Control-Mastery Theory and
Psychotherapy Resources
Alan
Rappoport, PhD
I am a psychologist and psychotherapist with offices in San
Francisco and Menlo Park, California, and have been in practice since 1980. I have
created this website to make my writings on Control-Mastery Theory available to
others. (Control-Mastery Theory is a modern psychodynamic approach to
psychotherapy originated by Joseph Weiss, MD and advanced by the San Francisco
Psychotherapy Research Group.) My hope is that these writings will be
beneficial to psychotherapists, therapy clients, and others interested in the
field.
In my professional practice, I specialize in psychotherapy
with adults and couples. I also lead clinical case conferences, teach, and
consult to other professional psychotherapists. I also offer clinical case
conferences by telephone. I have been teaching and writing on the theory and
practice of psychotherapy since 1993. I would be glad to hear from you.
Menlo Park, CA: 1010
Doyle St., Ste. #13, Menlo Park, CA 94025
San Francisco, CA: 10 Funston Ave., The
Presidio, San Francisco, CA 94129
Phone: 650.323.7875 Fax:
650.599.9802 e-mail:
arappoport@alanrappoport.com
My case conference in Control-Mastery Theory held via telephone
meets weekly on Tuesdays at 11:00AM, Pacific
Time. This teleconference makes training in the theory available to anyone,
regardless of location, and those with an interest in control-mastery theory
are warmly invited to participate.
We discuss cases presented by participants as a way of
helping participants address problems they may be having with a case, and as a
way of learning the Control-Mastery approach. Typically, two people have the
opportunity to present case material during each session. In addition to
discussing cases, we also discuss general theoretical matters, and occasionally
may focus on a single case for several meetings to build an in-depth
understanding of the therapy process. The meeting lasts for about 55 minutes,
and the fee is $45 per week.
Please contact me by phone or email if you would like to
register, or if you would like further information.
Diagnostic Plan Formulation
Forms
Note: These articles have been published and are copyrighted
by the journals in which they appeared. They may be viewed online, and a copy
may be downloaded for educational purposes. No commercial use may be made of
them, nor is mass reproduction allowed without permission of the copyright
holder. The Adobe Acrobat Reader is required to read and print these files. If
you do not have it, you may obtain it here.
The following article is a good introduction to
Control-Mastery theory:
How
Psychotherapy Works: The Concepts of Control-Mastery Theory (2002)
Introduction: Control-Mastery theory was
formulated by Joseph Weiss, MD in the 1960’s.
Weiss, a psychoanalyst, found that the Freudian model of psychotherapy
did not predict and could not account for improvements in some of his patients,
and he began an intensive study of these cases in order to better understand
the therapeutic process. In 1972, in collaboration with Harold Sampson, Ph.D.,
Weiss founded the Mt. Zion (now the San Francisco) Psychotherapy Research
Group, which since that time has been engaged in the development of the theory,
research, and teaching. The theory Weiss created is about the origins of
psychopathology and how the patient works in psychotherapy to overcome his or
her problems. He 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. (Examples of such beliefs are “I should be unhappy as my
mother is or she will feel lonely and blame me,” “I must have low self-esteem
so that my father will not feel threatened by me,” “If I express my emotional
needs to my parents or others I will be unduly burdening them”.) At the heart
of the theory are two concepts: that people have unconscious control over their
defenses, and that they have a wish to master their problems and unconsciously
organize their behavior in an attempt to do so. In psychotherapy, the
therapist’s task is to understand the patient’s unconscious plan to solve his
or her problems and to help the patient to do so.
The Structure of Psychotherapy
(1996)
Abstract: The view that psychotherapy
patients unconsciously organize their therapy process in the service of their
treatment goals has been advanced and empirically supported by Control-Mastery theory
proponents. This article discusses the patient’s plan according to
Control-Mastery theory and shows how it is made explicit in the Diagnostic Plan
Formulation. It describes how the plan formulation can be used to guide the
therapist’s interventions, and shows how it creates a structure that organizes
the whole therapeutic enterprise. A case example is given to illustrate the
therapeutic clarity and power that can result from the use of this approach.
The
Patients Search For Safety: The Organizing Principle in Psychotherapy
(1997)
Abstract: This article presents the
Control-Mastery view that patients organize the process of their psychotherapy
in their search for psychological safety with the therapist. According to this
theory, people unconsciously assess their social environments for signals of
safety and danger, relaxing their defenses when it seems safe to do so. In
therapy, patients test to find the safety with the therapist which would free
them to be less defensive in that relationship, and, ultimately, in all their
relationships. Understanding how patients’ activity in psychotherapy is
organized by their search for safety can simplify the treatment process for the
therapist and help to guide the therapist’s interventions. Clinical examples
are used to illustrate these ideas.
Freeing Oneself
From Pathogenic Adaptations (1996)
Abstract: Control-Mastery theory, proposed
by Joseph Weiss, is receiving increasing acceptance among psychotherapists. Two
main tenets of the theory are that psychopathology is caused by pathogenic
beliefs, ideas about oneself and the world which interfere with healthy
functioning, and that people attempt to disconfirm these beliefs by
testing their validity in their interactions with the therapist. I suggest that
pathogenic beliefs are more accurately and profitably seen as pathogenic adaptations,
modes of acting, thinking and feeling which seem required of them by others. I
also offer a modification to the testing paradigm called passive-into-active
testing. Both of these changes make the theory more powerful, improve its
internal consistency, and make it easier to apply.
Co-Narcissism: How We
Accommodate To Narcissistic Parents (2005)
Abstract: This article introduces the term
“co-narcissism” to refer to the way that people accommodate to narcissistic
parents. I use the term narcissism here to refer to people with very low
self-esteem who attempt to control others’ views of them for defensive
purposes. They are interpersonally rigid, easily offended, self-absorbed,
blaming, and find it difficult to empathize with others. Co-narcissistic
people, as a result of their attempts to get along with their narcissistic
parents, work hard to please others, defer to other’s opinions, worry about how
others think and feel about them, are often depressed or anxious, find it hard
to know their own views and experience, and take the blame for interpersonal
problems. They fear being considered selfish if they act assertively. A high
proportion of psychotherapy patients are co-narcissistic. The article discusses
the co-narcissistic syndrome and its treatment, and gives case examples of
patients who suffer from this problem.
Diagnostic
Plan Formulation Forms
The following files are versions of the Diagnostic Plan
Formulation form. The diagnostic plan formulation concept was originated by the
Research Group as a research tool and used to study numerous cases. I have
adapted the group’s concept to create several forms that have been helpful to
clinicians in organizing case material and in developing hypotheses about how to
pass patients’ tests.
Diagnostic Plan Formulation:
Therapist-Patient (This is a
graphic of the Therapist-Patient DPF form and may be downloaded and distributed
freely.) This version of the Diagnostic Plan Formulation is the one I am
currently using. It adds a section for considering the plan formulation for the
therapist, as well as that for the patient, to help understand and acknowledge
the therapeutic process as an interaction between two people. A discussion of
this revision may be downloaded as the Discussion of the
Therapist-Patient DPF.
Diagnostic Plan
Formulation Form: Revision 1. (This is a graphic of Revision 1 of the DPF,
and may be downloaded and distributed freely.) Revision 1 of the Diagnostic
Plan Formulation Form replaces the “Insights” column with a column for
“Therapist-Initiated-Interventions, and adds a column for “Therapist Factors.”
The rationale for these changes may be downloaded as the Discussion of DPF Revision 1.
Diagnostic Plan
Formulation: Original Version. (This is a graphic of the original DPF form,
which may be downloaded and distributed freely.) This version of the Diagnostic
Plan Formulation Form is the one used in my 1996 and 1997 articles. The use of
this form is discussed in those articles, along with demonstrations of its use
with specific cases.
Current
Writing, and Writings in Progress
The Importance of Narcissism in
Psychotherapy
This is a discussion of how narcissism in parents (which
results in the inability of the parent to accept the child as he or she is)
causes many of the psychological difficulties for which people seek
psychotherapy.
The
Experience of the Therapist
This is a discussion of the invisible person in the
psychotherapeutic relationship, the therapist. The therapy relationship is,
most fundamentally, a relationship, and yet almost all the attention is
usually focused on just one of the people in the relationship, the patient. Both
people determine the quality and value of the relationship for each person, and
in this paper I explore some of the issues related to this viewpoint.
The
Importance of Passive-into-Active Testing in Psychotherapy Supervision
This brief (and incomplete) paper calls attention to the
frequency of passive-into-active testing as the critical issue in cases
presented for supervision.
Websites
The San Francisco
Psychotherapy Research Group. This is the home page of the control-mastery
group, and lists events, classes, case conferences, a complete bibliography,
etc., etc. There are also some theoretical articles, information on the group’s
low-fee clinic, and membership information.
Writings of the San
Francisco Psychotherapy Research Group.
This site is dedicated to the writings of the San Francisco
Psychotherapy Research Group, and is a major resource for the group’s
publications. A large number of articles by control-mastery authors may be
found here.
Transformative
Relationships Website. This is the site which describes the book “Transformative
Relationships,” referred to below.
Behavior.net.
This is a forum with a number of interesting postings and discussions of
control-mastery theory. It does not seem to be used much currently.
The Emotion, Personality and
Altruism Research Group. This site contains some interesting research
related to control-mastery theory.
Center
of the Storm. Here you can order a videotape of a family therapy based on
control-mastery principles.
Books
How
Psychotherapy Works: Process and Technique. Joseph Weiss. New York: Guilford
Press, 1993. A highly readable introduction to the theory
by its originator. The book is intended for psychotherapists, but Weiss’
informal style and lack of jargon make it accessible to the layperson as well.
Hidden Guilt: Stop Punishing Yourself & Enjoy the
Happiness You Deserve. Lewis Engel and Tom Ferguson. Pocket Books, 1991. Intended for the layperson, the
authors discuss the importance of unrecognized guilt as a major cause of
unhappiness. (Also in hardback as Imaginary Crimes: Why You Punish
Yourself and How to Stop. Lewis Engel and Tom Ferguson. Boston:
Houghton-Mifflin, 1990.)
The
Psychoanalytic Process: Theory, Clinical Observations, and Empirical Research. Joseph Weiss, Harold Sampson, and
The Mount Zion Psychotherapy Research Group.
New York: Guilford Press, 1986. Intended for professionals, this book is a major
work. It is a complete presentation of the principles and theoretical structure
of control-mastery theory, as well as the empirical foundation for the theory
provided by the group’s research.
Why You Behave in Ways You Hate: And what you
can do about it. Irwin Gootnick. Roseville, Ca.:
Penmarin Books, 1997. A layperson’s introduction to some
aspects of the theory.
Trapped in the Mirror. Elan Golomb.
New York: Morrow, 1992. This is a book about narcissism
that has several excellent chapters describing a variety of narcissistic
parent-child relationships. I recommend it to many of my patients to help them
better understand their parents and the origin of their psychological
difficulties. (Dr. Golomb is not connected with control-mastery theory.)
Transformative
Relationships: The Control-Mastery Theory of Psychotherapy. Silberschatz, G.,
ed. (2005). New York: Routledge. An excellent current introduction to the theory. Case
examples, theoretical discussions, assessment techniques, and research support.