He described his understanding of coherence with the acronym SIBAM (sensation, image, behavior, affect and meaning). For Levine, a complete phenomenological experience is only given with the simultaneous activation of those five aspects. In the case of coherence, all five elements of consciousness combine with one another. Trauma creates a fragmentation of the coherence of experience. Separately from the meaning, an image triggers an affect, e.g. black rubber boots trigger the impulse to flee. The here and now becomes there and then. By emphasizing only two of the channels of the SIBAM model, cognition and behavior, cognitive behavioral therapy ignores three very important aspects of coherent experience, sensation, image and affect.[57] In his book Waking the Tiger, Levine estimates that a hundred million Americans experienced childhood sexual and physical abuse.[58]