Connect 2023.pptx
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This document provides an overview of group therapy from a Group as a Whole perspective. It discusses key theorists like Foulkes and Bion who saw the group as an entity with its own dynamics. The document outlines how to build group cohesion through Group as a Whole interventions, when to use such interventions, and examples. It also discusses using this approach to address diversity issues and increasing identification with the group, especially for online groups. Learning objectives are provided on applying Group as a Whole to build cohesion and awareness of diversity issues.
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Connect 2023.pptx
- 1. Out of this world and into Group: Group as a Whole: to build cohesion and community Instructor: Nancy Wesson, Ph.D., CGP, AGPA-F Center for the Study of Group Psychotherapy DrNWesson@sbcglobal.net Copyright @ 2023 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced.
- 2. Learning Objectives The workshop attendees will be able to: 1.Apply the Group as a Whole approach to increase group cohesion as demonstrated by group member statements about belonging and about "the group" itself. 2. Compare and Contrast three levels of group leader intervention in with the focus on Group as a Whole interventions. 3. Utilize group as a whole concepts to increase awareness and discussion of diversity issues in a psychotherapy group. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 2
- 3. Group therapy from the Group as a Whole lens Each client brings their inner world into the group through their interactions with others and unconscious processes. As members participate in Group therapy, group therapy becomes a corrective emotional experience. This is both a conscious and an unconscious process. (internalized images) Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 3
- 4. Building a Group as a Whole process Set norms where group members value group dynamics: early on make Group as a Whole comments or engage in process commentary. Develop bonding between members. Use of “We” for some Group as a Whole comments. “We are in intellectualizing at the moment. I wonder why? This encourages group members to use ‘we’”. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 4
- 5. When to use Group as a Whole Interventions When forming a group: “we-ness” “the group” To build a greater sense of safety and trust in the group. (increase self-disclosure) When building group cohesion: developing a greater sense of belonging, identity, and acceptance. When the group is stuck, low energy, and/or avoiding emotional risks with each other. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 5
- 6. Building a Group as a Whole process Curiosity about what is happening in the group. I wonder what just happened ? There seems to be less connection in group. May be considered the metalevel of group. There is what happened and then there is processing of what happened. (Yalom & Leszcz, 2020). Can build this in as a regular part of the group. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 6
- 7. Foulkes and Bion: the early theoreticians Members bring their inner world to group which is amplified through group interactions. Bion said members recreate their own “society” in group. Changes in other group members can bring about changes in the individual member. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 7
- 8. Foulkes (1948,1983) asserted that “every event, even if confined to one or two members, actually involves the interaction of a group. Such events are part of a gestalt in which individual members constitute the “figures” whereas the ground is rest of the group.” Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 8
- 9. Process Commentary: Nina Brown’s work According to Brown (2009), it is the group leader’s responsibility to describe what is happening in the entire group in order to bring about therapeutic change and effectively deal with resistance- The Process Commentary. The Process commentary describes what is happening in the “here and now.” She describes “Observing patterns of behavior, interactions between members or lack of interactions” (Brown, 2003, p. 186). Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 9
- 10. Three Levels of Intervention: Group Psychotherapy (Tasca et al, 2014) Intraindividual: What is going on in the conscious and unconscious of each member? Interpersonal: What is going on between members and each member and the group therapist? Group as a Whole: What are the dynamics of the whole group? Do members identify with this group ? Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 10
- 11. Foulkes and Bion: the early theoreticians Foulkes, a Psychoanalyst- One of the original thinkers on Group as a Whole. “Group Psychotherapy is “the situation of choice” for the study of unhealthy as well as therapeutic processes as they take place” in the immediate present, the here and now” of the group. (Foulkes, 1948). Tavistock model of group therapy developed via Group as a Whole. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 11
- 12. Bion and Group as a Whole Bion (1961) focused on the functioning of the entire group- group as whole. He saw the leader as an observer and ”conductor” of group dynamics. According to Bion both individual interactions within a group as well as group dynamics are essential for the group to be therapeutic. Tavistock model of group therapy developed via Bion’s theory. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 12
- 13. “Group Cohesion is a Group as a Whole process.” (Burlingame et al. 2002) Cohesion generally refers to the emotional bonds among members for each other and for a shared commitment to the group and its primary task. (Burlingame et al, 2002). “Esprit de corps.” Working as a team who shares the same goals and experiences. This is not any group “this is my group.” (Yalom &Leszcz, 2005) Sense of belonging and inclusiveness, ownership. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 13
- 14. Diversity is part of the group as a Whole Expect diversity in a psychotherapy group. Assume it is there. Diversity is part of the group as a whole perspective and influences group dynamics. Some types of Diversity: ethnic, cultural, gender sexual, ageism, race, physical, and physical disabilities or limitations. Sensitivity to diversity makes the group feel safer to everyone in the group. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 14
- 15. Diversity is part of the group as a Whole As a group leader be open to group members educating the group about their differences. Create an environment where it is greatly encouraged to think about and discuss diversity- differences. Train group members to become aware of diversity issues when others speak or behave or react in an unexpected way and to feel free to ask questions .i.e. about their concept of family,and of holiday expectations. Group leader can study types of diversity and norms that they primarily work with. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 15
- 16. When to use Group as a Whole Interventions When you wish to change what is happening in the group. (redirect) When a member is being blamed or potentially scapegoated, can use an intervention to change the perspective to the whole group. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 16
- 17. Examples of Group as a Whole Interventions/observations Questions: Is the group having a hard time telling Nina she is….. “The group seems very focused on Joe I wonder why that is?” Statement: The group seems to be avoiding a possible conflict by suddenly making “nice comments.” The group is quiet and reflective, the group seems to be…. I wonder why the group is…… I am curious why the group is….. Observations: Wow we have suddenly lost all of our energy as a group. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 17
- 18. When not to use Group as a Whole Interventions Group as a whole interventions bring the group out of the emotional realm and into intellectual analysis- so may not want to disrupt emotional intimacy in the group. When an individual group member is taking emotional risks and is demonstrating, perhaps for the first time, trust in the group. During therapeutic member to member feedback or encounters unless needed to prevent scapegoating. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 18
- 19. Group as a Whole: increasing Group cohesion In online groups group cohesion is very important. Norms can be set of strong identification and attentiveness in the group. The sense of belonging can be emphasized repeatedly by Group as a Whole comments. The group is an entity and everyone must be there fully for the group to take place. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 19
- 20. Group as a Whole and increasing Group cohesion in online groups When members identify strongly with the group they are more likely to keep their attention focused on the group (not space out). In the present time with many groups taking place working there is a strong need for belonging, intimacy, comfort, and safety. 20
- 21. Demonstration Group Course members will participate or observe in a training group experience. Group Contract to keep it safe Confidentiality- nothing leaves this room that took place. Express your feelings and thoughts as much you are able to. Discuss connections you feel with others in the group. Need 7 people for demo group. Will take first 7 people who volunteer. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 21
- 22. What to do when you in the workshop but are not in the demo group Notice when there would have been a good time to make a Group as a Whole comment and why. Notice if a Group as a Whole comment was used ineffectively. Notice your own reactions during the group. We would like to discuss them after the group. Copyright @ 2021 Nancy Wesson, Ph.D. Material in this slide collection is not to be copied or reproduced. 22
Notes de l'éditeur
- Foulkes is one of earliest thinkers. Group is always inside the mind. Individual psychotherapy is a form of group psychotherapy.” “Human living has always been in groups. These are ever changing according to conditions-geographical, economical, historical, technical, cultural. Correspondingly, the idea which the human individual has of himself and his group and of the relation between the two is ever-changing also” Introduction to Group-Analytic Psychotherapy p.23 (Foulkes, 1948, p.23) The levels are described in several articles in your reference lists This is our material in group to work with and there is an ample amount As you can see I have listed what theories usually emphasize which healing component of group therapy However there are definitely combinations which use more than one component: for example I am an interpersonal group therapist, when leading a group I also use Group as a Whole often also Away from group I tend to think more in terms of intersubjectivity and object relations- self-objects).
- Each client brings their own inner world into the group: wherever you go there you are. Obvious. In group this inner world is mixed in with other group members inner worlds. We will be discussing how group therapy- “the group itself” can be a healing force when member’s inner worlds are blended. Corrective emotional experience: IN 1946 Franz Alexander introduced the concept of the corrective emotional experience” The basic principle of psychotherapy is to expose the client to emotional situations he could not handle in the past. “The patient in order to be helped must undergo a corrective emotional experience suitable to repair the traumatic influence of previous experience. Alexander insisted that intellectual insight alone is insufficient, there must be an emotional component and systematic reality testing as well. Change takes place both at behavioral level and the deeper level of internalized relational images of past relationships, (Yalom, p.45) Now called by Yalom “the Corrective Recapitulation of the Primary Family Group.” It is a therapeutic factor.
- Bonding and identity Sharing of personal information - Where I live this is not an everyday skill. Right now bonding over struggles during the pandemic. Tired of working remotely, lonely.
- Safety and self-disclosure go together When members feel they truly belong and are part of something important “their group.” The sense of safety is increased. This does not work that well for drop-in groups. Minimize comings and goings if possible. Safety is the first stage of forming a group and must be established before the group can move to more in-depth therapeutic work. When to use Group as a Whole Interventions We will be discussing group cohesion more in-depth. Forming a group or member changes are taking place The group seems to have lost it’s energy.” “I wonder what we are avoiding.” You are there wondering what happened to your group All of a sudden it seems dead in the water. Good time for a group as a Whole comment. Safety The group seems stuck or the group is finding it difficult to move into deeper waters When members feel they truly belong and are part of something important “their group.” The sense of safety is increased. This does not work that well for drop-in groups. Minimize comings and goings if possible. Safety is the first stage of forming a group and must be established before the group can move to more in-depth therapeutic work. Norms are forming which you do not wish to form or scapegoating or monopolizing or dominance is taking place. Each client brings their own inner world into the group: wherever you go there you are. Obvious. In group this inner world is mixed in with other group members inner worlds. We will be discussing how group therapy- “the group itself” can be a healing force when member’s inner worlds are blended.
- The therapist focuses on the “entire interactional field” of the group to use the dynamics of the group as a whole to create therapeutic interventions The therapist focuses on the “entire interactional field” of the group to use the dynamics of the group as a whole to create therapeutic interventions
- Why the picture? Groupness- safety warmth, allowing the individual to group Why the picture? Groupness- safety warmth, allowing the individual to group
- Similar to Yalom Also lack of interactions: what is missing ?
- However there are definitely combinations which use more than one component: for example I am an interpersonal group therapist, when leading a group I also use Group as a Whole often also Away from group I tend to think more in terms of intersubjectivity and object relations- self-objects). Intraindividual : Usually the territory of individual psychotherapy own internal dynamics (object relations) defined by relationship history We look at this most carefully during the initial interview for group and for decisions about group selection Very unstable relationship history, undisclosed or unresolved trauma, disorganized or dismissive attachment pattern Positive: history of some positive relationships and attachment patterns. Interpersonal Emphasized by Yalom and seen as the primary basis for therapeutic benefit through behavioral change. Interactions between members lead to interpersonal learning and behavior change through therapeutic factors including feedback and imitation for example. Group as a Whole - Group as a healing entity fostering acceptance, group dynamics This is our material in group to work with and there is an ample amount As you can see I have listed what theories usually emphasize which healing component of group therapy However there are definitely combinations which use more than one component: for example I am an interpersonal group therapist, when leading a group I also use Group as a Whole often also Away from group I tend to think more in terms of intersubjectivity and object relations- self-objects). Interpersonal Emphasized by Yalom and seen as the primary basis for therapeutic benefit through behavioral change Interactions between members which demonstrate relationship patterns which can be changed through interpersonal learning and therapeutic factors (Yalom and Leszcz) I love this about group therapy There is so much going on and which can be worked with I love this about group therapy There is so much going on and which can be worked with
- Based his work on working with men post-world war II in the military Bion was stuck with post-war veterans in an army hospital. He put them together in groups and studied how the group functioned as a “Whole.” He was an observer who helped facilitate group dynamics which would help members work on their issues when they were ready. The group is fearful and needs to protect itself from intense feelings generated by the unconscious.
- Slide Eleven I love this part The group comes together and appreciates itself. The group appreciates itself. It is safer. There is strong sense of attachment and identification with the group. Members look to each other to work on themselves and encourage work between members.
- There are many more
- Slide 42
- Sometimes interactions are a form of resistance- talking about someone else instead of yourself in-depth To be discussed: sometimes the group focuses on one member in a negative way and blames them
- These Group as a Whole comments get members to think about the group. They do not want to miss out on something they belong to and people who are important to them. IN online groups we must have all seen how frightened our clients can become about Covid-19, work, the political situation, loss of income, Greater need for safety and comfort from others. Spacing out in groups is common People can feel zoomed out or look at their phone surreptiously. When the group has “groupness” typically no members wants to miss what happened in group and absenteeism is reduced. Belonging is important
- Members do not want to miss out on what is happening in group. Other members feel free to ask them questions and include them or comment about their presence in group.