When a Group Therapist Has Cancer: Therapist Self-Disclosure and Countertransference

Group therapists who experience a serious illness like cancer must navigate several dynamic processes and questions about how to proceed in the best interest of the group. Not much is written on this topic regarding group therapy, so group clinicians have little guidance to understand the underlying dynamics that might help them make the most informed decisions. In this article, I discuss my cancer diagnosis, which required my leaving a psychodynamic process group that I led for almost a decade. I review key dynamic processes that emerged in my final group sessions and present clinical vignettes to illustrate these processes. Dynamic issues that were most relevant had to do with the impact on the therapist of narcissistic injury from a medical diagnosis and the timing, extent, and appropriateness of self-disclosure to the group. Therapist countertransference manifestations included focusing on the self rather than the group, being too bold with complex interpretations, and feeling some relief at no longer having to contain the group's complex and opposing needs. Self-reflection, consultations with trusted colleagues, and discussions with co-therapists can help a group therapist identify and tolerate the inevitable partial countertransference enactments. A group therapist's genuine self-disclosure that is as free as possible of countertransference manifestations and the therapist's modeling of self-reflective capacities go a long way to helping groups make the most of their experience when a group therapist is ill.