Couples psychotherapy group: Treatment of the married alcoholic

As part of an intramural research program of the National Institute of Alcohol Abuse and Alcoholism focused on the psychobiogenetics of familial alcoholism, a psychodynamically oriented married couples psychotherapy group was formed. Its purpose was to determine whether this modality could be utilized as an outpatient treatment approach to identify and modify interpersonal interactions that affect both drinking behavior and the quality of family and marital life. This paper, a clinical case report, presents follow-up data and disusses both themes that emerged in the therapy process and the usefulness of this modality in the treatment of the married alcoholic.She was formerly Chief, Unit of Family Studies, Laboratory of Clinical Studies, National Institute of Alcohol Abuse and Alcoholism (NIAAA).At the time this paper was written, she was a Research Social Worker, Laboratory, of Clinical Studies, NIAAA, Bethesda, Maryland.     

Countertransference in group psychotherapy

This paper attempts to up-date our understanding of countertransference in the therapy group setting. After a brief review of some of the psychoanalytic and the group psychotherapy literature dealing with countertransference, the paper points out the vulnerability of the group therapist and presents examples of possible countertransferential situations, such as stereotyped roles, reactions to external aspects of patients, and therapists' insecurities. It concludes by suggesting ways in which group therapists can become more sensitive to their countertransferences.     

Antidepressants in group psychotherapy

This article alerts us to consider depression as a relatively frequent cause of impasse in the course of group psychotherapy. The authors recommend the combined use of antidepressant medication along with group psychotherapy when such depression is confirmed independently outside the group. Common obstacles and pitfalls preventing successful combined treatment are reviewed; the depressive logjam is differentiated from common resistance; and profiles of responders versus nonresponders are described. A rationale of the combined treatment, its results, and implications for group therapists are all delineated.     

Hostility in group psychotherapy

To run a psychodynamic group therapeutically, the leader must understand the meanings and functions of hostility. Fundamental to this task is the leader's awareness of his or her bias toward hostility as a constructive or destructive feeling and willingness to serve as a lightening rod for it. This paper discusses the sources of hostility during different stages of group development. The therapeutic handling of hostility is discussed under the following topics: theoretical considerations, defensive functions, and communicative functions. Case examples illustrate the proper handling of contractual violations, scapegoating, and narcissistic injury. Countertransference reactions to anger and rage in the group are discussed.     

Scapegoating in group psychotherapy

The purpose of this paper is to describe and illuminate the phenomenon of scapegoating in group psychotherapy. Specifically, the role of projective identification - on both individual and group-wide bases - in the evolution of the deviant is delineated. Individual, interpersonal, and whole-group interventions are presented along with the technique of functional subgrouping, a relatively new and particularly potent group intervention. Several case vignettes are detailed for illustration.     

Resistance in group psychotherapy

The authors view resistance generally as healthy and a sign of a more or less intact ego. A brief review of the psychoanalytic literature and the group therapy literature presents resistance as a mechanism that closes off aspects of the internal and external world seen as potentially dangerous. Patient resistances are identified as coming from cultural values, fear of strangers, fear of regression, and resentment toward the therapist. Clinical vignettes of group patients and group interaction are presented. Finally, resistance of therapists and indications of such resistance are also explored.