Three Propositions and a Commendation of Control Mastery Theory and Therapy

Proposition One: True empathic understanding is not something one has or does not have--it is instead something that occurs fleetingly and is mostly beyond our control. Empathic understanding, when it (infrequently!) occurs, lasts briefly, just for seconds or minutes, rarely longer. One can do many things to interfere with the opportunity to have moments of empathic understanding (e.g., not listen, focus on one’s own concerns rather than the other’s, etc.) but one cannot make an empathic moment of understanding happen. One usually can recognize when an empathic moment is happening, for its sign is a strong and sometimes surprising conviction that one finally seems to really “get” what another is experiencing at a moment when the other also appears relieved to be feeling truly understood (even if the other is unaware of showing any sign of feeling immediate relief in being understood).

Because empathic understanding is difficult to achieve, it is usually better to strive to maintain an empathic presence so that empathic understanding can happen as it may. An empathic presence can be developed and learned. An empathic presence is itself likely to strengthen another’s self-cohesion--so much so that another’s sense of well-being can be enhanced by it to such an extent that empathic understanding in some instances may be unnecessary.

An empathic presence is one in which the helper adopts an interested and caring approach to communication which conveys a desire to be as a friend who accepts any of the other’s expressions of need or injury or desire for a worthy goal and who does his or her best as a helper to give the other the type of support and encouragement needed to fill a need or soothe an injury or obtain a worthy goal.

The helper is ever mindful that his words can be felt as daggars if they inadvertently covey meanings that (a) criticize or blame the other for his or her difficulty or (b)fragment the other’s attention by diverting it to issues of no immediate concern to the other or (c) imply the other’s difficulty is a source of annoyance or inconvenience for the helper. Above all, an empathic presence is one in which the helper remains interested and caring in the presence of the other when communicating his or her difficulty no matter how emotionally intense or irrational that difficulty may appear.

Proposition Two: The opposite of understanding is not misunderstanding but rather a resolution to cease permanently any further struggle to understand. Understanding requires many frustrating and often disappointing periods of not understanding while continuing to struggle to reach moments of empathic understanding. By far the greatest amount of time spend in understanding many persons who we try to know well is spent in misunderstanding. This is so true that one can regard it as a maxim that it is wise to be suspicious that not much progress is being made toward understanding if there is not much struggle to reach an empathic moment of conviction that one really “gets” another’s experience. Persons who remain in a relationship with another but appear not to be struggling to understand or be understood may nevertheless be struggling unconsciously for such understanding. The more desperately one appears not to want to understand or be understood (i.e., appears to have made a resolution to cease to struggle for understanding), the more likely it is that a conscious resolution to cease struggling is being undermined by an unconscious struggle toward understanding. This struggle, whether conscious or unconscious, can almost always be made less burdensome,even interesting and enjoyable,if the helper puts the goal of maintaining an empathic presence far ahead of the goal of achieving empathic understanding.

Proposition Three: The strong conviction that one has a nonfleeting accurate and objective empathic understanding of another’s difficulty--and an understanding obtained without struggle and supposedly uncontaminated by one’s own subjective neliefs, perspectives, biases, preferences or desires--is an almost certain sign that one’s understanding is instead an unempathic imposition and likely intrusion of one’s own state of mind attempting to dominate the other’s so long as the other either feels misunderstood or does not show other signs of feeling or functioning netter. Stated differently, this proposition claims that prolonged periods of facile certainty about one’s objective accuracy in interpreting another’s subjective state are most likely to be the result of merely an effort to dominate another’s experience with one’s own if one has no indication that the other either feels or behaves at least somewhat better. The likelihood of dominance is greatest if one feels certain of one’s really understanding another while the supposedly understood person does not feel understood or remains no less mired in painful unrelenting difficult emotions or behavior. This proposition also implies that I regard the concept of the “negative therapeutic reaction” (i.e., a reaction in which a therapist performs a supposedly correct therapeutic intervention but the client does not improve or even deteriorates) to be otiose. And I do regard the concept of a “negative therapeutic reaction” to be otiose. Misguided certainty about one’s objective understanding of another would be less likely to occur if helpers placed the importance of an empathic presence ahead of empathic understanding, for with this arrangement of priorities, a helper would not welcome a feeling of confidence in his or her understanding so long as the other gives no indication of becoming less mired in his or her difficulty. Of course I understand that various phenomena in psychotherapy, such as a client's performing more severe tests when finding earlier tests have been passed by the therapist, may appear as remaining mired. But in a situation like this, the observant helper would still have evidence of the client's growing confidence or willingness to test.

Often an empathic presence is itself a source of soothing comfort for suffering or provides a space for organizing one’s subjectivity in odrer to later pursue one’s goals with more confidence even while full understanding is lacking.

Nietzsche said it most succinctly: Conviction has no place in science. And Einstein is often quoted as having said that no amount of proof can prove him right but that one experiment can prove him wrong. A scientific outlook struggles to achieve understanding of the world, but the struggle leads only to more or less tentative conclusions. We may believe in scientific conclusions based on good evidence or reason; but if we play by the ethics of science, our beliefs must remain doubtful to some extent.

Because I believe in the soundness of the these three propositions about empathic understanding, I find myself disagreeing with some psychotherapists who believe that in having a scientific foundation for their work they may practice their trade with claims that they can objectively understand a client and prescribe a course of treatment at the outset of therapy that will ameliorate a client’s difficulty. Maybe, maybe not. It depends on how things go after therapy begins. The trend toward brief psychotherapy and managed care is not an auspcious sign of either society’s willingness to respect intellectual honesty nor a scientific outlook in everyday clincial work.

One of the elegant features of Control Mastery Theory is the tentativeness of formulations of a treatment plan. In the manner of a scientific conclusion based on initial evidence about a client’s concerns and difficulties, a Control Mastery therapist begins by making whatever interventions are called for according to what the therapist surmises to be the client’s unconscious struggle that needs understanding and encouragement. In the course of carrying-out an intervention, the therapist is keen to pay very close attention to whether the client offers confirming or disconfirming evidence of the accuracy of the therapist’s formulation. If the patient responds with signs of disorganization and confusion, that is usually taken as a likely falsification of the therapist’s formulation. A change in formulation is then made by the therapist to determine whether the client’s response will engender more organized thinking or emotional confidence. The therapist, in the manner of an ethical scientist, looks carefully for indications that he or she was wrong in earlier conclusions. If I am not mistaken, I believe that a Control Mastery therapist may sometimes even become suspicious that the client may not be progressing if nothing happens to challenge the therapist’s interventions--for this could be a sign that the client has a painful tendency to feel excessively responsible for pleasing others. Some other therapeutic approaches also adopt a scientific outlook paying close attention to falsifying evidence against a therapist’s first formulations of a treatment plan. However, Control Mastery makes this process the centerpiece of how a therapist is to guide both his or her interventions and his or her conceptualizations of the client’s unconscious plan.

There are some clients who may need a therapist to take an authoritative, certain stand on some issue, as with, for instance, a client who needs to see an example of how to stand up for his or her one personal convictions in matters of personal or ethical choice. But even in this case the Control Mastery therapist would decide to give the client a model for taking an authoritative stand in a matter of personal or ethical choice (i.e., not a matter of scientific conclusion) based on an assessment of the client’s indications of a need for this type of modeling. If it were later found that such an authoritative stand did not facilitate the client’s achieving his or her unconscious goals, the authoritative stand would be changed to something else more genial to the client’s worthy goals.

The everyday practice of psychotherapy is not just and not exactly a scientific enterprise, as in well known. It is a scientifically-informed enterprise and one guided in its everday practice, when practiced intelligibly with individual patients, by the same global epistemological principles that guide scientific research. But psychotherapists are also and inevitably metaphysicians whose activities are profoundly rooted in ethical commitments and ethical goals. As the former president of the Unversity of Chicago, Robert M. Hutchins, put it, in 1943, so succinctly: “Once more, to find the good life and the good state, we must inquire into the nature of man and the ends of life. The minute we do that we are metaphysicians in spite of ourselves.”

Control Mastery Theory has one of the best records as a research-validated theory of psychotherapy but provides, in addition, a nondogmatic, nonshaming, nonacusatory approach to a scientifically-informed clinical practice that aims with exemplary respect for discomfirming evidence at helping patients in their quest for a good life.

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