The Interventions

One of my goals in psychotherapy is to lead the patients' focus away from the "slings and arrows" the world seems to throw at them, and from patients' beliefs that they must be passive victims of the vicissitudes of life. Through making the unconscious conscious, patients have the opportunity to become aware of their own part or responsibility, however small that part might be, in creating those "slings and arrows." This consciousness can empower patients to become aware of and change those patterns, freeing them to make conscious choices. These interventions, as well as others, encourage the patients to examine subjective experience from a different viewpoint. In this exploration, it is essential that the patients be encouraged to avoid self-blame for unconscious forces of which they have been unaware.

As discussed, one of the interventions I have used with success is "storytelling." These poignant and often wise stories come from the self-disclosures of other patients over many years. Obviously, personal names are never used when relating the story nor are details given that could be used to identify another patient.

I have found the following story very useful when a group is dealing with patterns of disappointments: A woman in one of my groups came up with a very interesting observation. She said, "If the same thing happens to me in several situations, I have recognized that the only common factor is me."

The Group Therapist .Is Storyteller

• This can open a discussion of the many ways we can unconsciously determine the outcome of a situation, such as: tone of voice, body language, choice of a person to interact with, etc.

A similar device useful in a discussion of feelings of helplessness is as follows: A man in one of my groups said he feels like someone who carries around two steel bars that he holds in front of him wherever he looks, while shouting, "Let me out of this jail."

• This usually provokes laughter and recognition of similar dynamics in the group members themselves.

A longer story that I found useful in a discussion of truth as a panacea was: A man in one of my groups was a salesman. He had devoted his life to trying to tell people what they wanted to hear. His group frequently told him that he sounded "phony." For a long time, he didn't seem to understand what they were telling him. Finally, they got through to him. He said, "I see it. I've never said a true word in my life. I've been so busy trying to read other peoples' minds, and tell them what they want to hear; I don't even know what I think. From now on, I'm going to tell the truth."

He returned to group the next week very proud that he had told the truth. He had been out with a friend who was very sensitive about the size of his nose. In the middle of a conversation, he suddenly turned to his friend and said, "Gosh you've got a monstrous nose. I don't know how you can stand to look at it when you shave every day. If I had a nose like that, I'd run to a doctor and have it cut off as soon as possible." He sat back then and waited for the group to applaud.

Somehow, they weren't pleased. As they examined the situation, they agreed that he had been honest about what was going through his head, but the question was why that was going through his head.

As they explored, it was discovered that the "friend" had been his boss, and, he felt, had dealt unfairly with him. He returned to the man he had attacked and apologized, explaining that he had tried to hurt him because of various incidents in the past where he felt he was wronged. The other man told his side of the story, which hadn't been known to him. Eventually, they were able to become real friends.

• This story usually provokes thought and discussion involving recognizing that even truisms like "Truth is always good" are too simplistic to fit complex human interactions.

Perhaps, the most useful story I have used is an illustration of the tendency to resist an extremely pertinent interpretation by dissociation or "nodding off," not hearing, or not understanding a simple statement:

Once upon a time, a woman was describing to her group a compulsion which forced her to search through food she had prepared for her children, to make sure she hadn't accidentally dropped any needles or pins into it.

A man said (very gently): "You know, sometimes a fear masks a wish."

The woman replied: "I don't know what you're talking about."

The man said (still very carefully): "I mean that perhaps somewhere in your unconscious, where you don't know about it and are not responsible for it, there's some little urge to harm your children, and this compulsion is a defense against that."

The woman said: "Funny, I can understand each word you've said, but I can't make any sense out of what you're saying."

The man (making strangling motions, shouted): "You want to kill your kids, you want to murder them."

The woman, sounding very confused, mumbled: "Everything's getting foggy, I don't understand what's going on."

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