CSL6805.01

Chapters 6 - 9

Psychoanalytic Approach

• Contributions– Sigmund Freud (1856-1939) Austria– Erik Erickson (1902-1994) Germany-

US:Boston– Alexander Wolf – began working with groups

in 1938• Influenced many other models of group

work

Sigmund Freud

• Father of Psychoanalysis

Erik Erikson

Goal of Analytic Group

• Restructuring the client’s character and personality system– Make unconscious conflicts conscious and

examine them• Reenact the family of origin in a symbolic way

– Historical past of each member is repeated in group

• Regressive-reconstructive approach– Regression into each member’s past to

achieve the therapeutic goal of personality reconstruction

Psychoanalytic Key Concepts

• Influence of the past– Experiences of first 6 years of life are seen as the

roots of one’s conflicts in the present• The Unconscious

– Thoughts, feelings, experiences kept out of awareness as a protection against anxiety

• Anxiety and ego defenses– Anxiety is feeling of dread resulting from repressed

feelings, memories, desires– Ego defenses protect ego from threatening thoughts

and feelings

Ego-Defense Mechanisms

• Ego-defense mechanisms:– Are normal behaviors which operate on an unconscious

level and tend to deny or distort reality– Members often manifest same defenses in a group that

operate in their lives outside of the group– Help the individual cope with anxiety and prevent the ego

from being overwhelmed– Have adaptive value if they do not become a style of life

to avoid facing reality– Defenses, if respected, can lead to greater self-

understanding in a group setting

Ego-defense Mechanisms

• Repression – distressed thoughts pushed into the unconscious

• Denial – suppresses reality in conscious• Regression – return to less mature developmental

level during severe stress• Projection – attributing own unacceptable thoughts &

feelings to others• Displacement – redirection of some emotion from a

real source to a substitute person or object• Reaction formation – behaving in a manner that is

opposite to one’s real feelings• Rationalization – justify behavior

Transference and Countertransference

• Transference– The member reacts to the therapist as he/she did to an earlier

significant other• This allows the member to experience feelings that would

otherwise be inaccessible• In groups, multiple transferences provide for re-enacting of

past unfinished conflicts• Analysis of transference—a hallmark of analytic groups

• Countertransference– The reaction of group leader toward certain members that may

interfere with objectivity; results in distorted perception– Countertransference is something to understand and explore

Resistance

• Resistance– Anything that works against the progress of group

therapy and prevents the production of unconscious material

• Analysis of Resistance– Helps members to see ways they typically defend

against anxiety• These acts interfere with the ability to accept changes which

could lead to a more satisfying life• Applied to group therapy, resistance, if recognized can be the

material to explore more deeply• Resistance is not a negative force to be defeated, but

something to understand and respect in members

Role of Group Therapist

• Some roles and functions of group therapist:– Roles depend greatly on therapist’s leadership style– Contemporary approach emphasizes therapeutic alliance– Leader helps members to understand their transference

reactions within the group and encourages exploration– Therapist helps members face and deal with resistances– Helps members to view the group as a social microcosm– To carry out their functions, leaders need to understand their

own dynamics and countertransference

Psychoanalytic Techniques

• Free Association– Individual reports immediately without censoring any

feelings or thoughts• Interpretation

– Group therapist points out, explains, and teaches the meanings of whatever is revealed

• Dream Analysis – Dreams are the “royal road to the unconscious”– Dreams can be productively worked within a group

setting– Members can share and explore dreams in a group

Developmental Perspective

• Developmental stages: Implications for group work– it is essential to understand stages of life to

understand repressed feelings• Freud’s psychosexual theory

– Basic aspects of traditional Freudian theory• Erikson’s psychosocial theory

– Understanding critical turning points at each of the stages of life

Evaluation of Psychoanalytic Group

• Contributions and strengths of the approach– Important to understand how past contributes to present

problem– Concept of understanding the functions of resistance– Provides a conceptual framework to understand anxiety and

defense– Transference and multiple transferences in a group– Importance of understanding countertransference

• Limitations of the approach– Limitations based on long-term approach for many clients– Critique of traditional analytic approach from feminist

perspective– The approach has not given full attention to social and cultural

factors

Adlerian Group Counseling

• Inspired by Freudian psychoanalysis

• Founded by Alfred Adler (1870-1937) Austria; US

• Rudolf Dreikurs popularized Adler’s work in US

• Alfred Adler

Alfred Adler’s Individual Psychology

Overview• A phenomenological approach• Social interest is stressed• Birth order and sibling relationships• Therapy as teaching, informing, and

encouraging • Basic mistakes in the individual’s private logic• The therapeutic relationship—a collaborative

partnership

The Phenomenological Approach

• Adlerians attempt to view the world from the client’s subjective frame of reference– How life is in reality is less important than how the

individual believes life to be– It is not the childhood experiences that are crucial—

it is our present interpretation of these events that matters

• One’s subjective view includes beliefs, perceptions, and conclusions– Adlerian group leaders strive to understand the

member’s world

Social Interest

• Adler’s most significant and distinctive concept– Refers to an individual’s attitude toward and awareness

of being a part of the human community– Mental health is measured by the degree to which we

successfully share with others and are concerned with their welfare

– Happiness and success are largely related to social connectedness

– Community feeling involves the sense of being connected to all of humanity

– Living entails the courage to face life’s problems

Birth Order

• Adler’s five psychological positions:1) Oldest child—receives more attention,

until dethroned

2) Second of only two—behaves as if in a race; often opposite to first child

3) Middle—often feels squeezed out

4) Youngest—the baby and pampered

5) Only—does not learn to share or cooperate with other children; learns to deal with adults

Style of Life

• Lifestyle is the story of our life• Private logic provides the lenses through

which we view the world (beliefs about self, others, and the world)

• Fictional finalism is the imagined central goal of perfection that gives unity to our personality

• It is not childhood events that shape us, but our interpretation of these events

• We can reframe childhood experiences and consciously create a new style of life

Nature of maladjustment

• A person has a mistaken opinion of himself or herself and of the world.

• A person engages in abnormal behavior to protect his or her opinion of self (e.g., when threatened with failure and insecurity)– Inferiority complex: The individual is overwhelmed by a

sense of inadequacy, hopelessness– Superiority Complex: very high opinion of self, quick to argue

personal solutions to problems are right– Family constellation: Mediates the genetic and constitutional

factors brought by the child and the cultural factors that influence the child.

– Safeguarding: Symptoms are developed for the purpose of safeguarding the fictional goal.

• The person becomes self-centered rather than other-centered• The individual is unconscious of these events

Inferiority Feelings

• Inferiority feelings are based on our assessment that is subjective

• Sense of inferiority is not a negative factor• Basic inferiority is springboard for mastering

our environment• To compensate, we strive for superiority• Group members are encouraged to talk about

feelings of inferiority

Role of Group Leader

• Adlerians stress an egalitarian and personal relationship

• Adlerian leaders develop collaborative relationships

• Leaders have the function of creating a structure that promotes:– open interaction– involvement– nonjudgmental acceptance– confrontation– commitment

Stages of an Adlerian Group

• Stage 1: Creating and maintaining good relationships– Laying the foundation for cohesiveness and connection

• Stage 2: Analysis and assessment: Exploring individual’s dynamics– Early recollections as an assessment procedure– Identifying a pattern of basic mistakes

• Stage 3: Awareness and insight– Gaining insight– Interpretation done in a collaborative way

• Stage 4: Reorientation and reeducation– A time for correcting faulty beliefs about self, life, and others– Members encouraged to act “as if” they were who they wanted

to be– Encouragement is essential during this stage

Encouragement

• Encouragement is the most powerful method available for changing a person’s beliefs – a basic aspect of all stages but essential during reorientation (stage 4).– Helps build self-confidence and stimulates courage– Discouragement is the basic condition that prevents people

from functioning– Through encouragement, members experience their own

inner resources and power to choose for themselves and direct their lives

– Members are encouraged to recognize that they have the power to choose and to act differently

How an Adlerian does Therapy

• Comprehensive Assessment using:– Family Constellation-questionnaire-social world

assessment

– Early Reflections-single incidents from childhood

– Lifestyle Assessment-develop targets for therapy by identifying major successes and mistakes in the client’s life

– “The Question” -- If I had a magic wand that would eliminate your symptom immediately, what would be different in your life?”

What Clients do in Therapy

• Explore private logic-concepts about self, others, & life – philosophy lifestyle is based upon

• Discover purposes of behavior or symptoms and basic mistakes associated with their coping

• Learn how to correct faulty assumptions & conclusions

Adlerian Brief Group Therapy

• Adlerian group counseling lends itself to brief interventions and time-limited formats

• Adlerian brief therapy is concise, deliberate, direct, effective, efficient, focused, planned, purposeful, and time-limited

• Some key principles of brief group work:– Need for rapid establishment of strong therapeutic alliance– Need for clear problem focus and goal alignment– Rapid assessment is a must– Active and directive interventions– Focused on strengths and abilities of members– A focus on both present and future– Tailoring treatment to fit the unique needs of each member

Adlerian in Multicultural Context

• Adlerian theory well suited to working with culturally diverse clients

• Approach gives emphasis to the person-in-the-environment

• Adlerians’ interest in social interest, in pursuing meaning in life, in belonging, and in the collective spirit fits well with group process

• Adlerian concepts and methods lend themselves to the creation of a healing community– Various methods can be used to create a healing

community– Healing community is created by leaders who possess

skills in winning cooperation, encouraging others, and establishing clear expectations

Evaluation of Adlerian Approach

• Contributions and strengths of the approach– The use of early recollections as a key to understanding

one’s story– The holistic nature of this approach– The freedom allowed to Adlerian therapists to practice in

unique ways– Adlerian concepts have group applications in many

settings– Adlerian ideas are found in many other therapeutic

approaches• Limitations of the approach

– Unless Adlerian group leaders are well trained, they can make mistakes in interpreting members’ dynamics

Psychodrama

• Based on theories and methodology of J.L. Moreno (1889-1974) Romania; Austria; US (1925) New York: Columbia

• Created in mid 1930s by J.L. Moreno and later developed by his wife, Zerka Moreno

• Complex method utilized by highly trained practitioners; offers tools for an integrative approach to group counseling

Psychodrama

• www.youtube.com/watch?v=zngVciTk2X0

http://www.youtube.com/

watch?v=VQUtxDK5V-w

Psychodrama

• An action approach to group therapy in which clients explore their problems through role playing, enacting situations using various dramatic devices to gain insight, discover their own creativity, and develop behavioral skills.

• Scenes are played in the here-and-now, even though they might have originated in a memory or anticipated event.

Key Concepts of Psychodrama

• Creativity - generated through active experimentation

• Spontaneity – response to a new situation or a novel response to an old situation; involves reflection

• Working in the present moment – assign new meaning to events of the past

• Encounter – understanding others’ viewpoints through role reversal and other techniques

• Tele – the degree of preference a member has toward others; two-way flow of feeling between people

Key Concepts

• Surplus reality – reflect the dimensions of events that do not occur in actuality

• Catharsis – natural release of emotions and attitudes

• Insight – cognitive shift connecting awareness of emotional experience with an understanding

• Reality testing – trying out behaviors• Role theory – examine roles we play,

negotiate them, and choose different ways to play the roles

Basic Components of Psychodrama

• The protagonist– The person who is the focus of the enactment– Protagonist selects the event to be explored

• Auxiliary egos– Other members who take part in the enactment

• The audience– Others in the group who observe and participate

• The stage– The area where the psychodrama enactment occurs

Phases of Psychodrama

• The warm-up phase– Initial activities to increase involvement of entire

group. Ex. Dyads to share conflicts they are experiencing; go-around technique

– Aimed at establishing an atmosphere of spontaneity• The action phase

– Involves the enactment and working through of a past or present situation or of an anticipated event

– Protagonist is encouraged to move into action– Theme is “Don’t tell us, show us”

• The sharing and discussion phase– Sharing involves statements about oneself– Discussion of the process comes after personal

sharing

Techniques in Psychodrama

• Self-presentation – protagonist gives a self-portrait to introduce the situation

• Role reversal – protagonist takes on the part of another personality portrayed in the drama; involves looking at oneself through another individual’s eyes

• Double – stands to the side of protagonist and says the words that aren’t spoken

• Soliloquy – verbalize thoughts or feelings• Empty chair – talk to someone not there

Techniques

• Replay – redoing an action• Mirror technique – another member mirrors

the protagonist’s postures, gestures, words; fosters self-reflection; must be used with discretion

• Future projection – increases awareness of available options for future encounters

• Magic shop – exchange one characteristic for another one already possessed

• Role training – experiment with new behaviors in the safety of the group

Evaluation of Psychodrama

• Contributions and strengths of psychodrama– An action-oriented approach– Active techniques that foster direct experience– Provides alternative ways of dealing with life’s problems– Can be integrated with other therapies– Promotes catharsis, healing, and self-understanding

• Limitations of psychodrama– Need to exercise caution in using techniques– Essential that group leader receives training and

supervision– Leaders need to know themselves

Existentialism

• Philosophers– Soren Kierkegaard (1813 -1855) Denmark– Friedrich Nietzsche (1844 – 1900) Germany– Martin Heidegger (1889-1976) Germany– Jean-Paul Sarte (1905-1980) France– Simone de Beauvoir (1908 – 1986) France– Victor Frankl (1905-1997) Austria

• Existential approach in US– Rollo May– James Bugental– Irvin Yalom

What existentialism is …

• A philosophical view that emphasizes the importance of existence, including one's responsibility for one's own psychological existence.

Existentialism

• Philosophical thought, worldview, rather than a model of group therapy

• Rejects deterministic views of traditional psychoanalysis and behaviorism and emphasizes our freedom to choose what to make of our circumstances

Phenomenological Approach

• Therapy is a journey taken by therapist and client into the world as perceived and experienced by the client.

• Effort to help clients examine how they have answered life’s existential questions and to challenge them to revise their answers and begin to live authentically.

Purpose of Existential Group

• Self-exploration with these goals:– Enabling members to become truthful with

themselves– Widening their perspectives on themselves

and the world around them– Clarifying what gives meaning to their

present and future life– Successfully negotiating and coming to

terms with past, present, & future crises– Understanding themselves and others better

and learning better ways of communicating

Key Concepts

• Self-awareness• Self-determination and responsibility• Existential anxiety• Death and nonbeing• Search for meaning• Search for authenticity• Aloneness/relatedness

Self-Awareness

• Through self-awareness we come to recognize the responsibility associated with the freedom to choose and to act

• Awareness is realizing that:– We are finite—time is limited– We have the potential, the choice, to act or not to act– Meaning is not automatic—we must seek it– We are subject to loneliness, meaninglessness,

emptiness, guilt, and isolation– We are subject to the deterministic forces of sociocultural

conditions and limitations, but we are still able to choose based on our awareness of these limiting factors

Self-determination and personal responsibility

• Existence is a given, but we do not have a fixed essence

• As self-determining beings, we are free to choose among alternatives and therefore responsible for directing our lives and shaping our destinies.

• Viktor Frankl – freedom can never be taken from us because we can choose our attitude toward any given set of circumstances.

Existential Anxiety

• Existential anxiety is normal—life cannot be lived, nor can death be faced, without anxiety– Anxiety can be a stimulus for growth as we become aware of

and accept our freedom– We can blunt our anxiety by creating the illusion that there is

security in life– Anxiety is basic to living with awareness and being fully alive– If we have the courage to face ourselves and life, we may be

frightened, but we will be able to change– Existential therapy does not aim to eliminate anxiety, but to

encourage members to develop the courage to face life squarely

– Once facing our anxiety, it is essential to make a commitment to action

Death and Nonbeing

• Death is essential to the discovery of meaning and purpose in life.

• Life has meaning because it must end, and life is enhanced when we take seriously the reality of the life we do have.

• When we accept the reality of our eventual death, we realize that we do have choices and accept the responsibility for how we are living.

The Search for Meaning

• Lack of meaning is major source of existential stress and anxiety– Finding meaning in life is a by-product of a

commitment to creating, loving, and working– Struggle to find sense of significance and

purpose in life is part of human existence• “The will to meaning” is our primary striving

– Life is not meaningful in itself; the individual must create and discover meaning

– The group experience can assist members in finding new meaning in their lives

Search for Authenticity

• We are true to ourselves• Doing what is worthwhile as we see it• It is a process and not an end result• When we lead an authentic existence, we

are constantly becoming the person we are capable of becoming.

• Existential guilt is the realization that we are falling short of becoming what we could become.

Alone and Relatedness

• We are ultimately alone, even though we have friends.

• Only we can give a sense of meaning to our lives and decide how we will live.

• We have a choice of experiencing our aloneness and try to find meaning.

• Because of an awareness of our aloneness, some of us try to avoid it with casual relationships and frantic activities.

Existential Therapeutic Relationship

• Therapy is a journey taken by facilitator and members– The person-to-person relationship is key– The relationship demands that therapists be in

contact with their own phenomenological world

• The core of the therapeutic relationship– Respect and faith in the members’ potential to cope– Sharing reactions with genuine concern and

empathy– There are no set techniques in this approach, rather

understanding is of central importance

Evaluation of Existential Approach

• Contributions and strengths of the approach– This approach stresses that techniques follow

understanding– Minimization of misusing techniques– Approach provides a framework for understanding

key universal human struggles that can be explored in a group context

• Limitations of the approach– Not highly relevant for people who want immediate

solutions or relief from symptoms– Existential group therapist needs a great deal of

maturity, wisdom, life experience, and training

“He who has a why to live for can bear with almost any how.”

~ Nietzsche