Coherence Therapy, previously referred to as Depth-Oriented Brief Therapy, was developed by Bruce Ecker and Laurel Hulley during the 1980's and 1990's. As a type of psychotherapy borne out of the constructivist tradition, Coherence Therapy's major tenet revolves around the individual as an active agent in creating his or her own reality. In conceptualizing Coherence Therapy, it is first necessary to speak to the major underpinnings of constructivist psychological theories in general. A brief overview of the development and progression of Coherence Therapy, including its current status in psychology at-large, will follow. The focus of the current review will then turn to symptom conceptualization and the structure of one's emotional reality, according to the Coherence Therapy model. Finally, the specific methodology utilized during a typical Coherence Therapy protocol will be presented in detail.
Like other post-modern psychotherapies, constructivist psychology questions the ability to know an ultimate truth, or reality. This is in direct contrast to modernist theories, which were upheld by a majority of philosophers and scientists from approximately 1650 until the 1950's (Kvale, 1992). Modernist theorists supported the existence of an ultimate reality; furthermore they believed that this truth can be revealed using straightforward, singular means. Primary means of uncovering this proposed ultimate truth revolved around scientific empiricism or reason / logic (Kvale, 1992). The postmodern era, which has dominated from the 1950's until present day, refutes the existence of one ultimate truth.
[...] Essentially, the neural process of memory reconsolidation is evoked through the transformative process, resulting in actual rewiring of networks implicated in the client's longstanding emotional truths. Researchers have even been able to link the stages involved in Coherence Therapy with actual change on a synaptic level. Linking concrete physiological processes and relatively abstract psychological concepts underscores the importance of identifying both phenomenological and neural bases for human experience. References Anderson, W. T. (Ed.). (1995). The truth about the truth: De-confusing and reconstructing the postmodern world. New York: Tarcher/Putnam. Ecker, B. [...]
[...] In light of this revelation, Ecker and Hulley focused their efforts on experimenting with various techniques aimed at fostering the client's recognition of their emotional truths (Ecker & Hulley, 1996). While implementing these techniques, it became apparent that recognition of emotional truths underlying problematic symptoms occurred quite rapidly for a majority of clients. Indeed, for many clients this emotional recognition occurred in as few as two or three sessions (Ecker & Toomey, in press). This resulted in the initial term of Depth-Oriented Brief Therapy (DOBT). To date, Ecker and Hulley's DOBT is one of the most widely used and well- respected constructivist therapies. [...]
[...] & Hulley, L. (1996). Depth-oriented brief therapy: How to be brief when you were trained to be deep, and vice versa . San Francisco: Jossey-Bass. Ecker, B., & Hulley, L. (2000). The order in clinical "disorder": Symptom coherence in depth- oriented brief therapy. In R. A. Neimeyer & J. [...]
[...] The goal of integration is transformation of the client's emotional truth from implicit knowledge to explicit awareness (Toomey & Ecker, 2007). Repeated integration exercises help to achieve this goal. The goal of the final stage of Coherence Therapy, transformation, is to eliminate the prosymptom position, thereby taking away implicit emotional truths which warrant the necessity of the problematic symptom (Ecker & Toomey, in press). Through integration, the emotional truth should now be readily accessible to the client as a component of his conscious awareness. [...]
[...] The first stage of Coherence Therapy is referred to as the discovery stage. During this initial phase, the therapist helps the client to identify the emotional reality underlying the formation of the problematic symptom (Toomey & Ecker, 2007). A major ideology guiding Coherence Therapy is the client as expert; he or she teaches the therapist what the prosymptom schema consists of, and how it once necessitated existence of the symptom (Ecker & Toomey, in press). This differs from more traditional in-depth approaches, psychoanalysis for example, which maintain the role of the therapist as teacher, revealing to the client the experiences leading to their symptom formation. [...]
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