At the third session, the same member expressed sympathy for the same woman and both of them shed some tears. By the third session I observed it became apparent that the group was solidly within the third stage, developing the cohesiveness necessary to meet the group goals. When any group member exhibited resistance or antagonism, another member would point it out before a leader had to say anything. I also noticed that the leaders intervened less during the third session than at either of the first two. Group members seemed to have gotten into a rhythm within the format of the group so that strong leadership was not as necessary as it might have been during the first two stages. When leaders did intervene they did so sensitively and carefully, not patronizing the members but assuming they knew why they were in the group and also how the group would help them achieve their personal goals.
Another unspoken group goal appeared to be individuated support. Group leaders and group members both seemed aware that each person had traversed a different life path; that members came from various cultural, religious, and ethnic backgrounds and also that members were of different ages, genders, and sexual orientations. Moreover, each member's experience with borderline personality disorder differed. Some were diagnosed in their late teens and had relatively intensive histories of dealing with the illness via individual counseling and medication. Many of the members were co-morbid with problems ranging from substance abuse to depression. Not all members could be expected to discharge from the group without needing ancillary support, while others could. The diversity exhibited at the group did not overwhelm the leaders at any point and no ethnic or racial conflict ever arose during the three sessions I observed. Substantial gender conflict and communication problems did surface, however, which the leaders had to address spontaneously. For instance, a lesbian woman in the group frequently and vocally disagreed with a male member discussion...
The successful transition from second to third stages proved promising, as only a few members appeared to have stagnated by being unwilling to participate. Similarly, no members were aggressive or overtly antagonistic toward leaders or fellow members during the third session whereas during the first session I observed, members peppered the meeting with uncomfortable interactions and power struggles among group members. In fact, two women during the first session tried to one-up each other on the extent of their self-mutilation. By the end of the third session, neither was expressing any false bravado about their cutting habits. One group member left the room for a few minutes during the first session, in the middle of a tantrum. Group leaders reacted calmly and used the incidence as a springboard for discussion. Their patience during outbursts was exemplary and helped create an environment of trust, empathy, and unconditional support in which all members felt free to express their feelings.
Following the first session, I felt that the leaders might have been too passive in their approach and too willing to let group members settle their own conflicts. However, by the end of the second session and especially at the end of the third I realized that their approach was absolutely tailored for the group and conducive to healing. Permitting group members to take responsibility for their actions created an encouraging environment in which the members with BPD could develop their self-esteem and self-confidence in a supportive environment. Because the members all suffered from similar symptoms, they demonstrated empathy and bonding during the third session. Therefore, group goals of solidarity, trust, and confidence-building were all being met and it is highly likely that by termination all members will emerge with increased self-awareness and self-esteem.
