Anaesthesia or psychotherapy: Eradicating thoughts or working them through

The author presents two sessions from the analysis of a depressive narcissistic doctor, which are characterised by a mixture of co-operation and pseudo-co-operation. The dialogue is in parts intellectualised, complicated, lifeless and schizoid. Points at which the patient shows surprising insights are then partly denigrated by him, on the basis that change is not to be expected. Semi-lifeless contact assists the defensive claustrophobia that he experiences in meaningful contact. It becomes very clear that he is then afraid of entering into an openly aggressive conflict that entails the existential threat of object loss. However, this has so far been avoided. The secret pleasure in an anal-narcissistic, sadomasochistic addiction to doubt persists in the partial denigration. The patient's artificially maintained self-doubt and doubt of the object reinforce a genuine confusion that consists in never knowing exactly what lies behind the helpful and needed object.     

Us and them: Memory advantages in perceptually ambiguous groups

Ingroup advantages and outgroup deficits in perception and memory are well-established in research on race, gender, and other ostensibly identifiable social categories. The present study extended this research to a social category that is not as perceptually apparent: male sexual orientation. Consistent with hypotheses, an interaction of participant sexual orientation and image sexual orientation revealed an ingroup enhancement and outgroup deficit for memory of faces that participants perceived—both accurately and inaccurately—as belonging to either their ingroup or outgroup in a subsequent task. Additionally, parallel effects were found for the accurate identification of sexual orientation—a finding consistent with previous literature. The present data highlight the importance of social categorization for subsequent memory and suggest that the underlying cognitive machinery responsible for the recognition of groups may be co-opted for other relevant social applications.     

Group psychotherapy with alcoholics: Interface with self-help groups

This paper addresses recovering alcoholics' concurrent involvement in psychotherapy groups and self-help groups. A developmental model of alcoholism group psychotherapy is presented, differentiating between early and advanced sobriety. Psychotherapy and self-help groups are compared and contrasted. Multiple group membership entails various areas of compatibility. Divergence and conflict result from differences in underlying conceptual framework and approach. Clinical implications of members' involvement in partially discrepant group settings are explored with an emphasis on transference and countertransference reactions. Multiple group membership is identified as a salient factor in alcoholism group psychotherapy at all levels of recovery.She is also in private practice.This paper was presented at the American Group Psychotherapy Association Annual Conference, Boston, February 1990.     

Leadership behavior,group climate and outcome in group psychotherapy: A study of outpatient psychotherapy groups

A recent clinical study of outpatient psychotherapy groups in a community mental health center explored the linkage between group leadership variables, group climate, and outcome. The study involved nine outpatient therapy groups, over 50 group clients, and several group therapists. A repeated measures design involving assessment of clients' outcome and level of functioning, group leadership style, and group climate was used to assess changes over a 6-month period. The findings suggest: 1) a reduction in symptoms and improved functioning for clients; 2) a similarity of perceptions by members and leaders of perceived leadership behaviors and group climate; 3) the presence of direct and indirect influences of group climate and leadership behavior on clients' outcome; and 4) a linkage between leadership behavior and group climate with the theoretical orientation of the group. The findings of the research are discussed in relation to the understanding of specific effects in group psychotherapy and the implications for construction of group psychotherapy theory.The authors would like to thank Robert Dies, Ph.D., for his helpful suggestions in the early phase of this study; Roy MacKenzie, M.D., for permission to use the Group Climate Questionnaire; Diane DePalma, Ph.D., for permission to use the Global Leadership Behavior Index; Chris Boltwood, B.A., for her untiring efforts in administering the instruments and coding and entering the data; and most importantly, the psychotherapy group members and the group therapists for their cooperation in this endeavor—without their help, this clinical study would not have been possible.A version of this paper was presented at the Annual Meeting of the American Group Psychotherapy Association, 1987, New Orleans, Louisiana. Lenore Phipps, R.N., M.S., C.S., was formerly Director, Group Psychotherapy Program at Park Ridge Mental Health Center, Rochester, now in private practice at Guild Medical Center, Norwood, MA 02062.     

Remembering the forgotten: psychotherapy groups for the nursing home resident

The mental health needs of the long-term nursing home resident receive little attention. It is especially difficult for the more cognitively intact resident to obtain psychological help. An integrated group psychotherapy model that incorporates developmental, cognitive-behavioral, and psychodynamic approaches is described, based on the author's clinical experience in developing and co-leading four groups in three long-term care facilities over a period of ten years. The technical and countertransference challenges of working with this unique population and in this format are described, along with clinical material to illustrate common themes. The success of the groups in improving the morale, sense of community, and quality of life for group members is demonstrated.     

Small groups in the church: Problems and dangers

Conclusion The conflicted quality of the emotional life of some local churches might not tolerate the creation and sustaining of a small-group program. Not only may there be paralyzing ministerial ambivalence, or pastors who are easily threatened, but there are instances where important lay persons do not feel free to participate in such an experience but cannot tolerate that it should be going on apart from them. But where there is sufficient personal and structural flexibility and psychological freedom, along with the potentiality of a skillful leadership, the kind of small-group program discussed here offers an exciting opportunity for personal and community recreation. If such a program has its problems and dangers it is, at the same time, ripe with a promise to be redemptively rich and fruitful. But only as we identify and respond to the former can we realize and fulfill the latter.     

Reproducing gender in counseling and psychotherapy: Understanding the problem and changing the practice

In this article I argue that the concept of gender is misunderstood by the majority of psychologists. Increasingly the term “gender” is mindlessly replacing the term “sex,” obfuscating decades of theory and research that elucidated gender as a complex social-psychological variable rather than a bifurcated individual-difference variable tied to biological sex. As a consequence, gender is largely ignored as an “active” variable in counseling research and practice. Current theory and research on gender as they apply to counseling and psychotherapy are first described. Then ways in which gender processes are often reproduced in counseling and psychotherapy and factors contributing to this practice are illuminated. Finally, areas particularly vulnerable to reproducing gender are described and some examples provided of the reproducing, and the disrupting, of gender processes in counseling.     

The modern confessional: Anglo-American religious groups and the emergence of lay psychotherapy

This article reconceives of secularization as a gradual process of increasing interaction between the (social) scientific and spiritual realms by examining the influence of Christian ideas of group confession on lay psychotherapeutic groups in Britain, Canada, and the U.S. in the early twentieth century. This article focuses on three religious group leaders of the interwar period: Frank Buchman (1878-1961), Gerald Heard (1889-1971), and Henry Burton Sharman (1865-1953). Influenced by Natural Theology and the holiness movement, they placed sin and its redemption within the world, reconceiving it as psychological individualism and its redemption as self-sacrifice to the group. This reconception endorsed the moral power of groups and influenced Alcoholics Anonymous and various groups within the Human Potential Movement.     

Containment and the threat of catastrophic change in psychotherapy groups

Wilfred Bion's seminal work with treatment and training groups is considered by many group therapists to be a classic study of group behavior. Despite the influence of his early work on groups, practitioners frequently find his later writings difficult to apply to group settings. The purpose of this paper is to illustrate the potential usefulness of Bion's later psychoanalytic writings to our understanding of the complex dynamics active in therapy groups. This paper examines the relationship among four concepts that Bion emphasized in his later writings: projective identification, containercontained, (Ps<---->D), and catastrophic change. Two clinical vignettes are presented to demonstrate how these concepts can aid the therapist in understanding the complicated dynamics active in therapeutic group settings.     

The triadic legitimacy model: Understanding support to disobedient groups

In a social-psychological perspective, many scholars have argued that disobedience plays a significant role in avoiding the degeneration of the authority into autocracy and in promoting social change. In particular, the tripolar model (minority-majority-population) proposed by Mugny (1982) emphasized the role of the population for the stability or the progress of every society. Authority may indeed preserve the status quo only on the grounds of its influence on a large population. Likewise, protesters may achieve social change only by influencing and involving a large part of the population in their struggles. In understanding why people decide to join a protest, the aim of this article is to integrate Kelman and Hamilton's (1989) analysis of legitimacy with the tripolar model on social influence. The model we propose – namely the triadic legitimacy model (TLM) – explains the dialectic between social stability and social change by considering both authority's and disobedient groups' legitimacies.     

Us versus them: Understanding the process of race perception with event-related brain potentials

Race is powerful social signal, imbued with a great deal of meaning and capable of affecting a wide range of behaviours and judgements. This review focuses on the use of event-related brain potentials (ERPs) to better understand the process and implications of race perception. Research to date repeatedly demonstrates the speed and automaticity with which racial category membership is encoded. The quick and relatively obligatory encoding of racial ingroup and outgroup distinctions in turn affects a variety of subsequent racially biased behaviours. Such findings not only speak to the close link between social categorization and behaviour, but also have been used to understand how the effects of race perception can be moderated.     

Preschoolers trust novel members of accurate speakers' groups and judge them favourably

By age 3, children track a speaker's record of past accuracy and use it as a cue to current reliability. Two experiments (N?=?95 children) explored whether preschoolers' judgements about, and trust in, the accuracy of a previously reliable informant extend to other members of the informant's group. In Experiment 1, both 3- and 4-year-olds consistently judged an animated character who was associated with a previously accurate speaker more likely to be correct than a character associated with a previously inaccurate speaker, despite possessing no information about these characters' individual records of reliability. They continued to show this preference one week later. Experiment 2 presented 4- and 5-year-olds with a related task using videos of human actors. Both showed preferences for members of previously accurate speakers' groups on a common measure of epistemic trust. This result suggests that by at least age 4, children's trust in speaker testimony spreads to members of a previously accurate speaker's group.     

Client perception of therapeutic factors in group psychotherapy and growth groups: an empirically-based hierarchical model

To assess group participants' perceptions of therapeutic factors, we developed an extensive questionnaire of 155 items that was administered to 489 members of 78 psychotherapy and growth groups of client-centered/experiential, psychoanalytic, behavioral, Gestalt and drama- and bodily oriented orientations. Using multivariate analyses we found a model that reveals the structure and connections of therapeutic factors as they are differentiated in the experience of the group members. Our model encompasses three hierarchical levels of abstraction: 28 Basic scales that appeared to be structured into seven main scales (Group Cohesion, Interactional Confirmation, Cathartic Self-Revelation, Self-Insight and Progress, Observational Experiences, Getting Directives, and Interactional Confrontation) and two dimensions (Relational Climate and Psychological Work). Validity for these therapeutic factors was found in their grounded content, statistically analyzed constructs, importance ratings, and correlations to intermediate outcome measures.     

Adoption: some clinical features of adults who have been adopted and the difficulties of helping them in NHS psychotherapy

This paper explores issues of adoption and specifically what happens when adults who have been adopted as babies present for psychological help in the NHS. Two clinical examples of women patients are given, and it is suggested that there is a re‐enactment of earlier adoption experiences within the approach to and engagement in psychotherapy. The tendency for splitting and projection between biological and adoptive mothers, good and bad mothers and the patient's body and mind are discussed, as are the implications for the transference and countertransference. The combination of the patients' problems and the restrictions imposed on treatment in the NHS due to scarce resources is explored.     

Complementary cultures in children's psychotherapy groups: conflict, coexistence, and convergence in group development.

This article presents a model for understanding development within children's psychotherapy groups. It is proposed that two complementary cultures exist within children's groups, one, indigenous peer culture, strictly of the children's making and the other, therapeutic group culture, created by the therapist in collaboration with group members. The therapist is wise to approach indigenous peer culture as an ethnographer might a native culture, with an emphasis on observation and seeking understanding rather than on intervention. The therapist can use the indigenous peer culture to speak to the children in their own language and eventually to engage them in collaboratively building a meaning system that is uniquely designed to address their psychotherapeutic needs. The article defines these concepts, develops them theoretically, and illustrates them clinically.     

Understanding how groups work: a study of homogeneous peer group failures

The study examines thirty-six homogeneous peer support groups that failed to positively benefit most of the participants. Outcomes were assessed pre and one-year post using measures of mental health, marital relationships, and motherhood role indices. Four central group process characteristics previously found to be common in successful peer support groups were used as a framework for developing a series of post hoc hypotheses. The groups were found to be low on cohesiveness defined behaviorally, saliency, cognitive structures for reframing common dilemmas, and limited in the range of therapeutic experiences.