It's very easy to misunderstand, and thereby MISUS, research findings. So I would like to clarify some important points that have been misunderstood.
With regard to how long it took the Control-Mastery approach to address Kathy's guilt, the answer is NOT 96 sessions. Kathy's guilt was addressed immediately in the treatment. From Kathy's initial presentation about difficulties being in the "sunshine," I interpreted to Kathy that she felt undeserving of being in the "spotlight," and that her guilt prevented her from achieving her goals. Not only did this Control-Mastery approach immediately address Kathy's guilt, but the application of this form of treatment reduced Kathy's depression from Major to less than Minor Depression WITHIN 16 SESSIONS. The evidence for these claims are published in the Journal of Consulting and Clinical Psychology, "A Paradigm for Single-Case Research: The Time Series Study of a Long-Term Psychotherapy for Depression" by Enrico E. Jones, Jess Ghannam, Joel T. Nigg, and Jennifer F. P. Dyer, 1993, Vol. 61, 381-394. In that paper, Professor Jones illustrates a fascinating graph of Kathy's measures of depression before treatment, every 16 sessions, at 6-months follow-up, and at one year follow-up. Kathy's severe depression reduces by about 80% IN THE FIRST 16 SESSIONS. The chart also demonstrates, however, 2 huge relapses of Major Depression - at session #32 and at session #160. The graph of Kathy's depression can be seen to demonstrate what psychodynamic therapists refer to as "working through" her insights over multiple aspects of her life. If Kathy had been treated in a Brief Therapy mode, even WITH a Control-Mastery Brief Therapy approach (See the Control-Mastery Forum for a large list of references to Brief Therapy from a Control-Mastery perspective. George Silberschatz and John Curtis have studied, researched, and treated patients from this perspective for many years.), she would have suffered at least two very serious relapses into Major Depression after termination. Instead, Kathy had 208 sessions which is the equivalent of 13 Brief Therapies! Some of the general research findings I have read about Brief Therapy have demonstrated that although results can be achieved in 16 sessions, follow-up data often fail to demonstrate the maintenance of these effects for very long. I AM NOT ARGUING AGAINST BRIEF THERAPY. I have provided clinical treatment in Brief Therapy research projects. I have done research on brief therapies. I like brief therapy for certain problems with certain patients. As the therapist in Kathy's case, however, I was pleased to participate in a study that respected the benefits of long-term, intensive treatment. At the time this project occurred, Professor Jones' project was one of the only research studies conducted on the long-term, intensive treatment of Major Depression. For Kathy's sake, I am pleased that we had that time period to "work through" in great depth many of the issues in Kathy's life that touched her guilt. Furthermore, Kathy has remained in periodic contact with me over the last 5 years and maintains her gains at this time.
Now, as far as the magic "96 sessions"goes, let's be careful understanding the data that was presented. The magic "96 sessions" is where Kathy CONSCIOUSLY experiences her guilt for the first time in her life as well as in the treatment. As Professor Jones' and Nnamdi Poles' interesting research demonstrates: BEFORE SESSION 96, only MY ratings and the ratings of INDEPENDENT CLINICAL JUDGES viewing the videotapes were CONSCIOUS of Kathy's guilt. BEFORE SESSION 96, Kathy was UNCONSCIOUS of her guilt. For 95 sessions, Kathy argued with me about her guilt and was unable to be aware of it. Awareness of her deep, profound guilt was extremely difficult for Kathy to achieve. Being aware of her guilt meant that Kathy had to feel many deeply painful emotions that previously overwhelmed her. One of the multiply-determined reasons that awareness of this guilt was so painful was that previously Kathy BELIEVED THAT SHE HAD CAUSED HER BROTHER'S DEATH. As this pathogenic belief decreased its hold on her through the therapy, gradually Kathy could face her feelings of responsibility because she no longer TOTALLY BELIEVES SHE CAUSE HER BROTHER'S DEATH. As the treatment deepened and as memories of that traumatic time around her brother's death degain to reach her consciously, she remembered the incident of her near-drowning. She had always "known" of the incident, but she had NEVER BEFORE REALIZED THAT IT WAS AN EXPRESSION OF HER UNCONSCIOUS GUILT. AT SESSION 96, Kathy realizes with profound amazement, "I think maybe I was trying to disappear like I had made Dan disappear. I was trying to TRADE PLACES with him because I believed I cause him to disappear." This "trading places" concept became a central dynamic in understanding how Kathy manifested her guilt throughout her life. Kathy gradually sees how she "traded places" with people she believed she had hurt. In fact, the whole abortion syndrome was an attempt to "trade places" with her mother because Kathy believed that she (Kathy) had killed mother's child; so in Kathy's own life as a mother, she had several abortions to "trade places" with mother. Kathy punished herself with similar losses to those she felt she had caused. She punished herself with abortions to "trade places" with mother in an effort to expiate her (Kathy's) guilt.
I thank you all for your comments and for providing me the opportunity to further clarify some important points.