Staff resistance to interpretive psychotherapy in the in-patient community meeting

The authors propose using the in-patient psychiatry unit community meeting for large-group interpretive psychotherapy, employing the model of Winer & Lewis (1984). This model rests heavily on interpretation of group transferences in the here and now. The staff has the task of discovering patients' veiled references to them and interpreting the patients' resistance to direct expression of their experience of the staff. The authors discuss the impact of introducing the technique upon staff members. Staff members resist this new model in order to defend against self-esteem injury, loss and regression, staff-staff conflict, and the recognition of their own disavowed internal motives. Staff self-esteem can be endangered by any programme change, by the loss of accustomed roles, by the patients' hostility and direct criticism, and by the staff's own sense of failure to realize therapeutic ambitions. Some of the resistance specific to interpretive group psychotherapy arises from the threat of group silence or alienation. The group leader, in addition, faces the difficult task of understanding the dynamics of a large group with only minimal support.