What is Core Problem Analysis (CPA)?
Everything is dialectical, which means that everything has two sides, such as night and day, black and white, or ying and yang. Our existence is also dialectical, consisting of conditional and unconditional sides that function alongside but separately from each other.
Conditional and Unconditional Elements
On the conditional end of the spectrum, we have our relationship with an environment – our thoughts, feelings and actions, ups and downs, wins and losses, mistakes and achievements, proud moments and disappointments, criticism and reinforcement from other people, etc. On the unconditional side, we have our relationship with self – as that to an entity. We just are – neither good nor bad (unconditional side), while our actions can be effective or ineffective, given a goal (conditional side).
When a relationship with self becomes conditional on life events (e.g., “I achieved, therefore I am good or I failed, therefore I am bad”), our existence becomes one-sided. Once a dialectical balance is disrupted, a person’s self-image starts to vacillate, depending on circumstances, between being positive and negative on the daily, and sometimes hourly, basis. This courses suffering, and a person gets stuck in attempts to artificially reduce fluctuations of life via 1) avoidance of the challenges of daily living and/or 2) force, which includes attempts to change other people and/or punish self for “being bad.”
There are many reasons why our relationship with self may transition from unconditional to conditional. Unfortunately, it does not take much to start the process. Simply saying “good girl or bad girl,” following a child’s response, merges the relationship with self with achievements and failures. Further, harmful invalidation, specifically in early life, facilitates this transition to a significant degree. Harmful invalidation includes criticism, judgement, comparisons, shaming, blaming, insulting, forcing, imposing, etc. Harmful invalidation provides feedback on the level of a response AND on the personal level. It communicates that both – a response and the person – are “not good enough” and that the maladaptive response is a proof that the person is “defective.” Thus, “who I am” starts to integrate with “what I do/feel/think.”
How Core Problem Analysis (CPA) Helps
Core Problem Analysis (CPA) has been developed to help 1) understand and restructure the relationship with self; 2) restore the dialectical balance; and 3) achieve a synthesis of “I am at peace with self at all times AND I am disappointed or proud of my responses.” CPA is derived from clinical work with children, adolescents and adults with severe emotional and behavioral dysregulation, and their families. The model is based on Dr.Perepletchikova’s 20 years of clinical experience. Further, CPA had been used as a part of an intervention in a randomized clinical trial of DBT for pre-adolescent children (Perepletchikova et al., 2017) https://pubmed.ncbi.nlm.nih.gov/28942805/
CPA adopts a position of synthesis between 1) strictly behavioral approaches, where responses are proposed to be mostly controlled by environmental factors, and 2) strictly dynamic approaches, where responses are proposed to be mostly influenced by unconscious processes. CPA allows examination and targeting of factors that are external and internal, and includes assessment of conscious processes, as well as material that is not on the level of awareness.
The main insight that is promoted by CPA is understanding the relationship with self via an analysis of vulnerabilities in the three core senses – self-love, safety and belonging. CPA also helps evaluate how these vulnerabilities influence the relationship with an environment (i.e., adaptive and maladaptive responses). Further, it provides CPA-specific therapeutic strategies to decrease these vulnerabilities.
Sense of self-love is a stable and enduring love for self as is, without conditions. It refers to a relationship with self as that to an entity, neither good nor bad, where experience of self-love is not based on satisfying a requirement of being “good enough.” Ability to experience self-love allows a person to appreciate and enjoy one’s own abilities, inborn aptitudes, talents and inclinations, as well as acquired facilities, interests, competencies, expertise and mastery. As opposed to attempts to self-define or satisfy standard imposed by the environment. Self-love is not synonymous with pride, self-esteem, self-confidence, self-care, self-actualization and alike. The later constructs belong to a conditional side of the existence, as they are based on the “if-then” contingency (e.g., “I feel proud because I solved this problem”). Self-love, on the other hand, is unconditional (i.e., “just because”).
Parental unconditional love for the child and radical acceptance of child’s responses form a foundation for the child’s ability to experience self-love. Pervasive and indiscriminate invalidation interferes with a child’s ability to experience love for self. It is hard for the child to appreciate that self-love is even possible if she believes that she cannot garner the love of her own parents.
Sense of safety refers to an ability to self-control and accumulate resources, knowledge, and connections sufficient to handle challenges, as well as a realistic appraisal of danger. Sense of safety starts to develop within a secure environment, where caregivers provide stability, protection and consistent support. Sense of safety continues to develop when a child acquires better control over her own responses and accumulates life experiences to trust that she is able to effectively deal with life challenges.
The sense of safety may not properly develop when an environment is unpredictable and sometimes responds effectively to the child’s needs and sometimes does not, pervasively invalidates child’s abilities to handle internal and external events and frequently accommodates maladaptive responses. Failure of the environment to provide consistent protection and support, interferes with the child’s ability to trust self, others and the world, and develop self-control.
Sense of belonging refers to an enduring sense of being welcomed as a part of a group. Sense of belonging starts to develop within a family, through a positive relationship with caregivers that provide a consistent message that the child is loved and her responses are accepted.
A relationship where parents frequently use downward comparisons and are critical, judgmental, retaliatory, invalidating, punishing and dismissive is likely to communicate messages to the child that she is different, “defective,” not accepted and even not wanted.
These senses are at the core because asking a question of “why is it important to love yourself or feel safe or belong?” is the same as asking “why is it important to breathe?” CPA stipulates that a primary function of all responses is to decrease vulnerabilities in the core senses (responses can have other secondary functions as well, such as coping, attention, retaliation, etc). Maladaptive responses function to decrease vulnerabilities in core senses in the short-term, while increasing them in the long-term (just like self-harm helps to decrease emotional arousal in the moment, while causing more problems for the future). Adaptive responses, on the other hand, may increase vulnerabilities in the core senses in the short-term, while decreasing them in the long-term (just like facing a challenge can be difficult in the moment and improves our capacity to skillfully solve problems in the future). In DBT-C, the therapist assesses vulnerabilities in these core senses by conducting CPA with children, as well as parents, and directly targets decreasing vulnerabilities in these senses during and between sessions. Further, parents are trained to perform CPA on themselves and with their children.
Want to Learn more about CPA?
Core Problem Analysis will be covered in detail in Part 2 of the upcoming information course for parents, Superparenting 101. Parents or caregivers interested in learning more about DBT-C or CPA can register for individual parts or the full curriculum.