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Coherence therapy

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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. [...]


[...] Therefore, as the term suggests, constructivists believe that, rather than being subjected to an ultimate reality over which they have no control, individuals are actually the primary agents in creating their own reality (Anderson, 1995). A person bases their perception of reality on previous experiences, encounters, and consequences of action. These factors are understood to affect all of the client's future interactions and experiences. Moreover, the schemas or emotional realities underlying experience perception are automatic and unconscious to the client themselves. [...]


[...] Psychology and postmodernism. Thousand Oaks, CA: Sage. Toomey, B. & Ecker, B. (2007). Of neurons and knowings: Constructivism, coherence psychology, and their neurodynamic substrates. Journal of Constructivist Psychology 245. [...]


[...] The coherence principle is implicit in constructivist approaches of all kinds. What differentiates symptom coherence within Coherence Therapy is its explicit implementation and operationalization throughout the entire therapeutic process (Toomey & Ecker, 2007). A conceptual example will help to clarify the complex notion of Symptom Coherence. Imagine an adolescent male, called Joey, who is confronted with bullying at school. For this individual, interpersonal interactions become laden with responses of anxiety, fear, and anger. He may carry these social expectations, or schema, over to future relationships, thereby anticipating a negative interaction with all individuals with whom he comes into contact. [...]

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