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Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 1


Therapists’ Self-Reported Chronic Strategies of Disconnection in Everyday Life and in

Counselling and Psychotherapy: An Exploratory Study

Mick Cooper

University of Strathclyde, Glasgow

Rosanne Knox

College of Haringey, Enfield and North East London, London

Author note:

Mick Cooper, Department of Psychology, University of Roehampton, London SW15

4JD, UK, 07734-558155, [email protected]; Rosanne Knox, College of

Haringey, Enfield and North East London, High Road, London, N15 4RU, 020 8802 3111,

[email protected]

Acknowledgments: Thanks to Mark Elliott

Correspondence concerning this article should be sent to: Mick Cooper, Department

of Psychology, University of Roehampton, London SW15 4JD, UK, 07734-558155,

[email protected]

mailto:[email protected]

mailto:[email protected]


Therapists’ Self-Reported Chronic Strategies of Disconnection in Everyday Life and in

Counselling and Psychotherapy: An Exploratory Study

Abstract

The aim of this study was to explore how therapists believe they may relationally

disconnect from other people, and their clients, with a view to developing strategies for

enhancing relational depth in counselling and psychotherapy. Participants were 168 trainee

and practicing therapists, who listed their chronic strategies of disconnection (CSoDs) in

everyday relationships, and then rated the presence of these CSoDs in their therapeutic work.

Thirty-nine categories of self-reported everyday CSoDs emerged, organized into seven

domains. Most prevalent were behavioral, passive and intrapsychic strategies. Over half of

the CSoDs were rated as being present in therapy to a minimal extent, most commonly

passive CSoDs, disingenuous CSoDs and humor. Male therapists, and trainee therapists,

were most likely to identify their CSoDs as present in therapy.

Keywords: Therapeutic relationship, counselling training, relational depth,

countertransference, strategies of disconnection


One of the best established facts in the psychotherapy research field is that the quality

of the therapy relationship is a strong and consistent predictor of therapeutic outcomes. As

the 2nd American Psychological Association Interdivisional Task Force on Empirically

Supported Therapy Relationships concluded, based on the most comprehensive series of

meta-analyses to date, “The therapy relationship makes substantial and consistent

contributions to psychotherapy outcomes independent of the specific type of treatment”

(Norcross & Wampold, 2011, p. 423). They go on to state: “The therapy relationship

accounts for why clients improve (or fail to improve) at least as much as the particular

treatment method.”

Within the empirical literature, the alliance between client and therapist has been

identified as a “demonstrably effective” element of the therapeutic relationship (Hovarth,

Del Re, Fluckinger, & Symonds, 2011), with an aggregate effect size (r) over 190

independent alliance-outcomes relations of 0.28. A key component of this, as defined by

Bordin (1979), is the therapeutic bond. This is the trust and attachment that exists between

therapist and client. A closely related concept is the connection between client and therapist

(Cooper, 2012; Sexton, Littauer, Sexton, & Tommeras, 2005). This can be defined as the

degree of intimacy and mutuality in the therapeutic relationship (Sexton et al., 2005). The

concept of connection is associated with the development of relational models of therapy (for

instance, Ehrenberg, 1992; Friedman, 1985; Hycner, 1991; Jordan, 1991; Schmid, 2002;

Stern, 2004), which hold that it is in the experiencing of “relational depth” (Mearns &

Cooper, 2005), or “moments of meeting” (Stern, 2004), that in-depth therapeutic healing can

occur. Consistent with this hypothesis, research using the Relational Depth Inventory

(Wiggins, Elliott, & Cooper, 2012) has found a strong relationship between the experience of

in-depth connection and therapeutic outcomes (Wiggins, 2011), over and above the

contribution of the therapeutic alliance. Qualitative interview studies with clients (Knox,


2013; Knox & Cooper, 2011) also indicate that moments of in-depth connection have a

significant positive impact on clients. This is both immediately and in the longer-term.

Such findings raise the question of how therapists may deepen their bond, or levels of

connection, with their clients. This is a complex question, for research suggests that a key

antecedent to deeper levels of connection is clients’ experiencing of therapists as honest, real

and genuine (Knox & Cooper, 2010). Hence, attempts by therapists to “bring about”

connection may be experienced by clients as contrived, and subsequently serve to undermine

its achievement. In this respect, a more constructive strategy may be to identify ways in

which therapists, themselves, may block the establishment of deeper levels of connection,

and to help them to find ways of managing and overcoming these activities.

A useful theoretical construct here may be chronic strategies of disconnection

(CSoDs), developed in relational-cultural theory (Comstock et al., 2008; Jordan, 2000;

Jordan, 2013; Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Jordan, Walker, & Hartling,

2004; Walker & Rosen, 2004). This is a school of therapy that complements the

multicultural movement, by identifying how developmental, contextual and sociocultural

factors can impede individuals’ abilities to create and sustain growth-fostering relationships

(Comstock et al., 2008). The basic assumption in relational-cultural theory, as evidenced in

the developmental literature (e.g., Bowlby, 1979; Meltzoff & Moore, 1998; Stern, 2003,

2004; Trevarthen, 1998), is that human beings have an inherent desire and ability to connect

deeply with others. However, through experiencing hurt in early close relationships, it is

argued that human beings can develop strategies of disconnection: ways of protecting

themselves from further emotional pain. These patterns of behavior are then seen as

becoming chronic, such that the individual may continue to enact them in adult life in ways

that are now unnecessary and self-defeating.

Such CSoDs can be understood as one aspect of an individual’s attachment style

(Ainsworth, Blehar, Waters, & Wall, 1978): their “comfort and confidence in close


relationships, their fears of rejection and yearning for intimacy, and their preference for self-

sufficiency or interpersonal distance” (Meyer & Pilkonis, 2002, p. 367). In contrast to

attachment theory, however, the relational-cultural approach does not associate avoidant

patterns of behavior with one particular characterological type. Rather, it holds that all

individuals, to a greater or lesser extent, have particular CSoDs.

In this respect, therapists, as well as their clients, can be considered to have a range of

CSoDs (Abernethy & Cook, 2011; Comstock et al., 2008). Given the chronic nature of these

strategies, it is likely that they will be pervasive across a range of contexts in the therapists’

lives, and this may include the therapeutic environment. In other words, therapists’ CSoDs

may have the potential to “leak” into their therapeutic work; and this may limit their ability to

establish, and maintain, strong therapeutic bonds with their clients. Hence, as Comstock et

al. suggest, it may be helpful for therapists to ask themselves “What are my strategies of

disconnection?” and “What do these look like in my personal and counseling relationships?”

Through doing so, therapists can become more aware of their blocks to in-depth relating, and

develop strategies for minimizing their impact in the therapeutic work.

This process has many parallels with the psychodynamic concept of

countertransference and countertransference management (Gelso & Hayes, 2002). In

countertransference, therapists’ actions towards their clients are “influenced by the analyst’s

unconscious, unresolved conflicts and needs” (Wolitzky, 2003, p. 49). However,

countertransference is a much broader concept, referring to a wide range of positive and

negative responses that therapists might have based on unresolved issues. By contrast, the

enactment of CSoDs in the therapeutic relationship refers to specific therapist actions that

block the formation of deepened bonding with their clients, as and where such connection

would be therapeutic. To date, empirical investigation in this specific area has been very

limited.


Research from the countertransference field, however, does indicate the importance of

investigating such phenomenon, as well as developing strategies for their management. In

the most recent meta-analysis, a significant, albeit small (r = -.16, k = 10), negative

association was found between countertransference reactions and psychotherapy outcomes

(Hayes, Gelso, & Hummel, 2011). Strategies for managing countertransference reactions

were found to reduce countertransference manifestations (r = -.14, k = 11), and to lead to

large and significant improvements in therapeutic outcomes (r = .56, k = 7).

The aim for this study, therefore, was to explore the specific therapist actions--based

on unresolved issues--that have the potential to inhibit the formation of deeper connections

with their clients. To achieve this, we attempted to explore three things. First, the types of

CSoDs that therapists believe are present in their everyday lives. Although CSoDs are

widely discussed in relational-cultural theory, there is little data available on the specific

forms that these CSoDs may take. A range of conceptual frameworks may be applicable,

such as coping strategies (Carver, Scheier, & Weintraub, 1989), the interpersonal circumplex

(Horowitz et al., 2006; Wiggins, 1979), or forms of resistance (Wolitzky, 2003). However,

we wanted to take an inductive, grounded theory-like approach (Strauss & Corbin, 1997), and

to initiate an “open” exploration of whatever forms of CSoDs might emerge from the data.

Second, we wanted to identify the extent to which participants thought that that each of these

strategies might “leak” into the therapeutic work. Literature on countertransference suggests

that it is a “ubiquitous” phenomenon (Hayes et al., 2011), and if the same is also true for

CSoDs, then this would support the development of strategies for CSoD management. Third,

we wanted to identify any demographic factors that might predict the presence of different

types of CSoDs, both in everyday life and in psychotherapy. Again, there is currently no

specific empirical evidence in this area, and an initial exploration of these predictors may

help to establish more targeted strategies for CSoD management.


Method

Overview of Design

Our study was based on a pluralist epistemological understanding (Goss & Mearns,

1997). This holds that, ‘both quantitative and qualitative research responses can be applied

together at any stage of an investigation’ (p. 194), and that triangulation through these

different methods has the potential to enhance the veracity and accuracy of findings. Here,

Qualitative or quantitative methods are not only used to corroborate or elaborate

each other: they constantly interact throughout the entire evaluation. The philosophy

of each is applied in an active, continuous and developmental hermeneutic process of

mutual interpretation and re-interpretation. (Goss & Mearns, 1997, p. 196)

This approach is closely associated with a pragmatic epistemological stance, in which

a range of methods may be used to best illuminate the question, or questions, under

investigation.

Qualitative and quantitative data were gathered from therapists who were

participating in a professional development workshop. Only self-reported data were

collected, and the limitations of this will be discussed later in the paper. Data were analyzed

thematically, and subsequently with descriptive and inferential statistical procedures.

Participants

In total, 168 individuals participated in this study: 134 females (79.8%) and 34 males

(20.2%). This consisted of 50 practicing therapists (29.8%) and 118 trainee therapists

(70.2%) based in the UK. A large majority of participants identified their predominant

therapeutic orientation as person-centered (n = 156, 92.9%), with small numbers of

participants also identifying with integrative (n = 5, 3.0%) and humanistic (n = 3, 1.8%)

orientations. Trainee therapists were primarily studying on Master’s and undergraduate level


counseling programs. The mean age was 45.8 (SD = 11.14) with a median age of 47. Clients

were asked to self-define their ethnicity, and 28 were subsequently coded as being of Black

and Minority ethnicity or Mixed ethnicity (16.7%), with 138 coded as being of White

ethnicity (82.1%), and two participants not disclosing their ethnicity. There were 22

participants (13.1%) who indicated some form of disability, with 145 indicating no disability

(85.1%) and three participants not disclosing their disability status.

Materials

Chronic Strategies of Disconnection Form.

The principal instrument used in this study, and designed specifically for it, was an

A4 form entitled: “Your strategies of disconnection”. At the top of this sheet, participants

were given the following instructions: “Please write down, as a short phrase or word, any of

your own ‘chronic strategies of disconnection’: i.e., ways in which you may stop yourself

from connecting deeply with others when it may be more rewarding to do so.” The sheet

then provided 10 rows, numbered 1 to 10, in which participants could write down their

CSoDs. In the right hand column of each row was a greyed out box in which participants

were subsequently asked to rate the presence of each CSoD in their therapeutic work.

Demographic sheet.

An A4 sheet of paper asked participants to indicate their gender (male, female or

other), age (open response format), ethnicity (open response format), disability (yes or no),

professional status (trainee in counseling/psychotherapy or professionally qualified

practitioner), and predominant therapeutic orientation (Cognitive Behavioral Therapy,

Psychodynamic, Person-centered, Humanistic, Transactional Analysis, Gestalt, Systemic,

Integrative, or Eclectic).

Procedure

Participants were recruited to this study within the context of a professional

development “research” workshop which aimed to explore--and generate data on--the


therapeutic relationship. All workshops were facilitated by the first author. Five one-day, or

half-day, workshops were delivered: three to mixed groups of professional and trainee

therapists, and two as part of a Master’s level training in counseling. The groups varied in

size from 25 to 59 participants. Participants were fully informed of the content of the

workshop and exercises through an information sheet dispatched approximately one week

before the workshop, and were advised that they need not take part in the exercises and could

withdraw at any time. At the commencement of the workshop, participants were invited to

sign an informed consent form, and to complete the Demographic Form.

For the part of the workshop relevant to the present study, participants were first

introduced to the concept of CSoDs. They were then asked to pair with someone at the

workshop, ideally someone they had not met before, and to take 15 minutes each to explore

with their partners what their CSoDs might be. It was emphasized to participants that they

should describe CSoDs in all aspects of their lives, and not to focus, for the time being, on

their therapeutic work. Partners were asked to listen supportively to the person describing

their CSoDs and ask exploratory questions, but not to make suggestions or interpretations of

what their CSoDs might be. After each partner had had an opportunity to explore their

CSoDs, they were asked to take five minutes to write their CSoDs down, independently, on

the Chronic Strategies of Disconnection Form.

As a final part of the procedure, participants were asked to reflect on the CSoDs they

had written down, and consider the extent to which each of them might be present in their

own therapeutic work: that is, to what extent they might also be prone to disconnecting with

their clients in these ways. To rate how present each of these CSoDs might be in therapy,

participants were asked to give each one a score in the greyed box next to it from 1 to 10,

where 1 meant that the CSoD was not at all present in their therapeutic work, and 10 meant

that it was consistently present in their therapeutic work.


Analysis

Qualitative.

The coding of the CSoD text responses was an iterative process that went through

several stages. Our intent was to adopt an inductive, “bottom-up” approach--akin to a

grounded theory method (Strauss & Corbin, 1997)--with a bracketing (Spinelli, 2005) of a

priori theories and assumptions to maximize the extent to which the analysis represented the

raw data.

In a first stage, both coders (the first and second author) read through each of the

CSoDs, and developed, independently, provisional sets of categories. These were then

discussed, and a common set of provisional categories was agreed. Each of the coders,

independently, then attempted to organize the CSoDs into this provisional framework; and

anomalies, inappropriate categories, and new categories were identified. At this stage, each

of the coders also attempted to construct over-arching domains into which the categories

could be organized. Following further discussion and review, a more refined set of categories

and domains were constructed, and both coders, again, independently coded the CSoDs into

this common framework. At this stage, 69.2% of the CSoDs were assigned by the two

coders, independently, to the same category, and this was considered a satisfactory level of

inter-rater reliability. The remaining 30.8% of the CSoDs were reviewed by the two coders

and assigned to categories by mutual agreement; and five new categories were constructed to

accommodate the CSoDs that did not appear to fit into any of the pre-existing categories.

Finally, the organization of the categories into the domains was reviewed and some minor

changes were made to ensure coherence and fit.

Quantitative.

The extent to which each of the categories and domains of CSoDs were present in

everyday life was calculated by simple frequency counts; with percentage of CSoDs and

mean number of statements in each category or domain per participant also calculated.


To test whether the number of CSoDs in each domain varied according to the

participants’ demographic characteristics, we first constructed five variables to represent

participants’ gender, age, ethnicity, professional status, and disability status. Gender,

professional status and disability status were created as dichotomous variables using data

directly from the participants’ Demographic Forms, and age was retained as a continuous

variable. Clients’ self-defined ethnicities were coded dichotomously into either White, or

Black and Minority (BME)/Mixed, ethnicity.

We then summed the number of CSoDs in each of the seven domains that participants

had described, and conducted seven multiple linear regression analyses, using the count of

CSoDs in each of the seven domains as the dependent variables, and the demographic

characteristics as the independent variables. Because we were conducting seven analyses, we

used a Bonferroni-adjusted α of .0071 (α < 0.05 for seven tests) to test for overall significance

with each model, retaining an α level of .05 for the variables within the regression models.

To examine the relative presence of the CSoDs in therapy, we calculated mean ratings

of presence for the CSoDs that had been coded into each of the categories and domains. To

examine whether this was related to the participants’ demographic characteristics, we then

calculated the mean ratings that each participant had given for CSoDs in each of the domains.

Where participants had not identified any CSoDs in a particular domain, no mean rating was

given. As with the frequency counts in each domain, we then conducted seven multiple

linear regression analyses on the mean ratings in each domain, using the demographic

characteristics as the independent variables, and the Bonferroni-adjusted α of .0071.

Results

Preliminary Analysis

In total, the 168 participants gave 1,065 responses, a mean of 6.34 CSoDs per

participants. The median number of responses per participant was six with a mode of five.


Types of Self-Reported CSoDs in Everyday Life

In the final grounded theory analysis, 39 categories of CSoDs were constructed and

organized into seven domains (see Table 1). In addition, three categories were constructed

for responses that could not be coded into any of the CSoD-specific domains. The first of

these categories, not otherwise specified, contained CSoDs that were idiosyncratic (n = 35)

and did not fit into any of the 39 categories, for instance “Try to find differences in values so

I can feel separate from other,” and “Fat--being fat can deter some men.” Second was non-

specific responses (n = 40), most commonly “withdraw” and “avoidance,” where participants

had described CSoDs in such general terms that they could not be assigned to any of the

specific categories. Finally were responses that were categorized as not a strategy (n = 39),

where participants had described particular responses to a stressful interpersonal event (for

instance, “Hurting” or “Remorseful”), rather than active strategies to disconnect from others.

The largest of the seven domains into which the CSoDs were coded was behavioral

strategies (n = 259), with a mean of 1.54 behavioral CSoDs per participant. These were

CSoDs in which the disconnection from an other involved some specific, physical activity or

movement. Most frequent here, and the second most common category overall, was

strategies that involved some physical avoidance of the other (n = 75), such as “Physically

leaving” and “Walking off”. Engaging in activities was the second most common means of

physical disconnection from others (n = 44), such as “Tidy the house” or watching

“TV/films”; followed by the closely related category of keeping busy (n = 35). A fourth

category in this domain was disconnection through avoiding contact with another (n = 27),

for instance by “not answering the phone”. Participants also described maintaining a stance

of independence (n = 23), for instance, “not asking for help”; and of isolating themselves (n

= 22): for instance, “withdrawing from social contact”. In 11 cases, participants described

tiredness, for instance falling asleep, as a means of disconnection; with 10 responses coded as


specific attempts to end or stop relationship, six as using drugs or alcohol, and six in terms of

not joining in.

The second largest domain into which the CSoDs were coded was termed passive

strategies (n = 215), with a mean of 1.28 per participant. These were ways in which

participants disconnected from others through submissive or deferential activity--at least at a

public level--or through adopting a non-responsive stance. Most common here, and the third

most common category overall, was going quiet or silent (n = 69), followed by adopting a

victim position (n = 31), in particular “sulking” or “silent treatment”. Being self-critical, self-

blaming or self-depreciating was also commonly described as a means of disconnecting from

others (n = 28); as was behaving in compliant or apologetic ways (n = 27). One participant

described this means of disconnecting from others as “Giv[ing] pleasant replies--Not asking

questions to interact. Lights are on but nobody is at home.” This related closely to strategies

of disconnection that involved conflict avoidance: for instance, “keeping the peace”,

“avoiding confrontation”, and “Avoid talking about difficulties in the relationship”.

Focusing on others (n = 16) was also described by participants as a form of disconnection, as

one participant put it: “Encourage people to talk to me and not talk to them about myself.”

This was closely related to strategies that involved rescuing, “helping”, or “fixing” things for

other people (n = 15), as a means of keeping away from deeper levels of connection. Two

final categories of CSoDs coded into the passive domain were not stating wants (n = 7) and

hiding/invisibility (n = 6).

The third domain of CSoDs were things that people did to disconnect from others that

operated at an internal, intrapersonal level--rather than being manifested on an external,

physical or interpersonal plane (n = 151, M = 0.9 per participant). The most common

category here, and the most common of the 39 categories overall, was mental withdrawal (n

= 82), which was described by participants in terms of “shut[ting] down”, “switching off”,

and “Retreating into self”. Participants also described intellectualization as a means of


withdrawal from others (n = 28), for instance “Take refuge in theory.” In 20 instances,

participants described a form of detaching from others that involved an emotional withdrawal

and a “cutting off” from feelings (n = 20). Daydreaming (n = 13) and distraction (n = 8)

were two final forms of interpersonal disconnection that seemed to operate at an intrapsychic

level.

The fourth domain of CSoDs, with 114 responses in total and a mean of 0.68 per

participant, was termed hostile means of disconnecting from others. Most frequent here, and

the fifth most frequent category overall, was the category of aggressive responses (n = 46), in

particular showing “anger”. Less frequently, participants described being critical or blaming

of others (n = 18); a cold, “standoff[-ish]” “defensive[ness]” (n = 15); and rejecting behavior

towards the other, in particular “pushing the person away” (n = 15). Finally, participants

described disconnecting from others through making themselves feel--or seem--superior (n =

10); and by controlling and “taking charge” of the interaction with the other (n = 10).

The fifth domain of CSoDs were methods of disconnecting from others that took

place within an immediate interaction, and were to do with changing one’s style of physical

or verbal communication (n = 86, M = 0.51 per participant). Most frequent here were

changes in eye contact (n = 30), particularly “avoiding” or “averting” eye contact, or

“disconnecting” one’s gaze and “looking into space”. Changing the subject was another form

of disconnection described by participants (n = 23), or “deflecting” the conversation away

from a more intimate or charged topic. In 21 instances, participants indicated that they

disconnected from others by not listening, or “Not hearing what is said by the other person”.

Finally, in this domain, participants described talking more as a means of disconnection (n =

7); or through “closed” or “stiff” body language (n = 5).

A sixth domain of CSoDs involved participants disconnecting from others by

behaving in ways that were somewhat insincere, and hid or disguised the person’s true

thoughts or feelings (n = 68, M = 0.40 per participant). The most common category of


responses here involved presenting a façade (n = 35), for instance “Pretend all ok but inward

fester” and “Putting on a smiley mask”. Within this domain, participants also described

disconnecting from others by feigning disinterest (n = 12): for instance, “Act[ing] like I don’t

care”; and through acting in superficial ways: for instance, “Not offering enough of myself,

my depth, to allow others the chance to connect.” Finally, participants described

disconnecting from others by adopting a formal and overly-“polite” stance (n = 9).

The final domain of CSoDs contained just one category, which was the fourth most

frequent category overall (n = 58, M = 0.35 per participant). This involved disconnecting

from others through the use of humor, including “laughter” and “making a joke”.

Predictors.

In terms of the overall number of CSoDs reported by participants, multiple linear

regression analysis found that just professional status was a significant predictor (b = 0.78, p

= .04, 95% CIs [0.03, 1.53]) with practicing therapists giving a mean of 6.90 responses (SD =

2.34) compared with a mean of 6.10 responses (SD = 2.13) for trainees.

Numbers of CSoDs in each of the seven individual domains were not significantly

related to any of the participants’ demographic characteristics: gender, age, ethnicity,

presence of a disability, or professional status.

Self-Reported Presence in Therapy

Ratings for the presence of the CSoDs in therapeutic work were available from 1,023

of the 1,065 responses (96.1%). The mean rating on the 1 to 10 scale was 2.51 (SD = 1.97),

with a median rating of 2, and a modal rating of 1 (n = 455 statements). The distribution had

a significant positive skew (1.49, SE = .08) and kurtosis (1.7, SE = .15), with 44.5% of

CSoDs rated as 1 (no presence in therapy), and 55.5% rated at 2 or above (present at least to a

minimal extent). Approximately one in six CSoDs (15.6%) were rated at 5 or more.

In terms of overall domains, Passive CSoDs were rated as being most present in the

therapeutic work (M = 3.08, n = 215); in particular rescuing behavior (M = 4.53, n = 15, 1st


most present category overall), focusing on the other (M = 4.18, n = 16, 2nd most present

category), being invisible/hiding (M = 4.00, n = 6, 3rd most present category), avoiding

conflict (M = 3.63, n = 16, 5th most present category), and compliance (M = 3.04, n = 27) (see

Table 2). This was followed by disingenuous CSoDs (M = 3.00, n = 68), in particular

formality (M = 3.63, n = 9, joint 5th most present category), superficiality (M = 3.08, n = 12),

and presenting a façade (M = 3.00, n = 35). Humor (M = 2.85, n = 58) was rated as the third

most present of the domains in therapy; followed by intrapsychic CSoDs (M = 2.83, n = 151),

in particular intellectualization (M = 3.72, n = 28, 4th most present category) and

daydreaming (M = 3.15, n = 13). Communication CSoDs were rated as the fifth most present

of the seven domains in therapy (M = 2.38, n = 86), with talking more (M = 3.00, n = 7) the

most manifest of this type. This was followed by the domain of hostile CSoDs (M = 2.15, n

= 115), with cold/prickliness (M = 3.23, n = 15) rated as most prevalent; and finally

behavioral CSoDs (M = 1.66, n = 259), none of which received a mean rating of three or

higher.

Predictors.

Multiple regression analysis found that participants’ mean ratings of how present their

CSoDs, overall, were in therapy was significantly related to two demographic characteristics:

gender and professional status. Male therapists rated their CSoDs as significantly more

present in therapy than female therapists (Mmale = 2.96, Mfemale = 2.40), with an unstandardized

beta coefficient in the final model of 0.59 (t = 2.50, p = 0.02, 95% CIs [0.11, 1.07]). Second,

trainees rated their CSoDs as significantly more present in therapy than qualified practitioners

(Mtrainee = 2.67, Mpractitioner = 2.16), with an unstandardized beta coefficient in the final model of

-0.51 (t = -2.34, p = 0.02, 95% CIs [-0.94, -0.08]). The R2 value for the final model was .06,

F (2, 157) = 5.33, p = .006.


For passive, humor, communication and hostile CSoDs, the multiple linear regression

analyses found that the extent to which participants rated them as present in therapy was not

related to any of the five demographic variables.

For behavioral CSoDs, participants’ mean ratings of their presence in therapy was

significantly related to two demographic characteristics, disability status and gender, with an

R2 for the final model of .09, n = 122, F (2, 117) = 6.00, p = .003. Disabled participants rated

behavioral CSoDs as significantly more present in therapy than non-disabled participants

(Mdisabled = 2.49, Mnon-disabled = 1.59), with an unstandardized beta coefficient in the final model

of 0.87 (t = 2.53, p = 0.01, 95% CIs [0.19, 1.56]). Male therapists rated behavioral CSoDs as

significantly more present in therapy than female therapists (Mmale = 2.25, Mfemale = 1.57), with

an unstandardized beta coefficient in the final model of 0.57 (t = 1.98, p = 0.05, 95% CIs

[0.00, 1.14]). Post hoc ANOVA tests comparing ratings of presence in therapy for each of

the ten categories of CSoDs in the behavioral domain (using a Bonferroni-adjusted α of .005;

α < 0.05 for ten categories) found that busyness CSoDs were significantly more likely to be

present for disabled participants as compared with non-disabled participants, Mdisabled = 4.00,

Mnon-disabled = 1.21, F(1,30) = 32.97, p < .001; as was independent CSoDs: M disabled = 6.00, Mnon-

disabled = 1.56, F(1,30) = 13.78, p = .002. With respect to gender, communication avoidance

CSoDs were rated as significantly more present in therapy by males than females: Mmale =

3.33, Mfemale = 1.35, F(1,24) = 12.63, p = .002; as were busyness CSoDs: Mmale = 2.50, Mfemale

= 1.17, F(1,31) = 9.55, p = .004.

For disingenuous CSoDs, participants’ mean ratings of their presence in therapy was

significantly related to participants’ age, with an R2 for the final model of .16, n = 49, F (1,

47) = 8.72, p = .005. Younger participants were significantly more likely to rate

disingenuous CSoDs as being present in therapy as compared with older participants, with an

unstandardized beta coefficient in the final model of -0.06 (t = -2.95, p = 0.005, 95% CIs [-

0.11, -0.02]). Post hoc tests found that age was negatively, but non-significantly, correlated


to presence in therapy for each of the four individual categories in the disingenuous domain

(-.46 to -.19).

For intrapsychic CSoDs, participants’ mean ratings of their presence in therapy was

significantly related to gender, with an R2 for the final model of .08, n = 97, F (1, 93) = 8.53,

p = .004. Male therapists rated intrapsychic CSoDs as significantly more present in therapy

than female therapists (Mmale = 4.50, Mfemale = 2.85), with a standardized beta coefficient in the

final model of 1.64 (t = 2.92, p = 0.004, 95% CIs [0.53, 2.76]). However, post hoc ANOVA

tests (using a Bonferroni-adjusted α of .01; α < 0.05 for five categories) found no significant

differences across gender at the level of the individual categories.

Discussion

To summarize the findings from this exploratory study: training and practicing

therapists in the UK, of a predominantly person-centered orientation, could each identify

several ways in which they believed they systematically disconnected from others in their

everyday lives. Most frequently, participants described physical avoidance strategies like

moving away from someone or immersing themselves in activities; and this was followed by

passive or submissive strategies, like going quiet or feeling sorry for themselves. Mental and

emotional forms of intrapersonal withdrawal were also commonly reported; as were

strategies that involved being aggressive and rejecting. Participants also reported that they

could disconnect from others by changing their style of communication, in particular by

avoiding eye contact; by being disingenuous; and through the use of humor.

In over 50% of cases, participants believed that these chronic strategies of

disconnection could be manifest, at least to a minimal extent, in their therapeutic work; and

approximately one in six CSoDs were rated as having a considerable presence. Most

commonly, it was the passive strategies of disconnection that were seen as being carried over

to the therapeutic work, in particular trying to rescue the other, being overly-focused on the

other, and “becoming invisible”. Disingenuous methods for disconnecting from others were


considered next most manifest in therapy, in particular being overly-formal. Disconnecting

from clients through humor, and through such intrapsychic mechanisms as intellectualization

and daydreaming, was also reported by participants. Communication, hostile and behavioral

CSoDs were less frequently reported by participants as being carried over into therapy.

Male therapists were significantly more likely to identify their CSoDs as being

present in therapy, as compared with female therapists. This was particularly behavioral

CSoDs--communication avoidance and busyness--and also intrapsychic CSoDs. Practicing

therapists identified a greater number of CSoDs than trainee therapists, but rated them as

significantly less present in therapy. Younger therapists were significantly more likely to

report disconnecting from their clients through disingenuous strategies as compared to older

therapists; and disabled therapists, as compared with non-disabled therapists, were

significantly more likely to report disconnecting from their clients using behavioral strategies,

in particular busyness and being independent.

In terms of the particular kinds of CSoDs that we identified, we had deliberately

adopted an inductive approach, to avoid our analysis being biased by any particular

taxonomic framework. However, on a post hoc basis, the perspective that would seem most

consistent with our analysis is that of the interpersonal circumplex (e.g., Horowitz et al.,

2006; Wiggins, 1979), in which interpersonal behaviors are viewed as existing along two

dimensions: degree of agency (from dominant to submissive), and degree of communion

(from warm to cold). Here, we found that two of our principal domains--hostile and passive

CSoDs--mapped closely on to the two opposing poles of the agency spectrum; while coldness

also emerged as a category in our analysis. Not surprisingly, given the focus on

disconnection, the warmth/agreeableness end of the communion pole did not emerge as a

domain of CSoDs; but humor did, which might be understood as a “warm” way of

disconnecting from an other. Our category of disingenuous CSoDs might also be seen as

mapping onto the circumplex variable of “unassuming-ingenuous” (between submissive and


warm), with the domain of intrapsychic processes mapping on to “aloof-introverted”

(between submissive and cold). In this respect, a future analysis of CSoDs might find it

useful to use the interpersonal circumplex as an a priori analytical framework; though it is

important to note that two of our domains, behavioral and communication CSoDs, did not

have any clear fit within this model.

Perhaps the most interesting finding of this study was that passive CSoDs were

reported as most prevalent in the therapeutic work. In some respects, this might simply

reflect the nature of the therapeutic encounter, in which therapists are more likely to act in

ways that are other-focused, rescuing and quiet; as opposed to hostile or physically acting

out. Nevertheless, behaviors such as being “invisible”, avoiding conflict, and feeling a victim

could not be considered inherent to the psychotherapeutic role. Furthermore, disingenuous

ways of behaving--adjacent to submissive behaviors in the interpersonal circumplex--

emerged as the second most reported form of CSoDs that was present in the therapeutic work.

This suggests, then, that therapists may need to be particularly alert to disconnecting from

their clients in ways that are passive and disingenuous, and which may be less obvious than

more dominant and active ways of disconnecting.

The prevalence of such passive forms of disconnection, however, may also be related

to the therapeutic orientation of the participants, which was primarily person-centered. Given

the emphasis in this approach on a “non-directive” mode of relating (Cooper, Schmid,

O'Hara, & Bohart, 2013; Levitt, 2005; Rogers, 1951), it may be that person-centered trainees

and therapists are particularly likely to disconnect from their clients in submissive, rather than

hostile or dominant, ways. Such a finding raises some important questions about person-

centered training and practice. Within this field, a stance of non-directivity is typically

lauded as a means of empowering the client (Grant, 2002). However, the present findings

seem to support Gelso and Hayes’s (1998) observation that the Rogerian quality may, at

times, be used defensively on the part of the therapist.


In terms of predictors, the tendency for male therapists to report more busyness and

communication avoidance CSoDs in therapy, as compared with female therapists, might be

considered consistent with gender role expectations and schema (Bem, 1981). This could

also be said of the overall greater self-reported presence of CSoDs in therapy for male

therapists, given the emphasis in the male role on agency as opposed to communion and

relatedness (Bakan, 1966). In addition, if these differences could simply be explained by

gender roles, we would expect to see males reporting more CSoDs in everyday life, which

was not the case. Males also reported a greater presence of intrapsychic CSoDs in therapy,

which is not particularly consistent with gender role expectations. Whatever the explanation

for these differences, these findings suggest that male therapists may need to be more vigilant

in identifying CSoDs in their therapeutic work. The same could be said of trainees who,

perhaps unsurprisingly, were more likely to report their CSoDs “leaking” into their

therapeutic work as compared with trained therapists. However, it is important to emphasise

that, given the exploratory nature of this study, these findings must be treated with

considerable cautious.

Caution is also needed because of several important limitations of this study. First, as

introduced in the design section of this paper, the findings are based entirely on self-report

data. Given that many defense processes, or “relational scripts”, may function at an

unconscious level (Magnavita, 2008), this means that the CSoDs identified here are likely to

reflect only a proportion of those that are actually enacted by therapists in their work. It also

means that the estimations of their presence in therapy, and predictive factors, may be biased

in a range of ways. In developing a deeper understanding of CSoDs and their role in therapy,

therefore, it will be essential to develop observational and client-report methods to extend the

present findings. In addition, it would be very valuable to see how therapists’ partners rated

their CSoDs, and whether this corresponded to the views of observers or clients.

Nevertheless, it is important to note that participants in the present study had either


completed, or were undertaking, therapy trainings focused around the development of self-

awareness. Hence, participants’ self-reports would be expected to show some degree of

insight, certainly sufficient to form the basis for a deeper exploration of this phenomenon.

Closely related to this, a second limitation of this study is that the Chronic Strategies

of Disconnection Form, itself, has not been established as a reliable or valid tool for the

assessment of CSoDs. As a primarily qualitative and exploratory tool, it does not lend itself

easily to such testing. However, in terms of future research, it may be helpful to transfer the

CSoDs identified in this study onto a quantitative measure that could then be tested for

reliability and validity (see below). Such a study would help to identify the underlying

factors across the CSoDs. It could also form the basis for further research in this area:

examining, in more rigor, the prevalence of particular types of CSoDs in therapy, their

relationship to demographic characteristics, their association with therapeutic outcomes, and

methods by which they could be more effectively managed.

A third limitation of the present study was that the sample was almost entirely limited

to participants from a single therapeutic orientation: the person-centred approach. This is a

very distinctive style of intervention, with a particular emphasis on non-directivity, such that

therapists who are attracted to--and trained in--this approach might be quite different from

others in the psychotherapy field. In furthering this line of research, therefore, it will be

important to examine whether these CSoDs are also present in the work of therapists from

different orientations. Future studies will also need to look at CSoDs across a wider

demographic profile. Participants in the present study were predominantly White and female

and this is another important limitation of the present work.

A final set of limitations are that participants’ responses, and the analyses, may have

been influenced by various demand characteristics and biases in the study design. When

participants were introduced to the idea of CSoDs, they were given an example, by the first

author, of how he has tended to withdraw into a ‘victim’ position when upset. This may have


biased participants’ responses towards passive and disingenuous CSoDs. In addition, a

similar biasing may have happened when the first author used this CSoD as an illustration of

how they can leak into therapy: describing how he sometimes, unhelpfully, withdrew into his

own “hurt” when clients talked about ending therapy. The authors’ own CSoDs may have

also unconsciously influenced the qualitative analysis towards their own experiences.

Another potential source of bias is that the participants discussed their CSoDs with a partner

prior to writing them down. They may also have felt pressurised to identify CSoDs, and to

rate them as present in their therapy work, because of the demand characteristics inherent in

the workshop tasks. Finally, the data collection exercise used in this study was also

proceeded by a series of other workshop exercises on relational depth, which may have biases

the participants’ responses in unknown ways.

Despite these limitations and the exploratory nature of this study, the present findings

do suggest that, at least in some instances, therapists’ CSoDs may “leak” into the therapeutic

work. This suggests, then, that it may be important for therapists to reflect on their CSoDs:

the ways in which they, themselves, might undermine the process of establishing therapeutic

connectedness. This development of “relational awareness” (Comstock et al., 2008) is

something that could be supported through clinical supervision (Abernethy & Cook, 2011), as

well as in training. Through doing so, therapists may then be more able to notice when they

are enacting these CSoDs in therapy, and to develop strategies for their effective

management.

To support this process, a Chronic Strategies of Disconnection Checklist has been

constructed (see Appendix). The checklist is directly based on the findings from this study:

transposing the 39 identified CSoDs onto an inventory. This can be used by therapists to

assess the types of CSoDs that are present in their lives, as well as the extent to which these

may filter through into their therapeutic work. This checklist might also form the basis for

the development of a reliable and valid measure of CSoDs, as discussed above.


Conclusion

Although it known that the quality of the therapeutic alliance is one of the strongest

predictors of outcomes, little is known about how therapists can develop this relationship.

The research in this paper focuses on developing relational depth, and specifically focuses on

helping therapists to develop an awareness of the actions that they might inadvertently enact

to impede this. This study, for the first time, provides some indication of what these CSoDs

might be, and the ones that may be most likely to leak into the therapeutic work. Although

this data is exploratory and based on self-report only, it provides a framework which can

support therapists to examine their own CSoDs. By recognizing these and developing the

skills to put them to one side in the therapeutic relationship, therapists may be able to

enhance their connectedness to clients.


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Appendix

Chronic Strategies of Disconnection Checklist

Chronic strategies of disconnection are patterns of behavior that we may develop to protect ourselves from hurt or anxiety in close relationships, but which may now be redundant: i.e., we tend to do them automatically when, in fact, it may be more beneficial for us to stay in closer connection with another person. Reflecting on your own experience, in everyday life, of close relationships and times in which you feel hurt or anxious, to what extent do you use each of the following strategies to disconnect from others (when you might be better off staying in connection)?

Not at all

A little

Moderately

A lot

Immersing yourself in activities 0 1 2 3Distracting yourself 0 1 2 3Talking a lot 0 1 2 3Being aggressive to others 0 1 2 3Acting in an arrogant way 0 1 2 3Criticising others 0 1 2 3Being cold or prickly 0 1 2 3Pushing others away 0 1 2 3Putting up a façade 0 1 2 3Feigning disinterest: that you don’t really care 0 1 2 3Being overly-formal or polite 0 1 2 3Keeping things at a superficial level 0 1 2 3Using humour or laughter 0 1 2 3Avoiding communication with others 0 1 2 3Isolating yourself physically from others 0 1 2 3Being busy 0 1 2 3Using drugs or alcohol 0 1 2 3Daydreaming 0 1 2 3Withdrawing emotionally 0 1 2 3Ending contact with people 0 1 2 3Intellectualizing 0 1 2 3Becoming tired or going to sleep 0 1 2 3Avoiding conflict 0 1 2 3Being compliant, appeasing 0 1 2 3Being controlling 0 1 2 3Not expressing your wants 0 1 2 3Mentally shutting down, ‘going into your head’ 0 1 2 3


Being closed in your body language 0 1 2 3Physically avoiding people 0 1 2 3Changing the subject 0 1 2 3Avoiding eye contact 0 1 2 3Not listening 0 1 2 3Not joining in with things 0 1 2 3Becoming quiet or silent 0 1 2 3Focusing attention on others 0 1 2 3Rescuing: being overly-helpful to others 0 1 2 3Being independent 0 1 2 3Trying to hide or make yourself invisible 0 1 2 3Criticising yourself 0 1 2 3Feeling sorry for yourself/’playing the victim’ 0 1 2 3

Stage 2When you have finished this checklist, please go back over each item, and rate how present each of these strategies may be in your therapeutic work. To do this, please give each strategy a score from 1 to 10 in the right-hand column, where 1 means that the strategy is not at all present in your therapeutic work, and 10 means that it is consistently present in their therapeutic work.


Tables

Table 1.

Therapists’ self-reported chronic strategies of disconnection (CSoDs) in everyday life

Domai

n Category N %

/

Participan

t

Behavioral 259 24.32 1.54

Physical avoidance 75 7.04 0.45

Activities 44 4.13 0.26

Busyness 35 3.29 0.21

Communication

avoidance

27 2.54 0.16

Independence 23 2.16 0.14

Isolation 22 2.07 0.13

Tiredness 11 1.03 0.07

End contact 10 0.94 0.06

Drugs and alcohol 6 0.56 0.04

Not joining in 6 0.56 0.04

Passiv

e

215 20.19 1.28

Silence/quietness 69 6.48 0.41

Victimhood 31 2.91 0.18

Self-criticism 28 2.63 0.17

Compliance 27 2.54 0.16

Conflict avoidance 16 1.50 0.10


Other-focus 16 1.50 0.10

Rescuing 15 1.41 0.09

Not stating wants 7 0.66 0.04

Hiding/invisibilty 6 0.56 0.04

Intrapsychic 151 14.18 0.90

Mental withdrawal 82 7.70 0.49

Intellectualization 28 2.63 0.17

Emotional withdrawal 20 1.88 0.12

Daydreaming 13 1.22 0.08

Distraction 8 0.75 0.05

Hostile 114 10.70 0.68

Aggressiveness 46 4.32 0.27

Criticism of others 18 1.69 0.11

Cold, prickliness 15 1.41 0.09

Rejecting 15 1.41 0.09

Arrogance/superiority 10 0.94 0.06

Controlling 10 0.94 0.06

Communication 86 8.08 0.51

Eye contact 30 2.82 0.18

Change subject 23 2.16 0.14

Not listening 21 1.97 0.13

Talking more 7 0.66 0.04

Body language 5 0.47 0.03

Disingenuous 68 6.38 0.40

Facade 35 3.29 0.21

Feigning disinterest 12 1.13 0.07


Superficiality 12 1.13 0.07

Formality 9 0.85 0.05

Humo

r

58 5.45 0.35

No specific domain 114 10.70 0.68

Non-specific strategy 40 3.76 0.24

Not a strategy 39 3.66 0.23

Not otherwise specified 35 3.29 0.21


Table 2.

Reported presence of chronic strategies of disconnection (CSoDs) in therapy

Domain Category Mean

presence

n

Passive 3.08 215

Rescuing 4.53 15

Other-focus 4.18 16

Hiding/invisibilty 4.00 6

Conflict avoidance 3.63 16

Compliance 3.04 27

Self-criticism 2.93 28

Not stating wants 2.86 7

Silence/quietness 2.78 69

Victimhood 2.23 31

Disingenuous 3.00 68

Formality 3.63 9

Superficiality 3.08 12

Facade 3.00 35

Feigning disinterest 2.40 12

Humor 2.85 58

Intrapsychic 2.83 151

Intellectualization 3.72 28

Daydreaming 3.15 13

Emotional withdrawal 2.60 20

Mental withdrawal 2.60 82


Distraction 2.25 8

Communication 2.38 86

Talking more 3.00 7

Change subject 2.50 23

Eye contact 2.28 30

Not listening 2.16 21

Body language 1.80 5

Hostile 2.15 114

Cold, prickliness 3.23 15

Controlling 2.20 10

Arrogance/superiority 2.10 10

Aggressiveness 2.05 46

Criticism of others 1.89 18

Rejecting 1.67 15

Behavioral 1.66 259

Tiredness 2.70 11

Not joining in 2.17 6

Activities 1.97 44

Independence 1.95 23

Communication

avoidance

1.58 27

Busyness 1.58 35

End contact 1.50 10

Isolation 1.47 22

Physical avoidance 1.41 75

Drugs and alcohol 1.00 6


No specific domain 2.89 114

Not otherwise specified 2.34 39

Non-specific strategy 2.82 40

Not a strategy 3.46 35

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pure.roehampton.ac.uk · Web viewTherapists’ Self-Reported Chronic Strategies of Disconnection in Everyday Life and in Counselling and Psychotherapy: An Exploratory Study. Mick