Group Psychotherapy With Ego Impaired Children: The Significance of Peer Group Culture in the Evolution of a Holding Environment

In this paper, we will attempt to delineate the process by which peer group culture emerges and develops among groups of ego impaired children. The process of culture building in groups, as will be illustrated in a detailed case presentation, is critical for the child's development of skills for structuring and ordering the internal and external worlds. By definition, ego impaired children lack the ability to organize their internal experience. The challenge of group treatment with these children is to provide a situation in which their maladaptive efforts to organize volatile affects and impulses can be tolerated and structured. If they are provided with an adequate holding environment, the children learn to create cultural structures (i.e., therapeutic group culture), for the representation of salient aspects of their emotional lives creates the basis for internal organization. Their growing capacity to build integrating structures, at first collectively within the group, (Pfeifer and Weinstock-Savoy, 1984), which previously could only be provided by the therapist functioning as an auxiliary ego.