1967 Causes of errors and failures in group analytic psychotherapy

Abstract

This paper aims to discriminate and conceptualize factors that are likely to cause errors and failures in group psychotherapy. One of the main causes of these errors and failures lies, in the present conception, in a defective selection of the group’s constituent elements, which does not take into account the importance of productive homogeneity for the therapeutic process. This homogeneity must correspond to the structure of the family group. When it is lacking, the therapeutic group, due to difficulty in finding typical objects, projections and identifications, may suffer temporary or definitive stagnation in its dynamic evolution. Productive homogeneity also implies a diversification of the neurotic structures at play in the group, so that there is no massive prevalence of certain characteristic defenses, such as schizoid, depressive or hysterical types, for example. Once the mixed structure of the group is guaranteed, it becomes crucially important for therapeutic success that there are parts of the Ego of the group members that canform an alliance with the therapist. This alliance of the therapist with healthy ego structures will, above all, allow productive regression, which is essential for the progress of the treatment, and will be all the more necessary the more psychotics and “borderline cases” participate in the group. The participation of patients with severe forms of obsessive neurosis in the group appears to be an unfavorable factor for therapeutic success, the same occurring when there is more than one homosexual patient. The glaring discrepancies in cultural level, considered not only in terms of education, but in terms of common potentialities and possibilities of empathy, can lead to the failure of the group. As for the technical aspects, capable of decisively influencing the success or failure of the group’s therapy, inadequate interpretation is considered to be, more than any other factor, responsible for the failure of the psychotherapeutic work. Interpretations should predominantly refer to the group as a whole, although individual interpretations may be valid, as long as they provoke collective reactions. Rigid and systematic interpretation, such as “acting out”, of any interaction between group participants outside of the sessions, as well as the demand for absolute discretion (and resulting interpretations), constitute a danger to the success of the group. Countertransference, in turn, is perhaps as important as interpretations, for the success or failure of therapeutic work. The therapist must be able to control and understand his/her countertransference reactions, and his/her ability to accompany the group with intense human dedication is also decisive. The problem of leadership, when insufficiently developed, can lead to the failure of the group. The presence of the observer experienced as the Superego, whether by the patients or the therapist, can sometimes become a restrictive factor to the success of the group. The flaws and limitations in the therapist’s training are often responsible for the failure of the group, since only rarely has the therapist participated as a patient in a therapeutic group. Only through progressive experience and in-depth knowledge of the various
currents of group therapy can the therapist critically acquire a valid scientific technique that is, at the same time, appropriate to his/her personal characteristics.