Experiences of a Psychotherapeutic Group of Jewish and Palestinians Participants and Conductors during Conflicted Times in Israel

Experiences of a Psychotherapeutic Group of Jewish and Palestinians Participants and Conductors during Conflicted Times in Israel

 Tsvi E. Gil, B. Sc., M. A., Anaam Abu El Hija, M. S. W., Juan Bar-El, M. D.

 Acre Community Mental Health Clinic, Mazor Psychiatric Center, Israel

Correspondence:   Tsvi Gil, POB 3626 Haifa Israel 3103601  tsvigil13@gmail.com, Tel. 972-542098207

Conflicts of Interest and Source of Funding:  We declare no conflict of interests.  No funding was requested for writing of this article.

Key Words:  Group therapy. Conflict, Parallel processes

 Abstract:  We present a group therapy perspective of groups viewed in widening circles.  These circles include a therapeutic group, its coleaders, and the professional staff, all of them included in a mixed population small town mental health clinic in Israel.  Further, at the background, there are the political and cultural surroundings of the town and the state.  All of these groups consist of Palestinian and Jewish members, namely, patients, professionals, and inhabitants altogether.  We discuss the nature of the processes that we observe in those groups.  Usually interpersonal relationships in those groups are mostly positive, with only a little allusion to the permanent political conflict that exists between these two nations.  We hypothesize that some defense mechanisms are in operation in order to minimize threatening conflicts and tensions and to maximize positive atmosphere and effectivity of those groups.  In WR Bion`s terms, basic assumptions are employed in order to enable apparent work group.  We believe this minimization of conflicts and tensions and maximizations of productivity in the groups` functioning are achieved with the price of defensiveness and constriction of personal and group minds.  Mutual expectations lead to behaviours that emanate from those expectations, and which are sometimes not authentic.  When do relate to the national identity of group associates, members incline to attribute cultural characteristics to their peers, sometimes superseding more personal and intrapsychic themes.  We bring forth special reference to the characteristics of the two communities involved, namely, individual vs. collective psychologies.


 Acre is a small town in the north of Israel.  About two thirds of its inhabitants are Jews and third are Palestinians, most of them Muslims, the rest are Christians or Druzes.  Acre is surrounded by rural settlements, most of them Palestinians.  The community mental health clinic in Acre is a small clinic that provides mental health to the inhabitants of Acreand its region.  About a half of the referees to the clinic are Palestinians.  The staff of the clinic comprises of psychiatrists, social workers, a nurse and a psychologist, as well as administrative staff.  We also have provisional students or volunteers in psychotherapy, art therapy, and the like.  Most of the clinic staff are Jews and usually do not know Arabic.  Only minority of the clinic staff are Palestinians.  This unfavourable situation reflects the wider circle of the State of Israel, in which three quarters of the population are (Hebrew speaking) Jews, and less than a quarter are (Arabic speaking) Palestinians.

Within the various facilities the clinic offers – psychiatric treatment, psychotherapy, and rehabilitation – we decided to establish therapeutic group.  The members of this group were Palestinians and Jews, in variable proportions.  The leaders of the group were Palestinian and Jewish psychotherapists.

The scope of the present article is a preliminary enquiry into the nature of those parallel circles, namely, the therapeutic group; its leaders; the clinic staff; and the community around us.

The therapeutic group:

 A preliminary decision one has to take when forming a therapeutic group is whether the group would be homogenous or heterogeneous (1)).  This decision has far reaching implications about the nature and process of the group to be. When we made our mind to make a heterogeneous group we took in consideration not only those mentioned in Gil and Jossman  (op. cit.), but also that (a) due to the composition of the clinic clientele there was a real need for group therapy for both Palestinians and Jews, and (b) an ideological and professional standpoint that a heterogenous group would reflect and represent in a more genuine way the participants life, as those who live in mixed society, in their town as well as in the state. This approach accords one of the social work paradigms of 'person in environment" (2).  Nevertheless we would mention only briefly that on other occasions, and taking on different considerations, we decided to create more homogeneous groups, e. g., spouses of Palestinians patients who suffered from severe mental disorders (3), and another group of art therapy for Palestinians women, both conducted by Palestinian therapists in Arabic. In those occasions we considered that use of mother tongue, as well as homogeneity in aspects of common culture, may yield considerable benefits for the participants.  Nonetheless we did not disregard that those benefits may involve potential disavowal and denial of conflicts that otherwise are inevitable in the life of groups.  As Yalom & Leszcz (4)  comment, groups that were originally intended to be homogenous may eventually show much heterogeneity (in terms of personality characters, preferences, roles taken by participants, and more so), and also the opposite holds true – heterogenous groups consisting of participants whom we saw as very different from each other may eventually consolidate to highly cohesive and uniform patterns of conduct.

 On the nature of bi-national groups:

The apparent smooth relations between Palestinians and Jews mental health workers who work together in the clinic, as well as among the group leaders, were remarkable.   These even relations seem to ignore conflicts, tensions, hostilities and suspects that may present in the community in general due to conflicts that exist between the nations, religions, and political movements that are inseparable components of the Israeli life.  We propose explanation to this phenomenon based on the fifth assumption.   Bion (5) suggested three basic assumptions that commonly exist in groups` life.  These assumptions are unconscious to the group members and only be interpreted by the group leader; however, they powerfully affect the behavior of the group members.  These assumptions are clusters of defenses that designed to aid the participants to cope with anxieties that evoked by being included in a group. The group members may develop dependency (usually in the leader, but sometimes in other group member or in the group as a whole) with the (magic) expectation that this dependency would protect and redeem them. Alternatively, they may fight with the hope they win or, at least, would be able to escape (leaving the group or disconnecting themselves), rescuing themselves from the dread they experience in the group.   And finally, they may pair with other group member and form with him or her an experience of intimacy with the hope that such bonding would assist them in coping with the threats in the group   ("love covereth all sins"' Proverbs 10:12).

Following Bion some theoreticians proposed further assumptions like Turquet (6) who called One-ness to the phantasy of the members to "join in a powerful union with an omnipotent force, unobtainably high, to surrender self for passive participation, and thereby to feel existence, well-being, and wholeness …thus lost in a feeling of ‘oceanic union".  Later Lawrence and colleagues (7) proposed a fifth assumption which they named `Me-ness`, in which grounding the relationships between the members is constituted by the implicit, latent unconscious agreement to be a non-group. The members thus behave as if the group did not exist because, if it did, it would be perceived as extremely persecutory.

Our own version of the Me-ness assumption may be formulated as following: the single members of a particular group may function well in this group (which otherwise may be threatening or unbearable for them) by ignoring some of the group's characteristics (which they perceive as potentially harming) and comply with its other, more general values.

 An example for that assumption is that patients in the therapeutic group consciously deal with some of their mental problems that brought them to seek treatment from the very beginning, ignoring some other aspects of the group.  A common saying is "We all human" or "We are all in the same boat", which implies that we unite around our mental problems and our joint wish to resolve them, and ignore other conflicts and tensions that may present in the group that consists of Palestinians and Jews.

Other example refers to the clinic staff.  Its members may cooperate around their common goal of providing mental help to the clinic patients, or over some folklore that is being built merely from working together for lengthy time (eating together, parties, trips), and simultaneously ignoring conflicts and tensions which are inherent in a nationality mixed staff.

 Mental Health: The Israeli case:

Israel was founded as the state of the Jewish nation, and Palestinians were a minority, often discriminated and deprived, weather objectively or subjectively.  Palestinians on the average are poorer and less educated than their Jewish associates.  Only toward the last decade of the 20th century Palestinians started to gain degrees in the mental health professions.  As a consequence, Palestinians mental health workers are not only outnumbered by their Jewish associates in mental health staff, but they also in lower positions (as the higher positions of directors and supervisors are held by senior Jewish professionals).  Hence the encounter of those groups when working together (as in the clinic staff) is not equal, as the Jewish members hold the more senior positions and decision makers.  Palestinian workers can hardly ignore the wider background of a century of conflict between the nations.  This conflict is accompanied by feelings such as superiority versus inferiority, rage, fear, guilt and mistrust.  These feelings not only felt but also projected, namely, Palestinians may attribute patronage to their Jewish colleagues, while on the other way around the Jewish workers may attribute hatred within their Palestinian colleagues.  Under such conditions working together cooperatively necessitates consciousness and sensitivity but also a massive use of defense mechanisms such as suppression, repression, denial, reaction formation, and probably more.  A person using such mechanisms is sincerely convinced that he or she has no hatred, anger, fear, superiority or inferiority standpoint toward his or her colleagues from the other nationality; what is left to the conscious matrix are diluted feelings of kinship, sympathy, concern, and the like.

 The group process:

 The aforementioned positive feelings resemble the first phase in the life of groups that was termed by McKenzie (8) as Engagement.  In the context of a therapeutic group it is the phase when the group consolidates and generates its identity.  This task is achieved by emphasizing the common and similar attributes of the group members, while neglecting differences.  Characteristic feelings of this phase are mostly positive, members pointing out their common distress, the need to be open and to share, expressing optimism and belief that if we all work together (and avoid quarreling) we will get to our common goal.  The common, explicit goal for a therapeutic group is resolution of the mental problems that brought them to treatment from the beginning.  When the clinic staff is concerned the common goal is an effective treatment for the clinic`s clients (as well as goals as a clean clinic, promotion, and the like).  In Bion`s terms this phase of engagement is transitional toward the `work group`.  What we propose here is that the work group may never be achieved, since the participants stay in what Fonagy (9) calls `Pretend Mode`, a state in which there is only loose relation between inner to external reality.  Or, in Winnicott`s (10) terms, a state of false (collective) self, in which the group behaves as the group thinks it is expected to behave and not necessarily as it genuinely feels, neither following its inner world of drives.

It is a bit curious to remark that the term `engagement`, which McKenzie (8) uses to describe the first phase in life of groups, is also the term used to describe betrothal, when a couple decides to be together, to commit to each other, to marry.  This is often the phase of ideal love, even infatuation, with great hopes for eternal love and mutual understanding, or, in Kohut`s (11) terms, phase of twinship. Getting married afterward, namely, the actual materialization of that ideal love may only deteriorate from this exalted summit.  Being together in the prosaic daily life, the encounter with the partner`s characters and habits, coping with differences in personality and preferences and with the inevitable conflicts, may sober the affective excitement of the phase of engagement.  In George Christoph Lichtenberg (1742-1799) saying, if love is blind, than marriage is the eye doctor.

However, it is worth mentioning, and following McKenzie (8) that many therapeutic groups, mainly those whom we label as `supportive`, remain in this engagement phase for long time, sometimes for the whole of the group life.  While maybe psychological conflicts are not explored nor resolved, the group`s members enjoy acceptance, support, sympathy and togetherness, qualities that they often miss in their life out of the group.  As for the clinic staff, staying in the ignorant atmosphere of engagement is not only more pleasant but also enables them to function and to accomplish their professional roles in a relatively conflict free environment.

Srour (12) mentions the term of the `white privilege`, which means, in our case, that the (Jewish) majority presumes as natural the present situation (in which they hold superiority), while the (Palestinian) minority has to strive and struggle if wishes to achieve the `privileges` the majority group already possess.  Accordingly, Srour suggests the observed peacefulness in the groups we discuss reflects the mutual interests the group's members hold to behave as though the groups are homogeneous, and to put aside differences and tensions.  Since the situation is not really equilibrated we assume that the Palestinian minority reconciles itself with the present situation, not showing any potential discomfort or struggle it may have, while the Jewish majority interprets this peacefulness as if everything is fine, and no conflicts or tensions are present.    We thought about an analogy to the atmospheric pressure, in which a pressure of more than 1 kilogram for every centimeter square of our body area is not felt by us because we are used to it as natural; we feel it only when something is disrupted.

An example:  toward the Jewish holidays, the New Year and Passover, our employers send greetings to all the workers; The Palestinian workers do not feel that these greeting are designed for them.  (We would like to comment here that after presenting a lecture based on an early version of this paper for the broader professional staff our directors started to send greeting also in the Arabic holidays).  Additional example is that on Jewish holidays the clinic is closed, but open on Arabic holidays.  The Palestinian workers are entitled to celebrate their holidays, but they are not able to come to work in the Jewish holidays.  It may seem to the outsider that while the Palestinian workers rights are maintained, the clinic culture adaptable with the (Jewish) majority who generously exempts his Palestinian colleagues from attending in their holidays.  Jewish workers, on the other hand, take for granted the vacation on their holidays.

The group as treatment:

Srour (12), following other writers whom he reviewed, suggests that awareness to unnoticed currents of opinions, positions, and feelings within the group may impel therapeutic work over contents, process and mechanisms that are hidden within our mind.  Feelings of anger, fear, guilt, as well as mechanisms of identification, projection, and projective identification are unescapable constituents of the human mind.  We expect to observe them within the minds of our patients but naturally therapists are not exempt.  More than that, being in a group evokes some of the developmentally earlier facets exist in the human personality. WR Bion (5) wrote that " the basic assumptions now emerge as formations secondary to an extremely early primal scene worked out on a level of part objects, and associated with psychotic anxiety and mechanisms of splitting and projective identification such as Melanie Klein has described as characteristic of the paranoid-schizoid and depressive positions. Introjection and projection of the group, which is now the feared investigator, now the feared object of investigation, form an essential part of the picture and help to add confusion to the scene unless recognized as being very active."  We would interpret (though in simplified manner) that what is observed from the surface is manifestations of depth processes emanating from developmentally early sources. The group is experienced as frightening, therefore its members apply primeval mechanisms such as projection, split, projective identification, introjection and identification.  An immense part of what is observed in the group life is actually manifestations of a usage of those mechanisms that are aided to shield the participants against the anxieties they experience.

Srour (12) shows in his review that over the world, participants of groups (both patients and therapists) who take place in an environment in which ethnic groups are in conflict incline to avoid expressing those conflicts, and apparently behave as if those conflicts do not exist, or are not relevant to the therapeutic situation.  It is particularly remarkable against the finding that the group members are definitely not indifferent to those conflicts, and actually they evoke within them strong inner reactions. However probably due to the intensity of those reactions and their perceived potential to be destructive to the therapeutic or collegial relations, the participants tend to shut them up forcefully.

Shoshani and his cowriters (13) think that the situation of an external powerful conflict (which is typically perceived as perilous, threatening, overwhelming) is apt to constrict the inner container of therapists (as well, we would like to add, of patients).  The undesirable consequences are that a large proportion of the intrapsychic as well as the inter-personal experiences remain outside the matrix (either of the personal or the group treatment, or of the clinic staff relations).  Similarly Baum (14) thinks that strong emotions take place, parallelly, among patients and therapists, both within them (e.g., emotions of anger, fear and guilt) and between them (e.g., "is this Palestinian identify with terrorists?", "is this Jew identify with settlers?", "is he or she hold prejudice against the ethnic group I belong to?").  Similarly the consequence is a reduction of the common space in which both parties are in motion.  Instead, they move in a relatively conf  ined territory of those mental problems which are perceived as treatable, with minimal reference to background, context and causes, and with much caution concerning any expression or act which may threaten to exclude participants from the delineated territory that takes place in this delicate dancing. Trust become crucial, though unspoken, issue: Does the other (therapist, peer, colleague) understand me? Can he or she see things as I do? Does he or she hold prejudice? Is he sincere with me?

Srour (12) suggests that working through those emotions and positions that hide within, and awareness to projections and projective identifications may lead to a discourse which is sincerer, more genuine, more therapeutic, and above all, seeing the other not only as a representative of the group he or she belongs to, but as a person for him or herself.  This may lead to empathy with those parts in the personality that are unbearable for oneself.

 Mixed groups:

 In mixed groups every member can turn to be, often unwillingly or unconsciously, a representative of his or her identity group.  Israelis who go abroad are aware of the expectation that they should behave as though they are the ambassadors of their country, even though deep inside they may oppose its policy or culture.  The majority members in a group are incline to relate to the minority member(s) as representing their belonging group.  This member may find him or herself carrying the burden of representing his or her nationality or community.  He or she may feel being pushed to that role, that is not necessary wished for.  But at times this member may rejoice this role since he or she receives the group attention and treated as special or the spoiled child of the group.  Members of the group (either therapeutic or the staff) tell each other about their religious and cultural habits.  Sometimes an outsider observer would feel as listening to an anthropological discussion about Polynesians…  And both parties get excited when finding similarity in their habits (e.g., both fast at certain dates, or both Christians and Jews celebrate the Passover).  On the surface it looks like a folkloristic conversation about manners, but we conjecture that this discussion serves as a gateway to an enquiry as to the positions the other party holds.  For example, Jewish members may try to sort out whether their Palestinian partners identify with Ghaza`s Hamas, and Palestinian members would try to recognize their Jewish peers' views concerning the military struggle against Arabic countries.  Volcan (15) commented that personal emotions and attitudes may be projected on a national conflict.  For example, a Jewish member who is mad at or hostile toward a Palestinian associate would attribute his or her feelings to their national conflict.  However we are aware that people may hold negative feelings toward other people regardless their national belonging or existing conflicts.

The minority in such a group may feel unsafe to manifest its genuine emotions and positions and therefore develop a false stance of politeness and kindness.  The members of the majority in that group accept this stance as genuine (probably as a consequence of a process of self-conviction, or wishful thinking).  They believe that this stance is the true essence of their associates, which makes possible for them to accept them (and thereby feel generous and progressive).  In other words, good relations that we observe between Palestinians and Jews who share a group are often attained throughout a suppression of conflicts in favour of emphasizing common themes.  In W. R. Bion`s terms, the group deludes itself that it makes a group work without basic assumptions.  An alternative but comparable pathway is that the group members make use of the basic assumption of pairing – they handle their strain of being minority among other national majority by means of getting closer, make friendship, or gaining similarity with another member.  By that behaviours they gain some gratification and avoiding alienation at the same token, while ignoring the conflicts and tensions that play on the background.

 The clinic`s group:

 There are some groups in the clinic (some existed for limited time and then closed, some run continuously).  The group in subject is of patients with durable problems, mostly diagnosed with personality disorders (sometimes associated with other diagnoses such as depression, anxiety, and the like).  The members of the group are both Palestinians and Jewish.  Also the leaders of the group are Palestinian and Jewish.  The two coleaders sit often and discuss their group matters, sometimes bring them forth to the staff meetings.  Meeting frequently created closer relations, which make possible discussing personal issues, including national conflicts, or political occurrences at times of conflict in the wider circles.  The partners in this `couple` become more sensitive to each other vulnerabilities, creating their private language of communication.  This makes the couple of the group leaders a small, or sub-group inside the larger group of the clinic staff. This is remarkable when taking in account that such communication does not take place between other workers of the clinic.  Following our discussion hitherto we may conclude that the rest of the clinic staff feel well and keep good relations at the cost of putting aside those aspects of their coexistence which may provoke tensions, conflicts, hostility or alienation.

We would like to additionally remark that most of the mixed groups discussed here are not symmetrical.  Typically there are more Jews than Palestinians – in the therapeutic group, in the clinic staff, in the town of Acre, and in the state of Israel.  This asymmetry affects the way members of those groups feel and behave toward each other and toward themselves.  The majority members are not as sensitive to this asymmetry as the minority members.  Minority members usually are in a continuous vigilance as to their share in the group, the way they are being treated, the measure their rights are being respected, and their need to prove themselves.  As for the majority members, the situation seems natural, with less sensitivity to its qualities, and often with the susceptibility to be generous toward the other members.

A living example may be found in the writing of this very paper.  One of the Jewish coauthors (TsEG) proposed the name "being Arabic in a Jewish group".  But the Arabic coauthor (AAEH) commented that this formulation seems to apparently presumes that the Jews consists the group, and the few Arabic join that group.  This seemingly neutral name implicitly presumes asymmetrical relations between the sub groups, and its acceptance by the Arabic members reflects overlook for this situation, namely, that they are `guests` in a Jewish group.  This comment highlights the necessity of the majority group to develop sensitivity to nuances in the minority group.  The minority group, on the other hand, habitually sustains a sensitivity as to its position, one that may be tangential with paranoid position.  For example, assuming referential interpretation to acts or statements of other members as deriving from these majority – minority relations, rather than emerging from other group contents or processes.

Being different in a group suggests projections, which are manifested in the form of "You the Jews" or "You the Arabic".  Such expressions imply that the single participant represents the values and the attributes of the national group he or she belongs to.  While one can indeed hold or express such values or attributes, it is significant when it is brought upon by other participants.  For example, when a Palestinian participant speaks about problems in his relations with his wife, Jewish members of the group point to the seemingly patriarchal character of the Palestinian society. Parallelly, when a Jewish participant tells about problems he or she has with his or her children, Palestinian members point to alienation they relate to Jewish urban families.  When two members belong to the different nationalities have a conflict, some of the group members relate it the national conflict (`Jews and Palestinians never can get along, they are like oil and water`).

The stance of the minority members may lead to the position of `outsider`.  While this position is apparently uncomfortable, it may also exemplify the functioning of the observing ego, which is "one of the vital activities of the ego in the psychotherapeutic process" (16).  These authors see this function so important that "deficiencies and dysfunctions of that capacity will delay if not preclude therapeutic benefits through `insight` therapies". So assuming, then, "group therapy provides the ideal arena for helping individuals cultivate the observing ego – that part of the sensorium that has the power of witnessing oneself in the world" (17).

However, as we formerly discussed, it is more typical for the group to ignore differences and values of a national origin, but rather to emphasize common values and attributes that may create and maintain the group, and which are broad enough to enable all of the group members to identify with.

 Collective vs. individual psychology:

The mixed group is an encounter point between individual and collective communities.  "Culturally influenced mental health attitudes"' wrote Boghosian (18) "…included the severity of stigma associated with mental illness, the importance of family in responding to mental illness, and the process of grieving in Middle Eastern cultures…. culture influences the experience of psychotherapy for these participants. Cultural identity and family dynamics played an important role in the therapy experiences of the participants".

The western culture is often described as `individual` when negated to Arabic culture which described as `collective` (19). Members of the so called individual society are expected to take responsibility of themselves, to have (or to develop) self-consciousness, to speak out openly their weaknesses and conflicts in order to work them out, to stick to values of autonomy and privacy, and to relate to other members of their society as equal individuals. For them the task of the group precedes relationships between the group members, and when deviate from the cultural norms are expected to experience guilt.  Members of the so called collective society, on the other hand, are described as sharing responsibility with their wider belonging group (the wider family, the clan, the village). Their consciousness is more of the collective than the individual self ("we consciousness") .  Harmony is appreciated more than open discussion of weaknesses and conflicts; belonging and shared responsibility is emphasized more than autonomy and privacy; peers are conceived as parts of the collective more than individuals for themselves, and relations with those peers are appreciated as at least equal to the common task; and deviation from the cultural normsis compensated by feelings of shame. Psychopathology in individual society is judged in terms of personal distress and disturbance in functioning, while in collective society psychopathology is related as deviation from the collective norms: the collective is more tolerant to the individual distress or malfunctioning when compared to individual society, but sees deviations from collective norms as severe and pathological.

In group therapy, the leaders are characteristically oscillate between working with the individual member of the group at particular moments (while other members either observe or participate in the work in process) or with the group as a whole and its hypothesized themes.  However, when taking collective point of view, the individual member is always an element of the whole surrounding, and there is no sense in working with him or her as if he or she is alone.

Transference in group therapy is usually related to as to the leaders, to the group as a whole, or both. While competing or challenging the leaders is regarded as one of the ways (mechanisms) people use to cope with the anxieties the group evoke within them (the `fight or flight`), however in collective society a deference toward the leaders and cooperation with the group are expected, and deviation from those behaviours or attitudes are considered as shameful or pathological. While values of individual society direct patients to receive decisions by themselves and to take responsibility for the consequences of their decisions, patients in collective society expect advice and direction from the therapists, who perceived as authority figures.

This picture gets somewhat complicated since those two cultures – the so called individual and collective – are represented not only in the composition of the group, but also in the composition of its leaders.  The Palestinian co-leader, putatively a representative of the collective culture, shows understanding and acceptance to collective values; but she is, as well, a graduate of western college education, works together with Jewish colleagues for years and embodied their values.  Similar assertion may be raised when concerning the Palestinian members of the clinic staff.

Finally, when relating to the group members, a pure dichotomy does not seem justified.  People are not truly individualized or fully collective.  Similarly to what was written above, group members are not necessarily or exclusively representatives of their belonging group.  The course of a group life is a matrix of the personalities of its members, the relations they create, and the wider circle of the cultural contexts in which the group operates.  Its entanglement is its beauty.


 Therapeutic groups are necessary in metal health clinics for the benefits they offer for their members; however in the context of a nationality mixed clinic they hold the added value of an encounter of members of the two nations.  Parallelly, an admixture of staff members of both nations is necessary so patients can be treated in their mother tongue and by therapists who are familiar with their culture and values.  Additionally, conjoint work of Palestinians and Jewish therapists may model a successful coexistence.  Though all of this do exist in our clinic, we tried to point that the harmonious functioning involves certain mechanisms and basic assumptions concerning the ways these groups operate, as well as the ways individual members function within them.  We claim that developing awareness to these mechanisms and assumptions is necessary, both for the therapeutic group as well as for the staff group. As for the therapeutic group being more conscious is indeed the raison d`etre, since group therapy is by its nature a transference therapy in the broad sense of the term – the understanding of ourselves through the means of the here and now with the group and its members.  Most therapists would consent that therapy should strive to advance patients` awareness of the mechanisms and coping styles they use when they handle interpersonal relations and adapting to groups and human constructions.  The clinic staff, on the other hand, may apparently function well in its `work group` mode (namely, working together in treating the patients) without being aware of those mechanisms (which we believe is the case in many similar clinics).  However we tried to demonstrate that this serene coexistence is achieved with the price of constriction of the range of what may be really shared, denial of latent conflicts, and putting them aside unresolved.  Confronting and coping with those issues may be experienced as threatening, but successful accomplishment may yield to higher levels of authenticity in the staff relations and their therapeutic capabilities.  In sum, Truth Cures.


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