Introduction: 99 Unconventional Interventions



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A Danger of Group

I still rue over a horrific incident while I was a fledgling group leader. At that time, I ran groups at a mental health clinic in Greenwich Village, New York. The patient population was diverse and colorful with artists, actors and musicians among white-collar and blue-collar patient population. I had been treating a gay man for about one year in individual therapy who had come to therapy for issues around impulse-ridden, polymorphous perverse, acting out of sado-masochistic anonymous sex in back room bars. He was out of control and it scared him but he couldn’t stop himself.

This was at the beginning of the AIDS epidemic when little was understood about the disease; it was erroneously referred to as “The Gay Man’s Disease”. He was frightened of contracting HIV but was felt helplessly driven to engage in dangerous and self –deprecating sexual behavior. He sought help for his sex addiction. I believed that a group could help this man to resolve his conflicted feelings about dependency, which I believed were at the core of his self-hatred.

I knew that his history. ‘Juan’ was the eldest of a large Hispanic family where is mother had several children by different fathers. In his child mind, she was always pregnant with a stranger’s child and he thought of his mother as a whore. She was overwhelmed by life and had no emotional energy left or time for him. She felt out of control in her life and took out her utter misery out on her children. Juan’s childhood was marred by his mother’s rages and her murderous feelings him and his siblings. As the oldest child, he got the brunt of her hate-filled physical and emotional tirades. If he misbehaved, she would punish him by tying him to a chair and leaving him alone in the basement for hours. This terrified him and enraged him at the same time. Juan was tortured by his conflicted feelings toward her. He loved his mother but hated her for neglecting him. I believed that talking about his childhood experiences, feelings of terror and impotent rage toward his serially pregnant mother, in a safe psychotherapy group setting, could help to stabilize his compulsion to act out of dependency feelings through extreme S&M sex.

I placed him in my coed group with members in their 20’s, 30’s and 40’s. One female member was visibly pregnant with a big baby bump. I include this detail because in his first group session, even before they spoke to each other and apparently unprovoked and out of the blue, the new gay member verbally assaulted the pregnant woman, calling her every hateful misogynistic slur imaginable. Needless to say, I stopped him and said that if he couldn’t contain himself he would have to leave. He left and I never saw him again, despite my attempts at contacting him to come in for an individual session to talk about what happened.

In retrospect, it occurred to me that just the sight of a pregnant woman ignited an instant over-reaction to women in general and to his hated mother specifically. It set off a long-buried rage from childhood. In the regressive atmosphere of a therapy group, the rage erupted.

To this day, I have wondered if his rage at the very sight of a pregnant woman could have been predicted. Were there red flags about him that I missed in the individual sessions that would have alerted me to the danger of putting him in a group with a pregnant woman? Despite consultations with more seasoned group leaders, the answer was always the same;” Sometimes you just don’t know”. This is both the good news and the bad news about group therapy. There is always an element of surprise. You never know what might happen. It’s exciting and at times exhilarating but it’s scary too. The group and the woman were quite traumatized by the experience and it took some time to process what happened and to restore their shaken trust in me. Now let’s return to the healing power in group of the basic kindness of others.




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