Addressing anniversary reactions of trauma through group process: the Hurricane Katrina anniversary wellness workshops

Natural disasters such as Hurricane Katrina, which devastated the Gulf Coast of the United States in the summer of 2005, have highlighted the need to develop effective post-trauma psychotherapeutic intervention strategies, not only to deal with the immediate psychological aftermath of trauma, but also the long-term effects of anniversary reactions. Governmental responses to Hurricane Katrina relief were greatly criticized for disorganization and delay. Both immediately afterwards and in ensuing months, people's life needs often were not addressed. People-to-people individual and group grassroots efforts, including those provided by mental health professionals, however, did reach local communities to service immediate needs and long-term emotional reactions. The present paper describes one such effort designed to help survivors cope on the occasion of the first anniversary of Hurricane Katrina. Specifically, anniversary reaction group workshops were held to address unresolved emotional issues and to promote healing by encouraging belonging, comfort, security, and resilience. The ultimate goal of these wellness workshops was to assist participants in understanding and resolving their anniversary reactions. Preliminary quantitative and qualitative findings suggested that this workshop format helped participants face their anniversary reactions, address their related psychological sequelae, and deal with their physical displacement. Participants were then able to find the emotional strength to reattach, form new communities, and begin problem solving. These methods, with appropriate cultural modifications, were subsequently used in China, to assist Chinese mental health professionals prepare for the first anniversary of the Sichuan earthquake.     

Insight-oriented group psychotherapy of latency-age children in an acute care setting

Traditional approaches to group therapy with latency-age children have stressed activity and nonverbal therapeutic interventions. These approaches originated in the 1940s with Slavson's activity aroup therapy. A review of the literature of the past 25 years reveals that many clinicians have increasingly employed verbal techniques with latencyage groups. Most such reports describe groups for latency-age out-patients. In this paper, a verbal, interpretive technique for group therapy with latency-age inpatients is described. Clinical vignettes are included to illustrate this technique. Our experience suggests that such a technique can become an integral part of the inpatient treatment program for the latency-age child.     

Preference-consistent evaluation of information in the hidden profile paradigm: beyond group-level explanations for the dominance of shared information in group decisions

Common explanations for the failure of groups to solve so-called hidden profiles focus on group processes, namely insufficient discussion of unshared information and premature consensus on a suboptimal alternative. As 2 experiments show, even in the absence of such group processes, hidden profiles are hardly ever solved. In Experiment 1, participants first received individual information about a personnel selection task and then read a group discussion protocol containing full information exchange. If the individual information was misleading (hidden profile), most participants failed to detect the correct alternative. In Experiment 2, it was determined that this effect is due to preference-consistent evaluation of information that constitutes an individual-level process mediating the failure of group members to solve hidden profiles.     

Critical Interaction Therapy: Couples Therapy in Combat-Related Posttraumatic Stress Disorder

There is a need for family therapy interventions that are specific to the conditions found in families of traumatized people such as combat veterans. In these families, the historically "real" event of the trauma often continues to exert influence on the family system despite collusive arrangements that serve to keep it hidden. In families of combat veterans, a situation develops whereby the veteran becomes triangulated with a dead buddy without the spouse's knowledge. The discrepancy between past and present emerges in what we call the critical interaction between the spouses. This article outlines a method of couples therapy that attempts to demystify this critical interaction, and begins to integrate the discrepant narratives of each spouse. The establishment of a nascent mutuality of perspective within the couple releases energies that can be directed toward support rather than symptom-formation in the family system.     

Growth in Criticism?

Reports of global ecumenical conversations are regularly published by the World Council of Churches in a collection of volumes titled Growth in Agreement. The assumption is that the dialogues are not just repeating the same arguments they made half a century ago, but that relations between member churches have grown qualitatively as a result of this process. This paper asks whether Orthodox critique of Roman Catholic ecclesiology reflects signs of growth or continues “traditional” stereotypical thinking about other churches and religions. The paper first examines Orthodox reactions to Lumen Gentium during and immediately after the Second Vatican Council, then compares them with Orthodox reactions to the council’s 50th anniversary. The paper concludes by asking whether Pope Francis’ endeavour to reform the Catholic Church in the direction of greater synodality is partly the result of the expectations of our sister churches’ representatives over the past 50 years.     

Trauma Accommodation and Anniversary Reactions in Children

Anniversary reactions in traumatized children have been well recognized in the literature. Examined herein are temporal issues in the mourning process often realized by traumatized children. The case study of Laura is presented as a clinical illustration of problems in trauma accommodation that include anniversary reactions in children. Anniversary reactions in children are more common than is generally recognized in clinical practice. Such reactions are more likely to be found among children who exhibit persistent, repetitive, but insufficient efforts of trauma mastery through their incomplete grief and inadequate mourning process. Clinical issues are discussed.     

Interactional dynamics between teen-age leaders and followers in the classroom

The interaction within 10 informal teen-age groups in classrooms were observed by two independent, nonparticipant observers. Every group in the study had a distinguishable leader. The hypothesis was that the hidden or “illegitimate” communication reflects basic assumptions, such as dependece on a leader or fight/flight movements within the group. The principal findings were the following: (a) The teen-age leaders dominated both the psychological space and the physical space. The leaders were treated differently by, and behaves differently toward, the followers. The pattern was found to suit an “object relations model”, in which the leader is used by the followers to serve as a container for unpleasant feelings and to express forbidden opinions. (b) The group movements in all 10 groups seemed to continously change during the school day and no group was either principally dependent or principally fighting/flighting. W.R. Bion's findings (Experiences in Groups, New York, Basic Books, 1961) on group movements in adult groups, such as therapy groups and professional organizations, seem to be valid for the hidden interaction in teen-age groups in the classroom.     

Collective action control by goals and plans: applying a self-regulation perspective to group performance

In celebration of the 125th anniversary of The American Journal of Psychology, this article discusses a seminal publication by Marjorie Shaw (1932) on small group performance in the rational solution of complex problems. We then propose an approach for the effective regulation of group goal striving based on the collective action control perspective. From this perspective, group performance might be hindered by a collective intention-behavior gap: Groups fail to act on their intentions despite being strongly committed to the collective goal, knowing what the necessary actions are, and being capable of performing them. To reduce this gap, we suggest specific if-then plans (implementation intentions) in which groups specify when, where, and how to act toward their collective goal as an easily applicable self-regulation strategy to automate collective action control. Studies in which implementation intentions improved group performance in hidden profile, escalation of commitment, and cooperation task paradigms are reported and discussed.     

How to achieve synergy in group decision making: Lessons to be learned from the hidden profile paradigm

Based on over 25 years of research on hidden profiles and information sharing in groups, and particularly our own work in this area, we outline a general model of how groups can achieve better decisions in a hidden profile situation than their individual members would have been capable of (i.e., synergy). At its core the model defines intensity and bias as the two key parameters that have to be optimised with regard to both the discussion of information and the processing of information in order to ensure synergy in group decision making. We review the empirical literature on information sharing and group decision making in the hidden profile paradigm (with a particular focus on our own studies) to illustrate how group decision quality can be enhanced by increasing intensity and decreasing bias in the discussion and processing of information. Finally we also outline why we think that the lessons learned from research using the hidden profile paradigm can be generalised to group decision-making research in general, and how these lessons can stimulate studies in other fields of group decision-making and group performance research.     

Group psychotherapy treatment of borderline personalities.

Borderline personalities have been treated in psychotherapy groups for over 40 years. This article elaborates some of the characteristics pertinent to the treatment of these patients. Combined treatment of group and individual therapy addresses the needs for object constancy, the integration of object and self representations, and the possibility of attachment to others. Collaboration with individual therapists in this process is essential and there are specific conditions that allow this to occur as well as guidelines to help them make referrals. Cotherapy can be especially beneficial if the cotherapy team is knowledgeable and experienced. The group therapist must have special training and supervision to conduct groups of such intensity and affectively laden content.     

When the therapist says goodbye

Therapist-initiated termination poses several unique problems for both the group and the therapist. This paper describes the termination process from the point of view of this therapist's experience in planning the termination of her group therapy practice. The reactions of other analysts to her decision to retire and the group processes and individual patient's reactions in this long-term psychoanalytic therapy group are described in detail. The author follows the group process and her own inner processes in the final six months of the group. The importance of the working through of the termination phase of therapy is supported by the experiences that were shared by the group and the therapist.     

Process and Content in a Therapy Group for Bipolar Outpatients

Although the literature suggests that homogeneous therapy groups are useful for bipolar outpatients, little is known about the process in such groups. Using the GCQ-S and a content analysis of discussion topics, we evaluated group process during the first 31 sessions of an outpatient bipolar group. Compared with normative samples, our group scored significantly higher in the Engaged dimension and significantly lower in the Avoiding and Conflict dimensions and in the anxiety/tension scale. Furthermore, 81% of the discussion topics were related to the three group goals, and an additional 18% dealt with general group issues such as orienting new members and attendance. The results from this pilot study suggest that bipolar patients can discuss relevant issues in a homogeneous group environment that is cohesive, open, and safe.     

Helping construct desirable identities: a self-presentational view of psychotherapy

The author reviews the research demonstrating not only that clients withhold personal information and reactions from their therapists but also that such discretion is associated with positive therapy process ratings and outcomes. These results run counter to traditional approaches to psychotherapy, which demand a high degree of openness from clients. These puzzling findings can be explained by conceptualizing psychotherapy as a self-presentational process, wherein clients come to benefit from therapy by perceiving that their therapists have favorable views of them. Creating these favorable impressions can involve clients' hiding some undesirable aspects of themselves from their therapists. The author offers findings from the psychotherapy and social-psychology literatures in support of this view and makes suggestions concerning what clients and therapists might optimally reveal in therapy.     

Morality in group and family therapies: multiperson therapies and the 1992 ethics code

Although virtually every psychotherapeutic approach or orientation has adapted group and family therapy to its conceptions of psychological dysfunctions and how to treat them, levels of training of practitioners in all of these approaches are often insufficient to meet the requirements of ethically as well as technically responsible conduct of treatment for persons in groups and families. The new ethics code (American Psychological Association [APA], 1992) does include a few issues specific to multiperson therapies, but other issues critical to the competent practice of group and family therapy remain unaddressed. The result can be confusing to those applying standards for individual therapy to multiperson therapies. It is argued that the classical ethical concerns of psychotherapists, informed consent, confidentiality, countertransference reactions, aand intrusions of therapist values, require special sensitivity to how they are expressed in mulitperson therapies. Practitioners of group and family therapies must be better sensitized to the technical distinctions and the associated ethical vulnerabilities of the modalities they use. Future planning for revision of the APA ethics code should take these factors into account.     

Naïve Groups Can Solve the Hidden‐Profile Problem

Research involving hidden‐profile tasks suggests that groups typically fail to detect hidden profiles. In previous studies, group members always considered the alternatives in the choice tasks prior to joining the group and, thus, entered discussions with preformed preferences (predecided groups). We set up a new condition, in which group members received their information regarding the choice alternatives at the beginning of their group session (naïve groups). When information was provided in the form of common rather than in the form of unique cues, naïve groups detected the hidden profile throughout. The results indicate that naïve groups are able to detect hidden profiles.     

Differential Reactions of Patients Receiving Group Psychotherapy with Concomitant Somatic and Drug Therapies

The embeddedness of combat aggression, violence, survival, and antiauthority dynamics in the psychic organization of Vietnam veterans in groups shape the treatment enterprise. Inherent in treatment interactions and dynamic processes of the Vietnam therapy group are the reactivations of Vietnam-historical reenactments. These involve strong affective reactions toward superiors and toward fellow combatants (“grunts”), with an attendant sense of group danger, unconsciously reminiscent of Vietnam's guerrilla war terrain. This paper notes that because of the tendency of the group to repeat actual events (as opposed to fantasied events), these groups require divergent conceptualizations and technical management. An innovative model comprising a series of developmental phases is presented. This model, called “the curvilinear regressive-progressive model” of treatment with Vietnam veterans, focuses on both peer- and leader-centered dynamics in working through guilt-driven defenses in members. The leader plays a pivotal function in monitoring levels of affect tolerance in the group, and is expected to manage countertransference reactions, and to have sensitivity to the effects of combat stress on self structure. As the Vietnam therapy group members relive the history of the Vietnam conflict in the group, the leader utilizes a flexible, phase-sensitive system of interventions to reactivate arrested development by creating a healing climate where developmental tasks can be mastered and integrated by group members.     

The dissemination of critical,unshared information in decision‐making groups: the effects of pre‐discussion dissent

Previous research in group decision making has found that in situations of a hidden profile (i.e. the best choice alternative is hidden from individual members as they consider their pre‐discussion information), unshared information is disproportionately neglected and sub‐optimal group choices are highly likely. In an experimental study, three‐person groups decided which of three candidates to select for a professorial appointment. We hypothesised that minority dissent in pre‐discussion preferences improves the consideration of unshared information in groups and increases the discovery rate of hidden profiles. As predicted, consideration of unshared information increased with minority dissent. The expectation of an improvement of group decision quality was partially supported. In diversity groups (i.e. each member prefers a different alternative) consideration of unshared information and group decision quality was significantly higher than in simple minority groups. Results are discussed in the light of theories of minority influence. The benefits of using the hidden profile paradigm with minority and diversity groups for theory development in the area of group decision making are highlighted. Copyright © 2002 John Wiley & Sons, Ltd.     

Disgust in Emotion Theory,Development, and Clinical Work: A Discussion of Josephs

Disgust is one of the primal emotions described by Darwin and strongly influences human motivation, behavior, and psychopathology. Disgust has sensory aspects, but when combined with certain cognitions it can take on moral implications. Although the biological source of disgust is protection from harmful substances, it can be manipulated to achieve political ends. Disgust combined with lust can sometimes lead to heightened sexual excitement. Disgust reactions may also be a defensive denial of our hidden desires. Psychotherapists must be careful to distinguish their own disgust reactions from the patient’s lovemap. In couples therapy, disgust reactions and mutual shaming processes can be clarified and restructured.     

Priming autobiographical memories: How recalling the past may affect everyday forms of autobiographical remembering

This study investigated the idea that when one recalls past episodes, that the content of those memories will activate additional episodic memories with like content, and such memories will then have the potential of surfacing in subsequent acts of involuntary and voluntary recall. We tested the episodic content priming hypothesis in two experiments. In Experiment 1, priming group participants first recalled memories about specific activities or events and then they were subsequently engaged in a word-cue voluntary autobiographical memory task. The results showed that priming group participants produced more episodic memories involving the primed content on this task than control participants occupied in the same task. In Experiment 2, episodic content priming was further tested on a measure of involuntary autobiographical memory (i.e., the vigilance task). The results on this task also revealed support for the episodic content priming hypothesis, including after a delay of 24 h.     

Group decision making in hidden profile situations: dissent as a facilitator for decision quality

The effect of diversity in individual prediscussion preferences on group decision quality was examined in an experiment in which 135 three-person groups worked on a personnel selection case with 4 alternatives. The information distribution among group members constituted a hidden profile (i.e., the correct solution was not identifiable on the basis of the members' individual information and could be detected only by pooling and integrating the members' unique information). Whereas groups with homogeneous suboptimal prediscussion preferences (no dissent) hardly ever solved the hidden profile, solution rates were significantly higher in groups with prediscussion dissent, even if none of these individual prediscussion preferences were correct. If dissent came from a proponent of the correct solution, solution rates were even higher than in dissent groups without such a proponent. The magnitude of dissent (i.e., minority dissent or full diversity of individual preferences) did not affect decision quality. The beneficial effect of dissent on group decision quality was mediated primarily by greater discussion intensity and to some extent also by less discussion bias in dissent groups.