Conflict in Group Therapy of Chronic Schizophrenics

Abstract

This paper describes a pivotal group session in which there was a major conflict between two members of a group that has met for many years. The group serves chronically ill outpatients suffering primarily from schizophrenia or schizoaffective illness. The aftershocks of the explosive outburst, the leaders' understanding of the contributing factors, countertransference feelings, and coping mechanisms are described. The literature recommends two pathways concerning the expression of anger and aggression in groups of severely disturbed individuals: restriction of intense negative affect or expression of such affect as a helpful component of a therapeutic process. We reflect on this question in sharing detailed clinical material and conclude that coping with aggression in such groups is dependent not only on the group context, but also on the relative fragility, strength, and tolerance of both members and leaders. A crucial step in dealing with eruptive crises consists of reflecting upon the leaders conscious and unconscious intervention motives and affects.

Dialogues in coloured spaces

“…Those men that were close to him became anxious, and a sense of discomfort in the group became evident. Given the fragility and anxiety levels at that time, it was decided to contain the anxiety and anger, PAGE: 62 as suggested by the literature (Hassan, Cinq-mars & Sigman, 2000), via brief acknowledgement, but also by bringing the group back to the task. This all has an effect in the group on both clients and facilitators.…”

“…CBT approach in relation to schizophrenia and groups has been positively reviewed (Bellack et al, 2004;Ritsher 2006). However, there is also support in the literature for a more group-analytical approach with people with enduring psychosis (Hassan, Cinq-mars, & Sigman, 2000;Muchnik & Raizman, 1998). This is especially relevant in the context of this men's group, as the facilitators sought to understand the art therapy interpretations and processes within the light of embedded schemas and psychoanalytical and psychodynamic processes.…”

Containing Psychotic Patients with Fragile Boundaries: A Single–Session Group Case Study

“…It is called the Thursday Group, and has served psychiatric patients referred from several out-patient clinics or the in-patient service of a general hospital since 1985. For further description of this group see Hassan, Cinq-Mars, and Sigman (2000).…”