Depth oriented brief therapy: How to be brief when you were trained to be deep - and vice versa, 1st Edition

by Bruce & Hulley Ecker

From start to finish, Depth-Oriented Brief Therapy presents a practical guide to working deeply and briefly with individuals, couples, and families. The book offers a clear and complete methodology and conceptual framework for producing lasting change beyond symptom relief; a compendium of specific techniques for depth-oriented brief therapy; a time-effective approach for working with clients whose presenting symptoms are driven by unresolved, lifelong emotional wounds; and abundant case examples covering a wide range of presenting symptoms, such as low self-esteem, chronic depression, anxiety, obsessive-compulsive behaviors, agoraphobia, symbiotic attachment, dissociation, psychogenic pain, and sequelae of sexual abuse. Depth-Oriented Brief Therapy is written for therapists, psychologists, counselors, social workers, psychiatrists, and other helping professionals who want to meet the challenge of managed care without losing the deeper levels of change traditionally associated with long-term or existential work.

Genres: Psychology, Counselling, Nonfiction

Hardcover

First published October 20, 1995

Reviews

[Katie · Rating 3 out of 5]

Update: I'm still working on this terribly slowly. I'm through the first half of the book, which provides (or tries to provide) the theoretical background for the model of therapy, and am now into the actual process. Things are looking up.

The basic idea is that the client's presenting symptom is important for him to have because it serves an emotional purpose, the "pro-symptom position." This is different from the conventional idea of "secondary gain" from illness; rather, it is a way in which a symptom functions to protect the person from something he fears more. The pro-symptom position is always unconscious. The anti-symptom position is the conscious desire to remove it--wanting to not be depressed, panicky, angry etc.

The basic therapeutic process is "radical inquiry," that is, inquiring after the root of the symptom, with the idea of figuring out what is behind it, from the client's (unconscious) point of view, rather than changing it. This sounds rather psychoanalytic, but the authors emphasize that rapid change can and should be expected from this process, although it has to be motivated and generated by the client.

It's an interesting model. I've seen this rapid, deep kind of change happen in therapy, both with my clients and in myself. This type of brief treatment has been renamed Coherence Therapy, if you want to look it up elsewhere, and was developed by careful examination of recordings of therapy sessions to find out what actually led to critical moments of change in the course of treatment. The theoretical basis seems sound enough; I'm interested in seeing empirical support so that third-party payors will support this model.

Unfortunately, the book is not well written, and I blame the publisher as well as the authors. No one seems to have run this thing past an editor, or in fact anyone who wasn't directly involved in the generation of its content, or who wasn't in a gigantic hurry. How about an undergrad from the drama or engineering department, who could be given class credit to read it and try to figure out what it's about? Then maybe they'd have fewer sentences like "The conceptualization in DOBT of the four orders of position structuring experiential reality is an extension of the seminal ideas of Bateson, who has had a profound influence on the development of constructivist as well as systemic psychotherapies." (A) It's a garden-path sentence, what's that word structuring doing in there, boys and girls; and (B) Ok, we'll get a student from the master's in counseling program, but they'll read it anonymously and get paid. Jeez louise.

A couple years ago, in one 30-minute session, my therapist helped me through a process that caused a deep, lasting change in how I felt--so deep that for a long time I had a hard time identifying what it was, but a profound change in my orientation towards the world that has had a lasting effect on my mental health. It was just a little visualization exercise focusing on a fairly innocuous memory from childhood--nothing terribly exciting.

[Nick · Rating 5 out of 5]

DOBT is a predecessor to Coherence Therapy as introduced in Unlocking The Emotional Brain (or “UtEB”) (Ecker, Hulley, and Ticic), and essentially represents the iteration of Coherence Therapy that existed prior to the explosion of neuroscientific research in the area of Memory Reconsolidation.

As others have said, it’s a bit long and wordy (not unlike its successor), but very illustrative of the framework and use of techniques for the therapy approach. It’s probably not necessarily if you’ve already read UtEB, but I found it fascinating to see the evolution of their approach.

The instruction to the therapist is well summed up in a pithy sentence at the end of the book: “the client has a pro-symptom emotional truth; do nothing but empathically find it; usher the client into experiencing it; and then, if necessary, assist the client to change it” (p. 259).

If you are already using or even simply interested in transformative, experiential therapy work (ex: EMDR, IFS, AEDP, EFT, MI), DOBT/Coherence Therapy are worth looking into.

[Maggie · Rating 3 out of 5]

This book was interesting in many ways but also opens me up to needing to learn more about DOBT. I'm fascinated by methods that work at the deeper brain level, rather than our thinking mind.