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Will we grow out of it? A psychotherapy group for people with learning disabilities

A forty-week psychotherapy group conducted along group analytic lines was run in an outpatient department of an NHS trust. The clients had mild learning disabilities. This was the first time that psychotherapy was offered to learning disabled clients within this trust. Many difficulties were encountered in the process of running the group, as has been the experience of others when running psychoanalytic groups with this population (Gravestock and McGauley 1994). Some of the difficulties related to contextual problems. Others were concerned with the painful process of the therapy itself. The pain of the process of thinking about oneself within the group and of being thought about by the therapist was very difficult for group members. This process highlighted the importance and meaning of thinking, and the difficulties associated with thinking for people with learning disabilities. As McCormack (1991) suggests, thinking brings awareness, but awareness can be extremely painful. The countertransference provided a powerful medium for understanding the struggles experienced by both the conductor and the group members. This paper begins with a description of some important aspects of what it means to have a learning disability. The paper then considers why a group analytic approach was chosen. Special emphasis is given to the importance of the countertransference in the process of conducting this group. Examples of feelings of shame, loss and rejection are described from group material and the powerful feelings of ambivalence and guilt evoked within the countertransference in the closing of the group are highlighted. Important contextual and practical considerations for conducting a psychotherapy group within a not familiar with psychodynamic ways of working are also Conducting psychotherapy with people with learning disabilities is not so different from conducting groups with any other client This paper aims to make this evident.