Unlocking the Emotional Brain - Page 2

Profound Change Events in Therapy

Yet most clinicians find that every so often, a client undergoes a profound change in therapy. We've all had such cases, in which a supposedly permanent schema mysteriously seems to dissolve. A potent emotional issue loses its compelling hold, as though a spell has been broken, and symptoms cease. Upon contacting the client long after therapy, we learn that the change held. Unfortunately, these profound change events haven't been a major focus of research and are hidden in the statistics of randomized controlled trials.

Against that background, for many years, my colleague Laurel Hulley and I closely examined our clients' major shifts to see whether we could discover what lay behind these striking departures from the averages. What moments or interactions during therapy resulted in sudden breakthrough and transformational change? When an unmistakable change occurred for a client during a session (whether the fourth or fifty-sixth), we minutely examined both the session's external ingredients—the exchanges in the client-therapist interaction—and its internal ingredients—the client's thoughts and feelings. Our aim was to determine what critical elements of process were present again and again, whatever the unique content of each person's material.

After years of teasing apart the complexities of our clients' major shifts, we were able to identify a well-defined sequence of experiences needed in therapy for profound change to take place. We were struck that counteracting was completely absent from the process. As we reshaped our therapeutic methods to focus on fostering these key steps, lasting change events became frequent in our practices. Liberating results normally expected to take years of in-depth work often happened in a few sessions, and we came to refer to this methodology as Coherence Therapy (after first writing about it as Depth Oriented Brief Therapy in 1996).

Even though we found we could predictably help clients achieve these deep shifts in a few sessions, we had no idea what was happening in the neural circuits of the brain that allowed such changes. Then, in November 2005, while searching through neuroscience research journals to better grasp the neural mechanisms that might underlie the transformational changes we were seeing in our clients, I came across a recent group of studies that dramatically challenged the standard theory that emotional schemas are indelible and permanent at the neural level.

This turnaround began from 1997 to 2000, when several studies showed that when an implicit schema gets triggered—reactivated by something in the present environment—the synapses supposedly locking it in place can unlock for a short period of time. Then they relock, making a reconsolidation of the memory circuits. While these synapses are unlocked, they can be disrupted, so that relocking is prevented, thus erasing both the implicit memory and the behavioral responses it produced. Afterward, those old responses can't be reevoked.

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