Welcome from Rome to all the members of the San Francisco Psychotherapy Research Group (SFPRG)! I would like to say thank you to George Silberschatz and the Board of Directors of the SFPRG for the opportunity of working on this blog of the SFPRG website, and to Marshall Bush for his ongoing support. The aim of this new blog will be to share and discuss some of theoretical, clinical, and empirical facets of CMT through brief posts.

The first topic I would like to talk about is the centrality of adaptation in mental functioning.  We try to adapt to our environment first unconsciously and then consciously because our unconscious functioning is basically sophisticated and adaptive. It is quite likely that such basic concepts are taken for granted by any CMT therapist, but I think that they deserve more reflection. In fact, therapists trained in different theoretical frameworks are not so accustomed to asking “To which kind of environment has s/he tried to adapt by thinking, feeling and behaving in this particular way?” It is much more likely that they try to understand which kind of desires s/he is trying to fulfill, which kind of defenses s/he is showing, or what kind of deficit is manifested by his/her problems. In contrast CMT therapists try to understand the kind of environment and traumas the patient needed to adapt to, how s/he is likely to have shaped his/her view of relationships, and how s/he would need this relationship to be in order to get better. However, quite interestingly, in a few recent papers clinicians and researchers working with Peter Fonagy (Fonagy, Luyten, Allison, Campbell, 2017a, b) within the framework of the mentalization theory have started to conceptualize psychopathology as an expression of their adaptations to traumatic environments.

It is not obvious that each person does her/his best to adapt to their particular reality first unconsciously and then consciously. In general, both lay people and psychotherapists tend to think that adaptation is a conscious (or preconscious) motivation pursued by conscious (or preconscious) thinking. The idea of an adaptive unconscious, that now is supported by y experimental data (see, for example, Wilson, 2002; Gladwell, 2005), is at the core of Joe Weiss’s theory.  Weiss developed his ideas from systematic clinical observations and from several hypotheses developed here and there by Sigmund Freud (1920, 1925, 1938) in the last twenty years of his life. While Heinz Hartmann in 1939 wrote a famous book on adaptation in psychoanalytic theory, most dynamic models developed after Freud regarded adaptation as only one of five metapsychological point of views (Rapaport, Gill, 1960), and rarely a very relevant one in understanding how patients work in analysis. So, the idea of an adaptive unconscious is quite specific of the CMT model, and informs the view that we understand what patients do in therapy as an expression of their adaptive efforts to get better (Weiss, undated, “The adaptive use of the analyst”). 

Saying that adaptation is central does not mean that there needs to be an “adaptation drive” or “survival instinct”.  Survival and adaptation are not something that we are motivated to pursue; they are the “expected outcome” of how our unconscious (and then conscious) mental functioning has been shaped by hundreds of thousands of years of individual and group selection (Minsky, 1986; Wilson, 2007). Our unconscious functioning, shaped by evolution, is basically adaptive in its motivational, affective, cognitive, and behavioral components. And it would be better to talk about multiple and relatively independent unconscious processes than about a single unitary unconscious mind.

Adapting to an environment means both modifying ourselves to fit the environment and also modifying the environment so that it fits with what we need. If my body needs food, it is adaptive that my mind indicates to me this fact making me feel hungry. And if I feel hungry, I start looking for food, and I may pull a fruit from a branch, and this modify my environment. Along the same line, if a little child wakes up and does not see her mother, she feels sadness and starts crying, which is very adaptive, and this crying alerts the mother, who will be pushed by her care system to go to her little child, which is adaptive too. So, adaptation means often a modification of the environment we live in – or we believe to live in.  

One of the main expressions of the centrality of adaptation in our mental functioning is our need for safety, which is initially personal safety, but in CMT it is much more -- we cannot feel safe if we believe that something bad may happen to our relationships and the people we love. So, in CMT safety involves not only the attachment emotional/motivational system, but also the care system and the play/cooperation system.  In this regard, CMT anticipated, and is in line with, the results of recent evolutionary and developmental psychology and neuroscience data showing the centrality and the precocious emergence of prosocial motivations in human functioning (Gilbert, 1989; Liotti, Fassone, Monticelli, 2017; Haidt, 2012; Panksepp, Biven, 2012; Tomasello, 2009; 2016; Wilson, 2015)

Just one more suggestion. It has been not rare that turtles had been seen to “suicide” under the wheels of cars on beachfront streets. Does this fact mean that even turtles, as human beings, may act so maladaptively and try to kill themselves? No. Actually, the behavior of these turtles is a perfect adaptation to the environment they are programmed to live in. They were simply looking for their way back to the sea at night after having deposited their eggs on the beach, and they were using the street lights as indications of where the sea was. If no cars had been there, the only light they could have seen would have been the moonlight reflected by the surface of the sea. So, they were acting according to an adaptation to an environment that had gradually changed. They were victims of a ghost from the past. Similarly, psychopathology is typically based on pathogenic beliefs, which are adaptations to an early traumatic environment.

Fonagy, P., Luyten, P., Allison, E., & Campbell, C. (2017a). What we have changed our minds about: Part 1. Borderline personality disorder as a limitation of resilience. In Emotion Dysregulation. 4 (1), 11.

Fonagy, P., Luyten, P., Allison, E., & Campbell, C. (2017b). What we have changed our minds about: Part 1. Borderline personality disorder, epistemic trust and the developmental significance of social communication. In Emotion Dysregulation. 4 (1), 9.

Freud, S. (1920). Beyond the Pleasure Principle. The standard edition of the complete psychological works of Sigmund Freud. (Vol. 13, pp. 1–64). London: Hogarth.

Freud, S. (1925). Inhibitions, Symptoms and Anxiety. The Standard Edition of the complete psychological works of Sigmund Freud, (Vol. 20, pp. 75-176). London: Hogarth.

Freud, S. (1938). An Outline of Psychoanalysis. Standard Edition. New York.

Gergely, G., & Watson, J. S. (1996). The social biofeedback model of parental affect-mirroring. The International Journal of Psycho-Analysis77(6), 1181.

Gergely, G., & Watson, J. S. (1999). “Early socio-emotional development: Contingency perception and the social-biofeedback model” (pp.101-136). In Rochat, P. (Ed), Early social cognition: Understanding others in the first months of life.

Gilbert, P. (1989). Human nature and suffering. Hove, UK: Lawrence Erlbaum Associates Ltd.

Gladwell, M. (2005). Blink: the power of thinking without thinking. Boston, MA: Little, Brown and Co.

Haidt, J. (2012). The righteous mind: Why good people are divided by politics and religion. New York: Pantheon/Random House.

Hartmann, H. (1939). Ego Psychology and the Problem of Adaptation. New York: Int. Univ. Press.

Liotti, G., Fassone, G., Monticelli, F. (2017). L’evoluzione delle emozioni e dei sistemi motivazionali. Teoria, ricerca, clinica. Milano: Raffaello Cortina Editore.

Minsky, M. (1986). The Society of Mind. New York: Simon & Schuster.

Panksepp, J., & Biven, L. (2012). The archaeology of mind: neuroevolutionary origins of human emotions. WW Norton & Company.

Rapaport, D., & Gill, M. (1960). The Structure of Psychoanalytic Theory. New York: Int. Univ. Press.

Tomasello, M. (2009). Why we cooperate. Cambridge, MA: MIT Press.

Tomasello, M. (2016). A natural history of human morality. Boston: Harvard University Press.

Wilson, D. S. (2007), Evolution for everyone: How Darwin's theory can change the way we think about our lives. New York: Delta Press.

Wilson, D. S. (2015). Does altruism exist: culture, genes, and the welfare of others. Boston: Yale University Press.

Wilson, T. D. (2002). Strangers to ourselves: Self- insight and the adaptive unconscious. Cambridge, MA: Harvard University Press.