Analytic Group Psychotherapy

GROUP PSYCHOTHERAPY was first advocated in America. Although two students and associates of the French psychiatrist, Dejerene, in a book published in 1904 remarked upon the relative improvement of psychoneurotic patients treated in groups in a large ward as compared with the more opulent patients treated in private rooms, they did not call attention to the significant point, that the. patients in wards exercised a reciprocal influence on each other. In 1905, Dr. Joseph H. Pratt, an internist and now professor emeritus of medicine, Tufts College Medical School, initiated a system of friendly counselling and inspirational lectures to groups of patients with pulmonary tuberculosis. He called these sessions "thought control" and, later, "classes in applied psychology. " From 1906 to 1934, he published eight articles on group psychotherapy. Many others followed or began that kind of therapy independently. Some of these are J. L. Moreno, whose particular contribution was psychodrama, at first with children in Vienna, later at St. Elizabeth's Hospital, Washington, D. C. , and Dr. Edward Lazell who in 1920 started group psychotherapy at the same hospital by means of lectures to patients. Under the influence of Dr. W. A. White, a large scale project was started at St. Elizabeth's with remarkable results. L. C. Marsh at Kings Park State Hospital, New York, in reporting the good results of group psychotherapy, stated that "institutions for mental patients should be considered schools rather than hospitals-and the mental patient should be regarded not as a patient but as a student who has received a 'condition' in the great subject of civilization, as most of us understand it, and psychiatry should thus approach him with an intent to reeducate rather than with an intent to treat. " Drs. Louis Wender and Paul Schilder, searching independently for some means to reach the greatest numbers of patients in state mental hospitals, published their findings in 1936. A. A. Low and J. W. Klapman in Chicago and Fritz Redl in Detroit pioneered in group psychotherapy. The Slavson Group in New York under the sponsorship of the Jewish Board of Guardians has been most active and prolific in research and publication of reports. This group has attempted to classify the technique and dynamics involved in group psychotherapy. * The practice of group psychotherapy has its roots in Freudian dynamics and concepts, and varies from play group psychotherapy to analytic group psychotherapy, using the dynamics of transference, catharsis, interpretation, insight, ego building, reality, and sublimation. This presentation is based on the experience of the author with about 40 women patients formed in groups at a sanatorium. The majority were neurotic, psychoneurotic or manic-depressive. Several were psychotic. Some of the patients were treated in groups that included their husbands, after discharge from the sanatorium. Analytic group psychotherapy is a concept of an attenuated mobile and uncensored societal setting, where persons who have failed in the larger and harsher social reality may again attempt resocialization in a permissive, friendly, and protected environment. It is not to be considered the poor man's makeshift for individual psychoanalysis. Group dynamics facilitate the regression and catharsis necessary to produce insight and ego strength, leading to more rapid recovery. Husband and wife participation in the same group led to a more tolerant acceptance by the husband of the concept of mental ailment, and empathy for the spouse. The role of the psychiatrist in group psychotherapy is very similar to that in individual psychoanalysis. He represents the reality to the patient and the group. He is objective but permissive, and not passive. Therapeutic goa/s are the same as in individual therapy, and may focus on the resolution of pre-oedipal conflicts or on situational maladjustments.