Group Therapy in Transactional Analysis

Theory through Practice

Anna Emanuela Tangolo, Anna Massi

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781000559378
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Tangolo and Massi offer a complete manual for transactional analysis (TA)-based group therapy. Group Therapy in Transactional Analysis demonstrates the evolution of TA as a relational psychodynamic therapy rich in clinical experiences both within individual and group settings.

The authors outline how to select clients, which setting to provide, how to establish contracts, and which techniques to use during group sessions. The book includes a full assessment of research and theory, clearly demonstrating efficacy and taking into account neuroscientific studies on intersubjectivity and the social brain. This is combined with a practical approach which supports therapists from the very first steps to the analysis of more complex interpersonal dynamics and dream analysis in a group setting. Finally, future research directions are discussed, together with an overview of an experiment on online groups in the time of coronavirus.

This foundational text will be a key reference for therapists in training and professionals new to the principles of transactional analysis. It will also be of interest to students on psychotherapy training and clinical psychology courses.

1WHY THE GROUP?

DOI: 10.4324/9781003215547-2

Alone together

The existential condition of being “alone together” is typical of this day and age. It is the condition of the Facebook user who, through a computer screen, finds themselves in touch with the world. The same can be said for the new political movements that are taking the streets: thanks to social networks like Twitter, it is easier to organize large gatherings of people, and it is just as easy for these gatherings to quickly disperse.

In her book Alone Together: Why We Expect More From Technology and Less From Each Other (2011), psychologist Sherry Turkle presents the results of an interesting clinical and ethnographical study on the relationship between individuals and technology, aiming at understanding how the web and the automation processes are changing our lives and shaping our identities. The author observed and interviewed more than 450 people: 300 young students belonging to different American schools and college campuses, and 150 adults. She found, for example, that the Internet and social networks make us “richer” in terms of acquaintances, yet these “friendships” are ever more precarious and short-lived. A number of other studies highlight how an average American in the age of Facebook, LinkedIn, and other social networks actually has fewer friends they meet in person compared to 10 or 20 years ago. We are giving up direct human contact in the name of technology, and a fear of disconnection is emerging, denominated by researchers as FOMO, Fear of Missing Out (Hunt, Marx, Lipson, & Young, 2018). We prefer to chat for hours through a profile or avatar often hiding our true face and name.

Technologies seem safer to us because virtual relationships are easier to manage and control, but most of all, they look like they are less subject to unforeseen turns of events. Digital culture gives us the illusion that we are all part of a community, whereas in reality, we are all more alone than ever. The consequences of this condition on our brain are still an object of study and research. The basis for Turkle’s reasoning can be found in the idea of a “fragmented ego,” and these ego fragments are distributed throughout the different virtual experiences and relationships with online contacts. According to the sociologist, the social and psychological aspects of these virtual experiences and relationships actually contribute to build up the individual personalities of the subjects that are experiencing them, exactly as – symbolically speaking – the many windows that make up the graphic interface of every operative system. Additionally, Turkle believes that web-based communication will gradually help us to conceive human identity as more fluid and complete, and allow us to perceive the many different egos coexisting inside ourselves. In her essay Life on the Screen (1995), Turkle stresses again that in environments mediated by digital interfaces, the ego is indeed manifold, and it interacts with other users rather fluidly through those same digital interfaces. Thanks to this network, individuals can communicate across the board with a potentially endless number of people belonging to different geographical areas, genders, and cultures: in a virtual reality, for example, they can embody a different gender identity, and in doing so, they might be able to widen their knowledge of that gender much more than they had ever thought possible; they might also be inclined to express more freely certain intellectual attitudes or psychological dispositions which would have had a harder time surfacing outside of a virtual context. According to Turkle, the plurality of egos manifested online is not identifiable with a psychotic symptom: quite the contrary, digital reality, encouraging the creation and accessibility of virtual worlds, may constitute a balancing factor with regard to the complexity of each individual’s personality. The required condition is that the individual in question manage to use the interactive experience offered by the web as a trampoline to acquire a certain set of competences and to increase emotional security also outside of virtual reality.

Building a social brain

If for years researchers have studied the brain as an element of its own, taking it out of its social context, today we know that it owes its survival to its interactions with others.

According to Alexander (1989), a well-known evolutionary biologist, our ancestors might have developed a complex brain in order to be able to negotiate and manage complex social interactions. A specific characteristic which sets apart human beings from other animal species is their capability to understand others’ thought processes through empathy and self-awareness. Alexander believes that our intelligence did not evolve to fight adverse natural conditions but to be able to compete with other individuals of our same species: the ability to comprehend the mental states of others as well as our own, called mentalization,¹ evolved so as to allow us to surpass our equals in shrewdness and cleverness. Since Homo sapiens is a social creature, their ability to “read” the mind of their peers allow them to quickly identify the elements on which others focus their attention, and to speculate with regard to their intentions and evaluation of events. Moreover, their ability to recognize non-verbal cues helps to access hidden aspects of other people’s minds, granting them a constructive influence on others.

Many neuropsychological studies today confirm that the development of the prefrontal cortex matches that of mentalization, of behavior prediction, and of emotional regulation processes. Thus, changes in brain structure are associated with the evolution of social intelligence: a slight proportioned expansion in the prefrontal cortex areas, around ten percent (Semendeferi & Damasio, 2000), was accompanied by an increase of neuronal interconnections in those areas. This expansion was also followed by an increase in volume of the right prefrontal cortex, an area involved in self-awareness, and the ability to remember personal experiences and plan for the future. According to Alexander, the right prefrontal cortex may help us find “a way of seeing ourselves as others see us so that we may cause competitive others to see us as we wish them to” (1990, p. 7).

Social interactions and mentalization

The role of mentalization, then, is not just to encourage collaboration and positive relationships, but most of all social survival. In a way, the ability to build healthy and authentic human relationships truly amounts to an evolutionary advantage. Environmental interactions, there since the very first stages of development, contribute to the “social building” of the brain: it is our ability to establish constructive relations with others that actually molds our brain.

Massimo Ammaniti in his interesting book Noi. Perché due sono meglio di uno (2014),² writes:

Going back to child development, there is consistent proof that we look for interactions with others even from birth, if not before, and that there is a relentless need to understand codes of exchanges and social interactions.

This specific disposition to sociality would represent a peculiarity of the human species which is absent in animals, since mutual aid may have significantly helped humans adapt and survive.

(p. 11)³

Anthropologist Robin Dunbar established a connection between size of the brain, mostly of the neocortex, and size of the groups in which the different species live… . A bigger group takes care of the individual, may be able to protect it from harsh environments and also contributes to the development of a more sophisticated brain structure.

(p. 102)

“When we interact with others or think about others, there is an activation of the medial areas of the brain such as the cingulate gyrus or the medial prefrontal cortex” (Ammaniti, 2014, p. 103). Some psychobiologists (Lieberman, 2013) speculate on the existence of a default mode network, a neural network distributed in different subcortical regions which activates during rest hours. The cognitive skills involved in this mechanism are the ability to reflect on and evaluate one’s own mental states and emotions as well as others’: it is a cerebral system of social representation which works even when the mind is at rest. These aspects correspond to what Berne calls “group imago” (Berne, 1963). So, the default system works to regulate the relation between self and others and make it predictable and manageable: in fact, it remains running in the background even during sleep and dreams. Additionally, studies on the reward system (Shulman et al., 2016) confirm an interesting data: the ventral striatum – the region of the brain responsible for satisfaction – activates when we develop cooperative behaviors and we feel welcomed by the social group. On the other hand, the cingulate cortex is responsible for the great sufferance set off by experiences of exclusion, thus confirming that experiences of reciprocity are encouraged and supported by our brain. This principle also regulates human communication in what concerns sharing and reciprocity: when arriving at the office, we say “what a nice day” even just to share a feeling, and this kind of communication is fundamental in order to boost connections with others (Tomasello, 2009). The we is inside our brain, our emotional system, our language, and the more human we are, the more plural we become.

Brain plasticity and environmental enrichment

Recent neuroscientific studies explain how some experiences are crucial to brain plasticity. The concept of plasticity is related to that of vulnerability to environmental stimuli and, on its own, it is neither positive nor negative. However, if the stimuli are positive, there is space to learn, grow, and even fix former negative experiences. Neuroscientist Berardi writes:

The plasticity of the brain shows that the brain is prepared to grow in a context characterized by safety, positive excitement, sincere shared availability and exploration. A large social group, the presence of several objects which stimulate curiosity, exploration...

Table of contents

• Cover
• Half Title
• Series
• Title
• Copyright
• Contents
• Foreword
• Preface
• Acknowledgments
• Introduction
• 1 Why the group?
• 2 Group theory
• 3 Change and empowerment factors in group
• 4 Intersubjectivity and the group as emotional regulator
• 5 Client selection and group composition
• 6 Setting
• 7 Therapeutic alliance and contracts
• 8 Decontamination work in a group setting
• 9 Deconfusion work in a group setting
• 10 Basic techniques: Therapeutic operations
• 11 Advanced techniques
• 12 Monitoring group evolution through group imago analysis
• 13 Transference, countertransference, games, and enactments
• 14 Dreamwork in group therapy
• 15 Efficacy of TA psychotherapy groups in the treatment of personality disorders
• 16 Depressive and bipolar disorders in a group setting
• 17 The end of therapy
• 18 A case study
• 19 Online groups at the time of coronavirus: an ongoing case study
• 20 Efficacy and limits of group psychotherapy
• Appendix
• Index