The Theory and Practice of Group Psychotherapy (42 page)

Indeed, it would seem that submersion in the love of a leader is a prerequisite for war. How ironic that more killing has probably been done under the aegis of love than of hatred!

Napoleon, that consummate leader of men, was, according to Tolstoy, not ignorant of transference, nor did he hesitate to utilize it in the service of victory. In
War and Peace
, Tolstoy had him deliver this dispatch to his troops on the eve of battle:

Soldiers! I will myself lead your battalions. I will keep out of fire, if you, with your habitual bravery, carry defeat and disorder into the ranks of the enemy. But if victory is for one moment doubtful, you will see your Emperor exposed to the enemy’s hottest attack, for there can be no uncertainty of victory, especially on this day, when it is a question of the honor of the French infantry, on which rests the honor of our nation.
²³

As a result of transference, the therapy group may impute superhuman powers to the leaders. Therapists’ words are given more weight and wisdom than they carry. Equally astute contributions made by other members are ignored or distorted. All progress in the group is attributed to you, the therapist. Your errors, faux pas, and absences are seen as deliberate techniques that you employ to stimulate or provoke the group for its own good. Groups, including groups of professional therapists, overestimate your power and knowledge. They believe that there are great calculated depths to each of your interventions, that you predict and control all the events of the group. Even when you confess puzzlement or ignorance, this, too, is regarded as part of your clever technique, intended to have a particular effect on the group.

Ah, to be the favorite child—of the parent, of the leader! For many group members, this longing serves as an internal horizon against which all other group events are silhouetted. However much each member cares for the other members of the group, however much each is pleased to see others work and receive help, there is a background of envy, of disappointment, that one is not basking alone in the light of the leader. The leader’s inquiries into these domains—who gets the most attention? Who gets the least? Who seems most favored by the leader?—almost invariably plunge the members into a profitable examination of the group’s innards.

This desire for sole possession of the leader and the ensuing envy and greed lie deeply embedded in the substructure of every group. An old colloquialism for the genital organs is “privates.” However, today many therapy groups discuss sexuality with ease, even relish. The “privates” of a group are more likely to be the fee structure: money often acts as the electrodes upon which condense much of the feeling toward the leader. The fee structure is an especially charged issue in many mental health clinics, which bill members according to a sliding fee scale based on income. How much one pays is often one of the group’s most tightly clutched secrets, since differing fees (and the silent, insidious corollary: different rights, different degrees of ownership) threaten the very cement of the group: equality for all members. Therapists often feel awkward talking about money: Group discussion of money and fees may open difficult issues for the therapist such as income, perceived greed, or entitlement.†

Members often expect the leader to sense their needs. One member wrote a list of major issues that troubled him and brought it to meeting after meeting, waiting for the therapist to divine its existence and ask him to read it. Obviously, the content of the list meant little—if he had really wanted to work on the problems enumerated there, he could have presented the list to the group himself. No, what was important was the belief in the therapist’s prescience and presence. This member’s transference was such that he had incompletely differentiated himself from the therapist. Their ego boundaries were blurred; to know or feel something was, for him, tantamount to the therapist’s knowing and feeling it. Many clients carry their therapist around with them. The therapist is in them, observes their actions from over their shoulder, participates in imaginary conversations with them.

When several members of a group share this desire for an all-knowing, all-caring leader, the meetings take on a characteristic flavor. The group seems helpless and dependent. The members deskill themselves and seem unable to help themselves or others. Deskilling is particularly dramatic in a group composed of professional therapists who suddenly seem unable to ask even the simplest questions of one another. For example, in one meeting a group may talk about loss. One member mentions, for the first time, the recent death of her mother. Then silence. There is sudden group aphasia. No one is even able to say, “Tell us more about it.” They are all waiting—waiting for the touch of the therapist. No one wants to encourage anyone else to talk for fear of lessening his or her chance of obtaining the leader’s ministrations.

Then, at other times or in other groups, the opposite occurs. Members challenge the leader continuously. The therapist is distrusted, misunderstood, treated like an enemy. Examples of such negative transference are common. One client, just beginning the group, expended considerable energy in an effort to dominate the other members. Whenever the therapist attempted to point this out, the client regarded his intentions as malicious: the therapist was interfering with his growth; the therapist was threatened by him and was attempting to keep him subservient; or, finally, the therapist was deliberately blocking his progress lest he improve too quickly and thus diminish the therapist’s income. Both of these polarized positions—slavish idealization and unrelenting devaluation, reflect destructive group norms and represent an antigroup position that demands the therapist’s attention.
²⁴

In a group of adult female incest survivors, I, the only male in the group, was continually challenged. Unlike my female co-therapist, I could do no right. My appearance was attacked—my choice of neckties, my wearing socks that were not perfectly matched. Virtually every one of my interventions was met with criticism. My silence was labeled disinterest, and my support was viewed with suspicion. When I did not inquire deeply enough into the nature of their abuse, I was accused of lacking interest and empathy. When I did inquire, I was accused of being a “closet pervert” who got sexual kicks from listening to stories of sexual violation. Though I had known that transferential anger from a group of female abuse victims would be inevitable and useful to the therapy process, and that the attacks were against my role rather than against my person—still, the attacks were difficult to tolerate. I began to dread each meeting and felt anxious, deskilled, and incompetent. The transference was not just being felt or spoken, it was being enacted powerfully.
²⁵
Not only was I attacked as a representative of the prototypical male in these group members’ lives, but I was also being “abused” in a form of role inversion. This offered a useful window into the experience of the group members who all too often felt dread, bullied, and lacking in skill. Understanding the nature of transference and not retaliating with countertransference rage was essential in retaining a therapeutic posture.

In another group a paranoid client, who had a long history of broken leases and lawsuits brought against her by landlords, re-created her litigiousness in the group. She refused to pay her small clinic bill, claiming that there was an error in the account, but she could not find the time to come to talk to the clinic administrator. When the therapist reminded her on a number of occasions of the account, she compared him to a Jewish slumlord or a greedy capitalist who would have liked her to damage her health permanently by slaving in an environmentally toxic factory.

Another member habitually became physically ill with flu symptoms whenever she grew depressed. The therapist could find no way to work with her without her feeling he was accusing her of malingering—a replay of the accusatory process in her relationships in her family. When one therapist, on a couple of occasions, accepted a Life Saver from a female member, another member responded strongly and accused him both of mooching and of exploiting the women in the group.

Many irrational reasons exist for these attacks on the therapist, but some stem from the same feelings of helpless dependency that result in the worshipful obedience I have described. Some clients (“counterdependents”) respond counterphobically to their dependency by incessantly defying the leader. Others validate their integrity or potency by attempting to triumph over the big adversary, feeling a sense of exhilaration and power from twisting the tail of the tiger and emerging unscathed.

The most common charge members level against the leader is that of being too cold, too aloof, too inhuman. This charge has some basis in reality. For both professional and personal reasons, as I shall discuss shortly, many therapists do keep themselves hidden from the group. Also, their role of process commentator requires a certain distance from the group. But there is more to it. Although the members insist that they wish therapists to be more human, they have the simultaneous counterwish that they be
more than human.
(See my novel
The Schopenhauer Cure
[pp. 221–253] for a fictional portrayal of this phenomenon.)

Freud often made this observation. In
The Future of an Illusion,
he based his explanation for religious belief on the human being’s thirst for a superbeing.
²⁶
It seemed to Freud that the integrity of the group depended on the existence of some superordinate figure who, as I discussed earlier, fosters the illusion of loving each member equally. Solid group bonds become chains of sand if the leader is lost. If the general perishes in battle, it is imperative that the news be kept secret, or panic might break out. So, too, for the leader of the church. Freud was fascinated by a 1903 novel called
When It Was Dark
, in which Christ’s divinity was questioned and ultimately disproved.
²⁷
The novel depicted catastrophic effects on Western European civilization; previously stable social institutions deconstituted one by one, leaving only social chaos and ideological rubble.

Hence, there is great ambivalence in the members’ directive to the leader to be “more human.” They complain that you tell them nothing of yourself, yet they rarely inquire explicitly. They demand that you be more human yet excoriate you if you wear a copper bracelet, accept a Life Saver, or forget to tell the group that you have conversed with a member over the phone. They prefer not to believe you if you profess puzzlement or ignorance. The illness or infirmity of a therapist always arouses considerable discomfort among the members, as though somehow the therapist should be beyond biological limitation. The followers of a leader who abandons his or her role are greatly distressed. (When Shakespeare’s Richard II laments his hollow crown and gives vent to his discouragement and need for friends, his court bids him to be silent.)

A group of psychiatry residents I once led put the dilemma very clearly. They often discussed the “big people” out in the world: their therapists, group leaders, supervisors, and the adult community of senior practicing psychiatrists. The closer these residents came to completing their training, the more important and problematic the big people became. I wondered aloud whether they, too, might soon become “big people.” Could it be that even I had my “big people”?

There were two opposing sets of concerns about the “big people,” and they were equally troubling: first, that the “big people” were real, that they possessed superior wisdom and knowledge and would dispense an honest but terrible justice to the young, presumptuous frauds who tried to join their ranks; or, second, that the “big people” themselves were frauds, and the members were all Dorothys facing the Oz wizard. The second possibility had more frightening implications than the first: it brought them face-to-face with their intrinsic loneliness and apartness. It was as if, for a brief time, life’s illusions were stripped away, exposing the naked scaffolding of existence—a terrifying sight, one that we conceal from ourselves with the heaviest of curtains. The “big people” are one of our most effective curtains. As frightening as their judgment may be, it is far less terrible than that other alternative—that
there are no “big people”
and that one is finally and utterly alone.

The leader is thus seen unrealistically by members for many reasons. True transference or displacement of affect from some prior object is one reason; conflicted attitudes toward authority (dependency, distrust, rebellion, counterdependency) that become personified in the therapist is another; and still another reason is the tendency to imbue therapists with superhuman features so as to use them as a shield against existential anxiety.

An additional but entirely rational source of members’ strong feelings toward the group therapist lies in the members’ explicit or intuitive appreciation of the therapist’s great and real power. Group leaders’ presence and impartiality are, as I have already discussed, essential for group survival and stability; they have the power to expel members, add new members, and mobilize group pressure against anyone they wish.

In fact, the sources of intense, irrational feelings toward the therapist are so varied and so powerful that transference will always occur. The therapist need not make any effort—for example, striking a pose of unflinching neutrality and anonymity—to generate or facilitate the development of transference. An illustrative example of transference developing in the presence of therapist transparency occurred with a client who often attacked me for aloofness, deviousness, and hiddenness. He accused me of manipulation, of pulling strings to guide each member’s behavior, of not being clear and open, of never really coming out and telling the group exactly what I was trying to do in therapy. Yet this man was a member of a group in which I had been writing very clear, honest, transparent group summaries and mailing them to the members before the next meeting (see chapter 14). A more earnest attempt to demystify the therapeutic process would be difficult to imagine. When asked by some of the members about my self-disclosure in the summaries, he acknowledged that he had not read them—they remained unopened on his desk.