Resistance And Counterresistance In The Group Setting

A young-adult analytic group receives a new member, Lucy. After a while, two members leave the group almost at the same time and two new ones join the group. Lucy withdraws with the arrival of these two new members and when faced with experiences discussed in the group, Lucy deeply resents the situation, as she cannot identify with the problems brought in by the other members. She starts to miss sessions and her absence becomes the main topic of several sessions since other members take her no show personally, feel guilty about what is happening, and demand a more active role of the therapist in relation to her. She justifies her absences during long and tedious phone conversations that she utilizes as individual sessions over the phone. The therapist tries to set limits on this new development. Even after having identified the extent of the patient's difficulties within the treatment, in terms of her resistance to attend the sessions, the therapist is aware of the group setting and the group frame including the decision regarding Lucy's status in the group. Whether she would continue on or not is acted out due to the therapist's enormous difficulty in calling Lucy. The therapist struggles with her own counter-resistance to the patient's behaviors. Her countertransference is one of irritation with the patient's acting out, since after being warned, the patient behaves poorly, negatively impacting the functioning of the group. The patient resists showing up for group but does not leave the group, either. Her acting out and her resistance drains and depletes the work to such an extent that the group and therapist counterresist, responding in kind to her modus operandi. The group situation demands an urgent intervention given the risk of group dissolution.

THE INTERVENTION

The counterresistance works exactly as a resistance on the part of the therapist: resistance to intervening, to interpreting, to creating meaning, since it opposes the recommended therapeutic attitude expected of the group leader. Ultimately, counterresistance leads to silence.

Step 1: Identifying Counterresistance

The therapist must examine what she or he is resisting/feeling in order to identify her or his counterresistances and to clearly understand what is happening in the group process. In the clinical vignette, various reasons were given (by the author/therapist) for postponing the telephone call to Lucy until I realized that my behavior, revealing extreme irritation along with an excessive zeal for the patient, indicated not only countertransference issues but also the obvious presence of the counterresistance phenomena.

Step 2: The Intervention

After understanding her or his counterresistance, the therapist must intervene, explaining firmly and as clearly as possible to the patient/group what is going on, aiming for the restoration of the attacked setting. In cases of deviation from the group contract, its reassurance must function as a compass for the maintenance of the group process. The denial of the frame indicates important resistances/ counterresistances in action. In those situations, clarifying interventions are fundamental therapeutic tools. Lucy was informed, without subterfuges, that if she does not come to the next group session she would be excluded from the process.

Step 3: The Interpretation

The comprehension and interpretation of the multiple resistances and transferences between the members of the group and their relations with the therapist are fundamental. Somehow they reveal unconscious pacts that work against group cohesion and its development. Lucy shows up for the next session and presents her reasons behind her absence. At this moment she is confronted by the group, who explains how her ambivalent behavior affects the group, presenting the consequences of her actions. I intervene with a clarifying interpretation, telling Lucy that the group members including myself have experienced some of the angst Lucy feels in relation to herself. She was doing to the group what she does with her life. The group and therapist are in limbo, just as Lucy is. She manipulates the therapist by resisting the proposed therapeutic frame, not showing up, and pushing others to give up on her. Her acting out and her resistance were paralyzing the group.

THE RENOVATED GROUP

After the intervention, the group can possibly move forward and understand that Lucy's absence and carelessness toward the group was eliciting ancient feelings of abandonment, anger, jealousy, rejection, and guilt for them. The members' ongoing questions regarding Lucy were revealing a genuine concern with the patient but also disclosing their subtle and veiled accusations toward me for not having effectively handled Lucy and adequately managed the group. The group could understand that they were also making use of Lucy's behavior to resist and to avoid working on other issues that need to be addressed. On the other side, I restored my own status within the group, which moved along the group process.

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