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Distribution or transmission in any form is prohibited by federal copyright law. Coherence Therapy was formerly known as Depth Oriented Brief Therapy.
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Video Part B (5:40) |
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Transcript of Video |
Commentary: Discovery in Coherence Therapy means eliciting experientially from the client how and why the symptom is actually necessary to have. This underlying material typically emerges in layers. What surfaced first here was, "If I let this connection end, I lose me." The meaning of "I lose me" was then discovered to mean that because the client merges with her couple partner, to lose the Other is to lose herself. (The client's opening references to her "in-utero," "primal" connection were already pointing to the same attachment style.)T: And the fact that that feeling is so, uh, present -- I mean there it was. We gave it a bit of an opening and it welled right up front, in front of all the other things --
Commentary: Though the client already had some awareness that she had been merging while in her couple relationship, she had no awareness that it was her own merging that was making it feel catastrophic and annihilative for the relationship to end, and that this was why she now would not let go, even after two years. The therapist has now begun prompting her to experience this for herself, and the awareness of it is a significant shift for her (though this dynamic may seem obvious to an external observer). With this awareness, the client began to recognize the sense, coherence, and personal agency behind her symptom of staying intensely involved with her ex. This last segment of work was the first integration experience for this client -- an experience of subjectively feeling, knowing and owning her pro-symptom position, beginning the integration phase of Coherence Therapy's methodology.
The therapist's way of prompting this experience was a somewhat too-cognitive, too-verbose approach, yet it was still successful because he worked entirely from an intention to usher the client into experiencing her own symptom-requiring emotional necessity. When the therapist offers words for the client's emerging material, this is done deferentially in Coherence Therapy, as an invitation for the client to feel for herself whether these words fit for her as emotional truth, rather than expecting the client to defer to and adopt the therapist's understanding as correct. The therapist's role in Coherence Therapy is a combination of spelunking guide, anthropologist and process coach who guides the client to illuminate with awareness key parts of her own implicit knowledge.
An alternate way in which the therapist could have prompted the same integration experience is Coherence Therapy's "what's the connection?" technique. The therapist would have said, "I'd like to focus for a minute on two things you've described, in order for you to feel for whether there is a connection between them. What's the connection, if any, between having that in-utero, primal connection, and 'If I let this end, I lose me'?" This technique socratically brings the client's attention to a linkage that the therapist has noticed, but without saying what the connection is, so that the client has the pure experience of discovering and integrating it as her own emotional truth.
Commentary: What is needed now is more integration experiences that will make her new awarenesses stable and continuous, and bring the newly conscious material into the network of conscious living knowledges (creating new neural integration between her implicit and explicit memory networks). The therapist now wants to create an integration experience in which the client will embrace and own her striving to merge with her partner.T: I'd like to try one other little bit that's right on my mind here, given where we've just come to. Um, I'd like you to try out picturing her (C: Mm-hm.) in front of you. And I want you to try out a simple sentence that I'll give you to say, as if to her. So let me know when you have her image there.
Commentary: The therapist has distilled and focused on what he understands to be the client's key attachment strategy that makes her symptom of ongoing, obsessive emotional involvement necessary: her felt necessity of merging. To capture the limbic-level realness of this wish verbally, he has formed a simple trial sentence using non-intellectual, emotionally immediate, highly personal phrasing: "I want to be you."C: No way! I don't want to say that!
Commentary: Once again the client has gone into sharp conscious resistance against the therapist's frontal invitation to feel and inhabit her pro-symptom emotional truth. Owning the disowned is often this unwelcome. The client seems to believe, as most people do, that giving full recognition to an unwanted side of oneself will only strengthen it, when actually the opposite is the case. The therapist will again cooperate with her concern by applying the "only a part" technique.T: Try it on. Because what we've done so far seems to point to that maybe part of you does.
Commentary: Another important integration experience has just occurred: The client knowingly embraced, felt, and spoke from and in her pro-symptom emotional truth, "An important part of me wants to be you; and I don't want to give that up."T: How did you know to do that? You just went through some looking process. How did you, how did you do that?
This is the point in Coherence Therapy at which the client's agency in producing her symptoms of unending attachment begins to be conscious. Her previous sense of powerlessness over these symptoms now begins to be replaced by awareness of her own powerful emotional agenda to merge and remain forever merged with her partner.
Integration experiences build connection between the pro-symptom, unconscious emotional schema and the conscious personality. The integration work literally brings the conscious attention of the neocortex over into the pro-symptom material in the emotional brain. New synapse linkages are created. The client is guided to recognize, feel and own the pro-symptom material both experientially (viscerally) and verbally (neocortically) at the same time. This focus on attending closely to and accurately verbalizing previously non-conscious emotional themes, meanings and adaptive tactics -- the emotional truth of the symptom -- is a major feature of Coherence Therapy. Such work -- facing and feeling avoided emotional meaning -- has been found in various process research studies to be a specific factor that is even more highly correlated with successful outcome than the non-specific common factors of trust, empathy, alliance, etc. (as reviewed in Chapter 6 of Unlocking the Emotional Brain).
Until the client's symptom-requiring position or schema has become routinely conscious in day-to-day living, the therapist has to persist in prompting integration experiences -- finding ways to usher the client into embracing and inhabiting this material. The therapist's own acceptance, validation, and empathy toward the client's pro-symptom position is crucial for the success of this process. This is the coherence empathy that characterizes Coherence Therapy. There must be no counteractive moves by the therapist during the integration work -- nothing that aims to change, stop or fix the pro-symptom material, because such steps have the effect of inducing a re-suppressing of it.
For creating the integration experience just demonstrated, the therapist used the overt statement technique, in which the client makes a short, present-tense, highly personalized I-statement of the emerging pro-symptom material. Having the client speak the overt statement to the relevant person, visualized, is particularly effective. This simple, versatile device is an effective way for clients to connect emotionally with their previously disowned material. Here again the essence of experiential process can be seen -- the direct, subjective inhabiting of emotional truth.
This technique, like other imaginal tasks, works because the brain's limbic system responds almost the same to perceptions coming from the external physical senses and those arising in imagination. It is for this reason that imaginal experiential techniques can effectively elicit and gain access to the emotional implicit learnings or schemas held in the emotional brain's implicit memory systems. When the client said the sentence to her visualized former lover, her limbic system responded as though the interaction were actually occurring.
A certain style of verbalizing is needed for the dual, cognitive-and-limbic illumination that is the essence of an integration experience. An example of this limbic language is the trial sentence, "I want to be you," offered by the therapist. Note again the succinct, present-tense, live-wire phrasing in maximally personal terms (I, me, you), with client speaking from and in the subjective experience of the pro-symptom emotional reality. The phrasing must be utterly candid emotionally, naming the emotional truth with words vivid enough to do justice to the passionate themes and purposes involved. Use edgy, gut-level language of purposefulness and agency, and avoid all phrasing that intellectualizes, factualizes, depersonalizes, or takes a victim position (as in, "she made me angry").
Commentary: The between-session task is a critical part of Coherence Therapy methodology. It is day-to-day awareness of pro-symptom positions that is the real measure of their integration. Most often the task uses an index card for concrete anchoring of the key emotional truths accessed in the session, as well as any instructions for specific tasks or practices. The second session was scheduled for two weeks later.