Coherence Therapy: What It Is And How It Is Used In Psychology
Coherence therapy is a constructivist therapy model, based on the principle of symptom coherence (which we will explain later). She was born 25 years ago by Bruce Ecker and Laurel Hulley, two renowned psychotherapists.
In this article we will see what this therapy is based on, how it works and what its most relevant assumptions and characteristics are.
Coherence therapy is a type of psychological intervention based on an experiential and constructivist approach. It was created by psychotherapists Bruce Ecker and Laurel Hulley more than 25 years ago (around the 90s). Throughout these years, the therapy has been improved and changes have been introduced.
Constructivism
What is constructivism? First of all, let’s go to its origin. “Constructivist thinking” appeared in the psychology paradigm in 1976, led by Watzlawick. However, it was George Kelly who was the first to talk about personal constructs, twenty-one years earlier (in 1955), when publishing his work The psychology of personal constructs.
Constructivism is one of the orientations of psychology, fundamentally based on how people understand reality, that is, in all those meanings that we attribute to everything we experience. Through this contact and knowledge of reality, we build our vision of it, in a totally subjective way and influenced by numerous factors.
Thus, each reality is experienced in a unique way, and we build this reality as we live and experience. Well, from constructivism we work with all those constructions of the patient, whether they are personal, social, work, relational constructions…
From constructivist psychotherapy, We work to identify these patient constructs, to understand them, to modify them when they are too permanent and rigid, to locate which constructs are perpetuating the symptom, etc. In this way, coherence therapy is based on this type of psychological orientation.
Origin of this type of psychological intervention
The origin of coherence therapy, as we have mentioned, is found in the authors Bruce Ecker and Laurel Hulley, who analyzed a large number of therapeutic sessions with patients; Through them, they observed how certain changes in the patient led to the cessation of symptoms of suffering and discomfort
They also observed that there were a series of “rules” within psychotherapy, which facilitated these therapeutic changes. These changes, however, were lasting and profound. From these observations, Ecker and Hulley developed coherence therapy, based on a non-pathologizing approach to life experiences and situations.
Objective and operation
Through coherence therapy, and based on its constructivist approach, it is intended identify those emotional, unconscious and adaptive constructions that the patient has been developing throughout his life, and that maintain and intensify his current problem (“the symptom”).
All this is achieved through a series of steps, which have the purpose of changing certain emotional learning that the individual has internalized; It is a process of memory reconsolidation Furthermore, neuroscience supports this process, as we will see later (where we will also explain in more detail what this “memory reconsolidation” consists of).
Thus, coherence therapy works through a series of steps; The therapist is the one who guides the patient in these steps, in order to achieve a lasting and therapeutic change in him that eliminates his suffering or his worries (which usually arise from unconscious constructions of reality).
The field of neuroscience, interested in finding out everything possible about the brain and its functioning, produced a series of conclusions that supported the model on which Ecker and Hulley’s coherence therapy is based. We are talking about the process of “memory reconsolidation”, already mentioned.
Specifically, in the year 2000, this process was described from the neurosciences. Is the only neuroplasticity mechanism that allows the brain to permanently modify certain emotional learning that has been very internalized.
Thus, it was seen how this process of memory reconsolidation corresponded in its entirety to the process described from coherence therapy to achieve therapeutic changes and cessation of the symptom.
Assumptions and characteristics
To get an idea of coherence therapy, let’s see what its assumptions and most relevant characteristics are. These are just a few (the most important ones), although there are more:
1. Importance of unconscious constructions
We have already seen what each person’s constructions are, and how they are related to the way in which each person constructs their reality. Thus, coherence therapy gives importance to these constructions, especially those unconscious ones (of which the individual is not explicitly aware, but which interfere with his well-being).
One of the objectives of therapy is to identify these constructions in order to work on them. Thus, we can say that the coherence therapy approach, although constructivist, also has notions of the psychodynamic approach
2. Non-pathologizing vision
Coherence therapy moves away from the psychodynamic approach in its view of symptoms (or its pathologizing approach). Thus, the patient’s symptoms, that is, those that create discomfort and/or suffering, are not conceived from a pathologizing point of view.
In this way, coherence therapy avoids classifying or pathologizing the patient’s behaviors, and focuses on how he subjectively experiences and constructs his reality explicitly (explicit constructions) and implicitly (implicit constructions).
3. Symptoms as personal choices
Coherence therapy understands the patient’s symptoms as a result of personal choices not as a result of cognitive errors (as cognitive therapy would do).
Regarding their characteristics, these choices are personal, generally unconscious, and adaptive. Thus, the individual chooses what he wants at all times, but as a result, symptoms sometimes arise.
4. Principle of symptom coherence
Coherence therapy is based on a principle, called the “principle of symptom coherence.” In fact, the entire therapy revolves around it. This principle has to do with the fact that People need compelling narratives on a conscious and unconscious level (When we talk about narratives, we are referring to personal constructions).
This means that, although the symptoms are perceived as something negative for patients, they are minimally compatible with an adaptive scheme of reality, the way we understand it. But how did this scheme come about? Through its encoding in our implicit memory at some point in our lives.
In other words, and so that it is understood; According to the principle of symptom coherence, the symptom must be coherent with certain adaptive constructions of the individual, necessary for it to be maintained.
5. Cessation of the symptom
The objective of coherence therapy, like that of all psychotherapies, is that the symptom that causes suffering stops conditioning the patient’s life. For this to occur, said symptom should not be required by the person’s current constructions of reality ; That is, when your construction (or construct/s) of reality does not “need” said symptom, it will disappear.
