Guilt, Yes. But Something Else, Too?

I see beliefs as being an important determinant of human behavior, as does CMT. I would like to ask, however, about what other factors CMT sees as influencing a patient's behavior during therapy.

I believe that guilt arises only when someone has been taught in some way to feel guilty. "Charlotte," the young woman whose case was first discussed in the Clinical Case Conference on 2/13/97, was certainly taught by her parents to feel guilty for any disagreement with them and for any show of independence on Charlotte's part. So I agree fully with the view that part of her problem involved the pathogenic belief that were she to seek a happy, independent life, she would damage her parents and be perceived as rejecting them.

But what if her parents weren't such nut cases? Suppose they understood, as many parents do, that a child is impelled to loosen its bonds with its parents as a natural part of growing up. Would the child not still feel ambivalent about what it is being impelled to do? Would it not still miss its parents and feel pangs--not pangs of guilt, but sorrow nevertheless at having to disengage somewhat from its parents' love? And wouldn't the child in the process of disengagement do exactly what Charlotte did? Wouldn't he or she strive to loosen parental bonds by establishing helpful adult relationships?

In a previous post, I contended that practitioners of all therapeutic disciplines supplement official theory with intuitive practice. I am wondering whether that was the case with Charlotte. She was led by her therapist to seek compensatory relationships, even though her therapist's interpretations seemingly focused on pathogenic feelings of guilt and shame. Is psychological bonding accounted for by CMT? Would it not have helped Charlotte to know that her struggle was only partially due to pathogenic beliefs, that part of what she was going through was a normal and healthy process of disengagement? Perhaps that is what she was taught. In any case, her therapist's guidance was right on the money, whether or not a discussion of bonding took place.

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