Unlocking the Emotional Brain— Bruce Eker, Robin Ticic, Laurel Hulley (2024)
Introduction
Transformational change is possible. Therapists want to bring about transformational change, dispelling deeply entrenched emotional learnings, i.e., learnings “formed in the presence of intense emotion, such as core beliefs and constructs formed in childhood.” However, as late as the 1990s, neuroscientists believed that emotional learnings “indelible, unerasable, for the lifetime of the individual.” But then some neuroscientists discovered memory reconsolidation, a type of neuroplasticity that allows emotional learnings to be “not merely overridden by actually nullified and deleted by new learning.” This new learning, they found, “creates new neural circuits, but it is only when new learning also unwires old learning that transformational change occurs.”
This book outlines the emotional coherence framework for psychotherapy, which provides a unifying account of (a) emotional learning and memory, (b) the unlearning and deletion of emotional implicit knowledge through memory reconsolidation, and (c) the therapeutic reconsolidation process.
Emotional learning produces schemas, which in turn help us to navigate life. Emotional learning includes an unconscious “mental model of how the world functions, a template or schema that is the individual’s sense-making generalization of the raw data of perception and emotion. This model is created and stored with no awareness of doing so.” “The emotional brain then uses this model or schema for self-protectively anticipating similar experiences in the future and recognizing them instantly when they begin (or seem) to occur. Emotional memory converts the past into an expectation of the future, without our awareness.”
Example. A man enters therapy for social anxiety and learns that he has long had a schema telling him that he will be shamed and rejected “if he differs openly with another person about anything.” What felt real to this man was not external reality but rather “a vivid illusion or mirage maintained by his own implicit constructs in emotional memory. It hardly seems an exaggeration to regard the limbic brain’s power to create emotional reality as a kind of magic that immerses one in a potent spell that feels absolutely real and would last for a lifetime.”
One goal of therapy is to make implicit knowledge explicit. Another goal is to understand that these implicit learnings are coherent, as they “make deep sense in light of actual life experiences and are fully adaptive in how they embody the individual’s efforts to avoid harm and ensure well-being.
Science
Introduction
Memory unlearning involves reversing memory consolidation, which is the transformation of “a fragile initial neural encoding” into “a stable, durable neural encoding in long-term memory.” For many years, extinction studies had led scientists to believe that old memories could only be suppressed but not unlearned, as extinction “forms a separate learning in a physically separate memory system from that of target learning, and that the extinction learning competes against, but does not replace, target learning.”
Prediction Error
The first memory reconsolidation discovery came in a study of rats, which found that when a consolidated memory was reactivated, it again became “de-consolidated into a ‘labile,’ destabilized condition.” These researchers further found that once the memory was activated, it remained destabilized for about 5 hours. Later researchers found that destabilization requires two things: (a) reactivation of the memory and (b) a prediction error, i.e., “a concurrent, additional experience of a ‘mismatch’ between what the reactivated learning expected and what was actually now perceived.”
The prediction error can be too weak or too strong — “too weak” meaning the mismatch is “too subtle to be unambiguous as a mismatch or even noticed” and “too strong” meaning the mismatch differs “from expectations so much that the experience” registers “subjectively as not relevant to the target learning’s expectations and therefore [is] not experienced as an error of expectation.”
FAQ
Does MR require emotional arousal? In theory, not necessarily, but in practice, yes, as the target memory in psychotherapy almost always “contains an emotion-generated element.”
How is MR different than a corrective emotional experience (CEE)? CEEs “often consist of only the desired new experience without the full juxtaposition.” MR consists of “the new experience occurring concurrently with foreground reactivation of the problematic emotional learning that has been maintaining the unwanted state of mind or behavior; and the new experience must contradict the negative expectation with high specificity.” Both “the target emotional learning and the contradictory experience” must “feel real and true.”
How is MR different than extinction? In extinction experiments, the tone is sounded repeatedly without the accompanying shock; this does not cause destabilization and MR. However, “a single presentation of the audio tone with no shock does induce stabilization and MR.”
Therapeutic Reconsolidation Process
A-B-C-1-2-3-V
Preparation Phase (Accessing Sequence):
Transformation Phase (Unlearning Sequence):
Verification Phase. We verify the transformational change through three markers:
The preparation phase can take several sessions, while the transformation phase only takes a few minutes. However, we’re complex, and so “there can be more than one emotional schema maintaining a particular symptom.”
Case Example
Step A: Identification of Symptom
EFT Case Example
Step A: Identification of Symptoms. Trish describes herself as feeling depressed and increasingly isolated; she avoids painful emotions as they cause her to feel helpless and hopeless; she resents her father and blames herself for many things.
Step B: Identification of Schema. Trish feels that she’s a bad person.
Step C: Identification of Contradictory Knowledge. Trish recognizes deep inside that she’s not a bad person but that her distress has been caused by the hardships she suffered. Trish then has an empty-chair dialogue with her father in which she blames him for several problems, thus further contradicting her schema that she’s a bad person.
Step 1: Reactivation. Step 2: Contradiction. The therapist says, “Tell him what it was like to be called a ‘devil.’” Trish: “It was horrible. You made me feel that I was always bad, I guess when I was a child. I don’t believe that now (Step 2), but when I was a child I felt that I was going to die and that I was going to hell because I was a bad person.”
Step 2: “I’m angry at you and I needed love.” This is a “recognition of the validity of her need for love.”
Step 3: “You humiliated me… It hurts me that you don’t love me.” Here she is “more and more fully disconfirming her original emotional learning that his behavior was a normal parental response to her badness.”
Steps 1-3. A two-chair dialogue between Trish and her inner critic. Having her inner critic speak can tell us more about her schemas (Step B) and reactivate the schemas (Step 1). Have her speak back to her inner critic is a chance to contradict these schemas (Step 2).
Steps 1-3. A one chair dialogue between Trish and her dad in which she continued to hold him responsible for his actions but also expressed compassion for the pain he himself had gone through. “No longer in the grip of previous emotional reactions generated from a young-child state, she was able to access adult knowledge about her father, which were juxtaposing with and disconfirming yet more of her previous way of making sense of his behaviors in terms of herself being bad and unlovable.”
Greenberg says that his process is one of “changing emotion with emotion,” but this is a misrepresentation of what actually happens. What actually happens is that “a particular pattern of emotion changes when the mental model generating that emotion is unlearned and modified (ending its subjective realness) by being contradicted and disconfirmed by a different mental model.” Trish’s shame arose “from her identity-model of ‘I’m bad and not worth loving,’ which was originally formed as the meaning that she construed for her father’s extreme harshness toward her.” In other words, “she believed her father’s negative messages about her.” Trish’s shame “disappeared as soon as that module of emotional learning was disconfirmed and unlearned by being juxtaposed with her own recognition of a fundally different meaning for his behavior, namely his failure to be loving even though she was and is good and lovable.
Transformational change is possible. Therapists want to bring about transformational change, dispelling deeply entrenched emotional learnings, i.e., learnings “formed in the presence of intense emotion, such as core beliefs and constructs formed in childhood.” However, as late as the 1990s, neuroscientists believed that emotional learnings “indelible, unerasable, for the lifetime of the individual.” But then some neuroscientists discovered memory reconsolidation, a type of neuroplasticity that allows emotional learnings to be “not merely overridden by actually nullified and deleted by new learning.” This new learning, they found, “creates new neural circuits, but it is only when new learning also unwires old learning that transformational change occurs.”
This book outlines the emotional coherence framework for psychotherapy, which provides a unifying account of (a) emotional learning and memory, (b) the unlearning and deletion of emotional implicit knowledge through memory reconsolidation, and (c) the therapeutic reconsolidation process.
Emotional learning produces schemas, which in turn help us to navigate life. Emotional learning includes an unconscious “mental model of how the world functions, a template or schema that is the individual’s sense-making generalization of the raw data of perception and emotion. This model is created and stored with no awareness of doing so.” “The emotional brain then uses this model or schema for self-protectively anticipating similar experiences in the future and recognizing them instantly when they begin (or seem) to occur. Emotional memory converts the past into an expectation of the future, without our awareness.”
Example. A man enters therapy for social anxiety and learns that he has long had a schema telling him that he will be shamed and rejected “if he differs openly with another person about anything.” What felt real to this man was not external reality but rather “a vivid illusion or mirage maintained by his own implicit constructs in emotional memory. It hardly seems an exaggeration to regard the limbic brain’s power to create emotional reality as a kind of magic that immerses one in a potent spell that feels absolutely real and would last for a lifetime.”
One goal of therapy is to make implicit knowledge explicit. Another goal is to understand that these implicit learnings are coherent, as they “make deep sense in light of actual life experiences and are fully adaptive in how they embody the individual’s efforts to avoid harm and ensure well-being.
Science
Introduction
Memory unlearning involves reversing memory consolidation, which is the transformation of “a fragile initial neural encoding” into “a stable, durable neural encoding in long-term memory.” For many years, extinction studies had led scientists to believe that old memories could only be suppressed but not unlearned, as extinction “forms a separate learning in a physically separate memory system from that of target learning, and that the extinction learning competes against, but does not replace, target learning.”
Prediction Error
The first memory reconsolidation discovery came in a study of rats, which found that when a consolidated memory was reactivated, it again became “de-consolidated into a ‘labile,’ destabilized condition.” These researchers further found that once the memory was activated, it remained destabilized for about 5 hours. Later researchers found that destabilization requires two things: (a) reactivation of the memory and (b) a prediction error, i.e., “a concurrent, additional experience of a ‘mismatch’ between what the reactivated learning expected and what was actually now perceived.”
The prediction error can be too weak or too strong — “too weak” meaning the mismatch is “too subtle to be unambiguous as a mismatch or even noticed” and “too strong” meaning the mismatch differs “from expectations so much that the experience” registers “subjectively as not relevant to the target learning’s expectations and therefore [is] not experienced as an error of expectation.”
FAQ
Does MR require emotional arousal? In theory, not necessarily, but in practice, yes, as the target memory in psychotherapy almost always “contains an emotion-generated element.”
How is MR different than a corrective emotional experience (CEE)? CEEs “often consist of only the desired new experience without the full juxtaposition.” MR consists of “the new experience occurring concurrently with foreground reactivation of the problematic emotional learning that has been maintaining the unwanted state of mind or behavior; and the new experience must contradict the negative expectation with high specificity.” Both “the target emotional learning and the contradictory experience” must “feel real and true.”
How is MR different than extinction? In extinction experiments, the tone is sounded repeatedly without the accompanying shock; this does not cause destabilization and MR. However, “a single presentation of the audio tone with no shock does induce stabilization and MR.”
Therapeutic Reconsolidation Process
A-B-C-1-2-3-V
Preparation Phase (Accessing Sequence):
- (A) Identification of Symptom: “Actively clarify with the client what to regard as the presenting symptom(s) — the specific behaviors, somatics, emotions, and/or thoughts that the client wants to eliminate — and when they happen, that is, the precepts and contexts that evoke or intensify them.
- (B) Identification of Schema. “Retrieve into explicit, direct awareness, as an affective, embodied experience that is verbally articulated while being felt, the emotional learning underlying and driving the presenting symptom(s).”
- (C) Identification of Contradictory Knowledge. “Identify a distinct experience of knowing (past or present) available to the client that can serve as living knowledge that is fundamentally incompatible with the model of reality in the target emotional learning retrieved in Step B, such that both cannot possibly be true.”
Transformation Phase (Unlearning Sequence):
- Step 1: Reactivation.
- Step 2: Contradiction.
- Step 3: Repetition.
- Example: The rat hears the tone, causing him to become fearful (Step 1); this time, unlike in the past, the tone is not paired with a shock, meaning his prediction is contradicted (Step 2); this sequence is repeated several times (Step 3).
- The old schema “can no longer be triggered by cues and contexts that formerly did so,”
- “Behaviors, emotions, thoughts, and somatic sensations (i.e., ‘the symptoms’) that were expressions of the schema reactivation cease to occur.”
- “Both of these changes persist effortlessly, permanently, and without counteractive or preventative measures of any kind.”
Case Example
Step A: Identification of Symptom
Richard struggled with self-doubt at work, causing him anxiety and preventing him from sharing his ideas with coworkers. He explained his symptoms during the first session, describing when they occurred and what they looked like (that is, specific thoughts, feelings, and behaviors). Coherence Therapy holds that a client’s symptoms were originally adaptive.
Step B1: Identification of Schema, Discovery Phase
Step B1: Identification of Schema, Discovery Phase
Here the client needs to experience “the previously outside-of-awareness, implicit emotional meanings and knowings coherently generating the symptom, and in this way becomes aware of the material directly.” In order to create an experience, the therapist “asked Richard to imagine being present at one of the daily work meetings, making a few brief, useful comments, and feeling confident in his knowledge while doing so.”
This is an example of symptom deprivation: you lead the client in imagining being in a triggering situation without the symptom; this is likely to give rise “to some specific dilemma or distress, which the client normally avoids, unconsciously, by producing the symptom.”
This is an example of symptom deprivation: you lead the client in imagining being in a triggering situation without the symptom; this is likely to give rise “to some specific dilemma or distress, which the client normally avoids, unconsciously, by producing the symptom.”
RICHARD: Now I’m feeling really uncomfortable, but — it’s in a different way.
THERAPIST: Okay, let yourself feel it — this different discomfort. See if any words come along with this uncomfortable feeling.
RICHARD: Now they hate me.
THERAPIST: “Now they hate me.” Good. Keep going: See if this really uncomfortable feeling also can tell you why they hate you now.
RICHARD: Wow. It’s because — now I’m — an arrogant asshole — like my father — a totally self-centered, totally insensitive know-it-all.
THERAPIST: Do you mean that having a feeling of confidence as you speak turns you into an arrogant asshole, like your father?
RICHARD: Yeah, exactly. Wow.
THERAPIST: And how do you feel about being like him in this way?
RICHARD: It’s horrible! It’s what I’ve always vowed not to be!
Step B1: Identification of Schema, Integration Phase
Richard became aware of his previously implicit schema that speaking with confidence would make him like his father while in an emotional state. To prevent this emotional state from going away, the therapist next took steps “to help integrate it into routine, ongoing, stable awareness.” The therapist did this, first, by asking Richard to make an overt statement of what he’d discovered:
THERAPIST: Let’s see if it feels true for you to say this sentence: “Feeling any confidence means I’m arrogant, self-centered, and totally insensitive like my dad, and people will hate me for it, so I’ve got to never feel confident, ever.”
RICHARD: Feeling any confidence means I’m arrogant, self-centered, and totally insensitive like my dad, and everyone will hate me for it, so I’ve got to never ever feel confident.
THERAPIST: Does that fit or feel true for you, in your body?
RICHARD: My body is buzzing with how true it feels.
The integration experience involves “having the client again speak from and within the felt emotional reality of the pro-symptom position, expressing it overtly as personal emotional truth. What matters is for the client repeatedly to have a bodily experience of the emotional realness of the discovered material.” In order to guide experiential work, the therapist must speak in a style that is “vivid, present tense, first-person, emotionally candid, highly specific,” e.g., “Feeling any confidence means I’m arrogant, self-centered, and totally insensitive like Dad, and people will hate me for it, so I’ve got to never feel confident, ever.”
The therapist must resist the urge to counter the newly discovered schema, e.g., the urge to “correct it, refute it, fix it, override it, avoid it, disconnect from it, or manage it.” Rather, the therapist must guide “the client simply to stay in touch with, and keep having experiences of, the symptom-requiring emotional truth, embracing and integrating the schema into conscious awareness just as it is.” The motto needs to be, “Once you have arrived at the symptom’s emotional truth, stay there. Pitch a tent. Set up camp right there.”
The therapist then created a between-session task that would “continue to create integration experiences.” On an index card, the therapist wrote Richard’s statement: “Feeling any confidence means I’m arrogant, self-centered, and totally insensitive like my dad, and everyone will hate me for it, so I’ve got to never ever feel confident.” The therapist then instructed Richard, “Read this once a day for a minute or two, and also whenever you’re noticing any self-doubting, and just let it bring you back in touch with how true this feels for you, just the way you’re feeling it right now. Don’t try to analyze or overcome any part of it. Just use the card to stay in touch with all of this on a feeling level.”
The following session, the therapist confirmed that Richard had continued to integrate this material. The therapist then asked Richard to remember “a recent occurrence of his self-doubting, self-invalidating self-talk at work, and simply to add onto that self-talk an overt statement (explicit verbalization) of his now-conscious need and purpose for it.” Richard’s self-talk: “How do I know what’s right here? Who do I think I am?” The therapist then guided Richard to say, “And I’m telling myself that so that I’ll keep quiet and won’t confidently say what I know and be hated as a domineering know-it-all, like my dad.”
THERAPIST: How does it feel to really stand behind your own deep purpose for doubting yourself?
RICHARD: I feel somehow more solid, but at the same time I’m surprised, again, to see how big this is to me.
At the end of the session, the therapist and Richard collaboratively wrote the following on an index card for his between-session task: “If I say anything with confidence, I’ll be just like my dad — a know-it-all lording it over everyone. And then people will hate me for that, just the way I hate him for it. So I’d better keep myself quiet by thinking, ‘What do I know?’ even though it makes me feel so insecure that I don’t express what I do know.”
Step C: Finding Contradictory Knowledge
There are many pathways we can use for finding contradictory knowledge. For Richard, the therapist used is opposite current experience. Richard described being in a work meeting; he thought of a good solution to a problem being discussed but kept quiet. Another coworker then proposed the same solution and said it with confidence, and Richard was surprised to see that everyone else in the room accept the coworker’s solution with happiness. This experience registered for Richard “as a violation of expectation.”
Step 1: Reactivation
The therapist then guided Richard in an imaginal exercise. “The moment to revisit is that point during the meeting when you’ve squelched your own good idea to keep from being hated like your dad, because expressing any confidence would make you resemble him. Just be back in touch with that, in your body, in that scene, to whatever degree you can.”
Step 2: Contradiction
The therapist asks if Richard still believes that “expressing any confidence would make you resemble [your dad,} and he says he does. Therapist: “And now the action continues: the other guy confidently comes out with the same solution that you’ve doubted, and you’re looking around the room and it feels really surprising and weird that folks are fine with hearing him put forward that same good idea with confidence. Can you feel that moment, to some degree?” The therapist here is juxtaposing contradictory knowledge, Richard’s schema and the actual response of his coworkers.
Step 3: Repetition
THERAPIST: Stay with being surprised at what you’re seeing — surprised because in your life you’ve had such a definite knowing that saying something confidently to people will always come across like your dad, like an obnoxious know-it-all, and people will hate you for that. That’s what you know, yet at the same time, here you’re seeing that saying something confidently isn’t always like your dad, and then people are fine with it. And it’s quite a surprise to know that. Does it feel true to describe it like that? Your old knowing right alongside this other new knowing that’s so different?
RICHARD: Yeah.
THERAPIST: All along, it seemed to you that saying something confidently could be done only in your dad’s dominating way of doing it, and now suddenly you’re seeing that saying something confidently can be done very differently, and it feels fine to people.
RICHARD: Yeah.
THERAPIST: So how does it feel for you to be in touch with both of these knowings, the old one telling you that anything said with confidence means being like your dad, and the new one that knows you can be confident in a way that feels okay to people?
RICHARD: It’s sort of weird. It’s like there’s this part of the world that I didn’t notice before, even though it’s been right there.
THERAPIST: You’re seeing both right now, the old part of the world and this other part of the world that’s new, even though it was right there all along. So keep seeing both, the old part and the new part, when you open your eyes in a few seconds and come back to the room with me. Can you keep seeing both?
RICHARD: Yeah.
THERAPIST: What’s it like to see both and feel both?
In the above dialogue, the therapist “guided four repetitions of the juxtaposition experience.” These “juxtaposition experiences are the actual moments in which profound change occurs — the radical unlearning and clearing away of troubled emotional learning by contradictory knowledge. Each juxtaposition experience consists of metacognitively experiencing the pro-symptom schema side by side with the sharply contradictory knowledge, with both knowings feeling vividly real, yet both cannot possibly be true.”
THERAPIST: Let’s see if it feels true for you to say this sentence: “Feeling any confidence means I’m arrogant, self-centered, and totally insensitive like my dad, and people will hate me for it, so I’ve got to never feel confident, ever.”
RICHARD: Feeling any confidence means I’m arrogant, self-centered, and totally insensitive like my dad, and everyone will hate me for it, so I’ve got to never ever feel confident.
THERAPIST: Does that fit or feel true for you, in your body?
RICHARD: My body is buzzing with how true it feels.
The integration experience involves “having the client again speak from and within the felt emotional reality of the pro-symptom position, expressing it overtly as personal emotional truth. What matters is for the client repeatedly to have a bodily experience of the emotional realness of the discovered material.” In order to guide experiential work, the therapist must speak in a style that is “vivid, present tense, first-person, emotionally candid, highly specific,” e.g., “Feeling any confidence means I’m arrogant, self-centered, and totally insensitive like Dad, and people will hate me for it, so I’ve got to never feel confident, ever.”
The therapist must resist the urge to counter the newly discovered schema, e.g., the urge to “correct it, refute it, fix it, override it, avoid it, disconnect from it, or manage it.” Rather, the therapist must guide “the client simply to stay in touch with, and keep having experiences of, the symptom-requiring emotional truth, embracing and integrating the schema into conscious awareness just as it is.” The motto needs to be, “Once you have arrived at the symptom’s emotional truth, stay there. Pitch a tent. Set up camp right there.”
The therapist then created a between-session task that would “continue to create integration experiences.” On an index card, the therapist wrote Richard’s statement: “Feeling any confidence means I’m arrogant, self-centered, and totally insensitive like my dad, and everyone will hate me for it, so I’ve got to never ever feel confident.” The therapist then instructed Richard, “Read this once a day for a minute or two, and also whenever you’re noticing any self-doubting, and just let it bring you back in touch with how true this feels for you, just the way you’re feeling it right now. Don’t try to analyze or overcome any part of it. Just use the card to stay in touch with all of this on a feeling level.”
The following session, the therapist confirmed that Richard had continued to integrate this material. The therapist then asked Richard to remember “a recent occurrence of his self-doubting, self-invalidating self-talk at work, and simply to add onto that self-talk an overt statement (explicit verbalization) of his now-conscious need and purpose for it.” Richard’s self-talk: “How do I know what’s right here? Who do I think I am?” The therapist then guided Richard to say, “And I’m telling myself that so that I’ll keep quiet and won’t confidently say what I know and be hated as a domineering know-it-all, like my dad.”
THERAPIST: How does it feel to really stand behind your own deep purpose for doubting yourself?
RICHARD: I feel somehow more solid, but at the same time I’m surprised, again, to see how big this is to me.
At the end of the session, the therapist and Richard collaboratively wrote the following on an index card for his between-session task: “If I say anything with confidence, I’ll be just like my dad — a know-it-all lording it over everyone. And then people will hate me for that, just the way I hate him for it. So I’d better keep myself quiet by thinking, ‘What do I know?’ even though it makes me feel so insecure that I don’t express what I do know.”
Step C: Finding Contradictory Knowledge
There are many pathways we can use for finding contradictory knowledge. For Richard, the therapist used is opposite current experience. Richard described being in a work meeting; he thought of a good solution to a problem being discussed but kept quiet. Another coworker then proposed the same solution and said it with confidence, and Richard was surprised to see that everyone else in the room accept the coworker’s solution with happiness. This experience registered for Richard “as a violation of expectation.”
Step 1: Reactivation
The therapist then guided Richard in an imaginal exercise. “The moment to revisit is that point during the meeting when you’ve squelched your own good idea to keep from being hated like your dad, because expressing any confidence would make you resemble him. Just be back in touch with that, in your body, in that scene, to whatever degree you can.”
Step 2: Contradiction
The therapist asks if Richard still believes that “expressing any confidence would make you resemble [your dad,} and he says he does. Therapist: “And now the action continues: the other guy confidently comes out with the same solution that you’ve doubted, and you’re looking around the room and it feels really surprising and weird that folks are fine with hearing him put forward that same good idea with confidence. Can you feel that moment, to some degree?” The therapist here is juxtaposing contradictory knowledge, Richard’s schema and the actual response of his coworkers.
Step 3: Repetition
THERAPIST: Stay with being surprised at what you’re seeing — surprised because in your life you’ve had such a definite knowing that saying something confidently to people will always come across like your dad, like an obnoxious know-it-all, and people will hate you for that. That’s what you know, yet at the same time, here you’re seeing that saying something confidently isn’t always like your dad, and then people are fine with it. And it’s quite a surprise to know that. Does it feel true to describe it like that? Your old knowing right alongside this other new knowing that’s so different?
RICHARD: Yeah.
THERAPIST: All along, it seemed to you that saying something confidently could be done only in your dad’s dominating way of doing it, and now suddenly you’re seeing that saying something confidently can be done very differently, and it feels fine to people.
RICHARD: Yeah.
THERAPIST: So how does it feel for you to be in touch with both of these knowings, the old one telling you that anything said with confidence means being like your dad, and the new one that knows you can be confident in a way that feels okay to people?
RICHARD: It’s sort of weird. It’s like there’s this part of the world that I didn’t notice before, even though it’s been right there.
THERAPIST: You’re seeing both right now, the old part of the world and this other part of the world that’s new, even though it was right there all along. So keep seeing both, the old part and the new part, when you open your eyes in a few seconds and come back to the room with me. Can you keep seeing both?
RICHARD: Yeah.
THERAPIST: What’s it like to see both and feel both?
In the above dialogue, the therapist “guided four repetitions of the juxtaposition experience.” These “juxtaposition experiences are the actual moments in which profound change occurs — the radical unlearning and clearing away of troubled emotional learning by contradictory knowledge. Each juxtaposition experience consists of metacognitively experiencing the pro-symptom schema side by side with the sharply contradictory knowledge, with both knowings feeling vividly real, yet both cannot possibly be true.”
Step A: Identification of Symptoms. Trish describes herself as feeling depressed and increasingly isolated; she avoids painful emotions as they cause her to feel helpless and hopeless; she resents her father and blames herself for many things.
Step B: Identification of Schema. Trish feels that she’s a bad person.
Step C: Identification of Contradictory Knowledge. Trish recognizes deep inside that she’s not a bad person but that her distress has been caused by the hardships she suffered. Trish then has an empty-chair dialogue with her father in which she blames him for several problems, thus further contradicting her schema that she’s a bad person.
Step 1: Reactivation. Step 2: Contradiction. The therapist says, “Tell him what it was like to be called a ‘devil.’” Trish: “It was horrible. You made me feel that I was always bad, I guess when I was a child. I don’t believe that now (Step 2), but when I was a child I felt that I was going to die and that I was going to hell because I was a bad person.”
Step 2: “I’m angry at you and I needed love.” This is a “recognition of the validity of her need for love.”
Step 3: “You humiliated me… It hurts me that you don’t love me.” Here she is “more and more fully disconfirming her original emotional learning that his behavior was a normal parental response to her badness.”
Steps 1-3. A two-chair dialogue between Trish and her inner critic. Having her inner critic speak can tell us more about her schemas (Step B) and reactivate the schemas (Step 1). Have her speak back to her inner critic is a chance to contradict these schemas (Step 2).
Steps 1-3. A one chair dialogue between Trish and her dad in which she continued to hold him responsible for his actions but also expressed compassion for the pain he himself had gone through. “No longer in the grip of previous emotional reactions generated from a young-child state, she was able to access adult knowledge about her father, which were juxtaposing with and disconfirming yet more of her previous way of making sense of his behaviors in terms of herself being bad and unlovable.”
Greenberg says that his process is one of “changing emotion with emotion,” but this is a misrepresentation of what actually happens. What actually happens is that “a particular pattern of emotion changes when the mental model generating that emotion is unlearned and modified (ending its subjective realness) by being contradicted and disconfirmed by a different mental model.” Trish’s shame arose “from her identity-model of ‘I’m bad and not worth loving,’ which was originally formed as the meaning that she construed for her father’s extreme harshness toward her.” In other words, “she believed her father’s negative messages about her.” Trish’s shame “disappeared as soon as that module of emotional learning was disconfirmed and unlearned by being juxtaposed with her own recognition of a fundally different meaning for his behavior, namely his failure to be loving even though she was and is good and lovable.
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