The Stealth Group

It occurred to me recently that I probably get ten questions about group therapy for every one about anything else we do at the Institute. Many of us feel some confusion about the group process and I would guess that most of us have had an inclination to avoid it, at least initially. We tend to not only undervalue group in the therapeutic process but to misunderstand how and why it is so effective. So why the confusion? I think it begins with the idea that group is no different than the individual session only split into pieces to be shared with the other members of the group, a veritable therapeutic pie. Some of us come to group with an agenda, much like we might if we were attending an individual session. We might arrive hoping to discuss a particular issue and then struggle with finding our moment to speak. If group should end before we have taken our “turn” we will often feel we have not gotten our moneys worth. These approaches belie the efficacy of the group experience. I think we need to look at several important factors to better understand how group can make a difference in our therapy. First,how is a Primal group different than the many other therapeutic groups in any community? From a Primal perspective,we see group as a pathway to feeling, an aid in feeling. A trigger for specific memories that might otherwise be avoided within the individual session. Practically speaking,Primal groups are often larger groups then those we might see in the average therapist’s office. They are also much longer as most groups outside of the Institute will be completed in about an hour and a half. On the other hand we have found we need more time to run a productive Primal group. My group for instance runs at least three hours and is affectionately referred to as “The group that never ends”. Perhaps most important of all is that we are not looking to modify behavior based on how our group participants relate to each other. So what is our view? We see group first and foremost as a microcosm.It represents every group in a sense, the family,school and workplace to name just a few. Rather than describe our experiences in those settings we expose them within the group. We do not need to discuss our difficulties in maintaining relationships or our problems with intimacy because eventually,within the group,those concerns will be revealed and accessible. We see group as an absolute treasure trove of clues, all leading us toward the reality of our childhoods and to deeper feelings. As therapists we find so much to observe and process. Who is consistently late? Who sits in the same spot for each group or closest to the door? Who is struggling within each group or refusing to speak? One can see how feelings previously concealed and suppressed will soon become illuminated. Undoubtedly the perception that I will not get the attention I need or that I am having to share my therapist or worse yet that I am ultimately invisible within this setting are extremely painful feelings. At the same time we must recognize they are connected to very specific memories. Would those memories be triggered within the individual session? Yes and no. Yes, I believe more often than not they would be, but possibly not as compellingly or persuasively and no because it is the nature of neurosis that we will avoid what we most need to feel. Group will often conquer that defense with a sneak attack or a re-creation. I remember many years ago a woman who came to my group,we will call her Jill. Within a few weeks of starting therapy she had assigned specific group members the unspoken task of representing each of her family members. Jill would often say things like “Joe you remind me so much of my brother,you speak to me exactly as he did!” or “Sarah you are the embodiment of my sainted mother”. Then one day a couple of months into Jill’s therapy I noticed something about her behavior in group that changed the course of her therapy. In the individual sessions Jill would describe her family and often in discussing her mother something would just not feel right. Something was off but she could not tell me what it was nor could she get close to the real feelings she had about her mom. The only thing she was able to tell me was that she adored her mom and she was a beloved figure within the family. So I am watching Jill in group and I say to her “You know Jill I have a very clear picture of all the members of your family but the only thing you have to say about your mom is how much you loved and admired her. But Jill, I am perplexed, you describe Sarah here as an exact replica of your mother, right?” “Yes,just like my wonderful mother” says Jill. “Then why have we never seen you respond to Sarah with anything other than hostility in group, in fact, if I didn’t know better I would have to say you pretty much hate Sarah…what might that be about Jill?”  Gretchen