An accountant by profession, one of my male patients fancies himself to be a rabbi. ‘Moshe’ (to protect confidentiality, identifying information has been altered in all blog entries  containing clinical material) uses the group as his bully pulpit; he gratifies  his oral needs by  pontificating his knowledge of The Talmud, The Commentary  and Jewish law. He is the group monopolizer  but the group is complicit with him.  They use him to avoid abiding by the group contract which states everyone must use an equal share of the talking time. This is a mutually exploitative group resistance.  While members roll their eyes at each other when he speaks, and look totally bored, no one confronted him on his mental masturbation. That is until one session when I began by asking the group:” What portion of the Midrash should Moshe comment on today?”  They were furious with me for blowing up the group collusion.  They wanted to blame him but I protected Moshe and accused them of using him to avoid their own pain.  This is no coincidence.  Moshe allows himself to be used by others in his ‘real’ life as well.  This was an opportunity for him to look at his need to be needed by others, often at his own expense. But this opportunity for insight only lasted for so long. He tried to engage me in a Talmudic argument about the inconsistencies of Freudian psychology. I frustrated his attempts to gratify his competitive oepidal strivings by saying: “Well, it’s only a theory”.  When the group’s confrontations aren’t enough to nudge him away from his self-absorbed pre-occupation, I ask him questions of minutiae that infuriate him: “What was Moses wearing when he climbed Mt. Sinai to receive the 10 Commandants?” “Did  manna from heaven come with condiments?”  “How many portholes were there in Noah’s Ark?”  I would never ask such seemingly disrespectful questions if I didn’t have a strong working alliance with him and the group.   Moshe uses words to cover the pain and rage of his own life: the loss of his wife to cancer, his daughter’s serious illnesses and the host of maladies that he daily suffers as a consequence of obesity, all of which he refuses to address.  I tweak his nose, so to speak, to get at the underlying, denied emotions. It seems to be working.