Terminating a Group

Abstract

Terminating a Group Jill Lewis1 issn 0362-4021 © 2016 Eastern Group Psychotherapy Society group, Vol. 40, No. 4, Winter 2016 357 1 Private practice, Atlanta, GA. Correspondence should be addressed to Jill Lewis, MA, LCSW, CEDS, 1867 Independence Square, Suite 105, Atlanta, GA 30338. E-mail jill@jlewistherapy.com. I started my outpatient mixed eating disorder recovery group in June 2010. I ran it every Monday night, unless I was out of town or it was a holiday. I have truly loved the experience of running this group. It started with five women and at its maximum had nine but usually stayed around six or seven. It was made up entirely of women in recovery from an eating disorder. They came from all walks of eating disorder history, from multiple higher levels of care to having this group as their first exposure to outpatient treatment. The group ebbed and flowed from more of a support group to more interpersonal, depending on the level of insight and on the capabilities of the group. At times, some group members became so sick that it was quite difficult to do true interpersonal group work, which was a huge barrier to treatment, but the group always worked through it. The current group members are as follows. The silent member—we will call her Ashley—is also my individual patient, whom I see twice a week. She is currently a restrictor and binger. Ashley speaks very little and has extreme social anxiety. She becomes very defensive when anyone invites her into the group discussion. She is insightful and smart as a whip. She teases the group when she does speak, because she knows how interpersonal groups are run from her years of being in residential and inpatient facilities. She sees and says things that no one else has the guts to say. She is valuable to the group, but she cannot see any value in herself. She has intense self-hatred and self-loathing that she thinks about everything before she says it and is constantly worried about all of the feedback. She often drops stuff into the room and it is just left there, because the group is unsure how to respond. She enacts her own sense of loneliness and isolation right into the group. 358 lewis Rachel has a history of severe anorexia nervosa, which switched to bulimia and then binge eating. She has also been to residential and many outpatient facilities. She is the “co-facilitator,” and her insight and enthusiasm are brought into the group every week. She can be quite high and low; she brings the drama. She is, however, able to call you out and actually see you. She feels the passion of everyone in the room; it is powerful and incredible. Her favorite line, and something that gets repeated, is “often I go home at night and just rub AHAVA products all over my jiggly body to show myself I am beautiful.” She has become very comfortable with who she is, even discussing the nature of her differently sized breasts. She is a singer and an artist and has created songs about her time in treatment and her eating disorder. Lauren is the recovery-minded member. I worked with her individually for about 14 months when she eventually decided she wanted a dialectical behavior therapy (DBT) therapist and it was time to transition out. I had seen her through three programs and felt quite hurt when she left, because I felt like our work was just getting started. The work between Lauren and me only continues to grow stronger in the group. She and I have a wonderful therapeutic connection, and she has said that I scare her because I see her. She came from a religious background, and she finds safety in Judaism. I also had an inkling that she was a lesbian. Eight months later, she shared that she did not want to be a religious Jew and that she was gay. She has also since transitioned from seeing the DBT therapist to seeing a Modern Orthodox eating disorder specialist, whom she felt was a better fit. Lauren is a powerful group member; she has the...