Dear Colleagues,

Happy New Year! A lot has happened since my last report to you in July, 2010. First of all, thanks to Kathie Dunn who has returned to publish the newsletter. Our newsletter has been a tremendously important communication service for SFPRG and the newsletter's interested readership. So thank you again Kathie!

One important follow-up from my last article: SFPRG did not pursue the possible option to relocate our offices to Jackson Street as we were considering last summer. We have signed a lease with the Presidio until December, 2013.

We have been pursuing other options to close our budget gap and to raise money to actually expand our services at the Clinic, our educational and research program. We have embarked on a new fundraising campaign in the last 6 months. We hired an experienced fundraiser, Sherri Morr, who helped us over the past 4 months. We have a new Board Member, Kasandra Burr, who energetically and competently chairs our fundraising committee. We had our first fundraising event, a Denny Zeitlin jazz performance at my home that was delightful. I greatly appreciated Denny's artistry as well as his generosity to SFPRG. We are planning 2 more events over the next six months.Read On

We thank all members who responded to our membership drive by renewing, many of you at a higher level. A sad note, our membership is down from last year and from four years ago.

Our committee is now attending each Education event to welcome people to our membership with information and a personal invitation. Harriette Grooh has attended both the Intro course from Steve Foreman and the Trauma workshop presented by Ginger Rhodes. I went to Sacramento for the Intro course presented by Susan Landes. We found that interest in connecting with SFPRG is high.

The Membership Committee is hosting a lunch on for New Participants to the March Convention on Tuesday at noon in Presidio #10. More information will follow.

We have in the works informal venues at SFPRG presenting the artwork of members with discussions on art forms with a simple pot luck and BYOB. This will facilitate more contact between members/colleagues and provide a lively format.

As your chair I welcome your suggestions about venues and activities and I also welcome anyone who has the time and interest to become part of our committee. Contact me at kathiedunnmft@comcast.net

The March International Workshop is filling up! Our splendid annual week-long workshop is featuring its usual array of classes on a wide variety of subjects, plus a core of classes on CMT basic concepts and daily morning teaching conferences for new and for repeat attendees.

This year we will have more than a score of attendees coming from Norway, as well as several others, all of whom have already signed up. More places are still available, so we encourage everyone to let their colleagues, students and supervisees know about this terrific bargain of learning.

We are continuing to plan classes and conferences for the remainder of the year. Our Post-Graduate Seminar continues in Berkeley, as well as our numerous excellent weekly case conferences and classes. We are mapping out how these offerings will unfold next fall, and have already scheduled for Denny Zeitlin to again present his fine one-day course in couples treatment, in November.

Look for more to come!

Who are the people who make up the membership of SFPRG? What attracts us to the theory and the organization? How do each of us approach our work, and what are our areas of specialization? Who is conducting research? Who is teaching and consulting? SFPRG has a forty year history, with a combination of long time members who "grew up" under the tutelage of Joe and Hal and those who have more recently become a part of SFPRG. The focus of this column is to get to know our members, the modalities in which we work, and how the framework of CM theory guides our approach to our clients. Let me introduce myself and my connection with SFPRG to you.

After being coaxed into attending Hal's case conferences in the mid 80's, a time of high enthusiasm and energy in the organization, I was immediately attracted to the clarity, thoughtfulness and the practicality of the theory, and I quickly realized that the theory was applicable to all the modalities in which I work: individual, couples and group therapy. I was fortunate to learn not only from Hal and Joe, but also from other senior practitioners. I value my membership in the organization and I have recently joined the SFPRG board. Read On

An Invitation to Participate in a Dialogue about Testing from Marshall Bush (1/10/11)

I would like to initiate a newsletter dialogue about testing, one of Weiss's most innovative and controversial concepts. My Friday research group has been studying this concept for the past 3 years. We have entertained a variety of questions about how best to define, operationalize, and measure testing. I think it would further the advancement of CMT to have a lively exchange of views about the nature and importance of testing in various types of therapy and human encounters. I am presenting some initial thoughts about testing for our members to respond to. I know that many of you have written articles about testing and developed your own ideas about this topic.

My own thinking about testing is shaped by Weiss's treatment of the topic in The psychoanalytic process (1986) and How psychotherapy works (1993). I believe that testing, like attachment, serves a vital adaptive function without which people could not survive and science could not progress. I believe that the essential purpose of testing is to discriminate between safe and dangerous situations and between truth and falsehood. Without the capacity to test, one would not know whom to trust or what to believe. Since testing in psychotherapy (and in all human relationships) is largely unconscious, having access to one's affect signals (which is how we access our unconscious thought processes) and a reasonable capacity for reality testing is essential for being able to plan passable tests and correctly interpret their results. People with limited access to their emotions are impaired in this regard, as are people who cannot question their false assumptions about the world. Very traumatized or discouraged people may not test at all; they just assume the worst. Read On

A new research project is underway at the SFPRG training clinic. The study will involve collecting pre-treatment and on-going treatment information from both patients and training therapists. A major goal of the project is to examine the relationship between developmental traumas and subsequent pathogenic beliefs. The study will also investigate the degree of agreement between patients' and therapists' perceptions in therapy.

Ultimately, this research project seeks to provide information about the identification of pathogenic beliefs and tests, and how this process relates to treatment outcomes. The Principal Investigator in this study is John Snyder, PsyD. John is a current Post-doctoral Fellow and Research Coordinator at the SFPRG Training Clinic.

I had the honor to present Control Mastery Theory at a conference in Cape Town, South Africa over Thanksgiving, 2010. Please see my presidential column for more information about that conference. As I mentioned, a highlight of the conference was having the opportunity to meet Anthony Bateman from London, who spoke about Mentalization-Based Therapy (MBT) in the treatment of borderline personality disorder and substance abuse.

I had read Anthony's book, Mentalization-Based Treatment For Borderline Personality Disorder, A Practical Guide, that he coauthored with Peter Fonagy in 2006, but I had never heard him present before. I don't think he has had the opportunity to hear a presentation of Control Mastery Theory prior to this conference either. Anthony was very charming and funny. We had many opportunities to talk about theory and research as the week progressed, over meals and during our presentations. Read On

March International Conference Information Online at www.sfprg.org Check our website under Continuing Education for information on our Spring Case Conferences and the 24th Annual International Conference on Control Mastery Theory. The schedule of classes for the week of March 7 is online. Several students and colleagues from Norway have already registered for the week.

SFPRG members are coming from across the country as well. People can sign up for the week or you may take any individual 2-hour segment on a first-come basis if there is room. The conference is being held once again at our offices in the Presidio.

Our Control Mastery Theory introductory course, "The Origins of Psychopathology and the Nature of Psychotherapeutic Change" will be held on Saturday, March 5, 2011 at the SF JCC on California St. at Presidio Ave. Dr. George Silberschatz will be teaching this class. $50 for 6 hours of continuing education for therapists. Details are on our website.

SFPRG Committees Standing committees meet in the SFPRG conference room every Friday at noon: The first Friday of the month is the Fundraising Committee meeting; second Friday is the Education Committee; the fourth Friday is the Membership Committee. All committees welcome member involvement. If you want input to a committee but cannot make it to The Presidio on Fridays, you can call in to the meetings. Contact Rob in the office for more information.

Offices in The Presidio We want to make sure that our members know that we signed a lease extension with The Presidio through the end of 2013. We have suspended our search for new space. Our current sub-tenants love being in The Presidio and don't want to leave!

However, there is one large office available for lease in Building 10 (from a former sub-tenant that moved out of state). If you are interested in having a look, call Rob at 415-561-6771.

I have a weekly psychotherapy consultation group that meets on Wednesdays from 1:30 to 2:30 at my SF office. The fee is $55 per week. Please write (george.silberschatz@ucsf.edu) or call (415 567-3669) if you are interested in participating.

Equine Insight offers Horsemanship groups for children. This 6-week group for children with special needs is structured to allow the horse-child interaction to facilitate change. This hands on, goal oriented treatment group allows each child to manage their unique being in relation to the horse. Begins January 24.

Mental health practitioners group ( 2 CEU's) New therapists groups begin January 19 and 24 from 12-2pm. Through experiential work with the horses, therapists will gain knowledge of how Equine Facilitated Psychotherapy operates while gaining valuable insight into your own cases and personal issues.

Groups are held in Novato.

Judy Weston-Thompson owner and operator of Equine Insight has been a licensed, practicing therapist for 22 years. She combined her passion for horses and psychotherapy to create a powerful healing modality. Serving people of all ages, she has been successfully running Equine Insight for 4 years. She also offers trainings and workshops in EFP. Please visit equineinsight.net for more information.

We have had four new directors join our Board in the last 6 months. Kasandra Burr, as noted above, chairs the Fundraising Committee. Jodi Reiter is our excellent current intern Board director. Eric Taggart, a recent former intern, has joined the Board as Treasurer and Chair of the Finance Committee, bringing energy and a lot of good ideas. Mia Salaverry, another former intern and current member of the Education Committee, is joining the Board, taking on the role of marketing and publicity. She has some very creative ideas about clarifying SFPRG's identity and value, and presenting that to the community.

Our Board met this past weekend to review our direction, strengths, and weaknesses as an organization. It was a very productive retreat and the present Board members unanimously expressed interest to meet each quarter.

Since my last report, I have had the good fortune to present a day-long lecture on Control Mastery Theory and technique at a conference in Cape Town South Africa on Thanksgiving Day. The conference was organized by Kari Lossius, a colleague from Bergen, Norway. The audience of about 100 were mostly Norwegians and South Africans. The speakers were from South Africa, the Netherlands, Norway, Hungary, and London. The Conference was on substance abuse but the speakers discussed topics as diverse as poverty and violence in South Africa, ADHD, genetics research, treatment of Borderlines with Mentalization-Based Therapy, and Control Mastery Theory.

Our Norwegian colleagues, including Hans Peter Broch, Torr Sletten, and Dag Oulie, have a long history of discussing, teaching, and promoting Control Mastery Theory in Norway as well as at conferences in warmer climates. They have invited many of our presenters such as John Curtis, Jessica Broitman, George Silberschatz, and myself at various times to present at conferences in Spain, Cuba, and South Africa. In Cape Town, I had the good fortune to reconnect with Norwegian friends and colleagues who have attended our International Conferences that we offer in March each year. In addition to Hans Peter Broch, who has come to San Francisco at least 17 times in the last 24 years, I saw Bernt Larsen, a child psychiatrist from Bergen whom I first met in Almagro, Spain in 2008. Since then, Bernt has come to San Francisco 2 or 3 times and promises to come again for this year's International Conference in March. Several other Norwegian participants in Cape Town had attended our International Conference 2 years ago in San Francisco. Many more attendees expressed interest in coming this year to our 24th International Conference in San Francisco.

One of the most interesting aspects of this year's conference in Cape Town was having the opportunity to meet and present with Anthony Bateman from London, who spoke about Mentalization-Based Therapy (MBT) in the treatment of borderline personality disorder and substance abuse. Please see my other column in this newsletter on Control Mastery Theory and Mentalization-Based Treatment.

One other footnote to the trip to Cape Town. In early November, before I left for South Africa, I attended a conference with Diana Fosha at the Wright Institute in Berkeley as a guest of Steve Kanofsky, one of our SFPRG members and an important faculty member at the Wright. I had the opportunity to meet Jerry Diller, another Wright faculty member. Jerry and Steve have a professional connection with a group in South Africa called the Institute for Healing of Memories founded by Father Michael Lapsley. The group is a non-profit group that helps victims of trauma, violence, and apartheid. It started during the Truth and Reconciliation hearings at the end of Apartheid after Nelson Mandela became president of South Africa in 1994.

The Healing of Memories program puts on workshops and trainings for victims of traumas (and for victimizers) in South Africa as well as all over the world. I had an opportunity to spend an afternoon with Alphonse Niyodesenga and other staff from the Healing of Memories Institute in Cape Town, learning about how they deal with victims of trauma, and introducing them to SFPRG. Steve Kanofsky and Jerry Diller recently put on a conference in Berkeley in December about the Healing of Memories approach to trauma. Because so many of our group is interested in the effects and treatment of trauma, I mention this organization from South Africa as an item of interest.

There is much more to report but I look forward to our next newsletter in February. See you next month.

Early on, I was struck by the positive nature of the theory, with its emphasis of growth and healthy development, as well as the focus on psychopathology and the role of pathogenic beliefs. I found the essence of the theory to be highly compatible with who I am and how I think as a therapist.

I am pleased to have been able to work with Hal Sampson, who's thinking and writing on "Treatment by Attitudes" influenced the importance I place on the therapeutic relationship itself, and the honest, caring nature of that relationship.

Over my 25 plus years utilizing CM theory in my practice in KentfieId I have experienced its power helping individuals overcome profound feelings of discouragement, and its power to help partners in couples develop greater love, understanding and respect for one another. I have a particular interest in how men interact with other men and have seen how effective CM theory is helping men in therapy groups achieve success in their lives and establish healthier relations with both men and women.

Our next issue will feature Dr. Rachel Rivers, another long time SFPRG member. If you are interested in being profiled in this column, or in just letting people know what you are up to in your professional life, please email me at maslowj@comcast.net for phone me at (414) 454-7698.

We know that testing in therapy serves a variety of functions and takes many shapes and forms. Patients test to find out how trustworthy the therapist is, how safe they will be to remember and discuss painful experiences, whether the therapist will repeat their parents' traumatizing behaviors and confirm or disconfirm their pathogenic beliefs, whether the therapist will model better ways of coping with traumas they found overwhelming, and whether the therapist will provide the corrective emotional experiences needed to master childhood traumas.

I believe that therapists differ widely in the extent to which they actively use the testing concept in the way they participate in the therapeutic exchange, process the patient's material, emotionally respond to the patient's feelings, and formulate interventions. Some therapists only think about testing when an unexpected problem arises or when reflecting back over a session. Some therapists have observed a decline in testing over time. There are diverse opinions about how, when, and whether to interpret a patient's testing behavior.

Therapists also differ in their ability to understand and tolerate different kinds of tests, especially passive into active tests. Therapists who are sensitive to rejection or prone to feel overly responsible for their patients, may find certain tests hard to endure or impossible to pass. And some patients pose tests that are indeed impossible to pass. All of these issues are worthy of dialogue, debate, and discussion.

Please send your commentaries, however brief, both to the editor of the newsletter, Kathie Dunn (kathiedunnmft@comcast.net), and to me at (drmbush@pacbell.net). I look forward to a lively exchange of ideas. Marshall Bush

There are areas of consistency between Mentalization-Based Therapy and Control Mastery Theory. One of the central tenets of mentalization (or mentalizing) is that the therapist tries to induce the patient to be able to think about thoughts and feelings and connect them to behaviors. According to this model, the mentalizing patient has greater access to creativity.

Even though CMT doesn't specify how the therapist should bring about greater ability to think about and integrate thoughts, feelings, and behaviors, our research group has used similar variables to these elements of mentalizing as process measures indicating patient progress in our psychotherapy research. In those studies, we have commonly used the Experiencing Scale (measuring connectedness to feelings), as well as the Morgan Insight Scale, communication scales, therapeutic alliance scales, even a "regression in the service of the ego" scale (Jack Bugas) to indicate patient progress or retreat in psychotherapy. We share with Fonagy and Bateman the belief that patients who can increase the ability to be aware of thoughts, feelings, beliefs, and wishes will do better regulating emotions, relieving symptoms, and relating better to others.

Another area of similarity between CMT and MBT is the relationship between MBT's concept of "psychic equivalence" and CMT's concept of "pathogenic beliefs". Fonagy and Bateman's concept of "psychic equivalence" is that patients have "self-related negative cognitions (that) may be felt to be too real".

"Psychic equivalence" directly parallels CMT's concept of "pathogenic beliefs" that are negative beliefs about the self in relation to the world. Bateman said, "The entire goal of psychotherapy is to instill uncertainty and doubt," which parallels CMT's maxim that the curative element of psychotherapy is undermining pathogenic beliefs.

Another crucial similarity between CMT and MBT is that they are both self-correcting. Bateman repeatedly said that if the therapist is on the wrong track, the patient will get worse and the therapist should stop doing what he is doing and try to take a different approach to promote the patient's ability to mentalize. This is similar to one of the most important prescriptions of CMT that the therapist should pay attention to how the patient is responding to the therapist's interventions and the therapist should do something different if the patient seems to be getting worse. Fonagy and Bateman have a notion of therapist interventions that are "anti-mentalizing" that I believe is similar to CMT's concept of therapist interventions that are "anti-plan."

Despite the important similarities between CMT and MBT, there are also significant differences. One of the most important differences is that MBT doesn't seem to have a concept of the patient's Plan. MBT doesn't ask what the patient is trying to achieve nor does it consider how the patient may be testing the therapist by a particular behavior. MBT is only interested in whether the patient mentalizes or not. MBT suggests a multitude of techniques to induce the patient to mentalize that may lead to very different interventions than a CMT therapist might use if he were thinking how the patient may be testing the therapist. Bateman concluded the therapist doesn't need a concept of the patient's Plan because if the therapist is on the wrong track and the patient gets worse, the therapist can shift technique until the patient shows signs of mentalizing.

The theory of Mentalization-Based Therapy is strongly based on attachment theory and Self-Psychology, focusing on the child's development of a stable sense of self and the ability to self-soothe. Whatever the theoretical differences about the origin and the resolution of psychopathology, the MBT group has a lot of experience and a great deal of empirical data about treating patients with Borderline Personality Disorder. We have a lot to learn about the treatment of this very difficult population of patients. I hope we have more opportunities to discuss and compare these important current models of psychotherapy in the near future so we can learn from each other.