutic Influences

Dr David Burns

Dr Burns was an early pioneer in Cognitive Behavior Therapy CBT), working extensively with Dr Aaron Beck, one of the two founders of CBT. In 1980, he wrote Feeling Good, a New Mood Therapy, which played a major part in popularising CBT.

In recent years, he has been developing TEAM-CBT, an extension to CBT that aims to meet the needs of those for whom CBT doesn’t appear to work. His descriptions of his approach to theraphy mirror that described here, in as much as he recognises the capacity for someone to experience the disappearance of symptoms after just a single session. He also points out the falacy of “self”, which maps directly to the first of the Ten Fetters described above.


Created in the 1950s by Eugene Gendlin, a student of Carl Rogers, Focusing offers a valuable approach to experience. It offers a number of valuable perspectives that can be useful helping people alter their approach to their experience.

Examples of Experiential Shifts

Difficulty Sleeping

Someone reported that, prior to their first session, they would take 40-45 minutes to fall asleep. After a single 30min session, this was no longer needed - they were able to fall asleep straight away.


Another person reported that they experienced significant self-judgement. After working with a practitioner, they no longer experienced self-judgement.

Panic Attacks

Another report was that a single session helped them change their mindset and understanding of stress and anxiety, seeing them as temporary. This was a significant contributor to them no longer experiencing panic attacks.


After two sessions with an Odoki Method practitioner, these responses were given:

I have a more positive outlook on the reasons behind some of my anxiety and have applied the exercises on a few occasions.

I’ve become better at noticing certain thought patterns that cause anxiety which has been helpful. I kind of forgot about the lot of the specific techniques.