Feel the old learning and the contradiction at the same time

Bring the old emotional learning fully to mind and, while it feels real, attend to the knowledge that contradicts it.

Pourquoi ça marche

This is the step the authors call juxtaposition. The person stays in touch with the old learning — not trying to get away from it — while also attending to the contradicting knowledge, so both feel real in the same moment even though both cannot be true. The therapist does not argue for either side and lets the contradiction speak for itself. Ecker and colleagues propose that this matches what laboratory research describes as reactivating a memory and then meeting a mismatch, which can open it to being updated rather than merely competed with.

Comment faire

1. Read your index-card statement aloud until the old learning feels emotionally real again.
2. While it still feels true, bring to mind the contradicting knowledge you found, as vividly as you can.
3. Do not decide which is right. Notice both at once and what happens in you.
4. Repeat the pairing a few times across a session or several days, as the authors describe a series of these experiences.

Données probantes

Reconsolidation is shown in the laboratory: Schiller and colleagues reported that giving new, non-fearful information shortly after reactivating a conditioned fear memory prevented the return of fear for at least a year, selectively for the reactivated memory. A 2018 addendum by the same authors clarified that participants were included or excluded on a qualitative judgment of their skin-conductance pattern, not only the stated numerical cutoff. A replication by Kindt and Soeter with fear-relevant stimuli and several measures of fear did not find that effect, and a meta-analysis of this retrieval-then-extinction method found a small-to-moderate effect in humans. Lane and colleagues propose that change across several psychotherapies works by updating reactivated emotional memories in this way. Ecker's writing (with Toomey, and in Unlocking the Emotional Brain) argues that coherence therapy's juxtaposition step is such a process; that claim rests on case material. (mechanistic)

The laboratory studies test conditioned fear to simple cues, not coherence therapy, so they support the step by analogy only; no trial has tested whether this step works through reconsolidation in therapy. If what comes up feels flooding, you lose track of where you are, or images will not settle, stop and continue with a trained therapist rather than alone.

Sources

• Schiller, D., Monfils, M. H., Raio, C. M., Johnson, D. C., LeDoux, J. E., & Phelps, E. A. (2010). Preventing the return of fear in humans using reconsolidation update mechanisms. Nature, 463, 49-53.
• Schiller, D., Monfils, M. H., Raio, C. M., Johnson, D. C., LeDoux, J. E., & Phelps, E. A. (2018). Addendum: Preventing the return of fear in humans using reconsolidation update mechanisms. Nature, 562, E21.
• Kindt, M., & Soeter, M. (2013). Reconsolidation in a human fear conditioning study: A test of extinction as updating mechanism. Biological Psychology, 92(1), 43-50.
• Kredlow, M. A., Unger, L. D., & Otto, M. W. (2016). Harnessing reconsolidation to weaken fear and appetitive memories: A meta-analysis of post-retrieval extinction effects. Psychological Bulletin, 142(3), 314-336.
• Lane, R. D., Ryan, L., Nadel, L., & Greenberg, L. (2015). Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: New insights from brain science. Behavioral and Brain Sciences, 38, e1.
• Ecker, B., & Toomey, B. (2008). Depotentiation of symptom-producing implicit memory in coherence therapy. Journal of Constructivist Psychology, 21(2), 87-150.
• Ecker, B., Ticic, R., & Hulley, L. (2012). Unlocking the Emotional Brain: Eliminating Symptoms at Their Roots Using Memory Reconsolidation. Routledge.
• Ecker, B., & Hulley, L. (2008). Coherence therapy: Swift change at the roots of symptom production. In J. D. Raskin & S. K. Bridges (Eds.), Studies in Meaning 3: Constructivist Psychotherapy in the Real World (pp. 57-83). Pace University Press.

Erreur fréquente

Focusing only on the new, better knowledge and leaving the old learning out of awareness. The authors say that this sets up a competing belief that leaves the old one intact and able to return; the change they describe needs both felt at once.