Maio 2009 Entrevista

Sociedade Portuguesa de Psicoterapias 50MINUTES Construtivistas Bruce Ecker

Coherence Psychology Institute

COHERENCE THERAPY Bruce Ecker é Psicoterapeuta em Oakland, Califórnia, co-autor da Terapia de Coerência, e co-fundador com S. Bridges do Coherence Psychology Institute. Em Maio 2009 a Sociedade organizou em Lisboa em parceria com o CPI, o Seminário Internacional e Workshop em Terapia de Coerência. Esta conversa teve lugar na tarde de 20 de Maio.

COHERENCE THERAPY Gregory Bateson, in a very different Bruce Ecker is co-originator of MAIN INFLUENCES way yet again an understanding of the Coherence Therapy and co-author of coherent production of what is visible Depth-Oriented Brief Therapy: How To —that there are unconscious personal Be Brief When You Were Trained To Be A.: You come from a family constructs, orderly knowledge Deep, and Vice Versa, systems training, right? structures giving rise to what looks as well as B.: Partially, but I wouldn’t say irrational on the surface. Paul Dell that was the main orientation. numerous wrote about replacing the concept of articles and A.: Ok, so what would you say are resistance with the constructivist training the main influences you can identify in concept of coherence, and the videos. He Coherence Therapy either theoretically constructivist brief therapies that were has taught or as methodological? so shaped by Bateson’s ideas, the widely in B.: We feel we were standing on strategic and systemic therapies, had a graduate many different shoulders and so I’ll try big impact on our thinking. The fact courses at to name several. There is Carl Jung’s that those therapies avoid the JFK University, professional workshop view of the psyche as coherent, underlying emotional material actually and clinical conferences, and operates although he may not have used that got us focused on how to include that a private practice in the San Francisco Bay Area. This Interview took place in term, but he saw that any symptom material—how to be brief and deep. Lisbon, the 20 May 2009, at the makes sense within the operation of the Gestalt Therapy and other humanistic psyche. The psyche is operating International Seminar & Workshop on and existential therapies made it so Coherence Therapy. More recently he intelligently in producing a symptom. clear to us that you have to work and Sara Bridges co-founded the That view is very influential for us. experientially to get direct access to the Coherence Psychology Institute.

[1] underlying, symptom-producing material What we set out to do was to apply emotional experience, as distinct from a and make it conscious and create shifts. constructivist thinking to the unconscious cognitive insight about that theme and And there is a mentor who Laurel Hulley emotional domain. talking about that theme. A coherence and I both fortunately had in our training: therapist aims in every session to have the Robert Shaw, a therapist who had a COHERENCE THERAPY client speak from and in the live strong, clear vision of the possibility of NOVELTY emotional experience of the relevant very rapidly restructuring a client’s material. So that’s one important relationship to a symptom and to the A.: Still on this topic of how much principle, the principle of accessing by circumstances in which a symptom this system integrates a wide range of subjectively experiencing the material occurs, creating rapid transformational therapies, what’s the novelty that directly. shifts. Coherence Therapy brings to the field of A.: Yes, indeed. psychotherapy? B.: Another is a principle of change, COHERENCE THERAPY B.: One novelty is what I just and it can be put in different ways, but I DISTINCTIVE FEATURES mentioned—it’s a constructivist approach like to put it as: People are able to change to the unconscious emotional world of a position that they experience having, but are not able to change an unconscious A.: Do you see Coherence Therapy people, without using interpretation. In position that they don’t know they have. as an integrated system of psychotherapy fact it’s very important in Coherence or more as an eclectic collection of Therapy for the therapist not to interpret And by “position” I mean a specific methods? to the client. And perhaps the main strategy for living based in a particular B.: I see it as a highly integrated novelty of Coherence Therapy is that it emotional learning or theme. That system and integrative in that it includes enables a therapist to dispel clinical principle indicates the process of many important features of many other symptoms through in-depth, Coherence Therapy, which is to enable therapies, yet not in a patchwork sort of transformational shifts, often life- someone to first consciously experience way. Often the word eclectic is used to changing shifts, in relatively few the themes and purposes that they are in mean a loose, ad hoc patchwork that isn’t sessions. fact living, that are giving rise to really unified, whereas Coherence A.: Right before your eyes. unwanted repeating patterns that we call Therapy is highly unified. The conceptual B.: Right before your eyes, with symptoms or problems. Once these things framework and the methods form a very decisive effectiveness. It’s not a miracle are consciously experienced, they are consistent, non-arbitrary overall system cure, it’s not an easy therapy for some then susceptible to a transformational of therapy. So it’s truly a synthesis in that therapists to learn and it’s not a cookie- shift. it combines many aspects of many cutter approach, not just a standard A.: Ok, great. therapies into a new whole that isn’t just a protocol, in that it requires creativity and B.: There’s another principle for how loose collection. customization and real sensitivity with that shift then happens, and that is also a A.: How much do you consider each client within a well-defined novelty which is at least as important as yourself a constructivist and also we methodology. It appears to be novel in the the ones I just mentioned. These would like to know if you were already a field to enable therapists to have that kind ingrained emotional themes and purposes constructivist while creating this system of in-depth effectiveness reliably in a and strategies of living that are creating of therapy and bringing together these small number of sessions. The field and maintaining a given symptom or various influences. assumes that it requires months or years problem can be dissolved, and then the B.: Yes, we regarded ourselves as of therapy to have such results. symptom ceases immediately. There’s a constructivists as we were forming built-in process in the mind and brain that Coherence Therapy and defining it to COHERENCE THERAPY we identified through studying many profound change events of our clients. ourselves. We were very interested in the GUIDING PRINCIPLES constructivist way of thinking and very What we found is that a transformational shift or even dissolution of these impressed by the constructivist approach A.: Which are the most important to helping people alter their experiential underlying emotional themes occurs therapeutic principles that guide your when the person is directly experiencing reality in a way that would change a integration? Is it possible to say you had symptom. And what we saw was that the the material and simultaneously some therapeutic principles that guide experiences another area of direct constructivist therapies at the time, in the your integration? late 1970s and early 1980s, were systems personal knowledge that is directly B.: Yes, I think we can name a few. contradictory to the knowledge in the that by design avoided in-depth work One is that a true accessing of an with the unconscious. We loved the symptom requiring material. This is what unconscious emotional theme and we call a juxtaposition experience. constructivist way of thinking and yet we strategy for living is achieved by a fully also loved and saw great value in-depth subjective experiencing of that theme and A.: This is a novelty too. work with the unconscious emotional strategy—a kind of immersive inhabiting material underlying a given symptom. or experiencing of that theme as a present B.: That’s a novelty. It has some parallels

[2] earlier in the history of the field both in work needs to be empathic. Empathy can Piaget’s work on accommodation and in be focused in several different places. The Festinger’s work on cognitive dissonance. empathy most familiar to therapists is SEMINAR 2009 When we identified the juxtaposition empathy for the experience of having the process for deep change of emotional symptom, the particular distress or themes, we were surprised to see how it hardship that comes in the experience of extends Piaget’s and Festinger’s findings the symptom. Then there is also empathy to the unconscious emotional world, the for what we call the client’s anti-symptom world of the unconscious emotional position, the wish to be rid of the knowledge structures. symptom, hatred of the symptom, the client’s wish to be rid of the suffering of having the symptom—that is anti- COHERENCE THERAPY symptom empathy. Coherence empathy TRAINING includes those two kinds of empathies, because it’s very important to join with A.: Changing the subject a little bit, going the client’s terrible experience of a to training and supervision. We would symptom and the wish to be rid of it. In like to know how do you conceive it. addition the coherence therapist again and Which are for you the main steps toward again expresses coherence empathy, the making of a good coherence which is empathy for how the symptom is therapist? actually very necessary to have, for B.: Well actually there are a number of reasons that emerge very clearly, despite important components that all work the suffering that truly comes with it. together that a trainee needs to develop A.: How mature or clinically educated skill for. Working experientially is one, a should a coherence therapist be in order very important one and that is, again, to accomplish good sessions? Do you very much about the difference between believe we can teach Coherence Therapy talking about the emotional themes of the to young psychotherapists or do we need client versus having the client actually more experienced ones? drop into the live experience of those B.: It’s learnable by therapists at emotional themes in the room in the every level of experience including moment. Another important training area graduate students who have little or no is the ability to stay coherence-focused clinical experience yet, and we’ve seen throughout the session, and we mean this in various graduate programs. In fact something very specific by that. we hear very inexperienced therapists Coherence Therapy focuses from start to reporting to us words such as “even finish on guiding the client toward and though I’m fumbling around with into the direct experience of how a given Coherence Therapy and really don’t feel symptom is actually emotionally I’m doing this smoothly or know how to necessary to have. So many therapies take find my way, even this clumsy application a rather opposite strategy of trying to help of it is getting remarkable effects”. a person get away from, disconnect from, avoid both the symptom as well as the International Seminar & underlying material generating the symptom and causing all the trouble. Workshop on Coherence Coherence Therapy perhaps Therapy - Lisbon 21-23 May counterintuitively heads directly toward Coherence Therapy is a unified set and into that underlying material of methods and concepts form requiring the symptom, and that’s what individual, couple and family work that enable a therapist to foster we mean by coherence-focused. And so, profound change with a high level for a therapist to maintain that way of of consistency. From the first thinking and that way of listening all session, the work is focused on guiding clients to get in touch with throughout a session turns out to be a ROBIN TICIC hidden, core areas of meaning and special skill. Along with that is the skill BRUCE ECKER feeling that are generating the of communicating what we call presenting symptom or problem. coherence empathy to the client. The SARA BRIDGES Lisbon 2009

[3] B.: It’s applicable with a very wide initially whether the symptom has a COHERENCE THERAPY AND range of people and client populations. It function—is doing something needed—or MANUALS is completely applicable with people who is functionless. There is no way to deduce are not self-aware, growth-oriented, or which type the symptom is, so the A.: You and Laurel Hulley have put a psychologically aware. The therapist coherence therapist does not try to lot of work into writing a Coherence guides the client into having experiences. theoretically figure that out. What Therapy practice manual and I think you The therapist is free to adjust his or her happens instead is that the experiential did a very good job, however manuals style and techniques to the individual process of Coherence Therapy reveals the sometimes have, as you know, the power client and has to come up with ways to underlying material giving rise to the to keep therapists distracted from clients, apply the methodology with the symptom and it becomes apparent which because they want to follow the manual individual. So two sessions that I do in type it is, not speculated or theorized. A and they forget the client, they forget that my office, one after another, can look and simple example is a client whose the map it is not the territory, since feel very different in style and pace and presenting symptom is an inability to fall Korzybski. They get too focused on ways of communicating, and yet I’m asleep—insomnia—and the chronic techniques and don’t see the bigger carrying out the same methodology. With fatigue this is causing. Then it gets picture. How much does Coherence someone who is very self-aware and revealed in therapy that all the time, all Therapy risk being misunderstood as a growth-oriented I’ll work in rather day long, she maintains either obsessive constructivist approach by being different ways than with someone who is thinking or compulsive activity, which are manualized? not, and yet both will be guided into the needed because if she is quiet and sits direct experiences of their own still, she starts to feel intolerable feelings B.: Any system can be misconstrued underlying material. Everyone is living and body memory, stemming from what in all sorts of ways. Coherence Therapy is from their own unconscious themes and she suffered in being molested as a child. a fairly complex system and there’s never purposes—they are right there in the Her obsessive thinking and compulsive any guarantee of it being properly room and we have to know how to get activity are functional symptoms that understood if someone is trying to learn it people in touch with these things. There shield her from feeling her unresolved only from the manual without guidance. are many ways of doing so. ordeals, and those symptoms in turn We emphasize when we are teaching cause the byproduct of being unable to Coherence Therapy that it is not defined COHERENCE THERAPY AND sleep, because sleep requires a quieting of by specific techniques. It is defined by a SYMPTOM FUNCTIONS the mind, which she must avoid. For her, methodology, not a set of techniques, and staying awake and being tired were not within that methodology it’s open-ended A.: This leads us to the question of meeting some need and had no function in terms of what techniques can be used the symptom, the functional symptoms in in themselves. But for some other client, to carry out the methodology. We a Jungian way too. In Coherence Therapy staying awake could have a function in emphasize this and yet we have seen is there the assumption that every itself, such as maintaining hypervigilance. some people take one of the techniques problem has its own pro-symptom It becomes directly apparent from the that we teach and use that one technique position? Putting this in another way: do client’s revealed material whether the over and over in a rather mechanical way, you believe every symptom is always symptom is itself carrying out an thinking this is Coherence Therapy. But functional? Don’t you believe in important function that has great therapists who get training in our program “accidentalism” which stands for the necessity or whether the symptom is a are soon guided out of such hypothesis that diseases are an accidental byproduct of something else which in misunderstandings. modification of the health condition? itself has a function and is doing something necessary. What is called A.: I’d like to come back to your Carl B.E.: Coherence Therapy does not “accidentalism” we think corresponds to Jung influence and ask you, does a good view all symptoms as functional. It what we see as functionless symptoms Coherence Therapy session require a identifies two broad types of symptoms: produced as necessary byproducts of “good client” in the sense of someone functional and functionless. Even functional symptoms that clients might with emotional intelligence and able to functionless symptoms are coherent, not present or even be aware of. follow his own emotional experience. however, in the following sense. A And does it require the client to have a functionless symptom is a symptom that A.: Do you see any risk that clear-cut, functional symptom? In these does not do something of value or get Coherence Therapy loses its power as a two ways, how much do you think some need met. Every functionless method, as a system of therapy and a Coherence Therapy needs special clients symptom exists as a byproduct, an methodology as people get familiar or with specific problems? What is the orderly byproduct of something else that educated in it, or on the contrary? How applicability of this model? is functional and is needed unconsciously do you see this? according to some pro-symptom position of the client. The therapist cannot know B.E.: If you are asking whether Coherence Therapy in some way loses its

[4] effectiveness because clients become A.: Would you say Coherence familiar with how it works, no, definitely Therapy is totally ineffective with some not. I’ve had many clients who get quite problems? familiar with Coherence Therapy and WORKSHOP 2009 come back after months or years to work B.E.: Well, among client populations on something else, as well as clients who at the extreme end of the spectrum of stay with me, with no gap, and work on what is often called character disorder some new problem or symptom after the (either borderline, narcissistic, schizoid present one is finished. And I see no and others) Coherence Therapy may diminishing of the effectiveness as a either be ineffective or the work becomes result of their familiarity with it. In fact, as slow as any other in-depth therapy, one of the nice features of Coherence because these are people who are so Therapy is that the therapist is free to be powerfully organized around not quite transparent and revealing to the accessing their vulnerable, underlying client about how the therapy works and emotional material—powerfully why the therapist is doing what he or she organized around never, ever opening up is doing, if the client has a need to know to that. And again, all the power is in the or to have an explanation. client so if the client’s power is that fully against going there, then the client is A.: This would never be more powerful than the therapist and the unproductive to them. It would never be therapist cannot get the client to do unproductive for the process to reveal… Coherence Therapy. There are methods that can be used to foster even such a B.E.: It’s perfectly ok. It does not client to do the work but the work weaken the process to reveal it. It can becomes very slow, gradual. even help, because some clients respond to the counterintuitive quality of Coherence Therapy and say “Hey, wait a minute! You’re bringing me right toward COHERENCE THERAPY WITH the stuff causing all the trouble, or pain, CHILDREN & ADOLESCENTS or distress, or grief, or fear. Why are you doing that?” You know? “Don’t I want to A.: Do you believe Coherence get rid of all this?” Right? Very sensible Therapy is possible with children and type of conscious resistance. And what I adolescents, and if yes, what does it find to be very reliable for handling that require? question is to give a short, transparent explanation that this actually turns out to B.E.: The answer is yes. It is very be the most effective way to dispel the nicely effective with children and stuff causing all the trouble. I’ve said to adolescents. I’ve had that experience some clients, “You know, for years you’ve myself many times. And what it requires been trying to get away from that is, once again, the use of ways of material, or to avoid it, or suppress it, or communicating that are attuned to that cut it off, or counteract it and it hasn’t individual child or adolescent. So again it International Seminar & comes down to the therapist’s freedom to worked, has it? And it turns out that it Workshop on Coherence adapt or adjust a style of communication, hasn’t worked not because you have Therapy - Lisbon 21-23 May failed to counteract well enough, but style of interaction and specific Coherence Therapy is a unified set because counteracting doesn’t work to techniques that will meet and work with the individual. But yes, I’ve seen of methods and concepts form really solve or transform this stuff. And individual, couple and family work what does work is to go toward it and get powerful transformational effects with that enable a therapist to foster very familiar with it, and then a process children and adolescents. profound change with a high level of consistency. From the first of change will open up that will be session, the work is focused on effective.” And almost without exception A.: How much do you believe they guiding clients to get in touch with clients hear that and are quite satisfied are capable of this movement of changing hidden, core areas of meaning and positions from cortical to limbic in a feeling that are generating the and ready to cooperate. presenting symptom or problem. metacognitive way as we adults are able, and children maybe not so much? How do you see this movement that enables

[5] B.E.: Are you asking about how to future developments. How would you like clinically that the specific process that we understand children and adolescents in to see it being researched besides going call juxtaposition has a major therapeutic Coherence Therapy from the point of under brainimaging, that I know you effect beyond what the common factors view of the brain? would love? Coherence Therapy applied alone can do. If I can give you an to what kind of psychological problems example it may make the point clearer. A A.: Of the brain and these would you like the most being client of mine wanted therapy for the lack movements that Coherence Therapy is so researched, besides procrastination which of confidence and the self-doubt that he skilled to promote. This movement I understand has been studied? always felt at work. He doubted his own between a cortical view, a limbic view, a knowledge so much that he felt insecure cognitive view, an emotional view, the B.E.: A small pilot study, a initial look at and anxious, and he usually stopped juxtaposition—how much can these shifts the how to do Coherence Therapy himself from speaking up and offering his and connections happen in an immature research was done at the University of ideas. And yet in fact he did excellent brain? Florida by Greg Neimeyer and Ken Rice, work and had many successful projects comparing Coherence Therapy with under his belt and was well respected by B.E.: And you’re asking about how colleagues. So how come he is plagued that happens in children? treatment as usual for procrastination. Very small study that got very interesting by self-doubt? Well, we found how come, results, very encouraging results. So because that’s what Coherence Therapy A.: Yes. Aren’t children less capable does. And what he got in touch with was than an adult? hopefully they’ll do a bigger study where the statistics allow for reliability of the that his self-doubt is how he makes sure he is not a know-it-all like his father, not B.E.: On the one hand, in my numbers. What’s most important for Coherence Therapy right now is simply a an arrogant, dominating, hated know-it- experience it’s true that adolescents and all. In other words, as a child he formed children are generally less willing, I’m large enough study that shows a strong effect size with statistical reliability and the schema, the emotional knowledge, tempted to say. Less inclined, less willing that to speak with any authority or to go into emotional states that are gets Coherence Therapy on the map as an empirically verified therapy, whatever confidence is being the same as Dad, and underlying a given pattern or symptom he’ll be hated for it like Dad is. That’s an during a session. Whereas with many symptom area is chosen. Procrastination is a very good one for that purpose. But all-or-nothing schema, which children so adults they are willing to revisit a often form. Well, he made all that situation, imagine a person, say or do what specially interests me, beyond that basic initial need, is research that would conscious, and it felt like a powerful and experiential work that gets them in touch very meaningful realization, but nothing with certain emotions that are underneath. examine what we believe may be the ability of Coherence Therapy to have a changed. For weeks it continued to feel And often in working with children and true and he kept doubting himself at adolescents one encounters a resistance to specific treatment effect. In other words a therapeutic effect that goes significantly work. Then an incident happened at work. cooperating with that kind of process. In a meeting, somebody suggested a key Nevertheless I’ve been consistently able beyond the common factors. An effect separate from the therapeutic effects of idea that solved a big problem, an idea to find ways to engage a child or that my client had just then thought of adolescent in a focus to that same the common factors. And here is why we believe that Coherence Therapy may too, but he had suppressed it as usual. underlying material. A shared recognition This was upsetting, and he looked around that it’s there. I might for example, say to prove to have such an effect. As you know, in Coherence Therapy the client and saw that no one seemed put off— an eight year old girl, “I see, I see you’re quite the opposite—and then he was really mad at grandma for making the car gets directly in touch with a previously unconscious emotional schema, a annoyed and critical with himself, and crash... I see!…”, in such a way that the nothing really changed. In our next child feels that I’m not judgmental, it’s powerful theme and purpose in which the presenting symptom is actually necessary session I used that incident to create a safe and it’s ok with me that she’s mad juxtaposition experience, and as often with grandma. The child may not be to have, whether it’s a behavioural symptom or a mood symptom or a happens, in his responses I could actually going directly into the experience of that see the moments when the old emotional anger in those moments, and yet there is thought symptom. What we observe again and again is that this deep new awareness reality lost its realness. After that he no enough internal accessing of the anger at longer felt that speaking with confidence grandma for Coherence Therapy to of the underlying necessity for the symptom does not in itself put an end to made him the same as Dad or would get happen effectively and for big shifts to him hated for it. His self-doubting simply happen. either the schema or the symptom, no matter how much the common factors are stopped and he was speaking his ideas well supplied, session after session. But comfortably, and this felt like no big deal, COHERENCE THERAPY FUTURE then, as soon as we create a juxtaposition he said. It was immediately upon having DEVELOPMENTS experience, abruptly the schema dissolves the juxtaposition experience that it all —it loses its emotional realness—and the shifted, even though the common factors A.: This leads us perhaps to the final symptom stops happening. It’s so clear were in good supply all along. That’s a topic and theme: Coherence Therapy’s very representative sequence that happens

[6] COHERENCE THERAPY 50 minutes conversation | Lisbon 20May 2009 consistently with Coherence Therapy B.E.: Right. Not at all mainstream. It clients. We think it’s the juxtaposition is quite revolutionary really, relative experience that creates these profound, to the assumptions of the field lasting shifts that end symptoms currently. It’s heretical, in fact, to permanently. suggest that a powerful specific A.: So you would like to see that treatment effect exists. specific aspect researched? PARTICIPANTS QUESTIONS B.E.: Yes. We’d like to see rigorous T.: How do you define a symptom? research verify this clinical observation What’s a symptom? which seems to indicate a treatment effect, namely the transformational effect B.E.: We define the symptom as away what we mean by it. I began using it of what we define as a juxtaposition whatever the client identifies as the because it seems to be the word that best experience. In other words the big experience or situation or repeating describes what’s—its phenomenological changes that we see as a result of pattern that is unwanted and the client — wishes it to stop. And to tell you the truth, Coherence Therapy observably do not T.: Because it’s the action of knowing. result from the common factors alone. even though we use the word symptom You can give those common factors of we wished we had another one-word way B.E.: That’s right. All constructs are used empathy, attunement, good working to refer to the unwanted, repeating pattern as knowings by the brain and the mind. alliance, etcetera, session after session that the client wants to stop, because Knowings of how reality is going to after session and the symptom-requiring “symptom” does have a pathologizing behave. Some therapists just immediately emotional schema does not change. It connotations and we like the whole understand and others are quite confused. keeps its emotional realness and its grip, system of Coherence Therapy to be free T.: I think it’s very like the “structural and the symptom that it generates keeps of pathologyzing. It is a non- coupling” of Maturana. happening. All of the sudden finally pathologyzing system so it’s unfortunate A.: It’s the concept closest to the there’s a juxtaposition experience and it that we’re stuck with this word that has knowings as Maturana sees it.B.E.: I all shifts and releases powerfully. So pathologizing connotations. And I’ve think that within the constructivist that’s the clinical indication that actually spent many minutes or even framework or paradigm, constructivists Coherence Therapy creates this specific hours trying to find a different word and tend to know what knowings means. treatment effect that’s beyond what the cannot! So if you can help us find one Maturana’s framework certainly fits right common factors can do. I would love to that seems as natural to use, you know, I in to thinking that way. But I think see a study identify that in a controlled would appreciate it. knowings is a natural idea to the manner and confirm that. The field has T.: I’ve found that many concepts of constructivist sensibility widely. come to believe that the specifics of Coherence Therapy don’t have the methodology don’t matter much and that translation to Portuguese. Like A.: Thank you so much! it’s the common factors that create nearly “knowings”—we don’t have a word to B.E.: You’re welcome. Thank you. all of the change. We think we have say it. something that goes beyond that. That B.E.: That’s interesting. Even in English, would be very significant to confirm. “knowings” is not in widespread use and A.: This is not mainstream now, this sometimes people don’t understand right suggestion you are making.

A Terapia de Coerência é uma abordagem prática para identificar e NA ESPECIALIZAÇÃO que a dissolver em apenas algumas sessões os Sociedade organiza promovemos a 50 MINUTES construtos não conscientes ou “verdades aprendizagem e a prática de emocionais” que estão por detrás dos princípios e métodos da Terapia de sintomas apresentados pelo cliente. Coerência. CONVERSATION A chave desta abordagem é o uso de Os autores do Modelo colaboram Sociedade Portuguesa de métodos experiencias que criam uma regularmente na especialização consciência quotidiana de como a queixa através de seminários, workshops, Psicoterapias ou sintoma é também uma solução muito necessária para num dilema específico e webinars. Construtivistas apaixonante de segurança, bem-estar ou www.sppc.org.pt justiça

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