Group-Analytic Contexts, Issue 80, June 2018

56 Group-Analytic Society International - Contexts
therapy. The more severe the structural deficiencies are, the more
important it is to create a strong bonding in individual therapy before
the patient enters the group (Türk 2017). The therapeutic alliance
unavoidably often gets a rupture, especially working with patients
with attachment disorders. And when this rupture gets noticed by the
therapist it depends on his ability to repair it and to restore the good
relation (Wöller 2016).
I want to share one of my images with you: Spiderman, the
superhero hanging between skyscrapers in New York City. I use
individual therapy to create more and more threads between
psychoanalyst and patient, threads so strong, that they become ropes.
These ropes will hold the patient when he may fall into a deep dark
hole during group therapy and will help him to climb out of it.
Case report: This case report shows that only a few additional
individual sessions had been necessary. The good relationship
protected her from leaving the group. It is an example of combined
therapy.
A woman with a severe hysterical disorder, 46 years old, had
been in my individual treatment for several years. At the beginning of
the therapy she could hardly walk and was twisted in herself and the
physicians and the physiotherapists were desperate. She used to faint
in various situations. She could not say: “I do not want this” or “I
cannot do that”. Instead she reacted by fainting and falling onto the
floor. This symptom has existed since she was 17 and I do not think
that she will ever be completely rid of it. This symptom is clearly
incompatible with her job as a headmistress of a school. She had
individual therapy for four years and she improved significantly. Over
a period of one to two years we talked about joining a group. When
she was finally convinced that it would help her to further improve,
she joined my Tuesday evening group. All group members are female
and have been or still are in my individual treatment. After the first
participation she came furiously to the following individual session.
“How could you do this to me? It was like sitting with my family in
former times. I am so angry.” Our good and trustful relationship made
it possible to work through what had happened in her first group
session. Her spontaneous regression was severe. We worked
successfully, and she decided to remain in the group.
What had happened? I had made a mistake. Usually, new
patients do not join the first group session after a holiday break, but
step into the second group session one week later. For no good reason
I had neglected this rule this time after my Easter holidays. It did have