Chapter 3: CohesivenessChapter 3: Cohesiveness

The Theory and Practice of Group Psychotherapy

Irvin Yalom, Ph.D

CohesivenessCohesiveness

• Cohesiveness in group therapy corresponds with therapeutic relationship in individual therapy.

• Therapeutic alliance is the most valuable variable in individual psychotherapy research.

• In group, it also includes the relationship the pt has with others and with the group as a whole (i.e. that is two more dimensions).

CohesivenessCohesiveness

• Cohesiveness in group represents the “we-ness” or amount of “groupness”.

• This provides the group with a better defense against any external / internal threats.

• Extremely difficult cohesiveness in order to research it appropriately.

• Yalom defines it as a member’s desire to remain in the group. The experience of warmth, acceptance and being valued.

CohesivenessCohesiveness

• It is fixed and can change as the group changes among the stages, composition, etc…

• Of all aspects of cohesiveness, it is the aspect of sharing one’s inner world while being accepted by others, that directly influences self esteem.

• One theory of group effectiveness is that some patients have a poor group history in their life.– Therefore, internalizing the atmosphere of cohesive

group, augmenting a process of self acceptance or self cohesion.

CohesivenessCohesiveness

• In a study of 139 subjects (described on p 52), the subjects state that the most positive aspect of the group was the feeling of security and acceptance.

• In fact, in this study the two predicting variables of positive outcomes were : – group cohesiveness and general popularity.

• Greater cohesiveness = increased disclosure, attendance, influenceability, intimacy and social risk taking.

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• However, this acceptance of others may be challenged by how participants accept themselves.

• As such, two challenges are inherently posed in group. – A person’s ability to establish and maintain

meaningful interpersonal relationship.– A person’ ability to maintain self worth/ self

esteem among others.

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• Self Esteem vs public esteem

• Childhood evaluations from others contributed to an internal reservoir of self worth.

• However, people to some degree continue to be concerned for the current evaluation of others.

CohesivenessCohesiveness• Public esteem - a group’s evaluation of someone.

– This depends on how important group is to person, the frequency of contact, and the relevance of the feedback to person’s traits.

– A discrepancy between self and public esteem leads to dissonance.

– If discrepancy is negative pt can:• Misperceive / deny• Devalue group• Rise to the occassion

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• These esteem issues were influenced by person’s popularity in group.

• 3 variables that did not correlate with outcome but did with popularity are: P60– previous self disclosure– interpersonal compatibility– chosen as leisure companions.

CohesivenessCohesiveness• Group Cohesiveness can also = Hostility

• Other variables associated with cohesiveness:

– try harder to influence other

– more receptive to being influenced

– receptive others and accepting

– greater security and relief from tension

– more participation

– self disclosure

– protect group norms

– group is less disrupted with member leaves.