Walter N. Stone

An Analysis of AGPA Institute Groups

ABSTRACTFifty-three 2-day training groups were studied with process and outcome measures. When the eight most successful groups were compared to the eight least successful groups on factor analytically derived dimensions, the formers leaders were characterized as more caring, charismatic, skillful, and less inhibiting, and the successful groups were described as more cohesive and less defended and superficial. The group climate results were compatible with the expectation that the better outcome groups would progress more rapidly through early group developmental tasks. A group climate measure of engagement obtained at the end of the first 3½ hour session was predictive of final outcome; interestingly, success was not achieved by avoiding conflict. The general psychodynamic process groups were viewed as more defended and inhibited than topic-centered specific interest groups.

Anxiety Levels in Dreams: Relation to Changes in Plasma Free Fatty Acids

Blood samples for determination of plasma free fatty acids were obtained throughout the night by means of an indwelling catheter. The first sample was drawn at the onset of rapid eye movements and a second after 15 minutes of these movements. Subjects were then awakened and asked to relate their dreams; a third sample was drawn 15 to 25 minutes later. Anxiety scores derived from 20 dreams of nine subjects had significant positive correlations with changes in free fatty acids occurring during REM sleep. No statistically significant relation was found between anxiety and the changes in free fatty acids occurring from the time just before awakening to 15 to 25 minutes later. Presumably, anxiety in dreams triggers the release of catecholamines into the circulation, and these catecholamines mobilize proportional amounts of free fatty acids from body fat.

peripheral Versus Central Mechanisms Accounting for Antianxiety Effects of Propranolol

&NA; A &bgr;‐adrenergic blocking agent, propranolol (60 mg orally in three divided doses over a 12‐hr period), significantly reduced basal anxiety scores in 12 healthy, nonanxious subjects as compared to a placebo in another 12 similar subjects. In response to a 10‐min stress interview, anxiety scores increased to equal levels, whether subjects were on propranolol or a placebo. On placebo, anxiety scores correlated positively (+0.70) with average plasma FFA. On propranolol, anxiety scores correlated negatively (‐0.55) with plasma FFA and the average pulse rate was significantly lowered. The experimental findings suggest that basal or resting anxiety may be maintained by peripheral afferent autonomic biofeedback, and the latter can be reduced by &bgr;‐adrenergic blocking agents; whereas, the magnitude of acutely aroused anxiety is mediated more through the central nervous system.

Prediction of changes in severity of the schizophrenic syndrome with discontinuation and administration of phenothiazines in chronic schizophrenic patients: Language as a predictor and measure of change in schizophrenia

Abstract Seventy-four hospitalized chronic schizophrenic patients, who were able to cooperate with testing and interview procedures, were studied for eight weeks to sequentially evaluate the effect of withdrawal and readministration of phenothiazine medication. The patients, Caucasians of both sexes, in the age range 24–54, had been on some one phenothiazine derivative for at least the previous six months. For the first four weeks all patients were on placebo, while during the next four weeks half were on placebo and half were on thioridazine. Patients were assessed initially using the standardized Spitzer et al. Mental Status Schedule and the Cattell 16 PF test. In addition, two or three five-minute verbal samples were obtained from each patient in the initial pre-drug withdrawal week to assess the level of social alienation-personal disorganization, hostility, and anxiety by the Gottschalk-Gleser method. Additional verbal samples were obtained twice weekly for the next eight weeks and Mental Status Schedule interviews were obtained at the end of four and eight weeks. The following results were obtained: (1) Average scores for social alienation-personal disorganization increased significantly over the first four weeks, indicating increased psychopathology. (2) Those patients who continued on placebo showed little further increase in social alienation-personal disorganization scores in the second four weeks; whereas, those patients who were given thioridazine showed a small, nonsignificant decrease in such scores. (3) The average number of words spoken in a verbal sample decreased significantly for the first four weeks while patients were on placebo. Patients having thioridazine drug the second period showed a significant increase in the number of words spoken. (4) Using multiple correlation techniques with scores obtained during the initial testing period it was possible to predict individual differences in response to phenothiazine withdrawal. A multiple correlation of .39 was obtained using six of the 16 PF factor scales. A multiple correlation of .42 was obtained using four “narrow” factor scales of the Mental Status Schedule. Using both sets of predictors the correlation was .50. (5) Using the general principal factor scores of psychoticism and disorientation from the Mental Status Schedule, a multiple cut-off criterion of 7 or more in either scale divided the patients into those who gave verbal samples with increasingly high scores in social alienation-personal disorganization when on placebo from those who showed practically no change on this verbal score measure. The same multiple cut-off differentiated those who showed a significant decrease in the number of words spoken in the first period. (6) A cut-off criterion of 2 on the initial social alienation-personal disorganization (content analysis) scores from five minute verbal samples, was also predictive of the chronic schizophrenic patients who were unreactive to phenothiazine drug withdrawal or administration (less than two) and those who reacted with an exacerbation of the schizophrenic syndrome to phenothiazine drug withdrawal or with a decrease in the schizophrenic symptom complex with phenothiazine drug administration (more than two). This cut-off criterion also differentiated those patients who showed a significant decrease in the number of words spoken during the first four week placebo period. (7) The theoretical and practical implications of these findings are discussed.

The waiting-list group.

This report describes a pilot study of a waiting-list group (preliminary process group [PPG]) that provided treatment for applicants to a university affiliated, urban mental health center. All individuals on the treatment waiting list were informed of the PPG. This semistructured group, meeting weekly, began with members presenting their problems, followed by free discussion, and ending with goal setting for the next week. Approximately one seventh (35 out of 262) of the clinics applicants during a 4 1/2-month period chose to enter the PPG. They differed from those who chose not to participate (wait list) by being older and less educated. Approximately 80% of both wait-list and PPG participants subsequently entered therapy. Significantly more PPG patients than those on the wait list entered group treatment. The PPG served clinic needs by providing prompt service for self selected individuals and by supporting the group therapy program.

Stimulus, affect, and plasma free faty acid.

&NA; In healthy young men average levels of plasma free fatty acid (FFA) correlated with anxiety, which had been measured by content analysis of speech samples in an initial sample, but not with that measured in a second sample obtained during a 45‐min experimental period. The correlation was significant whether the first verbal sample was obtained immediately or 25 min after the beginning of the experimental period. A second verbal sample obtained at the 25‐ or 45‐min point in the session did not correlate with the average FFA per experimental session. Fasting FFA levels were lower in well‐conditioned athletes as contrasted to nonathletes, and after 9 hr, as opposed to 14 hr, fasting. The request for and production of a verbal sample acted as a stimulus effecting a rise in FFA. This rise correlated significantly with anxiety scores derived from the verbal samples. Typically anxious subjects showed the greatest FFA responsivity. The present group of college athletes had a minimal average FFA rise following venipuncture. They also showed decreased variability in FFA with repeated experimental exposure. These findings support the hypothesis that adaptation can occur.

The curative fantasy in group psychotherapy

The concept of a curative fantasy includes patients conscious and unconscious hopes and expectations of what is necessary for their relief of suffering. On entering group psychotherapy these elements emerge in the treatment matrix. This paper describes how patients with significant deficits in their intrapsychic organization express their curative fantasies through the development of selfobject transferences. The concept illuminates aspects of patients entering and forming a group as well as some elements in unanticipated terminations.

The Role of the Therapist's Affect in the Detection of Empathic Failures, Misunderstandings and Injury

Therapists cannot be expected to always understand their patients or the process of their groups. Using evolving self psychology and theories of intersubjectivity, this manuscript explores the affective responses of therapists as a valuable indication that such misunderstanding is occurring. Clinical vignettes will illustrate three specific reasons for therapist misunderstanding: over-adherence to theory, boundary crossing, and inexperience. Additional examples will illustrate how countertransference can disrupt treatment when the group therapist conveys material or affects outside his or her awareness.

The effect of social systems on group relations training

SummaryTwo Tavistock group relations conferences were held for mental health professionals in different social systems: a university and a medical school. Three-month follow-up studies were conducted. When compared with those attending the medical school conference, members of the university conference reported that they participated more in the application group and conference discussion, learned more in the intergroup event and about how the group effects task performance, that the emotional impact of the conference was greater, and were more likely to recommend the training to a friend. A social systems analysis of the conferences is offered as a way of accounting for these results. The conferences differed with regard to: 1. sponsorship, legitimacy and support of training activities; 2. heterogeneity of learning opportunities, an indication of systems openness and 3. authority and sentient linkages between members and staff. The more positive responses of the university participants probably had to do with multiple departmental sponsors, a heterogeneous environment, and outside authority and sentient ties. The less positive responses of the medical school members most likely were due to sponsorship by only one discipline, low systems openness, and a lack of sentient and authority linkages between members and staff.

Transference neurosis in group psychotherapy : The concept and the reality

The contribution of Durkin and Glatzer to examination of transferences and the therapeutic process emphasizes the nature of peer transferences that of are sufficient depth to resolve personality conflicts. In the past two decades additional emphasis on the totality of the treatment relationship and of self psychology has added to understanding elements in the transference and curative process. A clinical illustration provided by Durkin and Glatzer is reexamined in light of these advances.