San Francisco Psychotherapy Research Group, Clinic and Training Center Newsletter
Issue #12
May 20, 2007
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Hello members and readers. This issue marks a year of presenting this newsletter to you. I thank all who read and participate and also welcome all to send articles or comments to editor: kathiedunnmft@comcast.net

PRESIDENT'S CORNER
 
From Jessica Broitman

This month found us partying as we thanked our supervisors and teachers for all they do to help us teach and train. We toasted them with great appreciation and affection. That very same evening another celebration occurred when several of our members displayed their art at the analytic institute. It was great fun to see what Stanley Steinberg, Estelle Weiss, Jane Dulay, Steve Foreman, and Barbara Sapienza have been producing. I also showed my very crazy cancer series which I am pleased to say is almost behind me. Read On


RESEARCH CORNER
 
From Marshall Bush

In response to the first round of feedback on developing operational definitions of 'testing', I am proposing this revised definition. Please look it over and see what other changes you would make:

Definition of a test: A test is a patient- initiated behavor that tries to solicit a helpful response from the therapist in an atempt to (1) establish safety in the therapeutic relationship, (2) overcome the obstacles to pursuing therapeutic goals, (3) disconfirm pathogenic beliefs, (4) master childhood traumas, (5) overcome pathological identification and compliances, and (6) develop new strengths. Read On


INTERN CORNER: Thank You SFPRG and How it Works in Norway
 
From Jan-Martin Berge

First of all I must use this opportunity to thank the SFPRG staff and all the March workshop participants on behalf of the Norwegian delegation for being friendly, open, warm and including. At this year's workshop, we were 9 people from Norway. All came from the city of Bergen either as a student (including myself), as associative professor or as a private practioner. I wish we had more time to get to know the city and to get to know more of the workshop participants, but maybe we get more time next year. You are all welcome to visit, and maybe one day Bergen will host a workshop! Read On


MEMBERSHIP COMMITTEE CORNER
 
From Kathy DePaola

I am happy to welcome our 124 new subscribers to our newsletter. We hope you have enjoyed reading about SFPRG classes, conferences, research and general news. The newsletter, which began in June 2006, was suggested by members as a way to increase contact and interaction among colleagues who would like to be more involved with SFPRG. It has been very successful and is not only an opportunity for members to keep up to date on SFPRG events but also to exchange ideas, write articles and get feedback on projects (see Marshall Bush's article). We would like to invite all new subscribers, if they are not already members, to join SFPRG and to become a part of the organization and continued development of control mastery theory.


MUSINGS ON THE JOY OF THERAPY
 
From Helene Goldberg

It all started when a former patient of mine called years after moving abroad to tell me that she realized that the most helpful part of our work together was that she could see that I genuinely enjoyed her and could appreciate her mind and sense of humor. I got over my disappointment that it wasn't my brilliant interpretations and insights; it was just that I really enjoyed her. When I thought about it, I realized that I generally make a point of enjoying my time with all my patients. And it's always a good thing. Read On


FOR YOUR INFORMATION
 

View Painting to Live , this timely exhibit curated by member Jane Dulay, MD, features member's Stanley Steinberg, MD, experience on Okinawa post WWII. The historical significance of this exhibit highlights the importance of recognizing and being recognized, and the ability to master the trauma of the effects of war through art. For event information please check out the website: http://ieas.berkeley.edu

  • Institute of East Asian Studies, UC Berkeley
  • Tuesday May 29th through Friday September 7th
Read On


Cont'd: President's Corner
 

Would you like to have an office with us at Funston? As I mentioned last month, we have decided to sign another 5 year lease at the Presidio, as a result we may have one incredibly beautiful office up for rent part time ( evenings and weekends) or fulltime, and one office available full or part- time. The Presidio has great views, parking and of course wonderful people to kibitz with in between sessions. Please contact Rob Petitpas, Office Administrator, to inquire about possible openings.

In Board News Norman Sohn, Peter Schumacher and Michael Lowenstein were unanimously re-elected to their second and final term. George Silberschatz has rotated off the board but will continue with his committee work as well as his numerous contributions through teaching and research activities. We thank him for his long dedicated service.

I am pleased to announce that Patsy Wood will be joining the board. In the future we will be looking for additional new board members. Might you like to join us or know a good potential board member? In particular we are looking for help with marketing, fundraising, accounting and legal issues. Please let me know if you have any ideas.

The board has been working on a new mission statement for the group and voted to adopt the following:

Our mission is to improve the practice of psychotherapy through the further development of Control Mastery Theory by educating mental health professionals, conducting research on psychotherapy, and providing mental health services to the community.

We hope to use it for our renewed fundraising efforts! The Presidio's board is joining our effort to raise money. We need to focus on raising enough money to assure the stability of the group, research efforts, our education and training program and the clinic. This will take a huge cooperative effort which I hope you will join me in! All grant writing skill and fundraising ideas are needed- please let us know.


Cont'd: Research Corner
 

Tests may be consciously or unconsciously planned and executed. The demand characteristics of a test can vary from mild to intense.

The therapeutic consequences of the therapist passing or failing a particular test will vary according to how central the test is to the patient's plan. The behaviors patient's use to pose tests may or may not be very different from their usual behavior.

Tests can be discrete, repetitive or continuos. The way a patient tests will be influenced by the patient's therapeutic goals, unconscious perceptions of the therapist, childhood traumas, pathogenic beliefs and childhood compliances and identifications.

There are two main types of tests (that can co- occur) which Weiss identified as "transferring" and "turning passive into active". In the former, the patient invites the therapist to treat him or her as the traumatizing parent did. In the latter, the patient treats the therapist as the traumatizing parent treated the patient. Tests can be passed or failed to varying degrees.

Next Step: The next step in this project is to develop categories for different kinds of tests with examples of each kind. In this light I ask members whether they think that testing in psychotherapy is always unconscious or can be conscious as well. If you have any examples of conscious testing, please email them to me: drmbush@pacbell.net

In addition I am attaching a rating form for therapists to fill out in order to further the research of control mastery theory for those in private practice. This form can be copied and pasted to a document or email:

Marshall Bush 5/13/07

FORM 6 FOR RATING TESTS IN SESSION_____

Rater's name__________________________ Date_________ Pt.____________

Episode Number_____

1. How likely is it that the patient is testing the therapist in this episode? (Check one)

Very unlikely____ Somewhat unlikely____ Somewhat likely____ Very likely____

2. Is the test more of a "transference test" or a "passive into active test"? (Check one)

Mainly a passive into active test____ A combined passive into active and transference test____ Primarily a transference test____ Clearly a transference test__­__

3. If the pt is testing the therapist, how strongly does this test demand a response from the therapist?

No demand____ Slight demand____ Moderate demand____ Strong demand____

4. If you think the pt is testing the therapist, what is the purpose of the test? (Fill in)

5. If you think the pt is testing the therapist, how likely is it the therapist passed the patient's test? (Check one)

Very unlikely____ Somewhat unlikely____ Indeterminate_____ Somewhat likely____ Very likely____

6. What evidence do you see for whether the patient's test was passed or failed? (Fill in)

7. If you consider this episode to be a test, how central is it to AR's plan? (Check one)

Not central____ Possibly central____ Probably central____ Clearly central____

8. To what degree is the patient consciously aware of testing the therapist? (Check one)

Not aware____ May be somewhat aware____ Probably aware____ Clearly aware____

Thanks, Marshall


Con't: Intern Corner
 

We had a lot of fun and found it very stimulating. There were many good lectures. I will never forget the morning sessions where Steve and Marshall guided us through a fascinating transcript of an analysis that took place some years ago. It was fun to be exposed to two CMT therapists, with different styles and attitudes but together made a valuable complementary unit.

For the most part it was not a problem to have lectures in the English language, but I must admit that I didn't know why all of a sudden everybody was laughing at one point in Bader's workshop, but that was only until the guy next to me translated and told me that Bader was talking about a patient who was turned on by Dentures!!

Being a Psychology student I came to hear of CMT in 2006. My teacher and supervisor Per Binder had been at the March workshop. Dag Aulie and Hans Peter Broch had been there for God knows how many years and me and my fellow students were third generation participants in that respect.

Looking at my own situation now in May 2007, I have participated at the annual workshop, have started writing my thesis on the theory, and I have also been accepted as an intern at SFPRG starting this summer. Great!

When I was there I asked many of you how you get your license in the U.S. I must say I was a bit confused, since there seem to be many ways to Rome for American students who want to do therapy.

In this article I will tell you how to become a Psychologist in Norway, why I would like to come to SFPRG and also use this opportunity to tell you that we don't have a place to stay during my internship.

SO: If anybody knows about an apartment from August to December that we can rent, I will be forever grateful for all help. My little family consists of my fiance, my baby boy, who is 6 months, and myself. My fiance has maternity leave so its so nice that the whole family can go "over there".

The Psychology Program at University in Bergen, Norway

After you have graduated from high school in Norway, all males must do one year of mandatory training in the military. Being a basketball player I got to play basketball all this year, but not all are as lucky as I. Many young Norwegian men have spent freezing nights in the wintertime somewhere in the middle of nowhere wishing they could be closer to mum's warm secure base.

When you decide to enter the university and want to become a Psychologist, there is only one program that you can apply to after completing a foundation course. First you take the foundation course together with (roughly) 750 other students. After the introduction year is completed, you apply for the 5 year program that will make you a certified Psychologist.

You don't need a lot of imagination to realize that there is a lot of competition getting into the 5 year program. One time there was a fellow student sitting next to me at a lecture in the introductory course. We were both taking the same course for the second time, (to improve our grades) and thereby our chances to get admitted to the program. She asked me if I wanted to exchange papers that we had written separately, where upon I agreed. She made it very clear that we were not to show them to other students.

Two weeks later, I was studying at a library when I heard the voice of this female student expressing an intense frustration. I walked out in the hallway and saw her with my paper in her hand, gesticulating to a fellow student friend that she didn't agree with the disposition I had written. Today she is in my class but much more calm.

It's not just fun to be an introductory student. Being one out of 750 and knowing that only 36 students are permitted to the program, does something to your psyche. I have worked some years at the local psychiatric hospital in our town, and there are always some students that are hospitalized after the exam period.

The good thing is that you can take retake the exam if the grades don't meet your standard or the standard to get accepted. I have a friend that took the same exam 4 times. After the second time, we stopped joking about it to him, but today we can look back at it with a smile since he got accepted to the programme on his 4th try.

The Psychology program is all together 6 years, consisting of one year introductory course and 5 years of the professional program. In the professional programme, we have 2.5 years of foundation subjects with ordinary exams. The last 2.5 years we don't have exams and that is wonderful. But, we have our own patients, and that can be more challenging than an exam or a test.

Our faculty has its own therapy clinic. It's divided into three institutes: pediatrics, youth and elderly patients. These patients agree to be videotaped and treated by a student therapist. In return the patients get treatment without charge, a short waiting list and eager students that really want to help them. Some informal research done at the clinic has shown that most patients are pleased with their treatment by students.

We as students work in groups of four, where we have our own patients, but we share the same supervisor. We get supervision every week and It is fair to say that we probably are being influenced too some extent by our supervisors. Being new to the therapy field, we are dependent on supervision. Good supervisors let the student find their own style, and make room for the students not to be rigid and defensive, but rather empathic and bold. I believe that Nancy McWilliams has a valid point when she claims that Psychotherapy is art.

When we have one year left of the program, we have to have a practicum at an institution outside the University. Some students work at a local hospital, others with school psychology, while even others have training at a business or foundation. This coming fall I will have my external practicum, and I would like to go to SFPRG.

In the last semester of our education we write our final thesis, and for my sake it happens to be on CMT and what promotes change in therapy. What a coincidence! I can get my training and get to be around professional CMT resources!

After graduation we get licensed as clinical Psychologists. It is only students from the 6 year program that get to call themselves Psychologists and that is probably why there is so much competition getting permitted to the last 5 year program.

What I have described is how it works in the city of Bergen. Cities like Oslo, Trondheim and Tromso also offer Psychology education, but there are just as many students at these Universities, so the competition is still a major factor for admission.

When you get your Psychologist degree you can treat patients but you can also do research. Some students decide to go into a doctoral program and do research. If you like to be a researcher you don't have to go through the 6 year program. You can get your B.A and followed by an M.A. and are then eligible to do research, but not to call yourself a Psychologist and do therapy.

So, that's how it's done in Norway. Almost all academic disciplines are divided into B.A and M.A, but three schools have retained their old degrees which are Psychology, medicine and odontology. I am very pleased to be in the program, and very excited of all the possibilities it lays the ground for. It is very competitive to get accepted, but when you get into the professional program there are so many possibilities, so many resources and a bright professional future, since Psychologist not are unemployed in Norway. We have a lot of clinical training in a safe environment with professional supervisors. And, if we like, we get to travel and do exchange visits like I plan to do this summer.

-All I need now is an apartment in the Bay area, and I am on my way for a new adventure, in the land of the free and the home of the brave.

See you soon, Love, Jan-Martin


Cont'd: Musings on the Joy of Therapy
 

Now this probably doesn't sound like anything out of the ordinary to most of you. I believe that, on the whole, we do enjoy our patients more than many therapists with different theories of how therapy works.

I started thinking about it and I realized that we are fortunate that our theory, by refusing to over- pathologize our patient's behavior in therapy, also frees us from the adversarial role that burdens our colleagues in different paradigms. In general, we seem less grim in our approach to our work and less likely to burn out.

It struck me too how other theories not only pathologize patients, but also pathologize the therapist. I noticed that many of my students were apt to blame any failure in their work on being too invested in helping their patients or liking them too much. They felt guilty for the very things that made them good therapists.

As therapists we've inherited a long tradition of anxiety about gratifying either our patients or ourselves. We've been made to feel guilty about colluding with patient defenses, encouraged to develop an exaggerated concern about maintaining the frame, been taught to overvalue our supposed neutrality and pushed to end up phobic about any feelings of affection toward our patients. It's no wonder many therapists begin to experience burnout or find themselves mired in therapeutic impasses with their patients.

The class I've been teaching for the last two years has been a lot of fun for all of us. Basically, it's a case conference, though now and then we read a pertinent article and discuss it and sometimes I find myself opening the class with a mini lecture on control mastery theory. I'm looking forward to starting up again in the fall.


Cont'd: FYI
 

NEED A PLACE TO WRITE OR WORK ON WEEKENDS?

Beautiful, spacious, quiet office available at 10 Funston in the Presidio, weekends and some evenings. Inquire at 415-561-6788.

SUMMER IN THE MOUNTAINS?

Large vacation home, 3 blocks from Donner Lake beach, sleeps 10+, mountain views. Available last three weeks in July and possibly other weeks. Call Kathy at 415-298-9563.


9 & 10 Funston Ave, The Presidio
Kathie Dunn MFT, Editor
San Francisco Psychotherapy Research Group, Clinic and Training Center

Phone: 415-561-6771
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