Group therapy offers a potent alternative to individual therapy. Its proponents regard it as a more democratic form of therapy: the therapist is less an authority and more part of the group; all members, potentially, are therapists for each other. It prepares people for the reciprocal nature of social living; for give and take; for receiving and giving help; for centring on the self and decentring from the self. In the busy, computerised, materialistic and often lonely world of the early 21st century, it may hold the key to a new form of community and relatedness.
Many people fear joining a therapy group and are sceptical of its value. There is a belief that only in one-to-one therapy is there the necessary safety and confidentiality to make the therapy viable. There are fears of being painfully exposed in a group, of emotional wounds being unexpectedly opened up, of deeply held secrets being revealed to strangers, of being shamed. There are also fears of competition: how to stand one’s ground, how to find one’s voice. Rivalry can take the form not only of who is the most powerful but of who has the most serious problems and hence is most deserving of help. There might also be intense rivalry for the therapist’s attention and love.
Then there is the problem of dealing with aggression. People who excessively inhibit their anger and are afraid of destructive impulses – a common problem – tend to fear the eruption of hostility and rage in the group. Will they survive, be damaged or damage others?
Of course, people do get angry. A woman in one group became scapegoated in a way that followed a familiar pattern – she evoked strong criticism for missing sessions and arriving late. But then, one day, she fought back, giving vent to long-repressed anger of her own, partly triggered by her relationship with the therapist, and from this she moved to a position of fuller, more satisfying involvement in the group.
Groups are not always the comfort zones that many long for, but this is part of the process of learning about oneself. Emotional development is often not easy but frustration, disappointment, envy and anger, if recognised and expressed in a supportive group, often lead to growth, even transformation. However, this takes time. Group analytic therapy is not a quick fix. It takes time to trust and be trusted. We are talking about months and years, not weeks (although there are short-term applications of the method).
If people believe that psychotherapy is an artificial situation, then coming to a group may change that. There is a quality of immediacy and intimacy that often feels more real than the mechanical or defensive – sometimes “false” - interchanges that happen I everyday life. For many people, this is a compelling experience of interpersonal encounter that can be profoundly illuminating about themselves and their relationships with others.
People come for group therapy for a variety of reasons (excessive anxiety, depression, loss, career difficulties, poor self esteem and so on) and discover in the process a new way of understanding themselves. Usually, the problem is helped – but what is gained is infinitely richer than mere symptom relief.
It is sometimes suggested that group therapy cannot deal with people’s innermost fears and fantasies, the darker side that is seldom shown to anyone, including oneself. Where there is trust in a group, however, this can be done, and to great benefit. In one group, a married man was tormented by his sexual fantasies which, he hinted, concerned his mother and his children. He had not acted out these fantasies, but was deeply ashamed and frightened of them. An older woman who had been in the group longer than him, and who had been helped by the group to talk about her experiences of sexual abuse as a child, was particularly sensitive to this man, listening to him attentively and suggesting that maybe his thoughts were linked to his poor relationship in childhood to his parents – perhaps his fantasies reflected his own wish to be touched, appreciated, loved. He was deeply struck by this link and for the first time was able to talk more openly about his fantasies. The rest of the group, instead of being shocked and condemning, as he expected them to be, were compassionate – there were resonances here for all.
The therapist is in the background, a gentle guide, supporting the process rather than directing it. In this way, the members of the group take on significant roles for each other, and the group as a whole becomes a therapeutic medium. S.H. Foulkes, the founder of group analysis, described the approach as therapy of the group, by the group, including the therapist. People who have been in individual therapy and then join a group tend to find it less hierarchical, more able to generate alternative perspectives, more personally challenging and sometimes more liberating – more playful, even. The experience of belonging to a group over time can itself be healing. To be oneself and to have a sense of belonging: these are valuable achievements in a pressurised, at times alienated, existence”.
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