The Theory and Practice of Group Psychotherapy

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Authors: Irvin D. Yalom, Molyn Leszcz
Tags: General, Psychology, Psychotherapy, Group
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and facilitates transfer of learning from the therapy group to the client’s larger world. Without a sense of the internal world of others, relationships are confusing, frustrating, and repetitive as we mindlessly enlist others as players with predetermined roles in our own stories, without regard to their actual motivations and aspirations.
    Leonard, for example, entered the group with a major problem of procrastination. In Leonard’s view, procrastination was not only a problem but also an explanation. It explained his failures, both professionally and socially; it explained his discouragement, depression, and alcoholism. And yet it was an explanation that obscured meaningful insight and more accurate explanations.
    In the group we became well acquainted and often irritated or frustrated with Leonard’s procrastination. It served as his supreme mode of resistance to therapy when all other resistance had failed. When members worked hard with Leonard, and when it appeared that part of his neurotic character was about to be uprooted, he found ways to delay the group work. “I don’t want to be upset by the group today,” he would say, or “This new job is make or break for me”; “I’m just hanging on by my fingernails”; “Give me a break—don’t rock the boat”; “I’d been sober for three months until the last meeting caused me to stop at the bar on my way home.” The variations were many, but the theme was consistent.
    One day Leonard announced a major development, one for which he had long labored: he had quit his job and obtained a position as a teacher. Only a single step remained: getting a teaching certificate, a matter of filling out an application requiring approximately two hours’ labor.
    Only two hours and yet he could not do it! He delayed until the allowed time had practically expired and, with only one day remaining, informed the group about the deadline and lamented the cruelty of his personal demon, procrastination. Everyone in the group, including the therapists, experienced a strong desire to sit Leonard down, possibly even in one’s lap, place a pen between his fingers, and guide his hand along the application form. One client, the most mothering member of the group, did exactly that: she took him home, fed him, and schoolmarmed him through the application form.
    As we began to review what had happened, we could now see his procrastination for what it was: a plaintive, anachronistic plea for a lost mother. Many things then fell into place, including the dynamics behind Leonard’s depressions (which were also desperate pleas for love), alcoholism, and compulsive overeating.
    The idea of the social microcosm is, I believe, sufficiently clear: if the group is conducted such that the members can behave in an unguarded, unselfconscious manner, they will, most vividly, re-create and display their pathology in the group . Thus in this living drama of the group meeting, the trained observer has a unique opportunity to understand the dynamics of each client’s behavior.

    RECOGNITION OF BEHAVIORAL PATTERNS IN THE SOCIAL MICROCOSM
    If therapists are to turn the social microcosm to therapeutic use, they must first learn to identify the group members’ recurrent maladaptive interpersonal patterns. In the incident involving Leonard, the therapist’s vital clue was the emotional response of members and leaders to Leonard’s behavior. These emotional responses are valid and indispensable data: they should not be overlooked or underestimated. The therapist or other group members may feel angry toward a member, or exploited, or sucked dry, or steamrollered, or intimidated, or bored, or tearful, or any of the infinite number of ways one person can feel toward another.
    These feelings represent data—a bit of the truth about the other person—and should be taken seriously by the therapist. If the feelings elicited in others are highly discordant with the feelings that the client would like to

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