Assessing Specific Effects of Inpatient Group Psychotherapy

Abstract

This article will examine how the psychoanalytic idea of containing can be used in group therapy to form a conceptual bridge such that the group dynamics are not simplistically reduced to individual dynamics, nor that the individual is lost in the “group–as–a–whole” concept. I take the concept of “containing” as versatile in the sense that Bion (1970) meant it to be—that is, the psychological phenomenon of containment is manifest at various system levels: intrapsychic, interpersonal, group, and societal. This article will explore how far this “bridging concept” can be pursued to understand groups theoretically. The article will review various forms of containing, following Bion’s ideas, and in particular a therapeutic, or flexible, form in contrast to rigid and fragile forms.     

The Efficacy of Group Therapy in a Case of Marriage Neurosis

Abstract

Corruptogenic organizational dynamics have been largely ignored in reporting about recent corporate scandals. Using a large group framework, the author identifies factors within an organization that create a breeding ground for unethical or illegal behavior and attract individuals unconsciously looking for ways to damage themselves or others. An organizational culture that promotes questionable attitudes and behaviors along with subgroups that produce powerful corruptive forces can destroy a firm and damage the economy. Enron and the Madoff investment group are identified as corruptogenic organizations put together by founders and a leadership core bent on self-destruction and traumatizing the community–outcomes beyond that which are usually linked to greed. Suggestions are provided to organizational consultants and policy makers as to how to determine the potential for corruption hidden in their midst and to implement countervailing structures and processes.     

Practicum of Group Psychotherapy

Abstract

Many studies on therapeutic factors in group psychotherapy were done during the 1970s and 1980s, primarily with Western samples. The present study was carried out in a psychiatric inpatient clinic in Turkey. Using Yalom’s (1975) therapeutic factor questionnaire administered at discharge, patients rated existential factor, instillation of hope and self–understanding as the most helpful factors and identification as the least helpful. There were significant differences among patients with regard to gender, age, education, and comorbid personality disorder, but not with Axis I diagnosis or number of attended sessions. Patients’ and psychiatrist’s ratings showed significant differences. Differences between this Turkish sample and those reported in common Western literature are discussed under the light of relatedness psychology, which is an important concept of cross–cultural psychology.     

Psychoanalytische Neurosenlehre: Eine Einführung (Psychoanalytic Theory of Neuroses. An Introduction)

Abstract

Courage–a mental act that involves a decision to face and deal with emotional pain as honestly as possible without any guarantee of a positive outcome–resides at the heart of the therapeutic alliance and the work of psychodynamic group therapy. The author’s experience suggests that group therapists tend to take for granted or underestimate the courage required to join and participate in a psychodynamic therapy group. Written from the perspective of self-psychology, this article provides a theoretical rationale for courage recognition as a central and crucial leadership function. Examples of courage are presented and contrasted with behaviors that appear courageous but are not. A detailed case example discusses the courage it takes for dyads to work through reciprocal negative transferences. Suggestions are offered to assist the group therapist in recognizing and calling attention to courageous behaviors.

The author discusses some of the pitfalls of our profession’s preference for value–free language and then shows how and why the occasional and judicious use of non–neutral language, courage being an example, can facilitate and deepen group work.     

Some Aspects of Group Dynamics

The authors examine the nature of the relationship between the group members and the group therapist and discuss the reasons underlying therapeutic frame failure. It is argued that competing viewpoints concerning the nature of the therapeutic relationship in group therapy have eventuated in problems in articulating a generally accepted frame definition. The authors propose a formulation of the frame for long-term groups that embraces therapist anonymity, total confidentiality, and neutrality. Finally, instances of frame violation are viewed as stemming from the therapist's need for objects, the attempt to forestall various types of transference, and the need to provide an avenue for the therapist's narcissism. Clinical material is used to illustrate group members' responses to therapist-induced frame failures.     

An epistemological analysis of gossip and gossip-based knowledge

Gossip has been the object of a number of different studies in the past 50 years, rehabilitating it not only as something worth being studied, but also as a pivotal informational and social structure of human cognition: Dunbar (Rev Gen Psychol 8(2):100–110, 2004) interestingly linked the emergence of language to nothing less than its ability to afford gossip. Different facets of gossip were analyzed by anthropologists, linguists, psychologists and philosophers, but few attempts were made to frame gossip within an epistemological framework (for instance Ayim in (Good gossip, pp. 85–99, 1994)). Our intention in this paper is to provide a consistent epistemological (applied and social) account of gossip, understood as broadly evaluative talk between two or more people, comfortably acquainted between each other, about an absent third party they are both at least acquainted with. Hence, relying on the most recent multidisciplinary literature about the topic, the first part of this paper will concern the epistemic dynamics of gossip: whereas the sociobiological tradition individuates in gossip the clue for the (theoretically cumbersome) group mind and group-level adaptations Wilson et al. (The evolution of cognition, pp. 347–365, 2002), we will suggest the more parsimonious modeling of gossip as a soft-assembled epistemic synergy, understood as a function-dominant interaction able to project a higher organizational level—in our case, the group as group-of-gossips. We will argue that the aim of this synergy is indeed to update a Knowledge Base of social information between the group (as a projected whole) and its members. The second and third part will instead focus on the epistemological labeling of the inferences characterizing gossip: our contention is that the ever-present moral/evaluative dimension in gossip—be it tacit or explicit, concerning the objects or the partners of gossip—is best analyzed through the epistemological framework of abduction. Consequently, we will suggest that a significant role of gossip is to function as a group-based abductive appraisal of social matter, enacted at various levels.     

Juegos en Dinamica de Grupo (Games in Group Dynamics)

Abstract

It is widely recognized that military service during wartime can take a toll on a soldier’s psychological health. Recent work has revealed effects on the families left behind as well, as reflected, for example, in an increase in child abuse and neglect in these families. My interest in studying the transgenerational transmission of trauma led me to offer the National Guard a pro bono group therapy for women whose husbands had been deployed overseas. A slightly unorthodox approach paved the way not only to group treatment but, ultimately, individual treatment for these women and their children. My hope is that this work can serve as a model for other therapists who share my interest in treating the intergenerational transmission of trauma by implementing group and mother-child psychotherapy.     

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.     

Group Dynamics and External Life Cycles

On the occasion of the 40th Anniversary of a symposium held on this controversial subject, the history of the relationship between group dynamics and group psychotherapy is reviewed. Within the contemporary framework of pluralism and integration, some guideposts are advanced that might help in the conceptual clarification of the affinity between these two disparate, yet related, fields. This might lead, in turn, to a more refined elicitation of the specific therapeutic factors inherent in the group treatment modality.     

Intensive Group Psychotherapy by George R. Bach

Emotional insight, is essential in order for therapeutic change to take place. Profound resistances to experiencing expressing, and understanding emotions are present in group members, the group as a whole, and the group therapist. Reasons for the three types of resistances are described. Specific therapist attitudes and therapeutic techniques are suggested to understand and effectively work through resistances at individual, interpersonal, and whole-group levels. Examples are given from an ongoing therapy group to illustrate the processes of understanding and working through resistances. Resistances on the part of the group therapist are identified and their possible effects on the group's resistance are explored.     

Group Dynamics in Janis's Theory of Groupthink: Backward and Forward

Janis's groupthink theory is an appealing explanation of how group process can get in the way of optimal decision making. Unfortunately, Janis was selective and not always consistent in his application of research in group dynamics. This paper traces groupthink to its theoretical roots in order to suggest how a broader and more consistent use of research in group dynamics can advance understanding of decision-making problems. In particular, the paper explores and reinterprets the groupthink prediction that poor decision making is most likely when group cohesion is based on the personal attractiveness of group members.     

Spontaneous Personality Synthesis in Group Therapy

Combined therapy is defined as concurrent dyadic and group therapy with the same therapist. This paper focuses on a neglected aspect of combined therapy: broaching and exploring this question with one's individual, patient. The author shows how raising this question: (1) alters the therapeutic field whether or not the patient joins; (2) can sharpen the therapist's understanding of the indications and contraindications for group membership; (3) offers untapped therapeutic approaches and opportunities to clarify issues in the individual treatment; and (4) stirs up countertransference issues related to issues of profitability, the transference of the patient in individual treatment, and the transference of the group-as-a-whole. Several case examples are provided.     

Therapeutic Factors in Adolescents’ Groups With and Without Movies

ABSTRACT

The study explores the therapeutic factors in two types of group interventions–-film therapy (n = 69) and affective support therapy (n = 48) for Arab adolescents (ages 13–14) in Israel. Film therapy is a relatively new method for groups, aimed at enhancing adolescents’ engagement in the process of group counseling. Six-hundred students from 11 schools were screened for the level of parent–adolescent conflict, based on a self-report measure. The 117 students who met the cutoff point constituted our sample. They were randomly divided into 12 small groups (6 in each type of intervention). A previous study reported the outcomes of these two interventions, showing equal progress in both groups (compared to control). The current study explores process variables, specifically therapeutic factors, in an attempt to enhance our understanding of those outcomes. Results indicated common therapeutic factors across both types of intervention. The factors of relationship–climate and other- versus self-focus were ranked the highest and, contrary to expectations, were significantly higher in affective support therapy than in film therapy.     

The Benefits of Group Therapy Observation for Therapists-in-Training

The authors contend, based on a survey of group therapy trainees, that observing an ongoing psychotherapy group in vivo provides an exceptional learning opportunity. Clinicians often experience resistance and anxiety regarding therapy group leadership, and group therapy is notoriously challenging to teach. Trainees consistently described the Group Observation course as one of the most effective training experiences that they have had. The observation group model mitigates many concerns that trainees have about group leadership and inspires enthusiasm and confidence for leading groups. Group observers learned vital group leadership skills, most notably: the ability to bear affect and trust the group process, the ability to follow and use group themes, metaphors, and underlying dynamics, and the ability to highlight attachment themes, work in the here and now, and promote immediacy.     

Proposed Revisions of the By-Laws of the American Group Psychotherapy Association,Inc.

Abstract

The social constructs of the group, the group self of an individual member, and the moral order of the group as a whole are described as basic, interrelated concepts essential to our understanding of scapegoating. Two patterns of scapegoating are then introduced: one concerns antagonistic, the other, agonistic relations of scapegoat to scapegoaters. A series of case examples are presented, one involves an advocacy group of socio-cultural “outsiders;” the other three pertain to scapegoating in therapy group settings. The case materials illustrate the meaning and usefulness of an intersubjective/social constructivist perspective on the problem of scapegoating.     

The Virtue of Gossip

abstract

The moral status of gossip is generally defmed negatively from a Western perspective and, I argue, is or should be accorded a more positive role in African accounts of ethics. In a broadly communitarian vein, I argue that a characteristically Western approach to gossip is problematic - in that it casts a fundamental aspect of human life as moral wrongdoing, does not provide an adequate fit between wrongness and censure, and excludes significant morally positive values realised through gossip - and argue for a more nuanced account. Examining and responding to five arguments for the viciousness of gossip, and proposing four candidate virtues, I develop an account that distinguishes vicious from virtuous forms of gossip.     

Life Cycle Crises

ABSTRACT

As couples are worked with in therapy, the issues they bring, both individually and as a couple, may reflect important developmental crises. This paper describes some of these issues from the perspective of Erikson'S epigenetic theory. Brief case examples are provided to illustrate the presentation and therapeutic course with these issues. While these issues will present strains that bring the couple into therapy, their understanding can also provide considerable motivation for strength and growth, particularly when worked with in the therapeutic arena.     

The Evolution of Business: Learning,Innovation, and Sustainability in the Twenty-First Century

This article-as part of a broader evolutionary inquiry toward human fulfillment, societal wellbeing, and environmental sustainability-explores new frontiers for business. In a rapidly changing global environment, corporations can become evolutionary change agents for the creation of a sustainable global civilization by fostering financial, social, and environmental results. The contemporary metaphors used to describe the business world can be limited in times when an emergent paradigm calls for new visions and actions. An evolutionary understanding, grounded in evolutionary systems theory, can open possibilities for leadership and innovation toward sustainability. Complex systems, such as organizations, need to learn to learn in harmony with the dynamics of their milieu in order to co-evolve and create value. The paper concludes with a reflection on the implications of the evolutionary paradigm for business education.     

A short-term grief and loss therapy group: Group members' experiences

Abstract

This article is an evaluative study of a short-term grief and loss therapy group conducted at a large Midwestern university's counseling center. The group was held for students who had experienced loss through death of a significant person. The author examines brief group psychotherapy, special considerations of the college student's grief experience, an adaptation of the brief group model for grieving students, and data gathered from the members of the therapy group. Students' scores on a grief instrument showed mixed results. Group members made journal entries at four times during the group experience. They reported that the group was a supportive and helpful experience; five of Yalom's (1995) eleven therapeutic factors could be discerned. Recommendations regarding the treatment of grieving students in a group setting are made.