Post from 'Neuropsychotherapist Jan 2, 2015'
Memory Reconsolidation Understood and Misunderstood
Coherence Psychology Institute
Misconception 9: A Long-Standing Emotional Reaction or Behavior Sometimes Ceases Permanently in Psychotherapy Without Guiding the Steps That Bring About Erasure Through Reconsolidation, and This Shows That Reconsolidation Is Not the Only Process of Transformational Change
As implied in the previous section, various therapy systems involve concepts and methodology that make no reference to memory reconsolidation or the sequence of experiences required by the brain to induce it, yet their methodologies do result in that sequence of experiences occurring with some degree of consistency, resulting in transformational change.
A close examination of the moment-to-moment process in published case studies makes the occurrence of the required steps apparent (Ecker et al., 2012, see pp. 126–155). Practitioners of such therapy systems might maintain that they have not guided those experiences when in fact they have done so. It is a well known meme in the clinical field how therapists conceptualize what they do, and what they actually do, are not necessarily the same. In my own psychotherapy practice I have occasionally seen transformational change result from sessions where I did not think the key sequence had occurred. In such cases I have made a point of then engaging my client in closely examining, in hindsight, the internal events that led to the shift or breakthrough. All such hindsight enquiries have revealed that a juxtaposition experience in fact occurred serendipitously, without being recognized or verbally labeled at the time.
Thus my own clinical experience (Bruce Ecker) suggests and upholds the hypothesis that transformational change of an acquired response is always the result of a juxtaposition experience—that is, of the reconsolidation process— even when there has been no explicit guiding of the steps required for erasure. A memorable example of such hindsight verification of juxtaposition emerged from a colleague’s case consultation. Her therapy client was a woman, aged 32 and married for five years, who was struggling with her obsessive attachment to and compulsive pursuit of the man who had been her major love through her early twenties. This problem developed after she and this man happened to cross paths again two years earlier. There had been no physical intimacy in these two years, owing solely to the man’s lack of responsiveness, but the woman’s emotional infidelity was significant and was causing her much guilt. The therapist had used a number of different types of therapy for many sessions, with little or no effect on the client’s heavy preoccupation with her former boyfriend. Most recently there had been several sessions in which the therapist had an uncomfortable sense of flailing and being ineffectual.
Then the client came into the next session and reported that a major shift had occurred. Her preoccupation and her pursuit of this man had stopped. This breakthrough was mysterious for both client and therapist. The client could offer nothing more than to speculate, “I think what you said sunk in somehow, that when an investment goes badly, sometimes it’s best to cut your losses.” This referred to an offhand, momentary comment made by the therapist in the previous session, a comment that seemed more like advice than therapy. It was counteractive in nature (an attempt to build up a cognitive understanding to override the emotionally driven symptom), was not dwelt upon, and the focus of the session had moved on. Yet the client indicated that the comment had somehow led to her liberating shift. Soon after that, the therapist consulted with me and mentioned all of this. I suggested a way for her to guide her client to look more closely into the process that had occurred internally: She could ask, “If it was new for you to hear that ending it with him could be OK even though you had an emotional investment in it from long ago, what were you previously believing or expecting about how it would not be OK to end it?”
This would be using the disconfirming knowledge to find the constructs or schema that had been disconfirmed, which is a reverse engineering of coherence therapy’s usual process of first finding the client’s symptom-generating schema and then, on the basis of the details of that schema, finding vivid contradictory knowledge to create a juxtaposition experience. But when a transformational shift occurs serendipitously, it is typically the disconfirming knowledge that becomes apparent first, while the disconfirmed schema is still unknown.
Subsequently the disconfirming knowledge can be used to bring the now defunct schema into explicit awareness, as I guided the therapist to do in this case. My colleague then briefed me on what emerged when she pursued, with some persistence, the enquiry I had suggested. The offhand comment happened to reach precisely into an unconscious schema that the client now put into words by saying, “I was struggling to keep my emotional investment in that relationship from being lost because I’d really put my heart and soul into that relationship, and on some level I felt that if it ended, I’d be losing so much of myself that I would die or just be an empty shell or ghost forever. But when you said it’s OK to get out of an investment even if you take a loss, all of a sudden that changed, because I saw, ‘Oh—people do that all the time. It’s not a disaster, it’s just practical.’ I saw that I could let go and lose that investment in him, and I wouldn’t turn to dust.”
That account points clearly to a juxtaposition experience that had formed in response to the therapist’s offhand comment. The woman reported also that it was not a struggle to persist in not contacting the man, though she did feel “a quiet sadness” each time she would have contacted him but did not do so. The non-reactivation of the symptom-generating schema or ego-state and the effortlessness of remaining symptom-free are key markers of erasure and transformational change.
Thus, when the steps required for reconsolidation and erasure have not been overtly or deliberately guided in therapy and yet transformational change is observed to occur, this does not imply that a process other than reconsolidation is responsible for the change.
Extensive clinical experience indicates rather that an unnoticed, non-verbalized juxtaposition experience is implicated and can probably be revealed by the type of inquiry illustrated in the example above. Informational and psycho-educational comments made to a client in therapy tend to result in mere intellectual knowledge and therefore do not, as a rule, represent an effective method for setting up the disconfirming experiential knowledge required to create a juxtaposition experience. The example above shows that juxtaposition experiences can sometimes form, unbeknownst to the therapist, even in clinical situations where we would not imagine that they could do so, such as in response to an offhand, common sense comment.