Since the time of Freud, psychoanalytic therapy has been one of the most well-known treatment modalities, but it is also one of the most misunderstood ones. This system of interpretation and therapeutic treatment of psychological disorders is also known as the “talk therapy” as it is based on the intercourse of the Analysand and the Analyst who listens to the patient’s talk about any aspect of his/her life.
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The Analyst’s concern is the unconscious of the patient through exploration of which solutions for his/her mental and emotional problems are found. The present situation in the field of psychoanalytic therapy is such that it is commonly regarded as time-consuming, expensive, and generally ineffective. In the current paper, on the contrary, it is argued that therapy has many benefits. The problem is considered with respect to group counseling.
The objective of the paper is to demonstrate the advantages of the use of the psychoanalytic therapy approach in group counseling. The problem is revealed through the following perspectives:
- An overview of the relevant literature is presented;
- The essence of the psychoanalytic therapy approach is considered;
- The main principles of group counseling are outlined;
- Application of psychoanalytic therapy in group counseling is investigated;
- Advantages of the use of the therapy are disclosed with the focus made on the efficacy of dream healing in groups and the role of groups in understanding and accepting the patient;
- The conclusion with advantages of the use of psychoanalytic therapy in group counseling is presented.
The Columbia Encyclopedia introduces the basic postulates of psychoanalysis. It throws light on the way Freud used his psychoanalytic method to treat patients with a variety of mild mental disorders. Psychoanalytic therapy is based on Freud’s observation that the physical symptoms of hysterical patients disappeared when apparently forgotten was made conscious. Freud highlighted the significance of the unconscious in the functioning of a healthy personality. He operated with it during his psychoanalytic therapy sessions.
Psychoanalytic Therapy (2004) by Hau and Leuzinger-Bohleber focuses on the recent developments in psychoanalytic therapy. The authors consider the efficacy of the theory and the necessity of its integration into statutory health care systems. The paper overviews the present state of research on the efficacy of various applications of psychoanalytic therapy and seeks to answer the question as to which problems in the therapy now deserve special attention as well as which type of it is best suited to meet present challenges.
Egbochuku and Obiunu (The Effect of Reciprocal Peer Counseling in the Enhancement of Self-Concept among Adolescents, 2006) study the efficacy of peer group counseling. The results of the experience conducted show that the peer group counseling technique is psychologically rewarding and can be used for the enhancement of self-concept for students.
In Scapegoating: Dynamics and Interventions in Group Counseling (2002), Clark shows how helpful psychoanalytic therapy might be for the group counselor to effectively process scapegoating interactions among group participants in a manner to facilitate group achievement of its full therapeutic potential.
In Faulkes’ Introduction to Group-Analytic Psychotherapy: Studies in the Social Integration of Individuals and Groups (1983), group-analysis as a form of psychotherapy in small groups is considered. This treatment has grown from the psychoanalytic approach. The ultimate aim of this therapy is liberation and integration of the individual through participation in group activities. The role of the conductor or leader in creating the group-analytic situation is emphasized: the author shows what the leader has to do to make all members of his group active participants in the solution of their problems; with this approach, the whole group benefits as well as every individual in particular.
In Analytic Group Psychotherapy (1952), Ruskin dwells on his experience with 40 women neurotic, psychoneurotic, or manic-depressive patients formed in groups at a sanatorium outlining the psychoanalytic techniques he used. Transference, catharsis, interpretation, insight and/or ego-building, social interaction through reality testing, and sublimation are specifically discussed.
Richard and Romich, in their work Acting-Out: Its Functions within Analytic Group Psychotherapy and its Transformation into Dreams (1952), consider how acting-out within groups can draw the boundaries between patients’ past and present experiences. From acting out, unconscious dynamics are transformed into dreams.
Dr. Ullman, in his Appreciating Dreams: A Group Approach (1996), investigates the healing power of dream as revealed in the work of dream groups. The book examines different procedures of how the activity of such groups can be organized. The main principles of safety, help, and support are highlighted.
In Dreams in Group Psychotherapy: Theory and Technique (2003) by Neri and Pines, it is affirmed that dreams told in groups are both individual and group creations. In the course of group members’ interaction, dreams that they reveal promote change in their behavior and personal development. Due to their unconscious content, dreams may establish the most authentic exchange between individual and group.
Psychoanalytic Therapy Approach
Psychoanalytic therapy is a treatment technique based on psychoanalysis. It has been in applied use for around 100 years. Freud, the father of psychoanalysis, studied hysteria and became convinced that it is caused not by organic symptoms in the nervous system but by emotional disturbance (Psychoanalysis, 2007, p. 39413). Freud observed that the physical symptoms of hysterical patients disappeared when apparently forgotten material was made conscious. Today, all psychoanalytic theories agree that the unconscious has central significance in the functioning of the healthy personality and in psychological illnesses (Hau & Leuzinger-Bohleber, 2004, p. 13).
Psychoanalytic therapy unfolds in the analytic situation between the Analyst and the Analysand. The essence of this situation lies in the fact that it is a transference situation. The Analysand is encouraged by the Analyst to revive his/her unconscious (for instance, earlier relationships to other people, which are still active in his/her mind, as they have not come to a satisfactory conclusion) (Foulkes, 1983, p. 9).
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According to the psychoanalytic conception, the chief structures of the personality take form through processes of interiorization in the first years of life through the interplay of individual disposition and interpersonal relationships (Hau & Leuzinger-Bohleber, 2004, p. 13). Therefore, the Analysand describes the pictures that appear in his/her mind, speaks of the roles of other persons in the earlier life, down to infancy. The Analysand is free to focus on everything he/she likes: previous love experiences, relations with friends, problems with parents, feelings of hate, fear, regret, panic, regret, remorse, guilt, etc.
The Analyst’s task is not to interfere with the process of transference. He/she does not stop the Analysand if the latter repeats the same things several times. By way of repetition, the Analysand experiences his/her most vital and most conscious conflicts. Together with the patient, the Analyst travels through his/her life: if the Analyst treats the Analysand as a real person in the present reality only, the Analysand returns to the present, thus abandoning the established transference.
The Analyst follows the patient exactly as the patient’s own unconscious mind dictates. However, though the Analyst allows the patient to go as far as he/she can to learn what he/she likes and dislikes, the Analyst recalls one to the present-day level, representing the existing reality. The efficacy of the therapy depends on the Analyst’s ability to fulfill both these tasks in the right proportion and at the right moment. If the Analyst succeeds in fulfilling both parts of the therapy, the Analysand links up his/her past with present life, brings up-to-date conflicts, and achieves a better integration (Foulkes, 1983, p. 9).
Psychoanalytic therapy is commonly referred to as the “talking cure” as it takes the form of simple talking interaction between patient and therapist. Through this interaction, an understanding of the unconscious processes and how they affect the human mind as a whole comes out. Most emotional, mental, and personal achievement problems are treated during the psychoanalytic therapy sessions. As a rule, the Analyst does not lecture or advise the Analysand about how he/she should manage his/her life. Rather, the therapist encourages the patient to understand the reasons why he/she cannot make out problems, what internal conflicts prevent him/her from solving them, and, in the long run, helps to decide what to do in life. The ultimate goal of psychoanalytic therapy is to help one improve the quality of one’s life and one’s relationships.
Group counseling is a challenging and dynamic form of counseling that presupposes interaction between the group of about 5-10 persons and the group counselor with the purpose of solving their emotional and mental problems. Members of the group meet together regularly for 1-2 hours each week for 11 to 17 sessions.
The types of groups vary from those primarily task-oriented to those that are basically therapeutic—members of the group experienced some difficulties of personal, educational, social, or vocational nature. Group membership is either homogeneous or heterogeneous. Homogeneous groups consist of similar members (adolescent girls, single parents, women who suffered from sexual abuse). Heterogeneous groups are composed of members who have different backgrounds or social status characteristics (people of various ages or careers). Members of homogeneous groups focus on one particular issue, whereas heterogeneous groups offer a multifaceted perspective.
In both cases, group counseling has many benefits. Group participants can experiment with different ways of behaving. They feel free to share their thoughts and ideas with others and learn how to establish effective communication. They can see themselves through someone else’s eyes. Group counseling does not only help patients to get rid of the problems that appeared in the past, or they suffer from at present, but it advises people on how to act not to repeat their mistakes in the future as well.
Application of Psychoanalytic Therapy in Group Counseling
Psychoanalytic therapy is a technique embracing a number of applications. In group counseling, two of them are most frequently used: analytic group psychotherapy and psychodynamic/depth psychology-based group psychotherapy.
Analytic group therapy is based on the premise that the conscious and unconscious conflicts and developmental disorders of the group participants are arranged not only intrapsychically but interpersonally as well. The latter occurs in the form of externalized pathological object relations.
The conscious and unconscious conflicts and developmental disorders can be examined in a multi-person relationship with the analytic tools of transference, countertransference, and resistance. Accordingly, the analytic group counselor works to reveal or interpretively accompany the influence of individual psychological and psychosomatic conflicts and/or developmental impairments on the interpersonal process in a multidimensional transference scenario, in which family-dynamic conflicts and sibling conflicts are recurrently actualized.
One focus of group counselors is on reestablishing the family/primary group in the unconscious of the group members with a range of transferences and relationship enactments. Another task of the group counselor applying psychoanalytic therapy is to concentrate on the group as a whole. The principle is that the individual contributions of the group participants unconsciously form a common theme; the equally balanced attention of the counselor on the individual setting corresponds to non-directive leadership in the group.
As regressive developments can arise more rapidly and more intensively in a group environment than in individual therapy, dealing with them requires especial psychoanalytic competence of the counselor in order to catch and influence maladaptive developments as early as possible. This implies an awareness of interpersonal defense mechanisms, psychosocial compromise formation, and unconscious group fantasies (Hau & Leuzinger-Bohleber, 2004, p. 26).
Psychodynamic/depth psychology-based group therapy differs from the above-discussed therapy in its depth of regression and its mode of interpretation, focusing on derived conflicts that manifest as relationship and role conflicts in the daily life of the group participants and that find their reflection in the group. The therapy is based on the interactional principle that places value on group members receiving direct feedback regarding capacities, words, or actions. So, the central aim of this form of therapy is “catching up” developmentally by working on inefficiently developed competencies as reflected by the reactions and evaluations of the other group participants and the therapist (Hau & Leuzinger-Bohleber, 2004, p. 28).
Advantages of Using Psychoanalytic Therapy Approach in Group Counseling
The Fullest Potential of a Dream as a Healing Instrument
It was already stated that the patient’s unconscious is the main field wherein the Analyst operates. Here we will speak of the importance that exploration of dreams as a way to understand the patient’s unconscious has in psychoanalytic therapy as applied in group counseling.
The thing is that “’ dreams are not in themselves social utterances, not a means of giving information, the dream is an intrapsychic phenomenon which has sleep-preserving functions, censoring unacceptable psychic contents” (Neri & Pines, 2003, p. 25). Jung writes: “the dream is a little hidden door in the innermost and most secret recesses of the soul opening into that cosmic night which was psyche long before was any ego-consciousness” (Neri & Pines, 2003, p. 26).
According to Dr. Ullman (1996), three aspects of dream content form an essential unity:
- the relevance of the dream to our immediate situation,
- bringing together pertinent information from the past, and
- the reliability of that information (p.4).
They have taken together these aspects of dream content to account for the special quality of dreaming consciousness and the potential healing power of the dream. Emotional healing is based on the patients’ ability to bring forth a new and more authentic view of their selves by seeing connections between past and present that, in scope and honesty, go beyond what they have seen before.
To achieve the best result in healing through dreams, the dream should be shared with another or with others (Ullman, 1996, p. 5). Sessions of group counseling appear to be an appropriate setting wherein the healing power of a dream can be disclosed. Though one can make connections between dream and reality on his/her own, the optimal healing involves more than one can manage alone. “Emotional healing, through dreamwork or otherwise involves coming to a more deeply felt understanding of oneself in and through a social support system.” (Ullman, 1996, p.5)
Dreamwork is risk-taking as it requires revealing the patient’s secrets. Through the work of dream appreciation groups as a part of group counseling, the group members’ dreams are best dissolved. In the act of sharing them with other people, group participants together find out how to interpret their dreams and elaborate ways of how to manage their lives.
Dreams come from a very private part of a patient’s psyche. At the same time, awake one cannot be as honest with oneself as he/she was while dreaming. Awake, people return to reality and become actors on the social scene, this or that way forbidding themselves to see what the dream might be saying. Participating in dream groups, people find help and support to return to that kind of honesty they had while dreaming.
The counselor’s main concern that arises is to establish an atmosphere of safety when patients share their dreams. As dreams touch on very intimate and personal concerns, the patient should trust the people that will learn about his/her dream. Many group members resist the public display of their dreams as they do not feel that it is safe to do so. Therefore, it is very important that the counselor should establish a supportive and nonjudgmental atmosphere that will encourage one to share one’s dreams.
We should also admit that in group counseling, dreams can be used with a purpose that differs from the one described above. Dreams might serve as a way in which self can be represented in the group. Any group participant may tell a dream in order to reveal some of his/her experiences to the audience. This is dream-telling, narrative. The dream can be perceived in different ways by other patients. The reaction might range from disinterest and evasion to a warm perception and involvement in a lively discussion.
In all cases, both the dream-teller and the rest of the group benefit: in the first case, the narrator becomes more responsive and understanding, moving from his/her position of self-isolation and self-destruction; in the second one – the response illuminates not the dreamer’s psyche only, but those of other participants’ as well, amplifying the group’s recognition of their shared processes (Neri &Pines, 2003, p. 28).
Understanding and Accepting the Patient
Though reasons for participating in group counseling differ, all group members have some problem with their ego involvement. In a group, the patient’s ego involvement with parents, siblings, teachers, and other members of society is projected towards the therapist as the leader and to other members of society. The patient enters the group emotionally traumatized, with acquired fears, anxieties, and self-rejection. The counselor and the group turn out to be a miniature social setting for the patient; the latter displaces on them his/her feelings and attitudes (Ruskin, 1952, p.142).
As a rule, at the beginning of the therapy, the patient demonstrates different hostile attitudes towards the therapist and the members of the group. However, the patient can tolerate the group. The psychoanalytic therapy activities evoke more and more positive attitudes with the patient. The latter is placed in an emotional setting where he/she feels free from fear and misgivings, through acceptance and understanding, allows oneself to regress to stages where his/her emotional development has been arrested (Ruskin, 1952, p.143).
The accepting therapist and members of the group encourage the patient’s ego-ideal to release from negative emotions. While discussing each other’s problems, the members of the group understand that what they felt to be their secret and specific problem is universal and not an unnatural state. Patients realize that they are not alone in their grief, others from the group have emotional or mental illnesses similar to their own, and therefore, they can easily understand each other.
The group therapist introduces the patient’s problem to the whole group for discussion and interpretation, after which the patient himself interprets his/her feelings and emotions, which results in relief of anxiety.
Still, two situations can emerge during discussion and interpretation: first, not all members of the group may be willing to accept an interpretation at the same time. Therefore, it is necessary to concentrate attention on a particular patient; second, people show their empathy for the patient talking about his/her problem by giving comparable illustrations of their own life situations, which tend to reduce the anxiety of the individual, making interpretation more acceptable. This is the treatment of a patient in a group through group treatment (Ruskin, 1952, p. 143).
A review of the existing literature on the problem enabled us to single out the following advantages of the use of the psychoanalytic approach in group counseling:
- Psychoanalytic therapy gives patients the opportunity to see themselves through the eyes of others and to see themselves in others (Egbochuku & Obiunu, 2006);
- As the patient speaks of his/her problem, some new aspects of it may arise. In a group environment it is easier to examine and understand difficulties just at the moment when they appear (Egbochuku & Obiunu, 2006);
- Groups are relatively safe places that contribute to the emergence of new ways of relating (Clark, 2002).
Everything stated above considered, we conclude that psychoanalytic theory is beneficial for group counseling. The empathetic and nonjudgmental environment that the group member finds him/her in encourages one to reveal feelings or actions that have led to stress or tension in his/her life. Professional work of group counselor who relies on the principles of psychoanalytic therapy and the patient’s desire to solve the problems he/she has served the guarantee of their common success in the field.
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Clark A. J. (2002). Scapegoating: Dynamics and interventions in group counseling. Journal of Counseling and Development, 80, 315-318.
Egbochuku, & J.J. Obiunu. (2006). The effect of reciprocal peer counseling in the enhancement of self-concept among adolescents. Education, 126 (3), 504.
Foulkes, S. H. (1983). Introduction to Group-Analytic Psychotherapy: Studies in the Social Integration of Individuals and Groups. London: Maresfield Reprints.
Hau S. &Leuzinger-Bohleber M. Psychoanalitic therapy. Web.
Neri, C. & Pines, M. (2003). Dreams in group psychotherapy: Theory and technique. Jessica Kingsley Publishers.
Richardz B., & Romich S. (1952). Acting-out: its functions within analytic group psychotherapy and its transformation into dreams. Int J Group Psychother, 52(3), 337-53.
Ruskin, I. W. (1952). Analytic group psychotherapy – For wives and husbands. Western Journal of Medicine, 77(2), 140-145.
Ullman, M. (1996). Appreciating dreams: A group approach. Sage Publications, Inc.