groups

Why Group Therapy Works, Part 4

by Sam Bearer, PLPC

We’ve already looked at how group therapy is a great way to help individuals make changes in their lives by choose to be radically vulnerable with the other group member, fostering in himself or herself an outlook of unconditional positive regard, and allowing the very personal, negative feelings about himself/herself or others to be shared and eventually challenged by the other group members.

This final piece focuses more on how the group can invest and intervene in the individual member’s life. Following the individual work of being open, the group now has the opportunity to disrupt radically the emotional foundations underlying each member’s coping behaviors that got him or her into therapy.

As the group gently and slowly does this work of disrupting the members’ coping behaviors, the internal dynamics of personal guilt and shame frequently rise to a conscious level.  At this point, every man I have seen who comes through our groups retreats back into his comfortable style of relating. It is nearly impossible in the early stages of work for the man himself to see this happening and do anything to stop it.  Often, he can no longer differentiate his personality, style of relating, and identity without an outside perspective or help.  It is no longer a conscious choice.  He may not have even noticed it happening.  But, I am willing to bet 99 times out of 100 that some other member in the group noticed.

The group is meant to be that outside reference point.

Once again, vulnerability comes into play here, because the group member who noticed should be willing to appropriately, with unconditional positive regard, call out his group mate.  This reintroduces all the dynamics of the personal work from part one: vulnerability, maintaining unconditional positive regard, and personal investment.  It also adds to it the gut check of interpersonal conflict. The group members are doing exactly as they should when they can reflect back both the positive and negative they experience in relating to each member.  This work engages members both internally and externally at once.  This may seem obvious, but it is so important, not to mention difficult.  We do this kind of thing in our lives all the time.  However, we are rarely fully engaging our awareness of both pieces simultaneously.  It takes hard work to build up this new skill.  Like learning a new language, we have to take many fumbling attempts to communicate this new way, and we usually struggle at it for a while.  The safety created in the group should promote and celebrate these attempts as well as normalize the experience as something everyone in the group is fighting to do better.  It takes time as well as higher levels of concentration, self-awareness, and intentionality than we generally are used to.

It needs to be said here that this process, in therapy as well as practicing these skills in life, will take some time to sink in.

This is especially true when you consider there are years if not decades of reinforced acting out behaviors that a client wants to change.  It is likely to require a proportionate amount of time and effort for this new way of relating or sense of self to take shape.  Other factors that might increase the length of time and work to be done might be connected to and complicated by experiences of abuse or trauma.  Though the progress may be slower than an individual may like and expect, small changes over time add up to big changes.  These small steps along the way should be highlighted and celebrated as part of the greater changes each client wants to see in his or her life.

 

Why Group Therapy Works, Part 3

 by Sam Bearer, PLPC

Group therapy is a great way to help individuals make changes in their lives.  There are several aspects of group work that help make these changes possible. The first two I’ve talked about focus on the client’s investment in the group process. The first is for each group member to choose to be radically vulnerable with the other group members. The second is for each member to foster in himself or herself an outlook of unconditional positive regard in which it is safe to share, feel, learn, and empathize within the group setting.

The next piece focuses more on how the group can invest and intervene in the individual member’s life. Following the individual work of being open, the group now has the opportunity to disrupt radically the emotional foundations underlying each member’s coping behaviors that got him or her into therapy. This is one of the most difficult parts of group work, but as is usually the case with therapy, it is essential for change.

Each member must allow the very personal, negative feelings about himself/herself or others to be shared and eventually challenged by the other group members.

These negative feelings are both bound up in and displayed by each person’s style of relating.  Almost without fail, these negative feelings have been activated within the first few sessions of group work because of conflicting expectations, styles of relating, radical vulnerability of some members but not others, etc.  However, they most likely have not been fully expressed.

This is so difficult for many reasons. The most common roadblock is that the learned responses to emotional stressors, also known as styles of relating or coping patterns, are so ingrained and automatic that slowing the process down into separate phases or component parts can be daunting.

Individuals often identify themselves as inseparable from their comfortable style of relating.

In our next blog, we will conclude this series on why group therapy works.

Why Group Therapy Works, Part 2

by Sam Bearer, PLPC

In the first part of this blog series, we looked at how vulnerability in a therapy group is key to unlocking positive change in our group members’ lives.  The second way group therapy works is by offering the experience of unconditional positive regard of the group for each particular member, both in a single instance of intentional vulnerability as well as consistently over time.  This experience becomes an emotional touchstone for a reality fundamentally at odds with, and outside of, the negative emotional experiences that so often serve as the foundation for addictive behaviors.  If we didn’t have these negative emotional realities, or had a better way of coping with them, we would not have to resort to our numbing drug of choice. 

The trouble is that at some point we learned to survive the negative emotional storm by using something to numb, and we became hooked. 

As a result, we have lost the internal resilience to be able to handle it.  This dulls our awareness to such a degree that we are no longer conscious of the emotions that drove us to use in the first place.  One unique way that group work helps to uncover these emotions and simultaneously provide an experience of unconditional positive regard is through playing out the relational patterns and dynamics that an individual learned in his family of origin.  However, because the group is not that same environment, the members of this “new family” will respond differently to an individual’s usual style of relating.  For many, this brings up all sorts of anxiety, but it also brings the possibility of learning different ways of coping with these anxieties in the here and now.  Each member experiences the other group members reflecting on how they are affected by each other’s stories and then learns how more accurately to process, reflect, and self-evaluate openly with the group. 

A person may never have considered the questions or perspectives that are shared by others, or he may receive empathy from the very kind of person he assumed would regard him as weak or unimportant.

 The way group therapy ties both of the dynamics of vulnerability and unconditional positive regard together is a safe environment.  This is in part created by the therapist but must be maintained and reinforced by the group.  If safety is not a common value of the group, it won’t be possible to adequately support members or appropriately challenge them, which I will talk about more in the next part of this blog.

Why Group Therapy Works: Part 1 

by Sam Bearer, PLPC

There is a lot of research out there evaluating the efficacy of group work to address lots of different issues. The evidence is clear that group work is tremendously effective in helping individuals make positive changes in their lives.  But why?  For the past two years, I have volunteered with a local ministry that runs men’s groups to address sexual addiction and acting out.  I have had the chance to observe and think about what makes these groups work.  This experience has helped me identify several different components that I believe are key to unlocking positive change in our group members’ lives.

The first is choosing to be vulnerable.  Every man that has come to our group has felt ashamed, isolated, and singled out by the experience of feeling trapped in his addiction or by being exposed in it.  The terrible discomfort of this experience may be enough to get him through the door and into therapy, but it doesn’t mean that the therapy will be effective.  The work each person has to do is to risk being totally open about his struggle in therapy.

Within a therapy group context, there is little room to shade the truth or hide parts of it.

One of the easiest and most prevalent ways of avoiding vulnerability is to share only the parts of the struggle that we have shared before, or can be framed as something that we used to struggle with or happened in the past.  So often, these past struggles are also very much present ones, but by placing it in the past, it puts convenient barriers up which it is easy to hide behind.  We have all tried to hide our struggles at one time or another.

At some point in our story, we learned it wasn’t safe to share and be vulnerable because someone close to us would exploit our weakness.

Group therapy is intentionally confronting this emotional reality and seeking to do the opposite.  Again and again, I have seen group members gently confront each other about whether or not individuals are sharing all of the impact of the story or just the safe parts.  When a group member deliberately and consistently chooses not to hide in this or other ways, it becomes possible for the other group members to empathize, connect with, and enter that individual’s experience in the present.  This willing vulnerability is a sign that change is already taking place in the group member as well as opening the door to the possibility of deeper, positive change.