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Coherence Therapy was formerly known as Depth Oriented Brief Therapy.

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Coherence Therapy Online Training
Course 700
Obsessive Attachment to Former Lover:
Transformational Change of Core Emotional Schemas
Part A
Links to this course's other parts:  Introduction to Coherence Therapy  ·  Part B  ·  Part C
For full coverage of Coherence Therapy methodology, see the Practice Manual and Training Guide.
Overview of Course 700
A woman client is in emotional distress from obsessive preoccupation with her former lover, two years after their 8-year couple relationship ended. Therapist Bruce Ecker, LMFT demonstrates Coherence Therapy applied to this woman's attachment problem. All three phases of Coherence Therapy methodology are shown -- discovery, integration and transformation of the unconscious emotional themes and purposes requiring the symptom. At the tenth session, the client reports that her obsessive attachment has ceased, illustrating (a) the naturalness of transformational change and expansion of well-being that occur in Coherence Therapy, and (b) the complete absence of methods designed to counteract, fix, or override symptoms.

Prerequisite for this course: Familiarity with basics of Coherence Therapy concepts and methodology, available by clicking the link above for the Introduction to Coherence Therapy.

Course videos total 20 minutes and are viewed in three segments (parts A, B and C of the course).
 
Coherence Therapy features you will learn in this course
Identifying the symptom - The eliciting of a specific initial description of client's experience of the problem.
Discovery experiences - How to zero in and swiftly elicit the specific, unconscious emotional themes and constructs generating clients' symptoms, engaging the implicit memory circuits harboring this material.
Integration experiences - How to prompt direct, subjective experience of the symptom-producing material together with verbalization of it for true accessing and the cultivation of day-to-day awareness of it.
Transformation experiences - How to utilize the brain's and mind's native ability to dissolve the emotional learnings maintaining symptoms, ending symptom production and liberating the client from life-limiting projections of the past onto the present.
 
Use of experiential methods - Techniques shown: sentence completion; overt statement; limbic verbalizing; integrative homework.
Client resistance - Use of a simple method that clears the client's sharp, conscious resistance.
The empirical reality of symptom coherence - The methodology reveals the presence in the client of a non-conscious, governing emotional schema in which the symptom is compellingly necessary to have. With conscious experience of this schema, personal agency dawns in relation to the symptom.
The special type of empathy that characterizes Coherence Therapy - Coherence empathy, the communication of recognition and acceptance of the emotional necessity of the symptom.

Video Part A (6:40)
Terms of use of video (previously accepted by you in purchasing this course): You agreed to be the sole viewer of this video on your computer;  not to transfer electronic copies of this video to any other computer or viewer; and to use this video solely for purposes of training and education as a mental health practitioner.
Recommended: Print out transcript (below) to follow as you view video on screen.

 

Transcript of Video

Session 1

T:
Okay. So -- tell me what difference you want this session, or other sessions we do, to make for you.
Commentary: The client's symptom is understood in Coherence Therapy to arise directly from, and so is linked directly to, some well-defined emotional schema or pro-symptom position. Coherence Therapy's discovery process moves along that linkage from the symptom to the underlying material. The first step in that process, and critical for its success, is for the therapist to elicit a clear, concrete description of the presenting symptoms. To do that, the therapist here began with the question, "What difference do you want?" Several other early questions are also useful for identifying what to regard as the presenting symptoms:

· "What's the problem, as you actually experience it?
· "How do you know that the problem is happening?"
· "How will you know if our sessions have been effective?"
· "Please walk me through a good recent example of it happening."
 
C: Um -- I'm trying to sort out the ending of a relationship.

*    *     *

C: The connection we had felt like one of those real primal connections that you don't get any other way except when you're in utero or something [laughs] and, um -- and so that connection -- it's just so painful, you know, to lose that. So that's a real strong, gut feeling.

*    *     *
 
C: I woke up this morning and I called her, and I ended up sobbing uncontrollably, which is not unusual for me. I mean it doesn't happen every day, but, but, dealing with her and dealing with emotional issues I cry pretty readily. And I was just really upset that she didn't understand me.
 
*    *     *
 
C: I want to be more clear for myself about whether I'm trying to let this thing go or trying to revive it...
T: If you got more clear about that, where would that get you? Why is it important to get more clear about that?
C: 'Cause I'm too obsessed with, with connecting with her... I need to live without -- how should I say -- I'm already living without it -- I need to be more at peace with living without that primal connection.
Commentary: In saying, "I need to be more at peace with living without that primal connection," the client was speaking from her anti-symptom position of wanting to stop herself from holding on to that primal connection very powerfully. The very fact that she does hold on means it is compellingly necessary to do so according to her pro-symptom position, yet to be discovered.
 
*     *     *
 
T: Now, so -- in connection again with feeling obsessed. Earlier when I asked you about -- well, first you said you want to get clear about whether you want in or out (C: Mm-hm) as one of the main goals you want out of our work together (C: Mm-hm) and when I asked you about that, it seemed like you went to the next level down about what that means and said, well, you want to stop being obsessed. (C: Mm-hm.) And then, when I asked you about that you said -- well, you said two things that I latched onto. (C: Mm-hm.) You said you want to be more at peace about living without that primal connection. That's what it -- that sounded to me like you were explaining what it would mean to be not obsessed.
C: Yeah.
T: Yeah. So that was another level down into the meaning of not being obsessed.
C: Mm-hm.
T: Good. And also, one other connection was that you said something about, "never again having it be this way." And I wasn't quite clear about what you meant there, and it seemed important.
C: I think I was talking about sort of never again -- feeling that I'm never going to have that kind of connection.
T: With anyone.
C: With anybody again.
Commentary: By persistently clarifying the differences sought by the client, her specific symptoms have been identified: her "primal," "in-utero" connection while in her couple relationship; her ongoing, painful pursuit of her rejecting former lover who left her two years ago; and her sense of powerlessness to exit this ordeal, as she wants to do with the therapist's help.

Exercise: With the client's presenting symptoms identified, what does the Coherence Therapy therapist do next? Answer the following four true/false questions. For each question, click on "TRUE" or "FALSE" to see if your answer is correct.
 
1. Next, the therapist forms a hypothesis about the themes and purposes making up the client's pro-symptom position (psp).
TRUE
FALSE
2. Next, the therapist sets up an experience of some resource that the client has, but has not applied to the presenting symptom or problem.
TRUE
FALSE
3. Next, the therapist sets up an experience for the client, designed to reveal to the therapist how the presenting symptom is necessary to have.
TRUE
FALSE
4. Next, the therapist explores early attachment and separation experiences that underlie her need for "in utero" symbiosis.
TRUE
FALSE

 
*     *     * 
T: So you know what I'd like to ask you to do -- I don't know if this is possible right now, but I'd like to take a look with you if whether it's possible -- I wonder if you could knowingly let yourself sort of flop over into the side of you that feels and says, "No, I will not let go of this."
Commentary: To begin the discovery process, the therapist has invited her to entertain a simple, explicit verbalization of her unwillingness to let go of her ex-lover -- a variation on the overt statement technique so useful in Coherence Therapy. The aim is to usher her into experiences of her own position in which staying attached is compellingly necessary.
C: Okay. You mean, for purposes of today.
T: Yes.
C: Okay.
T: For purposes of exploring that area of your feelings.
C: Okay.
T: Knowing all along that it's not the whole truth.
C: Right.
T: That there's a lot of other sides (C: Right.) that you've been pointing to. But I'm interested in looking into this one right now.
C: Okay.
Commentary: In saying, "You mean for purposes of today," client signaled some discomfort and reluctance over the therapist's invitation to own her pro-symptom position verbalized as, "No, I will not let go of this." To the therapist this appeared to be conscious resistance to "shadow" material -- that is, client is aware of her unwillingness to embrace material at odds with her conscious identity and values. The therapist responded with one of Coherence Therapy's approaches for working with this type of resistance, the only a part technique, which preserves the integrity and dignity of the client's conscious self-image when the discovered material diverges too uncomfortably from it. The material becomes tolerable if both therapist and client share the understanding that it does not characterize the client's whole self. Notice that the therapist respected her resistance and yet did not collude with it. Then, seeing that her resistance eased in response to "only a part," the therapist will next return to inviting her to feel and own this position, by verbalizing even more fully what the client has already communicated of it.
T: So, yeah, see if you can, as you just started to do, sink into that position in you, of, of feeling, "I can't let this go. I will not let this go. This is too -- too valuable, too important, too precious, and I'll never find it again the way I had it." (C: Mm-hm.) And, "No." [Silence.] You look like you're in touch with it. Are you -- is it there? Do you have that?
C: Let's go ahead and let's see -- let's pretend it is and see if I can -- [Laughs].
T: Okay. From that place, I'd like you to finish this sentence: "If I let this end--"  I'd like you just to say those words, hit the blank, and let whatever comes up finish the sentence, without pre-thinking it.
Commentary: With the client skeptical but now willing to open to her compulsively attaching position, the therapist here is using the sentence completion technique in a simple but very direct attempt to bring that position to light. "If I let this end" is a phrasing likely to evoke a response from a position that urgently wants to prevent an ending -- the client's pro-symptom position.
T: [Long pause.] Looks like pre-thinking is going on.
C: Yeah. [Laughs.] I'm sorry. I don't know how to do that.
T: Just start, just mechanically say the words, "If I let this end--"
C: If I let this end--
T: And what's there now?
C: [Pause.] Um-- [Pause.]
T: First thing.
C: [Teary and choked-up.] It's there -- I just have to get to say it. I lose me. [Pause.] Hnh.
Commentary: This moment illustrates the discovery experience that Coherence Therapy produces. As a result of a simple but carefully tailored experiential technique, material that is part of the client's unconscious, pro-symptom position has surfaced into conscious awareness, after initial resistance. "Experiential" work is widely stereotyped as dramatic, cathartic, and a big production, but here the truer nature of experiential work is apparent: It consists of the client simply bringing attention to and feeling an important emotional truth never before visited by conscious attention.

In neurobiological terms, the client's pro-symptom position exists in the emotional brain's implicit memory systems -- such as those in the subcortical limbic system and the right cortical hemisphere -- which form, hold and apply all emotionally intense knowledges and schemas. The discovery work in Coherence Therapy elicits a response from the implicit pro-symptom material that shows up in the client's conscious awareness, revealing the content of the symptom-requiring material. This client's sudden awareness of the sentence-completing words "I lose me" exemplifies the discovery experience.

Commentary: Here, pro-symptom material surfaced in the client's first completion of the sentence fragment. Sometimes several repetitions of the same sentence fragment are needed before pro-symptom elements emerge (typically after some anti-symptom endings, such as, "If I let this end, I'd feel so much better"). Repetitions are best practice also because they often elicit more than one pro-symptom position -- distinctly different ways in which the symptom is necessary to have.

Commentary: An error made by some Coherence Therapy novices is to attempt discovery of pro-symptom material by asking the client explicit questions about how the symptom is necessary to have. This is both futile (the material is truly unconscious, so the client cannot possibly provide useful answers, and some counterproductive responses are likely) and indicates a lack of understanding that the discovery work occurs through prompting experiences (such as by using sentence completion as just illustrated), not through asking cognitive questions.
T: Do you know what that means?
C: I don't know. No, I don't think so.
Commentary: "I lose me" is the emergence of pro-symptom material entirely new to the client's conscious, neocortical framework, so the therapist did not assume that the living meaning of these key words is apparent to her yet. The video will next cut to 7 minutes later in the same session, when the discovery work continued to uncover what "I lose me" means.
 
END OF VIDEO PART A
 
TO VIEW THE NEXT PART OF THIS COURSE, PART B,
CLICK HERE