Psychoanalytic group therapy

Domain I · Psychodynamic & depth psychology · Paul Schilder, Louis Wender · 1929 · New York

What it is

It is a small-group adaptation of psychoanalytic therapy for severely neurotic and mildly psychotic outpatients. Patients are prepared individually. They write about their lives and attitudes, then discuss this material in a small group. The therapist interprets resistance, transference and dreams…

Format

• Phase A: Selection and individual preparation
• Goals: diagnose, take a psychoanalytically oriented history, start a working relationship with the therapist, and judge whether the patient can use a group.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Subgroups, and secrets kept from the group. Working sign: members help each other without being asked.
• Shaming. Frame resistance as protection, not failure. Working sign: the group returns to the avoided topic.
• Individual sessions used to avoid the group or to gain a privileged position. Interpret this if it happens.
• Breaches of confidentiality. Never use a recognisable case. Working sign: members say "that's like me" and go on.
• Group "wild analysis" of the dreamer. Working signs: dreams begin to show the group or the therapist, and patients bring dreams spontaneously.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.