Working With Hidden Fragility In Group Members

Ego strength of group members is a critical focus of theorists when assessing a patient's appropriateness for group. Although conventional wisdom dictates having group members with diverse problems and backgrounds, Yalom (1985) suggests that homogeneity of ego strength is particularly important when considering group composition. Rutan and Stone (1993) essentially agree that members should possess similar ego strength when forming a new group; however, they believe that differences in ego strength can be an asset in more mature groups. Indeed, Kadis, Krasner, Winick, and Foulkes (1965) suggest that differences in pathologies and ego strength can promote group movement so long as we carefully consider how these intersecting personalities might highlight interpersonal tensions and difficulties that produce opportunities for working through and growth.

Ormont (1994) introduced the term "insulation barrier" to describe the defensive structure that all people possess in relation to one another. Since many theorists think of ego boundaries as ranging from permeable to impenetrable, this concept has practical utility in appreciating the relative emotional impact that we and the other group members can have on any one individual. While Ormont (1994) uses the term to refer to a rather fixed structure in a person's defenses, I believe that in times of regression or great stress, the relatively well-insulated individual can also become overly vulnerable to toxic stimuli, or untouchable as a defense against extraordinary threat. Whether a transient or relatively permanent condition, emotional underin-sulation or overinsulation of a group member requires special treatment in group psychotherapy.

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