yalom - chapter 6 - working in the here and now Flashcards
what do all styles of therapy use
the here and now
what are the 2 parts of the here and now that work together to make it work
1- experience - the immediate events of the meeting take precendence over events outside of hte group.
2- illumination of the process - must be able to recognize the process at work.
group is in the here and now and is able to double back on itself to examine that here and now behavior.
what 5 therapeutic techniques are seen in the use of the here and now?
social microcosm, feedback, catharsis disclosure, and use of socialization techniques.
what does interpersonal learning require in the here and now
illumination of the process. apply meaningful integration of what is seen to learn new things. this is the making sense of what is experienced in the group hence the learning.
what happens if there is only the witnessing of the here and now and no illumnination of the process
intense experience but it is evanescent experience. cannot retain the experience. no cognition.
what happens if there is only illumination of the process and no here and now.
lose of lively energy and meaningfulness. there is only cognition, no affect.
here and now is the battery, the process is the deeper meaning.
what kind of therapists are more likely to have groups that lack illumination of the process
rigid and aloof therapists (lacking affect)
what are the 2 jobs of the therapist to drive the group into the here and now
1- steer the group into the here
2- faclitate the self-reflective loop (illuminate hte process thru commentary)
what is the major role of the therapist outside of steer the group into the here and now
facilitated process commentary (illuminating the process - the cognition of the affect)
to be effective, where should most of our interpretations sit?
in the here and now.
define process
nature of the relationship between interacting individuals as members and the therapist.
process is opposite to what
content
what is the content
what is precisely and explicitly said.
what do we ask when we ask what is the process of the content
what is actually being said by the content - what is the meaning of what is being said or done in session. what is the how and why of what they are saying
what is paraverbal communication
the way that we talk thru nuance, inflection, pitch and tone.
what rules how we interpret the process of the group
the immediate needs o the group (the here and now)
should we wait until we have all the answers to ask a process question
no.
what is the power cell of the group
process exploration
why is process commentary/exploration a social taboo x4
socialization anxiety, social norms, fear of retaliation, and power management.
how does socialization anxiety affect process commentary/exploration
by focusing on the process we enlisth looking at criticism of our behavior which brings us back to our childhood exposures to criticisms. we feel judged in this space and that is disempowering.
how do social norms stop process exploration
social norm to keep powers invisible in social forms to maintain some level of freedom.
how does fear of retaliation stop process exploration
most don’t like being looked into so deeply and see it as intrusive.
how does process exploration get stopped by power maintenance
process exploration disrupts already standing hierarchical systems of power structures.
what is the first stage of the here and now
the activating phase
what is the task of the therapist in the activating phase
move the group into the here and now. focus on the relationship(s) here.
does the group focus on the here and now more so in the early stages or the later stages by their own powers
later stages. the early stages are the responsibility of the therapist.
what is the 2nd phase of here and now focus
illumination of the process
does the struggle for dominance ever stop in a group
no
who is the observer participant of the group
the therapist
how does the therapist observe x4
being objective and storing info (group historian), sees patterns of behavior, can be immune to the change of the group, keeps the original goals in mind,
if the leader is too anxious to address a matter, what does that say about hte group
then the group isn’t ready to deal with it
what is the best way to deal with really tense concepts of a group x3
balanced, nonblaming and self-revealing fashion (modeling it for the clients)
how is the here and now paradoxical
it cannot be totally here and now as it always describes things that just happened and pulls on past behaviors in the group/life of the clients. past events of the group are part of the here and now an dhelp to build it.
what is crucial about the here and now in refernece to the past
what matters is how we perceive the past in the here and now. use it to relate to the present
what is feedback for the here and now
low inference commentary that is both experience and process commentary.
how do we activate the here and now first and foremost
by thinking in the here and now.
when do we start thinking/acting/working in the here and now as the therapist
from the very first moment of every session - we are relentless in the here and now.
should we talk about the purpose and methodology of our interventions
yes. it demystifies them and humanizes us. it models the power structure and keeps the goals fo the group at the forefront (here and now) and helps set up the norms/social microcosm and build poitns for a corrective emotional experience.
how do we start building the here and now into the group
focus on what lessens the threat - focus on the positive interactions between group members as they occur
how do we get memebers to give and offer feedback
modeling
what kind of feedback do we seek
specific and interperonal focused.
what must feedback have to be effective
a focus on the here and now (the ability to change what is said in some way or accept it now)
what is the purpose of resistance
to regulate the pace of the client to see and express emotional truths
how do most express resistance
by being as the therapist and having an equality of feeligns towards everyone in the group (this is never true)
how should we self disclose
in the here and now as this increases exploration and openneess.
where should we always have our focus
on the here and now not the then and there.
what 2 things happen in the activating phase of the here and now
steering into the here and now and moving the content flow of the group from the then and there. this can be interrupting and should be addresed
why should we interrupt sessions
shows that we are invested in taking risks appropriately and know that this will lead to greater therapeutic outcome and deepens the work by overcoming anxities.
what does too little of leader interaction cause
floundering group that struggles too much
what does too much of a leader interaction cause
dependent group that persists to look to the leader.
should we go through obstacles
no. they are natural and real and necessary and they shoul be worked through or else they will always be there.
why would we want a client to fail
to return to their default status of behavior that has not been serving allows us in this way to directly address it.
what are the 6 stags of the illumination fo the process
1- recognize what they are doing in their interactiosn with others. 2- appreciate the impact of this behavior on others and themselves. 3- decide if they are satisfied with interpersonal styling. 4- exercise the will to change. 5- transfrom intent into decision and then decision into action. 6- soldify the change and transfer it from the group to their personal life.
what questiosn should we ask to recognize process
why is this happening in the group in this way at this time
how does understasnding process effect the therapist
we understand and see more into the group sessions and have more interest in them.
what is a common body language for anxiety
flexing the foot.
does body language denote conscious feeling or unconscious
unconscious
what is a great source of process data
our own reactions to the client.
where is the process in what is being said
the process exists in what is NOT being said
how can the therapist quicken self exploration of clients
through modeling and teaching others observe nonverbal behaviors
what can the abscence of a person show
make for awareness of things that others were not aware of.
what is a parataxic distortion
transference due to reactions from someone that are unrealistic.
what is displacement
responder reacts not to the current situation but to feelings from previous transactions.
are things ever one dimensional
no. never. not when it comes to group processes
wha tis the most powerful form of covert group tension
the struggle for dominance and status.
what is the primary task of a client
to acheive their goal (this changes over the course of therapy)
what is the first opportunity for change
when a person recognizes that they are being resistant.
what is the first opportunity for change
when a person recognizes that they are being resistant.
what stops the work from being done overall
secondary gratification (seeking affirmation from the person they find the most powerful, influential or powerful in the group - for example)
thus, secondary gratification stops the primary task.
what is resistance
pain avoidance.
how do we stop those seeking secondary gratificatoin
by reminding them of their primary task.
how does disclosing our feelings come across to the clients
implies a wish for closeness so the group models this behavior.
how should we present the disclosure of our interpretation fo the client
not as a demonstration of our own regard, but as a means of stating it as an issue for the client.
what is objective countertransference
reflection on the clients intepersonal impacts on you and others.
what is a subjective countertransference
idiosyncratic reacitons that relfect more on you as a person thin and carry into our relationships.
why is process commentary necessary for a very charged session
shows that high emoetions are big grounds for learning.
how should we frame our observation
as support and nonblaming.
what words should we always avoid x2
always and never.
what question should we ask of each intervention
how does does this intervention/question illimuniate hte process to help a client to change?
how do we create a self concept
through the reflection of self appraisals
what causes the intrapsychic action to change (what changes intention to decision to action?)
will power.
we cannot activate the will, so how can we help a client take action
assist to remove obstacles of their will and enhance motivations to change
what is the worst way to help someone take action through their self imposed will
through exhortation. (damn it, change - urging someone to do something)
what 4 things must be accepted to liberate one’s will to change
1- recognize that only they can hange the world they created for themselves.
2- there is no danger in change
3- to get what they really want they must change.
4- there can change and they are powerful enough to do as such.
how is everyone born regarding gropu sessions
everyone starts on equal footing and they are all born again to the group. and they are all responsibe for their hatching and how it should manifest.
how do we challenge the idea that there is danger in change with questions/interpretations
we use the idea of “as if” to challenge the assumption of the danger - you approach women as if you are afraid they will harm you always -
what is a way to act in group that would challenge the idea that change s dangerous
they would commit the feared act in the group. (this is very rare)
what must follow insight for it to be effective
action to change from the insight.
what motivates a person to change
knowing that the change has benefits to their life.
by what value should we measure an interpretation
by its function to bring about change (not type)
what allows an intervention to work properly
the relationship of the client(s) to the group/therapist
what prevents a client’s interpretation from being accepted
client to client interpretations are useful if they are not done so to establish power or dominance.
what are the 3 types of interpretation
1- use of the past
2- the group as a whole process commentary
3- transference
what is the past unconscious
the child within the adult
what is the present unconscious
current unconscious thoughts, fantasies and impulses that are influencing us.
do we perfectly recall the past
no. and therapy will alter our perception of it over time. this is called a reconstitution of hte past.
what is excavation of the past
pulling up crucial memories
what are the 2 levels of group life
1- group work
2- basic assumption group
what is meant by group work
conscious, rational and focused on the task at hand.
what is the basic assumption group of gropu life
uncosnciuos and irrational and resistant of tasks and duties of a group
what are the 3 forms of basic assumption group
1- dependency assumption
2- fight / flight assumption
3- pairing assumption
what is dependency assumption
group members feel ehlpless and desparate for rescue by the leader.
what is the fight / flight assumption
group is paranoid and mistrustful
what is the pairing assumption
group fantasizes about resuce by virture of a new mating relationship being foremd.
who implored mostly group as a whole processes
TAVISTORCK
what therapeutic factor uses group as a whole process
group cohesion
what 2 group as a whole forces stop therapy
anxiety laden issues and anti therapeutic group norms
what is group flight
when a group avoids an entire issue due to an anxiety laden issue
why would we discourage taking turns x3
it is a convenient procedure and gets rid of free interaction in the here and now. forces others into premature self-disclosure. it is a content solution for a process problem so it must be addressed at the process level.
which is more important to deal with, issues of the interpersonal or issues of hte entire group process
issues of the entire group process
