New York State Licensed Psychologist for over 30 years. Private practice in Binghamton and Sidney. Specialize in recovery from child abuse and other trauma and living with chronic illness or disability. How does group differ from individual psychotherapy?
Is group for me?
What are the rules in group?
What else should I know before joining a group?
You might begin by asking, “Should I be in psychotherapy at all?” Before explorers sailed around the world, Europeans didn’t think the world was flat, they knew the world was flat. When you were two or three feet tall, you knew that the way those five or six foot giants you lived with saw the world was the way the world really was. But the map your parents or other adults gave you was a flat map, it always is. You face a different world than the one in which they grew up. The European flat map worked in and around the European continent (we still use flat road maps to drive, for example, from New York to Chicago), but it will land you in the wrong place if you try to use it for intercontinental flights. In the same way, the flat map you got from your parents probably worked in your family, but the further you get from home the more the distortions trip you up. In psychotherapy, we explore the messages (the map) you got from your parents and help you decide which parts work well for you and which parts are landing you in places you’d rather not be. So, if your life is not blooming, if you find yourself in places you’d rather not be (especially if they are several similar places, e.g., a series of abusive relationships.), or if you just feel you could “grow” more, psychotherapy is worth trying.
Advantages of Group Therapy:
1. Members of a group get support from each other, as well as from the therapist. Often the approval of “ordinary people”, the other members, seems to carry more weight than that of the therapist who is a professional paid to be a good guy.
2. Group members tend to feel less “freaky” than people in individual therapy. , Because of something about the human condition, members always seem to find common feelings and themes in their lives, despite the great variety of people who may be included in a group. In his book on group therapy, Eric Berne describes including a terminally ill man in group. The members decided they all had limited life spans, so his problem was the same, only more extreme, than theirs.
3. It is easier to see how others make problems for themselves than it is to see how one does it oneself. Insight often comes when you realize that you sabotage yourself just the way one of the other group members does.
4. Therapists don't have all the answers. In group there are many opinions and ideas.
5. Group therapy tends to be more “alive and immediate” than individual. Members of the group often remind each other of people they have issues with on the outside. These issues are then available to work on directly in group, unlike the issues that are exclusively with outside people.
6. If no other member of the group reminds you of someone outside with whom you need to work things out, psychodramatic techniques can be used to have other group members “play” those people. Psychodramatic techniques may also be used to help members understand connections between thoughts, feelings and behavior, experiment with new behaviors, rehearse anticipated outside encounters, and finish unfinished business .
7. Group members learn, both from the therapist(s) and from each other, to communicate more openly. The group is a safe place to practice before trying out new behavior elsewhere. Group members are rewarded by the appreciation of their fellows, and often by observing behavioral changes in others that they have helped to produce.
8. Group therapy is especially good for developing social skills. It gives you chances to experiment with different ways of approaching a variety of people and getting honest feedback about the effects your behavior has on them.
9. Last, but, especially if you have no insurance, not least, group therapy is substantially less expensive than individual.
Advantages of Individual Therapy:
1. You get the full, undivided attention of the therapist.
2. Some people are more comfortable talking to a single professional individual than to “a group of strangers”. Please note that other group members cease being “strangers” after the first session or two. Some people find it threatening to be alone with a professional who focuses entirely on them, and are more comfortable with being one of a group
3. You get much more time to talk about yourself and explore every detail of your life in individual therapy. Note that one can be in both group and individual at the same time.
4. It often feels safer to talk about things one is deeply ashamed of in individual therapy, though that difference tends to fade after the group has been together awhile.
5. One advantage of being in both group and individual at the same time is that the therapist often sees behavior in the group that is useful to discuss in the individual session, or may, in the individual session, be able to help someone prepare to bring up a difficult subject in group.
Should I join a new group, or one that has been going awhile?
You seldom get the choice. New groups are not started frequently, and, when they are, it is usually because ongoing groups are full, or there are none. Many people want to join a new group where they can learn with the rest of the “beginners”. For my money, it is much easier to start with an ongoing group. Generally, the members are involved in whatever issues the group has been dealing with. They acknowledge the new member briefly and go on about their business. The new member has a chance to observe and get the lay of the land. Eventually the new member hears something familiar and says something like, “Wow! I didn’t know anyone else but me felt that way!” After that, the new member is part of the group.
I once read that penguins on an iceberg push and shove until one of them is pushed off into the water. The others watch to see if that one is eaten by sharks. If not, they all dive in. A new group often reminds me of that story. They all fence around, trying to get other members to open up. When someone finally does, assuming that the therapist and the group are supportive, then they all open up, and the group is off and running. Therapists have lots of methods of helping new groups get started.
Should I join a group that only takes members who have problems similar to mine?
On the one hand, there is no ‘problem’ exactly like yours or mine or anyone else’s. We are all complex human beings with many strengths and weaknesses, and we live in complex situations that are replete with multiple “problems”. On the other hand, there is something about the human condition that enables us to see similarities between even the most disparate seeming situations. Many times I have worried that what X said would upset or enrage Y, only to have Y say how moved and/or enlightened they were by what X said. I like groups that are varied, but I’ve often had someone ask, “Did you put us all in the same group because we had the same problem?”
What are the Rules in Group:
In my groups there are only two rules:
1. There is no violence in group.
2. Information about others learned in group may not be shared with anyone outside the group, including former group members.
To me, at least, both these rules seem obvious. In over thirty years of leading group therapy, I have never seen a violation of the first rule, and only once seen a violation of the second. The last was minor and inadvertent.
Some therapists make other rules. A common one is that group members should not associate with each other outside the group. I was once a member of a group that spent (Wasted, in my opinion.) an entire two hour session discussing a Peking duck dinner that three members had together. The rule makes confidentiality easier, and reduces jealousies and resentments in the group, but, on the other hand, there is much to be gained from members’ experiences with each other outside the group. Furthermore, in relatively small communities, it is hard to avoid putting people in group who are already acquainted and involved with each other. If something uncomfortable happens between members outside the group, they sometimes don’t want to talk about it in the group. Unfortunately, things one avoids talking about seem to keep jumping into the foreground in connection with issues one does want to discuss. Soon it becomes next to impossible to talk about anything. To avoid this, I recommend the following:
a) Members should let the group know if they are involved outside the group, even if it is only one member giving another a ride home.
b) Uncomfortable things that happen between members outside the group are an exception to the rule that you don,t have to talk about anything until you feel ready. It is very important to bring up these issues as soon as possible, no matter how reluctant any of you are to do so.
What else should I know before joining a therapy group?
1. Most new group members introduce themselves by their first names only.
2. Except when it involves something that happened between you and another group member outside the group, you don’t have to push yourself to talk about things for which you don’t feel ready.
3. Many groups, including mine, expect payment for every session, as long as you are a member, whether or not you attend. If you miss an individual session, the therapist, at least theoretically, can use the time to do something else. If you miss a group session, the therapist still has to lead the group. Exceptions may be made for extreme circumstances like extended illness.
4. Only you can decide when to leave group. No one can keep you against your will. You can leave because you’ve gotten what you need and feel ready to move on. You can leave because you can’t stand this horrible group one more minute. You can leave because you got a job in Oshkosh. You can leave for a thousand other reasons. Whatever the reason, it is recommended that you discuss it in group before you leave. Whatever your decision (and it is your decision), it is hoped that you will make it more comfortably after you talk about it.