The application of self psychology principles to long-term group therapy with schizophrenic inpatients

Concepts derived from a self psychology model are applied to an intensive long-term group therapy with hospitalized chronic schizophrenic patients. The clinical data suggest that initially patients' needs for safety and security predominate group process. Once an atmosphere of safety has been developed, patients begin to display needs for recognition and confirmation of themselves as unique, worthwhile individuals and for solace and consolation in regard to their traumatic life histories. A case study of the development of two group members reveals that these patients progressed from unshared, isolated, sometimes delusional visions of reality to the sharing of playful fantasies within the group and finally to an acknowledgement of painful life experiences. In their relationship with each other the patients moved from mutual isolation to a primitive relationship based on unconditional support, admiration and togetherness to a friendship in which they became increasingly able to confront each other with empathic failures and tolerate one another's separateness without withdrawal or decompensation.