Table 3 - uploaded by Bruce Ecker
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The Therapeutic Reconsolidation Process, pro- posed as a universal template derived from reconsoli- dation research for utilizing memory reconsolidation in clinical practice.
Source publication
After 20 years of laboratory study of memory reconsolidation, the translation of research findings into clinical application has recently been the topic of a rapidly growing number of review articles. The present article identifies previously unrecognized possibilities for effective clinical translation by examining research findings from the exper...
Contexts in source publication
Context 1
... soon as the three preparation steps A, B and C are completed, the therapist is now equipped to fa- cilitate the ECPE's three experiences of reactivation, mismatch, and counter-learning. Lastly, after complet- ing the ECPE, the therapist must obtain verification of erasure in the form of observations of the markers of erasure delineated in Section 3. Table 3 lists that seven-step clinical process defined by Ecker et al. (2012Ecker et al. ( , 2013a. Those authors designate this methodology as the therapeutic reconsolidation process, or TRP, and they propose it as being a univer- sal map of therapeutic process for utilizing memory reconsolidation to produce transformational change. ...
Context 2
... previous section drew upon reconsolidation re- search findings to assemble a maximally general clini- cal methodology of behavioral updating that is directly and entirely dictated and defined by the research, yet is not restricted to any particular laboratory procedures. The methodology that emerges from the research in that manner is mapped out in Table 3. Its core is the empirically confirmed process of erasure (ECPE), a sequence of three experiences, the consistent facili- tation of which requires the preceding three steps of preparation, in which relevant material is accessed and made ready. ...
Citations
... Mechanisms governing cognitive shifts during EFT sessions involve memory reconsolidation, the neurological process by which outdated mental schemas are revised or replaced (Ecker, 2018). This sequence is mentioned in Feinstein (2023), who cites an earlier work that details the way this process operates within energy psychology (Feinstein, 2021). ...
In a blistering critique of Feinstein (2023) and the practice of energy psychology in general, Boness et al. (this issue) address four concerns, asserting that: (a) the rationale for energy psychology is based on premises that are not supported by reliable evidence; (b) the claim that tapping on acupuncture points is an active ingredient in energy psychology is based on insufficient evidence; (c) the quality of efficacy evidence is low; and (d) the approach is not compatible with ethical practice. While acknowledging the validity of several of the commentators’ points, this rejoinder provides evidence that soundly refutes each of these assertions. It concludes that Boness et al. “have provided a scholarly commentary on energy psychology as the field’s evidence base arguably existed a decade ago and represent it as being current while neglecting the compelling efficacy evidence that has been published in the most recent decade.”
... Personal knowledge held in memory includes both knowledge of personal experiences (episodic memory) and knowledge of patterns that have been perceived in the world (semantic memory) and represented mentally as schemas and mental models (Renoult & Rugg, 2020;Ryan et al., 2008). It is well recognized that distress-laden episodic and semantic memory can manifest as problematic behaviors, states of mind, and somatic disturbance from outside of awareness (Ecker, 2018;Lane et al., 2015). ...
... The memory interference effect (Bjork, 1992;Robertson, 2012) consists of inducing new learning designed to create memory that interferes with and diminishes the expression of a target memory. Extinction is of course applied directly in exposure therapies (Foa et al., 1986), but the psychotherapy field utilizes a truly vast range of competitive change techniques and methodologies for interfering with the production of an unwanted state (Ecker 2015(Ecker , 2018Toomey et al., 2009). One of the most common of such techniques is the learning (the installation in memory) of relaxation practices to interfere with and counteract a tendency to produce anxiety or panic. ...
... These qualities of rapid, profound change are, admittedly, a forceful challenge to longstanding, conventional assumptions of the psychotherapy field, but they are solidly grounded in empirical research findings, and further, there are numerous documentations of such outcomes in the peer-reviewed clinical literature (e.g., Coughlin, 2006;Ecker, 2018;Lipton et al., 2011;Poon, 2012;Vaz et al., 2020). The concept of the "corrective emotional experience" (CEE), first introduced by Alexander and French (1946) and studied and discussed since then by many authors as an integrative concept (e.g., Castonguay et al., 2012), perhaps comes closest to a recognition of such change prior to the discovery of MR, which presumably is the internal mechanism of successful CEEs (as discussed by Ecker, 2018, pp. ...
A person’s “memory” is the stored form of all types of acquired personal knowledge, including both knowledge of personal experiences (episodic memory) and knowledge of patterns perceived in the world (semantic memory), such as the knowledge that staying safe around one’s rage-prone, alcoholic parent urgently requires never expressing any views or feelings of one’s own. This article explores the possibility of (a) understanding most, if not all, psychotherapeutic action as a reconfiguration of knowledge held in memory and (b) identifying each of the distinct, fundamentally different endogenous mechanisms, or types of processes, that can modify memory therapeutically. In this way, a potential means of unifying psychotherapy emerges, enabling us to identify how any particular therapeutic process influences symptom production through its memory modification effects. Memory neuroscience has identified mechanisms of memory modification sufficiently for the proposed explorations to be pursued fruitfully at this point. The resulting unification scheme consists of two qualitatively different, main modes of memory modification, each with submodes. This scheme can account for the full range of therapeutic outcomes, from partial, unstable, relapse-prone symptom reduction to transformational change, defined here as the enduring cessation of a symptom and its underlying theme of emotional distress. Case vignettes illustrate the fundamental modes and some submodes of therapeutic memory modification. Viewed through this unification framework, diverse therapy systems no longer seem to belong to different worlds. Rather, their distinctive techniques and methodologies become a rich array of options for tailoring memory modification and therapeutic change uniquely for each person.
... Many psychoanalytic and non-psychoanalytic views of the corrective experience in psychotherapy (see Castonguay & Hill, 2012), including recent developments studying memory reconsolidation as a change mechanism (Ecker, 2018), seem to require therapists' abilities to disengage, disembed, unhook from or, in any case, disconfirm 2 vicious cognitive-interpersonal cycles and expectations (Bernier & Dozier, 2002;Kiesler, 2001;Safran & Muran, 2000;Wachtel, 2008). Arguably, EEX facilitates such processes. ...
The attempt to identify and classify distinct experiences falling under the common designation of countertransference has been labelled the specifist tradition. In this paper, a model describing two dimensions differentiating four components of countertransference experience is proposed. For each experiential component (subjective countertransference, objective countertransference, therapeutic attitude and emerging experience), a brief description based on previous literature from diverse theoretical fields is offered, along with clinical implications and illustrations and an account of empirical literature explicitly or implicitly addressing the specific component. In conclusion, the model is presented as a heuristic guide that can serve different purposes across different therapeutic orientations, with valuable implications for practice, training and supervision.
... The hypothetical schema, a mental representation of a stimulus or event, and its functions have impacted psychology from its inception to the present. The schema has been central to multiple domains of psychology from its first mention in neurology (Head, 1920) to more recent research on motor development (Schmidt, 1975(Schmidt, , 2003Shea & Wulf, 2005), cognition and memory (Bartlett, 1932;Rumelhart, 1980;van Kesteren et al., 2012), cognitive neuropsychology (Kan et al., 2020), intrinsic motivation (Deci et al., 1999;White, 1959), optimal level of arousal (Berlyne, 1960(Berlyne, , 1966Dember & Earl, 1957;Hebb, 1949;Hunt, 1963;Ibáñez de Aldecoa et al., 2022;McClelland et al., 1953), clinical psychology (Ecker, 2018;Ecker & Bridges, 2020), and child development (Kagan, 1967(Kagan, , 2002Piaget, 1926Piaget, , 1952. ...
Research with 2-day-old neonates shows that they create mental representations—schemata—for their experiences and that this cognitive ability is hardwired and functional at birth. This research and studies with older infants indicate that both the formation and the expansion of schemata occur through moderate discrepancies, a concept that Jerome Kagan promoted conceptually and through his research. Discrepancy, as distinct from novelty, is insufficiently acknowledged in the literature on schema theory. The schema is both cognitive and affective and develops in unison in a curvilinear pattern with a gradual onset and exponential expansion. Optimal attentiveness and positive affect occur at the peak of formation and to moderate discrepancies. Redundancy beyond the optimal level produces decreasing interest and positive affect and increasing negative affect resulting in boredom and avoidance. These characteristics of schema development are difficult to study with older children and adults. Rumelhart (1980) regarded the schema as the “building block of cognition” and Kagan (2002) called its expansion through moderate discrepancies an “engine of change” implying widespread application for cognition and behavior throughout life. Kagan urged the search for structure (form) as opposed to function in cognition, and the curvilinear pattern of schema development and its characteristics, it is argued, is the structure he sought. Implications and select applications of schema development and expansion are presented.
... Each virtual construction was made into a virtual ball with physics since research suggests that treating thoughts as objects can decrease their emotional impact [20]. The user could pick up and squish the maladaptive and alternative thought representations together as a kind of embodied metaphor for integrating a new thought appraisal in order to decrease the emotional impact of the original maladaptive thought [29,40]. ...
... Examples of experiences include symptom deprivation, sentence completion, role play, imaginal interaction techniques etc (Ecker, 2016). The Principle of Immediate Accessibility asserts that the implicit model can be known rapidly (from one to several sessions depending on the underlying complexity of the material) (Ecker and Hulley, 1996;Ecker, 2018a). This stands in contrast to conventional wisdom in psychotherapy about the difficulty of reliably accessing unconscious material swiftly, and is based on Ecker's research developing the experiential techniques that facilitate this process. ...
... Thus far Ecker et al. have focused on the role of the Juxtaposition phase and presumed memory re-consolidation as being the core active element of this effective therapy (Ecker, 2018a). In contrast, this review will focus on the Discovery phase and its role in the therapeutic process. ...
... Although not its stated intent, the Discovery phase of CT often elicits suppressed memories as it "retrieves" the symptom necessitating schema, that is usually grounded in an emotionally intense childhood experience (Ecker, 2018a). Once explicit, the conflict and symptom are resolved with the emergence of agency, or what Freud called First Person Authority. ...
Coherence Therapy is an empirically derived experiential psychotherapy based on Psychological Constructivism. Symptoms are viewed as necessary output from an implicit model of the world. The therapist curates experiences and directs attention toward discovering the model. Rendered explicit, the model is juxtaposed with contradictory knowledge driving memory re-consolidation with resolution of the symptom. The Bayesian Brain views perception and action as inferential processes. Prior beliefs are combined in a generative model to explain the hidden causes of sensations through a process of Active Inference. Prior beliefs that are poor fits to the real world are suboptimal. Suboptimal priors with optimal inference produce Bayes Optimal Pathology with behavioral symptoms. The Active Inference Model of Coherence Therapy posits that Coherence Therapy is a dyadic act of therapist guided Active Inference that renders the (probable) hidden causes of a client’s behavior conscious. The therapist’s sustained attention on the goal of inference helps to overcome memory control bias against retrieval of the affectively charged suboptimal prior. Serial experiences cue memory retrieval and re-instantiation of the physiological/affective state that necessitates production of the symptom in a particular context. As this process continues there is a break in modularity with assimilation into broader networks of experience. Typically, the symptom produced by optimal inference with the suboptimal prior is experienced as unnecessary/inappropriate when taken out of the particular context. The implicit construct has been re-represented and rendered consciously accessible, by a more complex but more accurate model in which the symptom is necessary in some contexts but not others. There is an experience of agency and control in symptom creation, accompanied by the spontaneous production of context appropriate behavior. The capacity for inference has been restored. The Active Inference Model of Coherence Therapy provides a framework for Coherence Therapy as a computational process which can serve as the basis for new therapeutic interventions and experimental designs integrating biological, cognitive, behavioral, and environmental factors.
... Thus, we argue that traumatic amnesia, "[the] inability to recall key features of the trauma (usually dissociative amnesia; not due to head injury, alcohol, or drugs)" (DSM-5 American Psychiatric Association [APA], 2013), prevents the person from recognizing that an EMI is the source of their psychophysiological dis-ease, i.e., the person may not present with conscious knowledge of having experienced a severe trauma. Approaches to repair the broken psyche of the detached personality (Nijenhuis et al., 2010) or the amnesic state associated with sexual abuse and violence, for example, are well documented (Van der Kolk et al., 2001;Ecker, 2015Ecker, , 2018. Classically, the person is encouraged to revisit the traumatic experience and integrate new learning about the original event ( Van der Kolk et al., 1989). ...
... This drives higher brain functions to exert control over structures mediating fear, such as the amygdala. This downgrades the freeze response, allowing for a more autobiographical memory (Nijenhuis et al., 2004;Ecker, 2018). Our Split-second Unlearning approach is fundamentally different. ...
Background
Previously, we proposed a “Split-second Unlearning” model to explain how emotional memories could be preventing clients from adapting to the stressors of daily living, thus forming a barrier to learning, health and well-being. We suggested that these emotional memories were mental images stored inside the mind as ‘emotional memory images’ (EMIs).
Objective
To elaborate on the nature of these emotional memory images within the context of split-second learning and unlearning and the broader field of psychoanalysis, to initiate a conversation among scholars concerning the path that future healthcare research, practice, and policy should take.
Method
A narrative review of the attributes of EMIs utilizing relevant and contentious research and/or scholarly publications on the topic, facilitated by observations and approaches used in clinical practice. Results: We propose a refined definition of EMIs as Trauma induced, non-conscious, contiguously formed multimodal mental imagery, which triggers an amnesic, anachronistic, stress response within a split-second. The systematic appraisal of each attribute of an EMI supports the idea that the EMI is distinct from similar entities described in literature, enabling further sophistication of our Split-second Unlearning model of psychophysiological dis-ease.
Conclusion
Exploration of the concept of EMIs provides further insight on mechanisms associated with psychophysiological dis-ease and opportunities for therapeutic approaches.
... Knowledge of the actual mechanism(s) of change is expected to demystify the above patterns and answer what some regard as the most urgent question in the clinical field today: Why does psychotherapy work, when it works? Bedrock empirical knowledge of mechanism should lead to significant advances in (Ecker, 2018;Ecker & Bridges, 2020): ...
... • the effectiveness of psychotherapy • unification of the fragmented psychotherapy field • illumination of why the principles of change are what they are (Castonguay & Beutler, 2006;Goldfried, 1980) • creating "corrective experiences" that are effective consistently (Castonguay & Hill, 2012;Ecker, 2018;Goldfried, 1980) • defining how the dyadic therapeutic relationship contributes to change Toward establishing an evidence-based mechanism of change, Kazdin (2007) identified a set of six criteria, the specific features that must be demonstrated empirically to confirm a candidate mechanism scientifically. Kazdin's criteria, listed below, utilize the concept of mediator (Baron & Kenny, 1986): A mediator is any particular action or condition that results in lasting change by activating some actual internal mechanism. ...
... Fig. 1b shows that both the temporal process and the degree of such change stand in sharp contrast to partial, incremental change, depicted in Fig. 1a. (For numerous case studies that identify the actual moments of transformational change occurring, see Ecker, 2018 andEcker et al., 2012.) In psychotherapy outcome research literature, there has been scant, if any, recognition of the existence of transformational change, despite the fact that it has been observed and documented for a wide range of symptoms in the published cases of many different systems of psychotherapy (e.g., Badenoch, 2011;Coughlin Della Selva, 2006, 2016Ecker, 2018;Greenberg, 2010;Lipton & Fosha, 2011;Manfield, 2003). ...
Internal mechanisms of lasting therapeutic change have eluded empirical identification despite decades of outcome research. A breakthrough may be at hand in neurobiological research on memory reconsolidation (MR), which has identified (a) a fundamental mechanism of the brain capable of targeted, profound unlearning and nullification of subcortical emotional learnings and the behaviors and states of mind they generate, and (b) the specific experiences required by the brain for such unlearning. We review the empirically identified process of annulment of emotional learnings, show that it fulfills clinical theorists' criteria for a mechanism of change, and define an empirical study to validate or falsify this MR mechanism's hypothesized clinical occurrence and causal role in therapeutic change. Extensive preliminary clinical observations of transformational change, also described, strongly support the causal role of the mechanism. The MR framework could significantly advance psychotherapy effectiveness and unification, and resolve longstanding clinical conundrums and controversies.
... This sets up a juxtaposition of a traumatic memory with a regulated amygdala and no fear response. The juxtaposition of a traumatic memory with no fear response may then set up the prediction error necessary for memory reconsolidation (Ecker, 2018). ...
This article presents two vignettes on the successful use of the Flash Technique (FT) without bilateral stimulation and prompted without blinking. FT was first developed as a protocol to quickly bring down the emotional distress of a traumatic memory during the preparation phase of eye movement desensitization and reprocessing (EMDR) therapy, so that EMDR could proceed. A recent model for FT (Wong, 2021) proposes that, with FT, traumatized clients may be able to access their traumatic memory briefly, reflexively, and without the fear response, during blinking. This sets up a prediction error which, with repeated blinking, may lead to memory reconsolidation and processing of the traumatic memory. Since the access to the traumatic memory is reflexive and brief, the processing of the memory is outside of the awareness of the client and of the therapist, which is consistent with the practitioner’s and the client’s experience with FT. Wong’s model is based on published fMRI data from neuroscience and established concepts in working memory research, and the model will be reviewed in some detail in the article. However, it is also based on fMRI data for spontaneous and not-prompted blinking, and does not require bilateral stimulation, implying that processing could occur using FT without bilateral stimulation and without prompted blinking, relying instead only on spontaneous blinking. Our two vignettes provide two data points that support this aspect of Wong’s model.
... Ecker and Bridges (2020) state that when the reconsolidation of the memory process is achieved, the transformational therapeutic change is pointed out by markers such as symptom removal, the disappearance of the accompanying emotional activation or distressed ego-state and the permanent, effortless persistence of those two changes. As described previously, memory reconsolidation is a promising field (see Ecker, 2015Ecker, , 2018. (Norcross & Wampold, 2018). ...
Intersections between psychotherapy and neurosciences are at its dawn. The quest to understand the neural underpinnings of psychological processes has led several generations of scientists to explore neural correlates between mind, brain, and behaviour. Neuroscience methods and research has given psychology new perspectives and insights about the structure and function of complex neural pathways, that underlie human functioning (cognition, emotion, motivation, and interpersonal behaviour). By translating neuroscientific findings into psychotherapeutic principles of change, it is possible to promote responsiveness towards brain dysfunction that underlies patients' psychological malfunctioning. In psychotherapy, responsiveness is a core aspect of the therapeutic change process, especially to adapt psychological interventions to patients’ motivational stages and preferences, coping styles, neurobehavioral modes, and emotional needs. Within a transtheoretical and translational approach, contemporary neuroscientific findings are revised, discussed, and used to attempt to build-on fourteen theoretical brain-based principles that may be applied to psychotherapy. Translating these empirical findings into practical principles, clinical strategies and tasks is expected to enhance psychotherapy responsiveness grounded on a science-based knowledge of brain functioning.
