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Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 2
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,
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,
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 3
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 4
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,
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 5
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 6
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 7
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 8
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 9
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 10
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 11
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 12
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 13
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 14
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 15
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 16
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 17
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 18
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 19
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 20
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 21
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 22
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 23
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 24
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 25
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 26
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Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 31
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 32
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.
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 33
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 34
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 35
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 36
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
Running head: THERAPISTS’ CHRONIC STRATEGIES OF DISCONNECTION 37
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