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.     

Analysis of transference in Gestalt group psychotherapy

In Gestalt therapy, transference is viewed as a contact boundary disturbance which impairs the patient's ability to accurately perceive the present therapy situation. The boundary disturbances in Gestalt therapy most closely related to the analytic notion of transference are projection, introjection, and confluence. In Gestalt group psychotherapy, group members interfere with the process of need identification and satisfaction by distorting their contact with each other through projecting, introjecting, and being confluent. The Gestalt group therapist uses interventions directed to individuals and to the group to increase participants' awareness of these boundary disturbances and of the present contact opportunities available to them when these disturbances are resolved. In formulating interventions, the leader is mindful of the function of boundary disturbances to the group-as-a-whole as well as to individuals.     

Working with transference phenomena in group supervisory sessions

Conclusion Through this paper, I have tried to explore and illustrate the dynamics of the supervisory experience, in terms not so much of the content particulars as the subtle shifts in the interpersonal meanings of communication processes. Birdwhistell (1) has even gone so far as to suggest that individuals do not communicate; they engage in or become part of communication. He may move, or make words ... but he does not communicate. He may see, he may hear, smell, taste, or feel—but he does not communicate. In other words, he does not originate communication; he participates in it. In a parallel fashion, supervasion is not a simple linear model of student presentation followed by supervisor's intervention, leading to student's further presentation or pause for questioning of what the supervisor meant.Supervision, in my view, is a system that is only to be comprehended on a transactional level. Future research in this area would do well to investigate just how the student analyst projects his counter-transference reactions with patients as transference projections onto the supervisory group, and how the induced reactions in the listeners (the supervisory group) can be used to recapture in very vivid fashion the atmosphere surrounding the analyst and the patient in session together. The answer to these questions would help to clarify some of the existing theoretical confusion regarding internalization, identifications, and introjections. This approach of participating leadership and the free use of the process emerging in the supervisory session helps to dispel the omnipotent parental transference image, and seems to lead to increased empathy, responsiveness, perceptivity and intuition in trainees.     

The problem of reinterpretive distortions in group psychotherapy with borderline patients

Group psychotherapy with borderline patients is challenging work. A group in which the core of patients falls within this nosological category is described. The phrase reinterpretive distortion is used to characterize an aspect of these patients' communication style which makes their effective treatment quite difficult. Examples of the phenomenon are offered, as is an explanation of the dynamics which give rise to it and the functions it seems to serve. Effective ways to deal with reinterpretive distortions in the group psychotherapy context are suggested.     

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.     

Destructive and reparative transference in multiple levels of group psychotherapy

Group members are challenged to form psychologically meaningful relationships with therapists, other members, and the group as a whole. The way in which individuals perceive this challenge is based on their past experiences. Early relationships establish a perceptual frame in which fears of being hurt and concern about hurting others coexist. Balance between these two ways of generating meaning enables individuals to form relatively healthy relationships. Imbalance in this perceptual frame results in distorted perceptions and maladaptive patterns emerging as transference manifestations. Working through involves repeatedly addressing distortions as members relate to therapists, others and the group as a whole.     

Reality in analytic group psychotherapy: Beyond transference and countertransference

This study reports the results of a questionnaire, applied to therapists and their patients in 14 analytic therapy groups. It was found that the patients studied had an accurate perception of the group reality in the following dimensions: therapists' preferences for the members in their groups; power position held by each member in the group; and therapeutic benefit achieved by members in the group. Support was given to the existence of a relation among popularity, power position and therapeutic benefit; members who rated high in one of these variables generally were assigned a high position in the other two, and vice versa. These results suggest that patients in analytic group psychotherapy can be objective in their perceptions of the group reality, and that these perceptions are not always distorted by transference. The idea that, no matter how low-disclosing therapists remain, the patients in their groups will perceive their attitudes and feelings was supported by patients' accuracy in perceiving their therapists' preferences for members in their groups. These findings indicate the important role played by reality and the real relationship in psychoanalytic group psychotherapy.     

Amelioration of transference resistance: substitute therapists in milieu group psychotherapy

Building upon Wolf's (1949) notion of the use of an alternate session in group psychotherapy, this paper suggests that an alternate therapist substituting for an absent regular therapist in milieu group psychotherapy can facilitate similar therapeutic benefits. The mechanism of this process of overcoming transference resistance is seen as twofold: (1) sessions with a substitute therapist allow patients to confront the infantilization often present in a milieu setting and experiment with more autonomous ego functioning. (2) Sessions with a substitute therapist create conditions which are apart from the ongoing process of the therapy group, thereby allowing for a therapeutic splitting process to develop wherein transference feelings about the regular therapist can be expressed to his or her "alter ego." Several case vignettes are presented in order to illustrate the clinical utility of a substitute therapist.     

Homogeneous group therapy of borderline personality disorder

The authors maintained a time-limited, diagnostically homogeneous psychotherapy group of borderline patients for one year. The group progressed through prototypical stages of group development, but each phase was marked by variations of the aggressive drive and defenses against aggression that are characteristic of this disorder. The group provided a well-suited forum for the exploration of suicidal and homicidal impulses and the development of an observing ego. Despite the limits on generalizability from this group, it appears that group psychotherapy can be a valuable adjunctive modality for some borderline patients.Paper presented at the American Psychiatric Association Conference, Montreal, May, 1988.     

Group processes and the therapist's subjectivity: interactive transference in analytical group psychotherapy

Interactions among the group therapist, the group members, and the group as a whole, especially enactments, are conditioned by the therapist's identity, defenses, and present relationships within his or her social networks. It follows from these considerations that difficulties in a group process stem from the group therapist's inability to understand well-enough what the group members are acting out and that they can be overcome only if the therapist extends the limits of his or her identity. Therefore, it has to be taken into account that the leader of a group is always a member of other groups whose dynamics in turn determine one's capability to understand the interactions in the group in which he or she is a therapist.