運用基本假設團體概念促進邊緣型人格障礙團體成長為例

Using Concept of Basic Assumption Group to Analysis the Process of an Outpatient Group Psychotherapy for Patients with Borderline Personality Disorder

Objective: Using Bion's theory of group development, the authors intend to analysis the process of a long-term outpatient psychodynamic-interpersonal-existential group therapy for patients with Borderline Personality Disorder (BPD) at a medical center in northern Taipei, Taiwan.
Methods: Qualitative analysis was used to examine the data file from July 2009 to June 2010. A total of 44 group sessions were analyzed by using action research (Pam, 2003).
Results: Most of the group members had negative experience of losing significant others, resulted in negative feelings about changes happened in the group and induced group tension. The new-member- recruited-and-old-member-leave phenomenon every three month was a stress to all, separation issues become one of the group major issues. It could be observed that the group got stuck sometimes (e.g. be isolated by lacking eye-contact or verbal response, just guess what happened in the group but no evidence), and was productive sometimes (e.g. self disclosure immediately, be willing to listen and communicate). The former might related to ''basic assumption group'' which could compromise group effectiveness, and the latter was ''work group'' which could produce solutions and products of high quality and usefulness (Bion, 1959). The pivotal points were: 1) whether the therapists could recognize group members' unconscious anxiety or not and 2) the group members' ability of self-perception and self-disclosure.
Conclusion: Because patients with BPD have deficient ability of self-perception, results in dysfunctional reality testing and much more group tension (Yalom, 1995). If the therapists can recognize basic assumption groups, the work of the group will make progress. Patients with BPD will accumulate the ability of reality testing and corrective emotional experiences.