The Theory and Practice of Group Psychotherapy

Read The Theory and Practice of Group Psychotherapy for Free Online Page B

Book: Read The Theory and Practice of Group Psychotherapy for Free Online
Authors: Irvin D. Yalom, Molyn Leszcz
Tags: General, Psychology, Psychotherapy, Group
with others in their social sphere, will create in the group the same interpersonal universe they have always inhabited. In other words, clients will, over time, automatically and inevitably begin to display their maladaptive interpersonal behavior in the therapy group. There is no need for them to describe or give a detailed history of their pathology: they will sooner or later enact it before the other group members’ eyes . Furthermore, their behavior serves as accurate data and lacks the unwitting but inevitable blind spots of self-report. Character pathology is often hard for the individual to report because it is so well assimilated into the fabric of the self and outside of conscious and explicit awareness. As a result, group therapy, with its emphasis on feedback, is a particularly effective treatment for individuals with character pathology. 43
    This concept is of paramount importance in group therapy and is a keystone of the entire approach to group therapy. Each member’s interpersonal style will eventually appear in his or her transactions in the group. Some styles result in interpersonal friction that will be manifest early in the course of the group. Individuals who are, for example, angry, vindictive, harshly judgmental, self-effacing, or grandly coquettish will generate considerable interpersonal static even in the first few meetings. Their maladaptive social patterns will quickly elicit the group’s attention. Others may require more time in therapy before their difficulties manifest themselves in the here-and-now of the group. This includes clients who may be equally or more severely troubled but whose interpersonal difficulties are more subtle, such as individuals who quietly exploit others, those who achieve intimacy to a point but then, becoming frightened, disengage themselves, or those who pseudo-engage, maintaining a subordinate, compliant position.
    The initial business of a group usually consists of dealing with the members whose pathology is most interpersonally blatant. Some interpersonal styles become crystal-clear from a single transaction, some from a single group meeting, and others require many sessions of observation to understand. The development of the ability to identify and put to therapeutic advantage maladaptive interpersonal behavior as seen in the social microcosm of the small group is one of the chief tasks of a training program for group psychotherapists. Some clinical examples may make these principles more graphic. d
    The Grand Dame
    Valerie, a twenty-seven-year-old musician, sought therapy with me primarily because of severe marital discord of several years’ standing. She had had considerable, unrewarding individual and hypnotic uncovering therapy. Her husband, she reported, was an alcoholic who was reluctant to engage her socially, intellectually, or sexually. Now the group could have, as some groups do, investigated her marriage interminably. The members might have taken a complete history of the courtship, of the evolution of the discord, of her husband’s pathology, of her reasons for marrying him, of her role in the conflict. They might have followed up this collection of information with advice for changing the marital interaction or perhaps suggestions for a trial or permanent separation.
    But all this historical, problem-solving activity would have been in vain: this entire line of inquiry not only disregards the unique potential of therapy groups but also is based on the highly questionable premise that a client’s account of a marriage is even reasonably accurate. Groups that function in this manner fail to help the protagonist and also suffer demoralization because of the ineffectiveness of a problem-solving, historical group therapy approach. Let us instead observe Valerie’s behavior as it unfolded in the here-and-now of the group.
    Valerie’s group behavior was flamboyant. First, there was her grand entrance, always five or ten minutes late. Bedecked in

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