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Unread February 8th, 2005, 02:50 AM
Helene Goldberg Helene Goldberg is offline
Join Date: Jan 2005
Posts: 5
Default Re: "Integrating control-mastery theory & research with other theoretical perspectives"

Thinking about Judy's point of moment-by-moment plans: I think this is an essential part of any successful therapy. The actual experience of the intantantaneous give and take created in the communication between therapist and patient is vital. In a sense, there are micro-tests going on all the time in any communication--A dance that informs and creates a relationship. Yet I think there is great value in the idea of a macro plan. In fact, I think that the greatest strength of our theory is a hypothesized projection into an imagined future. Most theories focus on analysing the historical effects of the past or on the immediate experience in the present therapeutic relationship. The idea of the plan introduces an additional notion of a direction toward the future. (The concept of resistance is about protecting the past; testing is to alter the future.) It keeps us working to understand what's going on in the larger context of comprehensible goals. By goals, we primarily talk about the patient's goals, yet there is always our own personal/interpersonal goal as a therapist of creating a constructive relationship with another person. Our idea of the patient's plan acts as a guide to how that relationship should take shape.

It may be a bias toward order or health, and as such may seem overly optimistic, yet I believe that choosing to engage in therapy is an optimistic endeavor. I also believe that to focus on the patient's tendency toward health doesn't mean we are blind to pathology. I think that the plan concept merely encourages us to keep looking beyond the meanings of the patient's behavior that are a repetition of past traumas or patterns. Even though we are fully engaged in the immediate emotional reality of the relationship, the plan concept allows us to simultaneously hold on to the idea that a patient has intentionally chosen to engage in therapy for a purpose: to have a better life outside of the therapeutic relationship with us. And that we can work with the patient to understand what that life will consist of.

And like Tom and Rebecca, I think that our literature has oversimplified the idea of tests, plans, and pathogenic beliefs by making them too literal. In Joe's writings pathogenic beliefs are presented as rational units of understanding, whereas we actually develop an almost cosmological frame of how the world works from early on. It is vast and most of it is unconscious. It is made up of intersecting (though not fully consistent) families of metaphorical connections which include everything from the laws of physics, superstition, morality, and common sense-- to anything else we use to get along in our world and our lives. They form a web of interconnected beliefs. Some strands lead to a better life; others bind us to
repeated pain.
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