It is important at this point to emphasize the value of humor in the group. Good use of self-effacing (not-defacing) humor by the therapist models compassionate self-acceptance of imperfections, moving away from unrealistic expectations and false self-grandiosity. Humor can also be a defense to deflect pain. Nevertheless, laughing with, not at, one another may be a first for these men. They have experienced being the butt of derision or perpetrated cruel defensive attacks on others due to the need to ally with their abusers.
Countertransference is the hot potato of therapy. It can be the internal barometer of the group's process or one's Achille's heel which will thwart or even damage therapy. The writers have found the following guidelines useful: Co-therapists need to be in close contact, brutally honest with each other so as to monitor transference and countertransference reactions, and to manage the splitting that patients often attempt in group. Consultation is crucial if for no other reason than to avoid the common pitfalls in working with survivors which include over or under identification with the patients, overintellectualization, avoiding the pain, lack of clear and safe boundaries, perpetration, and maintaining an omnipotent or victim stance.
Frawley and Davies describe these transference and countertransference positions, which can be interchanged between therapist and client: the unseeing, uninvolved parent and the neglected child; the idealized, omnipotent rescuer and the entitled victim; the sadistic abuser and the helpless, impotently enraged child; and the seducer and the seduced. 2 We have found these positions relevant in work with male incest survivors in monitoring both transference and countertransference reactions.
The clinically rich but equally tricky re-enactment of the family which occurs in group work, can create problems if the therapists withdraw, are intolerant of their own pain, or feel panicky or stupid as transferential material is directed toward them. In order not to reenact the crazy making situation for the client, therapists must be willing to name and listen to the horror because the abuse survivor was either ignored, discounted, or blamed. The therapist team must stay connected to the client, and to their own issues.
The revolving wheel of victim-perpetrator-rescuer is vital to name in group process. Clients have been victimized throughout life. Therapists want to fix. What could be a better trap than for clinicians to want to "save" the client with brilliant, dramatic interventions. When this trap backfires, both therapist and client may end up feeling entitled or heroic without taking responsibility for present reenactments. Therapists must carefully consider the delicate underbelly of grandiosity, shame. As they help group members negotiate their experiences with responsibility, therapists must also watch a major pitfall of therapist narcissism, burnout. The clinical team will be modeling self-care by setting boundaries, monitoring their over-involvement or overprotective actions which devalue the clients' abilities to take care of themselves.