Heal My Heart: Stories of Hurt and Healing From Group Therapy
Heal My Heart: Stories of Hurt and Healing From Group Therapy
Heal My Heart: Stories of Hurt and Healing From Group Therapy
This paper records four stories that emerged from four group therapy members. These stories are stories of
fundamentally broken hearts. I utilise this material to address two psychological phenomena in group
therapy - self-disclosure and the corrective emotional experience. The overarching theoretical framework is
the existential approach to group therapy, and the underlying theoretical assumptions of relational
psychoanalysis applied to group therapy. In the context of the material I present several theoretical points.
Some of the chief points are the notion of the “in-between-ness of healing” and the importance of two
processes in healing - i) the process of telling the story (remembering) in such as way that it is relived both
emotionally and physically, and ii) followed closely by a corrective emotional experience. The emphasis in
this paper is that remembering and reliving in therapy is not enough and a corrective emotional experience is
required. Broadening this perspective of the healing mechanism of a corrective emotional experience, a
principle argument of this paper is that the therapeutic action in group therapy (as it can be in individual
therapy) is not insight but a new relationship
Relational psychoanalysis is not normally an The pioneering work of Harry Stack Sullivan
approach used in group therapy. However, I (1953) has been credited with developing the
have found that this theoretical framework is interpersonal or relational approach to
helpful and can be successfully applied to the psychoanalysis, but it is the contemporary
therapeutic process of making meaning of ‘things theorists such as Merton Gill (1981, 1983), Jay
that happen’ in the group context. Greenberg and Stephen Mitchell (1983), both
who parted conceptual company later on
Briefly, relational psychoanalysis, sometimes (Greenberg, 1991, Mitchell, 1988), Irwin
referred to as the ‘interpersonal approach’, has Hoffman (1991), Edgar Levenson (1981), and
the assumption that individuals are defined by Edward Teyber (1997), who have developed
their relationships with other people. From variations of the relational psychoanalysis model.
“Julia” remembered being 11 years old during explain myself, I did not apologise, I did not even
the group therapy process. She shared the care, I pretended as if nothing had ever happened.
following experience: To this day, I wish I had done things differently”.
“ When I was 11 years old, I had decided that I The sense of guilt and feeling that she should
wanted to be a part of the popular group. So, I have done something to restore things, to heal
made a deal with one girl that she would be my broken friendships has weighed heavily with
best friend. I dropped my old best friend, and Julia for a long time. She speaks now of not
became a part of the popular group. I made being able to connect authentically with her
things even worse by telling my mother that my friends and establish and maintain close and
old best friend and I had had an argument and trusting relationships. She feels that some of her
that it was all her fault and not mine. In my friends she had managed to make, she “pushed
family, lying is possibly one of the worst things away”.
that we could ever do, and today I carry with me
the guilt of lying to my mother about a situation Not only has she pushed away potential friends
that I had actually induced (just so that she would but she finds herself repeating her earlier pattern
not think badly of me). Even when I was given of making friends with people because she feels
the chance to sort out things with my old best these people are the “in group”, the “popular
friend, my pride held me back, and I never did group”. She remarked,
anything to put the situation right. I did not
“I lived with a group of girls last year, and there two girls, and so I pretend to be friends with
were strained relations between me and two of them in order to keep everyone else happy - just
the girls. I am, I understand, allowed to be so that I do not have to explain why I am such a
friends with people if we do not get along. I horrible person because I do not get on with
know that people are different and that not every them. I am too much of a coward to say what I
body is going to like everybody else. My feel ... I hate what I did to my friend when I was
problem is that I see everybody else likes these 11, but it seems that I cannot stop or change my
The Indo-Pacific Journal of Phenomenology (IPJP) can be found at www.ipjp.org.
The IPJP is a joint project of Rhodes University in South Africa and Edith Cowan University in Australia. This
document is subject to copyright and may not be reproduced in whole or in part via any medium (print,
electronic or otherwise) without the express permission of the publishers.
Indo-Pacific Journal of Phenomenology, Volume 2, Edition 2, September 2002 Page 6 of 15
behaviour. It feels like I am destined never to against the closed door, he felt a sense of being
have close friends again because of what I did. It shut out and so alone. He called to his parents
also seems that people notice this horrible quality repeatedly but the door remained shut, blocking
and before we get too close, something in the out any nurturing comfort from his parents
relationship causes them to move away from me. within. He felt a rising panic, and a certainty that
It makes me feel guilty and inadequate, and something dark and evil was advancing along the
because I feel like this, it affects all my corridor towards him. He repeatedly cried out.
relationships with friends. I notice that even with No one reached out and took care of him.
the boyfriends that I have had, I would rather that
they break up with me than me break up with William does not remember how long he stood
them, because I know that I can deal with being there as a small boy calling out, fearful and alone
hurt, but I am not able to change the situation if I in the dark. He does not know where his parents
hurt somebody else. I think that this relates to were and why they did not reach out to him. All
how I would rather deal with being betrayed, he remembers is that in his fear there was no one
then having to betray someone else again”. to comfort him, no father to hug him and make
the world safe again. No mother to warmly
“William” remembers growing up. In the group envelop his trembling body. He was alone,
he recalls one painful experience when he was a totally alone, and no one heard his calling. Now
very young boy. He had fallen asleep only to be at 26 William has this constant anxiety about
awakened by a nightmare. Fearful and confused being left alone, and metaphorically ‘outside’ of
he had sought out his parents. Stumbling down things - not belonging. He worries that he may
the darkened corridor of the large family house, not find someone to listen to him, to really care
he stood outside the closed door of his parents about him, to stop the trembling within. He fears
bedroom. There he had tried to open the door, abandonment and yet also believes that he does
calling out to them in his panic and terror, feeling not deserve to have loving protection from the
as if the demons of his dream still stalked him. demons of his world.
He felt so frightened and so small. As he
frantically called out to them, face pressed The group as an “alchemical vessel”
The group process itself becomes therapeutic individual working through their issues or
when it facilitates a process of what Alexander conflicts within the group may relive experiences
and French (1946) first termed ‘a corrective that they were unable to resolve by themselves,
emotional experience’. Many authors, for and the other group members contribute to the
example, Corey (2000), Corey and Corey experience by assisting individuals to undergo or
(1992), Davanloo (1980), Friedman, (1994), relive an experience which previously had
Malan, (1963, 1979), Mander, (2000), Sifneos traumatic results or consequences, but now will
(1987), Posthuma (1996), Teyber, (1997), and be experienced differently in terms of providing
Yalom (1995), have subsequently written about them with a different response to which they
the psychological significance and value of ‘the imagined would result. Thus they experience
corrective emotional experience’ in within the group new and positive emotional
psychotherapy. “A corrective emotional responses to the experience of the original event.
experience occurs when the therapist responds in
a new and safer way that resolves, rather than In the light of this, the group can be
metaphorically re-enacts, clients original metaphorically viewed as an “alchemical vessel”
conflicts (Teyber, 1997, p. 143). The notion of as it provides the basis for experiential re-
corrective emotional experience is equally learning in that the alchemical vessel provides
applied to the group therapy context. The members with a feeling of containment and
In any modality or context of group therapy, the constitutes the integrative process through which
overall aim is the same, namely, to overcome the patient gains a sense of her own reality,
inner conflicts that the individual members are wholeness and sense of genuineness as a person”
experiencing (Slavson, 1979). Many people (Stricker & Fisher, 1990, p. 76).
believe that they are unique in their personal
problems, therefore listening to other group Within the therapeutic space of the group, self-
members disclose highlights the fact that “there disclosure has a potential to move the individual
is no human deed or thought that is fully outside into a deepening and greater self-awareness as it
the experience of other people” (Yalom, 1995, p. presents the potential for dealing with inner
6). Self-disclosure is a process by which the self conflicts some of which are perhaps hidden and
is revealed and it is often referred to as the unconscious. However, self-disclosure is a
‘talking cure’ (Stricker & Fisher, 1990). complex act, and is frequently initially presented
However, if self-disclosure is not consistent with with some uneasiness concerning the imagined
the experiential sense of self then individual possible outcome and reactions of others,
members of the group will not procure the particularly if the information disclosed is of an
benefits of disclosure, and will in turn, become intimate nature. Disclosure becomes anxiety-
alienated from the group process, the group provoking as there is the potential for, and fear
members and themselves. “Finding the words to of, betrayal, rejection, and psychic impingement
represent, evoke, and express the experiential self or damage. Within an existential framework,
The Indo-Pacific Journal of Phenomenology (IPJP) can be found at www.ipjp.org.
The IPJP is a joint project of Rhodes University in South Africa and Edith Cowan University in Australia. This
document is subject to copyright and may not be reproduced in whole or in part via any medium (print,
electronic or otherwise) without the express permission of the publishers.
Indo-Pacific Journal of Phenomenology, Volume 2, Edition 2, September 2002 Page 8 of 15
anxiety about disclosing results in having to Within the therapeutic space of the
group it is often a frightening risk to let
make choices without clear guidelines and go of the old confining parts of
without knowing what the outcome will be and ourselves and open up to the
from being aware that we are ultimately potentiality of transformation. “At some
level we know that for new dimensions
responsible for the consequences of our actions. of ourselves to emerge old parts of
Kierkegaard (1813 - 1855) writes of existential ourselves must die. The knowledge
that as we grow we must exchange
anxiety or this fear as ‘the dizziness of freedom’.
familiar and secure ways for new and
unknown ones is in itself a source of
anxiety” (Corey, 2000, p. 255).
In the context of therapeutic change in group which needs to occur soon after the relived
work three closely linked points are made below experience. I shall re-visit this third point
which pepper the rest of the paper. Firstly, fear later.The imagined fear of self-disclosure
of self-disclosure is often an imagined fear based becomes immobilising and can result in a sense
on the original wound or trauma, and secondly, of troubled defensiveness and neurotic suspicion
gives rise to the emergence of psychological of others. Thomas writes in his journal before
themes that are repeatedly re-enacted in a series the start of one session:
of pivotal (mostly negative) past experiences.
One of these pivotal experiences (for example, “I don’t know what will come out of me
William as a small boy remembers and relives today, or what I will let out. Try as I
may, I am not calm. I am suspecting
being locked outside of his parents bedroom
and distrustful ... I sit, awaiting some
when he desperately needed their comfort after a kind of question, awaiting the
nightmare), is remembered in group therapy. invasiveness which I am sure will
present itself. I taunt my body, holding
This remembered experience or event in the
it in rigid defensiveness ... For I have
group context is not necessarily the original told myself that I am a mere presence,
wound, but has re-enacted again ‘faulty relational ungenerous and distanced. I will not be
breached, and so I can’t be damaged.
templates’ (Teyber, 1997) that first emerged in And so with my troubled heart I stay
the generic familial interactions between parent quiet and unrevealing”.
(or caregiver) and child, and that now dominate
William remembered his feelings
and guide all current thinking and behaviour.
Teyber describes these ‘relational templates’ as
“my greatest fear was in knowing that I
“ingrained relational responses and expectations”
had to self-disclose. Most of us find this
(p.18). These are relational patterns or difficult to do with our friends let alone
“relationship themes that are more pervasive ... in a group ... What I find difficult is what
they do with the information that I have
across the different narratives the client relates” just given them. Because I am insecure
(p.50). ‘Faulty’ relational templates are about myself, I needed to know what
understood as repetitive self-defeating relational the other person is thinking and how
they feel about what I have just said,
patterns. Thirdly, linked to the fourth point, to and whether they see me in a different
remember and relive (even the original light. Once I had self-disclosed, I did
experience) is not enough. What is essential for not know where I stood with people and
that made me uncomfortable and
therapeutic change in group work is the unsure of myself.
occurrence of a corrective emotional experience
Julia remarked that
“I was nervous. I knew that I wanted to I was unaware of my tension in my
work with my guilty feelings but I wanted body. When I did speak, afterwards I
to pull out and continue avoiding my felt relief but also a gnawing sense of
feelings. When it came time to disclose, may be others think less of me now.
I felt worried about embarrassing myself, What did they think about me?”
and I was not quite sure what to expect.
The Indo-Pacific Journal of Phenomenology (IPJP) can be found at www.ipjp.org.
The IPJP is a joint project of Rhodes University in South Africa and Edith Cowan University in Australia. This
document is subject to copyright and may not be reproduced in whole or in part via any medium (print,
electronic or otherwise) without the express permission of the publishers.
Indo-Pacific Journal of Phenomenology, Volume 2, Edition 2, September 2002 Page 9 of 15
interpersonal and psychological space which they
all occupy within the therapeutic space of the
Within the therapeutic space of the alchemical group and beyond, and such uncertainties have
vessel that is the group, when individuals choose both conscious and unconscious influences on the
to disclose, despite the existential and exactness which they all hope define their
phenomenological anxiety and the complex perception of themselves and ‘the world of
matrix of interpersonal projections and other’. It is possible within the alchemical vessel
distortions, healing begins in a small but definite that is the group that our intuitions regarding the
way. William, with his deep wounds of other, and our understanding of ourselves in
childhood abandonment, Thomas with his broken terms of those others are entirely inaccurate.
heart, Ellen with her guilt and remorse over the Self-disclosure so often defines the process of
death of her father, and Julia, carrying a sense of group work, and affects the healing of group
shame in betraying a childhood best friend and members and reveals how they situate themselves
lying to her mother, all began to self-disclose, to in the world. The group therapy process allowed
risk, to share, to open a closed door within, to these four group members to begin to examine
speak an unspoke truth, and to lean towards a their situatedness in the world, and explore their
greater sense of authenticity and freedom. I shaky distorted self-perceptions. The therapeutic
invited each to experience the impact of their encounter of the group sets the scene for the
revelations on the other group members. Each members to test the reality of their perceptions of
asked every group member what they thought self and others, and can dissolve these self-
about them now that they had told their stories. generated interpersonal distortions (faulty
They all received positive feedback which relational templates). In other words, the group
became a powerful corrective emotional as the alchemical vessel presents the therapeutic
experience. space in which reparations can be made,
projections withdrawn, and inaccurate
Doubts and conflicted feelings seem to pervade interpretations corrected.
group members’ intuitions regarding the
Thomas had told himself that he could protect The alchemical vessel had done its
himself and be safe by not disclosing, by not transformational work.
speaking out his truth and his pain. He had Returning to the notion that healing happens
chosen to remain silent: “I am a mere presence, between people, or the “in-between-ness of
ungenerous and distanced. I will not be healing”, one of the central points that I am
breached, and so I can’t be damaged. And so making in this paper is that the prime source of
with my troubled heart I stay quiet and healing is between people within the therapeutic
unrevealing”. When he did eventually speak, space of the group. It is the interpersonal
with trembling hesitation, his fears of self- relationships in the group that heal - it is the
disclosure arose dramatically. But in the complex matrix of the interpersonal dynamics of
complex act of disclosure, he metaphorically the people in the group that provide the
‘opened a door’. He felt anxious but he spoke interpersonal healing. This is illustrated in terms
and in that moment, the healing process began to of Thomas. Thomas’s prime source of healing
take place. His imagined fears of being rejected was between people in the group. Thomas was
and dismissed by the group, as he had once been, not rejected or shunned by the group members as
were grossly unfounded and quickly displaced he had perhaps imagined would happen because
when he received instead positive affirmation of his on-going current beliefs about himself
from the group members. In that moment he had based on the past event/old trauma documented
experienced a corrective emotional experience. above. The group accepted him. What he had
believes that remembering is not enough. “If (self-disclosure) is not enough. It is not by itself
remembering is not enough, what is missing is therapeutic. It must be accompanied by the
re-experiencing (Kahn, 1991, p. 55). In terms of chance for group members to re-experience or
this paper, I echo Gill’s (1981) opinion that relive the old wound or trauma in the presence of
clients problems were originally acquired others that results in new responses from others
experientially, and therefore, in order to be which teaches (re-learning) clients that this time
transformed or healed, they must be transformed it can be different to what they had expected
experientially. They must be relived. In the (imagined) would happen. This is the source of
context of group therapy, re-experiencing or healing - the corrective emotional experience - a
reliving must occur within a safe and caring new relationship. In this context, healing
therapeutic environment. This notion links to the happens between people - the “in-between-ness
related notion of the corrective emotional of healing”. Finally, in order for reliving or re-
experience in therapy - the primary source of experiencing in group therapy to be of value, it
therapeutic healing and change for clients - in must be contained within the therapeutic space.
that clients must re-learn the earlier learning by
recreating the old situation (in therapy) from About the Author
which they originally learned things about Dr Zelda Knight, a Senior Lecturer in the
themselves and the other. To re-phrase, the Department of Psychology at Rhodes University,
emphasis on re-experiencing or reliving is a registered Research and Counselling
represents a core component of most models of Psychologist. She obtained her PhD in 1997.
psychotherapy, both group and individual. It re-
focusses the classical psychoanalytic perspective Currently, Dr Knight is the Director of Masters in
of transference as well. To Freud, the value of Counselling Psychology Training and is co-
transference lay in its power and significance to founder and President of The South African
help the patient remember and remember with Association for Psychotherapy (SAAP) which
conviction. For Gill (1981) and others, the value seeks to promote the practice and research of
of transference lies in providing clients with an psychotherapy in South Africa. To this end, she
opportunity to experience once more the old has chaired the Organising Committees for
wound, and the response originally encountered SAAP’s two national psychotherapy conferences,
by it, and that now they can receive a held in 2001 and 2003.
significantly different response from the
therapist, and in the case of group therapy, from She has published extensively in refereed
the other group members. journals and books, and regularly presents
research at national and international
In summary, remembering in group or individual conferences.
therapy is not enough. Merely re-telling the story
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