Demystifying group therapy
Kirsten Heynisch, an experienced Clinical Psychologist & Group Therapist, gives us a glimpse into the workings of group therapy.
Group therapy is alive and well and just about everywhere these days – universities, hospitals, psychology departments, rehab clinics, private practice etc. However, I sometimes feel that group therapy is still one of the most misunderstood and underrated
modalities of psychotherapy. Why? Firstly, most clinicians specialise in some form of individual therapy and don’t have experience or training in group therapy, and thus therapists themselves often portray group therapy as second best, which is a great misunderstanding. Secondly, group therapy can be scary – it can be hard enough to share one’s problems with a therapist let alone a group of strangers. In my view, group therapy is powerful and amazing. Having undergone a lengthy training in group-analytic therapy which included six years of being a patient in a therapy group, I have become a great believer in its value. The experience of being in group therapy, whilst simultaneously studying and practising it, helped me see, feel and experience first hand the potential of this therapeutic modality. Group therapy certainly has changed me, my sense of belonging and connectedness, my way of communicating with others. It helped me to feel much more at ease in groups, which is most of the time, given we spend much of our time in groups.
The rich potential of analytic group therapy ... how does it work? Thinking about it, we are all born into a group – our family. Group therapy is a place where one can be 're-familied' or 're-socialised', meaning a healthy group culture can help us to learn and grow in ways that our family of origin was not able to offer. For
instance, most people struggle with how to deal with the conflicts which inevitably arise in families and groups. Also, many of us struggle with the balance between belonging, closeness and intimacy on the one hand; and authenticity and being true to ourselves on the other. Both parts of the equation are core to our experiences in life. Without a doubt, group therapy is a great way to practice and better understand how to relate with others and work on more effective and enjoyable ways to love, argue and negotiate differences. In this sense, group therapy offers a great opportunity to reflect and correct limiting original family dynamics and patterns of communication. Many of us could do with this kind of therapy. Having different and corrective experiences is one of the main therapeutic factors in group therapy. As we grow up, we take on board the spoken and unspoken rules and dynamics that colour the emotional climate within our family. If our family culture was marked by a lack of thoughtful and open communication with each other, we are bound to experience difficulties in our relationships later in life. This is serious, as it can undermine our sense of well-being and belonging and manifest in emotional and relationship problems. In group therapy, the therapist and the group members together develop a healthy and safe emotional climate in which unhelpful patterns of relating can be noticed and challenged. The group becomes a kind of 'play ground' in which new ways of communicating can be experimented with and reflected upon. These opportunities make a therapy group a rich and fertile
ground for change. The group-analytic therapy situation can be likened to a 'hall of mirrors' where the group members learn to see themselves more accurately through the multiplicity of responses and perceptions presented by the group. This is how our often negative selfperceptions can undergo modification. For example, feelings of inferiority ('I am worthless, unlovable, selfish,
unwanted') as well as feelings of superiority can get replaced by a more balanced and, therefore, less anxiety-ridden view of the self. This will result in a more realistic self-image, integrating different aspects of who we are. We discover through the group's reflections that we have gifts, talents and strengths that had been ignored. As our self image evolves from the feedback of
the group over time, we can see ourselves differently – in a more differentiated and true light. This can inspire far-reaching changes and enhance our sense of wellbeing – a hopeful destination to aim for! Stimulating interactions between group members become the focus of the therapeutic work. Reflecting on group interactions becomes a powerful way of learning about oneself and others.
Here is an example: Martha, a middle aged woman, grew up in an oppressive country. Moreover, her parents' expectation of undue compliance undermined her authentic self-expression. Her need for selfassertion was stifled and disapproved off throughout her childhood and teenage years, which was a traumatic experience for her. When Martha expressed anger within the family, she was met with strong disapproval and was often labelled as inconsiderate and ungrateful. This left her feeling bad and unwanted and she became more withdrawn and silent. As an adult, Martha easily felt like a 'troublemaker' when she expressed disagreement, even when articulated in a thoughtful and considered way. This was a major problem as she felt unable to set boundaries with her friends, co-workers and husband. Group therapy offered a fertile ground for corrective emotional experiences around the theme of authentic self-expression which helped her to loosen old relational patterns. In her therapy group, Martha became much liked and valued for taking the risk of articulating some of the more difficult issues within the group dynamics. The group offered a space in which she was able to recover aspects of her authentic selfexpression. Her group therapist also valued, enjoyed and invited her ability to question her and the therapy group which deepened and enriched the group process. Martha stayed in the group for three years and was able to internalize the group's validating and encouraging stance which had changed her and touched her life deeply. By working through these issues, Martha also helped other group members to discover and articulate their own capacity for self-expression and self-assertion as an essential and creative expression of being and feeling alive.
Hesitations to join a group...
It is not uncommon for people to initially feel some reluctance to join a group. Fears that it will be too difficult to talk about problems in the group usually disappear, sometimes quickly, and other times more gradually, in the encouraging atmosphere of the group. Sharing feelings and experiences in an intense, lively and supportive group creates an atmosphere in which mutual confidence and support can develop. Group members often make dramatic changes in their life and relationships, partly through the therapeutic effects that result from seeing themselves in the eyes of others, and partly through the opportunity to witness and participate in the therapy of other group members.
Who is the ideal candidate for group therapy?
Group therapy is for everyone. Why? Everyone deals with groups (family, work, social settings) and everyone has room to improve their ability to relate with others, whether understanding one’s feelings and sharing them or being more assertive and having better boundaries. Group therapy can be helpful for a variety of life situations and difficulties. Anxiety, depression, stress and trauma, relationship issues and low self-esteem are typical problems for which a group might be recommended. It may also be helpful to those who suffer from the effects of loss, separation, divorce or the psychological impact of health-related issues. Group therapy is also concerned with uncovering undeveloped aspirations and creativity of group members. Group therapy affects the deepest levels of the personality and thus is not a rapid therapy.
Group therapy in Chesham...
I am currently in the process of setting up this kind of group in Chesham. If you are curious about this and would consider joining a group, please feel free to contact me on
The Guest House
This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
As an unexpected visitor.
Welcome and entertain them all!
Even if they're a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still treat each guest honourably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.
Be grateful for whoever comes,
because each has been sent
as a guide from beyond.
In this poem, Rumi (1995) compares the essence of being human to the idea of a guest house, meaning that we are vessels for innumerable experiences and emotions throughout our lives: the depression, the joy, the dark thought, the shame, the malice and a crowd of sorrows.
The metaphor of the guest house with its 'new arrivals' and 'unexpected visitors' is associated with the capacity to contain a broad range of human experiences that life brings to us - invited or uninvited. The guest house could be thought of as an inner holding capacity, a psychical freedom, internal strength and continuity which, if well developed, allows us to be with the emotional heights and depths of our lives.
In line with Rumi's poem, I have come to understand that life’s experiences and challenges are un/manageable and overwhelming to the degree that we are un/able to tolerate the feelings they stir up within us. The potential range of experiencing stretches from being open to the beauty of nature, the compassion and love for another to an awareness of our own limitations and brokenness, the pains and joys of love and life, fragmentation and conflict, isolation, disintegration as well as integration and harmony.
What most often brings people to therapy is a real difficulty to accept, contain and reflect some of life's experiences (e.g. loss, separation, disappointments, feelings of loneliness, vulnerability). This difficulty of being present and attuned to our inner experiences and emotional states is frequently related to the nature of our early attachment relationships which can promote or undermine our capacity to feel, think and communicate.
In essence, our capacity to 'welcome and entertain new arrivals' in our inner guest house is often associated with the nature of our attachment relationships we have had in life and what we have been able to internalize from these experiences (e.g. a critical, judgmental inner stance; a kind, accepting, curious, encouraging inner voice or something in between). We tend to identify with and internalise experiences from our early attachments with parents and family, but also other meaningful long-term relationships, perhaps later in life.
Many people, to a varying degree and intensity, have experienced emotional neglect or trauma within the context of their family relationships. This can lead to difficulties later in life (depression, anxiety, eating disorders, difficulties to form and sustain supportive relationships, problems with identity and self-worth etc.).
My therapeutic approach, which has evolved over years of study, clinical work and my own life experiences and self-development, is concerned with identifying and working with these kind of difficulties. The therapeutic aim is to facilitate the gradual unfolding of our life-giving ability of making friends with our feelings - cultivating an inner holding capacity akin to Rumi's guesthouse - welcoming and entertaining expected and unexpected experiences.
Individual and group therapy, and sometimes a combination of both, offer an arena for vital corrective emotional experiences which can enable us to learn to better pay attention to ourselves and our feelings, to become more aware of others and their feelings, to better deal with conflict and the balancing of our own needs with those of others. Learning to change in this way requires a strong and sustained commitment to self-development. This in turn can engender a new sense of vitality and belonging in our life which we can carry into our relationships, families, work and other areas of life.