Making Changes with Group Therapy
Betty Joseph, a prominent Kleinian psychoanalyst wrote a book called “Psychic Equilibrium and Psychic Change.” She described how we all crave the familiar and resist disruption of our accustomed ways of thinking and feeling. Like the addict who works up the courage to attend an AA meeting, but stops before entering the room, often people reach out for therapy because they’re momentarily excited by some way they could be different, but then the fear of change resurfaces and they cancel before the initial sesion.
Once someone actually makes it to session, it’s the responsibility of the therapist to observe how the patient resists change. When you work in the here-and-now, you study the most minute ways a person protects himself from being influenced, from allowing the comment of a therapist, partner, family member or group member to penetrate and have an impact.
In group, Sarah tells Jim that she admires how he thinks creatively about problems. Jim says thank you, and the conversation is about to move on to something else.
“Wait a minute,” I say, “Jim, what prevented you from saying more about how Sarah’s words affected you just now?”
Jim’s confused. He didn’t actually register Sarah’s sentiment toward him. His “thank you,” was performative, social politeness. When he slows down and focuses on what it evokes in him to be complimented in this way, he shares how his creativity was frequently criticized as a distraction when he was growing up, not celebrated. This is painful to remember and vulnerable to share. Jim realizes that he didn’t allow himself to feel and express it because he was scared of being scorned.
“Who would scorn you?” I ask.
“You would,” he says, “you’d think it was weak that I let my family discourage me. ”
“So what if I did? Why does that mean you have to keep quiet?” I ask.
“I know you wouldn’t, but if you did scorn me, I would shut down,” Jim says.
“Sarah, what’s it like for you, hearing this?” I ask.
“It’s frustrating!” Sarah answers, “I hate it when you shut down, Jim. If Jacob scorns you, tell him to fuck off!”
Jim and the other members laugh. Evidently Sarah’s not the only one who would relish the opportunity to put me in my place. This highlights another theme, that much mental illness is a result of not being able to express aggression toward caregivers. One sign that our work is going well is that our patients can criticize us freely and with passion.
Hopefully, Jim’s experiment with going toward an uncomfortable emotion will reverberate beyond this session. The goal is not just that Jim starts changing a habitual way of responding. Ideally, Jim’s attitude toward psychic change itself will expand. He will become more aware of his proclivity to constrict himself in a familiar way, in other sessions and in life, and this awareness will empower him to try something new.