Unlocking the Emotional Brain: Eliminating Symptoms at Their Roots Using Memory Reconsolidation

by Bruce Ecker

After a successful set of juxtaposition experiences lasting only a few minutes, the client finds that the pro-symptom emotional reality or schema no longer has its former emotional realness or grip. Though it had shaped and constrained life for decades, its strangle-hold is suddenly gone and the symptoms it maintained simply cease (unless there is more than one pro-symptom schema, in which case each such schema must be dissolved in order to arrive at symptom cessation).

Can tw or more schemas interact in a way that they reinforce / protect themselves? E.g. two emotional learnings that are based on each other. If so, how to approach the resolution?

Juxtaposition experiences in Coherence Therapy differ fundamentally from the techniques of cognitive restructuring (a major component of cognitive-behavioral therapy; see, e.g., Frojan-Parga, Calero-Elvira, & Montano-Fidalgo, 2009) and cognitive defusion (used in Acceptance and Commitment Therapy or ACT; see, e.g., Deacon, Fawzy, Lickel, & Wolitzky-Taylor, 2011). In both cognitive restructuring and cognitive defusion, the therapist typically describes the client’s symptom-producing beliefs as “irrational,” “maladaptive,” or “pathogenic” and communicates to the client the counteractive intention to oppose and undermine either the content of the beliefs (cognitive restructuring) or their function (cognitive defusion). In contrast and as emphasized above, juxtaposition experiences are guided with no counteractive, invalidating notes whatsoever because such notes foreclose the emotional and neural processes necessary for bringing about transformational change (actual dissolution of symptom-generating constructs, not mere suppression of them). Cognitive restructuring, like cognitive reappraisal techniques, also tends to be carried out through a challenge of existing beliefs in a largely cognitive manner, in contrast to the fully experiential quality of process needed and used in juxtaposition experiences for achieving transformational change of emotional learnings.

while only a few repetitions are often enough to yield lasting dissolution, some pro-symptom schemas have a large contextual range, so they exist in memory in a distributed manner involving several different memory systems corresponding to different contexts of experience. Therefore it is prudent to extend Step 3, the repetitions of the juxtaposition experience, as long as possible and into as many contexts as possible through use of a between-session task.

In counteractive therapies, that imperative emotional necessity would typically remain unrecognized and intact as the therapist works to build up Richard’s trust in his proven knowledge and skills at work, aiming to correct his “incorrect” and “irrational” self-doubts. How likely is that to bring about a lasting shift, given that the underlying, passionate, urgent need for self-doubt remains in force? Counteractive overlays may take effect temporarily, but then they usually prove to be no match for the compelling intensity of the client’s implicit pro-symptom position, and relapse occurs.

Resistance arises sometimes in response to the transformation sequence. Despite well-designed, well-guided juxtaposition experiences, the pro-symptom material can remain in force, as shown in the case of Ted in Chapter 4. This indicates that the process of disconfirmation and dissolution is being blocked by resistance to some reorientation, loss, pain or fear that the client expects, on some level, to result from dissolution of the longstanding pro-symptom model of reality. Dissolution of part of what has seemed to be reality can involve significant emotional adjustments. The dissolution of personal constructs is a top-down process, that is, it is allowed to proceed, or not, depending on whether the emotional results feel tolerable to the client’s emotional brain in all areas, both consciously and unconsciously; the nature of the process is not simply mechanistic or neurological. Any resistance must therefore be sensitively respected and addressed, and in Coherence Therapy this is done by applying Coherence Therapy to the resistance itself: The therapist regards the resistance as a new “symptom” and guides discovery of the underlying coherent need for it by bringing into awareness the specific loss, pain, or fear that is making the dissolution of the pro-symptom schema too daunting to allow. When, as a result of this work, the ramifications of that dissolution do feel tolerable in all areas, the juxtaposition experience is repeated and now dissolution readily occurs. Using...

Another type of complication that can extend the work is a target schema having a large contextual range.

A schema that is strongly relevant in many different contexts becomes part of each separate neural memory network corresponding to each context. Only one context at a time is addressed by the juxtaposition experience that fulfills the transformation sequence in the therapeutic reconsolidation process. Therefore, a schema may be erased in one context but remain in effect for others; complete erasure of the schema across all of its contexts may require separately carrying out the transformation sequence (see Table 3.1 on p. 41) in each context, in order to erase the schema in each memory network that has incorporated it.

Successful completion of the therapeutic reconsolidation process is unambiguously verified by a number of distinct markers that are observed in the final verification stage, as follows. Non-reactivation. A specific emotional reaction can no longer be reactivated by cues and triggers that formerly did so or by other stressful situations. Symptom cessation. Patterns of behavior, emotion, somatics, or thought that were expressions of that emotional reaction also disappear permanently. Effortless permanence. Non-recurrence of the emotional reaction and symptoms continues effortlessly and without counteractive or preventive measures of any kind.

in the course of any type of therapy, whenever we therapists happily observe the markers of erasure without knowing clearly why profound change came about, we can reliably infer that a juxtaposition experience has occurred, unrecognized, and we can then use open-ended enquiry to guide the client to find and articulate the juxtaposition experience explicitly. Doing so has much therapeutic benefit for the client: With explicitness of juxtaposition experiences comes the client’s awareness of unlearning and evolving prior knowledge and of being capable of doing so.

“All this time I thought I was broken. For the first time, I see that I’ve been responding to what I experienced—and responding in a way that now makes total sense. What a relief it is to know I can feel okay about myself!”

All of the problem-defining and solution-defining constructs are emotional learnings that exist implicitly and nonverbally until awareness reaches them and they are felt as emotional truths and then accurately verbalized. The construct selected as the target for dissolution can be in either the problem-defining or solution-defining part of the symptom-necessitating schema.

The unlearning of core, troubling emotional themes is remarkably rich work.

Many techniques for finding contradictory knowledge are used in Coherence Therapy, with over a dozen described in a manual of such techniques (Ecker & Hulley, 2012),

The simple experiential practice of guiding an overt statement of a discovered symptom-necessitating schema—so effective for fostering the integration of the schema, as we saw in Chapter 3—does double duty by also launching mismatch detection, which is a natural function of your client’s brain that in many cases efficiently locates existing contradictory knowledge.

In the brain are specific regions and networks dedicated to detecting inconsistencies between current experience and existing conscious or near-conscious knowledge. This is a familiar experience, as when you encounter an acquaintance and sense clearly that something about his appearance has changed but cannot identify what the difference is, and you feel your mind persistently searching for it until suddenly you realize his moustache is gone. Neuroscientists usually describe this well researched function as “error detection,” but in the more complex realm of psychotherapy it seems more fitting to regard it as detection of inconsistencies or mismatches.

This built-in mismatch detector in a client’s brain is one of the most important resources in the search for contradictory knowledge,

The therapist, enquiring into Ted’s experience of his father, learned that Ted was mired in hurt and bitterness toward his father over what he described as a childhood full of frequent, severe, and rageful criticism, denigration and shaming by him. There was not one expression of fatherly warmth or love that Ted could remember.

This experiential recognition of agency is a basic characteristic of Coherence Therapy.]

According to Mary Main, whose research is foundational for the attachment perspective, an infant or child with a problematic, distress-generating caregiver actively organizes perceptions of this attachment figure’s responses and availability, forms constructs and mental models (schemas) of the contingencies involved, and develops specific strategies of behavioral and emotional self-expression for maintaining some degree of proximity and preventing the caregiver’s particular negative responses (Main, 1995). That process of learning forms the various types of attachment pattern.

The insecure-avoidant type of attachment develops with a mother who is consistently rejecting. The infant learns to expect a rebuff in response to any direct emotional expression of distress or need or any direct physical approach for contact. That learning identifies and models the problem with which the infant is confronted. The infant then also learns that his or her own distress is kept to a minimum by not seeking to communicate or connect, not feeling the need to connect or have attention (accomplished by dissociation or dis-integration of feelings), and actively avoiding direct interactional contact when the mother seeks it. That learning identifies a solution to the problem. The infant has intelligently formed the implicit knowledge that to feel the need for contact or to seek contact is to suffer rejection, aloneness, fear, and helplessness. The solution of avoiding both feelings and contact is an adaptive strategy because in this way the infant has and feels control over keeping his or her own emotional state more or less unperturbed and out of those torments. Thus the learned emotional schema defines both a problem and the solution for that problem—which, as we saw in Chapters 3 and 4, is the structure of emotional schemas retrieved by adults in psychotherapy. In adults, this attachment style is often termed dismissive because in this category people downplay the impact or importance of relational events, have few memories of childhood, and typically give brief r...

The attachment pattern known as insecure-ambivalent or insecure-resistant uses the opposite strategy of maximum emotional display, which is in this case an adaptive solution to a very different problem: a caregiver who is inept and/or self-preoccupied, but has been responsive at times when the infant’s behavior was intense enough to attract the distracted parent’s attention. That pattern of learning is an intermittent schedule of reinforcement, which is known to produce particularly tenacious learning. This infant understands—subcortically—that showing intense neediness and emotionality—such as throwing a tantrum—is what is required, but is not reliable, for getting the self-absorbed parent to respond as needed, and that whether needed interaction occurs at all depends on the infant making it happen. Thus, the infant has, by adaptive necessity, learned a fundamentally controlling, manipulative style of interacting, one aspect of which is ...

A third form of disturbed attachment is termed insecure-disorganized because of these infants’ lack of any adaptive strategy or solution to the attachment dilemma within which they live: a mother or caregiver who behaves in unpredictable, extreme and punitive ways, arousing severe distress in the infant but not providing comfort or help. The insoluble problem facing these infants is that the parent is needed for security while at the same time is perceived as a dangerous source of arbitrary aggression (Main & Hesse, 1990), a condition of “fear without solution” (Hesse & Main, 2000). These infants appear disoriented, frozen, or fearful—coherent but functionless expressions of helplessness and desperation in the face of harm and endangerment with no known self-protective response. The Emotional Coherence Framework emphasizes that although the infant’s response is disorganized and helpless, coherent learning is occurring in the formation of an implicit emotional schema or model of dyadic relationships in which the Other is expected to do extremely hurtful, terrifying things and oneself is completely defenseless. It is through the lens of that expectation that the individual then pe...

As many attachment writers and constructivist psychotherapists have noted, one’s adaptive solutions to attachment problems tend to operate as self-fulfilling prophecies.

The I’m in memory practice is a specialized form of mindfulness applied for bringing implicit memory into explicit awareness. It is often highly useful for facilitating the integration and transformation of emotional implicit memory containing traumatic levels of severe distress, including complex trauma within attachment relationships as well as trauma in other areas. The technique has been shaped into the particular experiential form described above for use in Coherence Therapy, but the essence of the practice—maintaining mindful recognition of being in a triggered state of reactivated emotional memory—has its origins in the human potential and self-awareness movement of the 1970s, to the best of our knowledge. The most obvious effect of this practice, as Regina demonstrated, is to spare oneself the experience of unknowingly projecting the reactivated memory of suffering onto the present external situation and suffering the present situation as if the original raw ordeal were happening again. That would be immersion in a flashback (retriggered traumatic memory) without awareness of it as a flashback. Instead, the I’m in memory practice utilizes each such episode of reactivation for further, mindful integration of the retriggered emotional memory, which in turn allows retrieval of meanings, constructs, and models formed and learned in the original sufferings. These then become targets for disconfirmation and dissolution in juxtaposition experiences, completing the therape...

The rapid reduction of emotional distress observed to result from this practice can readily be understood as a direct effect of these juxtaposition experiences dissolving (a) the view and feeling that something truly terrible is happening right now, (b) the view that the extreme feelings and thoughts I’m having mean there is something terribly wrong with me, and (c) the presupposition (implicit knowledge) that living my life in an internally cut-off, dissociated, dis-integrated state is my only viable option. Being freed of those three states of mind is a big relief.

Siegel teaches a style of informing therapy clients about brain functioning that de-pathologizes symptoms, largely eliminating the stigma and shame that many clients feel regarding their symptoms and fostering the client’s hopefulness and motivation in therapy.

For a highly competitive, perfectionist man—one who prided himself on not making mistakes and on being in total control—blaming himself and regarding himself as inadequate was a suffering that unconsciously was preferable to the suffering that would come with not blaming himself: knowing that life doesn’t allow control over what happens to loved ones.

That was clearly a core, master construct in John’s world. A change in that kind of construct tends to yield many lasting shifts in mood, thoughts, behaviour, posture, and energy. Being a definition or model of how some aspect of the world works, it is a fourth-order or deepest-lying construct in Coherence Therapy’s map of interior depth (Ecker & Hulley, 2000b, 2011).

I didn’t yet understand the connection between not talking and abusive drinking but now I knew that remaining verbally locked, unchanged and unchangeable, unreachable, was a position of safety, power, and autonomy for him.

Disorientation of this kind is witnessed commonly in clients when for the first time they become consciously immersed in pro-symptom material and their own purposeful (though formerly unconscious) agency in maintaining symptoms.

An axiom in Coherence Therapy is that a person cannot move away from a position that he or she does not yet knowingly occupy. In order to move forward, it is necessary first to find and inhabit one’s actual psychological position. Only when “standing in that position” is it possible to step away from it or—in other words—to “change.”

I’ve seen a wide range in the number of sessions required for a lasting, liberating shift to occur. But cases like Debbie’s have taught me to assume from the start of therapy that despite the long history and severity of a client’s symptoms, a real breakthrough can be just a few coherence-focused steps away.

the individual’s detailed, living knowledge of the conditionality of love.