Coherence therapy: what it is and how it is used in psychology

Coherence therapy is a constructivist type of therapy model, based on the principle of symptom coherence (which we will explain later). It 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 are its most relevant assumptions and characteristics.

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Coherence therapy: what is it?

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 made to it.

constructivism

What is constructivism? First of all, let's go to its origin. The "constructivist thought" appeared in the paradigm of psychology in 1976, by the hand of Watzlawick. However, George Kelly was the first to talk about personal constructs, twenty-one years earlier (in 1955), when he published 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 that 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 lived 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, work is done to identify these constructs of the patient, 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.

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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 gave rise to the cessation of the symptoms of suffering and discomfort.

They also observed that there was a series of "rules" within psychotherapy, which facilitated these therapeutic changes. These changes, yes, 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 from its constructivist approach, it is intended to identify those emotional, unconscious and adaptive constructions that the patient has been developing throughout his life, and that maintain and intensify his current problems ("the symptom").

All this is achieved through a series of steps, which are intended to change certain emotional learning that the individual has internalized; It is a memory reconsolidation process.. In addition, 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 their suffering or their worries (which are usually born as a result of unconscious constructions of the reality).

Support from neurosciences

The field of neuroscience, interested in finding out as much as possible about the brain and how it works, yielded a series of conclusions that supported the model on which Ecker's coherence therapy is based and hulley. We are talking about the process of "memory reconsolidation", already mentioned.

Specifically, in the year 2000, the neurosciences described this process. Is the only neuroplasticity mechanism that allows the brain to permanently modify certain emotional learning which is very internalized.

Thus, it was seen how this memory reconsolidation process corresponded entirely to the process described from coherence therapy to achieve therapeutic changes and the cessation of symptom.

Assumptions and characteristics

To get an idea of ​​coherence therapy, we are going to see what its assumptions and its most relevant characteristics are. These are just some (the most important), although there are more:

1. Importance to unconscious constructions

We have already seen what each person's constructions are, and how they are related to the way in which each one constructs their reality. Thus, coherence therapy gives importance to these constructions, especially those unconscious (of which the individual is not explicitly aware, but which interfere with his welfare).

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 it is constructivist, also has notions of the psychodynamic approach.

2. Non-pathologizing vision

Coherence therapy departs from the psychodynamic approach in terms of its vision 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 constructs) and implicitly (implicit constructs).

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 coherence of the symptom

Coherence therapy is based on a principle, called the "principle of symptom coherence". In fact, all 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 refer to personal constructions).

This means that, although the symptoms are perceived as something negative for the patients, these are compatible, minimally, with an adaptive scheme of reality, the way we have of understand it. But how was this scheme born? Through its encoding in our implicit memoryat some point in our lives.

In other words, and so that it is understood; According to the principle of the coherence of the symptom, the symptom must be coherent with certain adaptive constructions of the individual, necessary for it to be maintained.

5. symptom cessation

The objective of coherence therapy, like that of all psychotherapies, is that the symptom that causes suffering ceases to condition 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 their construction (or construct/s) of reality does not "need" said symptom, it will disappear.