PRELIMINARY REPORT OF AN EXPERIENCE IN THE GROUP PSYCHOTHERAPY OF SCHIZOPHRENICS
JOSEPH ABRAHAMS M. D.1
1 St. Elizabeths Hospital, Washington, D. C.
This experience may be discussed in the following terms:
1. It demonstrates that schizophrenic individuals can be led into psychotherapeutically effective relationships with each other in a group setting, through the exercise of a special type of group leadership.
2. The establishment of a therapeutic atmosphere in this type of group is marked by the gradual spread of a way of behaving or group mores accepted by all the members, of helpfulness, acceptance, awareness, and a desire for understanding of the other patients' problems, and, through that, to understanding of their own.
3. This atmosphere is established through the leadership of the doctor working through example and by the adoption by the patient, in his relationships with other patients, of the doctor's way of relating to him. The doctor needs to be as aware as possible of the dynamics of the group as a whole and of members to each other and to the group. He needs to be ready when necessary to protect the individual patient and the group from the impact of the intense emotion associated with the deep-seated disturbance of the psychotic.
4. The ability of one schizophrenic to understand another's defenses against anxiety results, in this therapeutic atmosphere, in the bringing to awareness of the meaning of their interpersonal relationships and the uncovering of earlier experiences associated with the patient's anxieties.
5. The therapeutic process resulted at first in an increase in hostile, depressed, and manic-like reactions, but, within a few months, there was established a gradual amelioration of the patients' social isolation, boredom, recrimination, and combativeness, and the substitution of a more cooperative atmosphere. The individuals also showed their improvement by an increasing ability to tolerate reality without recourse to psychotic defenses.
