August2012_Silberschatz

8/12/2019 August2012_Silberschatz

1/6

30 PSYCHOTHERAPY IN AUSTRALIAVOL 18 NO 4 AUGUST 2012

Transformative processes inpsychotherapy: How patients work intherapy to overcome their problems

G E O R G E S I L B E R S C H A T Z

Drawing on control-mastery theory, GEORGE SILBERSCHATZ considers how adverse or traumatic

childhood experiences play a central role in the development of psychopathology. Shock or stress

trauma can result in the development of pathogenic beliefs by the child in an effort to cope

with trauma. These painful, constricting, and debilitating beliefs are internalised cognitive-affective

representations of the traumatic experiences that can involve irrational conclusions, self-blame and

guilt, and are the cornerstone of later pathology. Control-mastery theory assumes psychotherapy

patients are highly motivated to disconfirm or relinquish pathogenic beliefs. This motivation to

solve problems and master conflicts is embedded in the concept of the patients plan. Often

unconscious, or not articulated consciously, these plans organise the persons behaviour through

evaluation and filtering of information. In control-mastery theory, the therapists primary role is to

help the patient carry out their plan. Patients work to disconfirm pathogenic beliefs through testing

these directly with the therapist. To solve problems and conflicts in psychotherapy, the patient must

create a relationship with the therapist that provides protection from the danger faced if warded-off

feelings, behaviours, goals and thoughts are to be brought into consciousness. Illustrated by case

examples, two categories of tests are described: transferencetests andpassive-into activetests.

PEER REVIEWED

The topic that has most intriguedme throughout my career as

a psychologist is the fundamental

question of how psychotherapy works.I began addressing this question inmy doctoral dissertation research(Silberschatz, 1978) by framing theinquiry in terms of how patients1workin psychotherapy and how therapistshelp (or hinder) their patients efforts.It should come as no surprise that mywork on this question did not end withmy dissertation, and I have continuedto pursue it ever since.

In this paper I summarise what Ihave learned (so far). My discussion

relies primarily on Weiss andSampsons control-mastery theory(Sampson, 1976, 1991; Silberschatz,2005; Weiss, 1986, 1993). A brief

description of how psychopathologydevelops is followed by a discussion ofhow patients work in psychotherapy

to master their problems and conflicts.My focus is on two particular concepts:the patients plan for therapy, and thepatients testing of the therapist duringpsychotherapy.

Psychopathology and the

patients plan to overcome it

According to control-masterytheory, adverse or traumaticexperiences play a central role in thedevelopment of psychopathology.Weiss (1993) posited two types of

traumatic experiences: shock trauma discrete

catastrophic childhood events suchas the death or serious illness of a

parent that overwhelm the childscoping capacities;

stress trauma persistent traumatic

experiences from which the childcan not escape, such as growing upin a dysfunctional family or beingraised by a depressed parent.

Children develop theories as partof their efforts to cope with traumaand in their theorising they areprone to draw irrational conclusions,which typically lead to self-blameand guilt (Shilkret & Silberschatz,2005). Weiss (1986, 1993) termedthese theories pathogenic beliefsand argued that such beliefs are the

cornerstone of later psychopathology.For example, a child who wasmistreated by her parents developedthe pathogenic belief that she deserved

Copyright 2012, PsychOz Publications http://www.psychotherapy.com.au


2/6

PSYCHOTHERAPY IN AUSTRALIAVOL 18 NO 4 AUGUST 2012 31Illustration: Savina Hopkins, www.savinahopkins.com

mistreatment. Tis unconscious beliefled to psychopathology later in herlife including depression, disturbedrelationships, and substance abuse.

Pathogenic beliefs are internalisedcognitive-affective representationsof traumatic experiences and theyare typically extremely painful,constricting, and debilitating

(Silberschatz & Sampson, 1991).

Control-mastery theory assumes thatpsychotherapy patients are highlymotivated to disconfirm or relinquishpathogenic beliefs. Tis fundamentalmotivation to solve problems andmaster conflicts is embedded inthe concept of the patients plan(Silberschatz, 2005; Weiss, 1993).According to control-mastery theory,patients come to therapy in order to getbetter, and they have a plan for doingso the disconfirmation of crippling

pathogenic beliefs. In therapy, as inother aspects of a persons life, plansare often unconscious or not articulatedconsciously; nonetheless, the planorganises the patients behaviour andplays an important role in evaluatingand filtering information.

Consider, for example, thecase of Jill (Silberschatz, 2005), acompassionate middle-aged womanwho sought therapy because she feltemotionally overwhelmed by herelderly, demented mother. Jill suffered

from the pathogenic belief that takingcare of herself meant that she wasselfish and cruel (accusations that hermother had voiced frequently whenJill was a child). Her unconsciousplan for therapy was to disconfirm herpathogenic belief (If I take care of myselfor put my needs and my familys needs rstthat means I am an uncaring, cruel, selshdaughter) so that she could pursue hergoal of finding a suitable nursing homefor her ill mother.

Jill s plan led her to carefullymonitor (albeit unconsciously) thetherapists reactions to her efforts tofind a nursing home. She had the

transference expectation that thetherapist, like her mother, would seeher as selfish or callous. When thetherapist encouraged or supported herefforts that is, when the therapistsupported Jill s plan she felttemporarily relieved. Troughout thetherapy, she continued to monitor andassess (unconsciously) the therapists

reactions and interpretations for any

indication of disapproval.Clinicians are far more accustomed

to thinking about the therapistsplan (i.e., a treatment plan) than thepatients plan. Nonetheless, thereis considerable research evidenceshowing that therapists who havebeen trained in control-mastery theoryconsistently achieve high levels ofinter-judge agreement in inferringthe unconscious plans of patients (for

reviews, see Curtis & Silberschatz,2007; Silberschatz, 2005). Tere is alsostrong research support in the fieldsof experimental and social psychologyfor the concept of unconsciouscognition and planning (e.g., Bargh,Gollwitzer, Lee-Chia, Barndollar &roetschel, 2001; Fitzsimons & Bargh,2003; Lewicki, Hill, & Czyzewska,1992; Lewicki, Hill, & Czyzewska,1994; Steele & Morawski, 2002;Westen, 1999), as well as in cognitive/behavioural therapy (e.g., Caspar,1995; Grawe, 2004). Te assumptionsunderlying the plan model are alsoconsistent with client-centered,humanistic, and experiential theories.For instance, a fundamental tenet inthe thinking of Rogers is that humans

have a self-actualising tendency andthat it is crucial ly important for thetherapist to create conditions thatallow the self-actualising tendency toflourish. Tis is essentially synonymouswith the control-mastery conceptthat patients come to therapy withan unconscious plan to solve theirproblems and master trauma, and thatthe therapists primary role is to helpthe patient carry out their plan.

patients come to therapy in order to get

better, and they have a plan for doing so the

disconfirmation of crippling pathogenic beliefs.



3/6


The patients tests of the therapist

Patients work on carrying out theirplans to disconfirm pathogenic beliefsin three ways. Tey may: use new knowledge or insight

conveyed by the therapists

interpretations; use the therapeutic relationship; test pathogenic beliefs directly with

the therapist.In delineating these three different

patient strategies I do not mean toimply they are mutually exclusive;indeed, patients frequently use al lthree ways of working. Te firsttwo insight conveyed throughinterpretation and the therapeuticrelationship are familiar to cl iniciansof various theoretical orientations as

they have been described extensively inthe psychotherapy literature. However,the concept of the patient testing the

therapist is a distinctive contributionof control-mastery theory and I willtherefore devote the remainder of thispaper to the testing concept.

According to control-masterytheory, perceptions of danger andsafety play a central role in explaininghuman motivation and behaviour: Oneof our most powerful motives and one

frequently overlooked by theoreticians isthe quest for a sense of safety. Our pursuitof a sense of safety is rooted in biology and

is to a considerable extent unconscious(Weiss, 2005, p.31). An important partof a patients efforts to solve problemsand conflicts in psychotherapy is tobring warded-off feelings, behaviours,goals and thoughts into consciousness.In order to do so, the patient mustwork to overcome the sense ofdanger she would face if she were toexperience these warded-off contents.She does this by attempting to createa relationship with the therapist thatwould protect her from this danger.

Te patient tests the therapist toassure herself that were she to bringwarded-off material into consciousness,the therapist could be relied upon to

respond in a way that would aordprotection against the danger (Sampson,1976, p. 257). Consider, for example,a patient who grew up in a family thatcould not tolerate his expressing anyangry, critical, or negative feelings.Te patient tested the therapist bytentatively disagreeing with her andby expressing mildly critical feelingstoward her. Te therapist respondedto these tests by pointing out thepatients tentativeness or discomfortin criticising her and by encouraginghim to say more about his anger. Tepatient felt reassured by the therapistsresponses that is, he felt a greatersense of safety and subsequentlybrought up relevant traumaticmemories of having been punished as a

child for his critical feelings.

ests are patient initiated behavioursthat require some kind of responsefrom the therapist.2ests may be

planned and executed consciouslyor unconsciously, but the patientsprimary intention in testing is alwaysadaptive. Early in therapy, patientstest frequently to ascertain what theycan work on safely with a particulartherapist. Te patient attempts todetermine whether the therapistwil l support his goals, understandhis problems, help him master earlytraumas, and whether the therapist hassome of the qualities and strengths thatthe patient lacks and wishes to acquire.

Generally speaking, patients testtheir therapists in order to disconfirmpathogenic beliefs and to solicit help inpursuing their therapy goals. ests areshaped by the patients interpersonalhistory, traumas, defenses, personalitystyle, conscious and unconscious goalsfor therapy, and specific pathogenicbeliefs.

wo broad categories of tests havebeen described in the control-masterytheory: transference testsandpassive-into

active tests(Silberschatz, 1986, 2005;Silberschatz & Curtis, 1986, 1993;Weiss, 1986, 1993). In a transferencetest, the patient attempts to assess

whether the therapist will traumatiseher as she had been traumatisedpreviously by family members or othersignificant figures in her childhood.For instance, a middle-aged womanin therapy frequently minimisedand glossed over the severity of herproblems. Te therapist learnedgradually that a neighbour hadsexually molested her when she wasnine, and when she told her parentsthey believed she was exaggeratingand simply misunderstood theneighbours affectionate playfulness.Tus her behaviour with the therapistrepresented a process of unconscioustransference testing she was tryingto ascertain whether the therapistwould be unresponsive and dismissive

of her problems and feelings as herparents had been. In the previouslycited example of a patient who grewup in a family that could not toleratethe expression of any angry or negativefeelings, the patient frequently behavedin a mildly negative, disagreeablemanner as part of a transference test,i.e., to see if the therapist needed tostifle his critical feelings as his parentsdid consistently while he was growingup. Each time the therapist did not

stifle the patients negativity thatis, disconfirmed his pathogenicbelief that anger and negativity areintolerable the therapist passedthe test. Had she conveyed eitherthrough her attitude, behaviour, orinterpretations that she could nottolerate the patients criticism or anger,she would have failed the test.

In apassive-into-active test, thepatient tries to traumatise the therapist,as the patient had been traumatisedearlier in life, in order to see if the

therapist can handle trauma moreeffectively than the patient could(Sampson, 1991, 1992; Silberschatz,2005; Silberschatz & Curtis, 1986,1993; Weiss, 1986, 1993). Tesetests represent efforts at masteringtrauma by doing unto others whatwas done unto you. Passive-into-active testing is also used to acquirestrengths that the patient lacks. Tepatient hopes to identify with thetherapists capacity to not comply

with, or be overwhelmed by, thepatients potentially traumatisingbehaviour. Tese tests can be veryhelpful because they provide a vivid

patients test their therapists in order to

disconfirm pathogenic beliefs and to solicit

help in pursuing their therapy goals.



4/6

PSYCHOTHERAPY IN AUSTRALIAVOL 18 NO 4 AUGUST 2012 33

opportunity for the patient to identifywith (and ult imately internalise) thetherapists ability to handle traumaticexperiences that the patient could nothandle. For instance, a patient wastraumatised in childhood by a cold,critical step-mother who frequentlytreated the patient with scorn, disdain,and ridicule. As part of her work tomaster this trauma in therapy, thepatient tested the therapist by turningpassive-into-active: she often reactedto the therapists comments scornfullyand with ridicule ( just as she had beenridiculed by her abusive step-mother).Te therapist passed these tests byresponding in a genuinely inquisitive,non-defensive manner he was neitheroverwhelmed, nor did he comply with

the patients scorn (i.e., he did not feelstupid or helpless as the patient had feltas a child).

Although patients are highlymotivated to disconfirm pathogenicbeliefs, doing so requires considerableeffort and repeated testing. Tere isstrong research evidence showing thatwhen therapists pass tests, patientsshow signs of therapeutic progress andwhen therapists fail tests there is alack of progress or therapeutic retreat

(for an overview of this research, seeSilberschatz, 2005). However, neithertheory nor research on the testingconcept implies that the patient teststhe therapist once or twice, and if thetherapist passes the test, the patientwil l relinquish pathogenic beliefs.

Patients unconsciously testand monitor therapist behavioursthroughout treatment, paying carefulattention to the content of therapistinterpretations (Silberschatz, Fretter,& Curtis, 1986; Silberschatz, Curtis,

& Nathans, 1989) as well as to thetherapists style and attitude (Sampson,2005; Shilkret, 2006). It would bemisleading to assume that the fate ofa therapy is sealed simply by whethera therapist passes or fails tests earlyin treatment. Tere is considerablevariability in the extent to whichtherapists pass or fail tests (Silberschatz& Curtis, 1993). ypically, successfultreatments include some failed testsand unsuccessful treatments include

examples of tests that were passed.When therapists fail tests repeatedly,the patient may alter the testingstrategy or may coach the therapist

(Bugas & Silberschatz, 2005) as part ofan effort to get the therapist on a moreproductive track.

Case illustration

A brief case example is presented toillustrate how traumatic experiences

lead to pathogenic beliefs and howthe patient works to disconfirm thesebeliefs by testing the therapist.

Zoe3, a woman in her late-40s,came to therapy in a state of acute crisisbecause her six-year relationship withPeter was ending. She had not beeneating or sleeping, and was extremelyanxious, bereft and distressed.Although she described Peter as thelove of her life, she made it clearshe had to do all the work in the

relationship, and if she didnt, it wouldfall apart. She was extremely self-sacrificing and clearly the care taker;Peter had no career, little money,and seemed to be highly narcissisticand quite needy. In these regards,he resembled Zoes self-absorbed,domineering husband from whomshe had separated (but not divorced)to pursue the relationship with Peter.Peter expected the patient to accept hisaffairs with other women. Te presentcrisis was precipitated by him tellingher he had fallen in love with someoneelse and intended to marry her.

Te patients proclivity towardself-sacrifice and taking care ofothers originated in her early familyrelationships. Tough her familyappeared to be like all the other happy,church-going families in the smallcommunity in which she grew up, herswas clearly a dysfunctional family. Shedescribed her father as very narcissisticand, since she worshipped him, he

seemed to prefer her company to thatof her mother. Te only way Zoe couldget close to him was by being his pet,someone he could show off to others.Mother was described as a depressedalcoholic who resented the patient forbeing close to her father. Tere seemedto be no room for Zoe to express herwishes, needs, or feelings Fathersself-centeredness didnt allow it, nordid mothers fragility and withdrawal.Father explicitly directed her not to

be angry at mother, encouraging herinstead to be understanding. Zoe saidshe has spent her whole life beingunderstanding.

Case formulation

Te aim of the formulation is tounderstand what the patient wantshelp with and how the therapist canbest provide that help. A control-mastery approach to case formulation

begins with summarising the patientsadaptive goals, some of which areconscious and some of which may beunconscious. Next, key childhoodtraumas are described followed bya description of pathogenic beliefsthat the patient developed fromthese traumas. And finally, we try toanticipate how the patient is likelyto test her pathogenic beliefs in thetherapeutic relationship, and what shewil l need from the therapist in order todisconfirm her pathogenic beliefs (for

a thorough description of our approachto case formulation, see Curtis &Silberschatz, 2005, 2007; Silberschatz,Itzhar-Nabarro, & Badger, 2007).

Zoes consciously stated goals inseeking psychotherapy were to feel lessanxious, distressed, and overwhelmedand to get a better handle on herrelationship with Peter. We inferredthat her unconscious goals were to beless of a caretaker, and to develop thecapacity to attend to her own feelings,

to take her needs and ambitionsmore seriously, rather than to be sopreoccupied with the needs of others.In other words, she wished to be lessunderstanding and to have greateraccess and to feel more entitled toexperience a wider range of feelings, inparticular, her angry feelings.

Te primary traumas in this casecenter on her disturbed parentalrelationships. Zoes early relationshipwith her narcissistic father impededthe development of her ability to focuson herself and her needs. Her motherprovided no real help or comfort.Instead, she resented her for beingclose to father, which led Zoe to feelintense guilt. Growing up in thisdysfunctional family left Zoe feelinglonely, anxious and extremely worried,especially about her depressed,alcoholic mother.

Te patients relationship withher narcissistic father led to theunconscious pathogenic belief that

she must comply with the needsof others and completely subjugateherself in order to be loved. Tisbelief obviously shaped the men she



5/6


chose as partners and contributed tothe feeling that she needed to acceptmistreatment and remain devotedto her man, no matter what. Herrelationship with both parents , butparticularly the relationship withher depressed, alcoholic mother, ledto the pathogenic belief that she isresponsible for the happiness and well-being of others. Her fathers strongdirective to be understanding ratherthan critical of her mother gave rise tothe pathogenic belief that she shouldnever be authentic because her feelings,particularly angry, critical feelings, aredangerous.

Zoe tested the therapist as partof her effort to disconfirm thesepathogenic beliefs. During the first

several months of therapy, many of hertests were passive-into-active tests. Shetested the therapist to see if he wouldfeel excessive responsibility for her(as she felt toward others) by callinghim multiple times a day and leavingmessages to call her back immediately.Her excessive phone calls representedclear examples of passive-into-activetesting in that she was working to seeif she could make the therapist feeloverly responsible in the same way that

she had felt burdened and responsibleas a child. Te therapist passed thesetests by demonstrating that he did notfeel omnipotently responsible (as shedid), and that he could set appropriateboundaries (as she could not).

A particularly dramatic instanceof the therapist fai ling a passive-into-active test occurred when the therapistnotified her of his upcoming two-week vacation. Zoe had been workingon her life-long pathogenic patternof feeling excessively responsible for

others at great expense to herself. Tetherapists vacation announcementgave her an opportunity to vigorouslytest the therapist to see if he wouldfeel excessive responsibility for her asshe felt for others. She complainedbitterly about his taking a vacation,let him know that the timing wasawful, and wondered how she wouldsurvive while he was away. Initially, thetherapist failed this passive-into activetest because he did feel intense guilt,

irrational responsibility, and showed aninclination to be self-sacrificing hewould have changed his vacation plansif his childrens schedule would have

allowed it! His guilt-ridden responsewas notably unhelpful because it madeZoe concerned that the therapistwould be unable to help her feel lessresponsible for others. Subsequently,she tested him even more vigorouslyby upping the ante, asking for his cellphone number so that she might callhim just to check in every day. Hepassed the test by declining her requestand thereby demonstrated that hecould set appropriate limits, would notbe irrationally self-sacrificing, and thathe could take care of his own needs.

Zoe posed numerous transferencetests in which she worked todisconfirm her pathogenic beliefthat she must comply with others orsubjugate her needs in order to preserve

her relationships. For instance, shetested the therapist by behaving ina flagrantly obsequious, subservientmanner in order to see if he wouldtake advantage of her or be gratifiedexcessively by her compliments andsubmissiveness. She then began testingto see how the therapist would reactto her expressing critical feelings,especially of men. Te therapistdecisively passed tests in which sheexpressed critical feelings toward Peter

(and other narcissistic men who hadtaken advantage of her).However, when she expressed

critical, angry feelings toward oneof her women friends, the therapistsomehow got off track. As part of herwork on feeling more comfortable andentitled to her angry feelings, Zoetold the therapist about an episodein which she felt angry at her bestfriend. In order to disconfirm thepathogenic belief that being in arelationship required her to subjugate

her feelings and assume the role ofthe dutiful caretaker, she needed thetherapist to support and encouragethe expression of her annoyance withher friend. Instead, he conveyed thesame pathogenic message she receivedfrom her father: You should be moreunderstanding.Tis is an example ofthe therapist clearly failing the patientstest. In a subsequent session, thepatient coached the therapist as partof an effort to get him back on track

by reminding him that her father hadalways told her that she should not beangry at her mother and that instead,she needed to be more understanding.

Later in that session, and in subsequentsessions, the therapist was moresupportive of her expressing anger andthe patient was increasingly able toexpress appropriate criticism and to feelmore entitled to be angry.

With sporadic exceptions, thetherapist generally helped Zoe workon her unconscious plan: he passedmany of her transference and passive-into-active tests, which helped herto disconfirm her pathogenic beliefs.A strong therapeutic al liance wasevident and she made substantialprogress. About eighteen months intothe therapy, she posed a significanttransference test by suggesting thatshe terminate therapy. Because ofher lifelong pattern of taking care

of or admiring others, she rarely (ifever) had the experience of being thesource of someones admiration orpleasure. Moreover, as a child whenshe was her fathers pet, her motherexpressed harsh disapproval and overtresentment of her. Her suggestionto terminate treatment represented acrucial transference test of the therapistto see if he could admire her, feel proudof her, and provide the support andencouragement she needed to expand

her world. By suggesting she continuetreatment, the therapist showed he feltneither threatened, nor disapproving ofher being the center of attention.

Summary

Research and clinical experiencehave shown that the quality of thetherapeutic relationship is a stronger,more consistent predictor of effectivepsychotherapy than form of treatment.Te therapeutic relationship can bestrengthened if therapists tailor their

approach and interventions to meetthe specific needs of their patients.Control-mastery theory, providesan integrated and evidence-basedframework for tailoring therapy in aresponsive, case-specific manner. Early,adverse relational experiences play acentral role in the development of laterpsychopathology. Tese early traumaticexperiences are internalised and leadto pathogenic beliefs. Patients come totherapy in the hopes of disconfirming

these pathogenic beliefs and one ofthe ways they work in therapy is bytesting the therapist. ests may beplanned and executed consciously or



6/6

PSYCHOTHERAPY IN AUSTRALIAVOL 18 NO 4 AUGUST 2012 35

unconsciously, but the patients primaryintention in testing is always adaptive.When the therapist passes the patientstests (disconfirms pathogenic beliefs),the patient feels an increased senseof safety and hopefulness, and thetherapeutic relationship is enhanced.

Footnotes

1. I use the term patient in the original

sense of the word one who suffers

rather than in the current medical model

usage (see Silberschatz, 2005, p. xvi).

2. While I limit my discussion to tests in

psychotherapy, it should be noted that

conscious and unconscious testing occurs

in all relationships; indeed, Weiss (1993)

argued that testing is the primary way that

people explore their interpersonal worlds.

3. This case is drawn from a training DVD,

Psychotherapy Case Formulation from thePerspective of Control-Mastery Theory,

that Susan Badger, Zohar Itzhar-Nabarro,

and I developed.

References

Bargh, J. A., Gollwitzer, P. M., Lee-Chai, A.,

Barndollar, K., & Troetschel, R. ( 2001). The

automated will: Nonconscious activation

and pursuit of behavioral goals.Journal of

Personality & Social Psychology, 81, 1014-

1027.

Bugas, J., & Silberschatz, G. (2005).

How patients coach their therapists in

psychotherapy. In G. Silberschatz (Ed.),

Transformative relationships: The Control-

Mastery theory of psychotherapy(pp.153-

167). New York: Routledge.

Caspar, F. (1995). Plan analysis.Bern:

Hogrefe & Huber.

Curtis, J. T., & Silberschatz, G. (2005).

The assessment of pathogenic beliefs.

In G. Silberschatz (Ed.), Transformative

relationships: The Control-Mastery theory

of psychotherapy(pp.69-91). New York:

Routledge.

Curtis, J. T., & Silberschatz, G. (2007).

Plan formulation method. In T. D. Eells(Ed.),Handbook of psychotherapy case

formulation(2nd ed., pp. 198220). New

York: Guilford.

Fitzsimons, G. M., & Bargh, J. A. (2003).

Thinking of you: Nonconscious pursuit

of interpersonal goals associated with

relationship partners.Journal of Personality

and Social Psychology, 84, 148163.

Grawe, K. (2004).Psychological therapy.

Bern: Hogrefe & Huber.

Lewicki, P., Hill, T., & Czyzewska, M. (1992).

Nonconscious acquisition of information.

American Psychologist, 47,796801.

Lewicki, P., Hill, T., & Czyzewska, M.

(1994). Nonconscious indirect inferences

in encoding.Journal of Experimental

Psychology: General, 123, 257263.

Sampson, H. (1976). A critique of cer tain

traditional concepts in the psychoanalytic

theory of therapy. Bulletin of the Menninger

Clinic, 40, 255262.

Sampson, H. (1991). Experience and

insight in the resolution of transferences.

Contemporary Psychoanalysis, 27,200207.

Sampson, H. (1992). The role of real

experience in psychopathology and

treatment. Psychoanalytic Dialogues, 2,

509528.

Sampson, H. (2005). Treatment by attitudes.

In G. Silberschatz (Ed.), Transformative

relationships: The Control-Mastery theory

of psychotherapy(pp.111119). New York:

Routledge.

Shilkret, C. J. (2006). Endangered by

interpretations: Treatment by attitude of

the narcissistically vulnerable patient.

Psychoanalytic Psychology, 23, 3042.

Shilkret, R. & Silberschatz, S. A. (2005).

A developmental basis for control-

mastery theory. In G. Silberschatz (Ed.),

Transformative relationships: The Control-

Mastery theory of psychotherapy(pp.171

187). New York: Routledge.

Silberschatz, G. (1978). Effects of the

analysts neutrality on the patients feelings

and behavior in the psychoanalytic situation.

Dissertation Abstracts International, 39,

3007-B. (University Microfilms No. 78

24,277).

Silberschatz, G. (1986). Testing pathogenic

beliefs. In J. Weiss, H. Sampson, & The

Mount Zion Psychotherapy Research Group

(Eds.), The psychoanalytic process: Theory,clinical observation, and empirical research

(pp. 256266). New York: Guilford.

Silberschatz, G. (2005). Transformative

relationships: The Control-Mastery theory of

psychotherapy.New York: Routledge.

Silberschatz, G., & Curtis, J. T. (1986).

Clinical implications of research on brief

dynamic psychotherapy: II. How the

therapist helps or hinders therapeutic

progress. Psychoanalytic Psychology, 3,

2737.

Silberschatz, G., & Curtis, J. T. (1993).

Measuring the therapists impact on thepatients therapeutic progress.Journal of

Consulting and Clinical Psychology, 61,

403411.

Silberschatz, G., Curtis, J. T., & Nathans, S.

(1989). Using the patients plan to assess

progress in psychotherapy. Psychotherapy:

Theory, Research, Practice, Training, 26,

4046.

Silberschatz, G., Fretter, P. B., & Curtis, J.

T. (1986). How do interpretations influence

the process of psychotherapy?Journal of

Consulting and Clinical Psychology, 54,

646652.

Silberschatz, G., Itzhar-Nabarro, Z., &

Badger, S. (2007). Psychotherapy case

formulation from the perspective of Control-

Mastery theory. Training DVD available from

the San Francisco Psychotherapy Research

Group (www.SFPRG.org).

Silberschatz, G., & Sampson, H.

(1991). Affects in psychopathology and

psychotherapy. In J. D. Safran & L. S.

Greenberg (Eds.), Emotion, psychotherapy,

and change (pp.113129). New York:

Guilford.

Steele, R. S., & Morawski, J. G. (2002).

Implicit cognition and the socialunconscious. Theory and Psychology, 12,

3754.

Westen, D. (1999). The scientific status

of unconscious processes: Is Freud

really dead?Journal of the American

Psychoanalytic Association Special

Issue: Between the millennia: Freud and

psychoanalysis, 47,10611106.

Weiss, J. (1986). Theory and clinical

observations. In J. Weiss, H. Sampson, &

The Mount Zion Psychotherapy Research

Group (Eds.), The psychoanalytic process:

Theory, clinical observation, and empirical

research(pp. 3-138). New York: Guilford.

Weiss, J. (1993). How psychotherapy

works.New York: Guilford Press.

Weiss, J. (2005). Safety. In G. Silberschatz

(Ed.), Transformative relationships: The

Control-Mastery theory of psychotherapy

(pp.31-42). New York: Routledge.

AUTHOR NOTES

GEORGE SILBERSCHATZ, Ph.D. is Clinical Professor in the Department of Psychiatry, School of

Medicine, at the University of California, San Francisco. He is Editor of Transformative Relationships:The Control-Mastery Theory of Psychotherapy (2005), and the President of the Society for PsychotherapyResearch. He will be offering training in Brisbane in November 2012. [email protected]

C i ht 2012 P hO P bli ti htt // h th

August2012_Silberschatz

Documents

Transcript of August2012_Silberschatz