Leigh McCullough

Who was Leigh McCullough?

Leigh McCullough was a psychotherapist, researcher and pioneer of short-term dynamic psychotherapy. 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 and anxiety; McCullough framed anger as an object that has learned 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 activates the super-ego, which then activates the ego defences against 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, and the change mechanism is desensitization of anger activation. In neuronal terms, the activation of anger neurons not followed by feared consequences results in a weakening of synaptic connections from anger neurons to anxiety neurons, allowing anger to be freely activated without the automatic activation of anxiety.