HOW TO BENEFIT FROM GROUP PSYCHOTHERAPY
Group psychotherapy can be a valuable experience in helping address issues, life problems and personal development. Like other types of therapy, group can be rewarding and affirming, as well as challenging and difficult. Group members often describe very different experiences of group, including how they did or did not benefit. If you are currently in a group or considering joining a group, it is important to consider both the issues and experiences that will help or hinder your participation.
Clarity about your purpose and goals in group is an important starting point. Your goals should relate to the purpose of the group, as explained by the Facilitator. Writing down your purposes and goals is often a helpful exercise; it provides you a tangible form to periodically review. In most groups, there is a process to reflect and review both individual participant's goals and the goals of the group as a whole. Here are sample questions that may help clarify your group goals:
1) What do you specifically hope to gain by joining this group?
2) Are your goals realistic in your view and the Facilitator's?
3) Has the Facilitator indicated these are appropriate goals to work on in this group?
4) How will you measure or evaluate your progress on your goals?
5) What specifically will get in your way of accomplishing these goals?
6) Do you have a specific understanding about how you will work on these goals in group?
Focusing while participating in group is of utmost importance. Focusing includes tapping into and emphasizing your listening skills and acknowledging (to yourself, and if possible, with the group) a variety of feelings which occur as the group begins, proceeds and ends. Some people aren't aware of feelings until a later time. Group often revisits earlier experiences which may be "unfinished". Distractions occur for everyone: Daydreaming, preoccupation, illness, confusion, difficulties discussing certain subjects, unacknowledged feelings about the group and its members are all examples of normal "distractions" that most people will feel from time to time.
A related issue is self-honesty. This may take several forms: How much you share about yourself; Your opinion as it relates to the subjects discussed in group and about the other participants; Feelings about the group as it does its work. People are in group to express their feelings and perspectives, but as in the world at large, many find it difficult to do so, concerned about offending others, being misunderstood or judged.
Group operates on several levels, the most commonly noted are: Content, Process, Intellectual and Feeling States. An important aspect of group is to pay close attention to feelings and to find a way to share them. Particular feelings may be helpful and reflective of your goals: Anger, sadness, depression, rage, hopelessness, grief, pessimism, confusion. For many group members, particularly men, being in touch with, expressing and exploring feelings is quite challenging. Participants often find the group to be one of few places they feel comfortable sharing their feelings. Sharing feelings can often stimulate a discussion, insight, feedback; all of which can assist in working on your issues.
The other side of the feelings continuum is intellectualization. We need our intellect to sort out issues, make decisions and think clearly. However, an over emphasis on the intellect in group discussions usually indicates an avoidance of feelings. Men often take pride in their intellectual capabilities, making headway in the world at large. Group chooses to emphasize feeling states and their significant relationship to problems and issues.One of the ways group therapy is commonly described is, What happens in your life outside of the group will most likely also occur in the group. In group we expect to see the issues that trouble you in life (Do you experience difficulties with relationships and intimacy? You will most likely experience those same difficulties in the group; Do you find people in your life untrustworthy and flaky? You will find some fellow group member[s] who has those characteristics.) Keeping in mind this framework will help remind you to look at the group as at least in part, a reflection of your life.
Whether stated in your goals or not, a key to progressing in group is to take risks and experience vulnerabilities. When do you take risks? Generally, this is reflected in your relative safety, comfort and trust in the group. Safety and trust are viewed and experienced differently by group members, but are invariably affected by the age of the group, how conflict is handled, the group's experience dealing with a variety of issues, the amount of turnover in the group and the relative number of new members, among other factors. Taking risks may simply reflect a desire to push yourself by saying more than you normally would or to reveal more of your inner self.
Vulnerability is related to risk taking in that you may reveal more of yourself, or you may expose yourself to the group and receive confrontive feedback. Such examples may include: Asking for direct feedback about some activity you are involved in; Asking the group to comment on how they see you; Expressing an opinion that may run counter to the prevailing views in the group; Experiencing group as not understanding, comprehending or accepting of you (some people will feel angry instead of vulnerable).
Several common group experiences run counter to working on your goals and obtaining meaning and benefit. The first is reflective of most group guidelines: Discussion and statements should be focused on you; commonly referred to as "I" statements. Most of us were brought up with "you" statements: ("You drive me crazy!"). I statements reflect your experience and clarify the purpose of an interaction, i.e., I feel dismissed and ignored when you don't look at me when I'm talking to you. The process of I statements helps clarify difficult interactions and honors different experiences and perspectives as valid.
Pitfalls in group are plentiful. If you find yourself being too helpful (always focusing on others, asking solicitous questions and bringing people out) you may be acting as the "co-therapist"; a role that often masks the issues you are in group to work on. Everyone in group has the ability to be insightful and helpful; these are not the exclusive role of the Facilitator's. An excessively helpful group member will most like be challenged by another group member if not by the Facilitator, and the ensuing discussion may help clarify what is occurring on several levels for the helpful group member.
If the group finds it is focusing a good deal of time on one person, this may be an indicator that something important is not being addressed. At times, people who are experiencing difficulty in the group do need extra time; overall the group is designed to share time with everyone, even though some people could use more time than others. Common reasons to focus on one group member are: That person is "needier" and thus needs more time; If group members don't "help", they will be left feeling frustrated, hopeless and helpless (or some other intense feeling), which may be similar to how the other person is feeling.
A related pitfall is "fixing" a group member and/or problem solving. At times, members ask for direct feedback regarding an issue, at which time it is warranted to give direct and feedback of a problem-solving nature. However, too much focus on problem solving may indicate a similar process is occurring as stated above.
Often group reminds participants of their families. Every family operates on a "system"; ways of describing the workings of the family as a whole and the individuals and their roles. The group also operates systematically, which sometimes is referred to as the group personality.Some families and groups operate with secrets and withholds. In general, both secrets and withholding have a strong impact on group. The group's progress will be delayed depending on the power, length and influence of the secret.
Withholding can occur in subtle ways. Two group members may share many perspectives and may communicate non-verbally across the room in response to someone's share. Winking, glances, facial expressions, body movements all can represent either conscious or unconscious feelings about what is happening in the moment.
Another family system description that may occur in group is alliances or sub-groupings. Alliances occur when there are particular bonds or shared experiences amongst a sub-set of the group, that does not reflect the whole group. Alliances happen naturally in group, as they do in the outside world. However, the process of working in group can be impacted by an unacknowledged alliance (i.e., the two group members who are the oldest; group members who are overtly different from the rest of the group; i.e., age, race, socio-economic status, class, HIV status, relationship status, etc.).
Sub-groupings also occur naturally in group, and can be viewed as a less dramatic than alliances. A sub-group is any part of the group that has a commonality. Sub-groupings can often benefit the group; it helps to feel less isolated and to recognize specific shared experiences. A large number of sub-groupings can exist if you consider the kinds of issues we sub-group around in the outside world: besides those items mentioned above, we sub-group around hobbies, religion, upbringing, oldest/youngest child, adoptees, height, weight, addiction, sexual interests, etc.
Resistance is a common term in psychology describing those issues that get in the way of the therapeutic process. Most clients in therapy have some experience with resistance. Many of the issues discussed previously are about resistance. Resistance can surface around practical issues, such as the group guidelines: Attendance, lateness, payment issues, socialization, and so forth. A new group member usually agrees to guidelines prior to entering group. In most groups there is an intermittent discussion about those guidelines and how members feel about them. Guidelines can be challenged either passively, assertively or aggressively. There are almost always additional meanings about conflict around guidelines, such as power, control and authority issues, and issues of autonomy.
In most groups, notice to leave is required. Leaving or the thought of leaving brings up an assessment and evaluation of the group as a whole as well as the individual member's goals. Good questions to ask in considering leaving, include: Has the decision to leave been thought out clearly and succinctly or is it an impulsive decision? What has been accomplished and what is there remaining to accomplish in the group? Is there anything significant that is being avoided by leaving the group? If staying is a consideration, what would make the group more valuable?
Group discusses a member's departure, which may include challenges as to the reasons for leaving. Regardless of group feelings, each person needs to decide for himself when the right time to leave is. Each departure comes with a good-bye process, often bringing up intense feelings and connections, appreciation of the group and its members. The group good-bye also allows individuals to look at past departures; it is not unusual for past good-byes to have varied emotions, to be incomplete, sad, and to evoke the complexities of grief.
With such impactful feelings and issues in store, group (as well as individual) termination is said to have an especially powerful impact on the member who is leaving. A certain percentage of group members subvert this good-bye process by leaving early, leaving with no notice, or otherwise not engaging fully in the good-bye process.
Group therapy helps create a strong impression on all of its members. If it does not, something is not working. The Facilitator's job includes helping out all members while in the group in various ways. Most facilitators are willing to be contacted outside of the group in order to help participants sort through difficulties that arise in group.
© 2006 Jaimie Moran