The process of scapegoating in a neonatal nurses' group

This paper reviews the literature on scapegoating, elaborating on the underlying mechanisms before describing the process of scapegoating as it occurred in a neonatal nurse support group. Illustrative vignettes are used to discuss how scapegoating was used by group members to avoid painful feelings arising from their care of extremely ill infants. Group process is related to the stages of the group's development as feelings were addressed more directly and the need to use scapegoating as a defense decreased.     

The Causes and Treatment of Backwardness by Cyril Burt

In this paper, self psychology is presented as a particular form of object-relations theory which directs the therapist to consider interactions within the group in the light of their effect on the sense of self of the individual. In traditional object-relations psychology the therapist works through defenses against the anxieties of expressing wishes for unacceptable forms of object-relations in the group, which are related to unconsciously warded off instinctual drives. In contrast, the therapist who adopts the framework of self psychology works through defenses against anxieties associated with expressing developmentally phase-legitimate self object needs. Thus, the individual's frustrated reactions to others are not interpreted as distorted and/or maladaptive, but as understandable reactions to the patient's experience of thwarted developmental needs for selfobject responsiveness which are repeated in the here-and-now interactions within the group. The selfobject transferences are described as well as the ways in which they may come into conflict with one another. Two clinical examples previously understood by the author from within a traditional object-relations framework are reviewed, and discussed from the perspective of self psychology.     

Indications for selecting family or individual therapy

Indications for either individual therapy or family therapy as treatments of first choice are identified at the initial family assessment.
A family approach is suggested in (1) scapegoating systems where the symptom is essential to the family homeostasis; (2) enmeshed families where communications are confused and diffuse; (3) paranoid-schizoid families where the family denies the symptoms and (4) families in a current acute shared crisis.
Individual treatment is indicated when (1) the patient has suffered traumatic separations; (2) separate help is asked for; (3) the therapist considers individuation necessary and (4) unusual life experience. Clinical examples are given.     

Introduction to Group-Analytic Psychotherapy by S. H. Foulkes

This article will explore special leader issues that emerge in psychodynamically oriented therapy groups with adult children of alcoholics. Particular focus will be on countertransference feelings that get stirred up in group leaders and techniques for dealing with some of these special dilemmas. Specific issues include (a) assumption of sameness between the therapist and the patient (the therapist assuming that he or she “understands” because of having also grown up in an alcoholic family); (b) the “will to restore,” which may be destructive when the therapist, whose own self-esteem is dependent on the patient's progress in therapy, forces a “rush to recovery” on the patient; (c) other personal issues in the life of the therapist that may also resonate with experiences of the patient; (d) “countertransference goodness and availability” as it affects therapists' abilities to set reasonable limits on their patients, as well as reasonable expectations for themselves; and (e) special issues regarding therapist transparency and self-disclosure.     

Selection of Patients for Group Psychotherapy

The concept of projective identification is reviewed, and its application to family and group systems is noted. Projective identification is then applied as a construct central to couples' groups, particularly useful in sorting out dynamics within couples, between couples, and toward the group-as-a-whole and its leader(s). Clinical examples are provided from a couples group co-led by the author, with indications of how this perspective on disavowal, interaction, and containment can be utilized therapeutically to provide a stimulus for intrapsychic and interpersonal change. The couples group offers a unique forum for working with projective identification, where this process presents a challenge to the therapist regarding the multiple levels from which to select appropriately and to “contain” skillfully.     

Parallel Group Treatment of Pre-School Children and Their Mothers

Object relations concepts are applicable in children's group psychoanalytic psychotherapy. The author attempts to explore and delineate areas in which developmental conflicts in object relations, emotional deprivations, traumas, and family pathologies are recapitulated in the group, and how the manifestations of pathologies can be rectified by the process and formation of the group and the role of the therapist as a “new object” in the management of individual and group transferences. Clinical examples are presented.     

Perceptions of Confidentiality Violations Among Psychologists

This study explored psychologists' perceptions of confidentiality violations. One hundred ninety-five psychologists answered questionnaires about a vignette regarding a male therapist accused of violating the confidentiality of a female client. The vignette varied on the following variables: (a) Confidential information was conveyed to either an insurance company or another client, (b) the therapist's account of the violation included either an excuse or a justification, and (c) scapegoating was included or not included in the account. The insurance condition and excuse condition produced more lenient judgments of the violation. However, excuses elicited more negative judgments of the therapist. Scapegoating generally elicited more negative judgments. Differences in the recipient of confidential information and the accounts given for violations have an impact on psychologists' perceptions of confidentiality violations.     

Perspectives on scapegoating in primary groups

Theory and research related to the scapegoat role and scapegoating processes in primary groups are reviewed. This review and evaluation of the literature leads to the conclusion that scapegoating phenomena, though often highly stressful, can contribute significantly to individual and group development. Treatment issues and approaches are discussed.     

Intersubjectively oriented,time-limited psychotherapy with children: how does the therapist evaluate the therapeutic process and what are the therapist’s tasks?

Based on the therapist’s evaluations of three therapies, this research aims to study the therapeutic process in intersubjectively oriented, time-limited psychotherapy with children. A primary objective is to further develop the therapy method. The study comprises therapies with children 6–11 years of age, who had experienced difficult family situations. Each child received 12 therapy sessions. The number of therapy sessions with children and parents was agreed upon beforehand, and the therapeutic objectives were approved by the parents. Each of the therapy processes were evaluated by the therapist by answering three questions and filling in three forms after each therapy session. The forms were: The Feeling Word Checklist; an alliance form for the child; and a process form. The therapeutic alliance and the behaviour of the therapist during the therapy sessions are discussed on the basis of the total material. The following main tasks for the child therapist emerged: structuring the therapy sessions; following the child’s initiatives; participating and cooperating with the child; exploring the child’s expressions; and understanding and regulating emotions.     

D.H. Lawrence's The daughter-in-law: Transforming a family system

Abstract

D.H. Lawrence's play The daughter-in-law, written in 1912, explores underlying, implicit conflict within a family. Set in a small mining town in England, the family consists of Mrs. Gascoyne, her sons Luther and Joe, and her daughter-in-law, Minnie, Luther's wife. The central conflict is between Mrs. Gascoyne and Minnie, who challenges her mother-in-law's control over her sons, who also compete with each other for the love and recognition of their mother. Joe, the youngest son, perturbs the family system and acts as a mediator, functioning as a family therapist. He sets a process in motion through which the rigid family alliances are challenged and ultimately realigned. Mrs. Gascoyne's self-image as a perfect, self-sacrificing, self-righteous mother ultimately is transformed, and she accepts Minnie as a family member. Brandchaft's concept of “pathological accommodation” explicates how enmeshed family members can collide, and thereby stultify their personal development. As Joe plays his role of “family therapist,” the family dynamic changes. Through the process of rupture and repair, each family member begins to recognize the needs of the other, and thereby a path for differentiation, individuation, and autonomy becomes possible for them.     

Warriors,authors and baseball coaches: the meaning of metaphor in theories of family therapy

This article examines the metaphors family therapists use in their theories to reveal aspects of the theories which are not explicitly stated, using Whitaker's symbolic experiential therapy, Minuchin's structural therapy and White's narrative therapy as examples. Such examination, drawing on social constructivist understandings of metaphor and meaning making, reveals that Minuchin's metaphors of family as organism and therapist as artist and warrior emphasize the family as relatively holistic and the therapist as relatively interventionist. In contrast, Whitaker's metaphor of family as ecological system or team and therapist as coach emphasizes the interdependence and context sensitivity of the family and relative powerlessness of the therapist to impose change. Finally, White, reflecting his explicitly post‐structural commitment, uses the metaphor of therapy as a journey undertaken with a map and as therapy as an act of re‐narrating a story.     

Intensive Group Psychotherapy by George R. Bach

Emotional insight, is essential in order for therapeutic change to take place. Profound resistances to experiencing expressing, and understanding emotions are present in group members, the group as a whole, and the group therapist. Reasons for the three types of resistances are described. Specific therapist attitudes and therapeutic techniques are suggested to understand and effectively work through resistances at individual, interpersonal, and whole-group levels. Examples are given from an ongoing therapy group to illustrate the processes of understanding and working through resistances. Resistances on the part of the group therapist are identified and their possible effects on the group's resistance are explored.     

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.     

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.     

Proposed Revisions of the By-Laws of the American Group Psychotherapy Association,Inc.

Abstract

The social constructs of the group, the group self of an individual member, and the moral order of the group as a whole are described as basic, interrelated concepts essential to our understanding of scapegoating. Two patterns of scapegoating are then introduced: one concerns antagonistic, the other, agonistic relations of scapegoat to scapegoaters. A series of case examples are presented, one involves an advocacy group of socio-cultural “outsiders;” the other three pertain to scapegoating in therapy group settings. The case materials illustrate the meaning and usefulness of an intersubjective/social constructivist perspective on the problem of scapegoating.     

The use of children's drawings in multiple family group therapy

This paper describes the advantages, difficulties and techniques of including young children in multiple family group therapy (MFGT). Multiple family group therapy consists of weekly sessions where three or more families meet conjointly with a therapist or cotherapists. Clinical vignettes demonstrate how to use children's drawings with parents to improve family communication. The efficiency of MFGT is compared to family therapy or individual therapy. The effective use of this modality with some children under 10 years is discussed.This research was supported in part by Alcohol, Drug Abuse, and Mental Health Administration Psychiatry Education Branch Grant MH 13882 from the National Institute of Mental Health.     

A Family Therapist for Life: Observations and Options

“Life” is used here in the chronological sense of years spent as a family therapist and in the existential sense of experiencing “life” in terms of satisfaction, meaning, and vitality in one’s living. In the 1950s, there were few guidelines for professionals recognizing the need for working therapeutically with families. Becoming and being a family therapist are discussed, along with lifetime learning about family and tolerance for ambiguity in understanding family and marital relationships and dynamics; flexibility in implementing therapeutic interventions; functioning in ways that fit with one’s personality, beliefs, and principles; working where one functions best; and what works at what stage for the family therapist and relating these to establishing and maintaining “life” in one’s living.     

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.