Group therapy


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  • Video
  • Whoever be the individuals that compose it, however like or unlike be their mode of life, their occupations, their character, or their intelligence, the fact that they have been transformed into a crowd puts them in possession of a sort of collective mind which makes them feel, think, and act in a manner quite different from that in which each individual of them would feel, think, and act were he in a state of isolation. There are certain ideas and feelings which do not come into being, or do not transform themselves into acts except in the case of individuals forming a crowd. The psychological crowd is a provisional being formed of heterogeneous elements, which for a moment are combined, exactly as the cells which constitute a living body form by their reunion a new being which displays characteristics very different from those possessed by each of the cells singly.
  • Totem and Taboo- Collective psychology; Psychoanalytic views
    -loss of libidinal bonds to the leader or among members, and how, in keeping with psychoanalytic dynamics, only the power of love is capable of overcoming the narcissism and hatred that distance us from one another.
  • In dependency, the essential aim of the group is to attain security through and have its members protected by one individual. The group members behave passively, and act as though the leader, by contrast, is omnipotent and omniscient. For example, the leader may pose a question only to be greeted with docile silence, as though he or she had not spoken at all.
    In the basic assumption of fight-flight, the group behaves as though it has met to preserve itself at all costs, and that this can only be done by running away from someone or fighting someone or something. In fight, the group may be characterized by aggressiveness and hostility; in flight, the group may chit-chat, tell stories, arrive late or any other activities that serve to avoid addressing the task at hand. The leader for this sort of group is one who can mobilize the group for attack, or lead it in flight.
    The final basic assumption group, pairing, exists on the assumption that the group has met for the purpose of reproduction. Two people, regardless the sex of either, carry out the work of the group through their continued interaction. The remaining group members listen eagerly and attentively with a sense of relief and hopeful anticipation.
  • problems with group cohesion - group think
  • Experiencing: the immediate events of the meeting take precedence over events both in the current outside life and in the distant past of the members
    Process- group members must examine process itself: must study its own transactions; it must transcend pure experience and apply itself to the integration of that experience
  • Focus on understanding the process, identify the connection between the communication’s actual impact and the communicator's intent; example: When did Freud die? 1938/ 1939 response
  • Nonverbal sense data: who sits where, who sits together, who chooses to sit close to the therapist, faraway? who is late, who is on time, who looks at whom when speaking, do they look at each other or at the therapist, who looks at their watch, who slouches in their seat, who yawns
  • You are interrupting me.
    Your voice is tight and your fists are clenched
    Whenever you talk to me, you take issues with me
    When you do that, I feel threatened and sometimes frightened
    I’ve noticed you’ve done that with the men in the group
    When there were not women in the group you seemed more approachable
  • As client notices group discomfort, anxiety rises
    “Why does the group permit and encourage one member to carry the burden of the entire meeting?”
    Use of compulsive speech for self concealment
  • behavior has meaning
    Repeated process checks
  • Implicitly or explicitly request help from the group by presenting problems or complaints then reject help offered
    Faith in group process suffers
    =don’t invest in a sympathetic, nurturing relationship with the client; agree with the content of the client’s pessimism while maintaining attached affect
  • Problems with intimacy; hard balance in group
    Possibly create a holding environment with group
    Great access to affect, unconscious needs, and fears - loosen group and facilitate therapeutic work
  • High Functioning v. Low Functioning = Still Functioning
  • Group therapy

    1. 1. Group Process psychotherapy: Theory, Technique, and intervention Theory, Technique, and intervention David A. Songco, M.A., Psy.D. New Insights, LLC Milwaukee, WI (c) 2014 New Insights, LLC
    2. 2. Overview
    3. 3. Overview • Theoretical Considerations • Gustav Le Bon • Sigmund Freud • Wilfred Bion • Irvin Yalom • Technique • Cohesion • Here and Now •
    4. 4. overview (continued) • Process commentary • Interventions • Problem group members • Monopolist • Silent client • Help rejecting client • Characterologically difficult client • Borderline Client
    5. 5. group experience inpatient process group psychotherapy - adolescents & Adults Community mental health
    6. 6. QuickTime™ and a decompressor are needed to see this picture. Group psychotherapy
    7. 7. Theory
    8. 8. Gustave Le Bon 1841 -1931 1841 -1931 • “The Crowd: A Study of the popular mind” • law of mental unity “It is only in this advanced phase of organisation that certain new and special characteristics are superposed on the unvarying and dominant character of the race; then takes place that turning already alluded to of all the feelings and thoughts of the collectivity in an identical direction.”
    9. 9. Sigmund freud • Totem and taboo (1912-13) • Group Psychology and the Analysis of the ego (1921) • Libido Accounts for group morphodynamics • Group Cohesion • lack of libidinal bonds • love
    10. 10. Wilfred Bion 1897-1979 1897-1979 • Experiences in Groups • Work Group & Basic Assumption Group • Primary task | underlying assumptions where behaviors are based • Basic Assumptions • Dependency • Fight-Flight • Pairing
    11. 11. Bion and tavistock approach • Tavistock Approach • Group as Whole • Less focus on individual process • Process interpretations reflect on group as whole dynamic, to basic assumptions
    12. 12. irvin D. yalom • Therapeutic Factors • Instillation of hope • Universality • Imparting information • Altruism • Corrective recapitulation of primary family • Development of socializing technique • Imitative behavior • Interpersonal learning
    13. 13. Technique
    14. 14. Group Cohesion
    15. 15. Group Cohesiveness 1. Try harder to influence other group members 2. Be more open to influence by the other members 3. Be more willing to listen to others and more accepting of others 4. Experience greater security and relief from tension in the group 5. Participate more readily in meetings
    16. 16. Group Cohesiveness (cont) 6. Self-disclose more 7. Protect the group norms and exert more pressure on individuals deviating from the norms 8. Be less susceptible to disruption as a group when a member terminates membership 9. Experience greater ownership of the group therapy enterprise
    17. 17. Here and Now • Here and Now Focus • Two symbiotic tiers - neither of which has therapeutic power without the other • Experiencing • Illumination of the Process
    18. 18. Process Focus • Definition of Process • the nature of the relationship between interacting individuals - members and therapists • Process versus Content • Individual Process and Complex Process
    19. 19. (Here and Now) (Here and Now) • Here and Now Focus - 2 Phases • Activating phase - move group into the here and now • Process illumination - identify and share process as it’s unfolding
    20. 20. here and now activation • Think in the here and now • “How can I relate this to the groups’ primary task? How can I make it come to life in the here and now?” • Therapist moves focus • from outside to inside • abstract to specific • generic to personal • personal to interpersonal
    21. 21. (Process Illumination) (Process Illumination) • Therapist must first understand and recognize process • “Why is this unfolding in this group in this particular way and at this particular time?” • Beginning Therapists Recognition of Process
    22. 22. process commentary • Can it be taught? • Gained through experience, practice, and error. • Progression • Example
    23. 23. process commentary • Therapeutic Insight and Change with process commentary • Here is what your behavior is like • Here is how your behavior makes others feel • Here is how your behavior influences the opinions others have of you • Here is how your behavior influences your opinion of yourself
    24. 24. Interventions
    25. 25. problem group members
    26. 26. The monopolist
    27. 27. Monopolist • Who • Effects on the group • Frustration and Anger • Deal with anxiety • Detrimental to Group cohesiveness • Therapeutic considerations
    28. 28. The Silent client
    29. 29. The Silent Client • Why So Silent? • Dread self disclosure • Waiting to be activated • Threatened by other group member • Silence is never Silent • Silence is behavior
    30. 30. The Help-rejecting complainer • Who are they? • Effects on the Group • Irritation, frustration, confusion • Management
    31. 31. The Borderline Client
    32. 32. Summary
    33. 33. Questions
    34. 34. Thank you.
    35. 35. References Freud, S. (2010). Totem and taboo: resemblances between the psychic lives of savages and neurotics. Charleston, SC: Nabu Press. Le Bon, G. (2008). The crowd. Boomer Books. Schneider, M, Corey, G, & Corey, C. (2008). Groups: process and practice. BrooksCole Pub Co. Yalom, I.D., & Leszcz, M. (2005). The theory and practice of group psychotherapy.