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

Coherence therapy is a model of constructivist cutting therapy, Based on the principle of consistency of symptoms (which we will explain later). He was born 25 years ago to 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 psychotherapists Bruce Ecker and Laurel Hulley more than 25 years ago (around the 1990s). Over the years, therapy has improved and changes have been made.


    What is constructivism? First, let’s go back to its origin. “Constructivist thinking” appeared in the paradigm of psychology in 1976, in the hands of Watzlawick. However, George Kelly was the first to talk about personal constructions, twenty years earlier (in 1955), when he published his book The Psychology of Personal Constructs.

    Constructivism is one of the directions of psychology, based fundamentally on how people understand realityIn other words, in all these meanings that we attribute to everything that we experience. By this contact and this knowledge of reality, we construct our vision of it, in a totally subjective way and influenced by many factors.

    So, each reality is experienced in a unique way, and we build that reality as we live and experience. Well, from constructivism, we work with all these constructions of the patient, whether they are personal, social, professional, relational …

    Constructivist psychotherapy, we work to identify these patient constructions, to understand them, to modify them when they are too permanent and rigid, To locate which constructions perpetuate the symptom, etc. So, coherence therapy is based on this type of psychological guidance.

      Origin of this type of psychological intervention

      The origin of coherence therapy, as we have mentioned, lies with authors Bruce Ecker and Laurel Hulley, who have analyzed a large number of therapeutic sessions with patients; through them they observed how certain changes in the patient led to the cessation of symptoms of pain and discomfort.

      They also observed that there were a number of “rules” within psychotherapy that facilitated these therapeutic changes. These changes, of course, have been long-lasting and far-reaching. Based on these observations, Ecker and Hulley developed coherence therapy, starting from a non-pathological approach to life experiences and situations.

      Purpose and operation

      By coherence therapy, and its constructivist approach, it is expected identify those emotional, unconscious and adaptive constructs that the patient has developed throughout his life, and they maintain and intensify his current problematic (“the symptom”).

      All this is achieved through a series of steps, which aim to change certain emotional learning that the individual has internalized; it is a process of reconsolidation of memory. In addition, neuroscience supports this process, as we will see later (where we will also explain in more detail what this “reconsolidation of memory” consists of).

      So, coherence therapy works through a series of steps; the therapist is the one who guides the patient in these stages, in order to achieve a lasting and therapeutic change which eliminates his suffering or his worries (which generally arise from unconscious constructions of reality).

      Support for neuroscience

      The field of neuroscience, interested in knowing as much as possible about the brain and how it works, has drawn a series of conclusions that support the model upon which Ecker and Hulley’s coherence therapy is based. We are talking about the process of “memory consolidation”, already mentioned.

      More precisely, in 2000, this process was described by neuroscience. is the only neuroplasticity mechanism that allows the brain to permanently modify certain emotional learning who very internalized.

      Thus, we saw how this process of reconsolidation of memory, corresponded entirely to the process described from the coherence therapy to obtain therapeutic changes and the cessation of the symptom.

      Assumptions and characteristics

      To get a feel for coherence therapy, let’s take a look at its most relevant assumptions and characteristics. These are just a few (the most important), although there are more:

      1. Importance in unconscious constructions

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

      One of the goals of therapy is to identify these constructs so that they can be worked on. Thus, we can say that the approach of coherence therapy, although it is constructivist, he also has notions of psychodynamic approach.

      2. Non-pathologizing vision

      Coherence therapy moves away from the psychodynamic approach by its vision of symptoms (or its pathologizing approach). Thus, the patient’s symptoms, i.e. those which create discomfort and / or suffering, are not conceived from a pathological point of view.

      In this way, coherence therapy avoids classifying or pathologizing the patient’s behaviors, and he focuses on the way he lives and subjectively constructs his reality, Explicitly (explicit constructions) and implicitly (implicit constructions).

      3. Symptoms as personal choices

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

      As for their characteristics, these choices are personal, generally unconscious and adaptive. So, the individual chooses what he wants at any given time, but as a result, symptoms sometimes appear.

      4. Principle of consistency of symptoms

      Coherence therapy is based on a principle called the “symptom consistency principle”. In fact, the whole therapy revolves around him. This principle has to do with the fact that people need compelling stories on a conscious and unconscious level (When we speak of stories, we are referring to personal constructions).

      This means that while the symptoms are perceived as a negative thing for patients, they are compatible, at a minimum, with an adaptive pattern of reality, as we understand it. But how did this pattern come about? Through its encoding in our implicit memory, At some point in our life.

      In other words, and for it to be understood; according to the principle of consistency of symptoms, the symptom must be consistent with certain adaptive constructions of the individual, necessary for the maintenance of the individual.

      5. Cessation of the symptom

      The goal of coherence therapy, like that of all psychotherapies, is that the symptom that causes the suffering ceases to condition the patient’s life. For that to happen, this symptom it should not be required by the actual constructions that the reality person has; that is, when its construction (or constructions) of reality does not “need” this symptom, it will disappear.

      Bibliographical references:

      • Ecker, B. and Hulley, L. (1996). Brief depth-oriented therapy. San Francisco: Jossey-Bass.
      • Ecker, B. and Hulley, L. (2011). Coherence therapy manual and training guide. Oakland: Institute for Coherence Psychology.
      • Jasiński, M. and Feixas, G. (2015). Coherence therapy and its place in the constructivist landscape. Article presented at the XXIst International Congress of Psychology of Personal Constructions. Hatfield: University of Hertfordshire.
      • Jasiński, M., Pau, C. and Feixas, G. (2016). Coherence therapy: a constructivist approach supported by contemporary neurosciences. Psychological action, 13 (1): 131-144.

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