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EP85 Case Discussion 02 Panel - James F. Masterson, MD; Salvador Minuchin, MD; Carl Whitaker, MD; Paul Watzlawick, PhD

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Topic Areas:
Case Discussions |  Psychotherapy |  Family Therapy |  Therapist Development
Categories:
Evolution of Psychotherapy |  Evolution of Psychotherapy 1985 |  Pioneers in Couples and Family Therapy
Faculty:
James F. Masterson, MD |  Salvador Minuchin, MD |  Paul Watzlawick, PhD |  Carl Whitaker, MD
Course Levels:
Master Degree or Higher in Health-Related Field
Duration:
1:01:34
Format:
Audio and Video
Original Program Date:
Dec 12, 1985
License:
Never Expires.
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Tags: Psychotherapy Countertransference Change Processes Encouraging Responsibility Observation Systems Thinking Therapist Flexibility Utilization Borderline Relational Instability

Description

Description:

Educational Objectives:

  1. To learn philosophies of various practitioners and theorists.

*Sessions may be edited for content and to preserve confidentiality*

 

Outline:

Case Presentation and Panel Introduction

  • Panel features James Masterson, Salvador Minuchin, Carl Whitaker, and Paul Watzlawick

  • Case: “The Needy Clairvoyant,” a 37-year-old divorced woman referred for psychotherapy

  • JJ presents with labile mood, depression, guilt, lack of direction, self-destructive relationships, and difficulty trusting her feelings

  • Family history includes alcoholic father, emotionally distant mother, and a brother who died of leukemia when JJ was 12

JJ's Background and Personal History

  • Described as fearful, different, but well-cared for in childhood; anorexic and unpopular as a teen

  • Thrived in art school; became involved in the peace movement and radical politics

  • Used psychedelic drugs and had casual sex in her early 20s; married a fantasized father figure, divorced soon after childbirth

  • Later relationships mirrored father-figure dynamics; repeated abandonment and idealization

JJ's Current Situation and Therapist's Feelings

  • Current affair is clingy and regressive, marked by dramatic separations and avoidance of responsibility

  • Lacks maternal feeling toward her 14-year-old son; spends more time with younger female friends

  • Avoids self-reflection, often focuses on boyfriend, arrives late to therapy

  • Therapist feels inadequate and directionless, struggling to engage the patient constructively

James Masterson's Developmental Object Relations Approach

  • Identifies JJ as a classic case of lower-level borderline personality disorder

  • Attributes pathology to early developmental arrest in separation-individuation phase (ages 2–3)

  • Cites contributing factors: constitutional deficits, maternal unavailability, and developmental stress

  • Recommends therapeutic confrontation to target self-destructive behaviors and faulty ego functions

Carl Whitaker's Therapeutic Approach

  • Acknowledges the therapist’s vulnerability in presenting the case

  • Suggests the therapist’s framing reflects their own unconscious projections and biases

  • Encourages exploration of JJ’s positive traits rather than dwelling solely on pathology

  • Recommends enactment techniques to help JJ concretize and test out fantasies

Salvador Minuchin's Critique and Therapeutic Focus

  • Criticizes the overwhelmingly negative portrayal of JJ in the case presentation

  • Suggests the therapist’s description reveals their pessimism about clients and therapy

  • Advocates for identifying JJ’s strengths and capacities alongside her symptoms

  • Recommends therapeutic enactments to disrupt rigid internal narratives

Paul Watzlawick's Perspective on Therapeutic Diagnosis

  • Questions the validity and realism of the case; suggests it borders on parody

  • Warns against over-labeling and encourages focus on concrete behaviors and goals

  • Proposes use of “worst fantasy” technique to explore JJ’s fears and consequences

  • Recommends a long-term developmental model to address complex personality dynamics

Discussion on Countertransference and Therapist's Role

  • Masterson underscores the importance of managing therapist countertransference

  • Advises therapists to process their own reactions before interpreting client behavior

  • Emphasizes therapist loyalty and presence, resisting the urge to act as an emotional outlet

  • Encourages direct questioning of client behavior to access underlying anxiety and defense

Audience Questions and Responses

  • Audience member raises concern about dual diagnosis in borderline presentations (e.g., substance abuse)

  • Masterson stresses treating addiction issues before commencing psychotherapy

  • Eric Diamond, author of the case, acknowledges critiques and admits need to include positive attributes of JJ

  • Panel concludes with emphasis on long-term, developmental, and respectful approaches for complex clients

Credits

Faculty

James F. Masterson, MD's Profile

James F. Masterson, MD Related Seminars and Products

James F. Masterson (M.D., Jefferson Medical School, 1951) was Director of the Masterson Group, P.C., which specializes in the treatment of adolescent and adult character disorders. Additionally, he was Director of the Masterson Institute (formerly Character Disorder Foundation); attending psychiatrist at New York Hospital, Payne Whitney Clinic; and Adjunct Clinical Professor of Psychiatry at Cornell University Medical College. Masterson has authored seven books and edited two volumes, mostly on the topic of psychoanalytic approaches to character disoreders and adolescents. His seminal work on the borderline personality has made him one of the most influential and studied practitioners of modern psychoanalytic methods.

Salvador Minuchin, MD's Profile

Salvador Minuchin, MD Related Seminars and Products

Salvador Minuchin, MD, developed Structural Family Therapy, which addresses problems within a family by charting the relationships between family members, or between subsets of family. He was Director of the Philadelphia Child Guidance Clinic. Although it was minimally staffed when he began, under his tutelage the Clinic grew to become one of the most modeled and respected child guidance facilities in the world.  In 1981, Minuchin began his own family therapy center in New York. After his retirement in 1996, the center was renamed the Minuchin Center. Dr. Minuchin is the author of many notable books, including many classics. His latest is Mastering Family Therapy: Journeys of Growth and Transformation. In 2007, a survey of 2,600 practitioners named Minuchin as one of the ten most influential therapists of the past quarter-century.

Paul Watzlawick, PhD's Profile

Paul Watzlawick, PhD Related Seminars and Products

Paul Watzlawick, received his Ph.D. from the University of Venice in 1949. He has an Analyst's Diploma from the C.G. Jung Institute for Analytic Psychology in Zurich. Watzlawick has practiced psychotherapy for more than 30 years. He was research associate and principal investigator at the Mental Research Institute. He was Clinical Professor at the Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center. Watzlawick is a noted family therapist; he is recipient of the Distinguished Achievement Award from the American Family Therapy Association. Also, he is author, co-author or editor of eight books on the topics of interactional psychotherapy, human communication and constructivist philosophy.

He formulated five axioms. They are:

  1. It is not possible to not communicate. Every behavior is some kind of non-verbal communication.
  2. Every communication has a content. In addition, there is 'metainformation', which says how the communicator wants to be understood.
  3. All partners involved in a communication process also interpret their own behaviour during communication.
  4. Human communication involves both verbal and non-verbal communication. In addition to the spoken words, there are is also a non-spoken part (gestures, behavior, intonation..) which is part of the communication.
  5. Communication between humans is either symmetric or complementary. This is based on whether the relationship of those communicating is based on differences or parity.

Carl Whitaker, MD's Profile

Carl Whitaker, MD Related Seminars and Products

Carl Whitaker, MD, was an American physician and psychotherapy pioneer family therapist. Whitaker is most well-known for acknowledging the role of the entire family in the therapeutic process. He is the founder of experiential family therapy, or the symbolic-experiential approach to therapy. Rather than scapegoating one family member or even a specific family problem, experiential family therapy looks at the entire family system. Several other approaches to family therapy have drawn heavily from Whitaker's theories.

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