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).


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.

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