Group therapy is a form of psychotherapy

where two or more clients work with one or more therapists or counselors. This method is a popular format for support groups, where group members can learn from the experiences of others and offer advice. This method is also more cost effective than individual psychotherapy and is oftentimes more effective.

It is common for those suffering from a mental illness or problem behavior to feel alone, isolated or different. Group therapy can help clients by providing a peer group of individuals that are currently experiencing the same symptoms or who have recovered from a similar problem. Group members can also provide emotional support and a safe forum to practice new behaviors.

Psychoanalytic therapy is one of the most well-known treatment modalities, but it is also one of the most misunderstood by mental health consumers. Founded by Sigmund Freud, psychoanalytic therapists generally spend time listening to patients talk about their lives, which is why this method is often referred to as "talk therapy." The therapy provider will look for patterns or significant events that may play a role in the client's current difficulties. Psychoanalysts believe that childhood events and unconscious feelings, thoughts and motivations play a role in mental illness and maladaptive behaviors.

While this type of therapy has many critics who claim that psychoanalytic therapy is too time consuming, expensive and generally ineffective, this treatment has several benefits as well. The therapist offers an empathetic and nonjudgmental environment where the client can feel safe in revealing feelings or actions that have led to stress or tension in his or her life. Oftentimes, simply sharing these burdens with another person can have a beneficial influence.

Types of Therapy

Siegmund Foulkes and Wilfred R. Bion established the groundwork for group analysis and psychoanalytic group psychotherapy.

According to the psychoanalytic conception, the group constitutes a staging ground for the externalization, figuration, and contention of pathogenic representations that are unacceptable in the intrapsychic space; it is a mechanism for linking and dynamic transformation of the formations and processes that cannot be internally bound without this detour through the work of intersubjectivity. Groups result in specific modes of transference and resistance. Interpreting these produces a reorganization of the psyche in its encounter with the object-based reality of others, with the prohibitions and founding statements of psychic life and of intersubjectivity. For its members, the group constitutes a powerful identificatory anaclisis; it generates creativity and the capacity for symbolization between intrapsychic and bodily reality and intersubjective and social reality. However, numerous clinical, methodological, and theoretical problems have yet to be worked out. Group psychotherapies are not a panacea. They require a personal demand and personal training; their effectiveness depends on the specific indications, limits, and principles involved.

Bion, Wilfred Ruprecht. (1965). Transformations: Change from learning to growth. London: Tavistock Publications.

Foulkes, Siegmund Heinrich. (1964). Therapeutic group analysis. New York: International Universities Press.

Moreno, Jacob L. (1966). The international handbook of group psychotherapy. New York: Philosophical Library.

There are many reasons why this form of psychotherapy is of outstanding value in attaining emotional insight and maturity.

When psychoanalytic group therapy is practiced by a skilled therapist he draws fully on modern psychoanalytic theory and technique. The method utilizes all the psychoanalytic fundamentals such as transference and resistance analysis, free association, and dream analysis. Yet this form of psychotherapy has additional features that are all its own and cannot be duplicated in individual treatment. Among these features, which make the technique so particularly effective, the following are most important:

In a group the members work through their problems in a true-to-life situation of constant personal interaction. They soon become aware of similar emotional difficulties in others. By understanding the feelings of his fellow members, the individual gains quicker insight into his own emotional problems and reactions. His psycho-therapeutic progress is continually stimulated by observing, experiencing, and sharing in the achievements made by the other group members.

Constant dynamic relations with the group help the individual to give up over-dependency on the psychoanalyst, which would otherwise tend to prolong the process of recovery. Another important element is the relatively low cost of group psychoanalysis, which eases the financial burden often created by other methods of intensive therapy.

An outstanding factor in the beneficial results of psychoanalytic group therapy is the multitude and variety of the interrelationships that take place in such groups. If a person sees the therapist only for individual sessions, he can react merely to a single individual on whom he projects emotional patterns established in childhood (transference). The emergence and understanding of these patterns and reactions are a prime factor in a successful analysis. Therefore, individual therapy alone might be restrictive, since it cannot arouse the whole range of deep emotions buried within the person. In group, however, the different personalities of the male and female members evoke a multitude of diversified emotional reactions and provide a number of personalities to whom the person reacts. In doing so he will come to understand his own feelings, behavior patterns, and conflicts.

In the individual session the analyst is limited by the person's subjectively colored reports of incidents and emotional reactions to them. In the group situation, however, the analyst and the group can clearly and objectively detect the manner in which each person's defensive and emotional patterns distort his perception of reality. Thus the group member is helped gradually to achieve insight into his own deviations from objectivity.

People who have undesirable personality traits and behavior patterns can be better helped to overcome these shortcomings in groups than in individual therapy. After all, the psychotherapist is limited in pointing out such flaws to the patient, since in doing so he might cause offense and harm the therapeutic relationship. However, undesirable characteristics of an individual will often become ap-parent through group interaction, and group members will more freely point them out. The underlying causes can then be analyzed and worked through.

Because the group situation is more like the outer world we live in as contrasted with the sheltered protection of the private session, any emotion expressed and worked through in a group constitutes a direct step forward. Personality changes thus achieved tend to be more permanent and definite.

Introduction to Psychoanalytic Group Psychotherapy, Part 2

By Stefan de Schill

americanmentalhealthfoundation.org

Psychoanalysis is a family of psychological theories and methods within the field of psychotherapy that seeks to elucidate connections among unconscious components of patients' mental processes, and to do so in a systematic way through a process of tracing out associations. In classical psychoanalysis, the fundamental subject matter of psychoanalysis is the unconscious patterns of life as they become revealed through the analysand's (the patient's) free associations. The analyst's goal is to help liberate the analysand from unexamined or unconscious barriers of transference and resistance, that is, past patterns of relatedness that are no longer serviceable or that inhibit freedom. More recent forms of psychoanalysis seek, among other things, to help patients gain self-esteem through greater trust of the self, overcome the fear of death and its effects on current behavior, and maintain several relationships that appear to be incompatible.

Psychoanalysis was first devised in Vienna in the 1890s by Sigmund Freud, a neurologist interested in finding an effective treatment for patients with neurotic or hysterical symptoms. As a result of talking with these patients, Freud came to believe that their problems stemmed from culturally unacceptable, thus repressed and unconscious, desires and fantasies of a sexual nature, and as his theory developed, he included desires and fantasies of an aggressive nature, as well. Freud considered these aspects of life instinctive drives, libidinal energy/Eros and the death instinct/Thanatos. Freud's description of Eros/Libido included all creative, life-furthering instincts. The Death Instinct represented an instinctive drive to return to a state of calm, or non-existence. Since Freud's day, psychoanalysis has developed in many ways especially as a study of the personal, interpersonal and intersubjective sense of self.

Prominent current schools of psychoanalysis include ego psychology, which emphasizes defense mechanisms and unconscious fantasies; self psychology, which emphasizes the development of a stable sense of self through mutually empathic contacts with other humans; Lacanian psychoanalysis, which integrates psychoanalysis with semiotics and Hegelian philosophy; analytical psychology, which has a more spiritual approach; object relations theory, which stresses the dynamics of one's relationships with internal, fantasized, others; interpersonal psychoanalysis, which accents the nuances of interpersonal interactions; and relational psychoanalysis, which combines interpersonal psychoanalysis with object-relations theory. Although these schools have dramatically different theories, most of them continue to stress the strong influence of self-deception and the influence a person's past has on their current mental life.

Though the most commonly held image of a psychoanalytic session is one in which a single analyst works with a single client, 'group' sessions with two or more clients are not unknown. Carrying out psychoanalysis in groups can be motivated by economic factors (individual analysis is time-consuming and expensive) or by the belief that clients may benefit from witnessing the various client-client and analyst-client interactions. In most forms of group-based analysis, the group is initially an artefact created by the analyst selecting the various members; the assumption is that the common relationship to the analyst will lead to the formation of a genuine group situation. Group psychotherapy of 'natural' groups (e.g. of whole families) seems to be a relative rarity.

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