Introduction to Group Psychotherapy
Scientific basis of group psychotherapy
Aristotle also called man a “social animal” and considered his need to establish contacts with his own kind as a source of his strength. Scientific research into the influence of a group on a person began in 1895, when the French social psychologist Gustav Le Bon introduced the concept of “group consciousness.” Like other researchers of that time, G. Le Bon was mainly interested in very large groups. Since G. Le Bon was greatly impressed by the primitive nature of people in large groups, he used the concept of “crowd” to designate the main object of his research. G. Le Bon suggested that people, becoming part of the crowd, begin to experience hypnotic effects and their behavior changes and often becomes unpredictable and poorly controlled. They lose their sense of responsibility for their actions, and their behavior begins to be guided by “group consciousness.”
G. Le Bon's main idea was that when people unite in groups, they weaken certain human functions inherent in them. He believed that large groups of people were characterized by regressive, primitive and uncivilized behavior. In particular, G. Le Bon wrote: “Just by virtue of his inclusion in an organized group, a person takes several steps down the evolutionary ladder. When alone, he can be quite civilized. When he is in a crowd, he becomes a barbarian, in other words, one who acts in obedience to instincts.”
G. Le Bon associated these changes with the action of three factors. First, he believed that by being in a group, people began to feel powerful and invincible. Secondly, there is a “contagion” effect in groups. He characterized “contagion” as a special kind of hypnotic state associated with the influence of a group on its members. And finally, what was most important is that, being in a group, people become especially suggestible: “Thus,” wrote G. Le Bon, “we can state the weakening of the conscious personality, the primacy of the unconscious personality, the emergence of identical feelings and thoughts thanks to suggestion and infection , the tendency to instantly transform suggested ideas into behavior. We consider all this as the most characteristic features of people in a group. They are no longer themselves, but become mechanisms that no longer use their will to regulate their behavior.”
Such thoughts, of course, cannot be considered as indications of the psychotherapeutic capabilities of the group. However, subsequently, more and more psychologists, albeit indirectly, begin to point out that groups also contain rich therapeutic possibilities.
The English psychologist William McDougall published his work “Group Consciousness” in 1920, in which he came to the same conclusions as G. Le Bon, believing that being in a group of people changes their behavior in a certain way. At the same time, W. McDougall expressed a new idea, namely that although being in a group makes people's behavior less civilized, it does not exclude the manifestation of individual characteristics. Thus, W. McDougall was one of the first to point out the possibilities available in the group for a positive change in the behavior of group members.
A prerequisite for realizing the positive potential of a group, according to W. McDougall, is its organization. As for unorganized groups, he was less optimistic in assessing their capabilities than Le Bon, considering them “overly emotional, impulsive, wild, inconsistent, indecisive and prone to extremes.” However, his book showed “how group organization can serve as a counterbalance to degradation and how better forms of its organization can lead to a complication of group life, thanks to which man can rise above the animals and even feel his kinship with the angels.”
In addition, W. McDougall noted that clear goals and objectives of a group are prerequisites for its effectiveness: “There is... one condition that can contribute to the transition of the behavior of a temporary and unorganized group to a higher level, namely the presence of a clearly defined common goal, recognized by all its members."
So, both G. Le Bon and W. McDougall, studying the influence of groups on the behavior of its members, identified a number of important phenomena, namely: the ability of a group to influence people’s behavior; the presence of the phenomenon of “contagion,” i.e., the appearance of identical feelings among group members; as well as the importance of group organization, reaching a certain agreement among group members regarding its main tasks.
Another major psychologist who made a significant contribution to the development of these studies was Sigmund Freud. S. Freud's works do not directly affect the functioning of small groups; his observations were more concerned with large groups, such as “Group Psychology and Ego Analysis” (1948). S. Freud was interested in the influence of the group on the behavior of the individual; his studies of group dynamics were an important step towards the subsequent development of the concept of the superego, considered as the ideal ego. Defining the differences between a group and a simple meeting of people, he came to the conclusion that the formation of a group is associated with the presence of a goal and clear leadership. In particular, S. Freud noted: “The group is unusually trusting and susceptible to influence, it does not have critical abilities, the incredible does not exist for it... Having an internal predisposition to all sorts of extremes, the group can only be motivated by excessive stimulus. Anyone who tries to influence it does not need the logical components of argumentation; he must portray everything in the most vivid colors, must exaggerate, must repeat the same thing over and over again... She respects strength and can only be slightly influenced by kindness, which she considers only as a kind of weakness... She wants to be controlled and forced, wants to be afraid of his leader. And finally, the group never sought the truth. They require illusions and cannot do without them. They always give preference to what is not real over what is real; they are subject to almost as much influence from falsehood as from truth. They have an obvious tendency to make no distinction between the two... The group is an obedient herd that cannot do without its leader. The group has such a strong need for obedience that it is ready to obey almost anyone who shows even the slightest sign of a mentor.”
Using the theories available in his time, S. Freud suggested that a group is formed when its members develop a libidinal dependence on the leader and on each other. The dependence of group members on the leader and on each other is of a different nature. He also suggested that group members identify with each other on the basis of their libidinal dependence on the leader. As an illustration of this thesis, he cited the army: “It is obvious that the soldier perceives those who stand above him, namely the commander of the army, as his ideal; at the same time he is identified with his equals, thereby creating in their community an obligation of mutual assistance and equal responsibility shared by all its members.”
Closely related to the idea of identification between group members is the idea of regression and dedifferentiation, according to which they do not have individuality, but strive to achieve common goals. This phenomenon helps explain that inclusion in a group can cause both feelings of joy and fear.
Another observation related to the ideas of S. Freud concerns how an individual abandons his ego ideal and instead accepts the goals and ideals of the group leader. Z. Freud compares the relationship of group members to the leader with a love relationship, when the one who is loved is seen as an ideal and the highest value. He noted: “When we love, a significant amount of narcissistic libido is transferred to the object. This is obvious in many situations involving the choice of a love object, when it acts as a substitute for some unattainable ego ideal.” This mechanism allows us to connect individual psychology with the functioning of groups, as well as explain those forms of behavior that have been described by other scientists.
S. Freud saw the way to overcome the regressive tendencies of the group in the manifestation of empathy: “From identification through imitation one can come to empathy, that is, to mastering the mechanism through which we can understand the mental manifestations of another.” In other words, following the regression associated with the formation of a group, its members can reverse the regressive processes by identifying with each other. This is associated with the manifestation of empathy, which contributes to the restoration of their identity and a better understanding of their own feelings and the feelings of others.
The closest thing to real group psychotherapy, according to J. Rutan and W. Stone (2002), was work within the framework of the Wednesday Evening Society. During the first decade of this century, a group of psychoanalysts met regularly to discuss the theoretical principles of psychoanalysis, citing their work with clients as illustrations. Pioneers of psychoanalysis such as Alfred Adler, Lou Andreas-Salomé, Paul Federn, Max Graf, Wilhelm Reich, Hermann Nünberg, Alfred Saenger and Frank Wittels regularly attended this group. At first, the group was educational in nature, but its founder, Wilhelm Stekel, was a client of S. Freud, which created a precedent for the use of psychoanalysis for psychotherapeutic purposes in such sessions. Members of the society regularly exchanged personal impressions. At the same time, S. Freud acted as the leader of the group. In the end, as follows from the minutes of the Vienna Psychoanalytic Society, the meetings became too emotional. The group members stopped meeting when the conflict that arose between A. Adler and S. Freud reached its highest intensity. Such destructive manifestations in a group between its members, between members and the leader are now considered as natural and typical metamorphoses of group life.
Paul Dubois method
Rational therapy proposed by this Swiss neurologist is the most affordable way to cure the patient. It is used not only by narrow specialists, but also by general practitioners.
Du Bois's rational psychotherapy uses the patient's ability to draw logical conclusions, make comparisons, and prove the validity of existing facts. This method was an alternative to treatment by suggestion. At the same time, rational psychotherapy primarily relied on the patient’s thinking and reason.
Paul DuBois believed that the origins of the development of neuroses lie in errors of judgment and weakness of the intellect. Of course, at present these theoretical conclusions are not accepted unconditionally. Nevertheless, many of Du Bois's recommendations and conclusions, which he made on the basis of numerous observations, have great practical value. An example of this is the description of a conversation between a Swiss neurologist and his patient who suffered from insomnia. You can get acquainted with it in the book “Neuroses” by A. M. Svyadoshch: “Do not think about sleep - it flies away like a bird when they are chasing it; destroy your empty worries with healthy thinking and end the day with some simple thought that will allow you to sleep peacefully.”
In his practice, Du Bois relied entirely on logic. Using this scientific direction about the laws of thinking, he quite convincingly demonstrated to his patient the errors that took place in his reasoning and were associated with an incorrect assessment of the pathological condition. Such an effect on the patient is the basis of this method. But besides this, Du Bois’s rational psychotherapy includes emotional influence, suggestion, study and further personality correction, as well as rhetorical didactic techniques.
The concept of group psychotherapy
Story.
While psychologists were trying to explain how groups influence people's behavior, practitioners were using small group work for psychotherapeutic purposes.
One of the first to use a group approach in treating clients was Joseph Pratt, an internal medicine specialist at Massachusetts General Hospital in Boston. Therefore, it is he who is considered by many to be the founding father of group psychotherapy.
In July 1905, he created a group of 15 tuberculosis patients who could not afford hospital treatment. In the group, J. Pratt did not conduct group psychotherapy in the modern sense of the word. Meetings usually took the form of lectures. He gathered clients into groups and talked to them about behavioral hygiene, the healing effects of fresh air and good nutrition. In turn, clients talked about their life situations, experiences, and discussed the problems and behavior of individual members of their group.
Recognizing J. Pratt's groups as the starting point of group psychotherapy, it is necessary to take into account two circumstances: firstly, these groups are the very first attempt to form a small group of clients in order to give them the opportunity to discuss their problems; secondly, even before attending classes, all group members committed themselves to follow certain rules. For example, each client was required to stop working and spend as much time as possible outdoors. This was one of the main conditions for their treatment. J. Pratt reported positive results of a new type of treatment.
At first, such a group approach to treating clients made purely economic sense, but later J. Pratt drew attention to the fact that the group itself, the influence of its members on each other, is a fairly powerful psychotherapeutic factor that has a positive effect on the course of the underlying disease. J. Pratt believed so much in the healing properties of the group that he developed a group therapy technique for people who do not have physical illnesses.
As already noted, the formation of group psychotherapy was greatly influenced by the works of S. Freud concerning the study of the psychology of the masses, the relationship between the masses and the leader, etc. His students and followers were among the first to try to use psychoanalytic treatment in a group setting.
The pioneers of the use of small groups for psychotherapeutic purposes were: E. Lazelle, who was the first to use this approach in working with psychiatric clients (mainly with schizophrenia) at St. Elizabeth's Hospital in Washington in 1919; T. Barrow, who worked with a group of neurotics starting in 1920; A. Adler, whose belief that man is social by nature led him to work with groups of clients in 1921; Yu. Metzel, who began using group psychotherapy with alcoholics in 1927; K. Mersch, who led lecture-type groups in New York in 1919; R. Dreikurs, who in 1930 began conducting the first closed psychotherapeutic groups, as well as engineer S. R. Slavson, who combined his work with conducting psychotherapeutic “activity groups” for children with emotional and behavioral disorders.
It is obvious that the practice of small psychotherapeutic groups has been strongly influenced by American researchers. America not only readily accepted this type of psychotherapy, but also became a refuge for many prominent Viennese psychologists who were forced to emigrate to the United States due to the difficult situation in Europe associated with the Nazi occupation, and contributed to the growth of interest in group psychotherapy.
However, Ya.L. is considered the founder of group psychotherapy. Moreno, he also owns the term “group psychotherapy”. In 1931, J. Moreno founded the first professional magazine, Impromptu, which was later renamed Group Psychotherapy.
The work of Kurt Lewin, especially his “field theory,” had an undoubted influence on the study of small psychocorrectional groups. More than seventy years ago he said that “it is easier to change individuals in a group than each of them individually.”
K. Levin, like S. Freud and other pioneers of psychoanalysis, used the concept of field to explain the process of personality development. Just as in physics the use of a mechanistic model turns out to be insufficient in many cases, K. Levin showed that when considering the process of personality development, it is necessary to take into account the variety of different influences representing different fields. One of the most significant influences is the influence of other people. Therefore, it is quite natural that K. Lewin became interested in the interaction of people in small groups. Primarily a researcher and theorist, he conducted experiments with groups, viewing them as a means of developing decision-making skills, increasing group effectiveness, and developing group morality. After World War II, K. Lewin continued his work at the Center for Group Dynamics Research at the Massachusetts Institute of Technology. This was the first academic project to study small group dynamics.
In 1947, the year of K. Lewin's death, three of his students - K. Benn, L. Brandford and R. Lippett - began to conduct a series of studies on group psychology. As a result, they created the National Training Laboratory, which was the first organization associated with the activities of sensitivity groups, or “training groups.”
The emergence and activity of sensitivity groups occurred approximately in the same years as the creation of the first psychotherapeutic groups. Sensitivity groups have been a source of very valuable experience and the development of a number of theoretical positions related to the capabilities of small groups. For example, Kurt Lewin used small groups primarily for the purpose of development rather than treatment.
Carl Rogers had a significant influence on the development of group psychotherapy, who essentially became the ideologist of another school, uniting those who worked with small groups.
The work of this school was initially associated with the training of consultants to work in veterans' organizations in the post-war years. The main difference between the approach of K. Rogers and the approach of K. Lewin was the different attitude towards the tasks of the groups. Roger's groups focused primarily on personal growth, as well as the development and improvement of interpersonal communication skills. In addition, these groups had a predominantly practical and psychotherapeutic orientation.
K. Rogers laid the foundations of the humanistic direction in psychotherapy. His “client-centered therapy”, concepts of “encounter groups”, “meeting process” laid the foundation for anti-authoritarian non-directive psychotherapy.
Thus, in the 40s, sensitivity groups were a separate direction, represented by two schools: one of them was associated with the work of Kurt Lewin and used small groups to increase personal and group effectiveness; the second was associated with the ideas of Carl Rogers and used small groups mainly for emotional stabilization and personal growth.
In 1978, Stanislav Kratochvil’s book “Group Psychotherapy of Neuroses” was published in Prague, which became a reference book for therapists practicing group psychotherapy.
Among modern domestic scientists, S. S. Libikh, A. L. Grossman, N. V. Ivanov, A. I. Zakharov, V. T. Kondrashenko, D. I. have done a lot for the development of group psychotherapy. Donskoy, E.G. Eidemiller et al.
In 1990, the monograph “Group Psychotherapy” was published under the editorship of B. D. Karvasarsky and S. Ledar (Poland). In the same year and with the same title, a book by K. Rudestam was published, and then a large number of other interesting publications, among which the most fundamental is the book by I. Yalom “The Theory and Practice of Group Psychotherapy” (2000).
Definition.
There are many definitions of the concept of group psychotherapy. J. Moreno (1932) defines group psychotherapy as the treatment of people in groups.
S. Kratochvil (1978) believes that group psychotherapy is a method in which group dynamics are used for therapeutic purposes, i.e. relationships and interactions of group members both with the psychotherapist and among themselves.
S. Ledar (1990) calls group psychotherapy a treatment method that is consciously, systematically and systematically applied in a specially organized treatment group, where the psychotherapist and participants use verbal and non-verbal methods of influencing the client and the group and jointly take an active part in therapeutic activities.
N. K. Lipgart et al. (1979) believe that group psychotherapy is a fundamentally new direction of therapeutic activity, focused primarily on activating the client’s personality and changing his relationship to his illness and the surrounding microsocial environment.
A. S. Slutsky and V. N. Tsapkin (1985) define group psychotherapy as a method of therapeutic influence on the client’s personality through his inclusion in an emotionally intense, psychologically positive interaction with a specially organized controlled microenvironment.
The above definitions indicate that there is no single understanding of the concept of group psychotherapy today.
Ways to heal with words
What are the main directions that are elements of psychotherapy? They are represented by the following main ways to eliminate diseases:
- Rational psychotherapy.
- Suggestive psychotherapy. This method includes waking suggestion, which occurs when a person is in a state of hypnotic sleep, as well as self-hypnosis, which is called autosuggestion.
- Group or collective psychotherapy. It can be domestic, behavioral, or playful. Imagotherapy and psychoesthetotherapy are also distinguished.
- Narcopsychotherapy.
All of the methods listed above will have the maximum effect on the patient when combined with other types of elimination of the disease, including drug treatment, physiotherapeutic procedures, occupational therapy, exercise therapy, etc.
Behavior modeling
This method belongs to cognitive behavioral psychotherapy. With its help, the patient is encouraged to independently solve his problems. Cognitive behavioral psychotherapy is carried out in three stages:
- Self-observation with elements of self-control.
- Conducting an analysis of problem behavior and identifying its source (teachers, parents, environment, etc.).
- Conclusion of a psychotherapeutic agreement. This is a kind of contract, which is a register of planned changes, as well as protocols of what has been achieved after performing independent home exercises.
Role-playing auto-training
When using this method, the patient will need to get used to the image of a cheerful or calm person. This method is great for preventing future conflicts and stressful situations. However, its effectiveness can only be felt by a person with an artistic nature.
In order to enter the role, you will need to choose a suitable ideal for yourself. The model can be either a real person or a movie character. But it is worth remembering: in order to remain calm in various situations using this method, you will need preliminary training.
Abstraction
People also resort to this method in their lives completely unconsciously. We try not to think about the traumatic situation. However, this can be quite difficult to do.
The distraction method allows you to get the maximum effect with weak, but constantly affecting negative stimuli. In this case, negative emotions can gradually accumulate, leading a person to nervous breakdowns and neuroses.
How can you distract yourself from a traumatic situation? For this we recommend:
- Sport games. Tennis, football or volleyball perfectly relieve irritation and eliminate grievances.
- The use of aesthetic therapy. In a state of distress, it is recommended to visit an art exhibition, watch a good comedy, or listen to talented music.
- Visiting good friends. Such a step will allow you to eliminate the bitterness that has accumulated in your soul and not take it out on your loved ones.
- Communication with nature. Negative emotions are especially well eliminated near the river, in the forest, in the mountains and in other beautiful places where peace of mind returns to a person.
In case of prolonged exposure to negative factors, it is recommended to change the situation by taking a vacation and going on a trip.
Muscle relaxation
This method, which is also called autogenic training, is especially popular among psychotherapists. People often use it when working independently to solve their problems. Autogenic training is an independent method proposed in 1932 by a psychotherapist from Germany I. Schulz.
The main objective of this method is maximum relaxation while simultaneously instilling in oneself certain sensations, as well as learning to control the functioning of internal organs. Lightning-fast muscle relaxation allows you to quickly eliminate nervous tension, and do this in any situation.
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