Facilitating Individuation Processes in Supervision Groups Comprised of Co-Therapists Conducting Group Therapy with Bereaved Parents

Helping Israeli bereaved parents work through losses and anger poses great emotional challenges for group therapists. Separation-individuation becomes an issue for both mourners and conductors alike. Supervision groups composed of such co-therapists often go through unique stages in the course of their development. The conflict between a defensive belonging to a dyadic subgroup with their co-therapist on the one hand, and involvement with the supervision group and its leader on the other, are the main reasons for this uniqueness. In these stages, special difficulties in the co-therapist's separation/individuation may be observed and furthered. An important emotional function we call reverse parallel process can be activated in supervision groups, and can eventually influence the therapy. It is achieved in the supervision through the containment and working through of difficult emotions disowned by the therapy group. What seemed to be an obstacle to the group's development, if processed by the co-therapists, can enable patients to work through their difficulties and improve their functioning. If, on the other hand, the co-therapists' separation/individuation development is faulty, containment dysfunction may burden the receptiveness and working through of dreadful projections, and result in massive acting-out. The rich Israeli experience in this field could contribute to cope with similar group situations.     

Psychoanalytic Psychotherapy for Severely Disturbed Borderline Patients: Observations on the Supervision Group of Psychotherapists

The authors describe the role of a supervision group of psychotherapists within a wider therapeutic field for severely disturbed borderline patients. The group concentrates on the transference and countertransference, seen according to Racker’s distinction between concordant and complementary identifications. The implications of the prevalence of the complementary identifications over the concordant identifications of the therapists to their patients and the resulting regression to primitive defense mechanisms can be counterbalanced by the group’s integrative functioning as receiver (1) of a variety of information about the patient, (2) of the therapist’s attempt to understand and synthesize, and (3) of the therapist’s countertransference reactions to his patient. The major discrepancies between the various conceptions of the borderline patients’ psychic world and the appropriate therapeutic technique to be applied are also discussed, as well as the way the group filters the information and integrates the therapeutic thought. It might be said, therefore, that, in the “inpatient” phase of the individual psychotherapy, the group of psychotherapists functions, for the patient and the treatment, in a synthesizing context, as it provides the therapist with a space of integration for his split-off part of self and object representations, which the therapist makes use of for his patient.*Members of the Athens University Project for Borderline Patients’ research team consisting of psychoanalysts and psychotherapists, Eginition Hospital, 74 Vas Sophias Avenue, Athens 11528, Greece.Maria Chatziandreou, M.D., is a member of the Hellenic Psychoanalytical Society.Haris Tsani, M.D., is a candidate of the Hellenic Psychoanalytical Society.Nikos Lamnidis, M.D., is a candidate of the Hellenic Psychoanalytical Society.Claire Synodinou, Ph.D., is a member of the Paris Psychoanalytical Society and an associate professor at Panteion University, Athens.Grigoris Vaslamatzis, M.D., is a training analyst of the Hellenic Society of Psychoanalytic Psychotherapy and an associate professor of psychiatry at Athens University.Address correspondence to: Maria Chatziandreou, M.D., 1-3, Skippi Street, 11525 Athens, Greece.     

团体心理治疗中凝聚力的概念及测量研究述评

团体心理治疗中的凝聚力最初多被定义为人际信任、吸引和卷入,随着研究的深入,凝聚力的概念逐渐向多维的方向发展。对凝聚力的测量主要有MacKenzie的团体氛围量表、Lese等的治疗因素-凝聚力分量表及Piper的凝聚力量表等。目前团体心理治疗领域的研究对凝聚力的认识缺乏一致性。从凝聚力的概念建构着手,探索团体心理治疗过程,开发评估工具,构建系统的理论和模型,是值得国内研究者关注的方向。     

Aggression Observation Scale for Group Psychotherapy

An observational scale to record aggressive behaviors, defenses, and interventions that occur during a psychotherapy group has been developed. Content and process items were included. The content items focus on the spoken material and are on a continuum of increasing group members' awareness of and responsibility for their anger. The process items are directed to underlying psychodynamic issues on a continuum from avoiding anger, to indirect and then expression of anger. Leader interventions (responses) are also included. The development of the scale, the Aggression Observation Scale for Group Psychotherapy (AOSGP), is described including pilot testing and reliability and validity findings.     

Group Psychotherapy in the Context of Cultural Diversity

The authors review the salient issues involved in therapy with culturally diverse populations. They present a framework where group therapy addresses those issues. Clinical vignettes from each of the authors serve to illustrate the power of group therapy with ethnocultural populations.     

Shame, Women, and Group Psychotherapy

This paper addresses gender-related experiences of shame, focusing on the shame-prone woman. Specifically the varied manifest behaviors, dynamics, and defenses commonly observed in shame-prone women are described. It is recommended that the addition of group therapy to individual treatment, once the client is ready, can expedite progress for these patients, as they are more able to integrate previously disowned and shamed aspects of themselves. A number of potential problems when working with these patients in group are identified and explored.     

Analytic Group Psychotherapy: A Uniquely Effective Crisis Intervention

This paper describes the author's experience doing crisis intervention with survivors of the 9/11 attack on the World Trade Center in New York City. It focuses on enhancing the understanding of and potentially expanding the theory and technique of analytic group therapy as applied to this unique situation.Private practice in     

Ethnicity, Culture, and Group Psychotherapy

Ethnicity and culture have great therapeutic import in the practice of group psychotherapy, especially given the increasing diversity of the population of North America, and this issue has not received appropriate recognition in the literature. In this paper these terms are defined, and the literature is reviewed. Ethnicity, culture, and psychopathology are discussed, focusing on treatment issues including transference, countertransference, resistance, group cohesion, group process, and multi-ethnic groups. The group therapist must be knowledgeable about ethnic and cultural issues in the lives of the group members in order to promote group cohesion and therapeutic effectiveness. The recognition and exploration of ethnic/cultural differences enhances the work of the group. Recommendations for treatment are discussed.     

Chaos, Group Psychotherapy, and the Future of Uncertainty and Uniqueness

This paper explores the application of chaos theory, a new non-linear dynamical theory, to the understanding of psychotherapy groups. Two features of psychotherapy groups that have been insufficiently described or explained, uncertainty and uniqueness, are considered in the light of the chaos theory notion that groups proceed through periods of order and disorder. The recommendation is made that chaos theory be explored further as the field moves into the millennium and a hundred years of its own existence.     

The Future of Training and Credentialing in Group Psychotherapy

High-quality group psychotherapy training is seen as more important than ever in the current health care environment. The training opportunities available at present are assessed. It is argued that there is a body of knowledge about generic group psychotherapy that can and should be taught, and that there are appropriate people to teach it. Credentialing is discussed, and it is suggested that the assessment of actual work in clinical situations must be emphasized if such efforts are to be meaningful.     

Self Psychology, Dreams and Group Psychotherapy: Working in the Playspace

This paper presents one leadership style within a self-psychological approach to working with dreams in group psychotherapy. It stresses an empathic attunement, the creation of safety, and an experience-near playful relationship. Playful is not used lightly here. It is used in the spirit of Winnicott's intermediate space where a mother suspends questions of what is real or not real and what is me and not me. Freud's analogy to a playspace forms a metaphor for the creation of a special atmosphere in a group, or for that matter in individual work as well, that encourages exploration, risk taking, and vulnerability. Working with dreams in this playspace deepens the curative process, not only for the dreamer, but for the entire group.     

Confrontation Group Psychotherapy with Gifted, Dually Diagnosed, and Self-Destructive Adolescents in a Residential Setting

An adolescent mutation has proliferated since the late 1960s who has been immune to traditional therapeutic and educational approaches. It takes a new breed of group leader to work with this difficult-to-treat youth, who either self-medicates abusing psychoactive substances and/or takes prescribed and potent psychotropic medication. Innovative and humanistic treatment techniques are needed to convince an unconvinced youth to use, rather than abuse, superior intellectual and artistic abilities.     

Cultural Psychotherapy: A Consideration of Psychosocial Class and Cultural Differences in Group Treatment

Most psychotherapists are aware of the many social issues and cultural factors that influence development throughout each individual life. Human nature, being a social nature, exists within relationships to others, the community, and a culture, sometimes a mixture of cultures. One social parameter, social class, redefined here as psychosocial class, has not received the same attention from psychotherapists as gender issues or ethnicity, two other important sociocultural spheres of influence on everyday life. It is suggested that group therapists are in a unique position to develop a cultural psychotherapy that addresses psychosocial class and cultural aspects of mental health. This paper includes a preliminary model of cultural psychotherapy that highlights the psychology of social class and culture for psychodynamic group psychotherapy.     

A Leader-Led Supervision Group as a Model for Practicing Genetic Counselors

With the stage set by the overview of supervision models in the previous paper, thispaper now presents the development and evolution of a currently ongoing leader-ledsupervision group for experienced genetic counselors. I discuss the procedures forgetting started; the creation and maintenance of the contract; typical issues and themesconsidered; the format for case presentation; and the overall growth of the group and itsmembers.     

Therapist Role in Narrative Group Psychotherapy

With its assumptions about the interpersonal origins of individual learning, narrative theory suggests certain leadership functions for group therapists: providing a perspective on how multiple meanings may be constructed about experience; leading the process of deconstructing individual narratives through careful questioning to distinguish persons from problems; enlisting participants in active awareness and engagement with group dynamics and group process; and enabling the co-creation of a group narrative through the development of a new community of conversations.     

Therapist Self Disclosure in Group Psychotherapy from an Intersubjective and Self Psychological Standpoint

The history of therapist self disclosure is traced from the early struggles of Ferenczi and Burrow to its valued, yet still ambivalent, contemporary status. The symmetry of self disclosure by therapist and group members is differentiated from the parity of their different roles and responsibilities. Using a case example, the process is discussed through which a therapist's self disclosure fosters task-appropriate satisfaction of selfobject needs as it also helps group members articulate and loosen archaic selfobject binds. The therapy group is described as a transitional space within which a therapist's disclosure offers members an intersubjective bridge to the therapist as well as a model for members' own active participation in the group's work.     

精神科住院患者团体心理治疗准备性会谈与治疗后访谈初探

精神科住院患者团体心理治疗较门诊患者团体心理治疗存在临床情境的特殊性,本研究探索将准备性会谈与治疗后访谈纳入治疗计划,治疗前向患者普及住院治疗、心理治疗的知识,澄清团体心理治疗的形式、目标、内容,了解患者对团体心理治疗的疑问、期望,允许患者做出是否参加治疗的决定,并在治疗后的访谈中强化疗效因子。     

Beyond Emotional Intelligence at Work:: Adding Insight to Injury Through Group Psychotherapy

The author applies the popular concept of Emotional Intelligence (EQ) to the group treatment of work problems. Adding psychodynamic insight to the existing EQ dimension of understanding emotions and utilizing emotional awareness, helps patients improve their reactions to problematic situations and individuals. By focusing on discordant episodes that arise in group, the author employs a systematic approach to identifying unconscious contributors to diminished job performance. Methods for assessing deficits in EQ and for processing relevant group discords are described. Clinical illustrations are provided.     

The Interplay Between Therapy and Supervision

This paper examines the relationship and interplay between therapy and supervision; and how the therapist who has particular similarities to the patient brings her own armentarium of defenses as well as life problems into the therapeutic and supervisory space. The paper explores how unconscious factors from childhood become reenacted in the therapeutic space and produce emotions that affect both patient and therapist. The paper describes in detail an upward as well as downward parallel process acted out by the therapist and patient in the transference–countertransference encounter along with the supervisor's conscious and unconscious role in this process. The paper concludes by offering recommendations to beginning analytic therapists.