Progress in Psychotherapy: The Perspective of Control-Mastery Theory

In the classical psychoanalytic tradition, the patient is seen as unconsciously governed by forces that are at odds with the healing process. But over the years, the concept of resistance against change has been subjected to modifications, and the patient’s contribution to the therapeutic relationship has come to be seen as more oriented to a conscious and unconscious collaboration with the clinician. This article aims to explore a new way of understanding how progress in psychotherapy is achieved and to reframe the therapeutic relationship from the point of view of Control-Mastery Theory (CMT). According to CMT, people are motivated to achieve adaptive goals, to master their traumas, and to feel better; to this purpose, patients unconsciously assume proactive roles in the therapeutic process. Indeed, they work during therapy to disprove their pathogenic beliefs, testing them in the therapeutic relationship, and helping the therapist through coaching behaviors, attitudes, and communications aimed at providing helpful information to understand the components of their own unconscious plan.