Some thoughts about the possible similarities and dissimilarities between Control Mastery and Cognitive Therapy.
CM clinicians believe patients come into therapy with unconscious as well as conscious goals, and that it is part of the therapist's task to infer these goals even though not verbalized. CM teaches one to focus on concrete problems of everyday life whenever these problems represent movement toward the conscious or unconscious goals of the patient. Caroline's original conscious goal was to decide whether to go to the prestigious graduate school to which she had been accepted for the fall. Graduate school was quickly replaced, however, by new immediate goals -- protection from substance abuse, unsafe sex, and muggings. These were not "clearly mutually agreed upon goals", but goals which I proposed. We worked in very concrete ways -- daily phone calls, etc. But focusing on these goals alone would have replicated the parental neglect and denigration making the patient feel blame and guilt for "loser behavior". It was essential that the therapist make clear the patient's dilemma that she felt torn between two choices: to destroy herself via drugs and other dangers or to destroy her "self" via compliance with her parents and be the family scapegoat. I believe she was profoundly relieved that I verbalized this dilemma from the first session, proposing a third choice, a healthy differentiated life of her own. This most important goal she could not have verbalized herself for many months.