Experiential and Didactic Group Therapy Program: The Sad Lady’s Group

John Breeskin, Ph.D.
John Breeskin, Ph.D.

Somatization Disorder is a condition that is both hard to diagnose and hard to treat. For many years, I was Chief Psychologist of a thousand-bed hospital outpatient mental health clinic. While I mean absolutely no disrespect by this comment, I would classify many of the clients referred to as “sad ladies.” These were women with multiple medical folders with each thicker than the next. Their bodies were cross-hatched with medical and surgical interventions, all of which were ultimately futile. In a fit of irritation and despair, the most recent in a long line of defeated physicians would disclaim, “Get thee hence to the Outpatient Mental Health Clinic!” As a result, these dear ladies would show up in my office, rejected yet another time. Often, they were “empty nesters,” low in self-esteem and self-image, and cemented into maintenance type marriages. It became apparent to me that their numerous outpatient visits symbolically represented a deep need to be touched intimately by a caring human being.

In response to this obvious human need, I quickly designed an intensive six-week group therapy program composed of both experiential and didactic components. We covered such topics as communication skills, assertiveness training, and trust-building.

I remember clearly our very first meeting. The ladies introduced themselves one at a time, and each would outdo the next in terms of the doleful, painful details of her journey. I was astonished! I pointed out that they were competing for “Victim of the Day” awards, and, for now at least, I was less interested in what was wrong than what was right with them. I told them that they did not need to compete for my attention. I was aware that they were problematic individuals in pain and all were well worthy of my concern. After we got that initial dynamic out of the way, we launched into team-building, trust, self-disclosure, and interpersonal bonding. The ladies grasped these principles quickly and firmly, and it changed their lives. One group, because the chemistry was so great, made me an honorary woman at the end of the six weeks, an honor that I will always carry with me.

Another group that I remember with great fondness, at the end of our six weeks together, decided to carry on the group by themselves. They proceeded to hire an attorney, a financial planner, a personal trainer, and, of all things, a psychologist to provide them with ongoing therapy. The psychologist called me in great bewilderment indicating that the ladies had called him and were interviewing him to see if he met their criteria. He called me to ask if this was on the level. I told him it was and that he would be normously enriched if he passed the evaluation. When I left the base two years later, the group had started an investment club and had accomplished several humanitarian tasks. Their manifold visits to the hospital clinics had dramatically diminished.

This model can be replicated easily in many different settings. Once these powerful healing forces are energized and released, much positive change can occur. It is important to take this model very seriously. On the surface it looks very simple, but it is not at all. The twin concepts of intentional kinship and reciprocity are central components of my theoretical model, together with the ever-present mystery of agape.