The Lady Cloaked in Fog Developing a Construction of the Therapist as a “Harbor Light”

In this chapter, we extend the developmental analysis of psychotherapy process (DAPP) to the analysis of a case of McCullough’s (1999) short-term “anxiety-regulating” dynamic therapy. McCullough bases her approach on an integration of principles from psychoanalytic, cognitive-behavioral, and experiential therapies. Central to the model is the idea of an affect phobia. McCullough (1999) has suggested that many individuals who seek psychotherapy fear experiencing their own feelings. Since McCullough’s work, a related literature on “experiential avoidance” has burgeoned (e.g., Chawla & Ostafin, 2007; Kashdan, Barrios, Forsyth, & Steger, 2006; Tull & Roemer, 2007). In McCullough’s view, different clients exhibit fears of different emotions. For example, individuals may experience fear of feeling anger, grief, closeness, or positive feelings about the self. An individual’s avoidance of different classes of strong emotions impairs the capacity for adaptive activity in the world. McCullough’s therapeutic approach entails combining increased exposure to the avoided feelings with a careful use of the therapeutic relationship for anxiety regulation to facilitate tolerance of the exposure. In what follows, we examine the case of the “Lady Cloaked in Fog” (McCullough, 1999), ¹ a 42-year-old depressed woman who exhibited difficulty experiencing feelings of closeness.