What is Facilitating Thought Progression (FTP™)?
Updated: Jul 23
A therapeutic innovation that grew out of neuroscience puts the treatment of mood disorders in the palm of your hand
Americans keep their smartphones close, as any mental health therapist knows from watching patients cradle their devices and check them furtively for messages. The Gallup Poll found that 91% of people between ages 30 and 49 “keep it near almost all the time during waking hours.”
The neuroscientists and digital experts who founded Hedonia™ saw an opportunity in this modern-day penchant, a chance to provide a novel-yet-simple therapy for patients with depression, anxiety, and other mood disorders.
That’s the basis for facilitating thought progression, FTP™ for short. FTP™ is a new adjunct therapy delivered through mobile games that patients play for 15 to 30 minutes daily.
FTP™ is designed to disrupt tormenting thinking patterns, lack of motivation, and the inability to experience pleasure, which are characteristic of mood disorders. And it’s grounded in years of neuroscientific research at Harvard Medical School and elsewhere.
Emerging insight into the causes of depression and anxiety
Neurotransmitters like serotonin and dopamine are the brain’s chemical messengers. They affect mood, sleep, appetite, and memory. Depression, for instance, has long been attributed to a chemical imbalance in the brain.
Medicines for depression known as selective serotonin reuptake inhibitors (SSRIs) work by blocking serotonin reuptake into nerve cells after it carries a message, making more serotonin available to pass messages between nerve cells. SSRIs like Prozac (fluoxetine), Lexapro (escitalopram), and Celexa (citalopram) have proven to improve the lives of many with depression and anxiety.
Over the years, however, it’s become clear to medical and mental health professionals that depression and anxiety are also thought disorders, according to Moshe Bar, Ph.D., the chief scientific officer of Hedonia™ and former director of the Cognitive Neuroscience Lab at Harvard Medical School.
“Ask anyone with depression, and they will tell you: Beyond a negative mood, the sources of their suffering are tormenting thinking patterns, lack of motivation, and lack of pleasure in life,” Bar says.
Thought patterns that characterize mood disorders
Therapists recognize the self-defeating thinking that is typical of people with depression. Bar identifies those patterns as:
A tendency to ruminate, to dwell on negative feelings, their causes and consequences in an inescapable loop.
Narrow and slow-moving thinking.
Inhibition about what they should do or say.
Focusing on little details with difficulty seeing “the big picture.”
Those behaviors are not only observable in patients’ behavior; they also revealed themselves in magnetic resonance imaging (MRI) studies of the brains of participants. In one such study Prof. Bar’s lab found that:
People with depression activate the brain’s network supporting expansive thinking, significantly less than those without depression.
People who ruminate and have constricted thinking experience a “critical loss” in neuron volume in the regions of the brain central to mood and memory.1
“The effect of depression is evident in all levels of brain functioning, from molecules to brain structures, to cognition,” Bar says.
Laboratory studies lead to the development of FTP™
Over nearly two decades, Prof. Bar and other researchers have tested their hypotheses that changing the flow of thought could affect symptoms of depression for the better. In other words, facilitating thought progression could improve individuals’ moods through noninvasive, simple exercises that would encourage them to:
Broaden their thought patterns to be more associative.
Widen their thinking to become more global and “big-picture.”
“Mood affects the way we think. But can the way we think affect our mood?” wrote Prof. Bar and Malia F. Mason, professor in the Columbia School of Business, writing about results of their research that indicated the answer is a resounding, “Yes.”
Mason and Bar measured the moods of two groups of study participants:
One group read chains of words that circulated around the same topic, imitating ruminative thinking. An example of such a “constrained” chain of words: lettuce, tomato, green, head, vegetable, cabbage, carrot, food, leaf, salad, hamburger.
A second group read chains of words in which the associations from word to word expanded and progressed. For example: thread, needle, shot, nurse, drugs, alcohol, wine, cheese, mouse, cat, dog, bone.
In the researchers’ analysis, the participants who read the progressive word chains showed significant improvement in mood when compared with the group whose word chains were constrained.2
In another study, participants were divided into two groups: One group read some text at a slow-to-normal pace, and the other read the same text at an increasing speed. The results: Fast reading significantly improved the readers’ mood.3
Other researchers asked a group of study participants to focus on a global landscape. They asked a second group to focus on small details within the landscape. The first group, which looked at the “big picture,” had improved mood.4
These and other studies, published in peer-reviewed journals, form a body of research demonstrating that facilitating thought progression (FTP™) by expanding people’s thinking patterns and speed can improve their mood — without the cost, risks, or side effects of medications.
Traversing neuroscience research labs to founding Hedonia™
Prof. Bar knew that millions could benefit from FTP™ if he could lift it out of labs and into their hands. He teamed up with Adi Pundak-Mintz, a longtime friend and investor, and Samuel Keret, a founding team member at Waze, a wildly successful app that Google eventually acquired.
For his next project, Keret wanted to do something with social impact. The Waze experience demonstrated how “sticky” apps are ones that people find fun, entertaining, and useful.
A digital application appealing to people with mood disorders could engage them in FTP™ exercises daily for 15 to 30 minutes. Mobile gaming, the Hedonia™ founders concluded, could do just that.
“If you can deliver FTP™ with a game, it will stick,” Keret says. “A game can create engagement and retention. And this is a good way for people who are unmotivated and lethargic to come back and use the treatment again and again.”
Importantly, Hedonia’s FTP™-based games are not meant to spark only moments of feeling good. Instead, through repeated play, they aim to increase the volume of neurons in the cortical regions of the brain that regulate mood and memory. These are the same regions that medications like SSRIs affect.
“So we have a new approach and a new way to make it accessible to patients,” Keret says. “It’s complementary to other treatments, including medication, cognitive behavioral therapy (CBT), and other forms of treatment.”
Bar notes that depression is a worldwide public health problem that affects millions and continues to defy easy answers.
“Depressed people are desperate for solutions. Testing new approaches like FTP™, combining those with therapies already in use, and reporting outcomes will help researchers and mental health professionals understand depression better and ultimately reduce suffering,” he says.
Harel, E.V., Tennyson, R.L., Fava, M. et al. Linking major depression and the neural substrates of associative processing. Cogn Affect Behav Neurosci 16, 1017–1026 (2016). https://doi.org/10.3758/s13415-016-0449-9
Mason, M. F., & Bar, M. (2012). The effect of mental progression on mood. Journal of Experimental Psychology: General, 141(2), 217–221. https://doi.org/10.1037/a0025035
Pronin E, Wegner DM. Manic thinking: independent effects of thought speed and thought content on mood. Psychol Sci. 2006 Sep;17(9):807-13. doi: 10.1111/j.1467-9280.2006.01786.x. PMID: 16984299.
Ji L-J, Yap S, Best MW and McGeorge K (2019) Global Processing Makes People Happier Than Local Processing. Front. Psychol. 10:670. doi: 10.3389/fpsyg.2019.00670