Analytic Group Consultation for Intermediate Beginners What I Wish I Knew When I Started to Run Groups

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

Biography

Arthur C. Byk, LCSW, is a New York based, analytically oriented psychotherapist in private practice, focused on individual, group, and couples therapy. He has five therapy groups that have been meeting for over 35 years. In his career he has led more than 8,500 group therapy and group consultation sessions.