Coherence Therapy - Symptom Coherence

Symptom Coherence

Symptom coherence is defined by Ecker and Hulley as follows:

• (a) A person produces a particular symptom because, despite the suffering it entails, the symptom is compellingly necessary to have, according to at least one unconscious, nonverbal, emotionally potent schema or construction of reality.
• (b) Each symptom-requiring construction is cogent—a sensible, meaningful, well-knit, well-defined schema that was formed adaptively in response to earlier experiences and is still carried and applied in the present.
• (c) The person ceases producing the symptom as soon as there no longer exists any construction of reality in which the symptom is necessary to have, with no other symptom-stopping measures needed.

There are several forms of symptom coherence. For example, some symptoms are necessary because they serve a crucial function (such as depression that protects against feeling and expressing anger), while others have no function but are necessary in the sense of being an inevitable effect, or by-product, caused by some other adaptive, coherent but unconscious response (such as depression resulting from isolation, which itself is a strategy for feeling safe). Both functional and functionless symptoms are coherent, according to the client's own material.

In other words, the theory states that symptoms are produced by how the individual strives, without conscious awareness, to carry out self-protecting or self-affirming purposes formed in the course of living. This model of symptom production fits into the broader category of psychological constructivism, which views of the self as having profound, if unrecognized, agency in shaping experience and behavior.