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Depotentiation of Symptom-Producing Implicit Memory in Coherence Therapy

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Depotentiation of Symptom-Producing Implicit Memory in Coherence Therapy Journal of Constructivist Psychology, 2008, in press DEPOTENTIATION OF SYMPTOM-PRODUCING IMPLICIT MEMORY IN COHERENCE THERAPY BRUCE ECKER1 AND BRIAN TOOMEY2 1Private practice in psychotherapy, Oakland, California 2Clinical Psychology Department, University of Memphis, Memphis, Tennessee In this second of three articles we suggest criteria defining the optimal use of neuro- plasticity (synaptic change) in psychotherapy and provide a detailed examination of the use of neuroplasticity in coherence therapy. We delineate a model of how coherence therapy engages native mental processes that (a) efficiently reveal specific, symptom- generating, unconscious personal constructs in implicit emotional memory, and then (b) selectively depotentiate these constructs, ending symptom production. Both the psy- chological and the neural operation of this methodology are described, particularly how it defines and follows the built-in rules of change of the brain-mind-body system. On neuroscientific grounds we suggest a fundamental distinction between transforma- tive change, which permanently eliminates symptom-generating constructs and neural circuits, and counteractive change, which creates new constructs and circuits that compete against the symptom-generating ones and is inherently susceptible to relapse. We propose that coherence therapy achieves transformative change through the reconsolidation of memory, a recently discovered form of neuroplasticity, and present evidence consistent with this hypothesis. Subjective attention emerges as a critical agent of change in both the phenomenological and neural viewpoints, profoundly connecting these two domains. The constructivist clinical methodology now tory.2 The goal of this study was to identify the known as coherence therapy and its conceptual brain-mind-body system’s native processes and framework, coherence psychology,1 emerged from rules of change. This was sought through close an ongoing, phenomenological study of psycho- scrutiny of the phenomenology whenever a ther- therapeutically induced change by Ecker and Hul- apy client of Ecker or Hulley had an experience ley (1996). Launched in 1985, this study was car- that led unambiguously to lasting symptom cessa- ried out in the local clinical scientist tradition tion. (Stricker and Trierweiler, 1995), in which a prac- The aim was to let the native phenomenology ticing clinician systematically utilizes his or her guide the shaping of the methodology—that is, to own sessions as an effectiveness research labora- identify the elements of the client’s internal proc- ess of change very accurately in hindsight (if nec- essary by querying the client about it); to discern 1 The name used from 1993 through 2005 was “depth- exactly which client-therapist interaction had suc- oriented brief therapy,” or DOBT. The change to “co- cessfully fostered that change process; to distill the herence therapy” and “coherence psychology” is in- pattern and principle of that interaction into a tended to reflect the central principle of the approach. method that could be applied knowingly with other clients; and to assemble a therapy compris- ____________________________________________ Correspondence: Bruce Ecker, 445 Bellevue Ave., Suite 101, Oakland, CA, USA 94610. 2 Ecker had previously worked in experimental physics E-mail: [email protected] research for fourteen years. 2 Implicit Memory Depotentiation ing only methods selected in that manner, methods ence has very recently developed to the point shaped for cooperating closely with the identified where the correspondences between the reduc- processes (Ecker and Hulley, 1996, 2000a, 2000b, tionist findings of the brain sciences and the holis- 2004). tic phenomenology of psychotherapy can begin to Therapeutic methods not selected-in by this be assessed. According to a neurophysiology re- process were discarded, even if they were deeply searcher at MIT, “Ten years ago we only knew familiar, widely practiced, and time-honored, such what some of the key components of synapses are. as offering interpretations. The working assump- Now we know what most of them are” (Olson, tion was that a therapy formed entirely in this 2004, p. 16). More than 1,000 different proteins way—dictated by the brain-mind-body system’s are active agents in controlling the operation of own terms—would be an optimized therapy that synapses and neurotransmitters. Nobel laureate would yield a marked increase in effectiveness. Eric Kandel states that, “Although we do not have A principal result was the finding that clients’ a complete understanding of how synapses work in-session experiences that resulted in lasting and how they are regulated for plasticity, learning change virtually always stemmed from interac- and memory, we do have a satisfactory under- tions in which the therapist had completely standing” (Olson, 2004, p. 23). stopped trying to counteract or prevent the client’s Attempting to model the psychobiology of symptoms or difficulties. The therapist had fo- optimal therapeutic change is new territory for us, cused instead solely on eliciting from the client for psychotherapy, and for neurobiology, so it is how and why the symptom actually made sense to necessary to create an orienting framework. We have within the client’s world of meaning. This suggest that a defining feature of a maximally ef- hidden coherence of the symptom proved to be fective psychotherapy is an optimal use of the quickly discoverable in most cases, not as a brain’s capacity for neuroplasticity, or synaptic speculation but as a personal emotional truth, even change. We propose a three-part definition of the if the client initially had no conscious notion of it optimal use of neuroplasticity: whatsoever. The observation of consistent, striking effec- (a) Recruitment of the most potent types of tiveness resulting from coherence-focused work, synaptic change, in contrast to the field’s standard, counteractive (b) in the brain regions and neural circuits approaches, led to the development of simple causing symptom production, methods for quickly detecting and revealing the cogent themes and purposes actually maintaining (c) on the shortest timescale neurally possible. clients’ seemingly irrational symptoms. Upon veri- fying in session with virtually all clients the coher- This definition specifies the what, where and ence of their symptoms and problems in living, when that could reasonably be regarded as an op- Ecker and Hulley (1996) defined “symptom co- timal recruitment of neuroplasticity. We will use herence” as a comprehensive model of symptom this definition in this and the following article as a production. gauge of psychotherapeutic optimization. Independently, research in neuropsychology Familiarity with the previous (first) article in has developed a complex knowledge of the brain’s this series (Toomey and Ecker, 2007a) is assumed native processes and rules of change on the reduc- here, particularly the overview of coherence ther- tionistic level of the brain’s physiology, neurons, apy, the definition of symptom coherence and the synapses, genes and molecules. Neuroscientists case example of Carol. Our purpose now is to de- too think and write in terms of “rules” of change, lineate: and they strive to identify the exact physiological and biochemical implementation of those rules. • The brain-mind-body system’s built-in rules If coherence therapy’s account of the brain- for change as defined by coherence therapy in mind-body system’s built-in rules of change is phenomenological terms. correct, it should be possible to demonstrate that • The methodological procedures of coherence these phenomenological rules correspond closely therapy and how they efficiently follow those to neurodynamic rules and processes. Neurosci- rules for change. Implicit Memory Depotentiation 3 • The neural mechanisms of change that are We will describe each of these, first in coher- plausibly recruited by these procedures. ence therapy’s experiential-phenomenological terms and then in terms of their probable neurody- These three strands, woven together, form a namic substrates. unified fabric of neural and phenomonological The immediate accessibility of unconscious knowledge of how the specific implicit memories constructs (Ecker and Hulley, 1996, 2000a, 2004) driving symptom production can be efficiently is apparent in the frequent observation while car- depotentiated, ending production of a wide range rying out coherence therapy that a person can ac- of symptoms reliably and rapidly. cess and directly experience longstanding, non- With few exceptions, we consider only the verbal, fully unconscious, symptom-requiring con- main features of the methodology, not the finer- structs after a few minutes of suitably designed grain techniques and skills involved in its imple- process. The guiding of attention to the uncon- mentation (for a more complete clinical discussion scious material can occur at any time, from the see Ecker and Hulley, 1996, 2000a, 2004). As de- first session; passage of time per se is not an in- scribed in our prior article, the methodology that trinsic requirement for the accessing to occur. defines coherence therapy has three main compo- Even constructs formed in childhood and uncon- nents: The creation of experiences that (1) dis- scious for decades can usually be brought into ex- cover, (2) integrate, and (3) transform pro- periential awareness through methods that accu- symptom positions. For each of these areas of rately bring attention into them. The unconscious
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