The basis of coherence therapy is the principle of symptom coherence. This is the view that any response of the brain-mind-body system is an expression of coherent personal constructs and schemas, which are nonverbal, emotional, perceptual and somatic knowings, not verbal-cognitive beliefs. A therapy client's presenting symptoms are understood as an activation and enactment of specific constructs.

The principle of symptom coherence maintains that an individual's seemingly irrational, out-of-control symptoms are actually sensible, cogent, orderly expressions of the person's existing constructions of self and world, rather than a disorder or pathology.

Various psychotherapies have been used to treat many conditions including mood disorders such as depression and bipolar disorder, Personality disorders, eating disorders, anxiety disorders, and addictions. The problems addressed are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner.

Psychotherapies are also used to treat people who may not have a diagnosed mental illness, but need help coping with some kind of life stressor, such as stress from work or family, dealing with disease or health problems, or any kind of major life change, such as the death of a parent, divorce or personal trauma.

Coherence therapy has been used to treat a wide variety of psychiatric issues including:

  • Depression
  • Anxiety disorders
  • Panic disorders
  • Agoraphobia
  • Eating disorders
  • Intimacy disorders
  • Obsessive compulsive disorder
  • Attention deficit hyperactivity disorder
  • sexual problems
  • post traumatic stress disorder and the aftermath of abuse
  • bereavement
  • anger issues

Coherence therapy is is focused on guiding clients to get in touch with hidden, core areas of meaning and feeling that are generating the presenting symptom or problem. Coherence Therapy makes use of native capacities for swiftly retrieving and then transforming the client's unconscious, symptom-requiring emotional schemas, which were formed adaptively earlier in life.

It is considered a type of psychological constructivism. It differs from other forms of constructivism in that the principle of symptom coherence is fully explicit and rigorously operationalized, guiding and informing the entire methodology. The process of coherence therapy is experiential rather than analytic, and in this regard is similar to Gestalt therapy, focusing or Hakomi. The aim is for the client to come into direct, emotional experience of the unconscious personal constructs producing an unwanted symptom and undergo a natural process of revising or dissolving these constructs, ending the existence of the symptom. Practitioners claim that the entire process often requires a dozen sessions or less, although it can take longer when the themes and emotions underlying the symptom are particularly complex or intense.

Pros for this therapy

Coherence therapy is a format where someone can get results quickly over the course of only a few sessions. A real change in his or her beliefs and perceptions can be achieved quickly, and the implications on his or her current emotional state can be understood. These results can be powerful and permanent, and work with individuals, couples, and families.

Cons for this therapy

There are very few cons for psychotherapy, however patients who are in an acute psychotic state or severely depressed and suicidal may need hospitalization and medication to be initially stabilized. Patients with anorexia, severe personality disorders, or other organic brain diseases such as schizophrenia may need medical attention as well. All courses of psychotherapy should be supervised by a psychiatrist as part of a comprehensive treatment plan.

Coherence Therapy was developed over the last 20 years by psychotherapists Bruce Ecker, LMFT and Laurel Hulley, MA. By micro-examining hundreds of deep change events of their clients, they identified the internal and external processes that had taken place. The aim was to identify the built-in rules of profound change and form a psychotherapy made up of nothing but methods tailored to engage these powerful, native processes.

Originally called Depth Oriented Brief Therapy (DOBT), the name was changed to Coherence Therapy in 2005 to reflect more clearly the guiding principle of the approach, which is the complete coherence of the unconscious knowings, meanings and feelings that underlie and maintain the great majority of symptoms and problems presented by therapy clients.

Coherence therapy is a system of psychotherapy. Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group. The problems addressed are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner.

Psychotherapy aims to increase the individual's sense of his/her own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialog, communication and behavior change that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).

Coherence therapy is based in the theory that symptoms of mood, thought and behavior are produced coherently according to the person's current models of reality, most of which are implicit and unconscious.

Primary Therapy: 
Review Date: 
February 15, 2012