Consultation, Please
June/July 2003 

Dear Consultant:
A female colleague and I have been running a group as co-therapists for several months. From our conversations prior to running the group, it appeared that our styles were similar, but this has not turned out to be the case. In the group she seems to be taking center stage and has chosen to share a great deal of her own life with the group. Almost every time a patient interacts directly with another group member, she brings the focus back to herself and interacts directly with that patient. I tend to stay quiet and only make interpretations when there is group interaction. The group appears to be confused, and several members have criticized me for not being more interactive. I know that I am somewhat shy, but I have done other groups where my group-as-a-whole interventions seemed to work well. We have tried to talk about our differences in style and I have suggested that we get consultation together. She has adamantly refused as she says we are both experienced psychologists, and our group is fine. I feel ill at ease with each approaching group and I think the group can sense the growing tension between us. I would appreciate any suggestions that you can give me as I feel strongly that we will lose members because of our divergent styles.
Sincerely,
Silently Seething

Dear Silent:
I doubt that there is anyone who works with a co-therapist who has not had some variant of the dilemma presented. That you sign yourself “Silently Seething” gives me a clue as to a possible source of the difficulty. When you start by stating your struggle in the framework of “The problem is I…” you might see a pattern in your concerns.

“The problem is I am silently seething.”
“The problem is I can no longer tell whether or not I can continue to work in this way.”
“The problem is I work very differently from her.”
“The problem is I tend to stay quiet.”
“The problem is I am shy.”
“The problem is I try to talk about out differences.”
“The problem is I have suggested we get consultation.”
“The problem is I am struggling with her nonverbally in the group.”
“The problem is I feel ill at ease.”

Now consider experimenting by changing just one of your behaviors and see what happens. For example, what would happen if you dropped the “silently” and seethed out loud? What if you dropped the “non” and struggled you’re your co-therapist verbally in the group?

You need to decide what you want from your co-therapist. How do you envision the two of you working together? What would be her role? What would be yours? Have you discussed this in detail with her?

When we are shy and trying to express ourselves, our own hearing becomes exquisitely sensitive. By that I mean that what we hear when we “try” sounds in our own ears as loud, possibly even strident, whereas the other hears only a meek whisper. Somehow our urgency, the extent of our discomfort and pain is not communicated. (Deleted last sentence – a bit too poetic for the GC.)

It is your responsibility to make certain that your own volume is sufficient. If you are dismissed or ignored, it is your responsibility to make yourself clear. The caveat here is that you must be clear inside yourself about what you want. If you are not clear, then there is little chance for successful communication.

Two of the reasons some of us work with co-therapists are that it is fun and it is a way to provide a model for relating. Clearly, you are not having fun. How would you evaluate your model for relating?

You originally chose your co-therapist for some reason. I hope you rediscover it and enjoy— or get out of Dodge.

Bettie Banks, PhD, CGP
Atlanta, Georgia

Dear Silent:
What a difficult position you’re in. This situation, of course, points out the necessity of exploring and negotiating a relationship with a potential co-therapist before embarking. It can be useful to co-lead a workshop or a time-limited group before beginning an open-ended psychotherapy group. However, even then, difficulties of the nature that you’re describing may arise.

Your group ??can?? feel the tension between therapists. It would be naïve to imagine that such a dynamic could be kept out of the group. Every time the group convenes, the co-therapists’ relationship is in the room. I’m sure that the group is reacting to the confusing signals the two of you must be sending. Your conflict, which seems to be playing out in the group, may be a struggle for control or for safety or for the therapists to be heard. It suggests to me that what you perceive as the group’s attacks on you may well be enactments of your relationship issues with your co-therapist. She seems to have the group engaged with her activity, and you seem to be becoming more passive in the face of that. Perhaps the group sees that you’ve been insufficiently active with her and is trying to tell you that. I wonder what might happen if you were to become more active in the group, and with her—in your own way and within the limits of your comfort, of course.

The fact that your styles are very different is not what imperils the outcome. Diversity in approaches can be an asset because they can serve complementary purposes and evoke different material from group members. You seem to be saying that your co-therapist does not respect your feelings. You’ve brought a concern to her; you feel she’s dismissed you, and that you’re powerless. Why haven’t you told her that you don’t like what she’s been doing as she directs the action toward herself? Perhaps you need to have the discussion (outside the group) that you’ve been avoiding. Without recapturing respect, there’s little hope.

Even though she’s rejected the notion of consultation for the two of you, that doesn’t preclude the possibility of your getting consultation for yourself. I think you need to discover what limits your safety to express yourself. If it’s not safe for you, one of the therapists, to express yourself, the group really can’t function. I think you need to find ways to make it safer.

Barry Wepman, PhD, CGP
Washington, DC

This Consultation, Please column was published in the June/July 2003 issue of The Group Circle.