No abstract

Current interest in shame is examined in its relationship to psychotherapy supervision. Clinician/trainees are vulnerable to exposure and humiliation in the course of their training. This article examines the sources of shame in supervision and offers some suggestions for reducing the shame that might compromise the professional well-being of neophyte clinicians and their supervisors.As the pendulum swings around to more concern about affects in psychoanalytic theories, we have come to see shame and guilt as important byproducts of the uncovering analytic process. Psychoanalytic writers define shame and guilt in a variety of paradigms consistent with their theoretical emphasis. Shame is distinguished from guilt in the psychoanalytic literature by Piers & Singer (1953), who defined guilt as the painful result of a transgression of a superego boundary, and therefore a willful act; shame, on the other hand, is a defect in the self that prevents the person from living up to the ego-ideal. Whereas guilt leads to castration anxiety, shame leads to abandonment and hiding. Furthermore, whereas a person usually feels guilty or not guilty, shame can be experienced along a whole spectrum of discomfort, ranging from awkwardness and embarrassment all the way to corrosive humiliation and fear of disintegration.Freud (1912/1963) and other drive theorists place shame as emerging from the exhibitionistic wishes and fears of the individual. Later in development, anal impulses around the loss of control generate shame. Still later, guilt emerges around the wishes to overwhelm the competitor in the oedipal triangle.

The author provides an overview of critical factors in the working phase of group psychotherapy from the perspective of psychodynamic theory. The discussion is organized around a clinical vignette to illustrate various types of intervention such as past, here and now, future; individual, interpersonal, group as a whole; in group--out of group; affect-cognition; and understanding--corrective emotional experience. The critical "windows into the unconscious," transference, counter-transference, and free association, are also discussed in terms of the clinical example. The author concludes his article with a few thoughts about the future of psychodynamic theory in relationship to group treatments.

The authors describe a range of critical issues that are common within homogeneously composed groups for patients suffering from Acquired Immunodeficiency Syndrome (AIDS) and AIDS Related Complex (ARC). They examine the need for these patients to understand their physical symptomatology, to reconsider life's priorities, and to confront their ethical and moral dilemmas. The authors also highlight special effects, unique group atmosphere and process, and the nature of the group contract that is essential for these patients.