An Interview with Bruce Ecker, MA, on Memory Reconsolidation and Psychotherapy
David Van Nuys, Ph.D. Updated: May 1st 2010
In this episode of the Wise Counsel Podcast, Bruce Ecker describes the core treatment method of Coherence Therapy, which involves helping therapy clients to burrow into emotional implicit memory, retrieve into direct experience the negative emotional learnings at the root of unwanted moods, behaviors and thoughts, and then to juxtapose those learnings with a vivid experience of contradictory knowledge. The result of this process is that clients frequently will report that the original learnings have lost all emotional power and associated symptoms have ceased. Ecker relates this method to emerging neuropsychological research on memory reconsolidation, a naturally occurring phenomena through which emotional memories can be dissolved and erased. Reconsolidation studies by brain scientists have shown that under special circumstances, the physical storage of emotional memories is unlocked by reactivation of the stored knowledge and is then reconsolidated back into a stable condition after a few hours. During that window, it is possible for new learnings to revise and even erase the existing emotional knowledge and the behavioral responses that it drives. Ecker maintains that the same reconsolidation process demonstrated in contemporary neuroscience research seems to be at work in coherence therapy and accounts for clinical observations of profound change and lasting relief from longstanding symptoms of many kinds.
David Van Nuys: Welcome to Wise Counsel, a podcast interview series sponsored by CenterSite, LLC, covering topics in mental health, wellness, and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.
On today's show we'll be talking once again with Bruce Ecker, MA, about recent findings on memory reconsolidation, which he feels add support to coherence therapy, a brief therapy approach developed by Bruce and his wife, Laurel Hulley. Bruce Ecker, MA, LMFT, is co-director of the Coherence Psychology Institute, co-author of many clinical publications, including Depth Oriented Brief Therapy: How to Be Brief When You Were Trained to Be Deep and Vice Versa, a frequent presenter at major psychotherapy conferences, and an internationally sought clinical trainer who has taught in graduate programs for many years. He has been in independent practice in the San Francisco area for over 20 years. More on coherence therapy can be found at www.coherencetherapy.org.
Now, here's the interview.
Bruce Ecker, welcome back to Wise Counsel.
Bruce Ecker: Thanks. I'm delighted to be back with you.
David: Yes, I say welcome back because I interviewed you here in August of 2009 about coherence therapy, an approach developed by you and your wife, Laurel Hulley. And as we discussed in our earlier interview, that approach was originally called depth oriented brief therapy. And I'm interviewing you again today because of an article in Nature which you say substantially supports your approach, but before we get into the Nature article and its implications, let me have you quickly give us an overview of coherence therapy for any listeners who might not have heard the original interview.
Bruce Ecker: Sure. Back in the late 1980s and early 1990s, Laurel and I took a close look at our therapy sessions because we had noticed that there were these occasional sessions in which profound change seemed to take place, a very deep-felt shift and a permanent ending of some major long-standing symptoms, such as panic attacks or depression or compulsive behavior. So we became very interested in what was going on in those sessions that had such effectiveness.
And for quite a few years, we selected out those sessions when they happened to occur and did a very close examination of what did we do, what did the client do, what happened internally and externally. And by examining those kinds of sessions across many clients, across many types of symptoms and problems, we finally extracted or culled a particular process that we recognized as happening across all those situations. And then we formed a psychotherapy made up of only that process. And, as you mentioned, we first called it depth oriented brief therapy and now coherence therapy.
And when we started to do therapy only according to that process, we found that we could bring about those kinds of deep, lasting changes in relatively few sessions for most of our clients. Well, you know that's a therapist's dream come true. It made our work all the more satisfying for us, as well as our clients, and we've been teaching it ever since.
David: Definitely. Now, do I recall that the significance of the word "coherence" is that it reflects your view that the symptoms are formed as part of a coherent, albeit unconscious, strategy that makes sense at the time even though it may later turn out to be maladaptive?
Bruce Ecker: That's right. The symptom, a client's symptom, which may seem to be so irrational or dysfunctional viewed from the outside, almost always turns out to be produced by emotional learnings from earlier in life. And these emotional learnings are very strange in how they operate compared to common sense.
Emotional learnings occur without awareness: we don't realize we're forming emotional learnings as we're forming them; we don't recognize that we're responding according to emotional learnings when we're responding from them. So, in effect, they are learnings or knowings that we don't know we learned, don't know we know, and don't know we're using to guide our own responses. And we're usually mystified by our own behaviors and moods without awareness of the very coherent, cogent - in other words, sense making - emotional learnings, that we formed and that we still carry. They're very tenacious. They last a lifetime unless very particular processes occur that can change them.
David: Yes, and I went back and reviewed the transcript from our previous interview, and there were a few things that really stood out for me in terms of recapping our overview here. One is that you emphasize that your approach is experiential; that you're not taking the person on a head trip so to speak, but you're eliciting a spontaneous re-experiencing of memories connected to the symptom formation.
A second major point seemed to be that your approach is what you called "non-counteractive," that you're not trying to directly counteract symptoms or oppose them. And a third thing that stood out to me was that you used juxtaposition of the memory associated with a feared consequence with a more recent memory or insight in which the feared consequence does not happen. Is that a fair summary?
Bruce Ecker: Yes, that's a good overview.
David: Okay, great. And as I recall, the theoretical underpinnings of your approach were based on the neuroscience of memory and the distinction between explicit memory versus implicit memory.
Bruce Ecker: Right.
David: Explicit memory being the stuff that we can deliberately recall, and implicit memory being memories that don't seem to be so much… that we can't summon up voluntarily?
Bruce Ecker: Right, exactly. The emotional learnings that I was describing a few minutes ago are a major example of implicit memory. These are learnings that we form and store in memory, but it's a very special kind of memory. The brain, it turns out, has a number of separate memory systems that behave very differently, and they're separate both physiologically in the brain as well as different from each other in how they behave. And emotional memory is an example of implicit memory, and a defining characteristic of implicit memory is what I was saying: you have no conscious awareness of the learnings that you hold in memory when they are in implicit memory, no conscious awareness of the experiences that you had in which you formed those learnings, and no conscious awareness of using those learnings in a given situation.
Now, we're all actually very familiar with implicit memory, though we may not think of it in those terms. For example, how do you know to form the grammar of your next sentence? That's very detailed, sophisticated knowledge that you have for how to do that, but you're not aware of the knowledge or how you learned it or when you learned it, and yet you're using is very quickly and skillfully.
David: Yes, that's a great example. And so psychological symptoms, then, seem to be rooted in nonverbal, implicit memory. Is that right?
Bruce Ecker: That's right. That's exactly right. And the learnings that we hold that are in implicit memory are completely cogent. They make complete sense. And when we got our clients to retrieve - in other words, bring into awareness - the specific emotional learnings underlying a given symptom or problem, they experience it as a rich retrieval of personal meaning that helps them make deep sense of major aspects of their lives that had previously baffled them.
David: Okay, so now we begin to venture into some new territory here under the word "reconsolidation." Dr. Mark Dombeck, who's the director of Mentalhelp.net, which hosts these Wise Counsel interviews, wrote a blog posting about research on memory in relation to PTSD, and he used the term "reconsolidation," which I guess has been in the literature for a while, pointing out that recent research suggests that long-term memories aren't necessarily permanent but have to be periodically reconsolidated. And you see this theoretical construct as supporting your theory of how coherence therapy works. So take us through that a bit, if you will.
Bruce Ecker: Sure. Yes. Reconsolidation has shifted from being a theoretical construct to an experimental, demonstrated, and well documented construct by neuroscientists since… well, the first paper they published on their research on reconsolidation showed up in 1997. And by 2000 there was enough replication that reconsolidation began to be taken very seriously by neuroscientists as a reality of how the brain works.
Reconsolidation is important because it is the brain's built-in ability to actually erase ingrained emotional learnings. Another quality of emotional learnings is that they are very tenacious; they tend to become very ingrained. And, in fact, until reconsolidation was confirmed in 2000, a century of research in learning and memory by neuroscientists and psychologists had led to the conclusion that these emotional learnings held in emotional implicit memory cannot be erased. They appeared to be indelible for the lifetime of the individual.
And as an example of emotional learnings, therapists are very familiar with them too, because so many patterns that therapists see with their clients are actually based on emotional learnings. For example, attachment patterns express emotional learnings. So do most automatic behaviors and compulsive behaviors. And whenever a therapist is recognizing some unresolved emotional issue, that particular issue or theme is an emotional learning. Traumatic memory is an emotional learning.
So I think it's fair to say that what therapists try to do most of the time with most of their clients is to help people reduce the grip of these negative emotional learnings that they carry, that neuroscientists and psychologists believed were permanent and indelible until reconsolidation came along. It was quite a turnaround to find that the brain does have a built-in process and mechanism that can erase these emotional learnings, and the process was named reconsolidation by neuroscientists.
Now, I feel I should mention that there are certain conditions that people have, such as learning disorders or autism, that probably are not mainly the expression of emotional learnings, but most of the time, a therapist in a general practice is dealing with emotional learnings. So the fact that these emotional learnings do turn out to be erasable is very significant; it has very big implications for psychotherapy.
Now, what everyone agrees regardless of… therapists have so many ways of going about what they do; there are so many different kinds of therapies. But what everyone agrees about the outcome that would be ideal in therapy is to actually dissolve or erase the underlying negative emotional learnings driving a given client's unwanted mood or behavior, because if you can erase those emotional learnings at the root of a problem or symptom so that the learnings don't even exist any more - they are not there in memory any more - then the mood or behavior problem driven by them just ceases and cannot return or relapse. So that's the ideal outcome.
David: Yes, let me just insert a couple thoughts here.
Bruce Ecker: Sure.
David: I think there's been a… the popular perception is that nothing is ever forgotten, maybe going back to Penfield's experiments in brain stimulation, where when he touched certain parts of the cortex, people would get vivid recollections of how many pickets were on the picket fence in front of their house when they were a child. So we all accepted this idea that everything that's ever happened to us is pretty much permanently stored in the brain, whether or not we could access it. At the same time, it's probably true that our ability to forget is as important as our ability to remember; that there has to be a process in the brain for forgetting things that are no longer quite so important.
Bruce Ecker: Yes, well, there are different types of forgetting. There's the forgetting in which knowledge simply slips into an unconscious status, right? So you're not consciously aware of it any more. We call that forgetting. The kind of forgetting that reconsolidation achieves is fundamentally different. It really is an erasing so that the material no longer exists. And it doesn't mean you no longer remember what happened to you - and the neuroscientists who did the recent study at New York University explicitly point this out. Reconsolidation erases the emotional response that was learned; it doesn't erase your ability to remember that this, this, and this happened to me.
So what's called autobiographical memory is not erased, just as you're saying. You continue to remember the facts of what happened to you, but what's erased are the emotional learnings that drive emotional reactions. In other words, suppose you react… the simplest case is, say, a phobia. It's a simple example of a very specific fear learned in response to a very specific object or perception. Right? Well, a person who has had their emotional response erased by reconsolidation would see the, say, the spider or the height that used to trigger terrible fear and would no longer feel the fear, but would still remember everything that ever happened to them that initially may have produced the fear, a bad experience. They would remember all that but no longer feel the emotional response.
It's the emotional circuits in the brain that drive the emotional reactions that are erased, not the factual memory or the autobiographical memory of what happened to you.
David: Okay, so as I was studying up for this interview, here's my understanding. When we retrieve an implicit memory, there's a period during which that memory has to be re-stored again or it will be lost, and that's the period of reconsolidation, and if you can disrupt that reconsolidation somehow, then the memory is not stored. Do I have that right?
Bruce Ecker: You're close.
David: Okay. Refine it for me.
Bruce Ecker: All right. I'll tell you how it works. You know, I could tell you how it works in the context of this study that the NYU neuroscientists just did. That might illustrate it as I explain it. How's that?
David: Yes, is this the article that was in the journal Nature, by Daniela Schiller, et al?
Bruce Ecker: Yes.
David: It's called "Preventing the Return of Fear in Humans Using Reconsolidation Update Mechanisms." So take us through that.
Bruce Ecker: Okay, good. Yes, that research was done by a team at NYU led by Elizabeth Phelps and Joseph LeDoux. You know what neuroscientists do in these studies is they first create the emotional learning that will then be the target of the experiment. That enables them to do a very controlled experiment that has rigor in understanding the results.
Now, in the NYU study, they had each subject view a computer screen, and every 15 seconds, a yellow square would appear for a few seconds. And the square was often, but not always, accompanied by a mild electric shock to the wrist. Well, this pairing of the square and the shock created an emotional learning consisting of a fear response - fear upon seeing the yellow square appear. And the researchers could clearly see each fear response by using a standard electrical measurement of skin conductance. So that's a learned fear response of a simple kind. It's known as Pavlovian conditioning or classical conditioning.
Bruce Ecker: Now, I should mention that I'll be leaving out some features of the experiment that don't really affect the points that I'll be making.
Bruce Ecker: Twenty-four hours after this fear conditioning was done, each subject - now each yellow-square fearing subject - came back in front of the computer screen, and the researchers then began the process that would erase the fear response through reconsolidation. The process consists of three main steps.
The first step is simply to trigger and reactivate the target emotional learning in the subject. The researchers did that simply by having the yellow square appear on the screen again, and they had it appear just for one time this time, whereas in the 24 hours earlier, the initial learning of the fear response, the yellow square appeared many times, about every 15 seconds. So this time, a day later, the square comes on just one time with no shock, and it triggers the fear response, and they see the skin conductance show the fear response.
David: And that's what we would expect from classical conditioning.
Bruce Ecker: Right.
David: It's the dog salivating all over again.
Bruce Ecker: Exactly. That's what it is. And that's a good example - simple, but good example - of what I've been meaning when I say an emotional learning. The second step of the process that they then did is to then present something while the target emotional learning is reactivated. They present something that mismatches or contradicts what that emotional learning expects the situation to do, or how the situation is expected to behave.
And it turns out it's this experience of a mismatch between what the reactivated original learning expects and what's actually happening that makes the neural circuits of the target emotional learning become destabilized, as the neuroscientists say, destabilized and now open to being revised. Destabilized means that the synapses maintaining the emotional learning are actually biochemically unlocked by that experience of the mismatch. So this step two of the mismatch is really the key for getting reconsolidation to happen.
In other words, just reactivating the memory does not by itself trigger reconsolidation or open a memory to revision. It's the reactivation plus a novel feature that is something of a mismatch or contradiction to what was originally learned. And in the NYU study, the way they created the mismatch was to show the yellow square just once instead of the every 15 second repetition many times which the original memory learned and expected. So it's just once, and then, right after the one presentation of the square, they had the subject watch 10 minutes of an episode from a TV series, which they called "a break," "taking a break."
David: And the purpose of that was… what?
Bruce Ecker: Well, I can't say what their purpose was. In this short research paper, they don't elaborate in great detail on their logic in the design. And I'm explaining how this works given my reading of dozens and dozens of original research papers on reconsolidation from many different labs that have detailed these steps of the process.
Bruce Ecker: Now, step three is to expose the subject to a new learning while what they call the reconsolidation window is open; in other words, while the original learning has been destabilized, so that it's open to being re-written. And what the NYU researchers did is to, after the 10 minute TV watching, they had each subject again look at the computer screen, and now the yellow square again appeared every 15 seconds many times with no shock ever happening. So that's a new learning that the yellow square is a harmless, safe object, and the researchers showed that this new learning successfully erased and replaced the original learning. The original learning was "square comes with shock and is to be feared."
And the tests that the researchers conducted after this new learning rigorously confirmed that there was actual erasure of the original learning; it no longer existed in emotional memory. Of course, the subjects could remember that they had watched squares the day before; they could remember that they were afraid of the square for a while; and they could remember that, gee, then I watched the squares again today, and now I'm not afraid of the squares. So autobiographical memory was completely intact, but the emotional reaction that had been learned the day before is what was erased.
David: Okay. Now we need to talk a little bit about extinction and Pavlovian conditioning. Showing them the yellow square without shocking them would typically be considered an extinction trial or experience, and I think that historically it takes a whole lot of exposures for the learning to "go away," and according to the article, or at least one of the articles I looked at, there's been some question of whether it ever really totally goes away in classical extinction. What are they doing that's different here that almost produces what we might call one-trial extinction - almost like one-exposure extinction - and that sounds like that's something new?
Bruce Ecker: Yes, your question is getting at the heart of the matter. It is something very, very, new. Yes, what neuroscientists showed all through the 20th century is that extinction can shut off a learned emotional reaction, but it does not erase the emotional memory that drives the reaction. The original tendency to react, for example… let's stay with the yellow square and the shock. In fact, what the NYU researchers did in their study is, with a second group of subjects, they did exactly that. They did extinction, and I'll explain.
All they did to compare the process that I just described to extinction was to omit step two, the mismatch. They did everything the same, except they didn't do that step where they just showed the yellow square once followed by a 10-minute TV break. Instead, with the second group, they came in the next day with their fear of the yellow squares, sat down in front of the computer, and they saw the same thing that the first group had in step three: the yellow square shows up every 15 seconds for a few seconds many, many times with no shock. That's classical extinction exactly. And the researchers did that because they wanted to compare the effects.
And they found that, after the extinction training, there was no fear response, no skin conductance signal. They then showed that that group that had the extinction training, as distinct from the first group with reconsolidation, that group later easily went back into fearing the yellow square. They did rigorous tests that I won't get into details here about, but the neuroscientists have rigorous tests to show that, in the extinction group, the original learning of the fear of the yellow square was still present.
In other words - and this is what was established all through the 20th century by neuroscientists - extinction creates a second separate learning that competes with the first learning. The second learning is "the yellow square is a safe, harmless object." But extinction doesn't erase the first learning with that; it sets it up separately. In fact, they even know the brain region where the second extinction learning gets installed. And the extinction learning competes and blocks the original fear response, but it's very easy to get the original fear response to win. That shows that the memory of that learning is still in place.
In contrast, the first group, which had the mismatching step two, for them, the original learning no longer existed. It couldn't be retriggered or reactivated and was actually erased. That's actually a world of a difference between the effect of reconsolidation carrying out erasure of the first learning and extinction carrying out a suppression, a counteractive suppression of the first learning that isn't a very strong effect.
As the neuroscientists at NYU actually said in their commentary on the research: under stress, a response that has been suppressed by extinction tends to relapse, starts to happen again, and therapists are very well familiar with that result, so when you use counteractive methods, you're sort of committed to an endless effort to manage and override the tendency of the symptom or problem to happen. Well, that's not an ideal outcome of therapy. Whereas reconsolidation, by virtue of erasing the response so that is isn't there to happen any more at all, really is the ideal outcome that everybody would love to have.
David: Okay, so what's the linkage, then, of this very basic research to psychotherapy and particularly to coherence therapy?
Bruce Ecker: Well, the three-step process that I described, which was identified by the neuroscientists, is always the key. In other words, in therapy we have to find ways to follow that process, but the process can be carried out using many, many different concrete methods. In fact, even when you compare neuroscience experiments, you see them using very different set ups and concrete procedures to carry out the same core process. So what we developed was a particular complete methodology for carrying out that process, and it's what we call coherence therapy.
Now, in therapy, unlike the experiments of neuroscientists, we do not know in advance what the client's original emotional learning is that's driving the problem or symptom that they come into therapy for. So any psychotherapy of reconsolidation has to first be able to find and reveal the very specific emotional learning maintaining a given symptom, and then that emotional learning becomes the target of change by the rest of the therapy.
Another difference, significant difference, between therapy and the experiments of neuroscientists is the complexity of the emotional learnings that are involved. There's far more going on in a therapy client's implicit emotional learnings that are carried in memory than the simple pairing of a square and a shock. There are instead layers of interconnected perceptions and feelings and meanings that were created in original experiences and constitute the emotional learning that's the target of the therapy.
David: Yes, and in that regard too, psychology has struggled to understand psychotherapeutic symptoms in terms of learning theory. I think early on there was a rejection of the idea that they were rooted in Pavlovian conditioning and a more of an embracing of the idea that they were rooted in the other kind of conditioning known as instrumental or - now I'm forgetting my Psych 101 - operational conditioning.
Bruce Ecker: Operational, right.
David: So I think that relates to what you're saying now, but it also raises the question then: do the findings at NYU apply to operational conditioning?
Bruce Ecker: Right. Well, we don't know that rigorously yet, but we designed this methodology of coherence therapy in response to that study we did before reconsolidation was discovered, just based on sessions in which we saw what looked like erasure of underlying emotional learnings and permanent, effortless cessation of what had been major chronic symptoms.
So those are exactly the hallmarks of erasure. For example, when a woman client early in the therapy gets in touch with terror of her mother's rage, and realizes that she never does certain kinds of behavior because those are the kinds of things that her mother would get enraged about when she was little, and then at the end of therapy, there's no longer any sense, any feeling of terror at her mother's rage, and now she's freely doing those behaviors with no fear, and it's effortless and it lasts. That's an example of the kind of profound change we mean, and we extracted this pattern that was involved in creating that profound change.
And then in 2005, when I first read about the reconsolidation research, you can imagine my delight when I saw that the process that the neuroscientists had identified for erasing emotional learnings was clearly the same process that we had organized psychotherapy around in creating coherence therapy.
So I cannot say it's rigorously established, but there's a lot of circumstantial evidence that we're carrying out the same process and erasing emotional learnings, and we'd love nothing better than for neuroscientists to do the rigorous version of what is happening in our clients' brains and establish it conclusively.
David: Yes. Well, there was a comment on the website where our last interview was posted, and one of the listeners left a comment there which I'd like to read to you for your reaction, actually calling for research on coherence therapy. Here's what the person wrote:
"We're all looking for ways to be more effective as therapists; however, according to the coherence therapy website, there are no clinical trials evaluating its effectiveness. It's not possible for anyone to know if coherence therapy is more effective than other therapies until it is scientifically evaluated - or even if it's equal to other therapies. That's the bottom line. The evidence to date for its effectiveness is anecdotal and nothing more, and I know that CT's methods (that is coherence therapy's methods) appear to agree with some new findings in neuroscience - I've read one of the articles on this - but that is not evidence for effectiveness. Correlation is not causation, as we all learned in Stats 101. I also have to ask why coherence therapy hasn't been rigorously evaluated if it shows outstanding results on a consistent basis and in a relatively few sessions. It's been around 15 to 20 years, which is plenty of time for behavioral scientists in the field to test it. Wouldn't they be testing the daylights out of it if the effects are so profound? But there is not one randomly controlled trial, not even a small published doctoral dissertation trial, nothing. I would love to see coherence therapy change the world. I will read the books and consider applying it in practice, but the truth is no one can actually know if Mr. Ecker's claims are true until they are scientifically evaluated. I hope some day they will be."
So what's your reactions to that?
Bruce Ecker: There's a lot to reply to in that.
Bruce Ecker: Well, first is to point out that last August, August 2009, at the annual convention of the American Psychological Association in Toronto, a group of researchers from the University of Florida actually did report the results of the first randomized controlled trial of coherence therapy.
David: Oh, great.
Bruce Ecker: Yes. And it was a small study. It was a preliminary study, but it was a randomized controlled trial. It had the gold standard design. But I have to emphasize it was a small study. The statistical power of the results isn't strong. It was a first look, really, at how to do that kind of study for coherence therapy, and the results were favorable, and the manuscript reporting the results has been submitted to a peer review journal and hopefully should be published very soon.
So the proper kind of research has begun. You know, for a new therapy to be around 15 years is the blink of an eye. Getting research done on these therapies is a very, very political process. There's a lot more to it than meets the eye, and we certainly welcome rigorous research. I agree with much of what that commenter wrote about the fact that none of this is certain until there is rigorous research that upholds it.
But, as I said, there are circumstantial indicators that I think even neuroscientists would take seriously. It's not proof, but there's strong support for the hypothesis that what we do in coherence therapy erases emotional learnings through the process of reconsolidation. It's a hypothesis based on strong indicators. You know, these are indicators that neuroscientists also use. In fact, the logic that the NYU scientists used to conclude that their study had induced reconsolidation is very similar to the logic we're using to say that it looks like coherence therapy does too.
In other words, you see the disappearance of the behavior that was driven by an underlying learning, and it disappears effortlessly: there's no counteracting, there's no attempt to stop it from happening. It simply stops. And the emotional response underlying that behavioral response is no longer felt by the subject and cannot be retriggered by cues and triggers that previously evoked it strongly. That's what neuroscientists use as a marker, and that's exactly what we use.
At the end of therapy, when it looks like it's been successful, we deliberately try to guide the client back into having the original response. We have them either encounter or vividly visualize the very same cues or images or situations that previously triggered the old emotional reaction strongly, and we find that it doesn't trigger any more. So with counteractive work, that doesn't happen; things keep retriggering in the face of the original cues. So, again, it's not proof, but these are significant markers of erasure.
And as therapists, you know, what we care about most in doing therapy is the actual changes that our clients feel and describe. I wish the researchers could keep up with the things we try and verify them as we go, but they can't. The world isn't set up that way, and when we find methods that our clients report as being very effective and getting the results that they wanted from therapy, then we stick with those methods whether or not the researchers have caught up and tested them yet.
David: That's probably a great place for us to wrap this up. Unless you've got something else you want to say, I think that's a good closing statement.
Bruce Ecker: No, I'm very happy with that. And once again, just like a few months ago, you've given me a good workout, David.
David: Okay, good. Well, you've given me good responses, I must say, and it's been a delight, and I continue to be impressed and intrigued by your work. So, Bruce Ecker, once again you've been very generous with your time, and thanks so much for being my guest again on Wise Counsel.
Bruce Ecker: It's been a real pleasure, and I just want to mention that any of your listeners who want to learn more, there are articles and lots of information about reconsolidation and psychotherapy on the coherence therapy website.
David: I hope you enjoyed this follow up with Bruce Ecker on memory reconsolidation and its possible implications for coherence therapy. One background point we didn't get to in the discussion was something I learned on Dr. Mark Dombeck's blog post. In that blog posting, Dr. Dombeck reported that the drug Propranolol has been used to disrupt the reconsolidation of memory in PTSD cases with some success. In other words, if the drug is administered shortly after the traumatic events have occurred, the anxiety emotions which might attach to that experience are disrupted in a significant percentage of cases.
I believe the NYU group set out to see if they could develop a non-pharmacological approach to disrupting the reconsolidation of traumatic memories. If you're interested in that study, it appears in I believe the January 2010 issue of the journal Nature. Once again, the article by Daniela Schiller, et al, is titled "Preventing the Return the Fear in Humans Using Reconsolidation Update Mechanisms."
You can find out more on coherence therapy by going to www.coherencetherapy.org, and you can write Bruce directly by sending your email to firstname.lastname@example.org, and you're also welcome to post comments on our site.
You've been listening to Wise Counsel, a podcast interview series sponsored by CenterSite, LLC.
If you like Wise Counsel, you might also like ShrinkRapRadio, my other interview podcast series, which is available online at www.shrinkrapradio.com. Until next time, this is Dr. David Van Nuys, and you've been listening to Wise Counsel.
Mr. Ecker references a recent article appearing in the January 2010 issue of the journal Nature titled, "Preventing the return of fear in humans using reconsolidation update mechanisms", by Schiller, Monfils, Raio, Johnson, LeDoux and Phelps which is withheld for ransom by the publisher at this page.
About Bruce Ecker, M.A., L.M.F.T
Bruce Ecker, M.A., L.M.F.T., is co-director of the Coherence Psychology Institute, coauthor of many clinical publications including Depth Oriented Brief Therapy: How To Be Brief When You Were Trained To Be Deep and Vice Versa, a frequent presenter at major psychotherapy conferences, and an internationally sought clinical trainer who has taught in graduate programs for many years. He has been in independent practice in the San Francisco area for over 20 years. More on Coherence Therapy can be found at www.coherencetherapy.org.
And the method is....? - Gaston Bachelard - Jul 16th 2013
How in the world do you conduct an interview about such a miracle therapy with no questions about specific methodology? Did I miss something? Is my memory that bad?
What about EMDR - Adrianna - Feb 1st 2011
Thank you so much for another stimulating podcast! These have made my commutes so much more enjoyable! I really did like the information in this presentation as well, particularly since my interests of late have been turning to the ever-developing field of interpersonal neurobiology, replete with its exploration of neural plasticity. It seems to me that the process of reactivating an emotionally charged memory and then using coherence therapy, EMDR, cognitive restructuring, creating a new narrative, etc. all lead to a reconsolidation. I would presume that it is the competency of the clinician which allows that reconsolidation to be one which is far less threatening and actually beneficial. It is my guess that coherence therapy is one of many psychotherapeutic interventions that reshapes the neuronal connections and ultimately provides clients with a very real sense of relief. That being said, kudos to all of your guest speakers, including Dr. Ecker, for providing clinicians with another valuable therapy tool!
NYU Study - Louis - May 5th 2010
Thanks for the wonderful podcast. However, did I miss something here? The NYU study cited here as the theoretical foundation says that there is a brief window of opportunity to erase memories. The Coherence Therapy proposes that it can access these memories way beyond this window frame as mention in the NYU article, or did I miss something?
The Aid of Technology - Dr Dave Haniff - May 1st 2010
The exposure of patients to their problems have been effective to reduce anxiety about their mental health issues such as phobias and Post Traumatic Stress Disorder (PTSD). A different approach to the problems is the use of Virtual Reality (VR), which is a realistic computer simulated environment to replicate the environment that causes fear. For example, if they have a fear of flying then a flight simulator will expose the patient to problem to an extent that it is no longer a problem. The therapy described in the article may benefit from the use of technology to evoke the memories that cause the problem through realistic graphical environments. The computer simulated environment may be easier to evoke a response than using the memories of the individual. However, more research will be need to ascertain whether this is the case.