The Theory and Practice of Group Psychotherapy (44 page)

A leader’s personal disclosure may have a powerful and indelible effect. In a recent publication, a member of a group led by Hugh Mullan, a well-known group therapist, recounts a group episode that occurred forty-five years earlier. The leader was sitting with his eyes closed in a meeting, and a member addressed him: “You look very comfortable, Hugh, why’s that?” Hugh responded immediately, “Because I’m sitting next to a woman.” The member never forgot that odd response. It was enormously liberating and freed him to experience and express intensely personal material. As he put it, he no longer felt alone in his “weirdness.”
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One objection to self-disclosure, a groundless objection, I believe, is the fear of escalation—the fear that once you as therapist reveal yourself, the group will insatiably demand even more. Recall that powerful forces in the group oppose this trend. The members are extraordinarily curious about you, yet at the same time wish you to remain unknown and powerful. Some of these points were apparent in a meeting many years ago when I had just begun to lead therapy groups. I had just returned from leading a weeklong residential human relations laboratory (intensive T-group; see chapter 16). Since greater leader transparency is the rule in such groups, I returned to my therapy group primed for greater self-revelation.

• Four members, Don, Russell, Janice, and Martha, were present at the twenty-ninth meeting of the group. One member and my co-therapist were absent; one other member, Peter, had dropped out of the group at the previous meeting. The first theme that emerged was the group’s response to Peter’s termination. The group discussed this gingerly, from a great distance, and I commented that we had, it seemed to me, never honestly discussed our feelings about Peter when he was present, and that we were avoiding them now, even after his departure. Among the responses was Martha’s comment that she was glad he had left, that she had felt they couldn’t reach him, and that she didn’t feel it was worth it to try. She then commented on his lack of education and noted her surprise that he had even been included in the group—an oblique swipe at the therapists.

I felt the group had not only avoided discussing Peter but had also declined to confront Martha’s judgmentalism and incessant criticism of others. I thought I might help Martha and the group explore this issue by asking her to go around the group and describe those aspects of each person she found herself unable to accept. This task proved very difficult for her, and she generally avoided it by phrasing her objections in the past tense, as in, “I once disliked some trait in you but now it’s different.” When she had finished with each of the members, I pointed out that she had left me out; indeed, she had never expressed her feelings toward me except through indirect attacks. She proceeded to compare me unfavorably with the co-therapist, stating that she found me too retiring and ineffectual; she then immediately attempted to undo the remarks by commenting that “Still waters run deep” and recalling examples of my sensitivity to her.

The other members suddenly volunteered to tackle the same task and, in the process, revealed many long-term group secrets: Don’s effeminacy, Janice’s slovenliness and desexualized grooming, and Russell’s lack of empathy with the women in the group. Martha was compared to a golf ball: “tightly wound up with an enamel cover.” I was attacked by Don for my deviousness and lack of interest in him.

The members then asked me to go around the group in the same manner as they had done. Being fresh from a seven-day T-group and no admirer of generals who led their army from the rear, I took a deep breath and agreed. I told Martha that her quickness to judge and condemn others made me reluctant to show myself to her, lest I, too, be judged and found wanting. I agreed with the golf ball metaphor and added that her judgmentalism made it difficult for me to approach her, save as an expert technician. I told Don that I felt his gaze on me constantly; I knew he desperately wanted something from me, and that the intensity of his need and my inability to satisfy that need often made me very uncomfortable. I told Janice that I missed a spirit of opposition in her; she tended to accept and exalt everything that I said so uncritically that it became difficult at times to relate to her as an autonomous adult.

The meeting continued at an intense, involved level, and at its end the observers expressed grave concerns about my behavior. They felt that I had irrevocably relinquished my leadership role and become a group member, that the group would never be the same, and that, furthermore, I was placing my co-therapist, who would return the following week, in an untenable position.

In fact, none of these predictions materialized. In subsequent meetings, the group plunged more deeply into work; several weeks were required to assimilate the material generated in that single meeting. In addition, the group members, following the model of the therapist, related to one another far more forthrightly than before and made no demands on me or my co-therapist for escalated self-disclosure.

There are many different types of therapist transparency, depending on the therapist’s personal style and the goals in the group at a particular time. Therapists may self-disclose to facilitate transference resolution; or to model therapeutic norms; or to assist the interpersonal learning of the members who wanted to work on their relationship with the group leader; or to support and accept members by saying, in effect, “I value and respect you and demonstrate this by giving of myself”?

• An illustrative example of therapist disclosure that facilitated therapy occurred in a meeting when all three women members discussed their strong sexual attraction to me. Much work was done on the transference aspects of the situation, on the women being attracted to a man who was obviously professionally off-limits and unattainable, older, in a position of authority, and so on. I then pointed out that there was another side to it. None of the women had expressed similar feelings toward my co-therapist (also male); furthermore, other female clients who had been in the group previously had had the same feelings. I could not deny that it gave me pleasure to hear these sentiments expressed, and I asked them to help me look at my blind spots: What was I doing unwittingly to encourage their positive response?

My request opened up a long and fruitful discussion of the group members’ feelings about both therapists. There was much agreement that the two of us were very different: I was more vain, took much more care about my physical appearance and clothes, and had an exactitude and preciseness about my statements that created about me an attractive aura of suaveness and confidence. The other therapist was sloppier in appearance and behavior: he spoke more often when he was unsure of what he was going to say; he took more risks, was willing to be wrong, and, in so doing, was more often helpful to the clients. The feedback sounded right to me. I had heard it before and told the group so. I thought about their comments during the week and, at the following meeting, thanked the group and told them that they had been helpful to me.

Making errors is commonplace: it is what is done with the error that is often critical in therapy. Therapists are not omniscient, and it is best to acknowledge that.

• After an angry exchange between two members, Barbara and Susan, the group found it difficult to repair the damage experienced by Barbara. Although Barbara was eventually able to work through her differences with Susan, she continued to struggle with how she had been left so unprotected by the group therapist. Numerous attempts at explanation and understanding failed to break the impasse, until I stated: “I regret what happened very much. I have to acknowledge that Susan’s criticism of you took me by surprise—it hit like a tropical storm, and I was at a loss for words. It took me some time to regroup, but by then the damage had been done. If I knew then what I know now, I would have responded differently. I am sorry for that.”

Rather than feeling that I was not competent because I had missed something of great importance, Barbara felt relieved and said that was exactly what she needed to hear. Barbara did not need me to be omnipotent—she wanted me to be human, to be able to acknowledge my error, and to learn from what happened so that it would be less likely to occur in the future.

• Another illustrative clinical example occurred in the group of women incest survivors that I mentioned earlier in this chapter. The withering anger toward me (and, to a slightly lesser degree, toward my female co-therapist) had gotten to us, and toward the end of one meeting, we both openly discussed our experience in the group. I revealed that I felt demoralized and deskilled, that everything I tried in the group had failed to be helpful, and furthermore that I felt anxious and confused in the group. My co-leader discussed similar feelings: her discomfort about the competitive way the women related to her and about the continual pressure placed on her to reveal any abuse that she may have experienced. We told them that their relentless anger and distrust of us was fully understandable in the light of their past abuse but, nonetheless, we both wanted to shriek, “These were terrible things that happened to you, but
we
didn’t do them.”

This episode proved to be a turning point for the group. There was still one member (who reported having undergone savage ritual abuse as a child) who continued in the same vein (“Oh, you’re uncomfortable and confused! What a shame! What a shame! But at least now you know how it feels”). But the others were deeply affected by our admission. They were astounded to learn of our discomfort and of their power over us, and gratified that we were willing to relinquish authority and to relate to them in an open, egalitarian fashion. From that point on, the group moved into a far more profitable work phase.

In addition, the “now you know how it feels” comment illuminated one of the hidden reasons for the attacks on the therapist. It was an instance of the group member both demonstrating and mastering her experience of mistreatment by being the aggressor rather than the mistreated.

It was constructive for the therapists to acknowledge and work with these feelings openly rather than simply continue experiencing them.
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Being so intensely devalued is unsettling to almost all therapists, especially in the public domain of the group. Yet it also creates a remarkable therapeutic opportunity if therapists can maintain their dignity and honestly address their experience in the group.†

These clinical episodes illustrate some general principles that prove useful to the therapist when receiving feedback, especially negative feedback:

1. Take it seriously. Listen to it, consider it, and respond to it. Respect the clients and let their feedback matter to you; if you don’t, you merely increase their sense of impotence.

2. Obtain consensual validation: Find out how other members feel. Determine whether the feedback is primarily a transference reaction or is in fact a piece of reality about you. If it is reality, you must confirm it; otherwise, you impair rather than facilitate your clients’ reality testing.

3. Check your internal experience: Does the feedback fit? Does it click with your internal experience?

With these principles as guidelines, the therapist may offer such responses as: “You’re right. There are times when I feel irritated with you, but at no time do I feel I want to impede your growth, seduce you, get a voyeuristic pleasure from listening to your account of your abuse, or slow your therapy so as to earn more money from you. That simply isn’t part of my experience of you.” Or: “It’s true that I dodge some of your questions. But often I find them unanswerable. You imbue me with too much wisdom. I feel uncomfortable by your deference to me. I always feel that you’ve put yourself down very low, and that you’re always looking up at me.” Or: “I’ve never heard you challenge me so directly before. Even though it’s a bit scary for me, it’s also very refreshing.” Or: “I feel restrained, very unfree with you, because you give me so much power over you. I feel I have to check every word I say because you give so much weight to all of my statements.”

Note that these therapist disclosures are
all part of the here-and-now of the group
. I am advocating that therapists relate authentically to clients in the here-and-now of the therapy hour, not that they reveal their past and present in a detailed manner—although I have never seen harm in therapists’ answering such broad personal questions as whether they are married or have children, where they are going on vacation, where they were brought up, and so on. Some therapists carry it much further and may wish to describe some similar personal problems they encountered and overcame. I personally have rarely found this useful or necessary.
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p

A study of the effects of therapist disclosure on a group over a sevenmonth period noted many beneficial effects from therapist transparency.
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First, therapist disclosure was more likely to occur when therapeutic communication among members was not taking place. Second, the effect of therapist disclosure was to shift the pattern of group interaction into a more constructive, sensitive direction. Finally, therapist self-disclosure resulted in an immediate increase in cohesiveness. Yet many therapists shrink from self-disclosure without being clear about their reasons for doing so. Too often, perhaps, they rationalize by cloaking their personal inclinations in professional garb. There is little doubt, I believe, that the personal qualities of a therapist influence professional style, choice of ideological school, and preferred clinical models.†