Dr. Lowenstein's Group TherapybyCharles Petersunn©
I have had requests to provide another story concerning Dr. Lowenstein. I do hope you enjoy it. You really don't need though to read the earlier one ("Teddy visits a therapist") to make sense of the current installment, although it would be preferable to understand her background and the context for her innovative use of group therapy for the treatment of difficulties with sexual intimacy. I hope you like it!
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Dr. Susan Lowenstein was quickly becoming one of the more successful clinicians at Templeton College. Success as a therapist is often built on referrals from satisfied customers, and it was apparent that she had quite a few.
One of her more common referrals concerned socially anxious, inhibited, and shy students. Shyness among adolescent college students is not actually terribly uncommon, but it was a diagnosable medical condition. The American Psychiatric Association had labeled it Social Phobia, Generalized Subtype.
Group therapy was not uncommonly used for Generalized Social Phobia. Group therapy was a natural prescription as it involved the precise stimuli that the patient feared (i.e., speaking to or in front of groups of people), and it provided the means with which to overcome this fear. Many of these groups included quite structured social skills training exercises that had proven to be very effective.
Dr. Lowenstein decided to implement a more experimental approach that recognized that a considerable proportion of the social anxiety of persons with these conditions concerned matters of personal intimacy. Her approach also drew upon her familiarity with gestalt techniques, as well as sensate focus therapy for sexual dysfunction. It was the mark of a creative mind to integrate ideas and techniques across different domains of mental disorder.
She was very excited to get started. If this did indeed work, it was quite possible that she could obtain a grant to further develop her approach. Minimally, she expected to be able to write up her results for a prominent scholarly journal. This could be her first step toward national recognition within her profession. Just the thought of this gave her goose bumps.
She put up flyers around campus seeking volunteers to engage in an experimental treatment for social anxiety, particularly as it concerned dating and personal, intimate relationships. It was not difficult for her to get her initial set of guinea pigs or, well, more respectfully, her first set of patients. As already noted, social anxiety is not an
uncommon problem among college students and Dr. Lowenstein was developing quite a positive reputation.
All of the participants were 18-19 years old, anxious in particular about developing sexual relationships. All of them were very inexperienced, sexually, which understandably troubled them, given their age. It wasn't like they hadn't tried. Most had dated, but they were so anxious and uncomfortable about the opposite sex, or about sex itself, that none had been able to last long within a relationship. It just became so stressful that they cut it off, or were dumped, before the relationship ever became consummated.
Dr. Lowenstein naturally selected an equal number of males and females. It would be important for one gender not to feel outnumbered by the other. In addition, the participants were strangers to one another. The exercises would be complicated by any prior familiarity.
She told them to arrive on Saturday morning for their initial session. Upon arrival the participants were asked to remove their shoes and sit on the floor in a circle. The floor was quite deeply, plushly carpeted, and so was comfortable to the feet and bottom. However, the clinical condition of the participants immediately became evident, particularly when Dr. Lowenstein indicated that they had to sit boy-girl-boy-girl. There was quite a bit of nervous selection. Nobody wanted to appear overly eager to sit next to someone they found especially attractive. What if he or she then decided to move somewhere else? Similarly, they did not want to be the one by whom nobody wanted to sit. So, they felt uncomfortable making a choice and not making a choice. Falling back on their usual approach to such situations, they hemmed and hawed, effectively making no choice.
Dr. Lowenstein therefore stepped in and assigned each of the eight participants to a place around the circle. They appreciated this very much. They could abdicate all responsibility for where they were sitting or, more accurately, by whom they were sitting.
Taking off one's shoes though was still a bit of a problem. Probably half of the participants were stricken with the fear that their feet would smell. Some of them dealt with this concern by sitting uncomfortably with their feet beneath them. Others chose to lie down with their feet stretched out far behind them.
A couple of the girls, however, had difficulty getting comfortable. They were wearing rather tight, short skirts, which were not at all optimal for sitting on the floor. They sat back on their haunches or on their side, constantly pulling on their skirts to keep them from riding up too high.
"Alright then, everybody get comfortable so we can get started."
None of them could really get comfortable. They were all glancing around the room, never making or sustaining much eye contact, wondering what would in fact happen in the group, hoping that they would not have to say anything, worrying if the person next to them was annoyed by their presence, and, with all of these thoughts, nervously stewing over whether they had put on enough deodorant.
"I know you must all be a bit apprehensive about what might or will happen today." That was an understatement. "I can assure you that you will find it to be a wonderfully maturating, actualizing experience. Colleen thought, 'Or, in my case, another traumatic failure.'
Dr. Lowenstein got right to work. She wanted to cover a lot of ground in their first session and so there should be no delay. She did though begin with a few deep breathing and other exercises to help relax everyone. All of the participants appreciated this, although some of them found that it just made them a little dizzy.
"Alright then, all relaxed?" That certainly wasn't true, but they were probably as relaxed as they were going to get. "The first exercise is silent communication. I want the boys to turn to the girl to their left, the girls turn to the boy to your right." She waited for them to follow the instruction. She could see a few faces flush with anxiety. She smiled to herself, knowing that by the end of the session, they would find this to be so much easier to do.
"To begin, I just want you to look into each other's eyes, and try to communicate a feeling without saying anything or making any facial expression. Just communicate with your eyes."
Most of the girls liked this. Colleen, though, found it uncomfortable. She really didn't like her glasses and certainly didn't like drawing attention to them. The other girls were nervous about doing it, but it allowed them to look directly and deeply into a boy's eyes without claiming any responsibility for doing so. They naturally smiled in the process. Dr. Lowenstein corrected them. "No smiling, girls."
The boys didn't like it at all. The girls all had rather pretty eyes. It should be quite nice to enjoy a moment like this, something that they normally would not experience. But, It not only made them nervous to have to look directly into the eyes of a girl. It also made them feel rather silly. What the heck were they suppose to be looking for?
Very quickly they wanted to look away, and they did. Dr. Lowenstein though kept her own eyes on them and quickly instructed them to maintain eye contact.
After awhile, they were able to maintain looking into each other's eyes for a good period of time, at least much longer than they normally would. But, it still did seem rather foolish. They had no idea what the girl was thinking, nor why they were even doing it. It wasn't like anyone was deeply in love. It wasn't long before both the boys and the girls began to mutually giggle and laugh over the silliness of the exercise.
Dr. Lowenstein had expected this. One purpose of the task, other than to help the participants learn to maintain eye contact, was to have them bond through a mutually awkward, embarrassing exercise. They now had a shared experience, one that broke
the ice precisely with regard to their social anxiety. Feeling awkward and stupid in the presence of another person can be overcome when it is evident that the other person feels precisely the same way.
"Alright then, let's move to the next exercise. This time, I want each of you to close your eyes."
That was a lot easier to do. In fact, it was helpful. They could ignore the fact that they were so close to a member of the opposite sex.
"Now, without opening your eyes, reach out and touch the face of your partner."
That wasn't so bad, although Tracie quickly removed her glasses as Carl's fingers bumped into them and would likely dirty the lens. Jason in fact knocked Colleen's glasses off. "Gee, I'm sorry," he quickly apologized. "It's okay," she replied, perhaps even feeling worse herself, as it was her own fault that she wore glasses.
"Now, as you each explore your partner's face with your hands, I want the recipient to first express an emotion of sadness."
They each did so. All of them, course, turned their mouths down, brows furrowed, eyes clenched a bit, and some even dropped their head.
Dr. Lowenstein proceeded through a series of emotions, having each of the group members alternate in carefully studying the affect of their partner based solely on contours of facial expression. It really wasn't that difficult of a task, at least for the basic emotions of joy, anger, fear, and sadness. Everyone felt a bit silly doing it, whether it was the assessor or the target. But, that was again part of the reason for the exercise, to help the partners bond through a task that both found a bit silly and mildly embarrassing.
The exercise was also helpful in getting the partners comfortable with physical contact. As Dr. Lowenstein suggested, "Understanding the emotion of your partner is not communicated simply through verbal expression. We express ourselves physically, through our facial expressions, and we can get to know, to understand our partner, physically, through touch. As you touch, feel, explore, your partner's expressions, try to communicate, through your fingers, an expression of caring, of warmth, of appreciation."
The group members were all quite uncomfortable with direct physical contact. Their palms would become sweaty at just the thought of touching, feeling, caressing, someone else's body. The gestalt exercise slowly acclimated them to the process of touching, exploring one another.
"Now, with both of your eyes closed, I want you to reach out and grasp your partner's hands, holding the other person's hand in your own." Many of them quickly wiped their hands off before they reached out, dreading the thought that their partner would notice the perspiration. "Express with your hand a feeling of warmth, affection, fondness, for your partner."
The reactions to this exercise were quite mixed. Some of them blushed instantly at even the thought of caressing the hand of their partner. A few giggled nervously. All of them, however, slowly grew to the task. It helped considerably that they were instructed to keep their eyes closed.
After awhile everyone had become rather comfortable with the task. Some of them were finding it to be rather sensual, perhaps even exciting. It wasn't like they were actually fondling their partners, and it certainly wouldn't lead to anything. But, perhaps that helped to relax them further. There were no demands, no expectations. It was the type of safe, comfortable, caressing that they would hope to experience on a real date, a real first time.
"Wasn't that nice?" Dr. Lowenstein asked. They all had to agree. It was still a little embarrassing; the fact that it had become so fun was itself a little weird, as they knew it was pretty ridiculous. But, they had to agree that they felt better, more comfortable, more relaxed, at touching each other.
Dr. Lowenstein recognized that it was time to step it up a notch, a significant notch. She went around the circle and handed each of them a blindfold. "Alright, that was just wonderful. But, for the next task, I want to be sure that nobody opens their eyes. Stand up now and put on these blindfolds."
That sounded a little foreboding, but many were thankful for the assurance of privacy. Given the success they had experienced so far, they stood up and happily reached for and put on the blindfolds. Tracie and Colleen first removed their glasses. They put them within the pockets of their skirts.
Dr. Lowenstein double checked to be sure that all of the blindfolds were carefully and securely placed. Once she was certain, she said, "Good, good. Now students, for this next task, I want you to remove your shirts or blouses, and slacks or skirts. You need to get down just to your undies."
Tracie and Colleen's hands went to their breasts and cunnies as if their clothes had already been removed, and Dr. Lowenstein was greeted with a chorus of "What!? "Oh no!" "Seriously!?" "Really?"
Dr. Lowenstein reassured them. "Now patients, you must learn to trust me, your therapist. This is a well established gestalt technique." Actually, that wasn't true at all. "Rest assured, nobody will leave this room feeling uncomfortable, embarrassed, or regretful. I know you feel that way now, but that is why you entered this therapy group. I am here with you, and I will guide you through this. Trust me, and you will thank me later for it."
Dr. Lowenstein's voice was certainly very reassuring. She sounded very confident. She couldn't really be asking them to do something that would be wrong, or that they would regret. She was a doctor, a professional psychologist, and, for that matter, a skilled and well-regarded sexologist. She probably had done this many times before.
That actually wasn't really true. Dr. Lowenstein was a skilled therapist. That was certainly true. She had been practicing for quite a number of years. However, she had only just recently learned about the treatment of sexual dysfunctions through a one-week continuing education workshop that she had attended last summer. It was her own creative genius to expand it to include group therapy.
Dr. Lowenstein began to remove her own clothes. She slowly moved around the circle, noisily removing a bit of clothing as she paused by each student. Social psychology experiments had demonstrated the phenomenon of group conformity. Once the students heard other students participating, that his or her partner was undressing, they would begin to remove their own clothes. They would feel very uncomfortable, very embarrassed, to be the only one not to participate. Dr. Lowenstein fueled the ruse by commenting, "Very good, dear," "Oh my, such a pretty brassiere," and "Good job, son, just place your pants behind you," as she worked her way around the circle.
The students felt an increasing pressure to join in. They could hardly be the only ones who refused to participate in a therapeutic exercise. What if it turned out that they were the last ones to remove their clothes? That might be even more embarrassing than removing one's clothes. What would be a more explicit, concrete demonstration of how inadequate they were? How would they ever expect to get better? And, besides, they were wearing blindfolds. It would all be quite safe.
The boys at first thought that they had it easiest. They readily removed their shirts. A few of them were wearing t-shirts (extra protection for body odor) and Dr. Lowenstein had to instruct them to take these off as well. But, it still wasn't revealing much. Nevertheless, none of them were particularly proud of their chests. Some felt they were too skinny, some felt they were too chubby, some felt they didn't have enough hair, and one felt he had too much hair. None of them liked their abs, and most of them were clearly sucking in their stomachs. "Now, boys," Dr. Lowenstein corrected them. "Remember, nobody can see you, so there is nothing to be self-conscious about." That allowed most of them to relax their stomach muscles, but a couple still couldn't help but continue to try to keep their stomach flat.
It was clearly more difficult for the girls to remove their blouses. They were risking much, much more than the boys. But, still, nobody would see. So, what was the real risk?
They were obviously terribly nervous about it, but also very excited. It was sort of like being at a slumber party, at least it felt that way. Just safe, innocent titillation. There were boys there, of course. But, it was like the lights were off and surely they were going to stay off. A few of them even giggled. What a very strange and exciting exercise!
It reminded Tracie of when she was younger and she and her friends went skinning dipping at Mr. Potter's pond, late at night. She would have never done anything like that during the day, nor would she normally do it at all. But, some of the other girls weren't the least bit reluctant. They quickly tore off the tops of their bathing suits and removed their bottoms and even tossed them on the shore! The boys yelled their approval, and then removed their own trunks.
Tracie reluctantly, but excitedly, followed suit, removing her suit, albeit not tossing it onto the shore. She did hold it up out of the water to let everyone know she had done it. Fortunately, it was dark enough that nobody could see her beneath the water, even though her skin was so pale.
The ones who had tossed their clothes onto the shore had to run and get them. It was dark enough that it wasn't easy to see them, but with the moon out, reflecting off their pale skin, it was still quite a sight. Tracie, though, saw very little, as she couldn't see that well without her glasses.
The group therapy was frankly easier, safer, than that evening. Tracie was in the safety of the therapist. Nothing untoward would happen, whereas it was entirely unclear and unpredictable what might have happened in the pond. And, besides, everybody in this case was blind to one another. Nobody could see anything at all.
Still, Tracie's heart pounded mightily as she removed her blouse. She was so glad that she had worn nice underwear, although she then realized that it wouldn't really matter, as nobody would see them. Well, Dr. Lowenstein would see them. She was always careful to wear clean, fresh, and nice undies when she visited a doctor. She adjusted the straps and cups of her brassiere, not really knowing for sure exactly why.
The girls were revealing more with the removal of their blouses, but the boys perhaps revealed more when they removed their slacks. Both Carl's and Mason's penises were becoming erect. They just couldn't help it. They couldn't see anything, but they could hear girls taking off their blouses and skirts. They readily imagined what that must look like and, even if they couldn't see for themselves, they knew that they were now in a room with four girls dressed only in their bras and panties; four pretty girls in their undies, and them standing in their underwear. What healthy young man would not get a stiff one?
Thank goodness for the blindfolds, though, so the girls wouldn't see their stiffies. But, they knew that Dr. Lowenstein would see them, and they felt terribly foolish. They quickly covered themselves with their hands, hoping she hadn't noticed.
Dr. Lowenstein, a very empathic therapist, could sense the discomfort of the group. Boys clasped their hands in front of their crotches, girls doing likewise or drawing one of their arms across their brassieres. They all nervously altered and shifted their stance, like they were waiting anxiously to go to the bathroom. "Now, which one of you thinks he or she is the most embarrassed person in the room."