A patient with a history of vicarious trauma who abided by her mother's injunction to "be nice" lest chaos ensue, developed a disengaged style of relating to others in the group. After many months of

Group ,4s a Place to Practice New Behaviors

group work she was able to practice alternative ways of engagement. Initially very tentative, she would preempt her response to her peers with: "I'm going to try something new as I want to practice saying what I think so please let me know if this is offensive," and proceeded to offer her thoughts or feelings regarding another group member. Inevitably, the group responded with very positive feedback and with reassurance that her remarks were perceptive and quite helpful.

Over time she became significantly more engaged and developed a bold and articulate, yet still "nice" way of being. In one instance she bravely shared her sense of discomfort about a peer's crass language and promiscuous behavior, saying that she believed that this young woman was destroying her much-stated desire for a relationship. The other group members were clearly relieved that someone had spoken up, but the following week the young woman announced that she had decided to terminate group treatment, and that this was the first of her last four group sessions.2 Although this event could have been experienced as proof of the original injunction regarding the horrible risks of not being nice, the group framework provided the time for her and others to explore and clarify feelings, resulting in the young woman's increased self-awareness, her subsequent decision to stay in group, and the "practicing patient's" reassurance of the positive outcomes of her assertiveness. Her interactions with group peers have since extended to her world outside where she has asserted herself initially with family members and then with friends, resulting in a sense of increased self-worth.


A patient with severe impulse control problems for which he has paid dearly in the workplace was adept at alienating group members with his hurtful comments about which he had little insight. Following about six months of careful work in which the patient's connection to the group was strengthened, he began to practice what he termed "postpone-postpone." The patient recruited the group in his diligent efforts to delay his reactions; in this effort they would encourage him to "hang in" with his feelings and thoughts despite his urges to react bitingly to others. This patient's relationships with group peers has shown marked improvements as was demonstrated when he successfully struggled with his powerful urge to "tell off' a new group member who was monopolizing the group session with constant and untimely advice giving. Although other group members may have been grateful had he done this dirty work for them, the group was left with the task of taking care of the new member's difficult behavior, and the "practicing patient" was left with a sense of increased self-control. Similar changes with this patient have begun to occur in his social relationships outside of group and are very gradually occurring in the workplace.

Your Perfect Right

Your Perfect Right

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