THE THEORY AND PRACTICE OF GROUP PSYCHOTHERAPY- Irvin D Yalom

*a broad and complex therapeutic factor representing both the group therapy analogue of such therapeutic factors as: insight, working through the transference, and corrective emotional experience, as well as processes unique to the group setting.

Humans have always lived in groups.

- clearly adaptive in an evolutionary sense: without intense, positive, reciprocal interpersonal bonds, both individual and species survival would not have been possible.

Studies early mother-child relations, concludes that attachment behavior is built into us.- If mother and infant are separated, both experience marked anxiety concomitant with their search for the lost object.

Reviewed ethnographic evidence: Desire for contact, for recognition and acceptance, for approval, for esteem or for mastery. As we examine human behavior, we find that persons act in such ways as to attain the approval of their fellow man.

We are not only gregarious animals liking to be in sight of our fellows, but we have an innate propensity to get ourselves noticed, and noticed favorably.Research documents pain and adverse consequences of loneliness. Rate for every major cause of death is significantly higher for the lonely- single, divorced, or widowed.

Systematic interpersonal theory of psychiatry: Key concepts:Personality is almost entirely the product of interactions with other significant human beings. The need to be closely related to others is as basic as any biological need and is, in light of the prolonged period of helpless infancy, equally necessary to survival.

Eventually the individual develops a concept of the self-:self-dynamism- based on these perceived appraisals of significant others.If this self-dynamism is derogatory, it will facilitate hostile, disparaging appraisal of other people and hostile appraisals of self.

Sullivan used to describe individual's proclivity to distort his or her perceptions of others.This occurs in an interpersonal situation when one person relates to another not on the basis of realistic attributes of the other, but wholly or chiefly on the basis of a personification existing chiefly in the former's own fantasy.

Similar to TRANSFERENCE but broader in scope; refers not only to the therapeutic but to all interpersonal relationships.

- according to Sullivan, they are modifiable primarily through CONSENSUAL VALIDATION, comparing one's interpersonal evaluations with those of others.

Interpersonal distortions tend to be self-perpetuating. Individual with derogatory, debased self-image may, through selective inattention or projection, incorrectly perceive another to be a harsh, rejecting figure. The process compounds itself because that individual may then gradually develop mannerisms and behavior traits, example- servility, defensive antagonism or scorn- that eventually will cause others to become in fact, harsh and rejecting.

Franz Alexander, 1946, introduced the concept of Corrective emotional experience when describing the mechanism of psychoanalytic cure. Basic principle of treatment: "to expose the patient, under more favorable circumstances, to emotional situations that he could not handle in the past." He must undergo a corrective emotional experience suitable to repair the traumatic influence of previous experience."

*the importance of the emotional experience in therapy and the patient's discovery through reality testing, of the inappropriateness of his interpersonal reactions- equally crucial to GROUP THERAPY.

Contains a host of inbuilt tensions: sibling rivalry, competition for the leader's attention, competition for the groups' attention, the struggle for dominance and status, sexual tensions, paratoxic distortions, differences in background and values among the members.- For the CORRECTIVE EMOTIONAL EXPERIENCE to occur, members must experience the group as sufficiently safe and supportive so that they may permit their differences to emerge, and there must be sufficient feedback and honesty of expression to permit effective reality testing.

1. A strong expression of emotion which is interpersonally directed and is a risk taken by the patient;2. A group supportive enough to permit this risk taking;3. Reality testing which allows the patient to examine the incident with the aid of consensual validation from the other members;4. A recognition of the inappropriateness of certain interpersonal feelings and behavior.

5. The ultimate facilitation of the individual's ability to interact with others more deeply.

Provides a social microcosm in which the maladaptive behavior of members is clearly displayed but also it becomes a laboratory in which it is demonstrated, often with great clarity, the dynamics of the behavior.

As one's interpersonal distortions diminish, one's ability to form rewarding relationships is enhanced. Social anxiety decreases; self-esteem rises; there is less need for self-concealment; others respond positively to this behavior and show more approval and acceptance of the patient, which further increases self-esteem and enhances further change. Eventually the ADAPTIVE SPIRAL achieves such autonomy and efficacy that professional therapy is no longer necessary.

Members of a cohesive group will1. Try harder to influence other group members;2. Be more open to influence by the other members;3. Be more willing to listen to others and more accepting of others;4.

Experience greater security and relief from tension in the group;5. Participate more readily in meetings; 6. Self-disclose more;7. Protect the group norms and, for example, exert more pressure on individuals deviating from the norms;8. Be less susceptible to disruption as a group when a member terminates membership.

Refers to the attraction that members have for their group and for the other members.

1. recognizing that life is at times unfair and unjust.2. recognizing that ultimately there is no escape from some of life's pain and from death.3.

recognizing that no matter how close I get to people I must still face life alone.4. facing the basic issues of my life and death, and thus living my life more honestly and being less caught up in trivialities.5.

learning that I must take ultimate responsibility.