Deep from the Start

Deep from the Start

Profound Change in Brief Therapy Is a Real Possibility

By Bruce Ecker and Laurel Hulley

January/February 2002

There is a moment that we therapists savor above all. We've just done or said something decisively effective and put our client in touch with a deep emotional reality. Before our eyes, a shift takes place--a shift in both mind and body--and the client slips from the grip of a lifelong pattern.

Such breakthroughs are the heart and soul of good therapy and they give most of us our greatest sense of professional satisfaction and purpose. Yet, few therapists like to admit how infrequently they occur in the average practice, no matter what the clinical approach. In much long-term therapy, breakthrough experiences seem to come almost randomly, and then only after months or years. In briefer therapies, on the other hand, deeply rooted emotional realities are often ignored altogether in favor of "reframes" and other forms of cognitive or behavioral change.

Two decades ago, seeking both depth and brevity in our clinical work, we began going over the process notes and audiotapes of thousands of our interactions with clients, especially those that yielded the most powerful turning points. What, we wondered, had happened differently in those sessions? Could we find a way to focus and organize depth-oriented therapy so that transforming moments could occur from the very first session? And could we fashion a brief therapy that could dive deep into unconscious emotional realities without sacrificing much-valued speed and focus?

We discovered that what distinguished the…

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