Attachment Theory, developed by John Bowlby and later developed further by his colleagues Mary Ainsworth and Mary Main was a sane move away from the metapsychology of Freud's Drive Theory. It recognized that children love their mothers not just because infants experience tension reduction and sensual gratification by suckling at the breast. The loved mother was not just a thing, not just an object of cathexis that happened to be connected to a breast. Bowlby saw the big picture that love and connection were central, biologically and evolutionarily wired experiences that he called "attachment".
Bowlby emphasized many of the same principles that Joe Weiss and other humanistic theorists recognized, the importance of safety, respect, connection, and earned trust in the therapeutic relationship. In this conference, I was hoping to introduce Control Mastery Theory to some Attachment devotees that may not be so familiar and to introduce Attachment Theory to some in our CMT community who may not be so familiar with Attachment Theory.
Wallin said in his book, Attachment In Psychotherapy, he was fundamentally interested in understanding what happens in psychotherapy that helps people get better. His focus was on the experience of safe attachment in parenting and in psychotherapy and how that leads the child and the patient to develop the capacity to regulate affects.
This is a central feature of attachment theory and also of Mentalization Based Therapy (MBT), a therapeutic model developed by Peter Fonagy and written about by Fonagy and Anthony Bateman. These ideas overlap with Heinz Kohut's belief in the importance of empathic attunement in parenting and in therapy that lead the child and the patient to develop improved capacities to self-soothe. Self soothing and affect regulation are very similar concepts as are healthy attachment and empathic relating.
Weiss' model emphasizes the importance of pathogenic beliefs that develop as a result of real, traumatic experiences in the world that perpetuate feelings of anxiety and depression. Weiss noted that compliance with these pathogenic beliefs and pathological identifications with loved ones who traumatized the child in the past lead to troubled relationships in the patient's current life, largely out of loyalty and desire to protect those loved ones. CMT's concept of specific pathogenic beliefs causing pathology is not inconsistent with Attachment Theory's concept that people often don't have good affective self-regulation or capacities to self-soothe. But it offers a slightly different narrative and a different emphasis on therapeutic technique.
Weiss would say that patients are not just suffering because they don't know how to self-soothe as much as they may be actively tormenting themselves out of guilt, or punishing themselves out of compliance or identification with a loved one. The therapeutic approach might respect non-specific therapeutic factors such as safety, respect, fairness, and attachment. But CMT's approach might also include an awareness of responding to patient's testing, and a discussion of the patient's compliance with pathogenic beliefs or the patient's pathological identification with a traumatizing parent.
The importance of compliances and pathological identifications is one of Joe Weiss' contributions to the understanding of what causes psychopathology and how therapists can help patients get better. Weiss also developed the important idea that patients unconsciously test therapists in therapy as a function of how safe they feel in order to overcome pathogenic beliefs and get better. The importance of testing, though recognized, is not given as much emphasis by other theorists and is one of Joe Weiss' major contributions.
This conference on October 27 will be an opportunity to not just talk about theory but to look at several therapy cases that went well from CMT's perspective of passed tests, relinquishing pathogenic beliefs, and resolving compliances and pathological identifications. At the same time I want to look at these same cases from Attachment Theory's perspective of healthier attachments leading to improved affect regulation.
This will be the first time we have had such a conference promoting a dialogue between Attachment Theory and CMT. This follows a very engaging and provocative discussion in Capetown in 2010 between Anthony Bateman presenting Mentalization Based Therapy and myself, presenting Control Mastery Theory. I hope this will be the beginning of many more such dialogues.
In Clinic news, we welcome seven new interns to join 8 continuing therapists at the SFPRG Clinic: Gena Castro, Valerie Crawford, Patrick Norton, Joy Phillips, Inger Louise Hole, Anne Berge, and Valentina Gandini. Patrick Norton and Valentina Gandini are very familiar faces because they have taken many classes and done research with us before. Inger Louise Hole and Anne Berge are our latest students from Norway and we cherish our connection with Norway. Our group of wonderful continuing interns will be Jodi Engstrom, Camerin Ross, Ilysa Goldblatt, Laura Condylis, Helga Fasching, Rick Pomfret, and Amy Freidman. John Snyder is continuing as a post-doctoral psych assistant until he gets his license in the fall. He will be helping organize the ongoing research program at the clinic and we appreciate his energy and contribution. Please think of the Clinic. We need referrals, supervisors, and teachers.
I hope to see you all at the honorary dinner on September 15. You can go to our website, SFPRG.org, to buy tickets to the dinner and also to register for the Attachment Conference. Have a wonderful end of summer.
Steve Foreman
