Primary Reference: Gerald Corey, Student Manual for Theory and Practice of Group Counseling

THE PSYCHOANALYTIC APPROACH TO GROUPS

WHAT THE HECK IS IT?

psychoanalysis n.

The method of psychological therapy originated by Sigmund Freud in which free association, dream

interpretation, and analysis of resistance and transference are used to explore repressed or

unconscious impulses, anxieties, and internal conflicts, in order to free psychic energy for mature love and work. The theory of personality developed by Freud that focuses on repression and unconscious forces and includes the concepts of infantile sexuality, resistance, transference, and division of the psyche into the id, ego, and superego.

GET YOUR PUMP ON (EXERCISE)

WHAT THE HECK IS IT? PART DEUX

This approach pays particular attention to the unconscious and to early childhood development Personality development is based on successful resolution of conflict at various stages of psychosocial development Focuses on the past as a determinant of current personality functioning

THE BASIS OF THE APPROACH

The first six years of life are seen as the roots of ones conflicts in the present Clients reconstruct and reconstruct their past and work through repressed conflicts to gain understanding of themselves How is my unconscious affecting me now?

THE PROCESS

Group leader and membership form the context for re-creation of the original family so members can work through unresolved problems
Transference,

Countertransference, free association are key elements Members identify how they are responding and deal with old issues in the here and now Individuals gain awareness of their defensive styles of interaction through feedback

GROUP VS. INDIVIDUAL

Group offers opportunity for multiple transferences Recreates family- to work out unfinished business Reactions to group members reveal symbolic clues from family of origin Here and now, but traced back to the past Members reexperience conflicts that originated in the family context.

So, tell me about your mother

SOME KEY IDEAS

Think analytically, even if one doesnt practice analytically It is important to consider the past to fully understand present behavior (Corey says so) Ignoring the past leads to superficial group work Understanding the influence lends control over it Resistance- even voluntary clients do it Corey asks clients how they expect to sabotage their own group work Anxiety and Defense Mechanisms emerge Transference and Countertransference are big deals Projections onto leader and members are clues to unresolved conflicts Family of O.- groups elicit feelings of attraction, anger, competition, avoidance, aggression, etc. Symbolic moms, dads, lovers emerge.

FOCAL POINTS
Dealing with resistance Working through transference Experiencing catharsis Developing insight and self understanding Learning to connect the past with the present

Leader: detached observer vs. relational analysis

UNIQUE ADVANTAGES OF ANALYTIC GROUPS

Members re-experience relationships similar to family of origin relationships Opportunity for multiple transferences Members gain insight into their defenses and resistances more dramatically than in IT. Dependency on authority of the leader is lessened because members provide feedback

LIMITATIONS OF THE APPROACH

Feminists dont dig it (or Sigmund at all) Doesnt adequately address environmental factors as influencers Long term (low SES folks disadvantaged, more for worried well, Insurance likes quick, fast and in a hurry) Cultural: some folks dont want to share their family business lots of pressure to share.

PUBLISHED RESEARCH

International Journal of Psychoanalysis June, 2005; JAMA, 2008

According to the results of meta-analysis, at least one RCT providing evidence for the efficacy of *psychodynamic psychotherapy was identified: depressive disorders (4 RCTs), anxiety disorders (1 RCT) post-traumatic stress disorder (1 RCT) somatoform disorder (4 RCTs) bulimia nervosa (3 RCTs) anorexia nervosa (2 RCTs) borderline personality disorder (2 RCTs) Cluster C personality disorder (1 RCT) substance-related disorders (4 RCTs).
more effective than no treatment or treatment as usual more effective than shorter forms of psychodynamic therapy

Provide evidence that psychoanalytic therapy is

PUBLISHED RESEARCH

The American Journal of Psychiatry, 2007

Demonstrated to be the more effective therapy for borderline personality disorder over dialectical behavior therapy (emotion regulation) and supportive treatment (ADL type advice)
Found to be as effective in treating mood and anxiety disorders as Cognitive, Solution-Focused and supportive (brief tx= faster results, long=sustained) Works for children with emotional disorders

Psychological Medicine, 2008

Psychotherapy and Psychosomatics, 2002

YOUR TIME

Send it

KEY TERMS (COREY STUDENT MANUAL PG 62)

Key terms and concepts:

Freud and Eriksons respective stages of development Anxiety Axis II: Borderline, Narcissistic Pers. D/O Brief psychodynamic therapy (BPT) Countertransference Denial Dialectical behavioral therapy (DBT) Displacement Ego defense mechanism Ego psychology Electra complex Fixation (stuck) Free association Identity crisis

Multiple transferences Object relations theory Oedipus complex Projection Psychodynamics Rationalization Reaction formation Regression Regressive reconstructive approach Relational analysis Repression Resistance Therapeutic regression Transference Unconscious