Analytic Group Consultation for Intermediate Beginners provides a complete, accessible guide to running groups, and addresses the gaps in training and the challenges that emerge in the group therapy experience.
Presented in bite-size sections that follow the rhythm of weekly consultation sessions, the book offers an experienced perspective on facilitating groups, addressing specific questions, challenges, and dynamics that may emerge during the process. It begins with common issues in starting a group—introducing it, demystifying the experience, translating symptoms into therapeutic goals, and clarifying its value in complementing individual treatment. Byk outlines key theories that inform his work, including object relations theory, systems theory, and ego psychology, providing a solid theoretical foundation for purposeful interventions. The book explores working with depression, boredom, projective identification, scapegoating, role locks, flooding, and enactments, and addresses difficult dynamics such as the "elephant in the room," guilt, shame, and the power of witnessing repair in group settings. Providing a solid base for practitioners to work from, the book compellingly explains how group therapy can help patients, and how to communicate its benefits to them.
Analytic Group Consultation for Intermediate Beginners will be of great interest to psychoanalysts and mental health practitioners in training, and those starting in group work. It will also be of interest to academics and students of psychology, psychiatry, and social work.
Table of Contents:
Preface
Introduction
1. Beginnings
The Parable of the Long Spoons
Demystifying the Group Experience
Considerations in Starting a Group
How Group Can Add Value to Individual Treatment
How Group Can Free Up the Therapist
Introducing Group
Clarifying How Group Can Help
2. Theory that Has Informed My Group Perspective
Wilfred Bion
Melanie Klein
Otto Kernberg
D. W. Winnicott
Margaret Mahler
René Spitz
Yvonne Agazarian
3. Things to Keep in Mind When Introducing Group
Translating Symptoms, Presenting Problems, and Complaints into Therapeutic Goals
Differentiating Self-Esteem from Self-Image
Character: Patterns of Behavior that Endure Over Time
4. A General Approach to Facilitating Group
Continuing to Do What They Do or Trying Something Different
Engaging Role Locks
5. General Considerations in Facilitating Group
The Support Trap
Patients in the Victim Position
Trauma
Self-Disclosure of the Therapist
Countertransference
Approaching Dreams in Group
6. Frames of Reference
All Behavior Has a Purpose
Me/Not Me
Empathic Attunement
Know Your Chickens
Disbelieving the Patient
There Is No Objective Reality
Look-Alike Events
Making the Relationship More Important than the Content
Should We Care about Our Patients?
Support Groups
What Didn’t Work in Your Last Therapy?
7. Therapeutic Stance with Patients
Your Nickel in the Dime
Observing Self/Experiential Self
Differentiating the Therapeutic Alliance from a Positive Transference 48
Establishing Mutual Assumptions
General Therapeutic Posture and Interventions
Reinforcement of Perspectives, Patterns, and Mutual
Assumptions
Initial Consultation
General Interview Questions
8. Practical Considerations
To Zoom or Not to Zoom: Dealing with Technology
Fees, Payments, and Other Practicalities
9. Preparing the Patient for Group
The Parallel Process in the Here-and-Now Experience
Group Norms and Agreements
Importance of Not Taking Feedback Personally
Finding Leverage in Dealing with the Secondary Gains of Dysfunctional Behavior
Goodness of Fit
Adding New Members
The Group Contract
10. Establishing A Group Therapy Culture
Useful Interventions in Developing a Group Culture
Challenging Moments: Using a Group-as-a-Whole Perspective
Framing an Experience
Ambivalence Framed as Competing Parts of the Patient
Helping Patients Shift Their Communication Pattern from Explaining to Relating Effectively: Using Agazarian's “Explain vs. Explore”
Helping Patients Move from Intellectualization
Helping Patients Identify Their Feelings
Dysfunctional Roles that Emerge in Group
11. Character Styles that Are Common in Group
Borderline Personality Disorder and Tendencies
Splitting
Bipolar Symptoms and Borderline Tendencies
Narcissistic Personality Disorder and Tendencies
Confusing a Narcissist's Need for Love with Love for the Patient
Witnessing a Rupture and Repair in Group
Projection and Projective Identification
Recognizing and Addressing Dysfunctional Roles and Role Locks
12. Common Clinical Issues Encountered in Group
Working with Depression
Happiness Cannot Be Pursued—It Must Ensue
Boredom
Working with Anger
Reminding the Group to Stay in the Here and Now
Using Present-Focused Language
Patients Who Have Difficulty Accessing Feelings
Patients Who Feel Nothing
Chitchatting
A Goldilocks Moment
Addressing Avoidance and Distraction
13. Common Challenges in Group
Scapegoating
Handling Enactments
Member Dropping Out Abortively
The Silent Group
Making a Group Member the Identified Patient
Dysregulated Patients
Addressing the Protest of “Blaming the Victim”
The Parable of the Sixteenth Dragon
Conflict vs. Deficit
Flooding
Addressing Breakdowns in Communication
The Defensive Use of Asking Questions
14. The Use of Fables
Kissing the Frog
The Three Little Pigs
Sleeping Beauty
Icarus
The (Other) Parable of the Sixteenth Dragon
15. Challenging Moments in Group
Addressing Potentially Explosive Topics
Useful Interventions in Challenging Moments
Dealing With the Elephant in The Room
Witnessing Repair in Group
Tolerating Guilt and Shame
Recognizing Cognitive Dissonance in Group
Dealing with Cognitive Dissonance
The Good Fortune of Being in a Group with Members You Can’t Stand
The Experience of Safety in Group
Exploring the Experience of Safety
16. Group Snapshots
A Solution to Being Lost in the Woods
Reinforcing “What Do You Need from the Group Right Now?”
Witnessing in Group
Defensive Styles in Group
Process vs. Content
The “Don’t Ask, Don’t Tell” Group
Group Member Bolts Out of the Session
Tendencies to Blame and Complain
Addressing Nonverbal Provocations
Using the Patient's Words
17. Endings
Reframing “We’re Going Around in Circles”
The Process of Termination
It’s All Grist for the Mill
References
Index
