San Francisco Psychotherapy Research Group, Clinic and Training Center Newsletter
Issue #37
September 18, 2009
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PRESIDENT'S REPORT
 
From Steve Foreman

Dear Colleagues,

Welcome back to a new school year after a wonderful summer. Fall classes are beginning again in September and October, including case conferences, research conferences, seminars, weekend conferences, and the new intern training program for the clinic.

Control Mastery Theory continues to grow. I have finished a new book that should be out next month applying Control Mastery Theory to Child and Family Therapy, entitled, Breaking the Spell, Understanding Why Kids Do the Very Thing That Drives You Crazy. The book is an analysis of the dance between parents and children, how kids test their parents and how parents worry and suffer too much.

Last spring, George Silberschatz finished a study relating therapist pro-plan interventions to outcome in a large cohort of over 40 cases, lending new credibility to the importance of accurately diagnosing a patient's plan in order to lead to a better outcome. This is a crucially important finding because Control Mastery Theory is the only model that looks at the patient's Plan in the way that we do. Besides the patient's contribution to the Therapeutic Alliance, the Plan Compatibility of Therapist interventions is the only variable that has been shown to predict the outcome of psychotherapy in the entire psychotherapy research literature. George's finding supports Joe Weiss' prediction (and most of our clinical experience) that pro-plan interventions lead to better psychotherapy outcome. Read On


IT'S TIME TO MAMBO!!
 
Membership Committee

Hello Members and eletter subscribers! It is once again time to Mambo and we invite you all to come and have fun with us. Postcards are going out the week of September 21.

The Mambo format is changed from last year: NO TOWN HALL BUSINESS MEETING!!

This means we are looking to have fun, socialize, network, eat and drink. We also have a DJ and all are invited to dance as well so bring your dancing shoes.

Details below:

  • Sunday, October 25, 2009
  • 5:30 - 8:30 pm
  • Swedenborgian Church
  • 2107 Lyon Street (at Washington), San Francisco
  • RSVP: Rob 415-561-6771 or sfprg@sfprg.org

In the event you cannot find street parking there is a garage 3 blocks away (and down the hill) at the JCC garage on California and Presidio.

In addition, please look for your SFPRG renewal letters in the mail and we invite eletter subscribers to join as well. Check our website for information on what and how. We value our membership and strive to present an organization which meets your needs and provides support and opportunity.

Please note: We deeply regret that our therapist search engine has been on the blink. We'll be up soon and thank you for your patience.


MEMBERSHIP RENEWAL DRIVE
 
From Rob Petitpas, Executive Director

First of all, thank you to those who managed to renew your membership online and put up your profile before our new website bugged out. The web designers have been working hard to figure out what the problem is and fix it. We hope that it will be working again by the time you read this.

Our apologies to those of you who have tried (and tried) to renew online and have been frustrated. I do want to make it understood that we would like all of our members to fill out the first part of the online form. This will make your information available to our member-only online directory. You will need a member login and password to access this online member directory; the member directory is not the same as the public Therapist Finder database. You can only get a member login and password by filling out the first section of your profile (it will be sent by the office).

You also will be able to update your information to the membership directory at any time. To be listed in our public Therapist Finder, you must check the appropriate box and fill out that information - the office has not put anyone into that database. Again, the link for current members to renew and create a profile is: www.sfprg.org/renew (Click below). If the link is not yet live, please check your email for notification of when it is working!

SFPRG welcomes new members and you may join via the website using the links under Membership on the menu. Thank you!

Fortunately, the continuing education registration links are working and you may register for our case conferences through the website or download a form to mail. Please let your colleagues know about the Introduction to Control Mastery Theory day-long on October 31 and the conference on Men's Psychotherapy Groups on December 5th.


THE PSYCHOLOGY OF THE DEATH PANEL DELUSION
 
From Michael Bader, DMH

A lot of heavyweight thinkers have offered explanations of the irrationality of modern political behavior--you know, behavior like Medicare recipients at town halls screaming about the evils of government-run health care or otherwise reasonable people likening Obama's plan to Nazi eugenics. George Lakoff theorizes that conservatives interpret reality through metaphors and meta-narratives modeled after authoritarian family structures. Drew Westen argues that they interpret facts according to emotionally based investments in conclusions they already hold, bypassing cortical centers of reason altogether. These and other analyses are powerful and helpful. But they aren't satisfying to me because they aren't specific enough to account for the passionate urgency and self-destructiveness of the right-wing rejection of a program that will obviously benefit them.

In both my consulting room and my writing and teaching about organizational and political change, my focus is on understanding the causes of irrational and self-destructive thinking and behavior. However, whenever I describe the deeper unconscious motivations behind political attitudes, I often encounter 2 types of negative responses: First, the people I'm "studying"-in this case, the Right-feel demeaned (much like campus radicals did in the 1960s and 1970s who were told they were simply working out their "issues" with authority), and, second, people on my side of the political aisle tell me that I'm using psychological mumbo-jumbo to unnecessarily complicate something quite simple. In this case, the simple truth turns out to be some throw-away line like "They're just racist idiots," or "They've been manipulated by the Radical Right."

While I personally share the anger at the Right of my progressive detractors, I would point this out to them: Just because we all have unconscious minds that irrationally interpret and react to the world, it doesn't mean that we aren't motivated by other feelings and attitudes as well or that we shouldn't be held accountable for the damage we do in the process. It simply means that when people routinely act against their own best interest, it's worth understanding all levels of their motivation. Progressives, by the way, aren't immune to unconscious self-sabotage; they display such irrationality all the time when they launch quixotic campaigns against the "enemy" that don't stand a chance of winning. But in the case of health care reform and the anti-government rage we see in town-halls and "tea-party" events, the irrationality seems to me more prominent on the Right.

Please click the link below to continue this article.

Michael Bader is a psychologist and psychoanalyst in San Francisco. He has written two books about sexuality, as well as many academic journal articles about psychoanalysis. In addition, he has written for Tikkun Magazine and the website Alternet.org on topics involving the application of psychological thinking to politics and culture. Finally, for the last 7 years, Dr. Bader has worked in an interdisciplinary leadership development program connected to the largest and fastest-growing union in the country, the Service Employees International Union (SEIU). You can find out more on his website, www.michaelbader.com.


INITIAL EXPLORATION BETWEEN CMT AND DEPTH PSYCHOLOGY: PART TWO
 
From David Michael Martin

Part Two: Pathology

In the last newsletter I made an introductory look at the primary elements of CMT and Depth Psychology. That section discussed the similarities and differences in the theories and showed how well they worked together. In this section I will take a brief look at the rudiments of pathology in each of the theories and how they differ and support each other in a therapeutic practice.

CMT theory assumes that the patient's problems stem from "frightening unconscious maladaptive beliefs" (Weiss, 1993). These beliefs are called pathogenic in this model. They are considered to impede the functioning of the client by adversely affecting his self-esteem and prevent his pursuit of adaptive and desirable goals. Weiss proposed that, "in attempting to adapt to unhealthy psychological environments people develop invalid, negative beliefs about themselves and others that make them unhappy and prevent them from living effective and satisfying lives. It is these beliefs that are the basis of psychopathology" (Rappoport, 2002). On the face of it, we will see that this is not so very different from the Depth Psychological approach. Read On


CMT ON YOU TUBE
 
From Vic Comello

The DVD Psychotherapy Case Formulation from the Perspective of Control-Mastery Theory w/ George Silberschatz and Susan Badger is now on YouTube in its entirety at http://www.YouTube.com/ControlMastery.

Because of YouTube's 10 minute/video limit, the content of the DVD is segmented, but the various installments are presented in order to make it easy for viewers to follow along.

Click the link below to view.


INSTITUE FOR CONTEMPORARY PSYCHOANALYSIS
 
Saturday Series - Bay Area

THE BODY AS BIG WISDOM: USING NON-VERBAL COMMUNICATION IN THE THERAPEUTIC HOUR

This two-part workshop will offer an opportunity to explore the interplay of nonverbal and verbal modes of communication in both the therapist and patient. Clinical material will illustrate the bidirectional process of connecting somatic and sensory processes to imagery and language in order to help a patient whose emotional life is heavily dominated by somatization. Rather than understand her psychosomatic symptoms as substitution for thought, this perspective treated her bodily complaints as serving a transitional role in the processing and expression of emotional communication.

How the therapeutic dyad constructs emotional meaning will be viewed through the lens of Wilma Bucci's ideas on subsymbolic emotional expression and her model of the referential process. Theory will be applied to case material for the treatment of psychosomatic processes, dissociation, emotional effects on the immune system, disorders in eating, and treatment in general.

To register, please email starr@keltonlocke.com. Include the following information: Name, Address, Phone number, Email contact.

  • December 5, 2009 11am - 2pm
  • January 16, 2010 11am - 2pm
  • Location TBA (SF or North Bay)
  • $25 ICP members; $35 nonmembers
  • Instructor: Starr Kelton-Locke, Ph.D

Betsy Wootten. ICP Bay Area Program Administrator, 6493 Cooper Street, Felton, CA 95018, 831-335-5526 phone & fax, bwootten@mac.com


OFFICE FOR RENT
 
From Frieda Schwartz

North Berkeley/Solano Office. Beautiful, psychotherapy office in an all therapist building available full-time. Location is ideal, near shops & transportation. The office is charming, bright with a fireplace. It is soundproof with waiting room call system and wheelchair access. Cleaning/utilities included. Call 510-526-0908.


Cont'd: President's Report
 

Others in our group are doing exciting, groundbreaking work expanding and adding to Control Mastery Theory. Alan Rappoport further developed Control Mastery concepts on psychopathology and technique in his wonderful paper on Co-Narcissism. Last year, Michael Bader presented his work, based on his recent book, extending Control Mastery theory in his analysis of sexuality and sex roles.

Advances were made by members of our group applying Control Mastery Theory to theories of aggression, to the interface with Cognitive Behavioral Therapy, and to novel treatment strategies of Borderline Personality Disorder.

At our 22nd Annual International Conference on Control Mastery Theory last year, in addition to our core seminars and usual topics, we presented seven completely new seminars on topics as divergent as the biology of women, young adults who fail to launch into adulthood, romantic love, and Trauma Theory.

In addition to presenting Control Mastery Theory to a conference in Almagro, Spain, last fall, Control Mastery Theory was presented for the first time to an enthusiastic international conference in Havana, Cuba, in the spring. Two psychiatrists from Havana will come and join us this March, 2010, for the 23rd Annual International Conference on Control Mastery Theory in San Francisco.

Our teaching program is vibrant locally, nationally, and internationally. We continue to have an active research program. The clinic continues to provide low cost psychotherapy to our community, while training clinicians in Control Mastery Theory. We are hoping to expand our program to include training post-doctoral clinicians. This will require a small stipend that the board will consider in our next budget.

The clinic would like to expand the number of trainees, which would require a larger administrative staff. We would like to eventually offer a small stipend to the pre-doctoral trainees as well. This will require more expense that will need to be supported by more income to our budget.

Expanding our teaching program and hiring statistical consultants and research assistants will also require more income to our budget. While trying to continue the strong teaching, research, and clinical program we have, we want to expand our teaching program, revitalize our research program, and increase our capacity to see more clinic patients. We want to teach more high-caliber trainees and pay them something as well.

In order to pay for our expanded program, we are currently exploring ways to decrease expenditures as well as increase income at SFPRG. We are trying to renegotiate our lease so that we may avoid a scheduled rent increase this and next year. We are looking at what it would take to possibly buy a new building so that we would have greater control over our space and protect ourselves from potential rent increases in the future.

We are looking at increasing income by becoming more efficient in the clinic and seeing more clients. We are also hoping to increase income by fundraising in the community, asking people who have benefited directly or indirectly from Control Mastery therapists to help fund the clinic, teaching and research programs.

We are also asking members to renew their membership and give more money than they usually have given if they can afford it. For people who can afford to give above the standard membership fees, we are asking for donations of $350, $500, $1000 or more if that is possible.

We are also asking for non-members to join SFPRG and take advantage of discounted conferences and classes, as well as participating in our new therapist data base on our exciting revamped website. Please renew your membership or sign up as a new member at SFPRG.org. As Peter Schumacher said in his column, there are still kinks to be worked out, but go to the website and call or email Rob Petitpas if you have a problem.

Have a wonderful September. I will see you next month.

Steve Foreman


Cont'd: An Initial Exploration
 

In CMT, psychopathology stems from pathogenic beliefs that typically originate from traumatic childhood experiences. Pathogenic beliefs are believed to be an attempt at adaptation to the life circumstances of the given moment. A person's response to trauma, no matter how dramatic or subdued, and his or her propensity to develop pathogenic beliefs in response to it, is influenced by a variety of factors. These factors include the basic personality of the individual, the well-being of those around them, the specific nature of the trauma, and, of course, and social context. Pathogenic beliefs are powerful, emotion-laden, painful belief structures that can cause severe emotional distress.

CMT theory believes that people are highly motivated to relinquish or disconfirm their pathogenic beliefs, but are impeded from doing so by their perceptions of danger. Pathogenic beliefs are conscious and unconscious 'anticipatory ideas' that derive from traumatic childhood experiences which then are constantly repeated in new relationships throughout a person's life. However, disconfirmation of pathogenic beliefs can happen in love relationships, friendships, work relationships or the therapeutic relationship (Silberschatz, 2005). As we turn our attention to the Depth Psychology theory of the complex, we will see many similarities that allow for a beautiful 'in tandem' use of the two theories. For Depth Psychology it is the complex that blocks our connection to the healing and fulfilling feelings redolent in the psyche. "They are instigated by interpersonal traumata like emotional abandonment, sexual abuse, and lack of adequate mirroring, and then they grow by gathering associations of a similar nature around themselves and by binding them to the core of the complex with emotion" (Stein, 1996). It takes no stretch of cognition to see the clear link with CMT theory.

The complexes can result in an eventual build-up like a psychic barrier between the ego and the deeper, instinctive/archetypal levels of the psyche. It is this barrier layer of complexes that can severely block the healing compensations of the natural psyche from reaching ego consciousness. According to Jungian theory, 'compensation' is the "self-regulatory dynamic process whereby ego-consciousness and the unconsciousness seek homeostatic balance, which also foster - - - the progressive movement toward wholeness" (Stein, 1998). For example, if we are too stressed and over-worked, but continue to forge ahead and consciously deny that we are out of balance and overly stressed our unconscious might send us a dream wherein a murderer is blowing up the office and we must flee for our lives away from work and towards an ocean beach. This hypothetical example suggests that we are not paying enough attention to emotional, non-work related aspects of our lives, and thus the dream attempts to create a balancing effect in the psyche. The intent of which is to be made conscious and compensated for in the waking life. Much like CMT pathogenic beliefs which can cut one off from a naturally fulfilling outlook and functioning in life, complexes can create 'fracture points' in the structure of the developing ego. In these cases, developing consciousness is disturbed and the integration of experience is blocked. This may foster the chronicity of defensive and neurotic psychic patterns, and block the client from the fuller, balanced expression of the underlying archetypal power, the expression of which leads one towards health, wholeness and balance of the psyche.

Again, complexes and pathogenic beliefs share many attributes. Complexes are the result of "life", and the more pathological and disturbing are usually caused by early childhood trauma or thwarted developmental experiences. Complexes can arise out of the relationship between the experience, context, feeling of safety and an attempt to understand and adapt to the life situation. The form a complex takes varies from person to person depending on several factors. Some of these factors are shared with CMT theory and, again, some move beyond it to postulate a deeper vision of the psyche beyond just the function of psychotherapy. These shared factors include: the personality of the individual, several temperamental variables (including Jung's typologies), the specific nature of the trauma, and, of course, the familial, social, geographical, cultural and temporal contexts (Stein, 1996). Where Depth Psychology moves beyond CMT theory is in its more philosophical type of psychological theorizing. Complexes engender intense emotions and are mental and "spiritual" by nature since they connect us to the larger, underlying archetypal pattern that goes beyond the individual.

Depth Psychology theory also supports the belief that people are highly motivated to resolve complexes. Among several aspects of the psyche, two prominent aspects are the 'ego' and the "Self'. The "ego" is the center of consciousness, the "I", and the "Self" is the center and the source of all archetypal images and of innate tendencies toward structure, order, and integration. Since the ego and the Self are on the same axis, it is the nature of the psyche to compensate for unhealthy behaviors, thoughts, and feelings by moving the person towards the rectification and healing, and thus the empowerment, of the archetypal pattern and experience. However, the complex is not necessarily viewed as "negative" per se, but as mythological, even mythopoetic in some Depth Psychology theories, but it is always an integral part of the healing and journey of individuation. In this instance 'mythopoetic' is the exact opposite of the medical model 'pathological'. Where pathological means something is wrong or diseased and needs to be fixed or healed, mythopoetic respects the hardships and mental/emotional struggles as a divine and intended part of the individual's journey towards individuation and life fulfillment. Where pathological is seen as purely negative, mythopoetic views struggle as inherent and necessary. Thus our difficulties are used to compel us towards betterness, not to mark us as evil, broken or diseased.

Thus, like pathogenic beliefs, the complexes are conscious manifestations of unconscious experience. The negative behavior of a complex can be repeated over and over again if the individual does not become aware of the sometimes subtle messages from the psyche in dreams, synchronicities and relationships.

Depth Psychology believes we are constantly presented with opportunities to move towards individuation which is, "the process of psychic development that leads to the conscious awareness of wholeness" (Stein, 1998). Also, similar to CMT, Depth Psychology emphasizes that these opportunities to resolve the negative complexes and neurosis are available at every moment. However we must learn how to become aware of and utilize the tools that the psyche provides.

Next time I will wrap up the discussion with a look at CMT "testing" and Depth Psychological "countertransference" types. This will give us a little deeper window into how the therapist can use both of the theories together in a harmony that helps define the nature of the work as well as create a safe and positive healing space for the client.



Kathie Dunn MFT, Editor
San Francisco Psychotherapy Research Group, Clinic and Training Center

Phone: 415-561-6771
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