ABSTRACT
Professional literature has shown that both Gestalt therapy and psychoanalytically oriented therapy when exclusively administered among groups have the potential of being faced by problems. Such problems usually include drop outs, resistance and regression among others. The report presented below examines the ideal of alternating methods with regards to group leadership together with alternating the group therapists. Group psychotherapy has always been considered as the most appropriate technique of treatment. However it is usually equally faced with a lot of resistance such as the ones presented above.
Special attention is accorded to group-destructive resistance which could pose a threat to the group therapeutic viability or the way in which members are treated. This paper examines in details the potential sources of resistance which could characterize psychotherapy treatment in any group. The usually covert relationship of the relationship of the resistances of the group members to those of the individuals in totality is discussed.
Introduction
As earlier indicated group psychotherapy has always been considered as one of the most effective methods of treatment. However, with time some difficulties and problems have began to be noticed with literature indicating that drop out being the most rampant of all the most common more during the beginning stages of the therapy (Kastner & Neumann, 1986, p. 593). Studies have shown that in psychoanalytically oriented groups, drop out is usually caused mainly by the group members feeling rejected which some drop out because they are not able to share with other patients. Usually, not all patients have them potential of benefiting from the Gestalt method since some have a feeling that apart from emotional experience, they require an additional perspective of understanding and foresight (Rabin, 1967, pp. 244-255).
Group Leadership
On the contrary, patients taking part in psychoanalytically oriented groups usually intellectualize and remain with few experiences emotionally capable of causing intrapsychic change. In a bid to overcome this problem, an attempt was made to expose the two groups, one to Gestalt therapy and the other to psychoanalytically oriented psychotherapy (Rabin, 1967, pp. 244-255). This was mainly owing to the fact that each technique offers help by various means in relation to the needs of the patient and their ability to work. However it is important to note that the merits and demerits of the single therapist/leader or even two cotherapist/leaders are available. What is important to note is that the style of leadership is influenced by individual preferences of the group psychotherapist. This has the implication that changing of the group leader enables the combination of the advantages of an individual therapist with those of cotherapy, while still keeping away from certain disadvantages (Kastner & Neumann, 1986, p. 593).
Supervision and Observation
To supervise effectively, the person in charge of supervision is expected to know the group well besides the fact that the person should occasionally be available during particular cessions to discuss the group with the therapist after the end of each session. A proposal for an alternate group leadership would lead to superior results with regards to observation and supervision owing to the fact that the observer/supervisor would be playing the role of a therapist in half of the sessions (Kastner & Neumann, 1986, p. 594). This would imply that the observer/supervisor would get involved in a more way than an observer/supervisor from outside.
Anticipated Difficulties of the Model
Several concerns however arise pertaining to the above model. One such concern appertains to whether exposure to various opinions and techniques would cause confusion leading to split of those participating (Kastner & Neumann, 1986, p. 594). The other apparent difficulty would relate to whether lack of an open communication between the therapists in the period of could lead to insecurity of the group thereby being the focus for anxiety. Still, the third concern is about whether the observer would be able to remain quiet as the active therapist is being attacked by the group (Rabin, 1967, pp. 244-255).
In other words, then concern here is whether both body language and mimicry would affect both participants and therapists. The other issue which would need to be looked in to is whether each therapist would try to demonstrate that their therapeutic approach is more superior during the period when they are acting as the active therapists (Rabin, 1967, pp. 244-255). The final concern which would be there would be pegged on whether the same risk would equally influence the sessions of supervision (Kastner & Neumann, 1986, p. 594).
Observation
Research observations relating to group work reveal that compared to past experiences with therapeutic groups, the procedure of turning the members into a cohesive working units yields rapid results. In this case, not only sensitive but also sensitive and painful subjects are capable of being brought up and addressed as opposed to the way they were traditionally done, with no slight characteristic of splitting or confusion. This implies that an aura of cooperation and support from the group would be achieved criticism of the therapists and the techniques which usually characterize group psychotherapy would be limited (Kastner & Neumann, 1986, p. 596). What this means is that alternating cotherapy and integrating Gestalt therapy with psychoanalytically oriented group psychotherapy would result to desirable outcomes (Rabin, 1967, pp. 244-255).
Resistance in group therapy
Resistance in group therapy is similar to resistance in individual therapy only that a group setting endows them with special qualities. Resistance in group takes unique dimensions in the group arena where group members take deal with each other’s resistance and defenses. When handling group resistance, the therapist should intervene first before the resistance is handled. The group members should have ideas to deal with resistance and how to utilize it effectively. Members in a group may have the tendency to beat about the bush for protective talking about innocuous material (Rosenthal, 2005 p. 7).
Group resistance especially to patients occurs with members having defenses and character rigidities due to reactions from fellow members. The members react to patients because of their unwillingness to accept a new point of view. This mostly occurs when examining the feelings and values of the patient and putting an effort to alter them. Also in groups, patients may attack other members verbally who are persistent in remaining silent or is stubborn. This brings a lot of pressure in the group relations and affects the member hence reducing the efforts of the group therapist in an individual therapy (Rosenthal, 2005 p. 8).
There are various solutions to group resistance therapy (Bry 1953, pp. 42-48). Among these include identification, universalization and mutual support which can overcome defensive resistances in individuals. Group resistance may be influenced by the existence of peer engagement in adult groups. Group members may have more of complains than working towards achieving group goals. Other members are there to oppose, question and disagree with comments the group therapist makes to others members in the group. Resistance in group setting may be brought by the existence of emotional currents (Rosenthal, 2005 p. 9).
The emotional currents influence members to act in an organized way, consciously and unconsciously in relation to the group therapist. This is evidenced by the tendency to develop libidinal and aggressive striving toward the therapist by the group members. It is this tendency that leads to group resistance to all the group members. Lack of democracy in groups can lead to resistance in group therapy. This is due to the monopolization of individuals or subgroups and shutting out quieter members who will resist to such treatment. Member may be more forecast only on the therapist and ignoring each other hence minimizing the contributions of each other (Rosenthal, 2005 p. 9).
Ignoring the therapist by members of the group may constitute a shared resistance. Members of a group may be more absorbed in their own personal problems and have less or no concern of other people’s difficulties. Also members may be willing to help others more and avoiding attention to their own problems. These two situations may lead to resistance in group therapy (Bry 1953, pp. 42-48). Members in a group may have concealed attitudes that can operate as a collective reluctance to fulfill the terms of the therapeutic contract. This resistance occurs due to ignorance, overlooking, toleration of a violation of analytic contract by one or more of the members. When a member in a group is resisting, the resistance is seen through lateness, absence, non- fee payment, monopolization and silence (Ormont 1968, pp. 420-432).
In order to avoid resistance group therapy, members should be encouraged to have a group contract (Bry 1953, pp. 42-48). The group contract will provide the setting and backdrop for the resistance and the fields within which it functions. In analytic group therapy, the group contract embraces group members to talk about important life areas. This may involve areas such as their past, present and future feelings towards each other. The therapist and the group will help each other discuss important issues in life. Through this, group members are encouraged to engage in physical rather than verbal communication with the other members (Ormont 1968, pp. 420-432).
Classification of resistances
There is no anticipation of associates with the ability of achieving their conditions of the indenture from the well informed assembly of psychotherapists on the preparations for divergences. The therapists are always watchful of the predictability of personal, sub group and assembly confrontation and the likelihood of an abnormal affiliate. A member who is out of the ordinary, articulates the confrontation openly and the disregarding members secretly (Ormont, 1968, pp. 420-432). There is an allowance from the abnormal affiliate on the permanence of his anomalous technique which is unconcealed due to the obviously acts out indirect approaches of the other affiliates.
Repression Resistance
This kind confrontation is the character fortifications which emerge outstandingly in the early stage of patient healing and regularly apparent by conscious protestations to revelation of notification about some region of life knowledge. A patient may decline to converse anything regarding sexual category, maintaining that it is too private instead of making it known to many people. The confrontation of personality offers valuable information about the kind of early training therapists received from parents. Therefore, these confrontations respond constructively to no-significant examination and amalgamation instead of improvement (Rosenthal, 2005, pp. 12).
Superego Resistance
The regularly met confrontations in collection management, psyche confrontation attends to the approaches which are building up in recount to parents in the oedipal stage. This engages judgment of embarrassment, responsibility and mortification around the notification which is revealing. Therefore, it ought to be accepted mentally that some tolerant may have occupied in extremely disgraced performance and the unwillingness of therapists in order to disclose enlightenment which may be practical (Rosenthal, 2005, pp.12).
ID Resistance
This confrontation initiates in the propensities which are insentient due to the inclination to continually searching for some beforehand skilled satisfaction which is the recurrence urge. There is a complexity which is met in compacting with the ID confrontation. This inhabits in the powerful incriminate of antagonistic vigor that influences it. ID resistance can articulate satisfactions which are connected with different stages of improvement and can be incriminated mainly by antagonism (Rosenthal, 2005, pp.12).
Secondary Gain Resistance
In this kind of resistance, one obtains covered enjoyment, particular advantage or improvement from the sickness of an individual together with its persistence or development of the management circumstances. This confrontation is frequently experimental in the incurable periods of behavior when therapists search for the preservation of any apparent expressive remuneration accumulation to them from their infirmity (Rosenthal, 2005, pp.16).
Transference Resistance
Devolution confrontation is the basic confrontation and the answer to the alleviation of the group. This was declared as the former approach attained due to the recurrence in the direction of the psychiatrist and is among the important class. There was a preparation that the occurrences of devolution are the foundation of the supreme confrontations on top of the most effective mechanism for psychoanalytic treatment (Rosenthal, 2005, pp.16). Also conveyance response can be expressed as a recurrence of the precedent, a remembrance lacking reminiscence which is in consistently connection with confrontation.
Conclusion
Group resistance to therapy is a common situation that occurs in many groups. Members in a group may have defenses and character rigidities due to reactions from fellow members. The members may react to patients because of their unwillingness to accept a new point of view Group resistance may also be influenced by the existence of peer engagement in adult groups. Group members may have more of complains than working towards achieving group goals. Other members are there to oppose, question and disagree with comments the group therapist makes to others members in the group. Various solutions to group resistance therapy can be used to use to reduce resistance of group therapy. Among these include identification, universalization and mutual support which can overcome defensive resistances in individuals (Bry 1953, pp. 42-48).
References
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Ormont, L. (1968). Group resistance and the therapeutic contract.
International Journal of Group Psychotherapy, 19: 420-432.
Rabin, H. (1967), How does co-therapy compare with regular group therapy? A
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Rosenthal, L. (2005). Resistance in group therapy: the interrelationship of individual
And group resistance. Modern Psychoanalysis, 30: 8-23.
Kastner, M., & Neumann, M. (1986), A Model Combining Two
Psychotherapeutic Approaches in Group Psychotherapy. Sackler School of Medicine, Tel-Aviv University, Israel, 23: 593- 597.
