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

This type of psychotherapy is based on a non-psychologizing conception of symptoms.

Coherence therapy is a constructivist model of therapy, based on the principle of symptom coherence (which we will explain below).It is 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.

Coherence therapy: what is it?

Coherence therapy is a type of psychological intervention based on an experiential and constructivist approach. It was created by the psychotherapists Bruce Ecker and Laurel Hulley more than 25 years ago (around the 1990s). Over the years, the therapy has been improved and changes have been introduced.

Constructivism

What does constructivism consist of? First of all, let us go to its origin. Constructivist thinking" appeared in the paradigm of psychology in 1976, by the hand of Watzlawick. However, it was George Kelly who first spoke of personal constructs, twenty-one years earlier (in 1955), when he published his book The psychology of personal constructs.

Constructivism is one of the orientations of psychology, based fundamentally on how people understand reality, i.e., on all those meanings that we have of reality.that is, in all those meanings that we attribute to everything we experience. Through this contact and knowledge of reality, we construct our vision of it, in a totally subjective way and influenced by numerous factors.

Thus, each reality is lived in a unique way, and this reality is constructed as we live and experience it. Well, from constructivism we work with all those constructions of the patient, whether they are personal, social, work, relational constructions...

From the constructivist psychotherapy, we work 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 too rigid, to locate which constructs are too permanent and rigid.to locate which constructs are perpetuating the symptom, etc. Thus, 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 to be found in the authors Bruce Ecker and Laurel Hulley, who analyzed a large number of therapeutic sessions with patients; through them, they observed how changes in the patient resulted in the cessation of symptoms of suffering and discomfort..

They also observed that there were a series of "rules" within psychotherapy that 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 functioning

Through coherence therapy, and from its constructivist approach, the aim is to to identify those emotional, unconscious and adaptive constructions that the patient has been developing throughout his or her life, and that maintain and intensify his or her 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 reconsolidation of the memory.. Moreover, neuroscience supports this process, as we will see below (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 through these steps, in order to achieve in him a lasting and therapeutic change that eliminates his suffering or worries (which are usually born from unconscious constructions of reality).

Support from neurosciences

The field of neurosciences, interested in finding out as much as possible about the brain and its functioning, yielded a series of conclusions that supported the model on which Ecker and Hulley's coherence therapy is based. We are talking about the aforementioned process of "memory reconsolidation".

Specifically, in the year 2000, this process was described from the neurosciences. It is It is the only mechanism of neuroplasticity that allows the brain to permanently modify, in a permanent way, certain emotional learnings that it has deeply internalized.

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

Assumptions and characteristics

To get an idea of coherence therapy, let's see what are its most relevant assumptions and characteristics. These are just a few (the most important), although there are more:

1. Importance to unconscious constructs.

We have already seen what each person's constructs are, and how they are related to the way in which each person constructs his or her reality. Thus, coherence therapy gives importance to these constructs, especially to the unconscious ones (of which the individual is not explicitly aware, but which interfere with his or her well-being).

One of the objectives of the therapy is to identify such constructs in order to be able to work on them. Thus, we can say that the coherence therapy approach, although constructivist, also has notions of the psychodiagnostic approach, also has notions of the psychodynamic approach..

2. Non-pathologizing vision

Coherence therapy departs from the psychodynamic approach in terms of its view of symptoms (or its pathologizing approach). Thus, the patient's symptoms, i.e., 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 the patient experiences and subjectively constructs his or her reality, in an explicit way (constructions of the patient's reality).explicitly (explicit constructs) and implicitly (implicit constructs).

3. Symptoms as personal choices

Coherence therapy understands the patient's symptoms as the result of personal choices, not as the result of cognitive errors.not as a result of cognitive errors (as cognitive therapy would do).

In terms of their characteristics, these choices are personal, generally unconscious, and adaptive. Thus, the individual chooses what he/she wants at any given moment, but as a result of this, symptoms sometimes arise.

4. Principle of symptom coherence

Coherence therapy is based on a principle, called the "principle of symptom coherence". In fact, the whole therapy revolves around it. This principle has to do with the fact that we people need convincing narratives at the conscious and unconscious level. people need convincing narratives at both the conscious and unconscious level (when we speak of narratives, we mean (when we talk about narratives, we mean personal constructs).

This means that, even if symptoms are perceived as negative for patients, they are minimally compatible with an adaptive schema of reality, the way we understand it. But how does this schema come about? Through its encoding in our implicit memoryat some point in our life.

In other words, and in order to be understood; according to the principle of symptom coherence, the symptom must be coherent with certain adaptive constructs of the individual, necessary for it to be maintained.

5. Cessation of the symptom

The goal of coherence therapy, like that of all psychotherapies, is that the symptom causing suffering ceases to condition the patient's life. For this to happen, the symptom must no longer be required by the person's current constructions of realitythat is to say, when his or her construction (or construct(s) of reality does not "need" the symptom, it will disappear.