two kinds of change - coherence therapy · psychology institute learning objective title: handout...

The Key to Therapeutic Breakthroughs:Unlocking the Emotional Brain

Bruce Ecker, MA, LMFT & Sara K. Bridges, PhD

Psychotherapy Networker SymposiumMarch 23, 2013

www.CoherenceInstitute.org© 2013 Coherence Psychology Institute, LLC

Two Kinds of ChangeTwo Kinds of Change

Counteractive,Counteractive,incrementalincrementalchangechange

Partial symptom Partial symptom reductionreduction

Effort to maintainEffort to maintain

Relapses occurRelapses occur

Transformational,Transformational,liberating, profoundliberating, profoundchangechange

Total elimination Total elimination of symptom of symptom

Effortless to maintain Effortless to maintain

Permanent, no relapses Permanent, no relapses

COHERENCEPSYCHOLOGYINSTITUTE

Memory ReconsolidationMemory ReconsolidationThe BrainThe Brain’’s Built-In Process ofs Built-In Process of

Transformational ChangeTransformational Change

•• Identified independently by cliniciansIdentified independently by cliniciansand neuroscientistsand neuroscientists

•• BrainBrain’’s process for erasing ans process for erasing anexisting piece of emotional learningexisting piece of emotional learning

•• Sheds light on diverse theories of therapySheds light on diverse theories of therapy


Overview of WorkshopOverview of WorkshopMORNINGMORNING

•• Main conceptsMain concepts

•• Steps of core processSteps of core process

•• Session videoSession video

•• Specific techniquesSpecific techniques

AFTERNOONAFTERNOON

•• Live sessionLive session

•• Practice sessionsPractice sessions(small groups)(small groups) COHERENCE

PSYCHOLOGYINSTITUTE





Learning ObjectivesLearning Objectives

•• Discuss Discuss three techniquesthree techniques for ushering clients into for ushering clients intodirect, lucid experience of the implicit emotionaldirect, lucid experience of the implicit emotionallearnings learnings generating a majority of clinical symptoms.generating a majority of clinical symptoms.

•• List the List the steps of therapeutic processsteps of therapeutic process that can dissolve that can dissolvean existing, symptom-generating emotional schema.an existing, symptom-generating emotional schema.

•• Define the Define the special type of experiencespecial type of experience that fulfills the that fulfills thebrainbrain’’s requirements for memory reconsolidation.s requirements for memory reconsolidation.


Learn

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ConvergenceConvergenceof clinical observations and memory researchof clinical observations and memory research

19951995 20042004Memory reconsolidationMemory reconsolidation

20122012


Emotional Emotional LearningsLearnings

•• If I show any vulnerability I'll be attacked.If I show any vulnerability I'll be attacked.

•• The only way to get any attention is to doThe only way to get any attention is to dosomething really bad.something really bad.

•• If I try for what I really want, the world willIf I try for what I really want, the world willcrush it, so I better not try for or even feelcrush it, so I better not try for or even feelwhat I really want.what I really want.

♦♦ Anything learned in the presence of strong emotionAnything learned in the presence of strong emotion

♦♦ Nonverbal, implicit knowing Nonverbal, implicit knowing verbal, explicit knowing verbal, explicit knowing






Emotional Emotional LearningsLearnings SCHEMASCHEMA

•• If I show any vulnerabilityIf I show any vulnerabilityI'll be attacked.I'll be attacked.

•• The only way to get anyThe only way to get anyattention is to do somethingattention is to do somethingreally bad.really bad.

•• If I try for what I really want,If I try for what I really want,the world will crush it, so Ithe world will crush it, so Ibetter better notnot try for or even feel try for or even feelwhat I really want.what I really want.

SYMPTOMS GENERATEDSYMPTOMS GENERATED

•• No vulnerable emotion,No vulnerable emotion,lacks intimacy, lonelinesslacks intimacy, loneliness

•• Provocative, aggressive orProvocative, aggressive oremotionally volatileemotionally volatilebehaviorsbehaviors

•• Passivity, underachieving,Passivity, underachieving,emotional disconnectionemotional disconnection


Memory ReconsolidationMemory Reconsolidation

•• Overturned the model of one-time consolidationOverturned the model of one-time consolidationand indelibility of emotional learning that wasand indelibility of emotional learning that wasbased on a century of extinction researchbased on a century of extinction research

•• 19971997––2000: Conclusive detection2000: Conclusive detection

•• Synapses unlock (de-consolidation) for aboutSynapses unlock (de-consolidation) for about5 hours before they re-lock (re-consolidation)5 hours before they re-lock (re-consolidation)


Markers of Schema ErasureMarkers of Schema Erasure

•• Non-reactivation. A specific emotional meaning and bodily emotional activation is no longer triggered by cues.

•• Symptom cessation. Behaviors, emotions, thoughts and somatics driven by that emotional activation disappear.

•• Effortless permanence. Non-recurrence of symptoms and emotional activation continues without counteractive or preventative measures of any kind.


Therapy follows same process & yields sameTherapy follows same process & yields samemarkers as in reconsolidation researchmarkers as in reconsolidation research





Memory Reconsolidation as a FrameworkMemory Reconsolidation as a Frameworkfor Psychotherapy Integrationfor Psychotherapy Integration

Same core process is evident inSame core process is evident inAEDP, Coherence Therapy, EFT,AEDP, Coherence Therapy, EFT,EMDR, IPNBEMDR, IPNB

…and maybe all other therapiesof transformational change?


Core Process for Schema ErasureCore Process for Schema Erasure

Reactivate the target emotional schema.Reactivate the target emotional schema.

Guide a contradictory experience. Guide a contradictory experience. This unlocks (de-This unlocks (de-consolidates) the target schemaconsolidates) the target schema’’s memory circuits.s memory circuits.

Repeat contradictory experience Repeat contradictory experience in juxtaposition within juxtaposition withtarget schema. This re-writes and erases target schema.target schema. This re-writes and erases target schema.

1.1.

2.2.

3.3.


Preparation for Core ProcessPreparation for Core Process

Symptom identification. Symptom identification. What / when: specificWhat / when: specificbehaviors, emotions, thoughts, behaviors, emotions, thoughts, somatizationssomatizations..

Retrieve underlying emotional schema.Retrieve underlying emotional schema.ImplicitImplicit Explicit Explicit

Find contradictory experienceFind contradictory experience..

A.A.

B.B.

C.C.






Therapeutic Reconsolidation ProcessTherapeutic Reconsolidation Process

A.A. Symptom identificationSymptom identification

B.B. Schema retrievalSchema retrieval

C.C. Find contradictory experienceFind contradictory experience

1.1. Reactivate target schemaReactivate target schema

2.2. Evoke contradictory experience in juxtapositionEvoke contradictory experience in juxtaposition

3.3. Repetitions of step 2Repetitions of step 2

V. Verification of erasureV. Verification of erasureCOHERENCEPSYCHOLOGYINSTITUTE

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Juxtaposition Experience ExampleJuxtaposition Experience Example


Staying in one jobStaying in one job makes anyone utterly makes anyone utterly miserable and dead, miserable and dead, just like Dad. just like Dad.

These teachers stay inThese teachers stay inone job and love theirone job and love theirwork and feel so alivework and feel so alivein it.in it.

Symptom: Compulsive changing of jobs for 35 yearsSymptom: Compulsive changing of jobs for 35 years

Target learning:Target learning: Contradictory experience:Contradictory experience:

Learning Learning Objective Objective

Many Therapies Congenial to TRPMany Therapies Congenial to TRP


AEDPAEDP Coherence Therapy Coherence Therapy EFT EFT EMDR EMDR Focusing Focusing Gestalt Therapy Gestalt Therapy Hakomi Hakomi IFSIFS IPNB IPNB NLP NLP SE SE TIR TIR

Such asSuch as……





Coherence Therapy MethodologyCoherence Therapy Methodology

1.1. RetrievalRetrieval into awareness of non-conscious into awareness of non-consciousemotional learningemotional learning//schema generating the symptomschema generating the symptom(TRP steps A-B)(TRP steps A-B)

2. 2. TransformationTransformation (disconfirmation (disconfirmation && dissolution) dissolution) of that learning of that learning//schema via juxtaposition experiencesschema via juxtaposition experiences (TRP steps C-1-2-3-V)(TRP steps C-1-2-3-V)


Explicitly guides the steps of theExplicitly guides the steps of theTherapeutic Reconsolidation ProcessTherapeutic Reconsolidation Process

Symptoms DispelledSymptoms Dispelledby Coherence Therapyby Coherence Therapy


Aggressive behaviorAggressive behaviorAgoraphobiaAgoraphobiaAlcohol abuseAlcohol abuseAnger and rageAnger and rageAnxietyAnxietyAttachment-pattern-basedAttachment-pattern-basedbehaviors & distressbehaviors & distressAttention deficit problemsAttention deficit problemsCodependencyCodependencyComplex traumaComplex trauma symptomology symptomologyCompulsive behaviorsCompulsive behaviorsCouplesCouples’’ problems of problems ofconflict / communication / closenessconflict / communication / closenessDepressionDepressionFamily and child problemsFamily and child problemsFidgetingFidgeting

Food / eating / weight problemsFood / eating / weight problemsGrief and bereavement problemsGrief and bereavement problemsGuiltGuiltHallucinationsHallucinationsInaction/indecisionInaction/indecisionLow self-worth, self-devaluingLow self-worth, self-devaluingPanic attacksPanic attacksPerfectionismPerfectionismPost-traumatic symptomsPost-traumatic symptomsProcrastination / InactionProcrastination / InactionPsychogenic / psychosomatic painPsychogenic / psychosomatic painSexual problemsSexual problemsShameShameUnderachievingUnderachievingVoice / speaking problemsVoice / speaking problems

www.www.CoherenceTherapyCoherenceTherapy.org.org

•• Free articles, case examplesFree articles, case examples

•• Online short coursesOnline short courses

•• Practice manualPractice manual

•• Books Books

•• DVDs of sessions by Bruce Ecker, DVDs of sessions by Bruce Ecker, LMFTLMFT

•• Long-distance training & certificationLong-distance training & certification pgm pgm






Symptom CoherenceSymptom Coherence

Symptom stops happeningSymptom stops happening as soon as the as soon as theunderlying learning or schema that makes theunderlying learning or schema that makes thesymptom necessary, no longer exists.symptom necessary, no longer exists.

Symptom happensSymptom happens because it is because it isemotionallyemotionally necessarynecessary for avoiding suffering,for avoiding suffering,according to at least one implicit learning or schema.according to at least one implicit learning or schema.

Coherence TherapyCoherence Therapy’’s model ofs model ofsymptom production / symptom cessationsymptom production / symptom cessation


Case Example: Case Example: Compulsive UnderachievingCompulsive Underachieving


VIDEO

Case Example: Case Example: Compulsive UnderachievingCompulsive Underachieving


VIDEO





Case Example: Compulsive UnderachievingCase Example: Compulsive Underachieving

Her retrieved, symptom-necessitating schema:Her retrieved, symptom-necessitating schema:

Mom goes into rage if I do something unfamiliarto her, and that rage terrifies me—there’s nothing worse than her rage—

so I better not do anything unfamiliar,I better not apply to be a talk show host,

so I won’t get that rage!The emotional truthof the symptom

Equivalent PhrasesEquivalent Phrases

Symptom-requiring schema or Symptom-requiring schema or ““partpart””

Pro-symptom positionPro-symptom position

The emotional truth of the symptomThe emotional truth of the symptom

for the retrieved emotional learningfor the retrieved emotional learning


In Coherence Therapy,In Coherence Therapy,

retrieval meansretrieval means……

Discovery experiencesDiscovery experiences

++Integration experiencesIntegration experiences

of symptom-necessitating schemaof symptom-necessitating schema







““II’’m still your daughter, and thatm still your daughter, and that’’s whats what’’s mosts most——ahmahm——well, see, itwell, see, it’’s s notnot most important to me. most important to me.””

““Mom, itMom, it’’s s notnot most important to me to be your most important to me to be yourdaughter. Itdaughter. It’’s most important to me to be myself.s most important to me to be myself.””


VIDEO


Juxtaposition ExperienceJuxtaposition Experience

Staying familiar isStaying familiar is most importantmost important because Mombecause Mom’’s rages rage at me is unbearable. at me is unbearable.

Being myself isBeing myself is most important.most important. Mom getting upsetMom getting upset with me is workable. with me is workable.

•• Both feel realBoth feel real•• Both cannot possibly be trueBoth cannot possibly be true

COHERENCEPSYCHOLOGYINSTITUTE Learning Objective Learning Objective


Verification of schema dissolutionVerification of schema dissolution


VIDEO





Coherence Therapy MethodologyCoherence Therapy Methodology

•• Symptom identification Symptom identification AA

•• RetrievalRetrieval of schema that isof schema that is symptomsymptom’’s emotional necessity s emotional necessity BB

•• Find contradictory knowledge Find contradictory knowledge CC

•• Transformation:Transformation: Guide juxtaposition experience 1-2-3Guide juxtaposition experience 1-2-3

•• Verify dissolution of schema V Verify dissolution of schema V COHERENCEPSYCHOLOGYINSTITUTE


Juxtaposition ExperienceJuxtaposition Experience

Staying familiar isStaying familiar is most importantmost important because Mombecause Mom’’s rages rage at me is unbearable. at me is unbearable.

Being myself isBeing myself is most important.most important. Mom getting upsetMom getting upset with me is workable. with me is workable.

Empathy for both sides equallyEmpathy for both sides equallyCOHERENCEPSYCHOLOGYINSTITUTE

Why Juxtaposition Is Non-CounteractingWhy Juxtaposition Is Non-Counteracting

No attempt to build up desired conditionNo attempt to build up desired conditionor suppress the unwanted conditionor suppress the unwanted condition

Client is guided to stay fully Client is guided to stay fully inin touch touchwith symptom-requiring schemawith symptom-requiring schema

Therapist favors neither knowing,Therapist favors neither knowing,empathizes with bothempathizes with both






Discovery ProcessDiscovery Processin Coherence Therapyin Coherence Therapy

•• Goal:Goal: Symptom-requiring schemaSymptom-requiring schema comes into clientcomes into client’’s direct experiences direct experience

•• TherapistTherapist’’s compass:s compass: Listen for / head for Listen for / head for how symptom is how symptom is emotionally necessaryemotionally necessary

•• Work in scene of symptomWork in scene of symptom’’s occurrences occurrence

•• Starting point:Starting point: Identify symptomIdentify symptom in concrete specificsin concrete specifics


Discovery ProcessDiscovery Processin Coherence Therapyin Coherence Therapy

•• No attempts to dispel distressNo attempts to dispel distress

no attempts to get symptom to stopno attempts to get symptom to stopor get symptom-requiring schema toor get symptom-requiring schema tolose powerlose power

•• No counteractingNo counteracting——


Discovery TechniquesDiscovery Techniquesin Coherence Therapyin Coherence Therapy

•• Symptom deprivationSymptom deprivation

•• Imaginal Imaginal interactioninteraction

•• Overt statementOvert statement

•• Sentence completionSentence completion

•• First timeFirst time

•• ExceptionsExceptionsCOHERENCEPSYCHOLOGYINSTITUTE

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Symptom DeprivationSymptom Deprivation

•• ““Imagine actually starting to do the taskImagine actually starting to do the task…”…”

SYMPTOM: PROCRASTINATIONSYMPTOM: PROCRASTINATION

•• Client encounters some form of task distressClient encounters some form of task distress previously avoided unconsciouslypreviously avoided unconsciously

DISCOVERY TECHNIQUESDISCOVERY TECHNIQUES


•• Full unpacking of the task distress then Full unpacking of the task distress then reveals the original suffering and emotionalreveals the original suffering and emotional learning making procrastination necessarylearning making procrastination necessary

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Overt StatementOvert Statement

•• Declarative sentence expressing emerging Declarative sentence expressing emerging emotional truth in gutsy phrasingemotional truth in gutsy phrasing


•• ““If IIf I’’m successful, Dad will tear me down,m successful, Dad will tear me down, so I better so I better notnot actually write my thesis. actually write my thesis.””



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Sentence CompletionSentence Completion

•• Invite client to Invite client to ““try out saying this first halftry out saying this first half of a sentence, and just let it complete itself.of a sentence, and just let it complete itself.””


•• ““The problem is, if I actually write my thesisThe problem is, if I actually write my thesis and successfully complete my programand successfully complete my program—”—”



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two kinds of change - coherence therapy · psychology institute learning objective title: handout...

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