Leigh McCullough

Leigh McCullough was a psychotherapist, researcher and pioneer of short-term dynamic psychotherapy (STDP). Her treatment model focused on the learned fears of experiencing certain emotions, or what she called affect phobias. This is an exceptionally clear and useful reformulation of psychodynamic conflicts in behavioral terms. For example, in case of a psychodynamic conflict between anger (or sexual desire, or grief, or closeness) and anxiety (or guilt, or shame); McCullough framed anger as an (internal) object that has learned (phobically) to activate anxiety. Thus in McCullough's reformulation, anger and anxiety do not stand against each other, as in an interpersonal conflict, but rather: anger activates anxiety, which then activates some defence mechanisms to avoid or inhibit the activation of anger. In terms of Freud's Id, ego and super-ego, the Id (anger) activates the super-ego (anxiety), which then activates the ego defences agains the id.

McCullough's reformulation of psychodynamic conflicts in terms of phobia both clarifies the therapeutic focus and suggests the intrapsychical change mechanism. Treatment of affect phobias progresses similarly to the exposure technique of behavioral therapies, with the difference that affects could be viewed as an internal phobia instead of external phobias such as fear of spiders or heights. Thus therapy should expose the patient to the activation of her anger (or sexual desire, or grief, or closeness), and the change mechanism is desensitization (or habituation) of anger activation. In neuronal terms, the activation of anger neurons not followed by feared (or shameful) consequences results in a weakening (desensitization/habituation) of synaptic connections from anger neurons to anxiety neurons, allowing anger to be freely activated without the automatic activation of anxiety (and thereby defenses against anger).

McCullough was an associate clinical professor at Harvard Medical School, director of the Psychotherapy Research Program at Harvard's Beth Israel Deaconess Medical Center, and a visiting professor at the Norwegian University of Science and Technology (Trondheim, Norway). She was the 1996 Voorhees Distinguished Professor at the Menninger Clinic and received the 1996 Michael Franz Basch Award from the Silvan Tomkins Institute for her contributions to the exploration of affect in psychotherapy. Dr. McCullough was on the editorial board of the journal Psychotherapy Research and of the Journal of Brief Therapy, and conducted training seminars in the Affect Phobia model worldwide.

Leigh McCullough was diagnosed with ALS in 2010 and died on June 7, 2012

Bibliography

• McCullough Vaillant, Leigh (1997). Changing Character: Short-Term Anxiety-Regulating Psychotherapy for Restructuring Defenses, Affects, and Attachment. BasicBooks.
• McCullough, Leigh et al. (2003). Treating Affect Phobia: A Manual for Short-Term Dynamic Psychotherapy.

See also

• David Malan
• Intensive short-term dynamic psychotherapy.
• Silvan Tomkins