No Good Deed...

by Marc G. Schramm, Psy.D., C.G.P.

Some years ago I took the Basic Training Course at my first American Group Psychotherapy Association Meeting. One of the course leaders (I forget who) made the observation that in group, as in life, no bad deed goes unrewarded. The example that stands out in my mind was of the typical group reaction when a member arrives late: the process stops as the group accommodates the late-arriving member, finding him or her a seat, and catching them up on what has happened so far. In some cases the process is not just interrupted, but hijacked as attention turns completely to the late arrival (who might well have "rescued" the group from an uncomfortable process or content.) The member is showered with positive attention for what is usually an infraction of the group contract to arrive on time. The therapist is often actively complicit in this process, even though the possible "acting-out" quality of arriving late is not itself explored.

This sort of thing occurs because both therapists and patients tend to be uncomfortable with even mild confrontation. Most of us are concerned that we not be seen as the "bad guy." Many therapists (myself included) find that they can more easily confront a patient on a boundary issue in individual therapy than in group. Managing one negative transference, after all, is easier than managing many! Moreover, group dynamics tend to elicit behavior from therapists (as well as patients) that is more reflective of social norms--and confrontation is generally not accepted social behavior.

Avoidance of conflict and confrontation can be far more destructive to a group than the above example illustrates. In addition to a "bad deed" being rewarded, "good deeds" can be undercut. I once took over a group from a trainee who had avoided dealing with boundary issues around non-attendance--or rather, she dealt with the attendance problems with an avoidant solution. She established a rule that if three or fewer members showed up for a session, then that session would be canceled. This of course effectively provided a disincentive to attendance, since one might make the effort to attend only to be sent home.

There is another commonly occurring situation where "good deeds" don't go unpunished that some of us have experienced at workshops and seminars. I had the good fortune once to have seen a live demonstration by Carl Rogers. A volunteer was requested from the audience of therapists to be the client. Rogers did a wonderful job even if he wasn't a strict Rogerian, and after about 40 minutes, questions and comments were solicited by the audience. It did not take long for it to become clear that almost all the questions and comments were not about Rogers' style and interventions, but rather were directed at "solving" the problem brought up by the volunteer patient. Eventually someone spoke up about this, complaining how the volunteer was inappropriately being put on the spot. These comments were greeted with strong applause and approval, but within a few minutes the original pattern of responses returned.

Many workshops and seminars encourage member participation, only to reward such participation by putting the person who spoke up on the "hot seat." Of course it may well be hard to avoid the pull toward critiquing clinical examples that people bring up, but it does contribute to the reluctance that seminar members often have in speaking up. It gradually dawned on me over the years of attending workshops (and giving a few) that the same process occurs in therapy groups--in my own therapy groups! Patients who spoke up first often ended up feeling they were put on the "hot seat." Fortunately, my group members were willing to note this process, and it is one I have (I hope) ameliorated over the years. If the problem occurs, I can direct my interventions toward seeking greater interaction. For instance, I can respond by asking if others in the group have experienced issues similar to those brought up by the first member, or if other situations had evoked the sort of feelings the first member described. If the "hot-seat" phenomenon persists, I can name it (or acknowledge it if it has already been named) and encourage the group to discuss it. However I respond, I don't want group members to feel "punished" for participating.

Please let me know if you have any interesting examples of counterproductive interventions by group patients or therapist, or questions about same. I'd like to share them in this column on a later occasion--and I will make every effort not to punish such good behavior!

Please give your example here.

12/07/2005

Marc G. Schramm, Psy.D., is a Founding Certificant of the National Registry of Certified Group Psychotherapists, a clinical member of the American Group Psychotherapy Association, and President of the Tri-State Group Psychotherapy Society. He is currently Cincinnati-Dayton Regional Director for Counseling Consultants, Inc. Call Dr. Schramm at 513-984-9222

 

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