The Theory and Practice of Group Psychotherapy (128 page)

23
Do not neglect to consider the real meaning of the help-rejecting complainer’s complaint. Some clinicians propose that there may be a hidden positive or adaptive value to the unrelenting complaints that needs to be understood.

24
Frank et al., “Behavioral Patterns in Early Meetings.” E. Berne,
Games People Play
(New York: Grove Press, 1964). Peters and Grunebaum, “It Could Be Worse.”

25
Wright, “Discussion of Difficult Patients.” R. Jacobs and D. Campbell, “The Perpetuation of an Arbitrary Tradition Through Several Generations of a Laboratory Microculture,”
Journal of Abnormal and Social Psychology
62 (1961): 649–58.

26
R. Moos and I. Yalom, “Medical Students’ Attitudes Toward Psychiatry and Psychiatrists,”
Mental Hygiene
50 (1966): 246–56.

27
L. Coch and J. French, “Overcoming Resistance to Change,”
Human Relations
1 (1948): 512–32.

28
N. Kanas, “Group Psychotherapy with Bipolar Patients: A Review and Synthesis,”
International Journal of Group Psychotherapy
43 (1993): 321–35. F. Volkmar et al., “Group Therapy in the Management of Manic-Depressive Illness,”
American Journal of Psychotherapy
35 (1981): 226–33. I. Patelis-Siotis et al., “Group Cognitive-Behavioral Therapy for Bipolar Disorder: A Feasibility and Effectiveness Study,”
Journal of Affective Disorders
65 (2001): 145–53. M. Sajatovic, M. Davies, and D. Hrouda, “Enhancement of Treatment Adherence Among Patients with Bipolar Disorder,”
Psychiatric Services
55 (2004): 264–69. R. Weiss, L. Najavits, and S. Greenfield, “A Relapse Prevention Group for Patients with Bipolar and Substance Use Disorders,”
Journal of Substance Abuse Treatment
16 (1999): 47–54. F. Colom et al., “A Randomized Trial on the Efficacy of Group Psychoeducation in the Prophylaxis of Recurrences in Bipolar Patients Whose Disease Is in Remission,”
Archives of General Psychiatry
60 (2003): 402–7.

29
M. Leszcz, “Group Psychotherapy of the Characterologically Difficult Patient,”
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39 (1989): 311–35. L. Ormont, “The Role of the Leader in Managing the Preoedipal Patient in the Group Setting,”
International Journal of Group Psychotherapy
39 (1989): 147–71. R. Klein, J. Orleans, and C. Soule, “The Axis II Group: Treating Severely Characterologically Disturbed Patients,”
International Journal of Group Psychotherapy
41 (1991): 97–115. D. Silver, “Psychotherapy of the Characterologically Difficult Patient,”
Canadian Journal of Psychiatry
28 (1983): 513–21.

30
J. Shedler and D. Westen, “Refining Personality Disorder Diagnosis: Integrating Science and Practice,”
American Journal of Psychiatry
161 (2004): 1350–65.

31
Gans and Alonso, “Difficult Patients.”

32
M. Leszcz, “Group Psychotherapy of the Borderline Patient,” in
Handbook of Borderline Disorders
, ed. D. Silver and M. Rosenbluth (Madison, Conn.: International Universities Press, 1992), 435–70. E. Marziali and H. Monroe-Blum,
Interpersonal Group Psychotherapy for Borderline Personality Disorder
(New York: Basic Books, 1994). S. Budman, A. Demby, S. Soldz, and J. Merry, “Time-Limited Group Psychotherapy for Patients with Personality Disorders: Outcomes and Dropouts,”
International Journal of Group Psychotherapy
46 (1996): 357–77. S. Budman, S. Cooley, A. Demby, G. Koppenaal, J. Koslof, and T. Powers, “A Model of Time-Effective Group Psychotherapy for Patients with Personality Disorders: A Clinical Model,”
International Journal of Group Psychotherapy
46 (1996): 329–55. A. Bateman and P. Fonagy, “Treatment of Borderline Personality Disorder with Psychoanalytically Oriented Partial Hospitalization: An 18-Month Follow-Up,”
American Journal of Psychiatry
158 (2001): 36–42. W. Piper and J. Rosie, “Group Treatment of Personality Disorders: The Power of the Group in the Intensive Treatment of Personality Disorders,”
In Session: Psychotherapy in Practice
4 (1998): 19–34. W. Piper, J. Rosie, A. Joyce, and H. Azim,
Time-Limited Day Treatment for Personality Disorders: Integration of Research and Practice in a Group Program
(Washington, D.C. : American Psychological Association, 1996). M. Chiesa and P. Fonagy, “Psychosocial Treatment for Severe Personality Disorder: 36-Month Follow-Up,”
British Journal of Psychiatry
183 (2003): 356–62.

33
J. Herman,
Trauma and Recovery
(New York: Harper Collins, 1992). M. Zanarin, F. Frankenburg, E. Dubo, A. Sickel, A. Trikha, and A. Levin, “Axis I Comorbidity of Borderline Personality Disorder,”
American Journal of Psychiatry
155 (1998): 1733–39. J. Ogrodniczuk, W. Piper, A. Joyce, and M. McCallum, “Using DSM Axis IV Formulation to Predict Outcome in Short-Term Individual Psychotherapy,”
Journal of Personality Disorders
15 (2001): 110–22. C. Zlotnick et al., “Clinical Features and Impairment in Women with Borderline Personality Disorder (BPD) with Posttraumatic Stress Disorder (PTSD), BPD Without PTSD, and Other Personality Disorders with PTSD,”
Journal of Nervous and Mental Diseases
191 (2003): 706–13.

34
M. Leszcz, “Group Therapy,” in
Treatment of Psychiatric Disorders,
vol. 3, ed. J. Gunderson (Washington, D.C.: American Psychiatric Press, 1990), 2667–78.

35
J. Sartre,
The Age of Reason,
trans. Eric Sutton (New York: Knopf, 1952), 144.

36
American Psychiatric Association,
Diagnostic and Statistical Manual of Mental Disorders,
4th ed. Text Rev. (Washington, D.C.: American Psychiatric Association, 2000).

37
O. Kernberg, “An Ego Psychology Object Relations Theory of the Structure and Treatment of Pathologic Narcissism: An Overview,”
Psychiatric Clinics of North America
12 (1989): 723–29. O. Kernberg,
Borderline Conditions and Pathological Narcissism
(New York: Jason Aronson, 1975).

38
J. Perry, “Problems and Considerations in the Valid Assessment of Personality Disorders,”
American Journal of Psychiatry
149 (1992): 1645–53. G. Mellsop et al., “The Reliability of Axis II of DSM-III,”
American Journal of Psychiatry
139 (1982): 1360–61.

39
Kernberg, “An Ego Psychology Object Relations Theory.” Kernberg,
Borderline Conditions and Pathological Narcissism.
H. Kohut,
The Analysis of the Self
(New York: International Universities Press, 1971). H. Kohut,
The Restoration of the Self
(New York: International Universities Press, 1977).

40
J. Gunderson,
Borderline Personality Disorder: A Clinical Guide
(Washington, D.C.: American Psychiatric Press, 2001). Piper and Rosie, “Group Treatment of Personality Disorders.” Leszcz, “Group Psychotherapy of the Borderline Patient.” Marziali and Monroe-Blum,
Interpersonal Group Psychotherapy for Borderline Personality Disorder.
Bateman and Fonagy, “Treatment of Borderline Personality Disorder.” American Psychiatric Association, “Practice Guideline for the Treatment of Patients with Borderline Personality Disorder,”
American Journal of Psychiatry
158 (suppl 11 2001): 1–52.

41
L. Horwitz, “Group Psychotherapy for Borderline and Narcissistic Patients,”
Bulletin of the Menninger Clinic
44 (1980): 181–200. N. Wong, “Clinical Considerations in Group Treatment of Narcissistic Disorders,”
International Journal of Group Psychotherapy
29 (1979): 325–45. R. Kretsch, Y. Goren, and A. Wasserman, “Change Patterns of Borderline Patients in Individual and Group Therapy,”
International Journal of Group Psychotherapy
37 (1987): 95–112. Klein et al., “The Axis II Group.” J. Grobman, “The Borderline Patient in Group Psychotherapy: A Case Report,”
International Journal of Group Psychotherapy
30 (1980): 299–318. B. Finn and S. Shakir, “Intensive Group Psychotherapy of Borderline Patients,”
Group
14 (1990): 99–110. K. O’Leary et al., “Homogeneous Group Therapy of Borderline Personality Disorder,”
Group
15 (1991): 56–64. S. Shakir, personal communication, February 1994. M. Leszcz, I. Yalom, and M. Norden, “The Value of Inpatient Group Psychotherapy: Patients’ Perceptions,”
International Journal of Group Psychotherapy
35 (1985): 411–33. I. Yalom,
Inpatient Group Psychotherapy
(New York: Basic Books, 1983). N. Macaskill, “The Narcissistic Core as a Focus in the Group Therapy of the Borderline Patient,”
British Journal of Medical Psychology
53 (1980): 137–43. S. Budman, A. Demby, S. Soldz, and J. Merry, “Time-Limited Group Psychotherapy for Patients with Personality Disorders: Outcomes and Dropouts,”
International Journal of Group Psychotherapy
46 (1996): 357–77.

42
M. Leszcz, “Group Psychotherapy of the Borderline Patient.”

43
Klein et al., “The Axis II Group.”

44
M. Bond, E. Banon, and M. Grenier, “Differential Effects of Interventions on the Therapeutic Alliance with Patients with Borderline Personality Disorders,”
Journal of Psychotherapy Practice and Research
7 (1998): 301–18.

45
K. Heffernan and M. Cloitre, “A Comparison of Posttraumatic Stress Disorder with and Without Borderline Personality Disorder Among Women with a History of Childhood Sexual Abuse: Etiological and Clinical Characteristics,”
Journal of Nervous and Mental Diseases
188 (2000): 589–95. M. Cloitre and K. Koenen, “The Impact of Borderline Personality Disorder on Process Group Outcomes Among Women with Posttraumatic Stress Disorder Related to Childhood Abuse,”
International Journal of Group Psychotherapy
51 (2001): 379–98.

46
Leszcz, “Group Psychotherapy of the Characterologically Difficult Patient.” Horwitz, “Group Psychotherapy for Borderline and Narcissistic Patients.” Wong, “Clinical Considerations in Group Treatment of Narcissistic Disorders.” N. Wong, “Combined Group and Individual Treatment of Borderline and Narcissistic Patients,”
International Journal of Group Psychotherapy
30 (1980): 389–403. Klein et al., “The Axis II Group.”

47
J. Kosseff, “The Unanchored Self: Clinical Vignettes of Change in Narcissistic and Borderline Patients in Groups: Introduction,”
International Journal of Group Psychotherapy
30 (1980): 387–88.

48
Shedler and Westen, “Refining Personality Disorder Diagnosis.”

49
American Psychiatric Association,
Diagnostic and Statistical Manual of Mental Disorders,
4th ed., 661.

50
Kernberg, “An Ego Psychology Object Relations Theory.” Kernberg,
Borderline Conditions and Pathological Narcissism.

51
M. Livingston and L. Livingston, “Conflict and Aggression in Group Psychotherapy: A Self Psychological Vantage Point,”
International Journal of Psychotherapy
48 (1998): 381–91. J. Horner, “A Characterological Contraindication for Group Psychotherapy,”
Journal of American Academy of Psychoanalysis
3 (1975): 301–05.

52
The tasks of therapy may be facilitated by theoretical frames of reference such as a self psychological framework or an intersubjective framework. Both approaches sharpen our focus on the subjective experience of the narcissistically vulnerable client. Leszcz, “Group Psychotherapy of the Characterologically Difficult Patient.” Livingston and Livingston, “Conflict and Aggression in Group Psychotherapy.” M. Baker and H. Baker, “Self-Psychological Contributions to the Theory and Practice of Group Psychotherapy,” in
Group Therapy in Clinical Practice,
ed. A. Alonso and H. Swiller (Washington, D.C.: American Psychiatric Press, 1993), 49–68. I. Harwood, “Distinguishing Between the Facilitating and the Self-Serving Charismatic Group Leader,”
Group
27 (2003): 121–29. W. Stone, “Self Psychology and the Higher Mental Functioning Hypothesis: Contemporary Theories,”
Group Analysis
29 (1996): 169–81. D. Brandchaft and R. Stolorow, “The Difficult Patient: Intersubjective Perspective,” in
Borderline and Narcissistic Patients in Therapy,
ed. N. Slavinsky-Holy (Madison, Conn.: International Universities Press, 1988), 243–66.

53
M. Pines, “Group Analytic Therapy of the Borderline Patient,”
Group Analysis
11 (1978): 115–26.

CHAPTER 14

1
E. Paykel, “Psychotherapy, Medication Combinations, and Compliance.”
Journal of Clinical Psychiatry
56 (1995): 24–30. D. Greben, “Integrative Dimensions of Psychotherapy Training,”
Canadian Journal of Psychiatry
49 (2004): 238–48.

2
H. Bernard and S. Drob, “The Experience of Patients in Conjoint Individual and Group Therapy,”
International Journal of Group Psychotherapy
35 (1985): 129–46. K. Porter, “Combined Individual and Group Psychotherapy: A Review of the Literature, 1965–1978,”
International Journal of Group Psychotherapy
30 (1980): 107–14.

3
K. Schwartz, “Concurrent Group and Individual Psychotherapy in a Psychiatric Day Hospital for Depressed Elderly,”
International Journal of Group Psychotherapy
54 (2004): 177–201.

4
B. Roller and V. Nelson, “Group Psychotherapy Treatment of Borderline Personalities,”
International Journal of Group Psychotherapy
49 (1999): 369–85. F. DeZuleta and P. Mark, “Attachment and Contained Splitting: A Combined Approach of Group and Individual Therapy to the Treatment of Patients from Borderline Personality Disorder,”
Group Analysis
33 (2000): 486–500. E. Fried, “Combined Group and Individual Therapy with Passive Narcissistic Patients,”
International Journal of Group Psychotherapy
5 (1955): 194.