Notes on Coherence Therapy (in progress)
Coherence Therapy by Dr. Bruce Ecker & Dr. Laurel Hulley
Reading notes, in my own words, in progress
The Two Positions of Every Unwanted Symptom
Every symptom involves two contradictory positions happening at the same time: the anti-symptom position and the pro-symptom position.
The Anti-Symptom Position
The anti-symptom position is conscious and insists on change. It's the part of us that hates the symptom, believes it's ruining our life, and wants it to stop. It's the part that shows up to therapy and lists the problems it wants to see fixed. This position genuinely believes the symptom is the problem and that eliminating it will bring relief.
Often, the therapist colludes with this part by also trying to eliminate or reduce the symptom. But this is only half the picture, and focusing only on counteracting symptoms doesn't work long term. It's like cutting a plant's leaf while the root system remains intact—it just grows back, sometimes even stronger.
The Pro-Symptom Position
The pro-symptom position is unconscious and insists on stability. This part of us understands that the symptom makes deep sense, feels vitally necessary, and has crucial value—at least from its perspective. This is a protective part working to shield us from old pain with a protective strategy (the symptom).
This is why we say that clients don't come to us with their problems. They come to us with their solutions, which have become problems.
For example, say you show up to therapy because there's a part of you that binge-eats or restricts food, drinks too much, rages, or collapses into depression. Of course another part of you wants this symptom/behavior to go away. But symptoms are not random, and they always serve functions. It's just that we're often unaware of how needed and meaningful the unwanted behavior actually is (at least it believes it is, from its perspective).
Why? Because the pro-symptom position is unconscious (kept below awareness). Each symptom holds specific emotional knowledge—a model of reality in which the behavior feels genuinely necessary for survival, safety, or maintaining core aspects of identity. This knowledge was formed through real lived experience and made complete sense in its original context.
Maybe the part of you that drinks or binges learned viscerally that emotional pain is unbearable and must be interrupted immediately, and substances or food became the most reliable interruption—or perhaps a way to rebel against inhibition with disinhibition.
Maybe restricting food became a way to experience control and effectiveness in one domain when everything else felt chaotic. Or perhaps you learned at some point that your value was tied to your appearance, and so controlling your weight became about ensuring your value.
The part that rages might feel this is the only way you will be heard, or to keep you safe from harm—that without this intensity, you'll be invisible, vulnerable, or powerless.
The part that collapses into depression might be screaming for you to slow down and listen to your needs and values—protecting you from burning out or living inauthentically by forcing a stop.
Structure of the Pro-Symptom Position
The pro-symptom position has three elements:
An emotional wound
A core belief formed from that wound
A protective action (the symptom)
Think of it this way: a younger part of us carries an emotional wound, formed a core belief (about ourselves, others, the world) from that wound, and another part developed some kind of strategy to protect us from re-experiencing that pain. Brilliant, isn't it?
Kind of like in Inside Out, when emotional memories are stored in core memories and from them core beliefs are developed. From those core beliefs, protective strategies develop to keep us from experiencing that emotional pain ever again.
Again (because it's important): The symptom exists because it protects against directly experiencing the emotional pain of an unhealed wound and against ever feeling that pain again.
Why Symptoms Persist
The anti-symptom position (the part that wants change) insists on getting rid of the symptom, while the pro-symptom position (the protective part maintaining the symptom) insists on keeping it. This creates an internal deadlock—parts at war with each other. The result is feeling stuck, resistance to change, relapse when change does happen, or a new symptom replacing the old one.
We can't eliminate a protective part (i.e., a symptom, a schema-based response) by fighting it or trying to make it stop. We need to understand what wound our symptoms are protecting and what job they're trying to do.
Core Principle of Coherence Therapy
Every symptom is coherent. The symptom is exactly the way it is because some unconscious or half-conscious part of us wants or needs it to be that way. Every symptom is purposeful, precisely implemented by a part of us that's trying to help.
The symptom is never us being out of control or defective, though that is how the conscious part of us that hates the symptom sees it. All parts have good intentions, even when their strategies cause problems. As Richard Schwartz (creator of Internal Family Systems) put it, there are no bad parts.
Why Traditional Approaches Miss This
Many modern therapies focus primarily on our anti-symptom position—the conscious part that wants the symptom gone. Many well-intentioned therapists using these approaches try to build up this position to defeat the symptom. They empathize with our suffering, accept our wish to be rid of the symptom, and encourage attempts to not have it happen. They may prescribe meds to this effect.
From the perspective of Coherence Therapy, Internal Family Systems, and other depth-oriented approaches, this is a prescription for ineffective work because it puts the therapist in the same ineffective position the client has been in—trying to override their hidden, emotionally powerful pro-symptom position (the unconscious protective part that feels its job is vitally important). The result is almost guaranteed resistance, relapse, a new symptom appearing, prolonged therapy, or a sense that the therapy is superficial and not addressing deeper conflicts.
What Coherence Therapy Does Differently (and brilliantly, I think)
In Coherence Therapy (and other approaches like Schema Therapy and Internal Family Systems), the therapist focuses work on the pro-symptom position—the unconscious protective part that maintains the symptom—as soon as possible in the first session and keeps it there. The therapist remains compassionate and understands when clients relate from their anti-symptom position (the part that hates the symptom), then draws the focus back to understanding the pro-symptom position and its function. In IFS terms, we're getting to know the protective part that generates the symptom, understanding what wounded part(s) it's protecting, and understanding it rather than trying to eliminate it directly.
There are 2 main tasks in every session:
Radical Inquiry is the method of getting clear on the hidden emotional themes that make up the pro-symptom position—the reasons a "symptom" is actually more important to have than not have, at least in some contexts. This is about discovering what the symptom/behavior is trying to do for us or protecting us from. In IFS terms, it's getting to know the protective part's job and the wound it's protecting. Sometimes, but not always, this is all that is needed. Both therapist and client know when this happens. The "symptom" updates itself, knowing it's not a useful strategy anymore, and/or that circumstances have changed and no longer require it to flare up.
Experiential Shift is the methodology of change when inquiry alone isn't enough. We need to have an actual experience that contradicts the emotional knowledge maintaining the symptom—an experience of change in the belief system that makes the symptom feel necessary. Both steps require us to face and feel emotionally unresolved material—meeting the wound and experiencing that we can be with it now in ways we couldn't before.
Two Ways Things Resolve
Once the pro-symptom position is found, understood, and integrated, resolution happens one of two ways:
Direct resolution: The pro-symptom position (the protective part) realizes the symptom isn't needed anymore. The symptom disappears. It's like the part says, "Oh, I see what I was trying to do, but you don't need that protection anymore." The wound has been healed or the belief updated.
Reverse resolution: The anti-symptom position (the part that wanted it gone) changes by discovering what the symptom was doing. Having the symptom no longer feels like a problem—it's now valued or acceptable. We appreciate what the part has been doing and welcome it to continue, maybe in a different form.
Either way, the two positions come into agreement. When that happens, there's no basis for internal conflict anymore. The symptom either dissolves because it's not needed, or it's no longer experienced as a problem because we understand its value.
À suivre.
