It occurs to me that I have not clearly delineated the similarities and differences between my and CMTís views. I notice, for example, that I never once mentioned the topic of pathogenic beliefs, even though this concept is important to my view of psychological process. I would like, therefore, to focus on a couple of theoretical tenets that were left unclear by commenting on a portion of Jessicaís overview of CMT found at the top of this forum. I will do this with respect to my understanding of Kathyís case. There is probably no point to this exercise, given the reaction to this series of posts, but, for the hell of it, here goes.
Control-Mastery theory assumes that the patient's problems are rooted in the grim, constricting pathogenic beliefs that the patient acquires in the traumatic experiences of childhood. The driving force behind the psychotherapeutic process is the patient's conscious and unconscious desire to recover the capacity to pursue life goals by gaining control and mastering self destructive patterns of thoughts and behaviors.
Agreement to an extent: I believe that pathogenic beliefs can arise from traumatic childhood experiences and from mistaken impressions that a child is led to, but I also believe that innocent beliefs can become pathogenic on a situational basis. For example, Kathyís belief that she was untalented, uncreative, and unworthy of special interest arose directly from the traumatic parental indifference and neglect she received as a child. This is not a pathogenic belief that a CM therapist would mention in a case history, but it is a problem that would be addressed in the course of therapy, nevertheless. That, of course, brings up one of my favorite themes, namely the divergence between the CMT description of the psychotherapeutic process and the way CM therapy actually proceeds. I recognize that there is no divergence in a CM therapistís mind, because all of the interventions are seen as strategies for getting to the guilt-related pathological belief that is troubling the patient. That mental patch wonít withstand logical scrutiny, however, as I hope I showed. Kathy wasnít inhibited by guilt. She felt guilty precisely because she had the freedom to undertake growth initiatives, despite the guilt they would generate. Just because guilt can be found doesnít necessarily make it an operative factor in a personís behavior. What was operative with Kathy was her anger with her parentsí treatment of her.
What stopped Kathy in her tracks were conflicting motives brought upon, in part, by two situational pathogenic beliefs, probably derived from her mother. One was that itís not possible to be a career woman and a good mother at the same time, that thereís an irreconcilable conflict between the two. I call this situational because it would not have caused Kathy problems if she had no career aspirations aside from being a mother. Another situational pathogenic belief arose from her identification with her parents, particularly her mother, which led her to believe that the kind of life her parents had was the only life that was open to her--her kind of person did not write books or short stories or have artistic ambitions. Again, this would not have caused a problem if her only goal in life was being a better mother than hers was.
Disagreement to an extent: Pathogenic beliefs are only one factor in a personís psychopathology, yet they are apparently all CMT talks about. Nevertheless, again, these other factors are generally recognized and attended to by CM therapists. Kathyís therapist took the time to show Kathy how to teach her son to get on with his life despite his fatherís refusal to recover from his depression. I must think that she did this in part because she recognized that Kathy suffered from the same syndrome. By showing her how to help her son, her therapist showed Kathy how to free herself from a debilitating behavioral tendency she picked up from her family. Although this was portrayed as arising from guilt related to her brotherís death, I believe the tendency arose much earlier as a matter of pure imitation.
Another thing missing in CMT is a concept of dynamics. Again, CM therapists understand the type of dynamics to which I refer; it simply isnít articulated. An example: If Kathy's childhood had been purely one of disinterest and neglect and if she had accomplished little in the outside world to give her hope, she probably would have never developed the symptoms that brought her to therapy. She would have been depressed and probably a good mother. She would have had the same dreams, but would not have acted on them. Kathy was lucky. She had a wonderful first two years of life, and she had a father who encouraged and praised her for his own reasons. She also found some success in the outside world. All of these things gave her dreams enough reality to keep her pursuing them. Her symptoms were symbolic of her quest. She tried to live the life of a simple mother and soon-to-be-wife. Her symptoms were a reminder that there was something more that was important to her that she was leaving out. Her symptoms were her conscience, a conscience that would have remained silent had she not fought for and won some victories in the service of her dreams.
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