A group approach to guilt in depressive and suicidal patients

A psychiatrist and a pastoral psychologist considered the problem of guilt as a source of alienation in depressed and suicidal patients by using a four-dimensional approach in a group psychotherapy setting. This involved functioning as cotherapists representing theological and psychiatric orientations and utilizing both didactic and insight-oriented approaches to elicit and explore meaningful material related to guilt feelings. With a number of exceptions, the patients did not appear to make a sharp distinction between the cotherapists' roles. The didactic openings on guilt served to provoke ready discussion of personal conflicts involving guilt feelings, especially in the silent patients who were not easily drawn into spontaneous discussion.