The Key to Therapeutic Breakthroughs: Unlocking the Emotional Brain Bruce Ecker, MA, LMFT & Sara K. Bridges, PhD

Transcription

1 Two Kinds of Change Counteractive, incremental change Partial symptom reduction Effort to maintain Relapses occur Transformational, liberating, profound change Total elimination of symptom Effortless to maintain Permanent, no relapses Memory Reconsolidation The Brain s s Built-In Process of Transformational Change Identified independently by clinicians and neuroscientists Brain s s process for erasing an existing piece of emotional learning Sheds light on diverse theories of therapy Overview of Workshop MORNING Main concepts Steps of core process Session video Specific techniques AFTERNOON Live session Practice sessions (small groups)

2 The Key to Therapeutic Breakthroughs: Learning Objectives Discuss three techniques for ushering clients into direct, lucid experience of the implicit emotional learnings generating a majority of clinical symptoms. List the steps of therapeutic process that can dissolve an existing, symptom-generating emotional schema. Define the special type of experience that fulfills the brain brain s requirements for memory reconsolidation. See handout slides marked: ng rni tive a Le jec Ob Convergence of clinical observations and memory research Memory reconsolidation 2012 Emotional Learnings Anything learned in the presence of strong emotion Nonverbal, implicit knowing verbal, explicit knowing If I show any vulnerability I'll be attacked. The only way to get any attention is to do something really bad. If I try for what I really want, the world will crush it, so I better not try for or even feel what I really want.

3 Emotional Learnings SCHEMA If I show any vulnerability I'll be attacked. The only way to get any attention is to do something really bad. If I try for what I really want, the world will crush it, so I better not try for or even feel what I really want. SYMPTOMS GENERATED No vulnerable emotion, lacks intimacy, loneliness Provocative, aggressive or emotionally volatile behaviors Passivity, underachieving, emotional disconnection Memory Reconsolidation Overturned the model of one-time consolidation and indelibility of emotional learning that was based on a century of extinction research : Conclusive detection Synapses unlock (de-consolidation) for about 5 hours before they re-lock (re-consolidation) Markers of Schema Erasure Non-reactivation. A specific emotional meaning and bodily emotional activation is no longer triggered by cues. Symptom cessation. Behaviors, emotions, thoughts and somatics driven by that emotional activation disappear. Effortless permanence. Non-recurrence of symptoms and emotional activation continues without counteractive or preventative measures of any kind. Therapy follows same process & yields same markers as in reconsolidation research

4 Memory Reconsolidation as a Framework for Psychotherapy Integration Same core process is evident in AEDP, Coherence Therapy, EFT, EMDR, IPNB and maybe all other therapies of transformational change? Core Process for Schema Erasure Reactivate the target emotional schema. Guide a contradictory experience. This unlocks (de- consolidates) the target schema s s memory circuits. Repeat contradictory experience in juxtaposition with target schema. This re-writes and erases target schema. Preparation for Core Process A. B. C. Symptom identification. What / when: specific behaviors, emotions, thoughts, somatizations. Retrieve underlying emotional schema. Implicit Explicit Find contradictory experience.

5 Therapeutic Reconsolidation Process A. Symptom identification B. Schema retrieval C. Find contradictory experience 1. Reactivate target schema 2. Evoke contradictory experience in juxtaposition 3. Repetitions of step 2 V. Verification of erasure Learning Objective Juxtaposition Experience Example Symptom: Compulsive changing of jobs for 35 years Target learning: Staying in one job makes anyone utterly miserable and dead, just like Dad. Contradictory experience: These teachers stay in one job and love their work and feel so alive in it. Learning Objective Many Therapies Congenial to TRP Such as AEDP Coherence Therapy EFT EMDR Focusing Gestalt Therapy Hakomi IFS IPNB NLP SE TIR

6 Coherence Therapy Methodology Explicitly guides the steps of the Therapeutic Reconsolidation Process 1. Retrieval into awareness of non-conscious emotional learning/schema generating the symptom (TRP steps A-B) 2. Transformation (disconfirmation & dissolution) of that learning/schema via juxtaposition experiences (TRP steps C V) Symptoms Dispelled Aggressive behavior Agoraphobia Alcohol abuse Anger and rage Anxiety Attachment-pattern-based behaviors & distress Attention deficit problems Codependency Complex trauma symptomology Compulsive behaviors Couples problems of conflict / communication / closeness Depression Family and child problems Fidgeting by Coherence Therapy Food / eating / weight problems Grief and bereavement problems Guilt Hallucinations Inaction/indecision Low self-worth, self-devaluing Panic attacks Perfectionism Post-traumatic symptoms Procrastination / Inaction Psychogenic / psychosomatic pain Sexual problems Shame Underachieving Voice / speaking problems CoherenceTherapy.org Free articles, case examples Online short courses Practice manual Books DVDs of sessions by Bruce Ecker, LMFT Long-distance training & certification pgm

7 Symptom Coherence Coherence Therapy s s model of symptom production / symptom cessation Symptom happens because it is emotionally necessary for avoiding suffering, according to at least one implicit learning or schema. Symptom stops happening as soon as the underlying learning or schema that makes the symptom necessary, no longer exists. VIDEO VIDEO

8 Her retrieved, symptom-necessitating schema: Mom goes into rage if I do something unfamiliar to her, and that rage terrifies me there s nothing worse than her rage so I better not do anything unfamiliar, I better not apply to be a talk show host, so I won t get that rage! The emotional truth of the symptom Equivalent Phrases for the retrieved emotional learning The emotional truth of the symptom Symptom-requiring schema or part Pro-symptom position In Coherence Therapy, retrieval means Discovery experiences + Integration experiences of symptom-necessitating schema

9 VIDEO I m m still your daughter, and that s s what s s most ahm well, see, it s not most important to me. Mom, it s not most important to me to be your daughter. It s s most important to me to be myself. Juxtaposition Experience Staying familiar is most important because Mom s s rage at me is unbearable. Being myself is most important. Mom getting upset with me is workable. Both feel real Both cannot possibly be true Learning Objective Verification of schema dissolution VIDEO

10 Coherence Therapy Methodology Symptom identification Retrieval of schema that is symptom s s emotional necessity Find contradictory knowledge A B C Transformation: Guide juxtaposition experience Verify dissolution of schema V Juxtaposition Experience Staying familiar is most important because Mom s s rage at me is unbearable. Being myself is most important. Mom getting upset with me is workable. Empathy for both sides equally Why Juxtaposition Is Non-Counteracting No attempt to build up desired condition or suppress the unwanted condition Therapist favors neither knowing, empathizes with both Client is guided to stay fully in touch with symptom-requiring schema

11 Discovery Process in Coherence Therapy Goal: Symptom-requiring schema comes into client s s direct experience Starting point: Identify symptom in concrete specifics Work in scene of symptom s s occurrence Therapist s s compass: Listen for / head for how symptom is emotionally necessary Discovery Process in Coherence Therapy No counteracting no attempts to get symptom to stop or get symptom-requiring schema to lose power No attempts to dispel distress Learning Objective Discovery Techniques in Coherence Therapy Symptom deprivation Sentence completion Overt statement Imaginal interaction First time Exceptions

12 Learning Objective The Key to Therapeutic Breakthroughs: DISCOVERY TECHNIQUES Symptom Deprivation SYMPTOM: PROCRASTINATION Imagine actually starting to do the task Client encounters some form of task distress previously avoided unconsciously Full unpacking of the task distress then reveals the original suffering and emotional learning making procrastination necessary Learning Objective DISCOVERY TECHNIQUES Overt Statement SYMPTOM: PROCRASTINATION Declarative sentence expressing emerging emotional truth in gutsy phrasing If I m I m successful, Dad will tear me down, so I better not actually write my thesis. Learning Objective DISCOVERY TECHNIQUES Sentence Completion SYMPTOM: PROCRASTINATION Invite client to try out saying this first half of a sentence, and just let it complete itself. The problem is, if I actually write my thesis and successfully complete my program