The Control-Mastery perspective: A clinical formulation of David’s plan.

The Control-Mastery theory is reviewed, focusing particular attention on the concept of the patient’s plan for therapy. A formulation of David’s plan is then presented. The formulation includes David’s early childhood traumas, his goals (conscious as well as unconscious) for therapy, the pathogenic beliefs (schemas) that have obstructed him, the tests that he is likely to present in therapy in order to disconfirm his pathogenic beliefs, and the insights that would be helpful to him. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The central role of pathogenic expectations and beliefs in a case of intense genital damage anxiety.

Pathogenic expectations and beliefs are constructions of reality, usually unconscious, that link frightening outcomes to the pursuit of normal developmental goals. These expectations, derived from past painful experiences, are conceptualized as a root cause for symptoms, repression, and other defenses. The first 5 years of an analysis are presented here to demonstrate how treatment technique is affected by an understanding of pathogenic expectations and beliefs as organizers of psychic reality and psychopathology. The major mutative force in this beneficial treatment was a process of gradually disconfirming the patient's expectations within a treatment relationship that the patient perceived as offering acceptance and empathic explanations of her psychic reality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediated and direct effects of general control beliefs on obsessive compulsive symptoms.

Although control-related cognitions have often been implicated in discussions of obsessive compulsive disorder (OCD), empirical investigations of the relationship between control constructs and OCD symptoms have been relatively limited. This article investigated the hypothesis that OCD symptoms may be linked with a higher desire for control (DC), but a lower sense of control (SC) over the self and environment, leading to motivation for compulsive symptoms. It also investigated whether this effect was direct, or mediated through other OCD-related cognitions. This hypothesis was investigated in a nonclinical population, using path analyses controlling for depression. It was found that higher levels of DC and lower levels of SC were associated with higher levels of OCD-related beliefs, and with symptoms via higher OCD-related beliefs. SC was also directly linked with higher OCD symptoms. Control beliefs regarding both the internal (emotions) and external (threat) environment were related to OCD symptoms. Implications for therapy and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Transformative relationships: The control-mastery theory of psychotherapy.

Reviews the book, Transformative relationships: The control-mastery theory of psychotherapy by George Silberschatz (see record 2005-00928-000). This book is an edited text that thoroughly reviews theory, research, and practice on control-mastery theory, a psychodynamic method developed at the San Francisco Psychoanalytic Institute. Overall, this is an impressive research program summarized in this chapter in a very accessible manner. The research program is a good case study of an effort to build an evidence-based treatment close to clinical reality. In addition, the book as a whole is probably the best way to get a summary of all aspects of control-mastery theory as well as a clear and interesting exposition of different aspects of the theory, research, and practice. One important clinical implication of the testing concepts is that the meaning of a therapist's interventions will vary depending on what specific pathogenic beliefs the client is testing. Control-mastery theory is highly case specific; a technique that is helpful to one client may not be appropriate or helpful to another. How effective the therapy is will be determined not by the technique used but by the extent to which the therapist can disconfirm the client's pathogenic beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Freud's legacy--is it still with us?

Unconscious processes of mind are a fact of life, both as phenomenon and as explanatory concept and were recognized before Freud. But it was Freud who not only put "the unconscious" on the map but also operationalized it in a new way--as a dynamic unconscious, laying down the foundation of a science of the unconscious, his Copernican revolution. The new science first provided a dual purpose method: investigating the emotional and ideational manifestations of disordered human behavior and psychological conflict and healing those disorders. In becoming a general psychoanalytic psychology, it played an important role in unraveling the dynamics of sexuality in the individual and society, literature and the arts, and in group dynamics in peace and war. The author emphasizes hitherto unacknowledged aspects: (1) The distinction between a theory of method and a theory of disorder; and (2) The role of interpersonal, or dyadic, dynamics in Freud's method, completing the largely monadic or intrapersonal focus in Freud. The author also discusses critiques of Freud's method both within and without psychonalysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The second century of psychoanalysis.

Presents a theory of unconscious mental life and makes predictions for the 2nd century of psychoanalysis. The theory of unconscious mental life assumes that a person unconsciously performs many of the same kinds of functions that are performed consciously and holds that psychopathology is rooted in cognition. The psychoanalytic process following from this theory is discussed and a research study designed to determine why a patient persistently made unconscious transference demands on the analyst is described. The author predicts that in the next 100 yrs, analysts will become less constrained and psychoanalysis will shed its concern for purity, accommodate the various common-sense ways that one person helps another, have more contact with other fields, and benefit greatly from research in related fields and in analysis itself. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Changes in the patient's level of insight in brief psychotherapy: Two pilot studies.

Describes 2 studies of the level of insight obtained in 16 sessions of brief time-limited psychotherapy. Four patients (aged 34–58 yrs) were examined using the Pro-plan Insight Rating Scale (PIRS) in Study 1, and 1 patient (aged 34 yrs) was examined using the PIRS—Revised in Study 2. All Ss initially demonstrated insight, but during the course of therapy their insight decreased. Toward the end of therapy their insight again increased. The average level of insight across each therapy was found to be related to outcome. Based on control mastery theory, the results reflect Ss' unconscious plans for working in therapy by testing their pathogenic beliefs in order to change them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Seductive symbolism: Psychoanalysis in the context of oncology.

Beliefs about what caused their cancer are a central facet of patients' experience of illness. These beliefs make up the patient's theory of etiology, which derives from various sources, including conscious and unconscious fantasy. This paper highlights this dimension of patients' experience, and the possible interaction between patients' psychogenic theories of etiology and their therapists' potentially generated psychogenic theories regarding patients' disease. It is suggested that a countertransferential pull for therapists exists to generate psychogenic theory regarding patients' cancer in the face of the threat of impotency it presents. This is discussed as a seductive pull into symbolism-based understanding of patients' cancer etiology—a pull this paper aims to characterize. It is suggested that the seductive pull results from the influence of psychoanalytic psychosomatic theory in the context of the dynamic between the ill patient and the therapist. Some psychoanalytic psychosomatic theory posits symbolism-based linear psychogenesis and the possible correction of soma via psyche in a great variety of illnesses and conditions, including cancer, and the hypothetical effect of this literature on the clinician's mindset and clinical work is considered. Specifically, it is suggested that this portion of our literature might serve a psychological function for clinicians, as it can help to shore up an omnipotence defense against the undertow of chaos inherent in cancer-related bodily dysfunction. More generally, it is argued that the context of existing psychoanalytic psychosomatic theory characterized by a focus on symbolism-based linear psychogenesis is potentially influential, and that this influence needs to be examined. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Review of Conscious and unconscious: Freud's dynamic distinction reconsidered.

Reviews the book, Conscious and unconscious: Freud's dynamic distinction reconsidered by Patricia S. Herzog (see record 1991-97475-000). Patricia Herzog's book is a critical examination of the way in which Freud presented the conscious/unconscious distinction. Herzog is a philosopher, and she provides the careful, analysis of Freudian concepts that good philosophers can, but which is unfortunately often missing from psychoanalysis. Her concerns are not empirical or therapeutic bur conceptual: the consistencies, inconsistencies, and interrelations in the family of Freud's theoretical concepts which has conscious and unconscious as key members. Herzog has provided a scholarly, close-to-the-text treatment of Freud's conscious/unconscious distinction, most surely a central aspect of the theory of psychopathology. But her presentation makes it hard work to grasp and integrate the points, and the reader is left to struggle alone to discover the links between her critique of Freud and themes in modern psychoanalytic or other psychological theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How the patient's sense of danger and safety influence the analytic process.

Discusses J. Weiss's (see record 1990-17877-001) proposition that a person may exercise unconscious control over repressions based on unconscious appraisals of danger and safety. This hypothesis derives from Freud's (1926) theory that repression is instituted due to anticipation that certain inner feelings or intentions would bring about a dangerous situation. Anticipation of danger evokes anxiety and leads to defense. The hypothesis implies that anticipation of danger (along with underlying pathogenic belief) is the linchpin that holds pathological formations in place. Clinical observations show that a patient's unconscious appraisals of danger and safety regulate analytic progress. These observations also change intuitions about how powerful unconscious contents may become conscious during analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The centrality of the system Ucs in the theory of psychoanalysis: The nonrepressed unconscious.

After Freud discovered an unconscious system (Ucs) between 1894 and 1896, a window opened for him to formulate a comprehensive theory of the human psyche, which he called psychoanalysis. The Ucs was its foundation. The object relations theories, ego psychology, self-psychology, and their offshoots managed to erode that concept from the theory in different ways and tried to replace psychoanalysis. The reason is that Freud, for a long time, associated the unconscious with the repressed. It was possible by reviewing his work in the field of repression, defense, and the unconscious to uncover the nature of the system Ucs. It is not possible for a school of psychology within psychoanalysis to ignore the systemic unconscious and replace it with a dynamic unconscious and still claim that it is psychoanalytic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative self-efficacy and goal effects revisited.

The authors address the verification of the functional properties of self-efficacy beliefs and document how self-efficacy beliefs operate in concert with goal systems within a sociocognitive theory of self-regulation in contrast to the focus of control theory on discrepancy reduction. Social cognitive theory posits proactive discrepancy production by adoption of goal challenges working in concert with reactive discrepancy reduction in realizing them. Converging evidence from diverse methodological and analytic strategies verifies that perceived self-efficacy and personal goals enhance motivation and performance attainments. The large body of evidence, as evaluated by 9 meta-analyses for the effect sizes of self-efficacy beliefs and by the vast body of research on goal setting, contradicts findings (J. B. Vancouver, C. M. Thompson, & A. A. Williams, 2001, J. B. Vancouver, C. M. Thompson. E. C. Tischner, & D. J. Putka, 2002) that belief in one's capabilities and personal goals is self-debilitating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mortality salience and the spreading activation of worldview-relevant constructs: Exploring the cognitive architecture of terror management.

Seven experiments assessed the hypothesis derived from terror management theory that reminding people of their mortality would increase accessibility of constructs central to their worldview. Experiment 1 found that mortality primes, relative to control primes, increased accessibility of nationalistic constructs for men but not for women. Experiment 2 replicated this finding and also found that mortality salience increased romantic accessibility for women but not for men. Four subsequent experiments supported the role of unconscious death-related ideation in producing these effects. A final experiment demonstrated that situational primes can increase the accessibility of nationalistic constructs for women after mortality salience. The roles of situational cues and individual differences in the effects of exposure to death-related stimuli on worldview-relevant construct accessibility are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarifications on Trieb: Freud's Theory of Motivation Reinstated.

Freud never used the term instinct to characterize human motivation, despite continued misrepresentations and commentaries that claim otherwise. Instead he described the process by which unconsciously enlisted variants emanate from their immediate, embodied sentient nature and evolve in both form and content to produce a robustly complex and overdetermined system of human development and social motivation. Freud's drive theory therefore remains the paragon for potentially explaining all facets of intrapsychic and interpersonal phenomena, from the most base and primordial urges of unconscious desire to the most cultivated and exalted dimensions of mind, individuation, culture, and intersubjective life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Revising psychoanalytic understandings of perinatal loss.

Discusses the need to revise psychoanalytic concepts to accommodate new understandings about perinatal loss, female sexuality, and guilt dynamics. Unspoken allegiance to some traditional psychoanalytic beliefs that are increasingly viewed as outdated may impede applying contemporary psychoanalytic frameworks to understand perinatal loss. Four tenets of psychoanalytic theory (the unborn child experienced as solely a fantasy, the mother's symbolic equation of her child primarily with the penis, unconscious causation of perinatal loss, and the ubiquity of unconscious ambivalence underlying parental guilt) are critically evaluated and revised to introduce a contemporary psychoanalytic understanding of perinatal loss. The author concludes that recognizing the pregnant woman's developmental, conflict-based, object, and narcissistic ties to her unborn child broadens psychoanalytic understandings of the meanings of pregnancy and perinatal loss. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Response to cognitive therapy in depression: The role of maladaptive beliefs and personality disorders.

This study examined whether personality disorder status and beliefs that characterize personality disorders affect response to cognitive therapy. In a naturalistic study, 162 depressed outpatients with and without a personality disorder were followed over the course of cognitive therapy. As would be hypothesized by cognitive theory (A. T. Beck & A. Freeman, 1990), it was not personality disorder status but rather maladaptive avoidant and paranoid beliefs that predicted variance in outcome. However, pre- to posttherapy comparisons suggested that although patients with or without comorbidity respond comparably to "real-world" cognitive therapy, they report more severe depressive symptomatology at intake and more residual symptoms at termination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification, repetition, and psychological growth: An expansion of relational theory.

This article extends previous work (S. Stern, 2002) examining the place of identification within a contemporary intersubjective theoretical framework. It is argued that (a) identification is as central to psychological life as Freud thought--we merely have lost the conceptual lens to see its central position--and (b) identification has been implicitly central in many contemporary theories of the self. An unconscious search for a certain kind of identificatory experience animates many instances of pathological repetition as well as many transformative analytic encounters. This idea represents an expansion of current relational theory, which has held to a more conservative, Fairbairnian view of repetition as driven by attachment to old object ties. One extended and 2 brief clinical examples are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating neural networks into decision-making and motivational theory: Rethinking VIE theory.

[Correction Notice: An erratum for this article was reported in Vol 44(3) of Canadian Psychology/Psychologie Canadienne (see record 2007-16858-001). The paper by Lord, Henges and Godfrey, referred to in some of the commentaries (this issue), was accepted as part of the Special Section on psychology without boundaries. However, it was inadvertently published in a previous issue. The full reference is: Lord, R. G., Hanges, P. J., & Godfrey, E. G. (2003). Integrating neural networks into decision-making and motivational theory: Rethinking VIE theory. Canadian Psychology, 44 (1), 21-38.] Uses a reformulation of V. H. Vroom's (1964) VIE (Valence-Instrumentality-Expectancy) theory to illustrate the potential value of neuropsychologically based models of cognitive processes. Vroom's theory posits that people's decisions are determined by their affective reactions to certain outcomes (valences), beliefs about the relationship between actions and outcomes (expectancies), and perceptions of the association between primary and secondary outcomes (instrumentalities). One of the major criticisms of this type of theory is that the computations it requires are unrealistically time-consuming and often exceed working memory capacity. In this paper, the authors maintain that if an individual has extensive experience with a problem situation, he or she can process decisions about that situation using neural networks that operate implicitly so that cognitive resources are not exhausted by simple computations; instead, the computations are performed implicitly by neural networks. By thinking about VIE from a neural network standpoint, at least one of its problems is eliminated, and several new insights into decision-making are provided. The authors use simulation methodology to show that such a model is both viable and can reflect the effects of current goals on choice processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)