Group Therapy as Entertainment
Marti Kranzberg, PhD, CGP 

The public airing of dirty laundry has become high concept entertainment. The most glaring and explicit example was the Clinton/Lewinsky affair in which the august Senate of the United States disclosed details so graphic that they made the tabloid press look strangely provincial. On a less grand and more quotidian scale, people on the talk show circuit play out their real life dramas in front of camera and audience thereby feeding some voyeuristic public need to be engrossed in the gritty particulars of other people’s interpersonal conflicts. 

Against this backdrop, a controversial book, Group: Six People in Search of a Life, chronicles group therapy sessions of six people and their charismatic psychiatrist. Complete with tragedy and triumph inside and outside the therapy office, Group tells a compelling story and raises thorny questions about the way that group therapy is portrayed to the general public. After all, group therapists may still be recovering from the legacy of television’s endearing Bob Newhart and his goofy, boundary-less group therapy. 

The Background
Paul Solotaroff is a journalist who spent two years in group therapy with Dr. Charles Latham. Impressed by the changes he and other patients made, Mr. Solotaroff approached Dr. Latham four years after terminating therapy and asked if he could write the stories of the people in his group. Dr. Latham declined, saying that it would “break faith with the group” (p. 9) but later offered to allow Mr. Solotaroff to chronicle a group that was forming, one that the psychiatrist later said was hand-picked for the book project. “I’ve stacked the deck good. This is the smartest bunch of people I’ve ever assembled” (p. 26). 

For 10 months the author attended group, sitting outside the circle of patients, taking notes and taping the therapy sessions. All patients consented to this arrangement provided that their identities were kept confidential. Additionally, all agreed to meet with Mr. Solotaroff outside therapy to fill in facts and details that did not come out during therapy. In exchange for their participation, patients were moved up in line from a waiting list of a dozen people (p. 15). 

Mr. Solotaroff readily acknowledges the contradictions and complexity inherent in writing the book about his former therapist, “especially if you are still in his debt—and to Dr. Latham, I thought I owed everything” (p. 14). Acknowledging the cloud of transference that hovers around his perceptions of his former therapist, he details some of his own struggles in dealing with Dr. Latham, the person, at various stages of preparing, writing, and publishing his book. 

The backdrop, then, is this: A former patient observed his former therapist conducting group therapy of six intelligent and articulate people who consented to having their therapy observed, taped and documented for publication. 

The Story
The book details the unfolding stories of the patients and their therapy over a 40-week period. Mr. Solotaroff transcribed dialogue from sessions and rounded out the story with insightful descriptions of the office, its decor and ambiance; the therapist, his sartorial tastes, his manner, his expressions; and the patients’ sagas, interactions with one another, appearances, demeanors, and stories told to the author in personal interviews.

The result is a sometimes tabloid-type tale of sex, drugs and alcohol, and money earned and lost. Group also manages to capture the all-too-human struggles of people seeking meaning in their lives. Ultimately, Mr. Solotaroff delivers a moving tale of six people’s pain and sorrow, struggles, successes and failures. In a telephone interview, Bonnie Buchele, PhD, CGP, FAGPA, clinician and President-Elect of AGPA, commented that she believes that Mr. Solotaroff did an excellent job of capturing the essence of participating in group therapy, perhaps because of his own experience as a patient. 

The Therapist
In the book, Dr. Latham is characterized as charming and enigmatic, prone to elegant soliloquies, pontification, and dispensing truth to his patients. He is portrayed as deeply committed to group therapy as a powerful agent of change and possesses a clear vision of what he wants to happen in the therapy. In the end, Mr. Solotaroff reveals his former therapist to be a flawed and enigmatic hero. He records the group’s bewildered reactions to Dr. Latham ’s rather abrupt alteration in demeanor, attire, and boundaries as he moves his office to a different location and the group nears termination.

A year after the group ended, Mr. Solotaroff visited Dr. Latham to discuss his first draft of the book and found him drunk in the middle of the day. Briefly in the epilogue of the book, he describes the psychiatrist’s descent into alcoholism and the subsequent deterioration of his family, finances, and therapy practice. He reports about his former therapist’s treatment and efforts to pull his life together and reinstate his medical license. And he ponders the question, “How could a man as troubled as Dr. Latham be as lucid and useful in group?” (p. 338). 

An article in the October 19, 1999, Village Voice by William Bastone identified Dr. Latham as Dr. Philip Romero, a Manhattan psychiatrist, and described the man in far less generous terms than Dr. Romero’s former patient. The article, entitled “The Charlatans,” included photographs of both the psychiatrist and the author, Dr. Romero in an austere picture resembling a police mug shot and Mr. Solotaroff in an oddly cropped photo from the jacket of Group that makes him look slightly sinister. Mr. Bastone charged both men with a host of shady ethical and financial dealings, including payments to Dr. Romero and plans for movie rights of the book. If true, these allegations cast a long shadow over the integrity of Dr. Romero and Mr. Solotaroff and, perhaps, the honesty of the book. Even without substantiating the veracity of the Voice contentions, clear ethical questions emerge. 

Ethical Considerations
Dr. Buchele noted four significant ethical violations. First, she denounced the misperception from the book that “anything goes” in group therapy. Noting that different theoretical schools have different perspectives on group boundaries, she said that each define and honor those boundaries. In Group, boundaries were unclear and rarely discussed.

Second, she expressed concern about how the book was written. What was the impact of a former patient writing a book about his former therapist? This was never discussed with the group. Dr. Buchele believed Mr. Solotaroff exploited the group by using its therapy to make money. This exploitation is more egregious if the Village Voice article is correct in its allegation that Dr.Romero/Dr. Latham also received financial compensation for the book. 

Third, the question of true informed consent emerges because the group’s members were moved up on a wait list for therapy if they agreed to participate in the group. How much choice did they actually have if they felt that they needed to be in therapy as soon as possible?

Fourth, the impact of having a non-group member in the therapy room was not raised in sessions. What effect did Mr. Solotaroff’s presence have on the group? Were group members free to talk about it? Additionally, what was the significance of the author becoming involved in the group member’s lives outside of the office when he interviewed them individually?

“Together,” said Dr. Buchele, “these represent a pattern of boundary violations and unclear, contaminated relationships.” 
In addition, a particularly appalling boundary violation concerned time structuring and a poorly handled termination. At the beginning of the final session, Dr. Romero/Dr. Latham decided that the group needed more time and offered to extend the session “three hours, four hours, whatever it took—he was willing to sit and listen until everyone had been heard from” (p. 291). He changed the time frame at the last minute, resulting in some group members missing part of the termination process because they had planned to leave at the usual time. Termination was murky, contaminated, and incomplete. 

Final Reflections
Mr. Solotaroff only briefly addressed the impact of the therapist’s life on group. Although Dr. Romero/Dr. Latham’s drinking appeared to be under control during the course of the therapy in Group, changes in his behavior were clearly affecting his patients, particularly towards the time of termination. His new office also housed his art studio. Having his art, “hulking and explicit” (p. 231) as part of the therapy office was clearly disturbing to patients. At the same time, he changed his dress from “tailored suits and Fratelli dress shoes” to “black jeans, biker boots, a work shirt and vest, and a Navajo bracelet fretted with turquoise” (p. 231). Although he was not obviously decompensating at this time, he was clearly unaware or unconcerned about the impact of these dramatic changes on his patients.

Given the blurred boundaries, the overarching ethical questions, and the covert impact of the therapist’s personal problems on group, it is remarkable that the patients did so well. Perhaps the book, with all its flaws, is a testimony to the power of groups to heal their members in spite of a seriously flawed therapist.

This article was published in the February/March 2000 issue of The Group Circle.