Group psychology in the totalitarian system: A psychoanalytic view

The author discusses the ideas of three important psychoanalytic thinkers about group processes in large social groups: Sigmund Freud, Wilfred Bion, and Erich Fromm. Their ideas are developed and applied to analysis of group processes in totalitarian systems, as they were known to the author in Czechoslovakia and the Soviet Union. In conclusion, treatment considerations as they apply to patients who grew up in these regimes are developed and illustrated by clinical cases.This paper is dedicated to Dr. Alexander Wolf, who made his groups growth-promoting, free and holding environments.The author wants to thank Valerie Angel, M.S.W., Eva Papiasvili, Ph.D., Susan Kavaler, Ph.D., Maria Luisa Bastos, Ph.D., and Nancy Smith for their support, critical commentary, and helpful suggestions.     

The ecological validity of laboratory and analogue assessment methods of ADHD symptoms

An important question in the attempt to generalize laboratory findings on attention deficit-hyperactivity disorder (ADHD) children to clinical issues concerning their assessment, diagnosis, outcome, and treatment response is the ecological validity of the commonly used tasks and analogue behavioral observation procedures. This paper examines the concept of ecological validity and issues inherent in its evaluation. The evidence from a variety of sources is then reviewed on the relationship between laboratory methods of assessing inattention, impulsivity, and overactivity and measures of these same constructs in natural settings. Additional findings pertaining to this issue from a recent study of 140 ADHD and normal children and 159 ADHD and normal adolescents using a multimethod battery of tests are also reported. In general, the ecological validity of most methods is of a low to moderate degree, with some traditional laboratory tasks proving unsatisfactory. A few tasks demonstrated acceptable degrees of ecological validity but even these require improvement. It is concluded that future advances in ecological validity are likely to come from: (a) a greater reliance on assessments of the target behaviors in natural settings and (b) combining several of the more promising tasks and analogue methods into a battery that is taken over longer time intervals than has been customary and averaged across repeated administrations.An earlier version of this paper was presented at the International Symposium on Attention Deficit Hyperactivity Disorder, Amsterdam, The Netherlands, April 6 and 7, 1989. The author wishes to thank Charles E. Cunningham, Ph.D., Susan Campbell, Ph.D., Mark Rapport, Ph.D., Eric Mash, Ph.D., and Herbert Quay, Ph.D., for their comments on an earlier version of this paper, and to Marcel Kinsbourne, M.D., for his comments on the presentation itself. The author was supported by funds from NIMH grants 41464, 41583, and 42181 during the preparation of this review.     

Self psychology and group therapy

This paper illustrates how the theories of Heinz Kohut elucidate the curative aspects of group treatment. Group therapy is an ideal milieu in which mirroring, idealizing and alterego transferences can be experienced and worked through. Transmuting internalizations, or psychic structure building, occur when optimal frustration of these needs can be provided by available selfobjects. In group therapy a patient can use the group-as-a-whole, the individual members as well as the leader as potential selfobjects. With the help of individual sessions to reflect on group encounters, a patient can gain a more fully integrated therapeutic experience.The author wishes to acknowledge Susan Sands, Ph.D., Jane Jordan, M.S.W., and Ruth White, Ph.D., for their help.     

Support groups for medical caregivers of people with HIV diseases

As we enter the second decade of AIDS, medical caregivers are experiencing stress and burnout as a result of their work with people with HIV diseases. There are common themes to the stress, as well as differences in the experience of stress according to the characteristics of the healthcare setting. Caregiver support groups are a means of reducing this stress by helping medical caregivers cope better, manage difficult cases, normalize their feelings, put understanding and context to their experiences, decrease isolation, and instill meaning in their work. The use of support groups across various medical settings is presented.The author wishes to acknowledge the assistance of Nicholas Covino, Ph.D., Peter Kassel, Psy.D., Randall Paulsen, M.D., Veronica Rempusheski, Ph.D., Dan Silverman, M.D., and Susan Burns Tisdale, R.N., in ongoing research regarding caregiver support groups. The author also wishes to express gratitude to Genya Bernstein, Psy.D., for many editorial contributions.     

Medication dynamics in group psychotherapy

The use of medications in insight-oriented groups has not been adequately investigated. We report a group in which the anxiolytic buspirone appeared to be associated with attractiveness to the group in the face of impending therapists' termination. We feel that in this group, medications became a variable associated with group cohesiveness, served as a vehicle for the expression of group dynamics, and as an indicator of regression within the group. These observations suggest that, under certain circumstances, medications may become an important variable in the process and expression of group dynamics.They would like to thank Myron Pisetsky, M.D., for reading the original draft of this paper, and are also indebted to Daniel O'Neil, Ph.D., for his input.     

Using group therapy to foster the psychosexual development of patients with eating disorders

When eating-disordered patients participate in long-term eating-dis-order groups, they move through phases of group development that parallel phases of psychosexual development. In the trust (oral) phase, members have an opportunity to experience a positive symbiosis, a suitable holding environment, and optimal frustration. In the control (anal) phase, members learn to identify and express anger constructively. In the intimacy (oedipal) phase, members learn to compete and be intimate. Individual and group movement is facilitated by the group leader being able to identify stages of group development and being able to utilize phase-related techniques.Many thanks to Anne Alonso, Ph.D., Robert Dies, Ph.D., and Geraldine Alpert, Ph.D., for their critiques of the first draft of this paper.     

Revolt in the garden of eden: An alternative group model

The most common model used to highlight the significant features of a group revolt has been Freud's primal horde myth. In this essay the utility of this model will be briefly reviewed, then its most apparent limitation will be addressed. To wit, in this model the women play no active part in the revolution. On the other hand, as a model for group behavior the myth of the Garden of Eden preserves much of what is valuable in the primal horde myth, including the oedipal paradigm inherent in the revolution and, at the same time, offers a critical psychological understanding of the very active involvement women do have in groups before, during, and after the revolt. This is the main focus of this essay and will be explored in depth. Concomitant with this exploration, certain commonly observed behaviors of male group members during this critical phase of group life can also be better understood. Furthermore, the Garden of Eden myth highlights other important facets of the group revolt, and these will be noted. Finally a clinical example will be explored that vividly underscores the value of this alternative model.The author is grateful to Thomas Kohut, Ph.D., W. Donald Ross, M.D., and Walter Stone, M.D., for their valuable comments on an earlier version of this paper.     

Introducing the living with illness group: A specialized treatment for patients with chronic schizophrenic conditions

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.The authors would like to thank Bruce Levine, Ph.D., and Terry Fujeoko, Ph.D., for their assistance with the initial formation of the group. Mr. Howe and Dr. Fujeoko originated the Living with Illness group and began the first group in 1985 at Waterbury Hospital Health Center, Waterbury, CT.     

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.     

Self-efficacy and depressive affect in college students

In an attempt to extend Bandura's theory of self-efficacy, we investigated the hypothesis that increases in self-efficacy, based on mastery experiences, would lead to improvements in mood and problem solving among dysphoric subjects.College students (N=79), classified as dysphoric or nondysphoric by the Beck Depression Inventory, were randomly assigned to anagram training groups that received bogus bar graphs suggesting either task ease or difficulty. Before and after training, subjects rated themselves on depressive affect (DACL) and self-efficacy. A difficult anagram task and a final DACL rating completed the procedure.Anagram training conditions did not lead to differential self-efficacy. However, multiple regression analyses showed that self-efficacy was related to depressive symptoms. Greater DACL decreases after training were seen in dysphoric subjects who reported higher posttraining self-efficacy. This improved mood is consistent with Bandura's theory. An unexpected finding among dysphoric subjects was that the higher their self-efficacy was, the lower was their final anagram performance. It appears that dysphoric/high self-efficacy subjects may have become more demoralized than dysphoric/low self-efficacy subjects when they encountered a need for much greater effort expenditure on the difficult anagram task.The findings suggest that skills training interventions which raise self-efficacy may be most effective in reducing depressive symptoms. The relevance of effort expenditure to the development of competine in depressed undiriduals appears to merit further investigation.where he served previously as Director of Clinical Psychology and as Chairperson of the Department of Psychology.Jeffrey Schwartz, Ph.D., a clinical psychologist, has been a staff member at the Cliffwood Mental Health Center in Englewood, New Jersey for the past five years. He is also engaged in private practice in New York City.Jefferson M. Fish, Ph.D., is Professor of Psychology at St. John's University in New York City, where he served previously as Director of Clinical Psychology and as Chairperson of the Department of Psychology.This paper is based on the first author's Ph.D. dissertation in Clinical Psychology at St. John's University under the direction of the second author. Both authors wish to thank Jeffrey Nevid and John Hogan for their support and contributions as committee members, and Marc Garcia for his invaluable assistance with data analysis. Requests for reprints should be addressed to the second author, Department of Psychology, St. John's University, Jamaica, New York 11439. All other correspondence should be directed to the first author at the same address.     

Treatment of alcoholic couples in outpatient group therapy

This paper summarizes special issues that group leaders are likely to encounter when adapting their skills to outpatient group therapy with alcoholic couples. More specifically, the paper: (a) discusses the advantages of treating alcoholic couples in a group as opposed to individual couple's therapy; (b) outlines the parameters of a couples group with alcoholic members that differentiate it from working with other kinds of couples in group; and (c) provides guidelines and techniques for tackling some of the specific kinds of problems and situations that arise.This paper was presented at the Annual Meeting of the American Group Psychotherapy Association, New York City, February, 1985.The author wishes to acknowledge the contribution of Geraldine Alpert, Ph.D., whose thoughtful comments and discussion helped to crystallize the concepts presented.     

Relationship: The bridge to the delinquent child

Summary We have attempted to isolate a crucial component in work with juvenile delinquents and their families. This component, defined as relationship, is felt to be the link between the disorganized, infantile, self-destructive world of the delinquent child, and the organized, productive world of society.We feel that those engaged in either individual or mass efforts to help delinquent children and their families are not operating in opposition to each other. We feel instead that these efforts can complement each other when they are organized, systematized, and utilized along a continuum that has meaning for each individual child and his family. We have expressed the idea that this crucial relationship or bridge can be established, nourished, and built skillfully under controlled conditions by many kinds of trained people.The concept of relationship which is developed in this article is very heavily based on the extensive work done in this area by the following persons: Irving Kaufman, M.D., Harry Durkin Jr., M.D., Thomas Frank, M.D., Lora W. Heims, Ph.D., Dorothea Jones, M.S.S., Joan Zilbach, M.D., and Joy Rabinowitz, M.S.S.The author gratefully acknowledges his long association with this group and the opportunities to crystallize and utilize the concept of relationship building in his work with the Massachusetts Society for the Prevention of Cruelty to Children, the Judge Baker Guidance Center, the Roxbury Chronic Problem Family Project, the Massachusetts Division of Legal Medicine, and the Massachusetts Youth Service Board.     

Recovery and Renewal: Journey of Hope to the Gulf Coast

When a group of 20 college students and seven adult leaders traveled to the Gulf Coast to repair houses damaged by Hurricane Katrina, they did not realize the multiple ways that they themselves would be renewed. Finding God in the struggle, celebrating diversity, and living with gratitude became the result that subtly changed many lives. Fredrica R. Halligan, Ph.D. is a spiritually-oriented clinical psychologist. She is currently Director of the Counseling Center at Western Connecticut State University and author of Listen Deeply to God: Exploring Spirituality in an Interreligious Age.     

Collaborative learning in engineering ethics

This paper discusses collaborative learning and its use in an elective course on ethics in engineering. Collaborative learning is a form of active learning in which students learn with and from one another in small groups. The benefits of collaborative learning include improved student performance and enthusiasm for learning, development of communication skills, and greater student appreciation of the importance of judgment and collaboration in solving real-world problems such as those encountered in engineering ethics. Collaborative learning strategies employed in the course include informal small group discussions/problem solving, role-playing exercises, and cooperative student group projects, including peer grading. Student response to these techniques has been highly favorable. Realizing the benefits of collaborative learning is a challenge to both teachers, who must give up some control in the classroom, and students, who must be willing to take greater responsibility for their learning. An earlier version of this paper was presented by the author at a mini-conference, Practicing and Teaching Ethics in Engineering and Computing, held during the Sixth Annual Meeting of the Association for Practical and Professional Ethics, Washington, D.C., March 8–9, 1997 The author teaches courses in Science, Technology and Society and is Director of the Benjamin Franklin Scholars Program, a dual-degree program in engineering and humanities/social sciences.     

The shattered mirror: Treatment of a group of narcissistic patients

Increasingly, group psychotherapy takes its place as a valid treatment model for patients with severe character pathology. This paper explores the impact of group treatment on a homogeneous group of patients with narcissistic character problems. The clinical example serves to illustrate the particular dynamics of this patient population; addresses the challenges inherent in treating these patients in a homogeneous, long-term therapy group; and, finally, underscores the countertransference pitfalls in such a clinical situation. Nonetheless, the successful working through of some of these patients' terrifying pathology supports the important of continuing experience and research into this arena.The author wishes to acknowledge with gratitude the invaluable assistance of J. Scott Rutan, Ph.D., in the planning and preparation of this clinical report.     

Sex role orientation and marital satisfaction in dual- and one-provider couples

Scores on the Baucom scales of Masculinity (MSC) and Femininity (FMN), and on three scales from the Snyder Marital Satisfaction Inventory, were obtained from samples of dual- and one-provider couples. Data on rewards and difficulties of the dual- and one-provider lifestyles were collected by means of open-ended questions. The two groups of couples did not differ in sex role orientation or marital satisfaction. The men's levels of MSC were positively related to their marital satisfaction in both groups, and the women's levels of FMN were especially important to couples' satisfaction in the dual-provider group. In both groups, cross-sex scores (women's MSC and men's FMN) were positively related to couples' satisfaction with marital companionship.Bernadette Gray-Little, Ph.D., W. Grant Dahlstrom, Ph.D., and Elizabeth Rossman, Ph.D. are gratefully acknowledged for the guidance and support they provided to the author during this research.     

Psychology and the soul

Otto Rank (1884–1939) wrote the present work at the height of his creative powers, betweenWill Therapy andArt and Artist. Here he presents a sweeping history of psychology—individual and social—from the animistic era to psychoanalysis. An earlier translation (by William D. Turner, 1950) was incomplete and somewhat inaccurate. Unlike Sigmund Freud, his mentor, Rank viewed religion with respect and clarifies its role in individual and communal life through this study of soul-belief through the ages. The book contains important insights on immortality, will, dreams, Judaism and Christianity, Hamlet and Don Juan, Jung and Adler, and Freud himself. (Translated by Gregory C. Richter and E. James Lieberman) Ph.D., is Associate Professor in the Division of Language and Literature, Truman State University, Kirksville, Missouri. He translated Otto Rank'sThe Incest Theme in Literature and Legend (1912), Johns Hopkins University Press, 1991. E. James Lieberman, M.D., author ofActs of Will: The Life and Work of Otto Rank (1985), is Clinical Professor of Psychiatry, George Washington University School of Medicine. This excert from the book of the same title by Otto Rank is printed with the permission of the publisher, The Johns Hopkins University Press, for which we are grateful.     

Internment and ministry: A dialogue with Joseph Kitagawa

This dialogue presents a profile of the late Joseph Kitagawa—a renowned scholar of the history of religions (Religionswissenschaft). It focuses on comparative religion and philosophy, as well as several other important issues related to his distinguished career as an Episcopal priest and dean of the Divinity School of the University of Chicago. They are: his experience of American concentration camps during World War II; Christian atheism and new theological models; concepts of time in Oriental and Occidental faiths; depth-psychology and contemporary ministry; and Paul Tillich's significance for the pastoral counseling movement.David M. Moss, Ph.D., Th.D., is the Book Review Editor of thisjournal and the Past President of the Georgia Chapter of the American Association's Division of Psychoanalysis. The interview is part of a series that will be published in a volume entitledDialogues in Depth Psychology and Religion.