Psychodynamic Group Therapy with Hispanic Migrants: Interpersonal,Relational Constructs in Treating Complex Trauma,Dissociation, and Enactments

ABSTRACT

This article introduces an interpersonal, relational approach to group therapy for Hispanic migrants with significant histories of violence, abuse, multiple losses, and recurrent trauma. Psychodynamic group psychotherapy may help to address trauma symptoms, insecure/disorganized attachment, grief, and isolation with newly arrived migrants. How the relational paradigm in group psychotherapy is contributing to current theories of complex trauma and dissociation is reviewed. Using this modality conveys the importance of examining trauma-driven enactments, dissociation and symbolization involving the members of the group, the group-as-a-whole, and the group leader. Clinical examples and group therapy interventions used to address powerful dissociative enactments are discussed.     

Art from the Heart

Abstract

This article describes art therapy techniques grounded in a relational-cultural approach used in a middle school group for girls. Art from the Heart is an interactive preventive intervention designed to facilitate increased connections among group members. It is intended to bring together multiethnic groups of urban girls with complex relational histories to learn about growth-fostering relationships, without relying on sophisticated verbal abilities. Specific techniques encourage the expression of “feeling thoughts” and other interpersonal dynamics that do not lend themselves well to words. The interactive nature of the art projects creates a context where interpersonal disconnections can be explored and understood, and connections can be celebrated, both by talking and by making art.     

Childhood Sexual Abuse and Intimate Relationships: A Support Group for Male Partners

Individual and group therapy modalities are common approaches to treating survivors of child sexual abuse (CSA). Survivors have identified a number of interpersonal problems that they experience with romantic partners but little is known about the partner’s perspective. Additionally, partners of abuse survivors are generally excluded from the treatment process. A short-term support group for the partners of adult survivors of sexual abuse was conducted concurrently with an Incest Resolution Group. The goal of the Partner’s Support Group was to gain greater understanding of the interpersonal relational problems as experienced by the partners, and to provide support, insight, and education regarding the impact of CSA. Clinical implications are discussed.     

Group Psychotherapy and Rehabilitation of Long-Stay Patients

Abstract

Bulimia is a complex disorder that can significantly interfere with psychosocial functioning. It is a particularly significant problem among adolescents and young women in college and university settings. The preponderance of literature on group therapeutic approaches for this disorder is from a cognitive–behavioral perspective. In this paper, we present a psychodynamic group therapy approach for female university students, informed specifically by self psychological and relational frameworks. Through clinical illustrations, we demonstrate how the group provides selfobject experiences, including mirroring, idealizing, twinship, and adversarial experiences, and how the group becomes the arena through which group members can experience, express, and understand emotions. The interpersonal context of the group uniquely provides opportunities for members to examine their bulimic symptoms in relation to interactions that take place outside of or within the group.     

Using Narrative Therapy in the Treatment of Adult Survivors of Childhood Sexual Abuse in the Context of Couple Therapy

Abstract

Childhood Sexual Abuse (CSA) is a prevalent social issue. Many theoretical approaches have been applied to the treatment of CSA, these approaches predominately focus on the treatment of children and adolescents, failing to address adulthood and couples’ relations. This limited focus fails to address long-lasting relational implications CSA survivors face. This paper proposes the application of a systemic therapeutic modality, Narrative therapy when treating adult survivors of CSA in couple therapy. The treatment of CSA in the context of couple therapy will be discussed. Clinical vignettes will be used. Implications for clinical practice and future research will be discussed.     

The Relationships Between Japanese Interpersonal Conflict Styles and Their Language Expressions

ABSTRACT

The present study investigated the influence of interpersonal conflict management styles on language expressions and the differences in expressions in same-sex relational categories based on specific in-group-out-group classifications. Questionnaires were administered to 367 university students in Japan. After reading a scenario, participants reported on actual language use and gave ratings on an interpersonal conflict management scale. The results revealed that Japanese change their expressions, along with psychological styles, depending on the relational target. They also indicated psychological constructs were related to their equivalent expressions. The results suggested that future research should take into consideration the potential differences in behavior and interaction posture inherent in various relational and situational categories.     

At the verge of unthinkable anxiety: On the relevance of a neurophysiologically informed relational perspective on meaning-making in psychosis

Abstract

This article examines the relevance of relationally oriented psychoanalytic phenomenology as a frame of reference for understanding psychotic states in schizophrenia. The etiology and structural characteristics of such states are examined from both a neurophysiological, and a relational and interpersonal point of view. Many findings indicate organic abnormalities in schizophrenia, acquired through an exposure to physical risk factors and genetic predisposition, but relational traumas also seem to have an impact on the form and content of psychotic states. This may happen through interruptions in the “use-dependent” maturation of the brain in a relational milieu. In addition, at the level of meaning-making, we find that the emotional and relational contexts—both past and present—give the substance or “raw material” for hallucinations and delusions. In a psychotic state, the person also tries to handle basic affects and relational needs, and to make meaning in states of overwhelming chaos and anxiety. Donald W. Winnicott's theory of “a holding environment”, Stephen Mitchell's theory of the relational matrix, and Stolorow, Atwood, and Orange's concepts of a “shattered world” and annihilation anxiety are used as a framework in the analysis of the phenomenology of psychosis. Two case illustrations, one from child psychotherapy and one from therapy with an adult patient, are used to illuminate the theoretical points of view.     

Lesbians Who Abuse Their Partners

Abstract

This study explored the functional, interpersonal style of a small group of lesbians who had abused their partners (N = 15) and enrolled in a pilot feminist abuse cessation therapy program. Each completed a Fundamental Interpersonal Relations Orientation-Behavior scale (FIRO-B), a self-report assessment tool that measures expressed and wanted inclusion, control, and affection. Robust findings from the small, ethnically homogenous sample are discussed in terms of their implications for understanding one interpersonal dynamic of control in lesbian relationships in which there is abuse. Future directions for therapy and research are also outlined.     

EMDR as a treatment for improving attachment status in adults and children

IntroductionThe purpose of the article is to examine the current literature regarding evidence for positive change in attachment status following Eye Movement Desensitization and Reprocessing (EMDR) therapy and to describe how an integrative EMDR and family therapy team model was implemented to improve attachment and symptoms in a child with a history of relational loss and trauma.LiteratureThe EMDR method is briefly described along with the theoretical model that guides the EMDR approach. As well, an overview of attachment theory is provided and its implication for conceptualizing symptoms related to a history of relational trauma. Finally, a literature review is provided regarding current preliminary evidence that EMDR can improve attachment status in children and adults.Clinical findingsA case study is described in which an EMDR and family therapy integrative model improved attachment status and symptoms in a child with a history attachment trauma.ConclusionThe case study and literature review provide preliminary evidence that EMDR may be a promising therapy in the treatment of disorders related to attachment trauma.     

Qualifications for Membership in the A.G.P.A.

A model of the development of group therapists is presented. It is proposed that student group therapists proceed through a sequence of stages, each of which is marked by characteristic therapist behavior. During the initial Group shock phase, the student reacts to the novelty of group therapy stimuli with individual therapy or content-oriented approaches. Reappraisal is a period of some therapist inhibition, frustration, or self-doubt. One step behind is a phase characterized by a gradual recognition of the process level of analysis, despite difficulty supplying the interventions autonomously. Using the here-and-now is a period of active intervention about interpersonal phenomena among group members. The techniques for highlighting this material are refined in the Polishing skills phase. The usefulness of models in training is discussed.     

Announcement

Abstract

Empathy has consistently been identified as an important quality of psychotherapists. Understanding unique ways that empathy emerges in group therapy may assist group therapists in fostering empathy. Rogerian and selected psychodynamic and interpersonal perspectives on empathy are discussed. Group psychotherapy poses a challenge for empathic responding, but also a rich opportunity for utilizing a more varied embodied approach to empathy.     

Integrative time-limited group therapy for bulimia nervosa.

This article presents an integrative group therapy model for the treatment of bulimia nervosa (BN) and describes the 12-session format, incorporating components of cognitive-behavioral therapy (CBT), psychoeducation, interpersonal therapy (IPT), and relational therapy (RT), in detail. Previous reports have found CBT, IPT, and RT to be effective approaches for BN when used separately. The integrative approach may have the advantage of achieving symptom reduction by two different mediating mechanisms, those that directly affect eating behaviors and those that address the interpersonal and relational context in which the disordered eating has developed. The group approach makes use of the peer group in providing new opportunities for self-exploration and self-correction. One advantage of an integrative model is patients' exposure to several different treatment modalities from which they can identify specific approaches that are most helpful to their recovery. This identification is valuable in directing future treatment, if needed. Pilot data for this approach are presented.     

Empirically distinguishing interpersonal styles within romantic relationships: What is helpful or harmful when having a goal for your romantic partner?

IntroductionRelationship research rooted in self-determination theory often focuses on autonomy support. However, rarely is this interpersonal style considered alongside other facets of relational behaviours such as directive support and control.ObjectiveThe present study aimed to distinguish the three styles by providing a tool that can simultaneously assess them.MethodA total sample of 710 French Canadians involved in a romantic relationship was used for factor extraction and test of dimensionality as well as reliability. Predictive validity was tested using multiple linear regressions with six outcomes: well-being, relationship quality, closeness, goal progress, cooperation and conflicts.ResultsResults suggested three distinct interpersonal styles, each of which showing a different pattern of prediction with the outcomes. Overall, autonomy support was associated with positive outcomes, whereas control was associated with negative outcomes. As for directive support, the global pattern was between the two others.ConclusionThe present research offers a scale which simultaneously assesses and distinguishes the autonomy-supportive, directive-supportive and controlling styles in a romantic relationship context using three items each. By examining the associations between these three interpersonal styles and various outcomes four months later, this study sheds light on helpful and harmful behaviours in relation to the goals people have for their romantic partner.     

The Influence of Individual Attachment Styles on Group Members’ Experience of Therapist Transitions

Abstract

Attachment theory has recently been applied to clinical practice in an effort to improve understanding and treatment of the maladaptive relational patterns clients bring to therapy. While most of this research has focused on individual therapy, interest in the application of attachment theory to group psychotherapy is growing. This paper will explore the impact of clients’ attachment styles on their experiences of co-therapist transition in an ongoing psychodynamic therapy group. This discussion will elucidate how knowledge of attachment theory and an understanding of clients’ individual attachment styles can be useful in predicting responses to therapist-initiated terminations and transitions.     

The role of repetitive thought in determining posttraumatic growth and distress following interpersonal trauma

Background and Objectives: Repetitive thought (RT) strategies have been linked to a range of negative outcomes following traumatic interpersonal events but are proposed to serve an adaptive function under particular circumstances. This study examined outcomes following RT within a transdiagnostic framework, and explored the potentially adaptive nature of trait-like and event-related RT. Design: The centrality of a traumatic event to one's identity was explored as a context under which the adaptive nature of RT might change. Young adults with interpersonal violence experiences (N = 163) reported use of trait-like and event-related RT, centrality of the event, depressive, anxious, and posttraumatic stress symptoms (PTSS), posttraumatic depreciation and posttraumatic growth. Methods: Hierarchical multiple regression analyses were used to examine main and moderating effects of four types of RT and event centrality on outcome variables. Results: Centrality positively predicted depressive symptoms and PTSS, depreciation, and growth. Brooding RT positively predicted all negative outcomes. Reflecting RT positively predicted anxious symptoms and PTSS and depreciation. Only deliberate RT positively predicted growth. Centrality did not moderate any examined relationships. Conclusions: Findings highlight the importance of addressing specific types of RT in interventions with survivors and of considering centrality as a robust contributor to outcomes following interpersonal violence.     

An Interpersonal and Intercultural Embrace

SUMMARY

Using Ono's (1997) “letter” format to share one's multiplicity of “voices,” I discuss the negotiation of interpersonal and intercultural factors of a gay, transcontinental, HIV serodiscordant relational connection with my late partner and a multicultural relational connection with my current partner. In this letter, I work to open paths of inquiry and understanding of our connections by intersecting relational “differences” (e.g., ethnicity, nations of birth, social class, HIV status, and religion/spirituality) with relational “similarities” (e.g., attraction and love, age status, shared gay identity, shared languages, and educational privilege). Finally, I address our learned and practiced skills for sustaining relational healthiness.     

Resilience Processes in Context

Abstract

This article considers resilience as a multiplicity of psychological characteristics that are shaped by the ecological interplay of relational, social, and cultural contexts. Bronfenbrenner's (1979) person-process-context model of human development is examined in terms of its implications for research and for both micro- and macro-level interventions. Attention is given to “the first context” and to the role of early attachment in the cultivation of resilient functioning. Attachment theory and research are reviewed. Themes are extracted from this research to suggest how psychotherapy with trauma survivors can mobilize the resilient capacities of trauma survivors and function as a reparative context. Implications of an ecological perspective and attachment theory and research for national and community-level interventions are considered.     

Voices from the Group

Summary

This article presents experiential reactions of male and female domestic violence perpetrators one year after completing a 52-week court-mandated intervention program. Data were derived from in-depth interviews as part of a larger research study looking at recidivism and other outcomes in a probation department with a domestic violence courtand a coordinated legal, programmatic and community response. Overall, elements that were most helpful in domestic violence intervention were primarily relational ones, such as group support and therapist/facilitator alliances, and secondarily, specific strategies of handling anger and other emotions, and interpersonal communication. The discussion focuses on the implications of these findings for therapists and facilitators involved in providing services for this population.     

The EMDR integrative group treatment protocol: EMDR group treatment for early intervention following critical incidents

IntroductionThis paper presents an overview of the Eye Movement Desensitization and Reprocessing – Integrative Group Treatment Protocol (EMDR-IGTP) that has been used since 1998 with both children and adults in its original format or with adaptations to meet the circumstances in numerous settings around the world for thousands of survivors of natural or man-made disasters and during ongoing geopolitical crisis.MethodThe author's intention is to highlight and enlightened the reader of the existence of this protocol that combines the eight standard EMDR treatment phases with a group therapy model and an art therapy format and use the Butterfly Hug as a form of a self-administered bilateral stimulation, thus providing more extensive reach than the individual EMDR application.ConclusionRandomize Controlled Trial Research is suggested to establish the efficacy of this intervention.     

What an Understanding of the Dynamics of Gossip Has to Teach About Group Dynamics and Group Leadership

Abstract

Although what transpires in group therapy is not gossip per se–except perhaps when absent or former members are discussed–listening to group interaction through an understanding of the dynamics of gossip can contribute to a greater appreciation of group dynamics and group leadership as well as enlarge therapeutic space. After examining the interpersonal dynamics of gossip, this paper discusses six ways in which an understanding of these dynamics can inform group leadership and shed light on group psychotherapy. Central features of gossip that appear in group interactions are explored: These include projection, displacement, self-esteem regulation, clarification of motivation, unself-consciousness, social comparison and bonding, avoidance of psychic pain, and making the ego-syntonic dystonic. The lively use of imagination in the mature phase of group therapy is conceived of as the time when the darker side of human nature–imagined gossip harnessed for therapeutic purposes–can be welcomed in and processed in a kind, playful, and compassionate manner.