Coherence Therapy

Coherence Therapy


Coherence Therapy, originally called Depth Oriented Brief Therapy (DOBT), is a form of psychotherapy used to treat patients with emotional symptoms. Unlike Cognitive Therapy, Coherence Therapy delves into the core of the patient to locate the deeper meaning or feeling which is causing which is causing them emotional distress. This basically allows therapists to come up with breakthroughs with their patients on a regular basis. This form of therapy was developed in the 1990s by psychotherapists Bruce Ecker and Laurel Hulley, and while it has only been around for about twenty years, it is considered a well-respected therapy. The idea behind Coherence Therapy is that thoughts, behaviors, and moods are formed by the patient on the basis of his or her reality of the world, and that getting to the root of the problem is the best and fastest way to alleviate it. The process of this therapy is experiential rather than analytical.

Goals of Coherence Therapy

Coherence Therapy reaches deep into the client’s hidden center meaning behind the emotional feelings to find the one unconscious idea that was put into the client’s head at an early age. It is similar to digging deep into the earth until you find what it is you buried down there so long ago. In fact, for many years depth has been seen as the most efficient way to attain results in psychotherapy. By discovering the base belief for the patient’s symptoms, the therapist can now change that belief for the client using certain strategies and techniques. The ultimate goal is for the patient to recognize that their symptoms are simply the ways in which he or she tries to either self-affirm or self-protect in his or her daily life. In a way, it is almost like a form of enlightenment, which is similar to Cognitive Therapy as well.

Coherence Therapy benefits the patient by being able to erase a myriad of types of learning and memory such as those of trauma or fear.

When is Coherence Therapy Used?

Coherence Therapy has successfully stopped agoraphobia, attachment issues, alcoholism, attention deficit, anxiety, bereavement issues, compulsive behavior, codependency, depression, eating problems, low self-esteem, intimacy avoidance, procrastination, rage reactions, underachievement, interpersonal problems, and more. The word disorder is not used because the idea behind this therapy is that people’s symptoms are simply expressions instead of personality disorders of some kind. Not only does Coherence Therapy alleviate the symptoms listed above, it also alleviates the emotional scars and patterns which accompany them. Coherence Therapy may also be beneficial for those with osteoporosis. The results from Coherence Therapy have been proven to be both powerful and permanent.

How Coherence Therapy Works

Like Cognitive Therapy, Coherence Therapy only takes a number of sessions before results are seen. From the very first day, the patient is encouraged by the therapist to attempt to disprove their emotional beliefs by using their own resources at hand. It is similar to the Cognitive Therapy treatment in that the therapist is teaching the patient as a teacher would a student, hence the quick session time. The therapist will be able to differentiate between the patient’s necessary and negative symptoms, deciding which are crucial functions and which are an affect of a separate coherent response. These are known as the functional and functionless symptoms.

For example, when depression protects us from expressing anger or other feelings, that is a crucial function and is therefore a functional symptom. However, when depression stems from isolation (a strategy in and of itself that makes us feel safe), that function is an affect of a separate coherent response and is therefore not necessary, but functionless. The therapist and patient work together though the patient’s symptoms to identify which of these are functional and which are functionless until the patient is able to complete this on his or her own.

As a means of replacing the patient’s underlying idea with something more positive, the therapist must create an experience that differs from the one the patient remembers. By repeating this contradicting experience a few times, it eventually unlearns what was actually experienced. This is known as a “juxtaposition experience”. The patient, of course, can eventually learn how to do this independently.

Criticisms of Coherence Therapy

Unfortunately there is a chance of something called resistance to schema dissolution happening. This is where the patient cannot get schema (the core idea underlying his or her symptoms) to be replaced with something positive due to a resistance. This can occur for more tricky instances, or after feeling desensitized to treatment, thus proving that coherence therapy is not always 100% effective.


Depth-oriented brief therapy: How to be brief when you were trained to be deep—and vice versa. Jossey-Bass social and behavioral science series.

Ecker, Bruce; Hulley, Laurel San Francisco, CA, US: Jossey-Bass. (1996). xii 288 pp.

Constructions of disorder: Meaning-making frameworks for psychotherapy.Neimeyer, Robert A. (Ed); Raskin, Jonathan D. (Ed)

Washington, DC, US: American Psychological Association. (2000). xiii 373 pp. doi:10.1037/10368-000

Toward a Cure for Osteoporosis: Reversal of Excessive Bone Fragility.Turner, C. H.

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