Coyne isn't opposed to support groups that are run by people well-trained to control stress and discourage rumination, and who understand that the group's goals have nothing to do with increasing survival. He thinks that sharing information, having a sense of community, and finding help with practical issues like getting rides to appointments can provide considerable comfort and support. "But if you ask many cancer patients why they want a support group," he says, "they'll say to strengthen their immune system and increase their chance of survival."

Encouraging the false idea that support groups increase survival rates can build false hopes and stigmatize cancer patients who don't participate. "Having a positive outlook won't extend the quantity of life," Coyne says. "And not everyone who has cancer is capable of feeling positive."

Trusting Therapists' Intuition

You've been successfully helping your anxious client learn to calm herself. Sometime between her appointments, you realize that about once each session, you've noticed a quick, barely perceptible twitch at the corner of her mouth. What does it mean? Is there a pattern? Then the thought disappears from your mind again. After all, she's been making progress. Next thing you know, she drops out of therapy.

In an era of behavioral interventions and empirically supported treatments, therapists' intuition—the subconscious sense that something important has happened during a session—has received scant attention. But as Theodor Reik wrote in 1948, therapists constantly are noticing a great deal subliminally—gestures, sense of touch while shaking hands, breath, choice of words, tone of voice, little stresses on certain words, vocal modulations, and rhythm.

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