How Therapy Works
As children, we are fascinated by the world around us. We are trying to figure out how this world works and we look to the big people, the adults, around us for answers. If those adults are mentally and emotionally healthy, we get ideas from our role models that obviously can bring mental and emotional health, and thus happiness.
 But if our role models had a belief system about how the world works that brought them unhappiness most of the time, then unfortunately that is all they can teach us. And we adapt to that. Like a plant trying to grow in arid soil. We grow, but with difficulty. And naturally, we then expect our life to be difficult – and guess what we create?!
There are various unhealthy messages or beliefs that we can receive from our role models (these can, of course, be parents, but not exclusively). We try and interpret them, make sense of them, so that we can still be loved, taken care of, by those adults who are so important to our very survival.
Examples of some of those beliefs/interpretations include:
- "Mom gets upset when I'm unhappy." Interpretation: "I have to be happy, put a smile on my face, even if I'm sad or angry inside. I don't want to burden her." Then as adults, we find it hard to reveal our true selves and get close to others.
- "Dad is jealous of his brother for being more successful than he is. He doesn't spend much time with him." Interpretation: "I'd better not surpass my Dad when I grow up, or he won't want to be around me either." And then, as an adult, we wonder why we aren't as successful as we consciously think we could be.
- "My parents don't seem to talk about problems. They just yell at each other about them." Interpretation: "I guess that is what marriage is like. I don't think that I want to get married at all. Or else, I don't want it to look like that. But how can I make it different?" And as adults in a relationship, we struggle with this.
Remember that our interpretations were made as kids and by now are part of our unconscious beliefs about how the world works. By definition, we're not aware of them.
Psychotherapy is about the recognition of these beliefs, with the help of a professional. It's hard to make something conscious that is unconscious all on our own. A psychotherapist observes our responses in session and deduces what beliefs might be driving those responses.
Healing requires making the pathological (don't serve us) beliefs conscious so that we can then challenge and change them. Understanding and grieving what losses might have ensued from these beliefs is also an important part of the healing process.
Basically, Control Mastery Theory is described above. The theory was formulated by Joseph Weiss, M.D., in the 1960's. A psychoanalyst, Weiss found that the Freudian model of psychotherapy did not predict, nor even account for, improvements in some of his patients. He did research on what works in therapy – what helps patients get better and why.
In 1972, he collaborated with Harold Sampson, Ph.D., to found the Mt. Zion (now the San Francisco) Psychotherapy Research Group, which continues to research and study this theory.
Weiss/Sampson postulate that patients unconsciously organize their therapy process and are thus in control of what they want to get from therapy, actually have an unconscious plan for their goals. And that patients, and people in general, unconsciously assess their social environments (including therapy) for signals of safety and danger. When we feel safe, we relax our defenses.
Thus using this theory, the psychotherapist ascertains what will help the patient feel safe enough to do the work that he or she needs to do. Patients will test the therapist (often unconsciously) to see if the therapist requires them to keep the same unhealthy beliefs in place as their role models did. Obviously, if that is the case, the patient will not feel safe to try new behaviors – to learn what he or she needs to learn – to create happiness. If that happens, the patient is unlikely to stay in therapy.
For more information:
Websites:
The San Francisco Psychotherapy Research Group.
This is the home page of the control mastery group, and lists events, classes, case conferences, a complete bibliography, etc.
Writings of the San Francisco Psychotherapy Research Group.
This site is dedicated to the writings of the San Francisco Psychotherapy Research Group, and is a major resource for its publications.
Books:
How Psychotherapy Works: Process and Technique. Joseph Weiss. New York: Guilford Press, 1993. This book is intended for psychotherapists, but the author's informal style make it accessible to the layperson as well.
Hidden Guilt: Stop Punishing Yourself and Enjoy the Happiness You Deserve. Lewis Engel and Tom Ferguson. Pocket Books, 1991. Intended for the layperson, the authors discuss the importance of unrecognized guilt as a major cause of unhappiness.
Why You Behave in Ways You Hate: And What You Can Do About It. Irwin Gootnick. Roseville, CA: Penmarin Books, 1997. A layperson's introduction to some aspects of the theory.
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