Articoli Scientifici

According to Control-Mastery Theory, patients attend therapy with an unconscious plan to achieve adaptive goals and disprove their pathogenic beliefs. One important way patients work to disconfirm these beliefs is by testing them. Moreover, patients coach their therapists on what they need at different times during their treatment. The aim of this study is to expand the results of previous studies suggesting that therapists’ responses that support patients’plan predict progress. We investigated whether therapists’ ability to pass patients’ tests correlated with patients’ improvement in the following session and whether their ability to follow patients’ coaches correlated with immediate improvement. Transcriptions of 98 sessions from six brief psychodynamic psychotherapies wer assessed by 12 independent raters. The patients’ plans were formulated, and tests and coaching communications were identified. The accuracy of the therapist’s responses to these tests and coaches was rated, and the impact of the therapist’s interventions on the patient’s following communication was measured. The results showed that when a therapist’s intervention passes a patient’s tests, patients show signs of improvement both immediately and in the following session, and when therapists follow patients’ coaches, patients show signs of immediate improvement. The clinical implications and limitations of the findings are discussed.

The study aims to empirically assess the control-mastery theory hypothesis that considers chronic couple confictuality as the repetition of relational vicious circles—that is, interactions where both partners test their pathogenic beliefs and fail their reciprocal tests, confrming their reciprocal pathogenic beliefs. In addition, the study aims to verify if interpersonal guilt is more activated during couple conficts. Our study involved 11 couples treated by four experienced therapists and nine trained, independent judges who, after reading verbatim transcripts of the couples’ psychotherapy sessions, used the Patient Scale of Couple Testing (PSCT), and the Patient Interpersonal Guilt Rating Scale (PIGRS) to rate segments of couple sessions. The results were obtained by applying generalized estimating equations and confrm our hypotheses: we could observe a greater presence of testing activity and confrmation of pathogenic beliefs in segments classifed as confictual for both partners and a stronger presence of interpersonal guilt in confictual versus nonconfictual interactions. These fndings support the idea that confict interactions can be seen as failed attempts by both partners to disconfrm their pathogenic beliefs.

The aim of this paper is to empirically assess the reliability of the plan formulation method for couples, a procedure for formulating the case, planning, and monitoring the couple therapies according to control-mastery theory. We hypothesized that when couples are looking for couple therapy, they have an unconscious couple’s plan for the therapy, which includes the couple’s goals; the pathogenic beliefs that the partners want to disprove; the traumas from which these beliefs originated and that the partners want to master; the vicious relational circles that make the couple suffer and that the couple wants to break; the virtuous relational circles that are expressions of the couple’s resources and that the couple wants to fuel; and the relational insights that may help the couple get better. Our study involved 15 couples treated by four experienced therapists. Four raters independently formulated each couple’s plan based on the first three sessions following a standard procedure, and we calculated the intraclass correlation for pooled judges’ ratings. For a subsample of three couples—who before and after treatment had completed the dyadic adjustment scale (DAS) and the outcome questionnaire-45.2 (OQ-45.2)—the compatibility of the therapists’ interventions with the couples’ and partners’ plans was assessed. The relationship between the ratings of compatibility, DAS and OQ-45.2, was assessed. The results showed excellent interjudge reliability for each couple’s plan formulation (average ICC=0.82), attesting to the validity of the procedure; and preliminary data on the therapeutic process suggested that therapists’ interventions compatible with couple’s plans could help partners achieve good outcomes.

The aim of this paper is to show the evolution of the psychoanalytic conception of fantasy/phantasy from a psychic activity aimed at denying reality and/or fulfilling frustrated wishes to a tool useful for adapting to reality. We will then review some recent findings of empirical research on imagination and mental simulation showing how these activities, and mind wandering in general, is expression of the constant effort of the psyche to set and pursue adaptive goals, to elaborate and test plans, and to master and solve problems and traumas. Finally, we will show how these empirical data are consistent with the conception of fantasy proposed by the control-mastery theory (CMT; Gazzillo, 2016; Silberschatz, 2005; Weiss, 1993), an integrated cognitive-dynamic relational theory of psychic functioning, psychopathology, and psychotherapy developed and tested in the last 40 years by the San Francisco Psychotherapy Research Group.

The aim of this paper is to show how the Plan Formulation Method, an empirically validated and clinically useful assessment procedure, can be adapted to the therapy of adolescents. According to Control-Mastery Theory, patients come to therapy with an unconscious plan to achieve their goals, disconfirm their pathogenic beliefs, and master their traumas. PFM is a procedure aimed at formulating the unconscious plan of a patient with high levels of reliability and it articulates this plan in five components: the goals that the patient wants to achieve, the obstructions to these goals, the traumas which have given rise to these obstructions, the way the patient will try to overcome these obstructions during the therapy (tests), and the insights that the patient needs to achieve in order to get better. To apply this method to adolescent therapy, we added two components: the vicious relational circles between adolescents and their relevant others which support the patient’s problems and that the patient wants to break, and the experience the adolescent needs in order to get better. Each component will be explained with the help of a clinical case. The possible applications of the PFM to adolescents both in clinical and research contexts will be discussed.

The aim of this study is to introduce the Interpersonal Guilt Rating Scale-15 self-report (IGRS-15s) in a sample of adolescents; this scale is a brief self-report tool assessing interpersonal guilt as conceived of in Control-Mastery Theory (CMT; Weiss, 1993), and to assess its psychometric properties. The IGRS-15 self-report (IGRS-15-s; Gazzillo et al., 2018) was constructed based on CMT literature on guilt and on the authors’ clinical experiences, has already been validated in adult samples and slightly modified for its use with adolescents. The sample of adolescents in this study was composed of 238 high-school students whose ages ranged from 12 to 21 years. In order to verify the factor structure of the tool, we performed a confirmatory factor analysis. We subsequently calculated the validity of the measure with Spearman Rho correlation coefficients between IGRS-15s factors and the other measures: the Interpersonal Guilt Questionnaire-67 (IGQ-67; O’Connor, Berry, Weiss, Bush & Sampson, 1997), the Basic Empathy Scale (BES; Jolliffe & Farrington, 2006), and the Rosenberg’ Self-esteem Scale (RSE; Rosenberg, 1965). The data collected support the internal consistency, as well as the concurrent and discriminant validity of the IGRS-15s for adolescents. This paper represents a first step toward the validation of the IGRS-15s for the assessment of interpersonal guilt in adolescence and provides clinicians with an empirically validated tool which may support them in their clinical work

A good enough theory of psychological functioning and development, and of how psychotherapy works, should take into account recent scientific developments about emotional, motivational, and cognitive functioning. They show how human beings are “wired” to adapt to reality and share a set of evolutionary-based emotions, motivations and skills that are shaped by the cognitive-affective structures (schemas) developed on the basis of the emotionally relevant experiences, in particular of the first years of life. Attachment theory (Bowlby, 1969, 1973, 1980) represents the first real attempt in this direction, although the clinical implications of this theory are still fragmented and not specific enough. We think that control mastery theory (CMT; Weiss, 1993) could be useful for integrating attachment, psychodynamic, and cognitive-evolutionary thinking. Such an integrated model is based on the centrality of adaptation, sense of safety, and real experiences; on the central role of inner representations/beliefs/schemas in linking adverse developmental experiences and attentional strategies, perception organization, emotional reactions, behavior, and psychopathology; and on the necessity to modify this relational knowledge in order to help patients get better. To explore the possible integration between attachment theory and CMT, we will focus on a specific topic, the disorganization of attachment and its psychopathological consequences, and we will illustrate the implications of this integration with a brief clinical example. We chose to focus on attachment disorganization because it is the attachment category more consistently related to psychopathology.

The aim of this paper is to illustrate the meaning and functions of dreams according to control-mastery theory (CMT), a cognitive-dynamic relational theory developed and empirically validated in the last 40 years by the San Francisco Psychotherapy Research Group (Gazzillo, 2016; Silberschatz, 2005; Weiss, 1993a; Weiss, Sampson, & the Mount Zion Psychotherapy Research Group, 1986). CMT stresses how dreams reflect the person’s efforts to adapt to reality; their production is regulated by a safety principle and is an expression of human unconscious higher adaptive functions. According to this model, dreams represent our unconscious attempts to find solutions to emotionally relevant problems. In dreams people think about their main concerns, particularly those concerns that they have been unable to solve by conscious thought alone, and they try to develop and test plans and policies for dealing with them. After having introduced the reader to the main concepts of CMT, we will illustrate the different facets of the CMT model of dreams with several clinical examples. Finally, we will describe the core elements of recently developed models of dream functions and meanings based on empirical research on sleep and dreams, and we will show their substantial compatibility with hypotheses proposed by CMT.

The aim of this article is to present an overview of several recently proposed hypotheses about the development of morality and guilt during the evolution of our species and the individual psychic development. The article will show how group selection seems to have favored the development of prosocial motivations, emotions, and skills, which are the basis of “moral” judgments and behaviors, and how the specific experiences of each individual and her/his belonging to a specific culture shape this first moral innate “draft.” We will then review relevant empirical data about the development of guilt in infancy and early childhood from empathic concern and the tendency to feel responsible for other people’s wellbeing, and the temperamental and environmental factors at the basis of adaptive and maladaptive guilt. Finally, we will show the substantial compatibility between these recently developed hypotheses and data and the hypotheses developed by the Control-Mastery theory starting from clinical observation and from the ideas of several psychoanalytic authors.

The aim of this paper is to describe and discuss the models of the process of change in psychotherapy developed by the Boston Change Process Study Group (2010), and by the San Francisco Psychotherapy Research Group (Gazzillo, 2016; Silberschatz, 2005; Weiss, 1993; Weiss, Sampson, & the Mount Zion Psychotherapy Research Group, 1986). The first model is centered on change in implicit relational knowledge and describes the process of change as being composed of “moving along” phases interspersed by “now moments” that can become “moments of meeting” if the clinician is to give authentic and specifically fitted responses. A moment of meeting opens up space for a change in the implicit relational knowledge of the patient. The second model is centered on the idea that patients come to therapy with an unconscious plan to master traumas, pursue healthy and adaptive goals, and disprove their pathogenic beliefs, and points to how patients test their pathogenic beliefs in the relationship with the therapist, coaching the therapist about what they need. Passing patients’ tests means helping them disconfirm or undermine pathogenic beliefs that hopefully will lead to disproving them. This second model focuses on the subjective meaning of the therapeutic process as seen from the perspective of the patient. We will also try to show, using clinical examples, how these two models can be integrated and how their integration may give us a more comprehensive, tridimensional vision of the therapeutic process.

Recent studies on moral development suggest the existence of a set of innate abilities which foster moral functioning. From a very early age on, children seem to show ability for moral discernment, together with emotions and pro-social motivations based on an innate propensity to empathize with people in difficulty and respect equity; moreover, they tend to feel guilty when they believe that they transgressed some basic “moral principles”. Evolutionary studies suggest that human morality stems from group selection. During its evolutionary history, human species met socioecological conditions that made group selection the dominant evolutionary force, thus favouring the development of cognitive abilities, emotions, and motivations essential for cooperation within groups. Also according to the CMT morality arises from the human need to preserve connectedness with other people - family members above all (attachment) - and the propensity to make them feel good (care). In sum, starting from an innate moral draft which is pre-reflexive and evolutionarily founded, morality and guilt would then be shaped by the emotionally relevant experiences people go through within their family and cultural environment.

This article introduces the Interpersonal Guilt Rating Scale-15 (IGRS- 15), a brief clinician-rated tool for the clinical assessment of interpersonal guilt as conceived in Control-Mastery Theory (CMT; Silberschatz, 2015; Weiss, 1993), and its psychometric proprieties. The items of the IGRS-15 were derived from the CMT clinical and empirical literature about guilt, and from the authors’ clinical experiences. Twenty-eight clinicians assessed 154 patients with the IGRS-15, the patient self-reported Interpersonal Guilt Questionnaire-67 (IGQ- 67; O’Connor, Berry, Weiss, Bush, & Sampson, 1997), and the Clinical Data Form (CDF; Westen & Shedler, 1999). A semi-exploratory factor analysis pointed to a four-factor solution in line with the kinds of guilt described in CMT: Survivor guilt, Separation/disloyalty guilt, Omnipotent responsibility guilt, and Self-hate. The test-retest reliability of the IGRS-15 was good. Moreover, the IGRS-15 showed good concurrent and discriminant validity with the IGQ-67. IGRS-15 represents a first step in the direction of supporting the clinical judg- ment about interpersonal guilt with an empirically sound and easy-to-use tool.

Control-Mastery Theory (CMT) is a cognitive-psychodynamic-relational theory of mental functioning, psychopathology and psychotherapy developed by Joseph Weiss (1993) and empirically studied by the San Francisco Psychotherapy Research Group (Weiss, Sampson, & The Mount Zion Psychotherapy Research Group, 1986). The central hypotheses of CMT are: the humans being's motivation to adapt to reality, their unconscious ability to execute higher mental functions and the importance of pro-social motivations and interpersonal guilt in normal and pathological mental functioning. The aim of this paper is to provide a review of the most important neuroscientific studies, along with both evolutionary and cognitive psychology researches that support these hypotheses. These studies showed how the evolution of species have been producing a series of behavioral systems, evolutionary based but “environmentally labile” which, overall, have promoted individuals and groups' survival and reproduction. To adapt to our own primary group, each of us builds a reliable set of beliefs about our surrounding world and about “moral rules” that govern relationships. Psychopathology can be seen as the expression of beliefs that had facilitated the adaptation of the child to a traumatic environment but have then revealed to be maladaptive because of the changing circumstances.

Quando si parla di inconscio ci vengono subito in mente Freud e la teoria psicoanalitica classica. Pensiamo, quindi, all’inconscio come a un ricettacolo di rappresentazioni ed emozioni che, inaccettabili, non ottengono il benestare dell'Io per accedere alla coscienza e da essa sono tenute lontane per mezzo dei meccanismi di difesa. Ma non è questa la rappresentazione dell’inconscio che emerge da un’analisi della letteratura scientifica contemporanea.

The aim of this article is to present validation data about a self-report rating scale for the assessment of interpersonal guilt according to Control-Mastery Theory (CMT; Silbershatz, 2005; Weiss, 1993; Weiss, Sampson, & The Mount Zion Psychotherapy Research Group, 1986), the Interpersonal Guilt Rating Scale-15s (IGRS-15s). In order to perform the validation of this tool in an Italian sample we have collected a sample of 645 nonclinical subjects. They had to complete the IGRS-15s, the Scale for the Measurement of the Impending Punishment (SMIP; Caprara et al., 1990), the Interpersonal Guilt Questionnaire-67 (IGQ-67; O'Connor et al., 1997), the Psychological General Well-Being Index (PGWBI; Dupuy, 1984), and the Affective Neuroscience Personality Scales (ANPS; Davis, Panksepp, & Normansell, 2003), together with an ad-hoc questionnaire for collecting demographic data, the Socio-Demographical Schedule. We have performed a confirmatory factor analysis to verify if the four-factor solution based on CMT and replicated in previous research (Gazzillo et al., 2017) was confirmed. Then, we checked the retest reliability of IGRS-15s after four weeks in a random subsample of 54 subjects. In order to assess its concurrent and discriminant validity, we calculated the correlations between IGRS-15s assessment and SMIP and IGQ-67. Finally, to test its construct validity, we assessed the relationships between the IGRS-15s and the affective systems using the ANPS and the wellbeing assessed with the PGWBI. The data collected support the retest reliability and the concurrent and discriminant validity of the measure, and we have collected preliminary data about its construct validity. Examples of the possible clinical and research applications of this tool are discussed.

La Control-Mastery Theory (CMT) è una teoria psicodinamica-cognitiva di matrice relazionale del funzionamento mentale, della psicopatologia e della psicoterapia sviluppata da Joseph Weiss (1993) e studiata empiricamente dal San Francisco Psychotherapy Research Group (Weiss, Sampson, & The Mount Zion Psychotherapy Research Group, 1986). Tra le ipotesi centrali della CMT vi sono la centralità della motivazione all'adattamento alla realtà, l’idea che siamo in grado di compiere inconsciamente operazioni mentali superiori e il ruolo di rilievo attribuito alle motivazioni prosociali e ai sensi di colpa interpersonali nel funzionamento normale e patologico. Scopo di questo lavoro è fornire una rassegna di alcuni dei principali studi neuroscientifici, di psicologia evoluzionista e di matrice cognitivista a sostegno di queste ipotesi. Gli studi considerati mostrano come l’evoluzione della specie abbia prodotto una serie di sistemi comportamentali evolutivamente fondati, ma “ambientalmente labili”, che nel loro complesso promuovono la sopravvivenza e la riproduzione dell’individuo e dei gruppi. Per adattarsi al proprio gruppo primario, ognuno di noi costruisce una serie di credenze affidabili sul proprio mondo circostante e sulle norme “morali” che regolano le interazioni. La psicopatologia può essere letta come l’espressione di credenze che hanno favorito l’adattamento del bambino ad ambienti traumatici ma si sono rivelate disadattive al mutare delle circostanze.