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Counselman, Eleanor F.; Gans, Jerome S.
doi: 10.1080/00207284.1999.11490940pmid: 10388234
Missed sessions in group psychotherapy are often overlooked or not talked about, thus forfeiting an important therapeutic opportunity. Group members miss meetings for many different reasons, be they the result of real-life events or clinically driven occurrences. Missed sessions can have important emotional and metaphorical meanings for the missing member, the other group members, and the leader. Countertransference difficulties may interfere with optimal exploration of the many meanings of missed sessions. Five clinical examples illustrate meanings that may reside in the missed session. A cancellation policy that provides a framework for such exploration is recommended.
doi: 10.1080/00207284.1999.11490941pmid: 10388235
A focus on patients' self-experiences and narcissistic vulnerability can enhance the deepening of curative process. From a self psychological view, deepening the therapeutic process means that, through the analyst's empathic immersion in the patient's subjective view, earlier and earlier forms of the patterns and beliefs that organize this view, including selfobject yearnings and fears of retraumatization, are experienced and become available for interpretation. Vulnerability is viewed as one end of a dimension of self-state. The other end is a state of self-protectiveness. Tenderness and emotional availability as aspects of a selfobject relationship are seen as crucial to the encouraging of vulnerable moments that are key to the deepening of curative process. A group session is presented to illustrate the attitudes that facilitate this process.
doi: 10.1080/00207284.1999.11490942pmid: 10388236
This article illustrates stages of group development in a semi-structured team meeting of staff and patients in an inpatient psychiatric unit. Clinical material drawn from such a group at the Massachusetts Mental Health Center is presented in support of the view that, even in a rapid-turnover ward, group process in a mixed-level, mixed-diagnosis “ward meeting” follows some predictable lines and responds to the articulation of certain predictable concerns. Garland's (1981) model of group development is adapted to show the cyclical nature of group process in a teaching hospital, where doctors as well as patients may make only brief stays. Effective leadership strategies are suggested.
Cohen, Bertram D.; Ettin, Mark F.
doi: 10.1080/00207284.1999.11490943pmid: 10388237
This article first outlines a theory of self-structure as a hierarchically organized multiplicity of versions of self. It then describes self-transformation as a two-part process: (Part 1) the articulation and strengthening of individual self-boundaries, and (Part 2) the reclaiming of split-off, denied, or projected aspects of self. Clinically, both parts are products of the communicative interaction among members, the therapist, and the group as a whole. A parallel conception of group development posits that the group, as an object and as a social system, also needs to: (a) articulate and strengthen its boundaries so that it may (b) contain the sustained interdependent, sometimes conflictual, interactivity among members that is essential to the self-reclaiming process.
doi: 10.1080/00207284.1999.11490947pmid: 10388239
Psychoanalytic psychotherapy is not well developed in Japan (Kotani, 1996). Until recently, group psychotherapy in particular has not been well received by patients or clinicians. Cultural difficulties in using group psychotherapy with Japanese patients have now been overcome and a theory of systematic intervention techniques has been developed. The basic dynamic factors of group psychotherapy such as culturally embedded aspects of social and personality structure are analyzed in this article. Culture-bound psychodynamic characteristics of Japanese patients as activated and worked through in the group process are first described with case illustrations. A systemic hypothesis linking cultural and psychodynamic structure is then delineated and the focal points of interventions are explained in terms of the field dynamics of social structure and boundary dynamics of personality structure.
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