The Healing Crowd

All about group therapy: what it is, why it works, and which group is right for you.

Manhattan Transference # 2

Ever had the feeling someone was making you crazy? What if you're the therapist?

This is a serialization of the chapter by the same name from  Confessions of a Former Child: A Therapist’s Memoir This series began here.

Louis Ormont, the dynamic and insightful psychoanalytic therapist, offered some understanding of the nuance that countertransference can yield. He noted that there is objective countertransference, and this is the kind we mostly understand and talk about. In the objective version we know that someone reminds us of a relationship from earlier in our life—and we know who it is. But a more subtle type referred to as subjective countertransference can happen where we know something is going on in the encounter that has activated us, but we don’t have a clue.

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#2

Why would Alice let such a grotesque little woman into the group? This was a professional group, not open auditions for Ringling’s. Perhaps she was a confederate designed to cause a reaction. Moreno himself had used trained auxiliaries to enhance the therapeutic process. Perhaps this was the case, a sort of psychodramatic version of candid camera. The group began and Alice introduced the mystery woman. A dialogue sprang into my head:

Did everybody get to meet Elaine?

Did anyone survive Elaine?

Elaine is a psychiatric nurse.

Elaine is a psychiatric case.

She is going to join the group.

She is going to ruin the group.

We learned that Elaine was a psychiatric nurse who had practiced at all of the major hospitals in Manhattan. She joined the group as a way of developing her skills so she could open her own practice.

Typically the first two hours of a session were standard psychodramatic therapy followed by an hour of analysis and critique. In this way each member received a dose of therapy followed by a do and don't discussion. This session proceeded in the usual way. We took time discerning if there was any unfinished business from the week before, then checked in with issues of the day. From this check-in a protagonist was chosen by the group to work on her issue. (She had fallen out of love with her husband and had started having feelings for a woman. She wanted to tell her husband but was conflicted, confused, and ashamed.) She identified a specific scene with which to begin and chose members from the group to play various roles. The whole idea of psychodrama is to recreate the feelings of the original experience—then explore them through an enactment. As you might imagine the experience is very powerful for the protagonist and typically quite potent for the audience as well. But this was not the case for the Duchess of Odd. During the most profound features of the drama Elaine managed to jangle her bracelets, drop her book, play with her earrings, or fashion her lipstick. Her actions were profoundly distracting and I secretly hoped the facilitator would stop only long enough to strangle her. This didn't happen. I tolerated this manipulative distraction out of respect for the protagonist but was determined to make my displeasure known later in the group. I never got the chance.

Elaine spoke up and said she was bored by whole thing. She couldn't relate to it and it wasn't interesting. She then launched into a detailed description of some affair her friend was having and talked, talked, and talked, until it was time to go. I was surprised the facilitator had not intervened sooner and astonished myself by not saying a thing. The group ended and Elaine escaped. I felt as if some nasty little kid had just rung my doorbell, left a pile of burning dog shit on the stairs and run away. I didn't know exactly what was going on but one thing was certain, there was something oddly familiar about how much I disliked her.

Several sessions followed and my irritation with Elaine grew. Each week she had new ornaments in her hair and ears, on her fingers, lips, or wrists. A parade of stupid hats with brightly colored gloves, scarves perhaps stolen from unemployed magicians, sleazy necklaces, and, on one occasion, shoes that didn't match—not her outfit, but each other. She had an impressive array of mannerisms designed to undermine the protagonist and draw attention to herself. By the end of the month it had gotten so bad I was forced to reflect on my own pathology in this process. I don't know how, but I had somehow drifted into an obsession with Elaine's behavior. Not only was I watching, noticing, and loathing her every move, I began to observe one of her behaviors more than the others. I was as worried about doing this as I was unable to control it. I had become the very definition of obsession. I was watching Elaine breathe.

Go to part 3.

Daniel J. Tomasulo, Ph.D., TEP, MFA, is a licensed psychologist specializing in group psychotherapy and psychodrama.

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