Control-mastery Theory Research Articles

Personalizing psychotherapy for personality disorders: Perspectives from control-mastery theory.

Personalizing psychotherapy for personality disorders: Perspectives from control-mastery theory.

Pathological worry and rumination according to control-mastery theory.

Pathological worry and rumination according to control-mastery theory.

Survivor guilt: Theoretical, empirical, and clinical features

The aim of this paper is to give the reader an overview of several theoretical, empirical, and clinical features of survivor guilt, and to integrate recent contributions of psychodynamic theory and, in particular, of control-mastery theory into the understanding of the concept alongside the latest findings in social psychology about it. After introducing the concept of survivor guilt and its origins in clinical observations on the consequences of having survived severe traumas (e.g., internment in concentration camps), we will discuss the findings in social psychology on the concept of survivor guilt in everyday social interactions, which is based on a conception that does not connect it strictly to severe traumas. We will then focus our attention on clinical observations and empirical research studies about survivor guilt, discussing the hypotheses developed by several control-mastery theorists about its role in psychopathology. Finally, we will illustrate some manifestations of survivor guilt with a brief clinical vignette.

The Plan Formulation Method for Adolescents (PFM A): Personalizing Psychotherapy for Adolescents

ABSTRACT The aim of this paper is to show how the Plan Formulation Method, an empirically validated and clinically useful assessment procedure, can be adapted to the therapy of adolescents. According to Control-Mastery Theory, patients come to therapy with an unconscious plan to achieve their goals, disconfirm their pathogenic beliefs, and master their traumas. PFM is a procedure aimed at formulating the unconscious plan of a patient with high levels of reliability and it articulates this plan in five components: the goals that the patient wants to achieve, the obstructions to these goals, the traumas which have given rise to these obstructions, the way the patient will try to overcome these obstructions during the therapy (tests), and the insights that the patient needs to achieve in order to get better. To apply this method to adolescent therapy, we added two components: the vicious relational circles between adolescents and their relevant others which support the patient’s problems and that the patient wants to break, and the experience the adolescent needs in order to get better. Each component will be explained with the help of a clinical case. The possible applications of the PFM to adolescents both in clinical and research contexts will be discussed.

The adaptive unconscious in psychoanalysis

This paper aims to emphasize the fundamental role of unconscious processes in our adaptation. We will point out how we are able to unconsciously perform higher mental functions such as setting goals and planning how to pursue them, dealing with complex data, and making choices and judgments. In the first part of this paper, we will describe the main features of conscious and unconscious processes as pointed out by recent empirical research studies, and we will see how safety is essential in pursuing our fundamental goals, and how unconscious mental processes are strongly oriented towards preserving our safety and pursuing these goals. Finally, we will discuss control-mastery theory (CMT), an integrative, relational, cognitive-dynamic theory of mental functioning, psychopathology, and psychotherapy processes developed by Joseph Weiss and empirically validated by Weiss, Harold Sampson, and the San Francisco Psychotherapy Research Group over the last 50 years. This conceptualizes unconscious processes starting from this “higher unconscious mental functioning” paradigm and, in accordance with research data, stresses that our main goal is to adapt to reality and pursue adaptive developmental goals while preserving our safety. Three clinical vignettes will help show how the concepts proposed by CMT have important implications for therapeutic process.

Progress in Psychotherapy: The Perspective of Control-Mastery Theory.

In the classical psychoanalytic tradition, the patient is seen as unconsciously governed by forces that are at odds with the healing process. But over the years, the concept of resistance against change has been subjected to modifications, and the patient's contribution to the therapeutic relationship has come to be seen as more oriented to a conscious and unconscious collaboration with the clinician. This article aims to explore a new way of understanding how progress in psychotherapy is achieved and to reframe the therapeutic relationship from the point of view of Control-Mastery Theory (CMT). According to CMT, people are motivated to achieve adaptive goals, to master their traumas, and to feel better; to this purpose, patients unconsciously assume proactive roles in the therapeutic process. Indeed, they work during therapy to disprove their pathogenic beliefs, testing them in the therapeutic relationship, and helping the therapist through coaching behaviors, attitudes, and communications aimed at providing helpful information to understand the components of their own unconscious plan.

The Importance of Compliance in Control Mastery Theory

ABSTRACT Compliance, according to Control Mastery Theory, is an emotional, cognitive, and behavioral response to trauma that reflects the beliefs that “you deserve what you get” and “you get what you deserve.” Patients “comply” when they 1) believe their distorted pathogenic beliefs are true, 2) act as if these beliefs were true, 3) reenact in present relationships traumatic, pathological interactions experienced earlier in childhood, and 4) tend to protect parents by justifying their hurtful behavior. Compliance results from the fact that children tend to believe parents as absolute authorities. Because of family loyalty and a wish to protect parents, children may assume the worst about themselves in dysfunctional families. Then they may act in ways that make their negative self-image true, consistent with the notion of a “self-fulfilling prophecy”. Based on these deeply embedded negative self-images and self-destructive roles, children may repeat these patterns long into adult life. Along with “pathological identifications”, the concept of “compliance” helps clinicians understand the origins of many self-destructive behaviors and why patients are so loathe to relinquish them. Clinical examples will illustrate the usefulness of understanding the role of compliance as well as treatment techniques.

The adaptive function of fantasy: A proposal from the perspective of control-mastery theory.

The adaptive function of fantasy: A proposal from the perspective of control-mastery theory.

Plan-compatible termination in psychotherapy: Perspectives from control-mastery theory.

Termination processes in psychotherapy vary widely across patients, therapists, and therapies. While general guidelines on termination can inform ethical and responsible termination practices, termination decisions and processes are likely optimized using a case-specific approach. Control-mastery theory (CMT) provides a framework for considering the unique ways individual patients work in psychotherapy and can be applied to help therapists understand and facilitate optimal terminations. The present article provides a brief overview of CMT and outlines perspectives regarding the decision-making and discussion of psychotherapy termination, the processing of termination, and the final session of therapy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Attachment disorganization and severe psychopathology: A possible dialogue between attachment theory and control-mastery theory.

Attachment disorganization and severe psychopathology: A possible dialogue between attachment theory and control-mastery theory.

Dreaming and adaptation: The perspective of control-mastery theory.

Dreaming and adaptation: The perspective of control-mastery theory.

Traumas and Their Consequences According to Control-Mastery Theory.

The aim of this article is to introduce the reader to how control-mastery theory (CMT; Gazzillo, 2016; Silberschatz, 2005; Weiss, 1993), an integrative relational cognitive-dynamic theory of mental functioning, psychopathology, and psychotherapeutic process, understands traumas, their consequences, and their mastery. In the first part of this article, we will present an overview of the debate about the definition of trauma within the different editions of the Diagnostic and Statistical Manual of Mental Disorders. Then, we will focus on the concept of complex traumas and on their consequences on mental health. Finally, we will discuss how CMT conceptualizes traumas and their pathological consequences. We will stress in particular how, according to CMT, in order for a painful experience to become a trauma, its victim has to come to believe that s/he caused it in the attempt to pursue a healthy and adaptive goal. In order to master traumas and disprove the pathogenic beliefs developed from them, people attempt to reexperience situations similar to the traumatic ones in safer conditions while giving them happier endings.

New developments in understanding morality: Between evolutionary psychology, developmental psychology, and control-mastery theory.

New developments in understanding morality: Between evolutionary psychology, developmental psychology, and control-mastery theory.

Nota introduttiva di Paolo Migone. Psicoanalisi e psicologia cognitivo-evoluzionista: un tentativo di integrazione

The of the theory of trauma in 1897 was a trauma for Freud himself, who was led to despair, and possibly reacted with an overemphasis on inner fantasies and drive theory. In a way, today we are facing a second trauma in the history of psychoanalysis: we might call it the abandonment of drive i.e., human beings strive not primarily to reduce drives but rather in order to seek objects, assign meanings, and assimilate new schemas. The current challenge is a revision of the psychoanalytic theory of motivation based on converging evidence from cognitive science, ethology, infant research, and psychotherapy research. Among the many models currently suggested in contemporary psychoanalysis, Weiss & Sampson’s Control-Mastery Theory is discussed in light of cognitive science and evolutionary epistemology: namely, within the frame of the 1960 classic by Miller, Galanter & Pribram Plans and Structure of Behavior, Edelman’s neurobiological theory, and Bowlby’s attachment theory.

Relationship between pathogenic beliefs and interpersonal problems: a cross-sectional study of Thai patients with depression

ABSTRACTPathogenic beliefs (PBs) are a key construct within control-mastery theory, a dynamic cognitive-relational psychotherapy approach. It is common for these beliefs to trigger interpersonal problems. The present study explored the relationship between PBs and interpersonal problems. Sixty-eight patients with depressive disorder were assessed using a 54-item Pathogenic Belief Scale (PBS), and the Inventory of Interpersonal Problems (IIP-32). Eight sub scales of the IIP-32 were analysed, along with the interpersonal circumplex (IPC) dominance and love dimensions. The PBS was significantly associated with the IIP-32 total score (r = .608, p < .01). The PBS scores were significantly correlated with the dominance dimension (r = −.285, p < .05), but not the love dimension. PBs have a significant correlation with interpersonal problems. They correlated with the submissive or hostile quadrant of the IPC, which measures negative sense of self and disappointment in oneself in relating to others.

Psychopathology and adaptation to environment: Fonagy model compared to Weiss model

In the recent transition of Fonagy and collaborators’ thinking, psychopathology results from a lack of resilience which, in turn, results from a lack of epistemic trust, which is an adaptive consequence of the early social learning environment and leads to limitations in the capacity to mentalize and properly evaluate interpersonal situations. The possibility to read psychopathology as the adaptation of the child to traumatic environment is indeed the core of the Control-Mastery Theory (CMT). According to CMT, the child is “wired” from birth to adapt to his reality; to this aim, starting from what he learns from the caregivers, he constructs, by inference from experience, a system of beliefs, more or less reliable, on himself, others, and his social world. Some of these beliefs are pathogenic when they associate an internal (feeling of shame or guilt) or external (departure or loss of the caregiver) danger to the achievement of a healthy and realistic goal. Once again, psychopathology results from an adaptation to traumatic experiences in childhood, but, in this case, the adaptation is mediated by a system of beliefs and, so, by the extreme trust that the child has in his caregivers.

Preliminary Data about the Validation of a Self-Report for the Assessment of Interpersonal Guilt: The Interpersonal Guilt Rating Scales-15s (IGRS-15s).

The aim of this article is to present validation data about a self-report rating scale for the assessment of interpersonal guilt according to Control-Mastery Theory (CMT; Silbershatz, 2005; Weiss, 1993; Weiss, Sampson, & The Mount Zion Psychotherapy Research Group, 1986), the Interpersonal Guilt Rating Scale-15s (IGRS-15s). In order to perform the validation of this tool in an Italian sample we have collected a sample of 645 nonclinical subjects. They had to complete the IGRS-15s, the Scale for the Measurement of the Impending Punishment (SMIP; Caprara et al., 1990), the Interpersonal Guilt Questionnaire-67 (IGQ-67; O'Connor et al., 1997), the Psychological General Well-Being Index (PGWBI; Dupuy, 1984), and the Affective Neuroscience Personality Scales (ANPS; Davis, Panksepp, & Normansell, 2003), together with an ad-hoc questionnaire for collecting demographic data, the Socio-Demographical Schedule. We have performed a confirmatory factor analysis to verify if the four-factor solution based on CMT and replicated in previous research (Gazzillo et al., 2017) was confirmed. Then, we checked the retest reliability of IGRS-15s after four weeks in a random subsample of 54 subjects. In order to assess its concurrent and discriminant validity, we calculated the correlations between IGRS-15s assessment and SMIP and IGQ-67. Finally, to test its construct validity, we assessed the relationships between the IGRS-15s and the affective systems using the ANPS and the wellbeing assessed with the PGWBI. The data collected support the retest reliability and the concurrent and discriminant validity of the measure, and we have collected preliminary data about its construct validity. Examples of the possible clinical and research applications of this tool are discussed.

Reliability and Validity of the Interpersonal Guilt Rating Scale-15: A New Clinician-Reporting Tool for Assessing Interpersonal Guilt According to Control-Mastery Theory.

This article introduces the Interpersonal Guilt Rating Scale-15 (IGRS-15), a brief clinician-rated tool for the clinical assessment of interpersonal guilt as conceived in Control-Mastery Theory (CMT; Silberschatz, 2015; Weiss, 1993), and its psychometric proprieties. The items of the IGRS-15 were derived from the CMT clinical and empirical literature about guilt, and from the authors' clinical experiences. Twenty-eight clinicians assessed 154 patients with the IGRS-15, the patient self-reported Interpersonal Guilt Questionnaire-67 (IGQ-67; O'Connor, Berry, Weiss, Bush, & Sampson, 1997), and the Clinical Data Form (CDF; Westen & Shedler, 1999). A semi-exploratory factor analysis pointed to a four-factor solution in line with the kinds of guilt described in CMT: Survivor guilt, Separation/disloyalty guilt, Omnipotent responsibility guilt, and Self-hate. The test-retest reliability of the IGRS-15 was good. Moreover, the IGRS-15 showed good concurrent and discriminant validity with the IGQ-67. IGRS-15 represents a first step in the direction of supporting the clinical judgment about interpersonal guilt with an empirically sound and easy-to-use tool.

Pathogenic beliefs among patients with depressive disorders.

IntroductionPathogenic belief is a central construct within control-mastery theory, which is an integrated dynamic-cognitive-relational approach in psychotherapy. Pathogenic beliefs result from traumatic life experiences and are considered the root of any psychological disorders presented clinically. Nevertheless, how and what type of pathogenic beliefs are attributed to clinical depressive disorder is unknown. The present study aimed to examine this issue.Patients and methodsThirty patients with depressive disorder, who came for psychotherapy at a psychotherapy clinic, were matched based on age and gender with healthy controls who were medical students. The 54-item pathogenic belief scale (PBS) was administered and compared between depressive and control groups using odds ratio (OR).ResultsThe depressed group’s PBS mean score was significantly higher than the healthy controls (t=3.78, P<0.001). Thirteen of 54 items significantly differed between the two groups with ORs ranging from 3.76 to 16.79. The content of pathogenic beliefs centered on the issues of negative sense of self, lack of self-efficacy and control, and relational difficulties related to feelings of fear and humiliation. Influences of culture and gender differences on pathogenic beliefs were discussed.ConclusionPathogenic beliefs relate to depression such that the higher the number of pathogenic beliefs one has, the more the likelihood of having depression. Since the PBS was developed based on clinical data (rather than theory based), cultural issues as well as age and gender may influence the development of pathogenic beliefs. Further study should be warranted and implications for clinical practice are discussed.

From Unfinished Adolescent to Young Adult

The distinct time in life known as emerging adulthood presents its own unique developmental challenges, most centrally the creation of an adult identity. However, an increasing number of young adults today are not living on their own, as would be expected, but instead are living with their families of origin. For some, co-residence is largely a function of current economic forces. For others, it is evidence of problems with the separation-individuation process. Assessing relational maturity and the development of autonomously valued goals is crucial in forming a treatment plan. Constructivist control mastery theory is a treatment approach that integrates psychodynamic and narrative paradigms and is especially well suited for the treatment of this population, whether applied as a family therapy or individual therapy. This approach focuses on fostering mastery-oriented conversations that facilitate the emergence of adult identity.