The courage of the group therapist

This report strives to legitimize for the field of psychodynamic group therapy the reflection on and study of courage. The authors surveyed group therapy leaders, asking them to describe courageous moments in their own group practice, and then explored the common themes arising in these examples, including openly confronting their mistakes, facing their own and group members' anger, and dealing with unexpected moments in group sessions. Attending to courageous leader moments-and the feelings of hope and pride that they engender-help to neutralize the negative emotions that group leaders are constantly invited to contain. Paradoxically, accessing courageous moments can also evoke feelings of shame in the leader. If we are to require ourselves to embrace the sometimes terrifying challenge of journeying into the unknown with our patients, we must learn to be honest not just about our mistakes and our weaknesses, but also about our successes and our strengths.     

The two faces of the group therapist

The group therapist wears two faces: spokesperson of the Establishment and spokesperson of significant truth. To run vital groups, these two roles of group leadership must stand in dialectic relationship to each other. The therapist introduces principles and practices that normalize group relations and provide a sense of cohesion, continuity, and regularity. However, to be constructive and promote significant truth, the group therapist must also be deconstructive, and encourage and support the group's questioning and challenging the very principles and practices that he or she asserts. A case example illustrates how the group leader is also two-faced in another sense of the term, since he or she may be false and insincere--or perceived as such--when being either the conservator or challenger of group process and culture.     

The chaplain as therapist

Summary In this presentation I have explored the dynamics that go on in therapy, showing how similar dynamics occur in pastoral relationships primarily in terms of the transference and countertransference phenomena. I have also called attention to issues or areas of concern that arise in therapy, equating them with issues with which theology has historically dealt, i.e., the relation of the natural to the supernatural, the problem of authority, the place of values in life, and the importance of individual responsibility. Finally, I have noted the importance of the chaplain's utilizing of psychodynamics in his ministry and specifically those areas where he should become informed and skilled, i.e., in the area of personality development as a way of understanding himself and in the factors that promote change and growth in another person. I have briefly noted the value of psychodynamics at the time of grief or loss.I hope that the focus upon the theme the chaplain as therapist will stimulate us to look at our ministry again. For those to whom this subject is new, may there be an interest in exploring it as an enriching dimension of ministry. For those who are already familiar with the impact that psychotherapy can have upon their ministry, may there be further experimentation at greater depth and broader latitude of some of the areas suggested in this treatment of the topic.This paper was presented at a joint session of the Protestant and Roman Catholic Chaplains at the 41st annual convention of the Association of Western Hospitals, Las Vegas, Nevada, April 20, 1971.     

The preoedipal patient and the pregnancy of the therapist

This article is a contribution to the sparse literature on the pregnancy of the therapist. The therapist's pregnancy is viewed as an event that can facilitate progress for some female patients with preoedipal problems. In these cases, it provides a dramatic opportunity to address developmental difficulties, including separation problems and inadequate ego ideal formation, through the analysis of the self-object transference. Clinical material illustrates the working through of these issues for a patient in whom the therapist's pregnancy was stressful but not traumatic. Therapeutic interventions were aimed at fostering greater differentiation between self and object. A contrasting case is also examined in which the pregnancy was felt to be traumatic and feelings about it largely denied. However, underlying transference issues were eventually addressed.     

The therapist with her back against the wall

This clinical paper describes once weekly psychotherapy with two boys with traumatic histories. The way in which the trauma enters the consulting room and the relationship with the therapist is explored. Technical issues are discussed, particularly the understanding of the countertransference and its modulation in communication with the patient. The therapist's intense personal anxiety about failure and about management of the difficulties that arise is linked to the impact of trauma.     

On self-disclosure: The vulnerable therapist

The therapist may stimulate the family's growth by sharing his personal experiences directly with them. This helps by providing the family with a model of a real (versus symbolic) person and encouraging them to respond in new and competent ways. As a result, the emotional commitment of the therapeutic system may deepen, while unconscious conflicts that have been causing impasses may surface and be resolved. The therapist hopes that his self-disclosure will benefit the therapy, but understands that there are risks involved. Specific guidelines can help in deciding when not to share, what kinds of problems can be revealed, and what attitudes best strengthen this endeavor. Self-disclosure is discussed here in an experiential frame-work. The author illustrates the above points with examples from his own personal clinical and supervisory experiences.The author would like to thank his wife, Linda Barth Garfield, MSS, without whose sustaining support this paper could not have been written, and his partner, Ellen Berman, MD, for her valuable comments and encouragement. The masculine pronoun is used in this paper for convenience, and because the author is often referring to himself.     

Keeping the therapist alive

This article focuses on ways in which therapists can mamtain vitality in their work with people. Becoming more aware of personal dynamics, particularly of the need for control and power, is essential. To remain open to new theories and approaches avoids the pitfall of professional encapsulation. Experiencing the client as a person not only facilitates empathy but involves therapists in the growth process as well. Developing a tragic awareness of life enables therapists to maintain a sense of awe, wonder, and grace toward the human predicament, thus bringing depth or spirituality to their work.He is also editor of TheHarding Journal of Religion and Psychiatry.     

The making of the group therapist: The role of experiential learning

The purpose of this paper is to review the necessary components of a comprehensive group therapy program. The balancing between the didactic and the experiential portions, and an analysis of the selection criteria, along with the rationale for a particular sequencing of elements in the curriculum, are discussed. A line between supervision and personal therapy is drawn. The author describes the milieu necessary for a successful training program to evolve and makes suggestions for improvements. The various experiential aspects of training are presented and critically evaluated. The training situation is examined from the point of view of the faculty, the trainee and the patients involved. The author marshalls evidence indicating that personal group psychotherapy in a patient group is the preferred form for most trainees for the experiential part of the program. The paper concludes that the sharing and cohesiveness of training philosophies and methods by the faculty is a prerequisite to the success of any training program.     

The family therapist as a system interventionist

Family therapists need to develop therapeutic strategies which can be effective in helping members of dysfunctional and crisis oriented families reconnect with additional sources of support and strength.The extended family and social system can serve as this source of support when it is convened, mobilized and reactivated to become involved with the concerns of the ailing members of the family. This paper describes the unfolding six network phases, and the roles undertaken by the team of therapists serving as system convenors, mobilizers, choreographers and resource consultants. The task of the therapists working with a dysfunctional family and its larger extended support system is seen as that of an effective clinical stategist mobilizing the resourcefulness and energies of himself and his team to reactivate a dysfunctional system to change.A modified version of this paper appears in the author's book Networking Families in Crisis, Human Sciences Press: New York, 1978.