Countertransference in group psychotherapy

This paper attempts to up-date our understanding of countertransference in the therapy group setting. After a brief review of some of the psychoanalytic and the group psychotherapy literature dealing with countertransference, the paper points out the vulnerability of the group therapist and presents examples of possible countertransferential situations, such as stereotyped roles, reactions to external aspects of patients, and therapists' insecurities. It concludes by suggesting ways in which group therapists can become more sensitive to their countertransferences.     

Hostility in group psychotherapy

To run a psychodynamic group therapeutically, the leader must understand the meanings and functions of hostility. Fundamental to this task is the leader's awareness of his or her bias toward hostility as a constructive or destructive feeling and willingness to serve as a lightening rod for it. This paper discusses the sources of hostility during different stages of group development. The therapeutic handling of hostility is discussed under the following topics: theoretical considerations, defensive functions, and communicative functions. Case examples illustrate the proper handling of contractual violations, scapegoating, and narcissistic injury. Countertransference reactions to anger and rage in the group are discussed.     

Antidepressants in group psychotherapy

This article alerts us to consider depression as a relatively frequent cause of impasse in the course of group psychotherapy. The authors recommend the combined use of antidepressant medication along with group psychotherapy when such depression is confirmed independently outside the group. Common obstacles and pitfalls preventing successful combined treatment are reviewed; the depressive logjam is differentiated from common resistance; and profiles of responders versus nonresponders are described. A rationale of the combined treatment, its results, and implications for group therapists are all delineated.     

Resistance in group psychotherapy

The authors view resistance generally as healthy and a sign of a more or less intact ego. A brief review of the psychoanalytic literature and the group therapy literature presents resistance as a mechanism that closes off aspects of the internal and external world seen as potentially dangerous. Patient resistances are identified as coming from cultural values, fear of strangers, fear of regression, and resentment toward the therapist. Clinical vignettes of group patients and group interaction are presented. Finally, resistance of therapists and indications of such resistance are also explored.     

Scapegoating in group psychotherapy

The purpose of this paper is to describe and illuminate the phenomenon of scapegoating in group psychotherapy. Specifically, the role of projective identification - on both individual and group-wide bases - in the evolution of the deviant is delineated. Individual, interpersonal, and whole-group interventions are presented along with the technique of functional subgrouping, a relatively new and particularly potent group intervention. Several case vignettes are detailed for illustration.     

Acting out in group psychotherapy

Acting out is a common occurrence in group psychotherapy. After a brief review of relevant psychoanalytic and group psychotherapy literature, this paper presents various kinds of acting out by the individual group members and the handling of such acting out by the therapist, discusses acting out by the group as a whole, and gives a brief overview of acting out by the group therapist. Specific examples are given of acting out and ways of dealing with it.     

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.     

Outcome in short-term group psychotherapy

This study examines the effectiveness of planned dynamic short-term group psychotherapy in a health maintenance organization setting. The groups, conducted by experienced short-term psychodynamically trained therapists, focused on common life-stage issues. A pretest/posttest design was employed; group participants completed a battery of self-report measures before, after, and 4–6 months after treatment. Group participants made statistically (and clinically) significant positive changes on the majority of change measures. They saw themselves as improved on target problems, became far less symptomatic, and reported considerable growth in interpersonal functioning.     

On mirroring in group psychotherapy

“A woman has two images. There is a magical person seen or remembered by those who love her, her finest qualities are flesh and spirit illuminated. She herself knows this ideal self; she projects it, if she is confident; or she daydreams her ideal self; or she recognizes it with gratitude in the admiring eye of others. There is at the same time a second image; the woman as seen by those who dislike or fear her. This cruel picture has an all too powerful mirror in her own negative idea of herself. She sees with fear her own ravaging impulses and most painful of all, a graceless, freakish, and unlovable physical self, this was the mirror her parents held before Edith. Her brothers saw her with love. She herself knew both images. Her life, and her poetry, constituted a flight from the second one.”