Why is it important to think about the
relationship between Control Mastery and
countertransference?
Control Mastery Theory is a distinctly relational
theory that offers unique insights into the treatment
relationship. Joe Weiss and Hal Sampson were the
first to explicate that patients grow in therapy to the
degree they feel safe to do so. And that transference
testing and passive into active testing offer vitally
important windows to understanding the patient’s
meaning and subjective experience of the world and
of the therapy.
In the original theory the therapist’s experience is
discussed only as it pertains to the patient’s testing,
and not in its own right as an inevitable element in the
treatment. This has the unintended consequence that
one half of the therapeutic relationship goes largely
unaddressed.
Over time, for many of us working with the theory, it
has come to seem important to develop a CM
understanding of countertransference. First, while it’s
true that the therapist must be able to renounce her
own needs in favor of the patient’s plan, it’s also true
that ignoring our experience with our patients can at
times result in the therapist behaving in unconscious
and anti-plan ways toward the patient. In life and in
therapy, we know that failing to recognize our own
affects can result in their “leaking out” in unintended
ways.
Secondly, it is necessary to our patients’ sense of
safety for them to feel emotionally connected to their
therapist. And the therapist’s authenticity is essential
to the patient feeling emotionally connected to the
therapist. By “therapist authenticity” I don’t
mean “disclosure”, but rather the therapist having the
self awareness and self knowledge to stay genuinely
present and engaged in the relationship as it goes
through ups and downs.
It seems unrealistic and potentially harmful to
pretend that it’s possible to be so psychologically
healthy that we have no issues. It would be far saner
to have a theory of how to deal with those inevitable
moments when our own personal issues or feelings
are triggered by a patient. For these reasons, we
need to develop a Control Mastery conceptualization of
countertransference, including an understanding of
the therapist’s personal process. Following are a few
issues we might want to consider.
Far from the original definition of
countertransference as the analyst’s unanalyzed (and
thus shameful) material, I suggest that
countertransference should never be viewed
negatively. How can we model self acceptance to our
patients if we secretly have shame about our own
internal process? What matters isn’t whether we
experience countertransference, but how we handle it
when we do.
Perhaps we will need to explicate ways of
distinguishing the therapist’s personal feelings from
the feelings that are triggered by patient testing.
Whenever the therapist’s personal issues are
aroused by patient testing, the fact they are coming up
with this patient at this moment is relevant to both the
patient and the therapist. The therapeutic task is to
understand what that’s about for the patient and the
most pro-plan way of using it for the therapy. In order
to do that, the therapist has to be able to hold in
awareness her feelings and the personal issues they
stem from and the patient’s feelings and history. This
level of integration can be quite challenging at those
times when we’re being severely tested. Patients can
be demanding, petty, dishonest, discouraging,
rejecting, critical, secretive, disregarding, demeaning –
and that’s just the short list.
The criteria for deciding what is pro-plan begin
first and foremost with the conditions of safety in the
relationship, and include the possible consideration
that all our patients have attachment issues in the
sense that they have developmental goals they want
to achieve that they unconsciously fear will separate
them from their attachment figures. The therapist is
the person the patient is depending on to not
traumatize the patient when he/she behaves badly,
tries something new, acts out, or in some other way
tests the therapist. CMT has been characterized
as “re-parenting”, and the therapist has been
described as a “developmental object” for the patient.
Any feelings of the therapist need to be consciously
recognized, thought through, and handled with the
patient’s history and sense of safety in the
relationship as the priority. This necessarily entails
personal growth on the part of the therapist, which is
one of the aspects of our profession that make it both
challenging and rewarding.
I’m not an expert on countertransference, and I
typically have more questions than answers. So I
hope this article will inspire you to send me your own
thoughts on this topic so we can begin an ongoing
discussion in the newsletter. What are your thoughts?
Also, if this topic interests you, be sure to join the
March Workshop presentation led by two Norwegian
members of SFPRG, Hans Peter Broch and Dag
Oulie. Hans Peter has written a book on
countertransference and has a lot to offer a
discussion of this topic.
Melanie Clark, MFT
mmetta@pacbell.net
