CONFRONTING DEATH - GROUP-PSYCHOTHERAPY WITH TERMINALLY ILL INDIVIDUALS

A model for group psychotherapy with terminally ill patients is propos ed, one in which the group is homogeneous and open-ended. Cancer and H IV infection are used as examples of chronic, terminal illnesses, and the relevant literature on group psychotherapy with these conditions i s reviewed. Treatment with both sets of patients has been characterize d by considerable variation in the structure, composition, and duratio n of the group. Being diagnosed with a terminal illness is traumatic a nd leads to denial, which may be adaptive or maladaptive depending upo n its behavioral manifestations. The homogeneous, open-ended group enc ourages adaptive denial, which fuels hope and the will to live. The me chanism through which this occurs involves the unconscious identificat ion with the group as an entity. This causes the emergence of a fantas y of a mother-infant dyad, within which can occur reworking of the dep ressive position. Scheidlinger, Turquet and Anzieu are cited to demons trate this unconscious function of the group. Finally, clinical implic ations of such a model are highlighted.