Existential issues in group psychotherapy

Existential issues in group psychotherapy derive from existential thought both as a philosophy and as a value system. Its origins derive from the weakening of traditional values and the growing alienation of man from himself. The unique features of existentialism can be applied to all forms of therapy. These features are universal to humankind. They are finiteness, aloneness, guilt, responsibility, and freedom. In including existential concerns as part of group psychotherapy, therapist and patients move more closely to bilateral relationships and subjective interactions.     

An individual approach to psychotherapy with psychotic patients

In this paper I attempt to explore particular aspects of the therapeutic process, especially the unusual way in which the therapy of this 11-year-old girl, referred for possible or potential anorexia nervosa, came to a sudden end. The oedipal configuration provides a useful theoretical framework in which to consider the course and vicissitudes of treatment. The restoration of a link between the child and her father allowed a distance to be created between mother and daughter. The meaning of this is considered both in terms of external events and clinically within the transference relationship.     

Intensive group psychotherapy of borderline patients

The group modality employed by the authors for the past two years to structurally treat borderline personality patients has proven successful and is presented here for consideration by other clinicians. The authors suggest that the ego deficits that can make the borderline patient a problematic group member are the very deficits that are often best treated in a group setting. The inherent curative factors of groups are discussed in parallel with the structural therapeutic needs of the borderline, and specific strategies and interventions for enhancing borderline structural growth are recommended. Inherent risks of treating this challenging patient population within the group modality are discussed, and suggestions for preempting or minimizing such effects are presented.     

Modified group therapy for psychotic and depressed patients

This paper describes a group treatment program for chronically ill patients which has been found to be more economical than traditional modalities of treatment of such patients and to minimize transference and countertransference problems. Technical guidelines and the theoretical rationale are discussed, as are the therapeutic factors in such a group. Case vignettes are given to illustrate both the group process and the individual patient's use of the group.The authors are deeply grateful to the residents of the department who, as cotherapists, shared in the planning and work of the coffee lounge groups. Invaluable to us also were the interest and ideas of Dr. Donald Miller who served as a consultant to this project.This is a revised version of a paper presented at Grand Rounds, Montefiore Hospital and Medical Center, Bronx, N.Y. in September, 1975.Miss Emery is, and Mrs. Levitan was, a social worker at Montefiore Hospital and Medical Center, Bronx, N.Y. Mrs. Levitan was formerly Principal Associate in Psychiatry (Social Work), Albert Einstein College of Medicine. Dr. Gadlin is Director of the Group Therapy Training Program at Montefiore Hospital and Medical Center, and Assistant Professor, Albert Einstein College of Medicine.     

Existential psychotherapy and the therapeutics of activism*

This paper considers the socio-political perspectives of Sartre, de Beauvoir and Fanon and their relationship to existential psychotherapy practice. It argues that their existential analyses of oppression must play a greater part in informing existential psychotherapeutic practice and pedagogy. In this current neo-liberal political age, in which therapy is increasingly being utilised as a form of psychological coercion and mystification, an understanding of the structures and systems of alienation and oppression that construct experience must translate to a broadening therapeutic concern beyond individual to social change. The author suggests that engaging with a politics of alienation and actively responding to the oppressive social conditions which generate distress and marginalisation should be intrinsic to existential psychotherapy practitioners and their representing institutions.     

Linguistic characteristics of neurotic, borderline and psychotic personality organization

Thirty patients were subjected to a Structural Interview by means of which 10 of them received the diagnosis NPO (Neurotic Personality Organization), 10 BPO (Borderline Personality Organization) and 10 PPO (Psychotic Personality Organization). About 2500 words and groups of words were extracted from the patients' utterances for analysis. The word-frequencies thus found were analyzed by a PLS discriminant analysis which yielded two significant principal components (main dimensions) explaining 57% of the variance. This analysis showed that the three groups of patients are well separated from one another and that there is a definite correlation between personality organization and linguistic variables. The main features of the BPO-patients in this study seem to be that they refer to positions outside themselves and their language is impersonal; we see this as an exemple of a vacillating identity. The NPO-group is characterized by an intense and rich language, signs of a more advanced symbolizing ability, deixis and high level defenses. The language of the PPO-patients is poor and its predominant feature is a lack of words; in our interpretation this indicates foreclosure and a lack of identity.     

Complications in group psychotherapy with AIDS patients

AIDS has a unique set of characteristics that makes group psychotherapy more complex than with other populations: (1) the threat of an early death, (2) a highly variable course of illness, and (3) stigma related to the illness and to the preexisting lifestyles of most patients. The specific ways in which the three factors seriously interfere with establishing and maintaining group cohesion are discussed, and clinical guidelines are suggested. In addition, a model for understanding and working with these and other issues in group psychotherapy, based on Erik Erikson's interpersonal theory of development, is presented. Finally, particular countertransferential difficulties are discussed in relation to the heightened emotionality common to AIDS psychotherapy groups.     

Reflections on group psychotherapy with eating-disordered patients

This paper addresses some of the dynamics, resistances, and transference and countertransference considerations in group psychotherapy with eating disordered patients. Several resistances are delineated, including guilt over being helped, the recreation of early problems around control and forced feeding, and withdrawal as a defensive operation. A brief vignette is presented which highlights the demand on the part of the therapist as well as the patient to contain and manage feelings rather than acting on them. Lastly, the author argues that group participation helps the patient to identify, articulate, and accept feelings and to promote assertiveness.This paper is based on a presentation given at the Training Institute for Mental Health on May 11, 1991.     

Results of short-term group psychotherapy of schizophrenic patients

A seven-week group-centered dynamic therapy course was conducted with 12 patients within the framework of a long-term treatment for schizophrenic patients. The purpose and method of treatment and the course of the group sessions are described. Analysis of the Freiburg personality inventory yielded no changes; the degree of agreement between the group mean profile and that of neurotics was striking. Analysis of the Frankfurt complaint questionnaire (Suellwold) revealed a reduction in the number of affirmative answers during and after treatment. The treatment is considered to have had positive results, although it has to be embedded in a more comprehensive treatment plan with supportive individual psychotherapy, psychopharmaceutic treatment and sociotherapy.