The function of the therapist's affect in therapeutic conflict in groups

Group psychotherapy theory and technique are presented with the goals of helping group practitioners working with difficult clients: 1) develop a treatment plan; 2) create a therapeutic alliance; 3) foster a responsive group climate; and 4) utilize the therapist's countertransferential reactions in dealing with therapeutic conflict. Historical modifications of the analyst's role in the development of group psychotherapy are noted. Emphasis is give to the recognition of therapist-client identifications in order to separate feelings induced in the therapist from countertransferential reactions, to enable the practitioner to respond appropriately to the affective and inspirational substratum of therapeutic groups.     

Trauma, reverie, and the field

The author uses a clinical vignette to demonstrate complex concepts at work--concepts such as those derived from a productive grafting of Bion's thinking onto the concept of the psychoanalytic field. The underlying theory is narrated by the use of images, which the author finds to be the most appropriate way to demonstrate this theory at work--a theory of the mind based on the concept of digestibility of emotions, as well as the progressive introjection of instruments to render such an operation possible. Key points include the waking dream thought, the analyst's reverie, unsaturated interpretations, continual re-dreaming on the content of the session as permitted by the field, and the development of the ability to metabolize emotional contents.     

The group therapist's absence and the substitute leader.

When a group is led by a single individual the therapist's absence creates a management problem. This article presents several options for the solo leader. The author has used a substitute leader, and this experience is presented and evaluated. Discussion includes selection of a substitute, group preparation, on-going use of the substitute, and benefits of this alternative for the management of the leader's absence.     

Associative dreaming: reverie and active imagination

The idea of countertransference has expanded beyond its original meaning of a neurotic reaction to include all reactions of the therapist: affective, bodily, and imaginal. Additionally, Jung's fundamental insight in 'The psychology of the transference' was that a 'third thing' is created in the analysis, but he failed to demonstrate how this third is experienced and utilized in analysis. This 'analytic third', as Ogden names it, is co-created by analyst and analysand in depth work and becomes the object of analysis. Reverie, as developed by Bion and clinically utilized by Ogden, provides a means of access to the unconscious nature of this third. Reverie will be placed on a continuum of contents of mind, ranging from indirect to direct associative forms described as associative dreaming. Active imagination, as developed by Jung, provides the paradigm for a mode of interaction with these contents within the analytic encounter itself. Whether the analyst speaks from or about these contents depends on the capacity of the patient to dream. Classical amplification can be understood as an instance of speaking about inner contents. As the ego of the analyst, the conscious component, relates to unconscious contents emerging from the analytic third, micro-activations of the transcendent function constellate creating an analytic compass.     

Privacy, reverie, and the analyst's ethical imagination

The author illustrates varying ways of using and thinking about forms of analytic reverie and the analyst's privacy. He discusses a few different registers from which the analyst can illuminate points of transference-countertransference enactment. The modality by which the analyst communicates these formulations of unconsciously held object relations and defenses varies and includes verbal interpretation through symbolic speech, interpretive action (Ogden 1994a), and, at times, interpretations that involve a construction of the analyst's subjectivity put forward to enhance the patient's understanding of enactments of the transference-countertransference. The author develops a concept, the analyst's ethical imagination, defined as the ways in which we consider and anticipate the implications of our interpretations.     

Superego transformations through the analyst's capacity for reverie

The author discusses the application of certain Kleinian and Bionian principles to psychoanalytic work with patients who suffer from symptoms arising out of pathological superego functioning. Clinical vignettes are presented to demonstrate how the analyst's willingness to employ reverie, and to move from conviction-based interpretations to more open and tentative ones, can help such patients to change maladaptive behavioral patterns that may have stemmed from early interactions with an unavailable or nonreceptive Other.     

Guarding confidentiality in clinical groups: the therapist's dilemma.

This study examines the confidentiality practices of highly experienced, well-trained group psychotherapists. A provocative finding was that practitioners rarely inform prospective clients of confidentiality limitations. Their reluctance to do so appears to be based upon the belief that it might discourage persons from entering treatment, as well as having negative ramifications for the therapeutic process (e.g., members may be less likely to talk about unprotected topics). The prevalence and content of breaches in confidentiality are explored. Ethical, legal, clinical, and educational implications of these and other findings are addressed. Research recommendations are offered.     

The therapist's self in dialogical family therapy: some ideas about not-knowing and the therapist's inner conversation

In this article, the focus is on the therapist's self, which will be in line with Bakhtin's thinking, viewed as a dialogical self. First, the dialogical view of the self is situated in the context of psychology's traditional focus on the individual self. Then, leaning on Bakhtin and Volosinov, the self is described as a dialogue of multiple inner voices. Some of the implications of this concept for family therapy practice are examined, focusing especially on the therapist's participation in the therapeutic process and on the therapist's inner conversation. The author argues that not-knowing does not only refer to the therapist's receptivity and respect but also implies that the therapist is aware of his or her experience and reflects on how his or her inner conversation might inform and enrich the therapeutic conversation. Finally, these ideas are illustrated with a brief clinical vignette.     

Projective identification and the therapist's use of self

This article addresses how therapists can recognize and therapeutically utilize client projective identification in therapy. Splitting and projective identification are conceptualized as occurring in sequence. Transference, countertransference, and projective identification are discussed as interrelated phenomena, which underlie the therapist's effective use of self as an instrument in therapy. A three phase intervention process, which emphasizes the importance of the timing of interventions, is introduced.     

Countertransference and the group therapist's state of mind

In this paper countertransference is discussed as an interference in the psychotherapists' state of mind. For the group psychotherapist the interferences have multiple origins. Oscillating demands for closeness to the group or distance from patients are indicators of complex dynamics. Inherent in group psychotherapy is the requirement of multiple identification with objects covering a developmental range for the therapist. A schematic model for the therapist's state-of-mind is offered in the hope that there can be greater clarity when countertransference is discussed.Paper presented at EGPS annual conference, Nov. 1, 1980.     

Bonding in group: the therapist's contribution

Bonding is an ongoing aspect of intersubjective experience, a type of mental relationship to oneself and others. As a behavioral mode, bonding utilizes verbal and nonverbal communication primarily to establish a basic feeling of connection between individuals. Bonding is the floor, a cognitive-affective state that precedes and prepares the way for the complex processes underlying identification. The concept relates to Bion's early theory of basic assumptions, and takes on new and different meanings according to his later ideas regarding social communication. Bonding is also a therapeutic posture or technique, an element in the establishment of group cohesion, the positive transference, and therapeutic and group alliance. Case examples illustrate how the therapist and other group members bring a complex of bonding needs and anxieties that must be negotiated to establish and maintain bonding, which is a necessary condition for successful therapeutic work.     

Unconscious perception and reverie: an intersubjective connection*

This paper discusses an intriguing topic for psychoanalysis: the concept of unconscious communication. Beginning with the concept of unconscious perception, it moves on to figurability and culminates with reverie. Auxiliary concepts, such as receptive unconscious, intersubjectivtiy, countertransferrence and empathy, are discussed in order to articulate the conceptual network on which theoretical arguments are based.     

Correlates of therapist's religious attitude and conservatism

This study examined the relationship between therapists' religious attitude in therapy, measured by the Therapist's Religious Attitude Scale and conservatism measured by the Wilson–Patterson Attitude Inventory. The 80 participants, 22 males and 58 females, were solicited from the American Psychological Association list server. Participants who endorsed a religious affiliation reported a more positive attitude to discuss religion in therapy and a higher conservatism and anti-hedonism. The higher score on the Therapist's Religious Attitude Scale was positively correlated with higher scores on conservatism, antihedonism, religion, and militarism subscales, and negatively correlated with the realism subscale score of the Wilson–Patterson Attitude Inventory. The clinical implications of these findings and the impact in therapy were discussed. It was advised that the therapists seek consultation when necessary.     

The therapist's anxiety and resistance to group therapy

When therapists contemplate starting groups, consider placing an individual patient within an existing group, or respond to the group reconfigurations when members are added or replaced, it raises their anxieties and resistances. Under these circumstances, the therapist must contend with many intersubjective factors: dread, fear, and idealization of groups; contagion and amplification of psychological phenomena; absorption in the group mentality; magnification of the therapist's centrality and importance; exposure and disturbance of existing relationships, and utilization of one's own emerging and evolving thoughts, feelings, and fantasies, along with the group's. Therapists learn about themselves and their groups by reviewing their countertransference, being alert to possible enactments, and listening to their patients, whose anxieties and resistances to group often reflect their own.     

Sanctuary and presence: An existential view of the therapist's contribution

Abstract

This inquiry endeavors to form an understanding of the summons to caring. The effort will expand upon the work of Milton Mayeroff and Martin Heidegger by way of incorporating an existential interpretation of the Buddhist concept of suffering.     

Symbolic attitude and reverie: problems of symbolization in children and adolescents

In comparison to the 1970s and 1980s, we now treat more children and adolescents who, because they have had traumatic experiences of violence, child abuse, deprivation or chronic physical illness, are not able to adequately use their symbolizing function. The question is which qualities and which analytical attitude we should and can offer in analysis to help a child regain his or her capacity to symbolize, irrespective of how poorly developed or blocked this capacity may be. In contrast to Jung and some Jungians, the author argues that although the transcendent function is a 'natural process' and hence archetypally grounded as Jung maintained, the transcendent function does not work spontaneously. Rather it requires a matrix based on the child's earliest relationship, which can later be re-enacted in treatment. Jung's general concept of a 'symbolic attitude' can be complemented and focused in a specific way through the use of Bion's concept of 'reverie', which contributes in a fundamental way to symbol formation within the transference/countertransference. This idea is illustrated by clinical material from a nine-year-old boy who suffered from a severe congenital intestinal disease and was blocked in his capacity to symbolize. From the perspective of treatment technique, the author shows how the drawing of 'comic book' narratives in a reciprocal exchange was brought into the treatment. The drawings evolved in a way that he understood as a modified form of active imagination with children. The drawing process helped the boy gradually to develop a symbolic space in the therapy and to contain a psychic space in his mind.