Use of the Group Therapist's Personality Via the Countertransferences

Rather than use the term therapist personality, the author uses an operational definition of countertransference to examine the intersubjective field between group therapist and individual patients, the group, and subgroups. Differentiating between objective and subjective countertransferences, the author traces their sources to the transferences and resistances that arise from individuals, subgroups, and the group-as-a-whole. The transferences, resistances, and their related countertransferences are then integrated with enactments and history to create interventions. The charismatic leader makes no differentiation between the countertransferences and primarily acts on impulse or a rigid system.     

The Integration of Behavior,Vol. III by Thomas M. French

This article presents a model for understanding development within children's psychotherapy groups. It is proposed that two complementary cultures exist within children's groups, one, indigenous peer culture, strictly of the children's making and the other, therapeutic group culture, created by the therapist in collaboration with group members. The therapist is wise to approach indigenous peer culture as an ethnographer might a native culture, with an emphasis on observation and seeking understanding rather than on intervention. The therapist can use the indigenous peer culture to speak to the children in their own language and eventually to engage them in collaboratively building a meaning system that is uniquely designed to address their psychotherapeutic needs. The article defines these concepts, develops them theoretically, and illustrates them clinically.     

Group Therapy Today: Styles,Methods, and Techniques

Abstract

This article describes the common resistance patterns that occur in ongoing cancer support groups. These resistances, which can often go unrecognized, are a normal part of group development and group life in such groups, rather than the result of a few “problem” group members. The thesis of this article posits that the identification and working through of these resistances creates openings to deeper engagement among members and to overall greater group cohesion. Technical guidelines are offered for working with these resistances in the group-as-a-whole, in members, and also in the therapist.     

Resistance in long-term cancer support groups

This article describes the common resistance patterns that occur in ongoing cancer support groups. These resistances, which can often go unrecognized, are a normal part of group development and group life in such groups, rather than the result of a few "problem" group members. The thesis of this article posits that the identification and working through of these resistances creates openings to deeper engagement among members and to overall greater group cohesion. Technical guidelines are offered for working with these resistances in the group-as-a-whole, in members, and also in the therapist.     

The impact of transference and countertransference in activity group therapy

The effective use of countertransference reactions in children's group psychotherapy is discussed. Countertransferences activated by the group dynamics or by the dynamics of individual group members must be analyzed and understood by the therapist if they are to be utilized. The analysis of resistances in children's therapy groups is enhanced by the therapists' awareness of their own countertransference reactions. Clinical examples are presented.     

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.     

Sensory Deprivation: A Symposium Edited by Philip Solomon

In psychoanalytical psychotherapy interpretation is the main activity of the therapist. It is related to revealing the latent structure of meanings of phenomena. The phenomena of analytical therapy are presented as generated by the interaction of two structures: the therapeutic setting and the theoretical models of the therapist. The analytical group setting is contrasted with the individual setting through the elaboration of its central characteristic: the lack of intimacy. This is seen as generating specific regressive phenomena in groups which the therapist will attempt to interpret following an object relations theory. A discussion of interpretations in analytical group therapy focuses on three levels: the group itself, the interpersonal, and the intrapsychic. These are presented as complementary rather than mutually exclusive. Finally, the therapists' function in groups is discussed through the notion of the oscillatory nature of their participation, from a passive–receptive stance to an active–synthetic function which leads to the delivery of an interpretation.     

Issues in the supervision of group psychotherapy: Countertransference and the group supervisor's agenda

Countertransference issues are of particular importance to the beginning group therapist. This paper describes the role of supervision in helping the beginning group therapist deal with counter-transference issues as they effect the formation of a group and the role that the group leader plays in facilitating therapeutic activity within the group. Particular problem areas and the countertransference they evoke and the role of supervision in working through are described.The author wishes to acknowledge the suggestions and support of Aaron Stein, M.D., and other members of the Division of Group Psychotherapy of the Department of Psychiatry of the Mt. Sinai School of Medicine.     

Containment and the threat of catastrophic change in psychotherapy groups

Wilfred Bion's seminal work with treatment and training groups is considered by many group therapists to be a classic study of group behavior. Despite the influence of his early work on groups, practitioners frequently find his later writings difficult to apply to group settings. The purpose of this paper is to illustrate the potential usefulness of Bion's later psychoanalytic writings to our understanding of the complex dynamics active in therapy groups. This paper examines the relationship among four concepts that Bion emphasized in his later writings: projective identification, containercontained, (Ps<---->D), and catastrophic change. Two clinical vignettes are presented to demonstrate how these concepts can aid the therapist in understanding the complicated dynamics active in therapeutic group settings.     

Spontaneous Personality Synthesis in Group Therapy

Combined therapy is defined as concurrent dyadic and group therapy with the same therapist. This paper focuses on a neglected aspect of combined therapy: broaching and exploring this question with one's individual, patient. The author shows how raising this question: (1) alters the therapeutic field whether or not the patient joins; (2) can sharpen the therapist's understanding of the indications and contraindications for group membership; (3) offers untapped therapeutic approaches and opportunities to clarify issues in the individual treatment; and (4) stirs up countertransference issues related to issues of profitability, the transference of the patient in individual treatment, and the transference of the group-as-a-whole. Several case examples are provided.     

What do psychodynamic therapists make of their reveries in the therapeutic encounter? A constructivist grounded theory study

ABSTRACT

The therapist’s mind can wander to daydreams, fantasies and preoccupations: mental events termed “reveries” in this study. As therapists attend to the current of their thought in the therapeutic encounter, the question of how to approach their reveries can arise. This qualitative study used semi-structured interviews with nine qualified psychodynamic therapists to investigate therapists’ attitudes to reveries. The research design and analysis followed the principles of Charmaz’s [Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. London: Sage; Charmaz, K. (2014). Constructing grounded theory (2nd ed.). London: Sage] constructivist grounded theory. Results showed that therapists experienced diverse reveries sometimes felt to yield deeper clinical understanding. Reveries were also seen to have a “freeing-up” function for the therapist and patient, and to require mental freedom to operate. Implications for theoretical understanding and recommendations for clinical technique are discussed.     

The issue of sexuality in group psychotherapy

Sexuality is an underlying, but often unspoken and ignored issue in group psychotherapy. Within the context of how a group reacts to and uses sexuality, the authors focus on three relationship areas: client/client, client/therapist, and therapist/therapist. Some of the hazards of failing to deal with sexually laden conflicts and intimacy issues in these relationships are explored. Some of the advantages of an open and honest approach to uncovering sexrole related stereotypes and behaviors are proposed. The authors attempt to demonstrate that recognition of therapists' and group members' sexuality must be appreciated as an important element in the therapeutic process.     

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.     

Fairy tales,landscapes and metaphor in supervision: An exploratory study

Objective: Supervision is an important requirement for most health professionals and finding innovative and creative forms of ensuring safe and ethical practice are helpful to practitioners. This paper explores the use of fairy tales, mental landscapes and metaphors to illuminate the therapeutic and supervisory relationship. A therapy case study was used as reference. Design: The design was based on a grounded theory methodology and qualitative‐based collaborative meetings between professionals. Both researchers/participants were from different therapeutic backgrounds; drama therapy and integrative counselling. Findings: Two main themes emerged relating to the therapeutic process: (1) Using Archetypal themes in fairy tales to enhance the clarity of the therapeutic landscape; and (2) The facilitation of the sense system through the use of small objects to reconceptualise the therapeutic dynamic. Conclusion: The use of metaphor and small objects to explore retrospective therapeutic encounters can enhance the role of supervision by broadening the cognitive landscape of the therapist. Implications for the therapist/client and supervisor relationships are considered.     

Some Aspects of Group Dynamics

The authors examine the nature of the relationship between the group members and the group therapist and discuss the reasons underlying therapeutic frame failure. It is argued that competing viewpoints concerning the nature of the therapeutic relationship in group therapy have eventuated in problems in articulating a generally accepted frame definition. The authors propose a formulation of the frame for long-term groups that embraces therapist anonymity, total confidentiality, and neutrality. Finally, instances of frame violation are viewed as stemming from the therapist's need for objects, the attempt to forestall various types of transference, and the need to provide an avenue for the therapist's narcissism. Clinical material is used to illustrate group members' responses to therapist-induced frame failures.     

Small and unfilled psychotherapy groups: Understanding and using them effectively

Many open-ended psychotherapy groups have fewer than five members, and fewer than the number the therapist considers necessary for the group to be filled. This paper discusses the rationale for starting such groups and the special dynamics of running them. It then suggests strategies for the therapist to use in maximizing their therapeutic effectiveness. Suggestions are made for further research into the demographic and dynamic aspects of such groups.     

Pre-group preparation model for long-term group psychotherapy in a private practice setting

In this paper the authors describe a method of pre-group preparation which has the function of establishing and maintaining a working alliance between the client and the therapist, reducing unproductive anxiety, generating hope for future productive therapeutic work, as well as providing the therapist with a screening technique for assessing the type of group composition that would be most beneficial for the client.We are grateful to our colleague, the late Walter Gruen, whose comments on this paper contributed to the final product.     

The Group Psychotherapy Literature 1958

This study applies Kohut's self-psychology toward an understanding of the self-functions that membership in a religious cult group (Divine Light Mission) provides for the narcissistic personality. It is proposed that there exists a psychosocial fit between the appeal of the cult group's structure and process and the needs of the narcissistic personality. The cult group offers reparative and substitutive functions to the follower who seeks an idealized selfobject to stabilize a defective sense of self. The special relationship of the follower to the Guru bears a close resemblance to the “idealizing transference” which arises between certain narcissistic patients and their group therapist. The therapeutic use and misuse of the “idealizing transference” in group therapy is explored and suggestions are made for its appropriate clinical management.     

Therapeutic Relationships Re-Defined

Abstract

The therapeutic relationship has traditionally been central to occupational therapy. This study surveyed 129 practicing occupational therapists in Connecticut, concerning how they define and use the therapeutic relationship with clients in today's cost-conscious health care environment. The following four hypotheses: (1) Therapeutic relationships are related to functional outcome, (2) Definitions of therapeutic relationships include words and phrases expressed in the literature and by experts, (3) There are differences in perceptions of therapeutic relationships among pediatric, adult, and geriatric specialty subgroups, (4) Most occupational therapists learned skills in developing therapeutic relationships “on the job,” rather than during professional education, were all supported. This study reaffirms the importance of the therapeutic relationship in occupational therapy practice and provides an updated definition: A trusting connection and rapport established between therapist and client through collaboration, communication, therapist empathy and mutual understanding and respect.     

Psychological mindedness and therapist attributes

Background to study: Psychological Mindedness (PM) involves an interest in and ability to extract and make sense of psychological information (thoughts, feelings and behaviours) from a situation. The nature of the psychotherapeutic role and training demands therapists think about motives, distortions and inner experiences of others. Aims: This study empirically examined the association between PM and adaptive therapist attributes, clinician empathy, self understanding and the therapeutic relationship in practitioners. Method: Forty eight therapists responded to a postal questionnaire. Results: Statistically significant correlations were found between adaptive therapist attributes; empathy, the therapeutic relationship and level of self-understanding and PM.