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IN DYADIC PSYCHOTHERAPY THE PATIENT must test the safety of the relationship with the therapist gradually. Increasing involvement and regression is accompanied by feelings of vulnerability and assaults on self-esteem. As the patient allows himself more latitude in regressive free association, he comes to feel more comfortable about what he perceives as the therapist's opinions and judgments about him. The patient in group therapy is even more open to assaults upon his sense of himself. Fears about what others in the group will think of him are often the strongest deterrent to joining a therapeutic group. There are more people to be trusted with one's weaknesses and secrets. The other patients in the group are not even professionals trained to help others but as psychiatric patients ought not to be trusted. The group is regarded as a "public" forum whereas dyadic therapy is regarded as "private."1 The group situation seems to present a requirement for greater public displays of oneself and at the same time presents greater possibilities of injury to self-esteem than the dyadic situation.
The purpose of this paper is to discuss various facets of the regulation of self-esteem in group therapy. To what extent can the patient's self-esteem be protected by the therapist in the face of the complex and continued threats to it posed by the group? What methods can be used for this kind of protection? What is the optimal balance of exposure and protection in the group?
Before attempting answers to these questions, a brief theoretical excursion is necessary. Problems of terminology, always treacherous