Read The Theory and Practice of Group Psychotherapy for Free Online
Authors: Irvin D. Yalom, Molyn Leszcz
believe there is an excellent chance that they will be particularly important to one another in the course of therapy. In fact, if the conflict is particularly uncomfortable, I may attempt to ameliorate some of the discomfort by expressing that hunch aloud.
The second most common type of critical incident my clients describe also involves strong affect—but, in these instances, positive affect. For example, a schizoid client described an incident in which he ran after and comforted a distressed group member who had bolted from the room; later he spoke of how profoundly he was affected by learning that he could care for and help someone else. Others spoke of discovering their aliveness or of feeling in touch with themselves. These incidents had in common the following characteristics:
1. The client expressed strong positive affect—an unusual occurrence.
2. The feared catastrophe did not occur—derision, rejection, engulfment, the destruction of others.
3. The client discovered a previously unknown part of the self and thus was enabled to relate to others in a new fashion.
The third most common category of critical incident is similar to the second. Clients recall an incident, usually involving self-disclosure, that plunged them into greater involvement with the group. For example, a previously withdrawn, reticent man who had missed a couple of meetings disclosed to the group how desperately he wanted to hear the group members say that they had missed him during his absence. Others, too, in one fashion or another, openly asked the group for help.
To summarize, the corrective emotional experience in group therapy has several components:
1. A strong expression of emotion, which is interpersonally directed and constitutes a risk taken by the client.
2. A group supportive enough to permit this risk taking.
3. Reality testing, which allows the individual to examine the incident with the aid of consensual validation from the other members.
4. A recognition of the inappropriateness of certain interpersonal feelings and behavior or of the inappropriateness of avoiding certain interpersonal behavior.
5. The ultimate facilitation of the individual’s ability to interact with others more deeply and honestly.
Therapy is an emotional and a corrective experience. This dual nature of the therapeutic process is of elemental significance, and I will return to it again and again in this text. We must experience something strongly; but we must also, through our faculty of reason, understand the implications of that emotional experience.† Over time, the client’s deeply held beliefs will change—and these changes will be reinforced if the client’s new interpersonal behaviors evoke constructive interpersonal responses. Even subtle interpersonal shifts can reflect a profound change and need to be acknowledged and reinforced by the therapist and group members.
Barbara, a depressed young woman, vividly described her isolation and alienation to the group and then turned to Alice, who had been silent. Barbara and Alice had often sparred because Barbara would accuse Alice of ignoring and rejecting her. In this meeting, however, Barbara used a more gentle tone and asked Alice about the meaning of her silence. Alice responded that she was listening carefully and thinking about how much they had in common. She then added that Barbara’s more gentle inquiry allowed her to give voice to her thoughts rather than defend herself against the charge of not caring, a sequence that had ended badly for them both in earlier sessions. The seemingly small but vitally important shift in Barbara’s capacity to approach Alice empathically created an opportunity for repair rather than repetition.
This formulation has direct relevance to a key concept of group therapy, the here-and-now, which I will discuss in depth in chapter 6. Here I will state only this basic premise: When the therapy group focuses on the here-and-now, it increases in power and
The second most common type of critical incident my clients describe also involves strong affect—but, in these instances, positive affect. For example, a schizoid client described an incident in which he ran after and comforted a distressed group member who had bolted from the room; later he spoke of how profoundly he was affected by learning that he could care for and help someone else. Others spoke of discovering their aliveness or of feeling in touch with themselves. These incidents had in common the following characteristics:
1. The client expressed strong positive affect—an unusual occurrence.
2. The feared catastrophe did not occur—derision, rejection, engulfment, the destruction of others.
3. The client discovered a previously unknown part of the self and thus was enabled to relate to others in a new fashion.
The third most common category of critical incident is similar to the second. Clients recall an incident, usually involving self-disclosure, that plunged them into greater involvement with the group. For example, a previously withdrawn, reticent man who had missed a couple of meetings disclosed to the group how desperately he wanted to hear the group members say that they had missed him during his absence. Others, too, in one fashion or another, openly asked the group for help.
To summarize, the corrective emotional experience in group therapy has several components:
1. A strong expression of emotion, which is interpersonally directed and constitutes a risk taken by the client.
2. A group supportive enough to permit this risk taking.
3. Reality testing, which allows the individual to examine the incident with the aid of consensual validation from the other members.
4. A recognition of the inappropriateness of certain interpersonal feelings and behavior or of the inappropriateness of avoiding certain interpersonal behavior.
5. The ultimate facilitation of the individual’s ability to interact with others more deeply and honestly.
Therapy is an emotional and a corrective experience. This dual nature of the therapeutic process is of elemental significance, and I will return to it again and again in this text. We must experience something strongly; but we must also, through our faculty of reason, understand the implications of that emotional experience.† Over time, the client’s deeply held beliefs will change—and these changes will be reinforced if the client’s new interpersonal behaviors evoke constructive interpersonal responses. Even subtle interpersonal shifts can reflect a profound change and need to be acknowledged and reinforced by the therapist and group members.
Barbara, a depressed young woman, vividly described her isolation and alienation to the group and then turned to Alice, who had been silent. Barbara and Alice had often sparred because Barbara would accuse Alice of ignoring and rejecting her. In this meeting, however, Barbara used a more gentle tone and asked Alice about the meaning of her silence. Alice responded that she was listening carefully and thinking about how much they had in common. She then added that Barbara’s more gentle inquiry allowed her to give voice to her thoughts rather than defend herself against the charge of not caring, a sequence that had ended badly for them both in earlier sessions. The seemingly small but vitally important shift in Barbara’s capacity to approach Alice empathically created an opportunity for repair rather than repetition.
This formulation has direct relevance to a key concept of group therapy, the here-and-now, which I will discuss in depth in chapter 6. Here I will state only this basic premise: When the therapy group focuses on the here-and-now, it increases in power and