Patient-Patient Relationships

In the course of individual therapy a great deal of importance is placed on the doctor-patient relationship and on the patient's attitudes toward himself. Soon after we began our method of group therapy, using Dr. Horney's theories and technique, it became evident that an additional relationship was present and was exerting its influence on the course of treatment. This is the patient-patient relationship, and we

consider it equal in importance to the previously mentioned relationships. To be fully aware of how the analysis of a particular individual is proceeding, it would be necessary to understand his relationship with each member of the group, in addition to other factors not under discussion at this time.

As the group begins to operate as an analytic medium, relationships between patients begin to form. It is necessary for the analyst to be aware of these relationships and of their character in order to understand and play his part in the emergence, clarification and identification of neurotic trends. A patient may be involved in several relationships at the same time; he may be competitive, vindictive and destructive toward one person, while appeasing another in a bid for protection, help and admiration. The two opposite attitudes may be expressed in the same breath. He may launch a vindictive attack on one person, and turn with a smile to another for agreement and support. All relationships do not actively affect the analytic process all the time. However, with the ebb and flow of continuing long-term analysis, every relationship will ultimately take the center of the floor. Some relationships in the group are more active, more fraught with conflict, and hence more frequently in the open. A relationship may change abruptly from a hostile one to a passive, friendly, self-abnegating one. When the factors that influenced this change in the relationship come into awareness, valuable insights may follow. On the other hand, some relationships, such as that between