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Tuesday, February 9, 2016

Group Therapy Offers Valuable Insight

When I suggest the possibility of participating in one of my Interpersonal Process Groups with my individual clients, most express a similar response: “It’s not for me!” Yet over time I can sometimes help individuals recognize that while individual therapy provides helpful direction for many issues, it has limitations that only group therapy can effectively address. As scary or simply unappealing as group therapy often sounds at the outset, it can be the single best way to understand and improve a wide range of interpersonal issues, whether they are evoked at work or school, with friends or acquaintances, or with those we love the most.

Most people find the prospect of talking about their personal problems with a group of “strangers” daunting, but group members are only “strangers” for the first week. Over time, group members have the opportunity to get to know one another in ways much of the rest of the “outside world” does not.

Most of us interact with other people multiple times a day, but some individuals struggle with feeling alone, isolated or disconnected, a problem group therapy can help rectify. In our “rugged individualist” culture, where we get the underlying message that we should be able to “pull ourselves up by our bootstraps,” many people confuse vulnerability with “weakness,” connection with “dependency.” Sometimes people are embedded in relationships that look good on the outside, but lack the connectedness and emotional intimacy that comes with expressing deeper thoughts and feelings. They may feel fearful of expressing their honest internal experience, afraid of being rejected and abandoned if they do so. Many people then also lack the insight, the skills and the opportunities to learn to engage more openly and effectively with others. As one proponent of group therapy describes it, “all our efforts go to defend our territories and to maintain our survival rather than to recognize the position of the other and to have time and energy to attend to our growth” (Cohn, 2014, p.3). The recognition and exercise of healthy boundaries that group therapy provides us cannot be replicated in individual therapy when one interacts only with one (paid) professional. I sometimes remind my group members that an intervention of any sort by one of them is likely to far outweigh anything I could say.

Several facets of group therapy help contribute to the workings of group. First, group members feel bound by a respect for confidentiality; my experience is that everyone is invested in the desire to keep what’s said in group in group. Secondly, everyone who participates in group therapy shares a goal of resolving some type of interpersonal problem, though the particular goals will vary. In fact, the very deviation of interpersonal goals creates a “microcosm” of sorts, a miniature reflection of the world outside group that provides members with authentic interpersonal experiences. Also, the Group Guidelines, which include a prohibition of contact with one another outside of group, help create a weekly 90-minute window in which members can share issues they may not feel free to tell people in their everyday life, and begin to practice more honest healthy behaviors they haven’t felt confident enough to try outside of group.

Everyone has problems in relationships sometimes, but some people experience a pattern of problems in their relationships that may or may not have been obvious prior to coming to therapy. Much of the power in group therapy lies in the inevitability that the problems people experience in their relationships in the outside world will eventually surface within the interactions of the group itself. Unlike most relationships in the outside world, however, group members are invited and encouraged to “process” the intentions, thoughts and feelings behind group interactions. The space and time that group therapy uniquely allows then provides each member the opportunity to share their experience of what is occurring, and to explore a potential range of responses. Group members can then digest how what they say and do may affect others, and to deliberately decide whether they want to continue to respond in that way, or choose another response.

For example, some people struggle with developing and maintaining a satisfying relationship with a boyfriend or girlfriend. Others change jobs because they find working with certain types of personalities difficult, yet “coincidentally” seem to keep encountering those same types of people. Still others are confused as to why they cannot establish a good relationship with their grown children, or with their parents. Some may struggle with being too blunt, or with being “people pleasers” who have difficulty saying “no” or expressing any negative response to others at all. Any and all of these problems can be better understood and alleviated through group therapy.

Sometimes people experience what has been referred to as “terminal uniqueness,” believing themselves to be such outliers to the “norm” that they feel perpetually alone. Sometimes this sense of isolation can lead to a sense of drowning, as though under some enormous cloud of ambiguous shame. Such people can benefit greatly from participating in group therapy, where they have the opportunity to recognize that, although their individual life situation may be unique, their feelings about it are simply human and, therefore, shared by others. The empathy that arises from the sharing of like-vulnerability is the glue of connection that can warm the heart, fill the soul, and contribute to the feeling of connection and purpose most people seek throughout their lives.

Group members also have the opportunity to learn to recognize how they automatically tend to impose their own thoughts, feelings and motivations onto other group members. This transference of their own experience onto others, known as “projection”, is an ongoing aspect of group dynamics. The people one meets in group therapy will inevitably bring up both conscious and unconscious memories of others in one’s past or current life with whom one has had difficulty. We all make assumptions about other people, assuming that they hold the same thoughts, feelings and motivations we attribute to one of our parents, a sibling, a spouse, or a child. Through these (mostly unconscious) beliefs we end up recreating the same dynamics in group that we experience in our outside lives.

For example, a group member who doesn’t speak much may illicit a variety of responses from others: one may see him, resentfully, as purposefully withholding; another may see her as discerning and wise; still another may presume the individual to be shy, when none of these reasons may actually explain the reserve of this particular group member. Yet, in having the opportunity to recognize and discuss how they are creating these personalized projections, individual group members can start to recognize how the projections they impose on people they associate with outside of group can unwittingly hamper and harm those relationships.

Group therapy isn’t for everyone, but its benefits are potentially boundless. It creates a unique opportunity for people interested in personal growth to learn about those parts of themselves that others observe, and yet, we are rarely, if ever, privy to. It helps us learn to more accurately gauge how others perceive us and how likely we are to inaccurately perceive others. It provides us with the opportunity to analyze and better recognize and understand those parts of us that we cannot see for ourselves. It provides a potentially rich and rewarding experience unlikely to occur in our daily lives. As Shay and Motherwell describe it, “group therapy offers an inimitable context for the in vivo exposure and resolution of myriad psychological and interpersonal issues. Immense benefit accrues from experiencing a sense of belonging, divulging shameful secrets, viewing one’s problems as universal, developing self-awareness in real interpersonal situations, improving social skills, and so on-all unique advantages inherent to group therapy” (Motherwell & Shay, 2005, p. 266).

References:

Cohn, Barbara, R., (2014). Creating the group envelope. In L. Motherwell and J.J. Shay (Eds.), Complex Dilemmas in Group Therapy: Pathways to Resolution, (2nd edn.) (pp.3-11) New York: Routledge.

Shay, J.J., & Motherwell, L. (2005). The challenge of the group psychotherapist. In L. Motherwell and J.J. Shay (Eds.), Complex dilemmas in group therapy (1st edn.) (pp. 265-269). New York: Brunner/Routledge.

By Lisë Osvold, Ph.D; Psychologist at Grew, Morter & Hartye in Raleigh, North Carolina. She has been leading a variety of groups since 1990. She is an active member of the Carolinas Group Psychotherapy Society, and currently conducts groups on Overcoming Emotional Eating, as well as two Interpersonal Process Groups per week. If you are interested in learning more about or participating in an Interpersonal Process Group, please contact Dr. Osvold at 919-786-6088.

GMH Winter Weather Policy


It's the time of year when Winter weather can affect road conditions, appointments, and schedules. Please be advised that each of our providers make their own decisions about whether to come in to our offices when there is bad weather. If you need to cancel your appointment due to weather, please contact your provider directly. Similarly, if your provider decides not to travel due to road conditions, she or he will contact you to cancel or reschedule your appointment. Be safe!

Thursday, January 22, 2015

Our Family is So Busy! Finding Ways to Create Meaningful Moments and Memories

With all the talk of “simplifying,” it seems people are busier than ever.

This increased pace is quite understandable given the impact of changes in the economy over the last decade.  In general, salaries have remained flat while the price of goods has increased.  So not only are people having to work more hours simply to keep up, they are also now commonly expected to take on extra duties as their companies pursue cost-saving strategies of eliminating positions and “right-sizing” their workforces.


In addition to these economic factors, there have been significant cultural changes in how people view “good parenting.” Parents now expect themselves to spend more intensive time (i.e. “quality time”) with their children and to pour more resources into their children than ever before—think elite sport teams, summer enrichment activities, leadership workshops, SAT prep courses, etc.  It’s no wonder parents and children alike are reporting increasingly higher rates of stress, sleep deprivation, substance abuse, and anxiety.

Although there are no quick fixes for these challenges of modern life, one strategy I use comes from the work of psychologist Mary Pipher.  In her book The Shelter of Each Other: Rebuilding Our Families (2008) she documents the ways that society not only strains parents but also undermines parent-child relationships. Pipher describes important research on the three most meaningful experiences people remember from their childhoods: family meals, vacations, and time spent outside.  As I reflect on these experiences, I suspect that each helps cultivate more present-moment awareness and connection—two factors that we now know are essential for health. The good news is that with intention, these are experiences many of us can more regularly incorporate into our family’s general rhythms.

Family Meals—Connecting around meals has been an important ritual through the ages.  The meals don’t have to be home-cooked, though, and they certainly don’t have to be organic or vegan.  Even the most basic meal of pasta or soup can create a space for reconnecting at the end of the day when accompanied by simple rituals such as setting the table, lighting a candle, or saying a blessing.  Due to hectic schedules, shared meals may not be a regular option for some families.  But investing in creating togetherness in this way, even if only once a week, can increase our family experience of connection and belonging.

Vacations—Too often, people think vacations must mean expensive trips to faraway places.  What I’ve learned, however, is that the positive impact of a vacation is less about destination, and more about its ability to provide an opportunity to connect in different—and more meaningful—ways.  When we take a vacation, we help ourselves re-focus on being together, creating shared experience, and being present with one another.  This is especially true if we are able to leave technology behind.  Vacations really don’t have to be fancy or costly; in fact, the more simple, the better.  Vacations can include day trips, car trips to visit relatives and friends, or camping at a state park.

Spending Time Together Outside— The soothing and restorative effects of being in nature have been well documented.  Additionally, we tend to interact differently with each other when we’re in the outdoors—we’re less distracted, more focused, and less stressed.  Having a picnic in the backyard, taking a walk in a park, going fishing, lighting a small bonfire—these are outdoor experiences that can help strengthen connection, and create positive memories.

As with any intention, it’s important to remember that it’s not “all or nothing.”  We don’t have to do these things all the time, or do them perfectly!  Even if we can increase the frequency of these experiences only by a couple of  times a month or year, they can help us strengthen our families, solidify our connections, and provide moments of pleasure and respite from the crazy, fast-paced world in which so many of us now live.



By Kayce Meginnis-Payne, Ph.D; Psychologist at Grew, Morter & Hartye, P.A. in Raleigh, NC. She works with adults experiencing anxiety, depression, and problems with interpersonal relationships. She also specializes in helping people heal from behavioral “addictions” such as perfectionism, people-pleasing, and codependence.


Thursday, January 8, 2015

DBT Family Skills Group

Dealing with an emotionally sensitive child or adolescent can be challenging, aggravating and bewildering.  Parents often struggle with managing their own feelings and needs while remaining connected and compassionate to these sensitive children who seem to demand so much. We are happy to offer a 12-week workshop series designed to provide parents with the skills to better cope with and support their emotionally reactive child or adolescent.

DBT, or Dialectical Behavior Therapy, as developed by Marsha Linehan, PhD of the University of Washington-Seattle, is a skills-based training that has demonstrated effectiveness in helping emotionally sensitive/reactive people to manage their lives more effectively.  The Family Skills Training Core Foundation Skills taught in this workshop are based on The DBT Family Skills Training Manual by Perry Hoffman, PhD of Cornell University.  Most people who have gone through training in DBT agree that this is “basic training that everyone should have.” We all need emotional awareness to be the best parent/friend/spouse possible.

As parents, you have read the books and followed recommended child rearing practices,  However, if your child has mood regulation difficulties he/she can quickly escalate their behavior to the point where the whole family seems to rise and fall with the mood.  Safety can become an issue as well as what the other children in the family are being exposed to.  We also know that biological vulnerability plays a large role here, and often one parent or another is up against the same challenges.  When parents are involved in changing, the child/adolescent receives the most effective modeling possible. An underlying principle in DBT is that we are each doing the best that we can AND there are more skills to learn!  The changes you make now will benefit future generations to come.

In this workshop, parents learn the same DBT skills that their child is learning, in order to help the entire family to communicate and function in a healthier way. As a parent, learning DBT Skills will allow you to:
  • Help everyone in the family to get their needs met.
  • Help understand the difficulties encountered by those who are emotionally sensitive and reactive.
  • Improve family communications and relationships.
  • Gain a common language with your child or adolescent and support his/her in learning new coping skills.
  • Provide structure to constructively and safely problem solve.
  • Reduce the level of emotionality in the family when talking about difficult issues.
  • Increase respect for your child’s efforts in trying new skills, along with encouragement to implement them.
  • Reduce shame and blame, providing new understanding and a problem-solving attitude.
  • Assist family members in changing aspects of family functioning for the benefit of future generations.

DBT skills Include:
  • Core Mindfulness Skills
  • Interpersonal Effectiveness Skills
  • Emotion regulation Skills
  • Distress tolerance Skills
  • Validation Skills
Each FST series runs for 12 sessions.  We will be meeting weekly on Tuesdays starting January 27, 2015 from 6:30 to 8:00 PM in the group room at GMH.  The sessions are $60 each and the whole 12 weeks is offered as a package ($720 total; payment can be made in installments).  A discount for two members from the same family is offered ($50 per session per person; $1200 total for two). Although we normally file insurance for our patients, insurance does not cover skills based training programs.

Space is limited so that each group member gets maximum benefit.


Co-lead by Mary Anne Hartye, PhD and Biancamaria Penati, PhD in Raleigh, NC. They have been working together as a team to help children and adolescents, and their parents, for over 18 years. To sign up for the series, please leave Dr. Hartye a message at 919-406-6179.

Tuesday, December 16, 2014

If you’re not having a “great” day, is it your fault?

Can anyone identify when the seemingly standard farewell changed from “Have a nice day,” to “Have a great day?” And did people’s experiences of their day actually get better either during or after that transition?

Just recently I saw a Coca-Cola™ advertisement on a billboard with, of course, two young, active, incredibly good-looking people, obviously having a great day, that said, “Open happiness.” And I wondered, how many people actually feel happier after they open a Coke? Most importantly, however, I wondered if anyone felt worse because opening a Coke didn’t make them happier.

Now the reader may want to assure me that, of course, people are not really influenced to believe such magical cause-and-effect relationships as the world of advertising consistently tries to persuade us to believe; we know that opening up a bottle of Coke won’t actually lead to happiness. But, do we?

Consumer culture, which abuts nearly our every move, exhorts us constantly to do, eat, drink, bet, buy, or go, generally promising that to do so would make us somehow better off, happier, ensuring a better (now even, perhaps, “great”) day. My question is whether the underlying message leads us to question that, if we are not having a “great day,” is it our fault for not doing so?


Many people suggest that greetings and farewells are usually experienced as benign transactions. When our coworkers greet us in the morning with, “Hi, how are you?” they don’t really want to hear that we just learned that the sewer pipe needs to be replaced, do they? Or that our spouse ran through a list of irritations about us just before we left the house. The “How are you?”, “Fine” exchange doesn’t set up the expectation that we are doing “great,” however. “Fine” is a generally benign word; “great” tends to set up a different, hyperbolic expectation.

I wish to present some anecdotal evidence to support my concern about a possible unforeseen negative consequence of changing “Fine” to “Good,” to “Great.” Sometimes, when I hear that one of my clients is feeling down or depressed, I ask her if she can distinguish what percentage of her is just the feeling, and what percentage is feeling badly about having the feeling.

My experience is that, most of the time, she identifies a greater percentage of the latter than the former, sometimes with twice the percentage in the “feeling badly about feeling badly” portion of the equation. I then suggest that the portion that she probably has some immediate control over is the “feeling badly about feeling badly” portion. What if she just allowed herself to feel the feeling? To just feel sad, or lonely, or angry, and let go of the negative judgment for having such feelings?

The desire to avoid negative feelings is common, but the drive to avoid them all together is also, unfortunately, common. This drive sometimes leads to addictive behaviors (the kinds of behavior we are encouraged to engage in by consumerism--do, eat, drink, bet, buy, and go). If you are not feeling good (or better yet, great!), there is surely something you could be paying for that would change that.

Author Ann Wilson Schaef contemplated this connection in her 1987 book, When Society Becomes an Addict. Schaef observes the United States culture as a whole to be a breeding ground of addiction and describes the enormous challenge of trying to live a healthy and engaged life in a culture that promotes addiction (i.e. the pursuit of feeling “great”, often at the expense of reality).

So what is the cost of running from sadness, loneliness, anger, and other normal feelings while chasing that fun-filled, happy, “great-day” life? When people actively seek the avoidance of negative feelings, it can inadvertently lead to an even worse experience: clinical depression. Sadness and loneliness are a normal part of the experience of being human; depression need not be. The perennial exhortation to “Have a great day,” may unwittingly lead some people to feelings of self-doubt: “Why aren’t I having a great day?” and then, “What’s wrong with me for not having a great day?” and finally, possibly, “It’s my fault for not having a great day.”

So I’ll stick with “Have a nice day.” Although, come to think of it, I generally prefer people to have whatever kind of day they’re having anyway, without feeling badly about it.


By Lise Osvold, Ph.D; Psychologist at Grew, Morter & Hartye P.A. in Raleigh, NC. She works with adults and adolescents in individual, group and family therapy, and has special interest in working with people with eating disorders.

Wednesday, December 10, 2014

Self-Hypnosis Training Group for Cancer Patients

We are excited to announce that GMH staff member Deborah Planting is leading a Self-Hypnosis training group for cancer patients and their caregivers through her affiliation with Medical Hypnosis Consultants PLLC at Duke Raleigh Cancer Center.  

Learn how to use Self-Hypnosis to help in managing your illness and the symptoms, reducing pain and stress, controlling the side effects of medications and radiation therapies, and generally enhancing quality of life.
When:  Thursdays 5:30 – 7:00 PM, January 8 – January 29, 2015 (4 weeks)
Location: Duke Raleigh Cancer Center, Duke Raleigh Hospital, Medical Office Building #7,    Cancer Center Board Room, 3404 Wake Forest Road, Raleigh
Register: Leave a message at Duke Raleigh Cancer Center: (919) 862-5984.                                 Group is limited to 12 participants
Fee: Free to cancer patients; caregivers are welcome on a space-available basis 
Offered by: the Duke Raleigh Cancer Center                       
Taught by: Medical Hypnosis Consultants, PLLC
 Led by: Deborah Planting, M.A., L.P.A., Certified Clinical Hypnotherapist

Tuesday, December 9, 2014

There is No Try

In the Star Wars movie The Empire Strikes Back, Yoda says, “There is no try.”

Try is such a strange word.   Try means to make an attempt or effort to do something.  In other words, “to try” something implies the possibility of failure.  And nobody wants to fail.

When I was 8 years old, I learned about the difference between “trying” and “doing.”  A part of the curriculum of my summer camp was to learn how to dive from a very high diving board.  I was petrified.  That first day, I slowly began to climb the long ladder up to the board.  At one point I was so scared that I told the counselor I couldn’t do it anymore.  He had told us previously that we should “Never say, ‘I can’t.’ Always say, ‘I’ll try.’” 


At that moment, he agreed that I could stop climbing because at least I “had tried.”   The next day I did the same.  I really “tried,” but felt I just couldn’t make it to the top.  And then I caught on.  As long as I “tried,” I would never have to actually jump off that scary diving board.  And guess what?  I never did.

If you “try” to change a habit, you either change it in a given moment or you don’t.  We sometimes attempt to create the perception of action by “talking about trying” but the truth is, it’s only once action has been taken that anything has been accomplished.

And thus, I agree with Yoda: “Do. Or do not. There is no try.”


By Deborah Planting, L.P.A. at Grew, Morter & Hartye in Raleigh, NC. She works with individuals using cognitive behavioral therapy and solution-focused techniques.  She is a certified Clinical Hypnotherapist and has received extensive training in Neurofeedback.
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