Thursday, October 6, 2016

Group Therapy

Supervising a group process at TBIPS has been challenging, for now I must treat many individual members as a single whole. In part, this means that each member of the group can be viewed as if a different self-state of the whole.  The group therapist, when he or she speaks, strives to address the group process and not any one individual member of the group. Still, it is tempting to do sequential individual therapy with varying individuals, especially if the therapist is more experienced in individual therapy. Also difficult is to remember that each member’s comments can speak to what the whole group might be feeling, a feeling of which the group, and each individual in the group, may be unaware and possibly projecting onto the member who speaks what others cannot say.

For example, one member may be quite angry and her anger seems to make everyone uncomfortable. Because it is the group therapist’s job to address the group process and not any single individual, the therapist could wonder aloud how person X came to be the one to hold all the anger for the group given that everyone carries anger and also to wonder aloud how the group came to designate person X as the vessel for its anger. In this way, person X does not have to be shamed for feeling angry, nor is she told to cease behavior that makes others uncomfortable. Not directly interpreting to person X about her anger may circumvent shaming her while at the same time leaving open the possibility to the group that person X might be the courageous one or the scape-goated one, and so on. That we have in common certain feelings serves to decrease isolation and alienation, as well as to bulwark self-esteem and validation.

Interpersonal competence can be learned in a safe environment. Group therapy has the benefit of exploring multiple permutations of interpersonal relationships in the very experience near here and now as they are formed and play out amongst group members. Because transference does not only arise between a member and the therapist but between members as well, other group members are responded to as if they are parents or siblings.

The group therapist is called upon to make her or his comments addressed to the group as a whole instead of having an individual session with one member in front of all the others members. Just as individual therapy includes not only understanding (insight, cognition left brain) but also the building of a relationship between the two members of the dyad, so group therapy includes the building of a group. A sense of belonging to the group can offer the much needed ‘twinship’ experience.

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