How does the group process work?

A newcomer to the group is greeted by many transference reactions. Early relatedness in the group are those of maximal distortions; later, just before termination, these patterns are based on more real foundations, the departing members tending to see themselves as they actually are

During the early sessions patients are increasingly made aware of their relationships with family members and other influential figures. It is pointed out to the members how frequently they respond to another group member or the leader as though s/he were a significant person in either the present or past. There is a tendency for each patient to see the group in terms of his/her own family and others with authority.

Initially obvious attempts are made to turn the group into a classroom, this should be resisted by the therapist. Toward the end of therapy, as the person is about to leave, there is generally a much more real (actual) meeting.

The therapist initiates a search of the past reasons to be found for the present behaviour: an attempt to remember rather than repeat. This is the reflective stance, which the therapist does first alone, and later with the others when they develop co-therapeutic ability.

If the group is organised according to the homogenous nature of the members’ complaints, the members will meet only to discuss an impairment, hoping to get some relief from it, while at the same time getting the attention of the group and the therapist. When the group stresses the status of the therapist, making her their leader, they become her followers and avoid analysis of transference.

Worse still, if the therapist sees herself as leader, and the group members merely as her followers, analysis of transference-countertransference is avoided. Some special purpose groups, not therapy groups are run along these lines – I would call them educational groups. Here the therapist remains the leader throughout, constantly being directive. The group never becomes “member centered”, always remaining “leader-led”.

The therapist, through insistence on group therapy, indicates that she alone cannot help the patient and that they need the group to assist them. The group therapist, unlike the individual therapist, goes against her fantasy that she is the sole healer, and recognises the capacity of all people to help one another. Group members are accepted as “co-therapists” which enhances each member’s worth.

The group-analytic group can be described as a series of emotional states, thus the conductor can at all times ask: “What is the group really doing at this moment? Is it attempting to avoid, or to get to a problem?”

Provide the group with little structure or direction and the initial reactions of patients is anger or confusion – this is used as material for exploration. The emphasis is on the interpretation of group behaviour rather than on individual behavior.

Group psychotherapy experience represents a microcosm of the world, the loneliness and isolation that patients experience is part of the total anxiety the world experiences.

Some people advocate that patients undergoing long-term drug therapy should be seen in groups.

Because the patient transfers onto the group members/therapist, it allows him/her to form an intensive relationship of dependence, and it reflects the degree of their maturity or the amount of psychopathology present. The therapist should use the transference constructively. It exists, even if he/she is not aware of it or doesn’t use it. The presence and recognition of transference establishes analytic group psychotherapy as distinct from the encounter and humanistic psychology movements. The therapist watches for the transference, uses it, and works it through before a patient leaves the group.

Transference and countertransference differ in the group from that in individual sessions, the definitions from Freud still hold.

The concept of transference can only be appreciated in terms of its historical development, different schools emphasise different aspects.

Freud referred to transference as “an almost inexhaustible subject”. The patients’ modes of relating in the therapy group are similar to those they use outside of treatment.

Transference is the process in which a person projects  a pattern of adaption which was developed in a previous life situation to a current life situation; s/he then displaces the affect  from that situation to the present situation.

Although the intensity of the transference on any one individual is reduced, the total emotional feeling is multiplied and intensified by the group situation.

Transference can be observed, clarified, and reduced, with a resulting fundamental change in the personality of the patient.

Transference makes the other person appear to be what they are not. Transference makes the perceived appear to be another.

Characteristics are put into the other that they do not have. It can emphasise or de-emphasise a person out of all proportion. Success in group psychotherapy depends largely on making transference overt, and working through them.