The Capacity to Use the Group as a Corrective Symbiotic Object in Group Analytic Psychotherapy for Patients with Psychosis

Abstract

Group psychotherapy is widely accepted for treatment of patients suffering from psychosis. Nevertheless, some uncertainties remain regarding efficacy of insight-oriented group psychotherapy in these cases. Embracing the thinking of those authors that consider corrective symbiotic experience as essential in psychotherapeutic treatment for patients with psychosis, we explore the possibilities of group psychotherapy in enabling corrective emotional experience in our group therapeutic activity. Through some clinical examples from long-term outpatient group psychodynamic psychotherapy, which was insight oriented, we demonstrate how this method works with patients suffering from psychosis in a carefully selected group. Our experiences are positive, showing that the group analytically informed approach can offer a corrective symbiotic experience to patients with psychosis. However, patients with very deep symbiotic needs, who exclusively demand gratification of their symbiotic transferences, are not recommended for inclusion in group analytic work.

Holistički biopsihosocijalni pristup u postizanju oporavka osoba s dijagnozom psihoze

“…Based on experiences of other authors, individuals diagnosed with psychosis experienced difficulties in the symbiotic phase (23)(24)(25) and in the development of secure attachment, which is linked to the ability for mentalization (26,27), and we observed these difficulties while working with our patient. The main psychological problem of this patient, which represents a risk for psychosis, was an excessive dependence on external objects, probably related to her experience of excessively gratifying symbiosis leading to a lack of development of the optimal level of frustration necessary for the development of the capacity for anxiety tolerance, i.e.…”

“…U skladu s iskustvima drugih autora da osobe s dijagnozom psihoze imaju teškoća iz simbiotske faze (23)(24)(25), kao i u razvoju sigurne privrženosti koja je povezana sa sposobnosti mentalizacije (26,27), opservirali smo ove teškoće u radu s našom pacijenticom. Glavni psihološki problem ove pacijentice koji je rizik za psihozu je pretjerana ovisnost o vanjskim objektima koja je vjerojatno povezana s njenim iskustvom pretjerano gratificirajuće simbioze zbog čega nije došlo do razvoja optimalne frustracije neophodne u razvoju kapaciteta za toleranciju tjeskobe, tj.…”