sexual expertknowledge

In our days the equal relationship between men and women is a difficult one. In this article we will rethink some of the sexual rituals between men and women, specifically such basic concepts as arousal, desire and also some power-aspects as they can occur in a sexual relationship.

Further down we will discuss the implicit philosophies of therapists, which still remain sometimes unconscious. This would influence treatment options and their effectiveness.

Rethinking a sexual focus, combined with the Object Relation Theory, supplies a clear paradigm for better understanding of both the female and the male partners. Special attention will be given to the understanding of the resistance of men in therapeutic processes. The issue of gender from the male


Louis Sommeling, PhD Psychologist, psychotherapist at the Groningen University in Holland and sexologist at the Rutgers Foundation ( Dutch National Institute for treatment of sexual problems), is Fellow of the Dutch Group Psychotherapy Association and the International Pesso Psychotherapy Federation.

At present he works on a book about Male Desire.


perspective in relation to psychotherapy is until today not very well developed in the international therapeutic community.

Surprisingly, the computer can aid the treatment of sexual intimacy problems without necessarily disturbing the therapeutic encounter. The Sexpertise programs as developed and spoken off here, will assist therapists as well as clients in making some expertise and experience concrete and available. This expertise has been developed mainly by the Rutgers Foundation, the Dutch National Institute for treatment of current sexual problems. (In the Low Countries, initially research was focused on problems resulting from a restrictive sexual morality. During the 1970s attention shifted to the rapid process of sexual liberalization and its practical consequences, such as the need for family planning education and services. The past decade was largely dominated by two issues: sexual abuse, including possible sexual contacts between helpers and clients, and research on sexually transmitted diseases. As most of these studies have been published in the Dutch language only, they have not sufficiently added to the international body of knowledge. This is regrettable because, particularly the Netherlands is now characerized by an open and permissive attitude regarding sexuality, which gives it quite a unique position in the world, not just in terms of attitudes and behavior, but also in terms of research possibilities.)






Today, modern sexologists agree that sexuality is first and foremost a psychological reality. Contrary to previous thoughts, our sexual behavior is not totally guided by a biological drive, but comes as a combination of hormones and humanly learned experience as well as its interpretation. These three factors together shape the characteristics of human sexuality. To say it in a popular way: sex is not only between our legs, but also between our ears!


In aiding our clients as therapists, we should help to become explicit about sexual arousal as well as the hidden needs we human beings are longing for. Also, some attention to the power aspects of the sexual game may support clients in shaping their personal sexual life.



Rethinking sexual arousal.


The arousal curve of the American researchers Masters and Johnson (1966) has been given much publicitity. It showed what happened following effective stimulation of penis and clitoris. This model of Masters and Johnson suggests, briefly, that partners must pass through this whole curve at all times, in order for them to have 'healthy' sex. Actually the effect of this model in practice may be called rather dubious: as if this ought to be everybody's 'natural' reaction, as if one ought to reach this norm in order to be classified as 'normal and healthy' beings. In our daily practice however, if you ask people to draw their arousal curve, this "standard curve" seldomly emerges. Rather, you'll see flat and steep lines, long take-off runs, nice detours etc. (fig.1).




figure 1.




Helen Kaplan (1974) describes how, in its suggestive clarity, the curve of Masters and Johnson turns out to be a simplification of reality: there is no such thing as a continuously rising

process. In physical arousal there are two stages to be


a) a genital-vagocongestive reaction (mainly blood supply, resulting in erection, moistening of the vagina and swelling of the labia)


b) a reflexive reaction of the flesh (primarily muscular, resulting in contraction of the muscles and orgasm).



So, partners, experiencing sexuality, embark on a sort of a two-stage rocket: a continuous stimulation of one stage could ignite the other. The value of Kaplan's findings is the insight that one stage being ignited, does not necessarily imply that the other stage has to be turned on too.

Here is how this has been conveyed to clients in the Personal Sexpertise program. In a mini-lexture on the arousal curve, (submenu for men), the following text appears on the screen:



Arousal does not necessarily have to end in orgasm. If arousal is like a walk up a mountain, then people can also stop halfway for a 'nice picknick on a mountain meadow'. After this, they may return to the valley, or go for the top anyway. So you have more than one way of making love at your disposal. The chosen way will probably fit much better your own wishes and possibilities as a woman or as a man. There is more than penis-centered top-excitement. Using sex this way, men will widen their possibilities of arousal. As a baby, a men's skin was a sensual organ from top to bottom, not just his penis. Later on in puberty boys would feel aroused by a single glance, a manner of walking, a nice figure, a looking forward to a meeting. This wide scale of erotic experiences often fades away for men, and that's too bad. It can be regained, though, for sexuality is not only made up by physically conditioned processes, but above all by ideas we've been talked into in the years that we've been living.




The fact that not only the clients but also many professionals still tend to think in terms of a merely biological model of sexuality too, has far-reaching consequences. To name some examples: unnecessary medical operations are still performed (e.g. for vaginism or a tight foreskin). Mythical prejudices are perpetuated, e.g. about asexuality of older women and men. Also, there are many no-sense making intake questions for clients, such as: "how many times do you do it?". There are more important questions to be asked than e.g. the latter, as we will see in the next section.


Sexual desire: what are we looking for in sex?


Fairbarn, an Object Relation theorist, formulates: "Libido is not primarily pleasure-seeking but object-seeking" (1952). Our needs are deeply psychological and not merely biologically rooted. Sometimes in sexual desire people want to touch mythical depths. At other times they want to fulfill a more basic human need, such as there are: support, nurturance, protection and "limitation" (Pesso, 1991). We can, in some ways of kissing someone else, basically seek the fulfillment of our own need for nurturance. In caressing along our body-contoures, our identity and ego-boundaries are tenderly limitated and validated. Holding one another in the darkness of the blankets, we protect and/or find protection. There are many 'erogenic' zones in the body as places where we can get - not strictly sexual -support ( e.g. behind the knees, the small of the back, the buttocks).

In an amusing story Lilian Rubin gives an illustration of how this can work with mainly not so much biological, but more psychological components of our so called 'sexual' excitements. She interviewed a man who felt very excited when he "got" a women into orally stimulating him; he felt an extreme power over her submissiveness. Then Rubin interviewed his female partner: she felt herself aroused by the same act of fellatio: she experienced power over the extreme vulnerability of the man!

In his investigations Fisher (1975) found at least eighty reasons for people to want to have sex. (For an categorization and therapeutic applications see fig. 2 ).



figure 2.



What are we looking for in sex? When people come with sex problems it is important for therapists, to invite them to think about their needs, by asking such a question. But giving an answer to this question, would suggest that people have an awareness of why they want something. Most of the time however, unconscious needs play a role in the background.

If we ask a client 'What is it you are looking for in sex, why do you do it?', the obvious answer is usually something like: 'Because I love it'. If you keep on asking however, often there turns out to be a good deal more to it. Possible hidden motivations could be: 'to relieve my sexual tension', 'to make another person feel nice and comfortable', 'to prevent a fight at home', 'otherwise I wouldn't live up to the standard coitus frequency of the average man and that makes me feel sure ', etc. People tend to sexualize their human needs. In those cases, they may use an 'improper' way to express those needs. They would have been better served, had they been able to express this some other way.

Inviting clients to think about their sexual motivations will supply alternatives. It creates possibilities to act in a more adequate and personal way and to better meet our needs.

Especially male therapists (Aghassy,1984,1990) can sometimes make mistakes in the interpretation of the behavior of their clients: behavior which looks on the surface 'sexual'can often also be interpreted as testing behavior or as a need for approval, support or affection.


Power-aspects of rules, definitions and therapy-strategies.

Belief systems, rooted in secret sex-specific ideas, sometimes have hidden power in our world. In the section above, we eluded to a different paradigm from the biologically oriented definitions of sexuality as they have emerged in a male oriented society.

Now, in the next paragraphs, we will look more closely to the influence this has had on clients and on therapists.

Sex can be seen as a game with rules (Vennix,1981). Discussing the rules can open couples' eyes for the power aspects of their sexual encounters. The definitions of the rules may seem "natural", but who has written them? It may be helpful in a therapeutic approach, to aid clients in re-owning their own, individually appropriated rules.

The computer program Personal Sexpertise helps to open client's eyes for gender-specifically formulated rules.

Here is an example of a male rule: 'The penis is the organ which offers the most pleasure, so a nicely fitting vagina is the best thing you can have'.

If women were to formulate these rules in a similar way, how would this same rule be reformulated in this case? [In the computerpgrogram the user is enabled to formulate her or his own answer to these questions.]

In this case such could be: 'The clitoris is the organ which offers the most pleasure, so soft fingers or a nice, able tongue is what one should look for in a man'.

A second example of a male rule: 'For me intercourse ends in a lovely orgasm; if she has her pleasure too, that's a welcome bonus'. In reverse the female rule can be: 'As a rule I don't climax during intercourse. I do, if we pet to climax; if he comes too while petting, good for him'.




Therapists should be conscious of the influence their own gender-specific ideas can have on the therapeutic treatments they offer. In the daily praxis of a Dutch sexologist for example, one can often encounter the following scene:

The couple comes in and he may say: "She never feels like it."

She nods "yes" and feels guilty.

He points at her and thinks: "She is the patient".


Which paradigm will lead the therapist here in his/her interpretations? The paradigms in the strategy we offer will have far reaching consequences for treatment!

In the computer program Sexpertise Professional, the program which accompanies the Personal Sexpertise, some choices and their consequences are listed:

As a therapist, you may think:


1. "Most likely there's something wrong with her. For that reason she'll need a psychological or physical examination."

2. "We'll start a therapy to teach her to own her sexual feelings, for that's what she lacks."

3. "We'll try and teach him how to lessen his libido."

4. "We don't speak about sexuality at all, because our focus is on relationship problems; relationship problems are always "deeper" than sexual problems."

5. "We are going to talk about their different expectations and belief systems regarding sex..."


Option 1 and 2 are typically macho points of view: the engine has broken down and must be repaired. She is being labeled as the patient. Therapy based on such assumptions, is likely to fail (the covered agression, showing itself in the body resistance, is not explored). Medical examinations are here performed unnecessarily. Medical treatment is only indicated in the case of physical pain or use of medicine. In most cases there is nothing wrong with the body. That there should be something wrong in a psychiatric sense with the woman is also not the first option in this common case.

Option 2: It is not clear why she doesn't feel like having sex. The problem 'lack of libido' mostly has its cause elsewhere. Maybe he is the one who is a poor lover, who has no notion of her form of sexuality. And she may not be aware either of the fact that she may have her own, different from his, forms of erotic desire.

Often, in therapeutic interventions, a choice is made here for one of the two partners. And often this choice is in favor of the man's optic and against the woman's. (It is assumed that she's the one who needs to change). That is why such a therapeutic intervention is bound to end in failure.

Men will usually say: when sex is okay, the relation will be okay. In reverse women will often say: when the relation is okay, sex will be okay. True, she may, also in this case, turn out to be the one who has an obvious problem. E.g. she can't have an orgasm, even while she herself would very much like to have one. Or she may be so tensed up that a penis cannot enter her (vaginismus) and she for herself would like to change that. This need to change does not need to be only for the relationship, but could also be really for herself. In that case a therapy for her would be indicated. But frequently it is the man too, who has some sort of trouble.

E.g. comparable to vaginismus with a woman, a man can suffer from a tight foreskin; this can also be because he is afraid of sex, or has never learned to masturbate properly. In such a situation, that should also be paid attention to. But not primarily by the doctor: a psychotherapist can provide him with some exercises too widen the foreskin and overcome anxiety.



Option 3: It may be an original and radically feministic option to point towards the male partner as the one who must change. The question is, however, will it become clear this way why she has not been able to solve her part of their problem without therapy? In this option the man is being labeled as the patient: the therapist sides too much in that case with the woman. For that reason this type of treatment is also likely to fail.


Option 4: Couples therapists in general tend to perceive sexuality as a "deeper" i.e. a communicative problem.

If they do so, they will not talk explicitly about sexuality. Such an attitude, however, can also be a rationalization of the therapist's own inhibitions. Many clients, coming to our institute after analytic or mere communication therapy, complain about that, because for them experiencing their problems as sexual, their therapist's attitude is not compatible. Would it not show mere respect for a therapist to enter the intervention through the client's entrance (and perhaps exit by one's own)?

Option 5: In my opinion the choice to talk first about the different expectations and ideas about sex with the client, is the most appropriate. It could be, that the woman does not feel like having sex, because she has no choice but sit at home all day long, while he is out there in the world. Or there may be something else she hates. After all this has been explored and she turns out to be interested in doing something about sex, the problem may be defined as follows: Perhaps sex to them is only having intercourse and it is just that which the woman does not like (but has not dared to speak out bout it so far).


So before starting any kind of sex therapy there are other

things we have to do as therapists. First, it has to become clear that a woman has a right to her own kind of erotic life and this can be different from his wishes. In the same way, we may have to convince the man that there is more to sex than penis-centered arousal. Furthermore we may have to show that sex therapy is not just a question of labeling one partner as the patient.

Generally the difficulty is to be found between partners; so they both have to take their responsibilities. But first of all we have to talk about their different expectations and ideas about sex. Having discussed these topics, the ground is prepared for training new behavior and new forms of making love (and now the body- and skin-focusing aspects of the Masters and Johnson-exercises may be a useful approach ).





The sexual focus as elaborated upon and rethought in the first section of this article, now will be integrated and completed with a perspective which relates to the Object Relation Theory. These two approaches put together, illuminate a paradigm which can guide our therapeutic interventions.

My research shows that group- or communication therapy for couples mostly effects women, in the sense that they become more assertive; men only feel a little more connected, but in general do not experience real individual change (Sommeling, 1991). This article will end by describing our experience with this dual therapeutic focus as a promising perspective especially for men to change their behavior.



Desire and autonomy.


The bridge between the two approaches was built by Winnicot. He formulated the relationship between healthy autonomy and adult sexual arousal management:

'Being able to enjoy being alone with another person who is alone, is in itself an experience of health. Lack of id- tension may produce anxiety but time-integration of the personality enables the individual to wait for the natural return of id-tension...' (Winnicot,1965).


This then leads us to asking an interesting question about sexuality: 'do we seek contact with another person because we are aroused?' or 'do we long for someone and therefore make ourselves excited?' (Schmidt, 1974). Sometimes we have to stand by, wait and sustain, without getting anxious.

To me it came as a shock when someone asked me for the first time, (referring to the Masters and Johnson curve): 'which part is the interactive phase, and which part the solophase?'. The initial stage of love making is highly interactive, there is a lot of contact with the partner and arousal can arise here by stimulating each other. But the middle part in which intercourse and orgasm has its place, is adequately named the solophase. Especially during this latter phase partners will be more on their own and solo. Despite all the romantic illusions about 'togetherness' we can only experience a true orgasm, if we decide to shift our focus of attention away from our partner and more to ourselves , from interaction to individual experience.

(The stereotyped ideal and norm of 'having an orgasm together' only can mean that both individuals have an orgasm at the same time). By accepting there is always 'something between', by realizing our existential aloneness and individuality, we grow till autonomous partners. The so-called 'primary sexual problems' then, rooted in the individual case-history, primarily are to be found in this solophase-area. And the so called 'secondary problems' mostly have to do with a lack of sufficient interactive skills (Everaerd,1981). Today sexual problems with intimacy in men are not, generally spoken, caused by a lack of interactive skills but are primary rooted in their individual case-history (Sommeling, 1992). So in therapy we have to focus on individuation - separation processes too and guide men to develop true autonomy. Psychologists like Nancy Choderow e.a. have described the problematic character of male identity (based in the dilemma of not-being the mother and not being able to find a figure of identification in a psychological absent father). We as men have learned that separation is more real than intimate connection. We are individuated but have not grown to autonomy. We experience often fear for symbiotic engulfment and defend ourselves by drawing our boundaries well by withdrawal and by controlling the other person involved. While deeply longing for connection with the other, we confuse at the same time 'contact' with 'symbiosis', by reactively wanting to claim and to possess women. We throw a "temper tantrum" if we don't get what we so desperately want. Therefore also in sexual relationship true contact is only possible after disentanglement from individual symbiotic illusions and after finding the 'optimal distance'.


Couples therapy and processes of men.

In ten years of group therapy with couples who have sexual desire problems, at first we, the therapists, mainly saw changes in women, but no real individual changes in men. In later years, men also experienced larger changes (Sommeling,1991).

What was the secret of this shifting with the increase of the treatment effects? First of all I was having a relationship with a self confident woman and in my own therapy process was focussing on personal change. But also I had a good working relationship with the female co-therapist; so we became a better identification-model for the couples we worked with.

Secondly, we managed and developed a dual focus of therapeutic interventions. Next to exploring the cognitions about sex as mentioned above, our interventions were more analytically focused on individuation-separation aspects.

By describing Group Focal Conflicts according to Whitaker and Lieberman (1964) we discovered successive phases in the changes the men went through and in the way they were working through their inner processes.

These phases were:


a. Stage of anxious entanglement. In the beginning of group- therapy, couples sit next to each other and speak about themselves in terms of "we".


b. Stage of aggression and accusation in terms of "she" and "he". Men and women are no longer sitting next to each other. The men accuse their wives of not wanting sex, and advise them to go see a doctor or the sex therapist. With this statement men take the one-up position of "sitting in a waiting-room", but at the same time keeping themselves in the submissive position of letting go off the solution of the problem! Here, we get a glimpse of the profound depths of some of men's problematic feelings towards women ( often rooted in negative mother projections); they can "eat" the mother, they have "rights" because they are married and therefore the 'owners' of the female body.


c. Stage of distance, the massive "no" of the women. Women have in this stage developed solidarity with each other, have gronw assertive and selfconfident. This leads to more confusion in the men and they started to feel more scared. 'Blaming my partner' doesn't seem to work anymore in this stage of the grouptherapy for couples.


d. The final stage: transition from individuation to autonomy. The therapists' support is especially needed for men in this anxiety causing stage. The male part of the clients begin to speak in terms of "feeling" and in the "I-form": "I as a man felt depressed, isolated, abandoned and not loved". Such a state of confusion turned out to be the painful condition for the development of more autonomy. Now is the time for the men to slowly start identifying with the (encouraging) male therapist and with the other men in the room, the famous "male bond" (Tripp,1976).



Masculine spirituality.

The difficulty which men co-experience in staying alone for sometime without looking outside themselves for another symbiotic confusion, is beautifully pictured in Nelson's lecture Malie sexualitty, male spirituality (1991):


"Women tend to experience their sexuality as internal, deep and mysterious. As a male on the other hand, I am often inclined to experience my sexuality as more instrumental. My penis is an instrument for penetrating and exploring a mystery which is essential external to me. And the linearity, the hardness, the straightness of the prized erection all are important to my understanding of reality. Then spiritually (...) I am prone to believe that mystery iale sexuality and masculine spiritus "out there" rather than sensing the mystery dwelling within me (....).

The flaccid penis is empty of the engorging blood which brings hard excitement to the phallus. Flaccidity is letting go of all urgency; the spiritual experience of sinking, letting go and emptying is an experience of divine grace, as interpreted in the Christian tradition. It means trusting God that we do not need to do, that our being is enough. It means trusting ourselves to the darkness...."



I would like to conclude here that autonomy is a condition for real sexual intimacy. It seems that especially men have to learn to be alone (which is something essentially different from withdrawal!). Instead of waiting until the woman will love him, a man has to learn the secret that only in a position of true autonomy is he able to be attractive. In that position of autonomy a man can take at the same time responsibility for the sexual and the communicative problems he and his partner are having as a couple. In such a position he will be less emotionally dependent on his partner and consequently claim her less as well.

When one of the male sex symbols of the eighties, William Hurt, won an Oscar, I asked some female clients what made him so attractive to them. Here are some of their answers: "He looks at you, really seeing you too, and at the same time he is true to himself". - "He is his own; he gives a lot, yet does not drown in it". In an interview Hurt himself said: "I think I discovered a long time ago, and rediscovered sometimes, that I am alone - not that I'm lonely, but I am alone".

Only autonomous partners are capable of having a good relationship and a human sexuality which is satisfying to both. The dual focus, as described above, of rethought sexual basic concepts and of attention for autonomy creates a clear paradigm for men to understand themselves.




This article is illustrated with some computer vignettes. Therapists tend to look down on computers, but clients are enthusiastic (Schwartz ,1984). Schwartz studied the use of computers in clinical practice and even mentions transference feelings. Binik (1988) and Reitman (1984) describe the use of computers in self help sex-therapy for some restricted sexual dysfunctions. In the Sexpertise computer programs the expert knowledge is systematized from a Dutch National Institute for treatment of sexual problems .

Reviewed theories on sexuality and therapy experience with today's sexual intimacy problems are made available to everybody (Sommeling, 1990).

The computer program Personal Sexpertise can be used by clients (the use should be supervised by the therapist). The computer program also can be used in some way by people who do not have severe problems. In interactive games Personal Sexpertise helps the user to acquire more insight into his or her own sexual as well as communicative functioning. There are games and mini-lectures on arousal, explorations on 'rules', and questions on sexual motivation. It is also possible to obtain feedback on stereotyped sex -specific roles, in the behavior "macho- or femiscore". The programm supports openness on intimate topics (e.g. fig.1 and fig.2). A quiz analyzes the user's prejudices, exclusively medical thinking, belief in myths, etc.. These games don't have the pretention to be validated tests, but will discuss attitudes and give feedback on cognition and traditional myths about sexuality (like e.g. the famous male myths of Zilbergeld (1978). Information screens on modern contraceptives, sex problems and literature are available as well as simple excercises for treatment of anorgasmia, vaginismus, erectile failure, premature ejaculation and a tight foreskin.

Especially for professionals there is a second program:

Sexpertise Professional. This computer program offers support to therapists, social workers and general practitioners in the field of intake assessment and treatment of sexual problems. Also more 'recent' problems, like incest, sexual abuse, AIDS and problems related to female emancipation are talked about here. Of course, a therapist can never be replaced by a computer.

Without reducing the therapeutic encounter however, the program may prevent the therapist from overlooking some essential questions. Some reflections about options for treatment

are added (individual, partner, sex- or communication-therapy).

Reported effects of medication on sexual dysfunctions are

pointed out.


figure 3


Installed on data-bank or TV-teletext, the information in these computer programs is easily accessible, twenty-four hours a day (fig.3). Already available comparative examples in the field of sexology are the Human Sexuality Computer Service in New York with one and a half million members of their electronic meetings (Lewis,1986); the Minitel program Sexolog in Paris with thousand consultations a month (Waynberg, 1989); and the here mentioned Sexpertise programs in Rotterdam, Holland. Professionals or laymen can get information or put, during day or night, questions in an electronic mail box and be answered in a matter of days.

The Sexpertise program as outlined here has to report in the period 09-89 till 12-90 a monthly average of 345 consultations. In an inquiry 70% of general practitioners are intended to consult the programs 4-20 times a year. The professional version is used by therapists, in some clinics and also for training programs. The personal version - next to use at home and in the context of therapy - has now been used for some years in introductory weeks for entering university students.


This article outlines some perspectives for treatment of today's sexual problems of couples. A paradigm is suggested and concrete applications are described. I hope that both, this article and the computer programs will be a contribution to the solution of a typical problem of our time: finding a way for self confident women and men - both modern autonomous beings - to lead a life of inner freedom and intimacy together.

(dutch demo. Order for english version personal sexpertise




1. A favorable exception is the journal 'Psychotherapy',

Volume 27/Fall 1990/Number 3.


2. Pesso: 'Lacking adequate experience of limit-imposing

interactions, the child is unsure of his or her own boundaries and vulnerable to a sense of omnipotence on the one hand and

powerlessness on the other'.


3. In a lecture at the World Congress of Sexology, Amsterdam,



4. For homosexual couples these problems are more or less

comparable. When in heterosexual couples it is the female

partner who has more outspoken sexual needs, paradoxically it

is my experience that there is probably a problem of a different nature, which lies beyond the scope of this article.


5. A jesuit adage (St.Ignace of Loyola).


6. We like the sometimes so nice and quickly upcoming arousal

of men and their rich initiatives. We only discuss the

always followed stereotype way of behavior. Also women can

handle in stereotyped and merely technical ways of sexual



7. The solophase can be perceived as a metaphor for the

existential aloneness of people. The concepts of solophase

and individuation are related associatively. Only when

individuation is developed till autonomy, people are able

to communicate truly and intimately.


8. Primary problems always were there, secondary problems arise

later on after periods of no problem.


9. Autonomy is a discussed concept. We don't have in view the

19e century concept of a liberal moral culture. Within a

Kantian tradition it is trough dominating our emotional lives

that we assert our autonomy, which is a feature of reason alone. True autonomy has to transcendent false polarities, its is both dependent and independent, emotional and rational, tender as well as strong ( Seidler, 1988). It is adult 'stand on your own'. Autonomy and individuation are different things: autonomy is the area of the real self, individuation is the boundary of that area.


10. According to Whitaker and Lieberman (1964) each group session is a compromise between a wish and an anxiety. By describing

these successive Group Focal Conflicts we 'discovered' the





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