Ivan Urlić

Working through shame in groups for victims of trauma and war.

Abstract The feeling of shame is very difficult to recognize, to reveal, to face, and to work through. Starting with some expressions of human aggression, the authors underline the difference in treating feelings of guilt and feelings of shame. The authors detail the elaboration of shame in group psychotherapy with released prisoners of war and with war veterans and review important analytic theoretical concepts of shame, projective identification, empathy, and countertransference. They examine the importance of unlocking and identifying the silent shame, as well as the mourning process essential to working through the burden of catastrophic shame. Special counter transference problems with PTSD patients are analyzed.

Psychotherapeutic Treatment Program for Post-traumatic Stress Disorder: Prospective Study of 70 War Veterans

The aim of this study was to assess the effectiveness of the psychotherapeutic model of treatment of war veterans in Croatia with post-traumatic stress disorder (PTSD). The symptoms of PTSD are analysed and evaluated, together with associated neurotic symptoms, ways of coping with stress, and indicators of quality of life and depression.

Trauma and Reparation, Mourning and Forgiveness: The Healing Potential of the Group

Introduction: Understanding Post Traumatic Stress ‘The war is the woe of human nature’, wrote the Renaissance writer from Dubrovnik, Marin Držć (1979: 10). The Croatian experiences at the end of the 20th century had to pass through another woe of that kind, after having suffered two world wars and experienced three entirely different political and social systems. So far very little or almost nothing is known about impacts of these historical periods on the population, and it is only during the last decade that there has been research into therapeutic efforts, in order to understand better how warfare and terrorism influences the entire human personality and the society. At the beginning of the war in Croatia in 1991 and in Bosnia and Herzegovina in 1992 it was very popular to quote the Chinese curse: ‘May you live in interesting times’. These times in the former Yugoslav state started to evolve a decade before this war broke out, culminating in armed conflict. The ‘usual’ dynamics of life became ‘interesting’ ones, bringing about deep changes, leading to death and destruction in personal, social and cultural spheres, as well as in the establishment of some newly-independent states, different organizations of these societies, and the possibilities for them to reaffirm their specific cultures and cultural heritage. After the end of the war in Croatia I received from one veteran the following letter:

Recognizing Inner and Outer Realities as a Process: On Some Countertransferential Issues of the Group Conductor

This article highlights specific and unique challenges which confront the therapist when dealing with patients suffering from the effects of trauma within a war situation - refugees, displaced persons and relatives of those who have ‘disappeared’ in war. In presenting clinical vignettes, the author focuses on war in Croatia, whilst also demonstrating how many problems are common to all those in war situations, including the therapist as well as patients, particularly problems and dilemmas in countertransference and empathy.

Long-Term Improvement in Coping Skills Following Multimodal Treatment in War Veterans with Chronic PTSD

Abstract Due to the long-lasting and resistant symptoms characteristic of chronic combat posttraumatic stress disorder (PTSD), its treatment is complex and often requires a tailored therapeutic approach incorporating both psychotherapy and pharmacotherapy. A multimodal approach of psychoeducative, sociotherapeutic, and dynamically oriented trauma-focused groups is described. We assessed the short- and long-term effectiveness of this therapeutic program by monitoring its impact on PTSD symptoms, depression, neurotic symptoms, coping skills, and quality of life for three years. The findings revealed short-term reduction in the symptoms of PTSD and depression, while the long-term results were manifested as the increased use of all coping mechanisms and a greater level of obsession.

Denial and Dissociation in Mothers' Postmortem Identification of Their Sons

“The things I had seen and suffered were burning inside of me; I felt closer to the dead than the living, and felt guilty at being a man, because men had built Auschwitz, and Auschwitz had gulped down millions of human beings, and many of my friends, and a woman who was dear to my heart. It seemed to me that I would be purified if I told its story . . . ” —Primo Levi, The Periodic Table of the Elements

The Capacity to Use the Group as a Corrective Symbiotic Object in Group Analytic Psychotherapy for Patients with Psychosis

Group psychotherapy is widely accepted for treatment of patients suffering from psychosis. Nevertheless, some uncertainties remain regarding efficacy of insight-oriented group psychotherapy in these cases. Embracing the thinking of those authors that consider corrective symbiotic experience as essential in psychotherapeutic treatment for patients with psychosis, we explore the possibilities of group psychotherapy in enabling corrective emotional experience in our group therapeutic activity. Through some clinical examples from long-term outpatient group psychodynamic psychotherapy, which was insight oriented, we demonstrate how this method works with patients suffering from psychosis in a carefully selected group. Our experiences are positive, showing that the group analytically informed approach can offer a corrective symbiotic experience to patients with psychosis. However, patients with very deep symbiotic needs, who exclusively demand gratification of their symbiotic transferences, are not recommended for inclusion in group analytic work.

The Phenomenon of Silence A Group-Analytic Exploration of Meanings in Psychotherapy and in Everyday Life

The phenomena of silence and quietness have been omnipresent in human life since its beginning. Nevertheless, they are rarely explored in their comprehensive and particular meanings. The author explores the meanings of silence and quietness in psychotherapy and in everyday life through theoretical considerations, clinical and social life examples, bearing in mind the psychodynamic/group analytic frame of reference. The dynamics of the transformation of non-verbal communication into verbal, the many meanings of an apparent lack of communication, and its understanding and differentiation from the culture of keeping silent are discussed, as well as the roles of internal and external group influences. In conclusion, the author refers to the phenomena of silence and quietness as regressive, repressive, transitional, transferential and countertransferential, as well as progressive phenomena spectrum. This article is dedicated to Malcolm Pines for the pleasant and thought provoking encounters, both personally and through his works, and for his sharp eye in perceiving messages and nuances of verbal and silent communications in depth and width, that inspired me to examine the contents of silences.

Special Section: Supervision: Editorial Introduction

The psychoanalytic culture has recognized the process of supervision as one of the essential elements of its development. It might be assumed that the Wednesday night meetings at Freud’s home which began informally in 1902 were the beginnings of what would later be referred to as ‘supervision’. Freud’s work was significantly enriched by the work of Ferenczi and of many others of the most prominent psychoanalysts and psychodynamically-oriented psychotherapists. Psychotherapy supervision as we know it today began in the 1920s, when Berlin psychoanalyst Max Eitington proposed that a psychoanalyst in training should undergo supervised psychoanalysis sessions. Since then, the ‘tripartite’ model of any analytic training consists of personal analysis, the learning of theory and of supervision. When group-analytic training is in question, the personal analysis is done in the group, and the main task of supervision is the understanding of the relationships that are developing in the group matrix. The challenging situation of supervision includes the complex matrix of relationships – patient to a therapist, therapist to a patient, and supervisee to a supervisor. The network of relationships becomes even more complex when the supervision of group-analytic work is in question. Therefore, during group analysts’ training the continuous supervisory process represents one of the three essential requirements. That was inbuilt in the Essential Training Standards of EGATIN (European Group-Analytic Training Institutions

On the Path of Reconciling with the Deeply Wounded Parts of One’s Internal World: Mortals, Saints and Sinners Revisited

It is interesting to look at the discrepancy between everyday use of expressions demanding forgiveness like ‘sorry’, ‘excuse me’, ‘I beg your pardon’ and many others, and the presence of dilemmas about the significance and possibilities of reaching the forgiving attitude in the professional psychological spheres. Obviously the subject is very intricate and raises many questions. In this sense Farhad Dalal is not the exception to the rule. He has developed interesting questions and comments in his article on forgiving the unforgivable. Already from the title there radiates the intrinsic dilemma of possibility and impossibility to reach some mature point of view in that respect, regarding certain deep, narcissistic wounds that remain deeply carved in one’s memory and emotions. There are people who would like to avoid any complex dealing with the phenomenon of forgiveness (like actual Russian president Yeltsin who said that forgiveness belongs to God, and that his obligation was to send transgressors to him as soon as possible). Indeed there are wounds that are not easy or even possible to forgive. Even long life might be considered short with regards to the possibility of completing the forgiving process (or mourning, or reconciling as well). This is a sign that the mourning process is not completed and that the forgiving attitude cannot take root due to dilemma being reheated time and again by one’s vulnerability. Here we might recall the notion of ancient Greeks’ wisdom that everything flows (panta rei). Thinking on the nature of the forgiving phenomenon we are reminded of its ‘fluid’ properties, of its ups and downs, back and 662773 GAQ0010.1177/0533316416662773Group AnalysisUrlić: Response to Dalal research-article2016