Achieving Profound Change with Coherence Therapy

Changing Memory

Psychotherapists can help us make breakthroughs in dealing with depression, but often the insights gained during a session don’t lead to permanent change. Why is it that we can’t always put the new insight into daily use and sometimes forget it as soon as we’re out of the room? That’s the problem that a new approach, called coherence therapy, tries to solve.

Like the work that led to focusing oriented therapy, the coherence concept came from the investigation of two therapists, in this case, Bruce Ecker and Laurel Hulley, trying to find out why it was that some of their clients could achieve profound and permanent change in a brief period while most did not. What set these successes apart?

A Pattern of Profound Change

They found a pattern common to all the breakthrough experiences across a wide variety of cases and conditions. Later they found evidence supporting their approach in neuroscience research on the ways the mind could undo emotional memory patterns that had long been thought to be permanent. They summarize this research as well as the steps in coherence therapy in their new book, Unlocking the Emotional Brain.

The first steps in the process they identified sound familiar enough. Clients come in with deep depression or other disorder and feel completely controlled by it. The first step is to work with the client to get them to reproduce the experience of depression by stepping into a typical situation that seems to trigger the problem, or simply relive a moment to capture the full effect of depression if there is no triggering mechanism.

Reliving rather than talking about the symptoms is important to bring the client into the deepest feelings of the experience and to allow the therapist to see behaviorally, emotionally and intellectually exactly what happens.

The idea is that the depression is part of a well-defined pattern of response that the client developed in early life as a protective mechanism to deal with emotional pain, rejection, abuse, isolation or whatever the situation might have been. That’s a familiar concept in my own therapy, but the difference is that I usually describe my depression in a detached way rather than reproduce and relive the experience.

By working with clients in re-entering the dramatic experience of the problem, the therapist tries to drive home why this behavior feels so inevitable. What purpose does it serve? What greater problem is avoided by the intervention of depression and all its debilitating symptoms?

How Depression Can Serve a Purpose

The first breakthroughs come when clients can grasp on an emotional level that this is purposeful behavior, a coherent, well-constructed response to a type of situation and potential danger that first arose in early years. The pattern established itself spontaneously without conscious effort and entered a deep level of implicit memory below ordinary awareness.

That is why it seems so overwhelming, as if it were imposed from without, a force the person can’t control. Now they can see that there is a form and point to the pattern. The benefit of protection from whatever the threat might be, however, comes at the high price of crippling life in many other ways.

In one case, Ecker describes a woman who had shut down completely in deep depression and no longer felt any connection to her family. He worked with her through three or four sessions to relive a series of experiences until she could uncover the core purpose of this behavior going back to early life. At first, shutting down emotionally seemed to be a response to protect her from the hostile reactions of her parents. It was a way of keeping herself safe, and realizing this marked a turning point for her. Yet there was a lot more to it than that.

By revisiting other memories and also testing her reactions to sensitive situations in the present, she went deeper until confronting the basic problem of having no boundaries with her parents. Her mother seemed to take anything of emotional value from her and appropriate it as her own. It wasn’t until she hit that ultimate problem of protecting her sense of who she was as a person that something shifted in a lasting way.

To be able to see depression as a coherent strategy for protecting her selfhood made sense of the behavior but also made it unnecessary. She had achieved a distance from depressive behavior so that she could plainly observe how and why it had served her but also see the unacceptable loss of satisfaction in life that the strategy entailed.

Change Takes More than Talk

The way therapists usually try to change a pattern like this is to help the client develop a counteracting one that is much more beneficial. The idea is that with practice these new patterns can take the place of the old. However, this approach often doesn’t hold up over time. Relapse is common because the old pattern, still present and deeply embedded in implicit memory, reasserts itself and seems to obliterate even the recollection of the new strategy.

Ecker found that the necessary step was to help the client have experiences that prove on an emotional level to the client that the old schema is no longer necessary or helpful, that disproves its value completely. In that way, and only in that way, can the implicit memory link that unconsciously drives behavior be erased.

It’s like the memory reprocessing in EMDR, and Ecker sees coherence therapy as a framework that can be applied through a number of other therapeutic methods that have emerged in the last twenty years, including EMDR.

Ecker describes in several case studies that clients like the depressed woman may have to go through many breakthrough experiences before reaching the deepest pattern that reveals the original motive for a protective strategy. Then the client, with the new understanding of the behavior, needs to have new experiences, whether in the therapist’s office or in daily life situations, that dramatically bring home the realization that the pattern is pointless.

Ecker believes that most breakthroughs in therapy don’t last because they lack the necessary follow-up to reprocess the deeply embedded memories they challenge. They take place initially during an altered state of heightened consciousness and awareness, arrived at with the help of a therapist. To take a deeper hold by erasing old remembered patterns, clients need to experience the change as part of everyday life as well.

He also emphasizes the importance of imprinting the new knowledge by having the client come up with phrases that make emotional sense to him and repeat them several times. He has clients write down these phrases to keep them visible during the day so they can be repeated and referred to often. We’ve all had the experience of forgetting something of this sort that was so powerful when grasped in a therapy session. Ecker’s methods address that problem.

When the deepest breakthroughs occur and are reinforced by everyday experience, then clients see the old patterns as completely meaningless, bizarre, even funny. Those behaviors have completely lost their links to the deepest levels of emotional remembrance and no longer have an unconscious hold on their lives.

This is powerful stuff that makes a lot of sense to me. I continue to be plagued, even now, with behavior patterns that seem to control me and go directly counter to the values I hold about the life I want to lead. The coherence approach may be another powerful tool for gaining a greater sense of self-mastery, the feeling that I am choosing what I do rather than being driven by unconscious forces.

To what extent do you feel locked into patterns of behavior that never change? How have you been able to deal with them?

15 Responses to “Achieving Profound Change with Coherence Therapy”

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  1. Courtney says:

    This is rather simple in concept. With ordinary therapy, therapists use talk therapy to help the client gain insights, or they dictate how the client is to change their behavior. These strategies can sometimes work. However, when there are false beliefs involved, they are not enough.

    With Coherence Therapy, there are 2 types of “positions” about the problem the client has. There is the anti-symptom position, and that one needs no therapy. If you are anxious, depressed, phobic, or unmotivated, and you seek therapy, you are acting appropriately in that aspect. You don’t want the condition as it is wrecking your life, and a person who’s less than sane would need to be told they have a problem.

    The important issue is the hidden pro-symptom position. There has to be a reason why the person wants the symptom. That is some belief that makes the symptom necessary. For instance, during a violent attack as a child, you may learn the maladaptive belief that the entire world is a really bad place or that the entire world conspired to cause that to happen and that you were singled out. So if you feel the whole world hates you, you’d grow into an angry individual. You may even view your unproportionate anger to situations and the consequences as further evidence that the world is out to get you. So in therapy, you’d need to let your defenses down, even using the energy of the anger to get you to the root belief that is driving it. Then, you’d have to do something counterintuitive of stating the belief as it is without editing and perhaps using the language you used at the time of the trauma. And you’d have to work with that statement to get it into the conscious memory. So the person might say, “I am very mad that the world hates me and is set up against me!” But the client has to get to that spot themselves. The therapist can ask probing questions to get the client to the place of the trauma. But the client has to make the discovery, and it needs reinforcement.

    Then in the future, when triggering events come, the client is to make connections to the underlying belief. Then they will realize that it doesn’t fit the situation at hand. Then the reactivity to the situation goes away or comes from a different faulty core belief that needs to be addressed next.

    It is important to not clean up the core belief when it comes up, since denying the belief won’t make it go away. You have to get on board with the emotional mind and let the emotional truth come up. The nice thing about Coherence Therapy is that it is generally gentle. So you can get to the truth without fully reliving any trauma. It can be compared to judo, while something like Rational Emotive Therapy would be more like karate.

  2. Robert says:

    It seems taking on a Coherence treatment would be enormously task in i’ts self.

  3. Tan says:

    I can totally relate to the challenge of sustaining the new insights gained in a psychology session. Below is my experience in turning a rational awareness of a problem into ‘feeling’ and ‘living’ the new insight from the very first day, and further re-inforcing it every day after my first ‘awakening’ day.

    I was living with childhood attachment disorder for the first 30 years of my life. I didn’t experience depression, but I think the process would just work for depression and other types of behavior patterns as well.

    I first realized my attachment disorder (formed in childhood) when I was experiencing a major shock after a relationship breakup and was in the process of looking for an ‘answer’ for the situation. To describe it shortly, I grew up never experiencing a sense of emotional closeness with my mom, who was particularly hostile and aggressive towards me, especially when she was upset. My dad never stood up for me even when I felt most wronged and hurt by my mum. I felt all on my own. Out of my natural inclination, I stood up and fought against my mum every single time I felt hurt and wronged by her. I even entertained the idea of running away from home quite a few times but the unknown world outside home was too scary for me as a kid back then to ever dare to make it happen. The whole thing hardened me in many ways.

    During my teenage years and many years into my adulthood, the way I learnt to ‘feel’ towards my mum is the main, and perhaps the only way I know how to ‘feel’ towards another human beings. I realized my entire life I never ever knew what ‘love’ means, what deep connection between 2 human beings feels like and tastes like.

    When I first rationally recognized this pattern and even how and why it was formed, it was a critical first step. But how could I go about ‘feeling’ and ‘living’ the new truth? ‘Knowing’ and ‘feeling’ are two very different things.

    I decided to adopt the ‘sentimental’ approach to start with and keep my momentum. I would allow myself to look at anyone I was speaking to and internalize it as if I wanted them to be the first person to show me how ‘love’ would feel like. I continued to rationally allow and remind myself stay fully open to the possibility that true connection between 2 human beings is possible.

    The 2nd approach I adopted was trying to learn to (quickly) internalize the new truth from the experiences of the other people. I hungrily looked for detailed descriptions people put up online about their experiences of deep connection with someone. I tried to imagine and internalize what they say, try to understand and feel for myself how that bond would actually be like, and how I would develop it for myself.

    Basically, this was similar to a muscle training exercise. I reminded myself to keep working on it to build it up because initially the muscle is really weak and it could be easy to lose the momentum.

    The result was fast and significant. I managed to ‘feel’ the new truth from the very first day of rational realization and continue to further re-inforce it every single day since then.

    I need to stress the critical importance of maintaining a sincere desire and hunger to change during the entire process.

    Also, what works would depend on the causes of the problem and each person’s ‘attachment disorder’ type. My approach briefly described above might only work for people with similar personal makeup and personality type. For example, if someone also experienced a lack of emotional safety and closeness from parents but instead of standing up to fight for themselves and becoming hardened during the process, they adopted the opposite coping strategy, running away and hiding and becoming extremely ‘scared’ and vulnerable to people, most likely they would need a different reasoning mechanism to overcome the disorder. However, my 2 steps-approach above would still be applicable.

    • Anonymous says:

      This is awesome! Especially this: “I need to stress the critical importance of maintaining a sincere desire and hunger to change during the entire process.”

    • Horst says:

      Great approach Tan! I can relate very well to your experience and am experimenting in similar way. Will be good to hear of you looking back over this, whether your 2 step-approach made a lasting difference to develop your capacity to feel positive towards others. Good read, rich in meaning for me.

  4. I’ve undergone Coherence Therapy and it is great.It is important to put into practice what we have learned in the therapy.I agree.This is a powerful tool for gaining a greater sense of self-mastery, the feeling that I am choosing what I do rather than being driven by unconscious forces.I highly recommend this.

    • John Folk-Williams says:

      Thanks for letting us know that this has worked so well for you. Have you written anything about the experience that I could refer people to?


  5. Donna-1 says:

    What kind of “phrases” that one might repeat to one’s self? Are you talking about “positive thinking” type of phrases? I think I understand what you are describing in these therapeutic sessions. And certainly I would think this is the goal of all good therapy, isn’t it? Getting a grasp on what caused the initial problem and seeing how it is still affecting the person’s life? And this would lead one to recognize a certain regression into past ways of dealing with problems that do not translate well into the present, and thereby break the cycle? It seems to me the problem is finding a therapist with whom you can be totally honest and having courage to try something new. Or am I missing the point?

    • John Folk-Williams says:

      Hi, Donna –

      They’re not talking about positive thinking or affirmation phrases. The words have to be the client’s words that come directly out of the experience they’re dealing with – it sounds like the way you try to match words to the felt sense in focusing until you get something that feels right. The method Bruce Ecker describes is like all good psychodynamic therapy – it’s the follow-up experience that makes all the difference. That was the distinctive feature they found from studying hundreds of cases – the part that led to lasting change. If you check out the website, there are some case studies you can download that make this much clearer.


  6. This addresses my main concern with therapy, and makes a lot of sense. I will explore this further! Thank you 🙂

  7. Judy says:

    Ah, yes – breaking those old patterns. I think the biggest obstacle for me is my huge fear of anger – either in myself or anyone else. It keeps me from being direct with people and becomes a heavy burden when it’s my anger. I think I talk myself into thinking I don’t have a right to be angry or to want what I want, etc. I don’t do very well at handling this at all, am still working on it. I’m doing EMDR and I think I’ll get to the bottom layer eventually. It all sounds so clear during a therapy session, but then in real life I freeze up. It’s hard to imagine this ever seeming funny any time soon.

    • John Folk-Williams says:

      Hi, Judy –

      The problem about it being clear in therapy but not later is what Bruce Ecker is trying to get at with the coherence approach. It must be the central problem with all psychotherapy – why don’t you actually change after making these breakthroughs in a great session? It’s worth reading the case studies at their website. They have several examples of the “disconfirming” experience that needs to follow the insight.


  8. Evan says:

    This sounds like basic third force psychotherapy. My favourite being gestalt.

    This doesn’t mean that it isn’t excellent, just that it is far from new.


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