Group-Analytic Contexts, Issue 80, June 2018

Newsletter – Summer 2018 55
desired the help of a group. I thought that group therapy could
accelerate the process and the success of therapy. I decided to test my
hypothesis. Since 2008 I have practiced combined therapy.
In my private practice many patients now ask for combined
treatment. They are often curious to step into group therapy but also
want to feel safe and have single sessions too. However, most of my
group patients are not in combined treatment. I have five
psychoanalytic groups and only eighteen individual sessions. Why is
this? I have found that the longer patients are in combined or
concurrent treatment the more likely they are to choose to move to
solely group treatment. Often individual treatment isn’t necessary any
longer.
I have never felt this is a dilution of the group process but
rather a condensation, a strengthening. Colleagues who fear dilution
never have worked with combined treatment. Or maybe, they are not
experienced in using both modalities. It is possible of course that the
strength of the transference is sometimes weakened by combined
therapy, but this can be very helpful and necessary for the mental
defence of the patient.
As far as I know only a few colleagues practice outpatient
combined therapy in Germany, although combined therapy is very
common with inpatients in Germany. Outpatient combined therapy
seems more common in the USA. In 2009 a whole issue of the
“International Journal of Group Psychotherapy” was dedicated to this
theme. I want to quote Priscilla Kauff (2009) three times:
“…the two modalities can reinforce and accelerate the often painfully
slow and difficult task of helping to make the transference process
accessible to analysis and ultimately to work through and relieve its
grip on the functionating of the patient.”
“The more familiar the patient becomes with the existence of the
transference process…the better able he or she will be to alter that
input and the more likely positive change will occur.”
“Any window that allows access to the transference process will
clearly contribute to the overall success of treatment.”
Main topics with case reports
The importance of bonding
In my opinion developing a good relationship during individual
therapy is a necessary and unavoidable preparation for joining group