Articoli Scientifici

This article aims to offer an overview of our knowledge about separation/disloyalty guilt, a maladaptive kind of interpersonal guilt that derives from pathogenic beliefs that associate the healthy and adaptive goals of being separate, different, and independent from important others with the danger of deeply hurting them. These pathogenic beliefs stem from early relational traumas and adverse experiences, such as having had relatives who showed their children that they were visibly hurt by the attempts at exploration and differentiation from their children. Separation/disloyalty guilt has been shown to correlate with eating disorders, panic disorders, obsessive and phobic disorders, illness anxiety disorder, and with transdiagnostic features such as difficulties in mentalization, emotion regulation, and intolerance to frustration. We describe how patients with separation/disloyalty guilt can look for disconfirmations of these pathogenic beliefs during their psychotherapies and how clinicians can help them have the corrective emotional experiences they need.

This article aims to give the reader an overview of the concept of omnipotent responsibility guilt, which, according to control-mastery theory (CMT), is the emotional manifestation of a set of pathogenic beliefs that make people believe that if they put their needs in the foreground and do not try to satisfy the needs of their important others, their significant others will suffer. These pathogenic beliefs were generally developed to adapt to early traumatic and adverse experiences, that is, experiences that disrupted the patient’s sense of safety in acute, systematic, or chronic ways. In the case of people with omnipotent-responsibility-related pathogenic beliefs, among these experiences, we find parents with physical or psychological problems, parents who were victims of accidents, parents who were separated or were mourning some loss and wanted their children to take care of them, and situations where parents reversed their roles with their children. Omnipotent responsibility guilt correlates with different forms of psychopathology, such as depression, obsessive-compulsive disorders, and anxiety disorders, and with several transdiagnostic features, such as worry and low self-esteem. We describe some clinical exemplifications to show how, according to the CMT, patients with pathogenic beliefs supporting omnipotent responsibility guilt can try to become aware and disprove these pathogenic beliefs and master their traumas in psychotherapy, and how therapists can help them have the corrective emotional experiences they need to get better.

Burdening guilt refers to the belief that one’s emotions, needs, and ways of being are a burden to others, and is one type of interpersonal guilt proposed by the control-mastery theory (CMT). The aim of this article is to validate two new measures of burdening guilt. In the two studies conducted, we examined the psychometric properties of these scales and the relationship between bur- dening guilt and self-perceived burden (burdensomeness), self-esteem, shame, anxiety, depression, mental health, attachment insecurity, adverse childhood experiences, social desirability, empathy, and suicidal ideation. In Study 1, we presented a newly developed Burdening Guilt Rating Scale (BGRS) and its correlation with measures of the abovementioned dimensions. In Study 2 we verified, through confirmatory factor analysis and correlation techniques, the possibility of expanding the Interpersonal Guilt Rating Scale-15 with a shorter, 5-item burdening guilt scale derived from the BGRS, and showed that this shorter scale correlates similarly to the longer one. Findings allowed us to validate these new scales providing empirical measures of burdening guilt—a theoretical concept with important clinical implications.

The aim of this article is to show how the plan formulation method (PFM), an empirically validated method for case formulation based on control mastery theory (CMT), can help clinicians make sense of and use what they feel during sessions to better understand and treat their patients. We give a brief overview of the main psychoanalytic conceptions about countertransference, provide a brief introduction to CMT, and describe the concept of the plan and the PFM. We then show, using several brief clinical examples, how the components of the plan (patient’s goals, pathogenic beliefs, traumas, tests, and insights) may help understand clinicians’ in-session feelings.

Psychotherapists can experience various kinds of emotions in response to their patients’ communications and behaviors over the course of therapy. These may be understood in the context of interpersonal dynamics associated with patients’ testing activity. The concept of testing, as part of the patient’s plan for therapy, is explained from the perspective of Control-Mastery Theory. Different kinds of testing behaviors, aimed at disconfirming the patient’s pathogenic beliefs, may evoke different emotions in the therapist. Understanding the patient’s testing strategies can help to make sense of the therapist’s emotional reactions, manage countertransference, and guide therapeutic responses. This paper describes testing behaviors, according to the patient’s compliance and non-compliance with pathogenic beliefs, along with corresponding therapist emotional responses. A descriptive clinical case is provided to illustrate various tests and their associated emotional reactions within a therapy session.

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 give the reader an overview of several theoretical, empirical, and clinical features of survivor guilt, and to integrate recent contributions of psychodynamic theory and, in particular, of control-mastery theory into the understanding of the concept alongside the latest findings in social psychology about it. After introducing the concept of survivor guilt and its origins in clinical observations on the consequences of having survived severe traumas (e.g., internment in concentration camps), we will discuss the findings in social psychology on the concept of survivor guilt in everyday social interactions, which is based on a conception that does not connect it strictly to severe traumas. We will then focus our attention on clinical observations and empirical research studies about survivor guilt, discussing the hypotheses developed by several control-mastery theorists about its role in psychopathology. Finally, we will illustrate some manifestations of survivor guilt with a brief clinical vignette.

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

aim of this article is to propose an interpretation of pathological worry and rumination based on the control-mastery theory (CMT), an integrative, relational cognitive-dynamic theory of mental functioning, psychopathology, and psychotherapy process developed by Joseph Weiss and empirically verified by Weiss, Harold Sampson, and the San Francisco Psychotherapy Research Group over the last 50 years. In the first part of this article, we will introduce the basic concepts of CMT and how this theory integrates dynamic and cognitive concepts into a relational theoretical frame. Then, we will review several definitions of pathological worry and rumination and their clinical features and consequences. We will differentiate these processes from the normal reflection processes aimed at solving problems and mastering traumas and will review research data supporting this differentiation. Finally, we will discuss some of the more important cognitive theoretical models for explaining pathological worry and rumination. In the last part of this article, we will describe how CMT can help understand pathological worries and ruminations and their functions. According to CMT, pathological worry and rumination are distortions of normal reflexive thinking often caused by pathogenic beliefs that support interpersonal guilt, and their unconscious aim is often self-punishment. Three clinical vignettes will help us show how CMT can help us understand and treat pathological worry and ruminations.

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.

Vorrei condividere con vuoi alcuni pensieri sulla natura della vergogna e sul suo trattamento. La mia speranza è di suscitare il vostro interesse per questo argomento. Aiutare i pazienti a superare i loro problemi connessi a sentimenti di vergogna è uno dei doni più grandi che possiamo fargli. LA VERGONGA NELLA VITA QUOTIDIANA La vergogna è un’emozione che permea la maggior parte degli aspetti della vita quotidiana. Inconsciamente filtriamo i nostri comportamenti sulla base del rischio a cui ci espongono di apparire folli o inappropriati e di sentirci fraintesi. E quando proviamo vergogna, ci geliamo e ci ritiriamo. Per questa ragione, gli psicologi (Paulson, 2000) considerano la vergogna e l’orgoglio come le principali emozioni della vita quotidiana. Condividiamo le cose di cui siamo orgogliosi e nascondiamo quelle di cui ci vergogniamo. La vergogna è inoltre considerata una misura di quanto è sicuro il nostro attaccamento con le figure importanti della nostra vita. La capacità di correre rischi emotivi è pesantemente influenzata dalla vulnerabilità alla vergogna. Quando siamo in grado di condividere i nostri sentimenti di vergogna, i muri che mettiamo tra noi e gli altri iniziano a cadere e il livello di intimità aumenta. È difficile empatizzare con qualcuno che mantiene una facciata di perfezione.

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.

Worry and rumination are maladaptive cognitive strategies with the purpose to manage negative emotions and threatening events (Wells & Matthews, 1994), and studies have shown that they are associated with an increasing of anxiety and depression (Fresco et al., 2002; Nolen-Hoeksema, 2000). Although the relationship between guilt and shame with depression and anxiety is well documented (Cândea & Szentagotai-Tătar, 2018; Thibodeau, & Jorgensen, 2011), only few studies (Orth et al., 2006; Mor & Winquist, 2002; Spasojevic & Alloy, 2001) investigated the mediational role of worry and rumination in the relationship between guilt and shame and depression and anxiety. We hypothesized that worry and rumination correlate with all types of interpersonal guilt and with shame and that they mediate the effects of these moral emotions on depression and anxiety disorders. We recruited a sample of 343 subjects, to whom we administered the Interpersonal Guilt Rating Scale-15s (IGRS-15s; Gazzillo et al. 2018), The Other as Shamer Scale (OAS; Goss, Gilbert, & Allan, 1994), The State-Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983), The Beck Depression Inventory II, The Penn State Worry Questionnaire (PSWQ; Meyer, Miller, Metzger, & Borkovec, 1990) and The Ruminative Response Scale (RRS; Nolen-Hoeksema & Morrow, 1991; Treynor et al., 2003) and an ad hoc form for assessing sociodemographic and anamnestic information. In line with our hypotheses (Gazzillo, Leonardi, Bush, 2020), worry and rumination correlated with all types of interpersonal guilt. Moreover, worry and rumination were positively correlated with depression and anxiety disorders; specifically, rumination emerged as a mediating factor between self-hate and depression, while worry was a mediating factor in the relationship between omnipotence and trait anxiety. Finally, our hypothesis that, in worrying and ruminating, shame had a relevant impact, was also confirmed. This study suggests that guilt and shame may be a powerful component of mental health problems and that worry and rumination represent risk factors for the maintenance and exacerbation of these disorders.

The aim of this paper is to present a theoretical and empirical overview of the hypothesis that patients’ behavior in psychotherapy can be understood as an expression of their efforts to disprove their pathogenic beliefs by testing them in the therapeutic relationship. According to Control–Mastery Theory (CMT; Gazzillo, 2016; Silberschatz, 2005; Weiss, 1986, 1994), psychopathology stems from unconscious pathogenic beliefs developed in response to early traumas. Pathogenic beliefs associate the achievement of healthy goals with a variety of unconsciously perceived dangers. Thanks to the inborn human motivation to adapt to reality and to the power of adaptive unconscious mental functioning, patients come to therapy with a unconscious plan to overcome their pathogenic beliefs by testing them with their therapists. Tests are consciously or unconsciously devised actions aimed at disproving pathogenic beliefs. CMT describes two broad categories of tests: transference tests and passive-into-active tests. Tests require specific responses from the therapist to be passed. When therapists pass patients’ tests, patients feel safer and may make therapeutic progress; when tests are failed, patients feel endangered and may get worse. Consistent with CMT assumptions, studies on testing have shown that a therapist passing a patient’s tests is associated with immediate positive effects on the patient, but more studies are needed.

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.

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.