The goal of Coherence Therapy (“CT”) is transformational change. In CT, we pick a symptom to work on (e.g. depression, anxiety, addiction, avoidance, etc.), find its root cause, and then engage in real life experiences between sessions which rewire the brain so that the contexts producing the symptom no longer do and the symptom disappears, never to return.
Coherence Therapy is an experiential therapy developed by Bruce Ecker. Here, “experiential” means that the deeply held emotional truth is generally not stored in the forebrain. Emotional truths tend to live as a feeling or a deep unconscious knowing, and not as a rational idea. In CT, we work experientially to access those truths – entering actual scenes from our life in an embodied way, rather than cognitively.
CT was formerly called “Depth Oriented Brief Therapy.” It’s designed to be effective in months of therapy, not years.
We pick a specific symptom to change (e.g. “I’m depressed”).
Discover the deeply held emotional learning that necessitates the symptom. CT holds that symptoms aren’t a sign that we’re broken. At some point, the symptom was a tool we learned to avoid something that would be more painful if we didn’t have the symptom. In discovery, we learn how the symptom was emotionally necessary – how it helped us at some point in our lives. (e.g. “As a kid, I watched my parents live in anguish because they cared so much and always felt like failures for not meeting their own standards. I learned that if I care about things and try, it will always lead to anguish, so it’s critical I not care too much or try too hard.”) *Note: there are causes for depression which are not psychogenic (e.g. genetic causes, thyroid issues, menopause, sleep deprivation). In these cases, psychotherapy is not the first line of treatment.
Coherence therapy leans on a branch of neuroscience called memory reconsolidation to permanently eliminate a symptom by changing the brain’s wiring at the root of the issue. Once we have clarity on the emotional necessity of the symptom, we write it down on an index card, so that we can explore disconfirming knowledge in real life between sessions. Continuing with our example, we have “I learned that if I care about things and try, it will always lead to anguish.” In this case, disconfirming knowledge might be “I can care about things and try, and it does not lead to anguish”. You’d then practice caring about things and trying, and seeing if it leads to anguish. Your brain cannot hold both Context → Symptom Needed and Context → Symptom Not Needed. When you experience Context → Symptom Not Needed, your brain requires and the context no longer produces the symptom.