The experience lived by psychotherapists and clients in group psychotherapy in Humanistic Phenomenological Clinic: a phenomenological study

Abstract

This article describes how psychotherapists and clients live the experience of group psychotherapy under the humanistic-phenomenological view executed as part of qualitative study of phenomenological nature, in which Versions of Meaning written by two psychotherapists and ten clients are used as tools. The critical phenomenological analysis of the emerging issues suggests that when people are together seeking growth, in a mutual care and acceptation atmosphere, their life stories meet and a wisdom that is particular of the group arises, guiding it into its own creative way to continue life. The use of critical phenomenological approach provided an approximation to the phenomena with their multiple outlines, in the varied possibilities that a group of people in the process of psychotherapy can reveal, announcing that everything happens in the interlace psychotherapist-clients-world.

Keywords:
group psychotherapy; humanistic phenomenological psychotherapy; lived experience; phenomenological research

Resumo

Este artigo descreve como psicoterapeutas e clientes vivenciam uma experiência em psicoterapia de grupo sob a lente humanista-fenomenológica a partir do recorte de uma pesquisa qualitativa de cunho fenomenológico, utilizando como instrumento de pesquisa as Versões de Sentido escritas por dois psicoterapeutas e dez clientes. A análise fenomenológica crítica dos temas emergentes sugere que, quando pessoas estão juntas na busca por crescimento, num ambiente de cuidado mútuo e aceitação, as suas histórias espontaneamente se cruzam, surgindo uma sabedoria própria do grupo, que o mobiliza em uma direção própria e criativa de dar continuidade à vida. A utilização da lente fenomenológica crítica proporcionou a aproximação aos fenômenos em seus múltiplos contornos, nas infindáveis possibilidades que um grupo de pessoas em processo de psicoterapia pode revelar, anunciando que tudo acontece no entrelaçamento psicoterapeutas-clientes-mundo.

Palavras-chave:
psicoterapia de grupo; psicoterapia humanista-fenomenológica; experiência vivida; pesquisa fenomenológica

Résumé

Cet article décrit comment psychothérapeutes et ses clients vivent une expérience en psychothérapie humaniste-phénoménologique de groupe, faite dans le cadre d’une recherche phénoménologique qualitative, qui utilise comme instrument Versions de Sens, écrit par deux thérapeutes et dix clients. L’analyse phénoménologique des questions critiques émergentes suggère que, lorsque les gens sont ensemble dans la quête de la croissance, dans un environnement de soin et entente mutuel, leurs histoires s’entrecroisent spontanément, en dévoilant une sagesse propre du groupe qui le mobilise dans une direction créative d’assurer la continuité de la vie. L’utilisation d’une approche critique phénoménologique a guidé un rapprochement aux phénomènes, avec ses plusieurs contours, moyennant les possibilités infinies qu’un groupe de personnes en processus de psychothérapie pourrait révéler, annonçant que tout se passe dans l’entrelacs psychothérapeutes-clients-monde.

Mots-clés:
psychothérapie de groupe; psychothérapie humaniste phénoménologique; expérience vécue; recherche phénoménologique

Resumen

En este texto se describe la experiencia de psicoterapeutas y clientes en psicoterapia humanística-fenomenológica de grupo, hecha a partir de un estudio cualitativo fenomenológico, en el cual se empleó como herramientas de investigación versiones de sentido escritas por dos terapeutas y diez clientes.El análisis fenomenológico de los asuntos críticos emergentes sugiere que cuando las personas están juntas en busca de crecimiento, en un ambiente de mutuo cuidado y aceptación, sus historias se cruzan de forma espontánea, surgiendo así sabiduría del propio grupo, que lo moviliza a una dirección propia y creativa de dar continuidad a la vida. El uso de la perspectiva crítica fenomenológica ha proporcionado una aproximación a los fenómenos en sus múltiples contornos, en las infinitas posibilidades que puede revelar un grupo de personas en el proceso de psicoterapia, anunciando que todo sucede en el entrelazamiento psicoterapeuta-clientes-mundo.

Palabras clave:
psicoterapia de grupo; psicoterapia humanista fenomenológica; experiencia; investigación fenomenológica

By the time of the 1st and 2nd World War - between 1910 and 1947 - the social importance of group practices was already known. Group practices emerged as a resource to promote changes to allow participants to develop closer relations with each other. Many times, participants enjoyed no personal relationship even with their family members (Rogers, 1970/2009). To them it was a chance of “escaping or recovering the self from eventual effects of dehumanization” (Fonseca, 1998, p. 177) caused by wars. In addition, there was a large contingent of veteran psychiatric patients, and a shortage of psychotherapists made individual psychotherapy impossible, leading to the valuation of group therapy (Yalom & Leszcz, 2006).

Expanding its work beyond the psychological demands of the post-war times, up to now the group psychotherapy process works as a microcosm that represents the community, in which relational problems and the society’s trends can be observed, investigated and understood. The group may be a valuable space where new paths can be tried. It can also bring therapeutic reflexes to members and facilitate important impacts and changes on the society (Schimid & O’Hara, 2007).

In group processes, the possibilities of intervening on and crossing histories of each participant are expanded; members have the opportunity of providing mutual support by grasping the other’s suffering, “a person explores his/her own feelings but also the feelings of the others (besides the mediator) in relation to them” (Wood, 1983a, p. 28). Likewise, the impact of the changes of attitudes externally to the group, on the social surrounding of each participant, is more comprehensive (Hobbs,1951/1992; Lemos & Cavalcante, 2009; Wood, 1983a). This way, the movement of expanding and recognizing group practices opens possibilities of understanding the group “as a locus of healing within the larger society” (Schimid & O’Hara, 2007, p. 98).

The collective spaces for psychotherapy evidence their social contribution on different spheres of psychological work like community, hospital, organizational, clinical and other areas. This reinforces the importance of scientific surveys to provide grounds and consistence to this far-reaching field of work in mental health. Moreover, when investigating surveys on group psychotherapy in the humanistic light, one finds the existence of theoretical studies (Boris, 1992, 2013; Coppe, 2001; Cury, 1993; Ribeiro, 1994; Rogers 1970/2009; Wood, 1983b, 2008; Yalom & Leszcz, 2006) on the topic that discuss the stages, process and the mediator’s role. However, little (Correia, Ferreira & Moreira, 2013; Hobbs, 1951/1992) is discussed about the meaning of the experience lived itself, which is the object of this paper.

Based on the critical view of worldly men, intertwined with the world or, in other words, that builds the self and is built in and with the world, the humanist-phenomenological focus was the referential that grounded this paper (Moreira, 2007, 2009, 2012a, 2013b).

This article was elaborated based on the first author’s Master’s degree dissertation under the guidance of the second author. The survey aimed to understand how psychotherapists and clients live a group psychotherapy experience in the humanist-phenomenological light. The attempt to investigate what happens when people are in a group psychotherapy process and the meanings resulting from this experience, considering the relevance of group processes in social changes, mobilized us around understanding the investigation and discuss, by now, the main emerging topics.

The instruments used were the Versions of Sense - improved with an ethnographic resource - and the participants’ observation using Field Journals. Considering the wide range of data found using both instruments, here we present the content that resulted from the psychotherapists’ and clients’ Versions of Sense.

Group Psychotherapy in Humanist-Phenomenological Clinic and the notion of experience

The Humanist-Phenomenological Psychotherapy came into life from the combination of the thinking of two groups of thinkers: humanist psychotherapists from the United States (Rogers, Rollo May, Perls, Maslow, among others) and the European psychiatrists (Binswanger, Boss, van den Berg, Strauss, among others) influenced by the philosophical phenomenology (Moreira, 2009).

In the Person-Centered Approach (PCA) human being is understood as a trustworthy organism (Rogers, 1977/1978) in an integration process and that has a constructive and self-regulator human nature. The actualizing tendency (Rogers, 1977/1978) is the ground for the PCA theory. It refers to a positive tendency inherent to the human being that brings forth creativity and learning, and that needs only the proper psychological conditions (Rogers, 1961/2009).

These principles were firstly applied to individual psychotherapy; however, since 1945 these are being extended to group activities, expanding the PCA theoretical formulations to the Group-Centered Psychotherapy, Meeting Groups, and Community Meetings or Workshops (Cury, 1993).

The actualizing tendency also grounds the humanist-phenomenological clinic constitution. However, (Moreira, 2007, 2009, 2012a, 2013a) extrapolates the metaphysical perspective proposed by Carl Rogers, believing that individuals have both positive and destructive capacities, and have a potential that is neither inherent nor individual. In other words, “it is a worldly potential of development” (Moreira, 2009, p. 76).

(Rogers, 1961/2009) says that “if I can provide a certain type of relationship, the other person will discover within himself the capacity to use that relationship for growth, and change and personal development will occur” (p. 37), thus considering the psychotherapeutic relation as a booster of the psychotherapy process. In the light of the humanist-phenomenological clinic, (Moreira, 2009) emphasizes the relevance of favorable conditions, unconditional acceptance, sympathetic understanding and authenticity (Rogers, 1961/2009) to change the psychotherapeutic process. However, he also reveals that: “in my experience these conditions are always required. However, they are not always enough” (Moreira, 2009, p.54).

For (Moreira. 2009), in addition to individual aspects inherent to the human being and the relevance of the psychotherapist-client link built, one should consider its ties with the world jointly with all cultural, historical, political and biological variables that influence on and constitute the human being. This is more an anthropological viewpoint than an anthropocentric one, considering that it recognizes the mutual constitution between human being and the world (Moreira 2007, 2009, 2012a, 2013b).

Based on human being’s co-existence in the world, here we try to access the pre-objective and pre-reflective experience that cannot be understood in a cause-effect relation, or as response to a thoughtful consciousness, since it would be nothing but memories of happenings. The subject living the experience cannot be set apart from the actual experience, since everything is interlaced with the world.

Using Merleau-Ponty’s thinking as the perspective to understand the experience lived gives us access to the paramount intention that allows understanding the world as it is shown, based on the description of this world. To that we should suspend preconceived ideas, prejudices and previous knowledge - attitude known as phenomenological reduction - to let emerge what arises from experience, even being aware of the incompleteness of this attitude (Merleau-Ponty, 1945/2006) considering that if we are constituted in the world, interlaced and intertwined in and with it, this total detachment becomes a challenge.

Most of the papers published in the Humanistic-Phenomenological Approach refer to experiences in individual psychological clinic (Fontgalland, 2011; Bloc & Moreira, 2013; Melo, Pita & Moreira, 2013). There is only one publication that approaches experience in group psychotherapy (Correia, Ferreira e Moreira, 2013) focused on a facilitation experience. This reinforces the importance of carrying out investigations in this light.

Considering the rationale that grounds clinical methodology in the humanistic-phenomenological light proposed by (Moreira, 2009, 2012a, 2012b, 2013b), we understand that Merleau-Ponty’s phenomenology also inspires and grounds clinical psychology in group psychotherapy.

In the group context using such referential, experience in the world appears as “an open totality whose synthesis cannot be finished” (Merleau-Ponty, 1945/2006, p. 296), an indefinite reality that will welcome the singularity of the experience of each member, each psychotherapist and of the group as a whole, assigning a unique meaning to what will take place in that meeting. The world and, thus, the experience attained in it “is not a sum of things that one could always cast into doubt, but precisely the inexhaustible reservoir from which things are drawn” (Merleau-Ponty, 1945/2006, p. 460).

Contextualizing Psychotherapy and Research Group

The group psychotherapy process and the research counted on the participation of 12 persons, of which 10 were clients and two psychotherapists. All members were adult women, with age ranging from 24 to 67 years, literate, belonging to low and medium classes, and resident in different neighborhoods in the city of Fortaleza, state of Ceará, Brazil.

The periodicity defined for the group to meet was three months, in the months of June, July and August 2013, totaling 10 sessions with meetings once a week. Each session lasted two hours, from 18:30 to 20:30, and was held in a group care room at the University of Fortaleza.

To attract subject-collaborators to participate in the group, meetings were held with professionals from the University health services. Professionals welcomed the proposal and emphasized the relevance of works with groups considering the huge demand for psychological care in the community, and the large number of people waiting for specialized psychological care at health units. By then, the research objectives were explained and the professionals were asked to refer patients of that care unit interested in group psychotherapy.

Following were the criteria for inclusion in the group: adults (older than 18 years) with existential demands for psychotherapeutic care such as grievance, separation, anxiety, distress and other conditions that did not fit in cases of serious psychopathologies and that could impair their participation in the group. The group was also disseminated to literate persons because the research instrument demanded writing skills.

The health professionals publicized the proposal among potential participants. Participants were selected based on the sector’s medical records analysis, or interested persons spontaneously sought for it after seeing the advertising poster. Based on the target audience presented by the researcher, health professionals made face-to-face contact, which served as sorting stage.

Considering the need to ensure compliance with ethical principles in the qualitative survey (American Psychological Association, 2012), a meeting was held with the registered individuals, named Welcoming Meeting. By then, participants were officially invited to participate in the Psychotherapy and Research Group. The survey objectives and operation were explained. We have presented the Free and Informed Consent Term (FICT) to get the group members’ agreement to participate in the Master’s Degree survey.

The Critical Phenomenological Method

The critical phenomenological method proposed by (Moreira, 2004; 2009) was elected due to our interest in trying to understand the phenomenon in the light of Merleau-Ponty’s thinking. The method considers human being in its different profiles comprising the social, economic, political, biological dimensions and others. Likewise, expanding it to understand this human being in group psychotherapy provides a comprehensive view on the experience lived, considering the different components of this experience: the relation of each psychotherapist with the self and with the other mediator; of each psychotherapist with the group members and the group as a whole; and, of participants with each other and with the self.

The research instrument

The research instrument used was the Version of Sense (Amatuzzi, 2010a) defined as “free report not intended to be an objective record of what happened, but a live reaction to that, written or spoken immediately after it happened” (p. 76).

The version of sense allows a spontaneous report aimed to overcome the merely descriptive and mechanistic reports that describe the experience in an objective and technical way. Such a report also emphasizes what has touched the psychotherapist, the expression of what was lived during the session in the relation with the client, with potential to become a sort of phenomenological X-ray of a meeting (Amatuzzi, 2010a, p. 79). It emerges as a valuable tool that allows for recovering what has been lived in the session, retrieving memories and developments of feelings to the author. By writing the version of sense the psychotherapist puts on the records what she considered more crucial in the therapeutic meeting, her perceptions about the self, the client and the group, i.e., her immediate experience (Correia et al., 2013).

Besides being used in the clinical space as an instrument to mediate the monitoring of therapeutic care, the Version of Sense is used in the educational practice and advice and works with groups. It has also been used in the training and supervision of students, and in the research scope (Amatuzzi, 2010a; Correia et al., 2013).

In this research we, the psychotherapists, have elaborated the Versions of Sense in all sessions immediately after the end of the meeting. This resulted in 11 written versions, totaling 22 versions of sense of both psychotherapists. The group members, in turn, prepared the versions at three different moments - on the 5th, 7th and 10th sessions - writing them on the last 30 minutes of the session. Writing the versions at different times is justified by the fact that the instrument itself is a gradual learning process (Amatuzzi, 2010a). This way, it allowed the subject-collaborators to explore more deeply the experience of writing the Version. In the first version during the 5th session five members of the group participated; in the 7th session nine have participated; and, in the 10th and last session six persons participated, considering that two refused to write. Therefore, altogether there were 20 versions of clients. The sum of all versions of sense was based on the analysis of 42 versions of sense by the psychotherapists and clients of the psychotherapy group. All versions of sense were signed and dated to allow us to identify, during the analyses, who had prepared them and at which moment of the group process.

Just like in the Amatuzzi’s proposal (2010a), the subject-collaborators (psychotherapists and clients) were instructed to write a spontaneous report showing their perceptions about the experience of participating in a psychotherapy group, freely exposing the facts that touched them and the most significant moments. We have tried to provide an environment favorable to openness and safety, considering there is no right or wrong way, so that each participant could use the instrument to manifest, in their own words, their experience in the psychotherapy group.

Data Analysis

In data analysis we took a step ahead the initial stage corresponding the literal transcription of data surveyed using the instrument, considering there was no transcription from verbal text to written text. This moment was devoted to exhaustively reading the Versions of Sense. In the second stage we have divided the written texts’ content into “movements”, smaller units, i.e., we subdivided the original text into excerpts. Following, still using the phenomenological reduction as a way to ensure access to phenomena in their complexity, although aware about its incompleteness (Merleau-Ponty, 1945/2006), we have pooled similar topics in all sessions, reaching the emerging categories. The third step was to perform the descriptive analysis and construe the meanings of categories emerging from all the elaborated material. Finally, we reached the stage “leave the brackets”. Here, we ceased the phenomenological reduction, assuming the worldly position and promoting dialogue between the theoretical referential and the experience lived.

During the appreciation of the emerging topics, the group members and mediators are mentioned using fictitious names to ensure confidentiality. Throughout the excerpts of the versions of sense we have put in brackets, after the quotation, the psychotherapist’s name (Julia or Sofia) or of the remainder subject-collaborators of the survey, the group members (Bia, Catarina, Fausta, Frida, Luzia, Paula, Salete, Sônia, Maitê, Yasmin) and when it happened. That was to facilitate readers’ understanding about the group process movement.

The worldly phenomenological analysis of the Versions of Sense

We have distributed the phenomena surveyed into three core categories that appeared in the versions’ analysis: emerging feelings in the intersubjective relation with the self, the group, psychotherapists and the society; the senses of a psychotherapy group; and, the attitudes, interventions and facilitating resources.

Emerging feelings in the intersubjective relation with the self, the group, psychotherapists and the society

The feelings that emerged in the group context refer to the sensations expressed during the psychotherapy group process regarding the intersubjective relation between psychotherapists/clients/world.

Yasmin has also mentioned how she felt misunderstood when she told her history to another person, and how she feels confident in expressing herself there, in the group space ... she said she felt so smothered, needing to talk about it ... (Sofia, 3rd session).

I feel light and relieved, comfortable, I love the group, it is open for us to talk about our problems. (Salete, 7th session).

Initially, the feelings that emerged in the group context referred to the feelings of missing room to talk about the self and be carefully heard; of holding in emotions in family relations; difficulty in expressing feelings; and, embarrassment in relationship with other persons. These sensations seemed to lead to the use of masks to hide the real self and the needs of each person (Amatuzzi, 2010c; Bozarth, 2001; Fonseca, 1988; Rogers, 1970/2009; Wood, 1983b). As the group moved on, and based on the meeting and environment of trust established (Amatuzzi, 2010c; Bozarth, 2001; Rogers, 1970/2009; Wood, 1983b), new sensations came about such as well-being, calmness, confidence, welcoming, care, love and fulfillment.

We have identified impressions of ambiguous emotions - pleasant and unpleasant - since the group members and psychotherapists have shared the feelings arising in the group meeting, and revealed how they felt in society, in family relations, with co-workers and in relations in general, considering their worldly existence. Despite the conflicting emotions, we do not report anything generated by the society, in a dual understanding that assumes a separation between subject and object, humanity and world. The inspiration in Merleau-Ponty’s (1945/2006) phenomenology enables the dialectic understanding that we are each of us or, simultaneously, the psychotherapy group, and we are this society, jointly with all feelings that overreaches us.

Psychotherapy group’s senses: 1) Private and welcoming space to share histories with no judgment; and 2) Interlacing of histories that optimizes the processes of change.

The senses that emerged from individuals regarding the psychotherapy group point out a broad understanding of a space of care and exchange, where histories intertwine and confound, enabling deepening the psychotherapeutic care, strengthening ties, promoting growth and changing persons that participate in it.

It has served as an “outlet” because it is the very only moment I have to express what is upsetting me, with no fear of what the others will think, and also where I can be what I me, the person behind a character that is always happy and well; I can take off my masks and live reality, show I’m weak and delicate, that I’m needy for affection, and I can comfortably tell all my anxieties, regardless how our friends or family members listen to us and are with us, they will never understand as well as people here. (Bia, 7th session)

We could notice that the group members found a space to be what they are, living aside their “armors”, accepting their weaknesses and navigating through their histories. In an environment of understanding and intimacy (Amatuzzi, 2010c; Bozarth, 2001; Fonseca, 1988; Rogers, 1970/2009; Wood, 1983b), each participant “tends to detach from what they are not” (Brito and Moreira, 2011). Many times they cannot find this space in their family relations (Rogers, 1970/2009).

crossroads of life journeys where I get lost and find myself ... my role as psychologist and human being is confirmed and mixed with my role as daughter, wife, woman. (Sofia, 5th session)

when I listen to people talking about their problems, sometimes these are like my problems, and I feel like as if I was talking. Is that possible? (Maitê, 5th session)

These excerpts show how group psychotherapy has assisted its members to expand their networks and envisage the rich diversity of existences and different ways of handling with similar situations in life (Schimid & O’Hara, 2007). Analyzing the speech, we can emphasize that participants and we stroll around the histories of each other. Many issues that bothered the participants were both singular and universal, belonged to all participants and, at the same time, were unique to each one (Yalom & Leszcz, 2006). Listening about the lives of other individuals in the group many times meant listening to our own histories. Moreover, it opened opportunities to view new paths, knowing they were not alone (Schimid & O’Hara, 2007).

The session was for them, and was theirs, an important moment for the whole group triggered by the history of their lives (Paula and Fausta). Histories are basted, cross one another, hook up, tie knots, weaving the fabric of life (Julia, 9th session).

The excerpt of Julia’s version shows the wealth of a group psychotherapy process. Here we can see the intertwining of histories built in the group, which seems to have boosted the “life fabric” as written, allowing the rise of new ways of existing. This excerpt recalled the expression of the Formative Tendency (Amatuzzi, 2010c; Rogers,1983a; Wood, 1983b) as a power existing in nature and that circulates towards greater expansion, interrelation and complexity (Amatuzzi, 2010c; Rogers, 1983a; Vasconcelos & Cavalcante, 2008; Wood, 1983b, 2013).

it is like as if the world were painted in new colors, histories that are now of suffering and pain and, with lots of creativity and resilience, are transformed and transmuted into faith and hope. (Sofia, 5th session)

Refreshing and transforming. We are now part of a garden; when we get here we are nothing but small seedlings but, thanks to the caregivers of this garden, we are becoming beautiful trees that are strong and fruitful (Paula, 10th session).

This moment of closure raises all feelings, but above all we leave here feeling we are cherished, loved, cared by such special persons. Also, we always take with us the good we received here. (Bia, 10th session)

The speeches of several participants and of the psychotherapists about the psychotherapy group sense evidence a room for learning, renewal, creation of possibilities more in tune with the true self. It served as a booster to processes of change and to promote better quality of life, opening new experiences of participants and also bringing reflections to psychotherapists (Wood,1983b).

As emphasized by Bia, by the end of the psychotherapy group we can also find the willingness to transcend the feelings experienced, and the joy provided beyond the relations defined in that context (Rogers, 1983a; Wood, 1983a,1983b, 2013). This process provided Bia with perspectives of potential improvements in her relationships in society.

Attitudes, interventions and facilitating resources

This topic expresses the conditions, attitudes, interventions and resources that made up this experience and had therapeutic importance to the group process.

Salete was by my side, and I could exchange with her glances of care and affection. I looked at the group with cheer, always trying to feel, perceive how each person was (Julia, 1st session).

It is like coming out of hiding in life, when we listen we learn how important life is, and that sometimes we just can’t see what really matters ... . When we talk, we find that many times we are about jumping into imaginary abysses ... . (Paula, 7th session).

Catarina then started talking and talked a lot, a lot about her disappointment with the daughter that got married out of the blue, and moved away. Many times she talked about the loss of her grandma and of the daughter, at the same time; the histories confound ... . She really needed talking (Julia, 1st session).

Being attentive to body languages as a whole, beyond the act of looking, talking or listening, enabled recognizing and accepting the issues experienced by clients, the expression of affections. Moreover, it enabled following-up, in a sensitive way, how each member was, her breathing, expressions of doubt, anxiety and needs announced, which could be deepened and cared.

(Moreira, 2009, 2012a, 2013b) calls this attitude of access to what is available beyond the organs of sense in phenomenological humanistic psychotherapy as phenomenologically seeing and listening. In this sense, understanding the mutual constitution of human and world, our perception as psychotherapists should comprise the whole context and variables involved, considering that “seeing is touching, listening is seeing, touching is seeing. There is a unity of senses that communicate one another” (Carmo, 2011, p. 37).

many times today I was confused, recalling my history with my mother, how we have progressed in our relation, how, as Paula said, “I had my childhood drawn”; so, I could somehow welcome my child that still lives in me. (Sofia, 2nd session)

Reading this version makes us perceive that, as psychotherapists, we allow ourselves to stroll around our histories, jointly with the clients. We worked according to what we felt, being genuine with our feelings and desires, thus contributing with other members and the group as a whole to get more and more in touch with what we effectively are (Burks & Robbins, 2012; Quinn, 2008; Rogers, 1970/2009,1957/2008; Schnellbacher & Leijssen, 2009; Vasconcelos & Cavalcante, 2008; Wood, 1983b), although this attitude of being congruent is barely fully attained (Souza, Carvalho and Moreira, 2013). Being authentic in the therapeutic relation with clients is crucial. However it does not mean we are congruent in all the remainder relations in life. In addition, our “imperfections” help us to understand the client’s “imperfections” during therapy and, thus, to follow them up in a more integral way (Rogers, 1965/1977).

Bia cries a lot, recalling she couldn’t say goodbye to her grandma. Paula takes care of her and I share how I felt when my mother passed away. (Julia, 9th session).

On the speech above Julia, the psychotherapist, noticed a thread of Bia’s history of losing beloved ones, and shared with the group her experience about her mother’s death as a way of providing Bia with new ways to handle with her grieving. (Souza et al., 2013) say that “assuming an authentic posture and frankly talking about the self and its contents in the session with clients are different things” (p. 268). Likewise, the posture of the psychotherapist Julia in the aforementioned version of sense was to share her experience to assist Bia rather than to share her personal issues to be solved in the group (Correia et al., 2013; Rogers, 1957/2008, 1970/2009).

Since it is a subtle movement, therapists should be careful when talking with clients about their own experiences. This should be done only in rare occasions, focusing on the client’s need, and in a way to allow them to move forward in their histories (Schnellbacher & Leijssen, 2009).

Bia said she is afraid of being alone, she always imagine something bad will happen and she would be blamed for that. In my heart I could feel the hard efforts of Bia during her life to control her fear, and I could say it to her (Julia, 3rd session).

Through the record of Julia’s version we understand that in her relation with Bia she was captured by feelings and meanings brought about accessing the “as if” experience in the client’s light, “to see and feel the world like the client feels, and navigate this world with her” (Amatuzzi, 2010c, p.70). Known as sympathetic understanding, this attitude refers to the psychotherapist navigating the strange world of the other (Vieira & Freire, 2006) and, somehow informing the other about that understanding of his/her experience (Bozarth, 2001; Correia et al., 2013; Fontgalland & Moreira, 2012; Gobbi, Missel, Justo & Holanda 2005; O’Leary, 2008; Rogers, 1970/2009).

I really wanted to listen to her histories, and was somehow disturbed of asking her to sign the consent term, worried about bureaucracy and practical issues in such a sensitive moment (Sofia, Welcoming Meeting).

Considering that it was a group of psychotherapy and research, at some moments one of us, psychotherapists, should be attentive to the practical research-related issues. Balancing our roles as psychotherapists and researchers was somewhat disturbing. In those moments, the presence of co-mediation ensured care to the group. Moreover, as mediators present in an integral and genuine way, as shown before, we could contribute with the client’s and the group’s process (Correia et al., 2013; Rogers, 1970/2009, 1957/2008; Wood, 1983b). Co-mediation allowed the natural alternation of contact of each of us with our issues, resting sure of the support by another mediator (Yalom & Leszcz, 2006), never leaving the group alone or without support.

it is knowing that it’s pure love, asking nothing in exchange, because what really minds is to receive and pass this love, cheer and peace that are reflected in each of you and that contaminate us (Paula, 5th session).

We acknowledge that our caring relation one another has extrapolated to the members, contaminating everybody and favoring a welcoming environment. Building a mediation team may seem to be an easy task, but is of utmost relevance. Reciprocal openness is crucial (Yalom & Leszcz, 2006), as well as consensus about the theoretical lenses that will ground the group mediation work, respecting the different personal styles. (Fonseca, 1988).

How much life, death, life! The group plunged into deep rivers, in troubled and muddy waters. But I know that every river runs to the sea of life! It comforts me! (Julia, 9th session)

The version shows our understanding about the group as a trustworthy organism (Rogers, 1970/2009; Wood, 1983b) with its own knowledge that helps them to follow their path that, many times, can be different from our expectations. By trusting the group wisdom we let them explore their potentials and limitations, approach their experience that is tempered with strengths and weaknesses, joys and sadness, as a whole being built.

Sonia is a very positive person, always maximizes the group, always helps who wants to talk, when someone ends, she always says: “come on, it’s now your turn, talk, I know you want to talk” (Julia, 1st Session).

We observed the work of Sonia in the group. She was always prone to help and contribute. During the group process she always took on a role of encouraging, explaining the importance that talking in your own way has to the psychotherapeutic process. By giving up the control and ready answers the psychotherapist can be amazed with the emergence of interventions of moderation by one of the members (Amatuzzi, 2010b; Wood, 1983a, 1983b).

Live wisdom of the group arises when the group members communicate heartfully, in a close way, “when communication flows and we are open to what is expressed, wise and unforeseen things happen” (Amatuzzi, 2010b, p.131). The emergence of group wisdom allowed us to try the new, the unforeseen and the surprising, opening creative paths of live to each member and to us (Amatuzzi, 2010b; Correia et al., 2013; Wood,1983b).

Ending in a circle, standing up, embracing one another in a clinching of care, with Paula recalling that together we stand. Hugging each group member was really refreshing. Hugs are spontaneous. (Julia, 2nd session).

Bia reported many hard moments, that many times she thought about committing suicide because she could see no sense in her life, and she starts shaking. I felt a strong need of staying close to her and holding her hand. And I did it. I changed my seat (Julia, 8th session).

I wanted to hold Yasmin, but I also felt I could break her speech and she needed talking, talking and being heard. And the group was fully attentive, and listened and welcomed her. (Julia, Welcoming Meeting)

This group was permeated by moments of movement in the care environment and expression of feelings through affective contacts, as those reported above. It did not intend to suspend the intensity of experiences lived, but compassionately welcome the contents that, in most times, were dense. Based on Merleau-Ponty’s phenomenology we believe that the need for physical contact, mostly expressed by hugs, is a cultural trait, considering that the group was from the Northeast region of Brazil. In that region, people use to talk touching the other, and greet the others with hugs (Correia et al., 2013).

Besides paying attention to our own needs, like wanting to hug Yasmin as expressed in the last quote presented, we should also observe what clients needed by that time and, at the same time, the needs of the group as a whole (Rogers, 1970/2009). Grounded on the relationship the client establishes with the self, with the psychotherapist, the group and the world, Julia could make the phenomenological reduction (Correia et al., 2013; Merleau-Ponty, 1945/2006; Moreira, 2009, 2012a, 2013b; Moreira & Torres, 2013), put “in brackets” her desire of embracing Yasmin, believing that Yasmin needed talking, and could rest on the group wisdom.

Many times I took a deep breathe to try to set free everything that seemed to be imprisoned in me, maybe memories of my histories, maybe forgotten fragments of moments lived or, who knows?, the caregiver’s desire of healing the world’s pain! (Julia, 2nd session).

The body consciousness of Julia about how she was breathing, the contact with her journey, allowed building “an environment of sympathy, esteem, attention and congruence in relation to ourselves” (Bowen, 2004, p.81). When the psychotherapist listened to the self, working in tune with her feelings (Rogers, 1970/2009), it has not interfered on the process of listening to the group. Rather, it allowed deeper presence. As (Souza et al., 2013) say, “being authentic, therefore, means being presence” (p. 274).

letting tears roll on the face is like redemption ... I feel my soul free and ready to move on in life (Paula, 7th session).

The difficulty of some members in crying and letting tears roll in front of the group revealed the imprisonment of feelings. In the psychotherapeutic environment, awareness about breathing and holding tears back allowed clients to get in touch with the emotions held inside and painful situations that could not be previously experienced, but that in the group context could be accessed and acquired new senses.

Psychotherapy allowed clients to perceive their own organism once the self-discovery process assumes gradual approach of inner feelings and of how these have been working with the self and the others. Clients could create a new “break-even point” (Bowen, 2008) between their intentions and behaviors, integrating feelings and actions in a smoother and more congruent way.

I was disturbed with some of Sonia’s interventions, trying to explain and interpret why Maitê’s son started doing drugs; I talked to Sonia, validating her care but reinforcing that our care was then with Maitê, and we should not interpret what made her son start doing drugs (Sofia, 4th session).

Yasmin and Paula talked to her very well, setting limits (to Fausta) and showing that each one’s experience was unique and singular (Sofia, 6th session).

We noticed that this movement of assuming a position on the other’s history, mainly for the purpose of offering solutions, was found virtually throughout the entire process of this group. As unfolding of the unconditional acceptance as a condition that facilitates the change of personality, as proposed by Carl (Rogers, 1961/2009), the mediator must accept the group or group member with their uniqueness, following them up and attentive to their demands, with no anticipation (Correia et al, 2013; Rogers, 1970/2009). In this way, the mediator helps them to re-building the limits for the self and for the others (Fonseca, 1988).

Aiming to ensure space of care, the psychotherapist must promote the required interventions in the event of any judgment that could compromise the individuals’ movement towards becoming who they authentically are.

During the group process, in face of our successive interventions, weighting the importance of limits in relations, the clients performed interventions on the speeches of the other members, which sounded like judgment on their histories, taking on the responsibility of the limits they should impose to ensure their private space.

Today, many dams were opened and I can breathe easier! Coincidentally or otherwise, on the second-to-last day! As Fausta said, “at a given moment I knew it had to come out, because we are in our second-to-last meeting”, she recalls! It is like as if the fact that the group is for fixed-term would hasten each one’s therapeutic process! (Sofia, 9th session).

Considering the group as a live organism, it has the time to born, flourish and die. The mediator should clearly explain to participants the group’s limit and durability. This is a condition for the group to “effectively live and disclose its potentials; for people to get free to fully live their lives and what they can achieve, and effectively achieve and create, in this period of time” (Fonseca, 1988, p. 85).

The temporal limit of the group’s duration made people dimension the time available, define and connect more deeply with what they want to live, their intentions in the life time defined to the group (Fonseca, 1988; Rogers, 1983a).

We have gently talked about the each participant’s process, about how writing was good to appropriate the group sense into their lives, of getting in touch with how they were feeling. (Sofia, 9th session).

The act of writing assumes a movement of seeking for understanding something, “reproduce what cannot be fully reproduced” (Amatuzzi, 2010a, p.64), like as if writing were necessary to process and understand something that seems “vague or oppressive” (p. 65). When expressed in writing, what has been said changes and makes room to other senses. We noticed that in the group this space for writing allowed finding new meanings, representing a commitment with the ‘become’ in relation to something experienced.

Final Remarks

This survey about psychotherapists’ and clients’ experience in group psychotherapy suggests that when people are together, sharing the same intention to grow, in a space free of judgments, the participants’ histories are naturally interlaced, giving rise to the group’s unique wisdom that encourages them towards more creative paths.

We have observed the importance of providing a welcoming and safe environment, where the group members gradually expressed their needs, getting in deeper touch with what they really are. We emphasize the crucial participation of a co-psychotherapist to support the mediation and harmony of participants. This allowed the group to deeply dive into the emerging issues.

We felt that the quality of our presence, the plenitude and attitude of being fully available in the relation with clients, attentive to our experiences, telling to clients what persisted and emerged in the relation established, served as boosters to the psychotherapy process.

Considering the interlacing of the members’ histories, including ours as psychotherapists, the participants could look into their own histories in a new light, reviving feelings and assigning new senses to their experiences. By the end of the group period, we could observe more congruence among the group members, deeper speeches and lighter expressions.

It is worth highlighting that we observed the emergence of mediating attitudes not only by the psychotherapists, but also by all the group members. This is one of the highlight aspects regarding the richness of the group work. The strengthening of ties by the participants allowed smooth interventions and the growth of each client, the psychotherapists and the group. It also facilitates mutual care and helpfulness that go beyond the relations with the individuals in the psychotherapy group, in face of their worldly existence.

This study contributes to the area clarifying how a worldly view of humanity, inspired by the Merleau-Ponty’s phenomenology, could contribute to understand the group process in this light, expanding the perspectives of use.

Understanding this experience of individuals in group psychotherapy, in the critical phenomenological light, approached the worldly nature of phenomena in the wide range of possibilities disclosed by a group of persons in psychotherapy process. It favored the comprehensive understanding of phenomena and their multiple profiles. This, in turn, allowed us to understand each client as interlaced in the world, and all the variables that make them up. It was a rich experience that happened in a singular way, based on the meeting with those individuals, psychotherapists, building the group and, at the same time, universally expressing a way of working similar to other groups. Understanding how psychotherapists and clients experience a group psychotherapy process, as presented herein, points out the relevance of surveys in this area. In addition, it shows the need for expanding the group work in mental health and in the different fields of work as a potential transformer.

Referências

• Amatuzzi, M. M. (2010a). Versão de sentido. In M. Amatuzzi, Por uma psicologia humana (Cap. VI, pp. 75-89). Campinas, SP: Alínea. (Trabalho original publicado em 1996)
• Amatuzzi, M. M. (2010b). Processos humanos. In M. Amatuzzi, Por uma psicologia humana (Cap. IX, pp. 123-137). Campinas, SP: Alínea. (Trabalho original publicado em 1996)
• Amatuzzi, M. M. (2010c). Rogers: ética humanista e psicoterapia. Campinas, SP: Alínea.
• American Psychological Association. (2012). Manual de publicação da APA (6a ed., D. Bueno, trad., M. L. Tiellet Nunes, rev. téc.). Porto Alegre, RS: Penso.
• Bloc, L., & Moreira, V. (2013). Condições para a mudança psicoterapêutica e intervenções fenomenológicas: reflexões a partir do caso Fátima. In V. Moreira, Revisitando as psicoterapias humanistas (Cap. 3, pp. 49-60). São Paulo, SP: Intermeios.
• Boris, G. D. J. B. (1992). O processo de cooperação na psicoterapia de grupo em Gestalt-terapia (Dissertação de Mestrado). Universidade Federal do Ceará, Fortaleza, CE.
• Boris, G. D. J. B. (2013). Grupos vivenciais e cooperação: uma perspectiva gestáltica. São Paulo, SP: Intermeios.
• Bowen, M. (2004). Psicoterapia: o processo, o terapeuta e a aprendizagem. In A. M. Santos, C. R. Rogers & M. C. V. Bowen, Quando fala o coração: a essência da psicoterapia centrada na pessoa (Cap. IV, pp. 69-81). São Paulo, SP: Vetor.
• Bowen, M. (2008). Algumas reflexões sobre psicoterapia. In F. Cavalcante Jr. & A. F. Sousa (Orgs.), Humanismo de funcionamento pleno (Cap. 3, pp. 51-57). Campinas, SP: Alínea.
• Bozarth, J. (2001). Terapia centrada na pessoa: um paradigma revolucionário. Lisboa, Portugal: Ual.
• Brito, R. M. M., & Moreira, V. (2011). “Ser o que se é” na psicoterapia de Carl Rogers: um estado ou um processo? Memorandum, 20, 201-210.
• Burks, D. J., & Robbins, R. (2012). Psychologists’ authenticity: implications for work in professional and therapeutic settings. Journal of Humanistic Psychology, 52(1), 75-104. (Trabalho original publicado em 2010)
• Carmo, P. S. (2011). Merleau-Ponty: uma introdução. São Paulo, SP: EDUC.
• Correia, K. C. R., Ferreira, L. M., & Moreira, V. (2013). Uma experiência de facilitação de psicoterapia de grupo no enfoque humanista-fenomenológico. In V. Moreira, Revisitando as psicoterapias humanistas (Cap. 4, pp. 61-82). São Paulo, SP: Intermeios.
• Coppe, A. A. F. (2001). A vivência em grupos de encontro: um estudo fenomenológico de depoimentos (Dissertação de Mestrado). Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ.
• Cury, V. (1993). Abordagem centrada na pessoa: um estudo sobre as implicações dos trabalhos com grupos intensivos para a terapia centrada no cliente (Tese de Doutorado). Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP.
• Fonseca, A. (1988). Grupo, fugacidade, ritmo e forma: processo de grupo e facilitação na psicologia humanista. São Paulo, SP: Ágora.
• Fontgalland, R. C. (2011). A experiência de ser empático para o psicoterapeuta humanista-fenomenológico iniciante (Dissertação de Mestrado em Psicologia). Universidade de Fortaleza, Fortaleza, CE.
• Fontgalland, R. C., & Moreira, V. (2012). Da empatia à compreensão empática: evolução do conceito no pensamento de Carl Rogers. Memorandum, 23, 32-56. Recuperado de http://www.fafich.ufmg.br/memorandum/a23/fontgallandmoreira01
  » http://www.fafich.ufmg.br/memorandum/a23/fontgallandmoreira01
• Gobbi, S., Missel, S., Justo, H., & Holanda, A. F. (Orgs.) (2005). Vocabulário e noções básicas da abordagem centrada na pessoa. São Paulo, SP: Vetor.
• Hobbs, N. (1992). Psicoterapia centrada no grupo. In C. Rogers, A terapia centrada no cliente. São Paulo, SP: Martins Fontes. (Trabalho original publicado em 1951)
• Lemos, P. M., & Cavalcante Jr., F. S. (2009). Psicologia de orientação positiva: uma proposta de intervenção no trabalho com grupos em saúde mental. Ciência & Saúde Coletiva, 14(1), 233-242.
• Merleau-Ponty, M. (2006). Fenomenologia da percepção. São Paulo, SP: Martins Fontes . (Trabalho original publicado em 1945)
• Melo, A. K., Pita, J., & Moreira, V. (2013). Psicoterapia humanista fenomenológica com Paula: lente da Gestalt-terapia sobre o transtorno borderline. In V. Moreira, Revisitando as psicoterapias humanistas (Cap. 6, pp. 103-118). São Paulo, SP: Intermeios.
• Moreira, V. (2004). O método fenomenológico de Merleau-Ponty como ferramenta crítica na pesquisa em psicopatologia. Psicologia: Reflexão e Crítica, 17(3), 447-456.
• Moreira, V. (2007). De Carl Rogers a Merleau-Ponty: a pessoa mundana em psicoterapia. São Paulo, SP: Annablume.
• Moreira, V. (2009). Clínica humanista-fenomenológica: estudos em psicoterapia e psicopatologia crítica. São Paulo, SP: Annablume.
• Moreira, V. (2012a). From person centered to humanistic-phenomenological psychotherapy: the contribution of Merleau-Ponty to Carl Rogers thought. Journal of Person-Centered & Experiential Psychotherapies, 11(1), 48-63.
• Moreira, V. (2012b). O inconsciente no pensamento de Merleau-Ponty: contribuições para psicoterapia. In A. Tatossian & V. Moreira, Clínica do Lebenswelt: psicoterapia e psicopatologia fenomenológica (Cap. 12, pp. 220-229). São Paulo, SP: Escuta.
• Moreira, V. (2013a). Da proposta de Carl Rogers à psicoterapia humanista-fenomenológica: revisitando as fases da abordagem centrada na pessoa. In V. Moreira, Revisitando as psicoterapias humanistas (Cap. 1, pp. 25-34). São Paulo, SP: Intermeios.
• Moreira, V. (2013b). Psicoterapia humanista-fenomenológica: a contribuição de Merleau-Ponty para o pensamento de Carl Rogers. In V. Moreira, Revisitando as psicoterapias humanistas (Cap. 2, pp. 35-48). São Paulo, SP: Intermeios.
• Moreira, V., & Torres, R. B. (2013). Empatia e redução fenomenológica: possível contribuição ao pensamento de Rogers. Arquivos Brasileiros de Psicologia, 65(2), 181-197. Recuperado de http://seer.psicologia.ufrj.br/index.php/abp
  » http://seer.psicologia.ufrj.br/index.php/abp
• O’Leary, C. J. (2008). Response to couples and families in distress: Rogers’ six conditions lived with respect for the unique medium of relationship therapy. Person-Centered and Experiential Psychotherapies, 7(4), 294-307.
• Quinn, A. (2008). A person-centered approach to the treatment of combat veterans with posttraumatic stress disorder. Journal of Humanistic Psychology, 48(4), 458-476.
• Ribeiro, J. P. (1994). Gestalt-terapia: o processo grupal. São Paulo, SP: Summus.
• Rogers, C. (1977). Teoria da personalidade e dinâmica do comportamento. In C. Rogers & M. Kinget, Psicoterapia e relações humanas (Vol. 1, pp. 195-212). São Paulo, SP: Martins Fontes. (Trabalho original publicado em 1965)
• Rogers, C. (1978). Sobre o poder pessoal. São Paulo, SP: Martins Fontes. (Trabalho original publicado em 1977)
• Rogers, C. (1983). Um jeito de ser. São Paulo, SP: EDUSP.
• Rogers, C. (2008). As condições necessárias e suficientes para a mudança terapêutica na personalidade. In: J. K. Wood et al. (Orgs.), Abordagem centrada na pessoa (pp. 143-162). Vitória, ES: EDUFES.
• Rogers, C. (2009a). Grupos de encontro. São Paulo, SP: Martins Fontes. (Trabalho original publicado em 1970)
• Rogers, C. (2009b). Tornar-se pessoa. São Paulo, SP: Martins Fontes. (Trabalho original publicado em 1961)
• Schmid, P. F., & O’Hara, M. (2007). Group therapy and encounter groups. In M. Cooper, M. O’Hara, P. F. Schmid & G. Wyatt (2007). The handbook of person-centered psychotherapy and counseling (Cap. 8, pp. 93-106). Basingstoke, England: Palgrave Macmillan.
• Schnellbacher, J., & Leijssen, M. (2009). The significance of therapist genuineness from the client’s perspective. Journal of Humanistic Psychology, 49(2), 207-228.
• Souza, C., Carvalho, L. B., & Moreira, V. (2013). O desenvolvimento do conceito de autenticidade nas diferentes fases da psicoterapia de Carl Rogers. In V. Moreira, Revisitando as psicoterapias humanistas (Cap. 13, pp. 260-274). São Paulo, SP: Intermeios.
• Vasconcelos, T. P., & Cavalcante Jr., F. (2008). Concede-se morte, suscita-se vida. In F. Cavalcante Jr. & A. F. Sousa (Orgs.), Humanismo de funcionamento pleno (Cap. 8, pp. 145-155). Campinas, SP: Alínea.
• Vieira, E. M., & Freire, J. C. (2006). Alteridade e psicologia humanista: uma leitura ética da abordagem centrada na pessoa. Estudos de Psicologia, 23(4), 425-432.
• Wood, J. K. (1983a). Sombras da entrega. In C. Rogers, J. K. Wood, M. M. O’Hara & A. H. L. Fonseca, Em busca da vida: da terapia centrada no cliente à abordagem centrada na pessoa (pp. 23-44). São Paulo, SP: Summus.
• Wood, J. K. (1983b). Terapia de grupo centrada na pessoa. In C. Rogers, J. K. Wood, M. M. O’Hara & A. H. L. Fonseca, Em busca da vida: da terapia centrada no cliente à abordagem centrada na pessoa (pp. 21-89). São Paulo, SP: Summus.
• Wood, J. K. (2013). Sete verões entre pessoas: diário de bordo sobre a abordagem centrada na pessoa em grandes grupos (R. F. Telles, trad.). São Paulo, SP: Via Lettera.
• Yalom, I. D., & Leszcz, M. (2006). Psicoterapia de grupo: teoria e prática (R. C. Costa, trad.). Porto Alegre, RS: Artmed.

Publication Dates

• Publication in this collection
  Sep-Dec 2016

History

• Received
  20 June 2014
• Reviewed
  18 Feb 2015
• Accepted
  07 Oct 2015