July 21, 2013

Dear Colleagues,

I am writing just after our first annual Summer Samba, a delightful SFPRG party at Jessica Broitman's home yesterday in Berkeley. Over forty people attended. It was an opportunity to meet some of the new interns and connect with many former interns, old friends, colleagues, spouses, and their kids. There was a small jazz band (guitar, keyboard, and saxophone), fine food, warm hospitality, and wonderful East Bay sunshine. (We don't see so much sunshine lately in San Francisco.)

I spoke with former interns who are looking for ways to reconnect to SFPRG. They described busy lives after graduation -- working hard to get jobs and establish their practices. A few had new marriages and children. All wanted to find some way to stay in touch with the group and with each other. Some expressed an interest in an ongoing case conference, perhaps in Berkeley. We talked about setting up an SFPRG Facebook page for former interns. One expressed interest in a list-serv. We are very excited to look into social media options for SFPRG and especially for those who have gone through the SFPRG training program. I have spoken with former interns from New Jersey to Oregon. A common theme is that people feel connected with the group but they want SFPRG members to reach out to them and to check in.

To all of you who have graduated the SFPRG internship, please contact us if you wish to stay involved. Many of you already teach or supervise at the Clinic. Some teach at the March Workshops. Some of you continue to serve on committees or on the Board of Directors. Many stay in touch by attending SFPRG big weekend conferences or weekly continuing case conferences and seminars. Please let us know what your needs and interests are now. You are the future of the research group.

I have reported in this column that we are planning a series of weekend conferences entitled "New Directions in CMT, Theory and Research" where presenters will talk about their new theoretical work and research at SFPRG. The initial idea was to perhaps start in August, continue in September, and possibly offer a third meeting in October. As expected, most people will be away in August so the plan now is to schedule the first conference on Saturday, September 15 at 9 am in the Conference Room at 9 Funston. Marshall Bush and I will introduce the speakers and moderate the discussion. Our hope is that people interested in research and theory will come to present and to learn. We are offering Continuing Education Credits. Depending on how many people want to present, we may offer a second meeting (date to be announced). The meetings will eventually become a monthly group where research protocols will be discussed, developed, and offered to Ph.D./Psy.D. candidates looking for meaningful dissertation topics, data, and connections to appropriate faculty chairs. We are also hoping these meetings will encourage people to develop ideas, teach, write, and hopefully publish in order to further Control Mastery Theory.

I want to remind you of more events coming up this fall. On Saturday night, September 7, we are honoring Stan Steinberg and Lynn O'Connor at our third annual Honorary Fundraising Dinner. On October 12, Susan Landes is organizing a conference entitled "Current Trends in Addiction: A Dialogue between Terrence Gorski and CMT." On October 26 we are planning the third annual SFPRG Art Show. Enjoy the rest of the summer. We are looking forward to a wonderful fall. See you next month.
Steve Foreman

This is the third year that we at SFPRG are honoring members who have made significant and meaningful contributions to our research group, whether it be through teaching, doing research, giving workshops, presenting at conferences, supervising, administering programs, or promoting Control Mastery Theory and the mission of SFPRG. This event is a yearly opportunity for old and new friends to socialize, to appreciate each other, and to recognize important work that many people have made to our group. In addition to being an honorary dinner, it is a fundraiser. We want to raise the profile of what our group is doing and what individuals have done for our group. We would like to see many of you attend with your friends and families to toast the honorees.

This year, 2013, we recognize Stanley Steinberg, M.D. and Lynn O'Connor, Ph. D. for their outstanding contributions to SFPRG and Control Mastery Theory. We will be honoring Stanley and Lynn at a dinner at Quan Bac Vietnamese Restaurant at 4112 Geary Street between 5th and 6th Avenues on Saturday, September 7, 2013 at 5:30 pm. The cost of the dinner will be $100 per person, proceeds going to SFPRG. Reservations and payment can be made through our website

Stanley Steinberg

Stanley is a training analyst at the San Francisco Center for Psychoanalyis. He has been on faculty at Mount Zion and at the University of California San Francisco Departments of Psychiatry. He is former Director of Psychiatric Training at Children's Hospital and former President of the San Francisco Psychoanalytic Institute.

In addition to being a psychoanalyst, Stanley is an artist and has been intimately involved in the art world for much of his life. During college he met Sarah Stein, Gertrude Stein's sister-in-law. They became friends and he spent many weekends at her Palo Alto home, which housed many of the Matisses, Picassos, and Cezannes that are currently in the collection of the San Francisco Museum of Modern Art. Stanley has shown his own original artwork at the SFPRG art shows and has lectured to the SFPRG community on art and psychoanalysis.

Stanley has taught and supervised senior members of SFPRG and interns at the Clinic. He was a close friend of Joe Weiss since 1950 when they were both psychiatric residents at Mount Zion. They were both interested in art and psychoanalysis. Stanley and Joe published a paper together in 1954 entitled "The art of Edvard Munch and its function in his mental life." He discussed theory and practice with Joe as Joe developed Control Mastery Theory from the early 1950's for the next 50 years. Stanley's office was next door to Joe's for years when SFPRG was housed at the San Francisco Psychoanalytic Institute's offices on Sutter Street for many years and then he came with Joe and Hal when SFPRG moved to the Presidio in 2002 He continues to maintain his practice in the SFPRG building.

Stanley was important to Control Mastery Theory not only because he was a friend and daily sounding board for Joe Weiss, but he was a political ally at the San Francisco Psychoanalytic Institute where Joe received tremendous resistance for his unorthodox theory. Stanley defended Joe's theory and research to the Education Committee of the SFPI and to the investigators in a site committee from the American Psychoanalytic Association who came to San Francisco with a specific agenda to investigate whether Joe's theories were undermining the teaching of psychoanalysis at the SFPI.

Lynn O'Connor

Lynn is one of the most prolific writers and researchers in our group. She has published over 15 articles and chapters on a wide range of subjects including substance abuse, empathy, guilt, shame, evolutionary biology, altruism, cross-cultural issues, mindfulness, and Tibetan Buddhism. She co-authored 7 articles with Joe Weiss, and was first author on 5 of them. She wrote a classic paper, "Individual psychotherapy for addicted clients: An application of Control Mastery Theory" with Joe Weiss. She has extensively studied interpersonal guilt and developed the widely used measure "the Interpersonal Guilt Scale" (IGC). Lynn has co-authored articles with many members of our group, including Hal Sampson, Bill Meehan, Marshall Bush, Stefanie Brown, Nnamdi Pole, and Jack Berry. Lynn founded EPARG (Emotions, Personality and Altruism Research Group), which she co-directs with Jack Berry. Lynn has written about Control Mastery Theory from the perspectives of evolutionary biology and ethology, expanding and introducing Joe's theory to a wide new audience of researchers and scientists outside of our immediate physical and intellectual arena.

In addition to directly doing research, Lynn has supervised and been dissertation chair for scores of students doing research on Control Mastery Theory, guilt, shame, and substance abuse issues. Lynn has been on faculty at the Wright Institute where she has influenced hundreds of students and faculty over the years. In 2001 she received the Raymond D. Fowler Award from the American Psychological Association of Graduate Students for her outstanding contributions to graduate students' professional development. Lynn co-facilitated a weekly psychotherapy research seminar with Joseph Weiss from 1992 to 2000. She was a consultant and evaluator for Walden House where she brought therapists and administrators from that program to Joe Weiss' case conference on a monthly basis. She was a research associate at the Haight-Ashbury Detoxification and Aftercare Project. She reviews manuscripts for journals such as Psychological Bulletin, Emotion, and others.

Along with Gilbert Newman and Jessica Broitman, Lynn co-founded the SFPRG Clinic and Training Program. For the first two years, the Clinic was housed at the Wright Institute. Lynn served as the Clinical Director and the Research Director from 2001 to 2004. Lynn has made a substantial contribution to Control Mastery Theory and SFPRG from the perspectives of doing research, developing and disseminating the theory, supervising clinicians and researchers, administering programs, and integrating CMT in novel ways to other related fields.

Thank you to Jessica Broitman & Gibor Basri for having our Summer Samba on their patio at their home in Berkeley.

Take a look at pictures taken by Susan Landes from the Summer Samba and other events: http://www.flickr.com/photos/sfprg/

Hello Community:

As promised we have a date and a fabulous speaker for our fall conference on Addiction. The conference is titled, Current Trends in Addiction Treatment: A Dialogue Between Terence Gorski and Control Mastery Theory. It will be held at the SFJCC on Oct. 12. Check out our website for registration information. Terence T. Gorski "is a pioneer in the development of Relapse Prevention Therapy, who has achieved international acclaim for his work. He is considered a leader and authority in the addiction, behavioral health, social services, and correctional industries for his work in recovery and relapse prevention." We are thrilled to have Terry come to San Francisco to discuss his theory of relapse prevention and what is current in the field of addiction. To read more about him and his work go to www.cenaps.com.

We are in the planning phase of the March Workshop and have come up with some ideas that may be implemented next year. One idea is to offer beginning and advanced levels of our core courses. Another is to have people sign up in advance for the workshops they would like to attend so we don't have imbalances in attendance. We are also considering follow up workshops on the two conferences we have held this year, one on Trauma and one on Addiction. If you have any thoughts about the March Workshop, let me know. We are also interested in topics you may have for the March Workshop or future daylong conferences.
Dr.Susan Landes

We are having a lovely summer at the clinic. The first ever Summer Samba brought out many old and new interns which was wonderful! Thank you all for helping us start this new activity. The band was fantastic and the conversations great fun! We plan to create a new tradition of summer fun!

We continue introducing you to our graduating interns with Rick Pomfret. Rick is leaving after four wonderful years. Rick is known for his wicked sense of humor and excellent patient care. Please consider him for many referrals. In his own words:

"I'm an East Coast transplant that had a Nashville layover after college and arrived here during the first dot com boom. Prior to SFPRG I had placements in an SF city clinic and Haight Ashbury Psychological Services. I did my pre- and post docs at SFPRG supervised by David Auld, Carol Drucker, Molly Sullivan, Marshall Bush and Susan Badger. I've worked a good deal with sexual and physical abuse survivors and those in post collegiate transition, but enjoy working with a range of clients including kids. I'll be practicing in the financial district and San Rafael where I live with my wife and 8 month old daughter. I've recorded and played music for 25 years and look forward to incorporating some of this into work with mid-childhood/early adolescent children as this was the focus of my dissertation... a post-Wiggle focus if you will. My fee ranges from $85 to $150 and I can be reached at (415)863-3536."

This year's Art Show has been moved to Saturday, October 26th! The rains of December prompted us to move it. If you are interested in participating, please send an email to the office: sfprg@sfprg.org
Mark your calendar!

A therapist who rents in our building at 10 Funston is looking to sublet her furnished office on Tuesdays and Fridays. If you would like more information please email christasantangelo@yahoo.com

If you are interested in renting with us full-time please contact the office: sfprg@sfprg.org

SFPRG is winding down our annual Membership Drive. Thank you to those that have already sent in checks or renewed online. We rely on members to help keep SFPRG running.

Please renew your membership at the highest level you are comfortable with. If you are not yet a member, please "pay it forward" and help us spread this wonderful theory by supporting SFPRG with your membership.

Go to sfprg.org to renew or join today! Thank you!

The Signal and the Noise, Why So Many Predictions Fail - But Some Don't

by Nate Silver, Penguin Group, New York, 2012.

I first heard about Nate Silver from my politically savvy sons during the 2008 elections. Back in 2003, Silver had developed a system to predict the performance statistics of major league baseball players. By 2008, he had founded the website, FIveThirtyEight.com to predict the outcome of the 2008 election. (FiveThirtyEight.com takes its name from the number of electors in the United States Electoral College.) Silver's remarkable feat was that he correctly predicted the winner of the 2008 presidential election in 49 out of 50 states as well as the winner of all thirty-five senate races. In 2012, he correctly predicted who would win the presidential race in all 50 states and who would win the senate race in 31 out of 33 states.

Silver developed an enthusiastic following, not merely with my sons and their friends, but with many people who followed the elections closely. He was known as the "liberals' valium" since his blog consistently predicted Obama the strong favorite, despite the mainstream press calling the presidential race a "toss-up" in the weeks preceding the election right up to the last day. Rather than giving a "yes" or "no" prediction of who would win each race, Silver reported the probability or odds of each outcome, including a margin of error. He used the same probabilistic approach in his forecasts of baseball players' performance.

His book, The Signal and the Noise, looks at a wide range of phenomena that invite predictions -- the weather, earthquakes, the economy, financial markets, baseball, poker (Silver was a professional poker player for a few years), politics, flu outbreaks, terror attacks, and even computer chess programs. (He told the story of the first computer chess machine, the "mechanical Turk", built in 1770, that actually had a German chess master hidden within the mechanical box, directing the chess moves.) This book is about the problems of prediction, giving the history of spectacular failures, including the 2008 financial meltdown. It explores why commercial weather forecasters always overestimate the probability of rain, and why television pundits routinely make false predictions but don't seem to care as long as ratings are high.

He reported on a very provocative study by John Ioannidis from 2005, "Why Most Published Research Findings are False." Ioannidis argued that in 1000 studies, one in ten or about 100 studies test hypotheses that turn out to be true whereas nine out of ten, 900 out of 1000, test hypotheses that end up being false. An example of a "true" hypothesis may be that cigarette smoking leads to lung cancer and heart disease. For example, a "false" hypothesis may be that ethnic group X is less intelligent than White Anglo Saxon Protestants. When studies are performed, 80% of the studies of "true" hypotheses will turn out to confirm the hypothesis (true positives) whereas 20% will not confirm the hypothesis (false negatives). With regard to the studies of "false" hypotheses, 80% will accurately disconfirm the hypotheses (true negatives) while 20% of the studies will erroneously confirm the hypothesis (false positives). The problem is that there are so many more studies testing "false" hypotheses that even with only 20% false positives, there turns out to be more than twice as many false positives than true positives. In 1000 studies, 80 (80% of 100) will confirm true hypotheses (be true positives) while 180 (20% of 900) will confirm false hypotheses (be false positives). That is how Ioannidis concluded that in the published research in most scientific fields, more than 2 out of every 3 studies are wrong. This is compounded by the fact that most negative results are not even published in journals (such as when the study shows that drug Z had no effect). The studies that do get published are the positive studies that include true positives and false positives.

The Signal and the Noise is about imperfect human beings making predictions, testing hypotheses, and struggling with a complex reality. I thought it would be useful to present this book review in the newsletter because Silver gives two important messages that relate to psychotherapy.

The first principle Silver announced in his introduction refers to objective reality. He wrote, "This book is emphatically against the nihilistic viewpoint that there is no objective truth. It asserts, rather, that a belief in the objective truth - and a commitment to pursuing it - is the first prerequisite of making better predictions" (p. 14). The debate about objective or subjective reality was discussed in this column last year when I reviewed Stolorow's presentation on Intersubjectivity. Stolorow argued that we can't know objective reality in the therapist's role because of our transferences. In a laudable attempt to protect patients from wrong interpretations from their metapsychology-laden analysts, I believe Stolorow and the Intersubjective school went too far in assuming we can't talk about or know objective reality.

Silver went on to say, "The forecaster's next commitment is to realize that she perceives (objective reality) imperfectly" (p. 14). He said you can know reality but not completely, only probabilistically. You can know what will probably happen, so much so that you can bet on it. Those who are more aware of the principles that rule the world, who are more aware of their own limitations, and more aware of their own subjective biases, are better bettors. Similarly, those who approach their patients with humility, but who gather data, who make predictions, who modify their predictions based on new data, will be better clinicians.

Hal Sampson and Joe Weiss encouraged students and clinicians to come up with hypotheses about their patients from the very beginning, even based on how they looked in the waiting room before they opened their mouths in session. They both said, "Make hypotheses, make interventions, and change your hypotheses based on how the patient responded. Did the patient get better after an interpretation or worse? Why? Make hypotheses as you go -- you might be wrong -- and modify them as you go."

Nate Silver makes a similar argument. You can't know reality absolutely but the second principle that applies to psychology is "think probabilistically." Think about what is most likely going on when a patient yells at you? Did you just fail a transference test or did you just experience a passive-into-active rendition of what the patient experienced as a child? Should you back off and apologize or should you not? Joe and Hal said, "Look to the data and come up with a hypothesis to put the patient's behavior and the history together."

Silver writes, "Our brains process information by means of approximation" (p. 449). He went on, "Bayes's theorem requires us to state - explicitly - how likely we believe an event is to occur before we begin to weigh the evidence. It calls this estimate a prior belief... What isn't acceptable under Bayes's theorem is to pretend that you don't have any prior beliefs. You should work to reduce your biases, but to say you have none is a sign that you have many. To state your beliefs up front - to say 'Here's where I'm coming from' - is a way to operate in good faith and to recognize that you perceive reality through a subjective filter" (p. 451). Sounding like Weiss and Sampson, Silver wrote, "Try, and Err... Make a lot of forecasts" (p. 451).

Silver's remarkable book about making predictions is more than about politics or baseball or poker. It is about a way of viewing reality and challenging each of us to wrestle with reality at the intersection of objectivity and subjectivity. He encourages courage, honesty, and flexibility, all qualities that make a good clinician. He quoted the economist, John Maynard Keynes, "When the facts change, I change my mind. What do you do, sir?" (p. 65). Reading this book was like a visit with Joe and Hal.

Dear Colleagues,

It is my pleasure to announce that I have a new private practice intern working under my license, Lili Micaela MA, NCC. Ms. Micaela is currently a registered candidate with the BBS for Licensed Professional Clinical Counselor (LPCC). Lili graduated from Appalachian State University in Boone, NC, where she earned a masters degree in Counseling and a post-masters certificate in Expressive Arts Therapy. While at ASU, she took a position as an intern at Hospice of Watauga, where she worked with terminally ill patients and their families and, in addition, ran a weeklong children's grief camp.

Lili brings a wealth of experience to her work in clinical counseling. In addition to her end-of-life, grief, and bereavement counseling experience at hospice facilities in North Carolina, she has performed individual psychotherapy and couples therapy at Chrysalis Community Counseling Services in Santa Rosa, and at the Women's Therapy Center in Berkeley. She also has performed assessments, crisis intervention, and solution-focused counseling at United Behavioral Health's Employee Assistance Program in San Francisco. And she has worked in addiction and recovery with dual-diagnosed trauma survivors at Marin Services for Women (MSW) in Greenbrae. Lili also implemented a "Family Night" program and designed a grief group for women in recovery at MSW.

Lili Micaela is currently part of my Understanding Control Mastery Theory class, the Monday morning case consultation group that I lead for therapists and interns, where she is an important contributor and lively discussant. Her participation and her case presentations have demonstrated competence, compassion, and a readiness for private practice. Please consider Lili as a referral option for patients you can't take on, patients needing Saturday appointments, and/or for those who need a lower fee.

Currently Lili is particularly interested in mature people's development & inner growth, in what she calls the 'Third Act' of life. Her areas of interest and training include:
* Life Transitions and Change
* Women's Empowerment
* Affordable Relationship Counseling, for all loving combinations of people
* Depression and Anxiety
* Trauma issues
* Prime of Life / 'Third Act'
* Work and Career issues
* Stress Management
* Addiction & Recovery
* End of Life
* Grief Counseling, including pet loss

Lili offers short-term and long-term therapy. She also offers the option of longer, 75-minute sessions for couples and for individuals who prefer more time. Her fee is $90 with a sliding scale, and Lili is working out of my office at 337 Spruce Street in the Presidio Heights neighborhood of San Francisco. She can be reached at 415-264-8393.

Regards,
Peter Schumacher, LMFT