The Effects of Interpatient and Group Influences in a General Hospital

This article discusses the leader's use of metaphor in outpatient, psychodynamic group psychotherapy. Four clinical examples are provided that illustrate how the phase of group envelopment informs the leader's use of metaphor. Therapeutic features and uses of metaphor include (1) the development of ego skills that transform passivity into activity and foster the examination of unhealthy norms; (2) the modulation and rechanneling of potentially destructive affect and the intensification of affect that is denied, minimized, or avoided; (3) the creation of a verbal play space in which shared group language evolves; (4) and the provision of various levels of concreteness and abstraction as well as differing perspectives. Abuses of metaphorical interventions are discussed.