Abstract
Following a discussion of the treatment of “difficult patients” in group analysis, two theories are proposed concerning a fourth basic assumption in the unconscious life of groups, called “Incohesion: Aggregation/Massification” or “(ba) I:A/M” and the personification of basic assumption processes, in particular that of (ba) I:A/M by difficult patients. These theories are illustrated with clinical data. Special attention is given to crustacean and amoeboid forms of encapsulation as a defence against the fear of annihilation within the context of the traumatogenic process. It is suggested that for difficult patients the treatment of choice is dyadic psychotherapy/psychoanalysis followed by group analysis.
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