Control-Mastery Theory - CMT

This paper aims to provide an overview of self-hate, a concept developed by control-mastery theory (CMT) to describe a set of pathogenic beliefs that share the common core of a deeply negative self-representation and self-evaluation, and that are often at the basis of severe personality pathology. Pathogenic beliefs that support self-hate are developed to adapt to early traumatic relationships that made the person feel unrecognized and unloved for who they are. These pathogenic beliefs make the person feel bad, inadequate, unworthy, and undeserving; in addition, empirical research has shown that they are often associated with relevant transdiagnostic psychopathological factors such as difficulties in mentalization, emotional dysregulation, low self-esteem, deep feelings of shame and guilt, depression, interpersonal problems, and a low level of personality functioning. During psychotherapy, patients with issues related to self-hate can be very challenging, and it can be difficult for therapists to develop a strong alliance with them. We will overview the principal manifestations of self-hate, the features of the traumas at its basis, the empirical research data collected on its psychopathological correlates, and their implications for treatment, stressing the importance of therapists’ attitudes and the centrality of corrective emotional experiences.

The sense of emptiness is still a poorly defined construct in the literature, yet it is frequently reported in individuals with borderline personality disorder, depressive symptoms, and narcissistic personality disorder. This paper aims to replicate those research studies showing that there are significant correlations between emptiness, insecure attachment styles, maladaptive childhood experiences, shame, impulsivity, depression, and borderline and narcissistic personality features. Additionally, it was hypothesized that a significant correlation would exist between the sense of emptiness and burdening guilt and self-hate, and that self-hate would mediate the relationship between adverse childhood experiences and preoccupied attachment and sense of emptiness. The sample consisted of 128 Italian participants recruited online, who completed a battery of self-report questionnaires designed to measure the psychopathological features described above. The sense of emptiness was strongly correlated with depression (rho 0.81, p

Introduction This study investigated the relationship between illness anxiety and interpersonal guilt as conceived in control-mastery theory. Additionally, we explored how illness anxiety symptoms relate to general anxiety, depression, alexithymia, autonomic nervous system reactivity, personality functioning impairment, sociodemographic factors, and childhood experiences. Methods A sample of 201 participants completed measures of illness anxiety (Health Anxiety Questionnaire), interpersonal guilt (Interpersonal Guilt Rating Scale-20s), anxiety (State-Trait Anxiety Inventory), depression (Beck Depression Inventory-II), alexithymia (Toronto Alexithymia Scale-20), personality dysfunction (Level of Personality Functioning-Brief Form 2.0), and autonomic nervous reactivity (Body Perception Questionnaire-22). Sociodemographic and childhood traumas and adverse experiences data were collected via an ad hoc questionnaire. Results Individuals with worried and autonomy-limiting caregivers reported higher levels of illness anxiety. Correlation analyses revealed significant positive associations with illness anxiety and all the variables measured. As expected, partial correlation demonstrated that separation/disloyalty guilt and burdening guilt are the most associated with illness anxiety symptoms. Unexpectedly, however, survivor guilt lost significance when controlling for other types of guilt. Hierarchical multiple regression identified anxiety as the strongest overall predictor of illness anxiety, followed by separation/disloyalty guilt and bodily reactivity indices. Discussion This study suggests that interpersonal guilt may be a key component in sustaining illness anxiety symptoms in anxious people. In particular, the interplay between anxiety, separation/disloyalty guilt, and autonomic overreactivity appears to contribute to illness anxiety concerns and behaviors. Working on these aspects may be essential for positive long-term outcomes of psychotherapy.