This study is widely praised for demonstrating that reconsolidation works on the relatively complex learnings maintaining an addict’s craving, though it wasn’t meant to be real therapy and didn’t address whether the results held after participants left the rehab center. It’s fascinating that the new learning, described above, resulted in not just a toleration of feeling heroin craving, but a huge reduction of that craving, which seems to mean the craving was generated by the learnings that were dissolved through memory reconsolidation.
Of course, while these and many other highly controlled studies show that the three-step sequence accounts for the brain’s erasure of emotional learnings, the uncontrolled complexity that therapists contend with in their sessions is another domain entirely. Why should anyone think that erasing simple classical conditioning in crabs or the cravings of addicts securely enfolded within a hospital program will carry over into true therapy? The answer lies in the work of two of the authors (Ecker and Hulley), who, in the early 1990s, closely scrutinized large numbers of lasting therapeutic breakthroughs and found they were brought about by the same sequence of experiences later identified in reconsolidation research. The process was described in their 1995 book Depth Oriented Brief Therapy.
We’ve now had 20 years of learning how to facilitate the erasure process in therapy and training therapists to use it. Out of this exploration has come a large body of clinical observations and case studies showing that the needed sequence can indeed be guided systematically in therapy, yielding the same markers of profound change that researchers regard as the distinctive signature of erasure. The clinical examples that follow show the emotional depth and versatility of the therapeutic reconsolidation process, as well as the freedom of style and technique available to therapists within the three-step blueprint.
Reconsolidation in Therapy
Carol was in her mid-thirties and had an 11-year-old daughter. Despite her emotional closeness with her husband, she had an aversion to sex with him, which baffled and saddened her. In therapy, one of our female associates initiated guided discovery work to find out why, in Carol’s world of nonconscious learnings, it was important to avoid sex with her husband. Soon, in a quiet voice, with her legs crossed and her head in her hands, Carol recalled that when she was 15 years old, her mother had walked into the bathroom, found her masturbating, and become overjoyed. Her mother, who was flagrantly open about her own erotic behavior, then deeply mortified Carol by telling her father and several family friends about this “beautiful news.”
In revisiting this episode, Carol became aware of the unconscious emotional learning, or implicit schema, that resulted from that experience: sexuality has no boundaries within a family. What that meant to her emotional brain in her present family life was that enjoying sex with her husband would make her similar to her mother and mortify her own daughter through a violation of sexual boundaries. That expectation had been making avoidance of sex urgently necessary.
Carol’s implicit schema certainly had formed as a result of an insecure attachment bond with her mother, but it couldn’t be decisively contradicted and disconfirmed through a relationship with a trusted female therapist, as strict attachment theory would dictate. Instead, our colleague approached emotional contradiction through another route. When Carol left the session, she carried an index card on which the therapist had written her new, now explicit awareness: “I hate to admit it, but experiencing sexual pleasure with my husband makes me more like my mother. So, even though it’s hurting my marriage, I’ll continue to avoid sexual contact, because it’s better to sacrifice pleasure and intimacy than to risk doing to my daughter what my mother did to me.” Carol was now facing and feeling the previously unconscious emotional schema that was driving her dread of being sexual. It’s this emotional learning or schema that would now be the target for erasure.
Her homework was simply to read this card every day. Doing this would integrate her new awareness of her problematic learning into everyday consciousness, laying the foundation for a mismatch experience. In her next session, she told her therapist that something had shifted, because the sentences on the card—which had been deadly serious to her before—had begun to seem “almost silly.” With delight in her self-discovery, she said she’d realized that her sexuality was her own, not her mother’s. That lucid realization was the contradiction of the target learning, and it created the mismatch needed for unlocking synapses.