ABSTRACT
Professionals starting on a rehabilitation unit must join the unit culture, learning to work side by side with addiction counselors who are often "in recovery." They then face the task of integrating self-help and psychological models of treatment. Patients undergo their own induction, first accepting the attribution of "addict," and then joining a subculture of recovery that provides ego support and a sense of higher purpose. Group therapy is the primary avenue of acculturation for both patients and professionals.
Subject(s)
Hospitalization , Patient Care Team , Psychotherapy, Group , Substance-Related Disorders/rehabilitation , Acculturation , Adult , Alcoholics Anonymous , Alcoholism/psychology , Alcoholism/rehabilitation , Female , Humans , Male , Social Environment , Substance Abuse Treatment Centers , Substance-Related Disorders/psychologyABSTRACT
Building upon Wolf's (1949) notion of the use of an alternate session in group psychotherapy, this paper suggests that an alternate therapist substituting for an absent regular therapist in milieu group psychotherapy can facilitate similar therapeutic benefits. The mechanism of this process of overcoming transference resistance is seen as twofold: (1) sessions with a substitute therapist allow patients to confront the infantilization often present in a milieu setting and experiment with more autonomous ego functioning. (2) Sessions with a substitute therapist create conditions which are apart from the ongoing process of the therapy group, thereby allowing for a therapeutic splitting process to develop wherein transference feelings about the regular therapist can be expressed to his or her "alter ego." Several case vignettes are presented in order to illustrate the clinical utility of a substitute therapist.
Subject(s)
Defense Mechanisms , Milieu Therapy/methods , Psychoanalytic Therapy/methods , Psychotherapy, Group/methods , Transference, Psychology , Group Processes , Humans , Professional-Patient RelationsSubject(s)
Group Processes , Psychotherapy, Group , Humans , Interpersonal Relations , Leadership , Peer Group , Transference, PsychologySubject(s)
Psychotherapy, Group/methods , Aggression/psychology , Ego , Humans , Inpatients , Psychotherapy, Brief/methodsABSTRACT
The author reviews the history of the literature on inpatient group psychotherapy. Key observations of early workers--the central role of the group leader, the experiential benefits of the group, and the relationship to the milieu--have not resulted in wide application of this form of therapy because of limitations of previous conceptual models. The model presented draws on concepts of general systems and object relations theory. General systems theory explains how the small therapy group symbolically reflects the dynamic process of the psychiatric unit. Object relations theory provides a unique understanding of the central regulatory function of the therapist and the beneficial effects of the group. The author provides clinical illustrations of these points.
Subject(s)
Psychotherapy, Brief/methods , Psychotherapy, Group/methods , Residential Treatment , Female , Group Processes , Humans , Male , Mental Disorders/therapy , Object Attachment , Professional-Patient Relations , Psychoanalytic TherapyABSTRACT
The endings of human relationships, the processes of separation and termination, are discussed by the author, a psychoanalytically oriented psychiatrist, from the perspective of individual and group psychotherapy. Separations are viewed as psychologically traumatic, activating psychic states analogous to those seen in early childhood. The loss reactivates the toddler experience of giving up the mother as an encompassing need-satisfying object. A process of unresolved mourning ensues. The relationship of this entire experience to early states of self-identity formation explains its traumatic nature, yet provides new opportunities for continued consolidation of the sense of self. This, in turn, enhances one's potential for mutuality in new relationships.
