SUFFERING LOVES THE COMPANY OR THE THERAPEUTIC FACTORS OF GROUP PSYCHOTHERAPY

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Group psychotherapy is similar and at the same time different from individual psychotherapy. The differences are primarily related to the number of participants, in the individual - these are two participants, and in the group - 5-15. This increase in the number of participants means more than the extension of individual psychotherapy to several people at the same time. Multiple participation provides a qualitatively different experience, coupled with unique therapeutic options.

“Everyone will be rewarded according to his faith,” - this is how Mikhail Bulgakov paraphrased a well-known phrase from the Bible. Special studies and documented data show that the more the client believes that he will be helped, the more effective the therapy will be. In every therapy group, there are people who are at different stages on the path to well-being. Group members have long-term contact with those group members who have improved. They also often meet with group members who have similar problems and are successful in overcoming them, which strengthens the belief in positive change and the effect of group therapy.

At meetings of the Society of Alcoholics Anonymous, newcomers are helped to select a curator - a member of the society with a long history of abstinence. Successful members of the community tell stories of their fall and their salvation in meetings, instilling faith in newcomers.

Most people turn to the therapist, being disturbed by the thought that no one else suffers the way they do, that they alone experience incomprehensible fears, suffer from ridiculous thoughts, only they have unpredictable impulses and fantasies that cannot be explained. In this, of course, there is some truth, since many of them have their own "bouquets" of stress factors and what is hidden in the unconscious. The group format of psychotherapy, especially in its initial stages, promotes dissuasion in the uniqueness of problems, which in itself is a powerful factor that can improve the condition. When a person listens to other members of the group, he discovers that he is not alone in his problems, the problem ceases to be so terrifying and insurmountable. Awareness of the universality of experiences prompts a person to open up to the world around him, and then a process is launched that can be called - "Welcome to the people", or "We are all in the same boat", or "Suffering loves company". Despite the peculiarity of human problems, certain common denominators always exist, and the members of the psychotherapy group very quickly find “companions in misfortune”.

Most of the participants in the psychotherapy group, by the time they have successfully completed a course of group therapy, have learned a lot about the functioning of the psyche, the meaning of symptoms, interpersonal and group dynamics, and the process of psychotherapy itself. Didactic learning serves as a mechanism for the initial unification of people in a group, while other therapeutic mechanisms have not yet been "turned on". Explanations are full and effective therapeutic forces. Explaining a phenomenon is the first step to controlling it and reducing anxiety.

There is an ancient Hasidic story about a Rabbi talking with the Lord about heaven and hell. “I will show you hell,” the Lord said, and led the Rabbi into a room in the middle of which there was a large round table. The people sitting at the table were hungry to the point of exhaustion. There was a large pot of meat in the middle of the table, enough to feed everyone. In the hands of the people who were sitting at the table were spoons with very long handles. Each of them could reach the pot with a spoon and scoop up the meat, but since the handle of the spoon was longer than a human hand, no one could bring the meat to the mouth. The rabbi saw that the torture of these people was terrible. “And now I will show you heaven,” the Lord said, and they went to another room. There was the same large round table with the same pot of meat, the people sitting at the table had the same long-handled spoons. The people at this table were well-fed and well-fed, they laughed and talked. The rabbi did not understand anything. “It's simple, but it requires a certain skill,” said the Lord. "As you can see, they have learned to feed each other."

In groups, the same thing happens as the Hasidic story tells: people receive by giving, not only in the process of direct exchange, but also from the very act of “giving”. Many people who have just started psychotherapy are convinced that they are unable to offer other people anything useful, and when they find they can do something important for others, it restores and maintains self-esteem and self-worth. In general, in group psychotherapy, a person achieves a mature balance between give / take, between independence and realistic dependence on other people.

People come to group psychotherapy with a history of negative experiences from the first and most important group, the parental family. The therapeutic group has many similarities to the family, the leaders of many groups are a man and a woman, which brings the configuration of the psychotherapeutic group closer to the parental family. Group members interact with group leaders and other group members in the same way they have interacted with parents and other significant figures in the past. There are numerous variants of interaction models: some clients are extremely dependent on the leaders, whom they endow with super knowledge and arch-power; others fight leaders at every turn, claiming that they are blocking their growth; still others try to create a split between the co-hosts, provoking disagreements between them; the fourth fiercely compete with other members of the group, trying to focus all the attention and care of therapists on themselves; the fifth are looking for allies in order to "throw off" the leaders of the group; the sixth abandon their own interests, ostensibly selflessly caring for other members of the group, etc.

The group format of psychotherapy largely focuses on the adequacy of interpersonal relationships and provides an opportunity to discover new, more satisfying ways of interacting with people. The task of group psychotherapy is not only to analyze children's family conflicts, but, more importantly, to free a person from their influence. The old patterns of behavior are questioned from the point of view of their reality, they must be replaced with new patterns corresponding to reality. For many people, working on their problems together with leaders and other group members is in many ways associated with an unfinished relationship.

Social learning - the development of basic communication skills - is a therapeutic factor that is at work in all therapeutic groups. More experienced members of psychotherapy groups are very good at communication skills and are determined to help other people, they have mastered the methods of conflict resolution, they are not inclined to judge and evaluate, but they are much more empathic and express empathy. In the process of group therapy, a type of behavior is born that can be called "therapeutic", tolerance, the ability to accept and understand another person, which is an indicator of an increased sense of security.

In group therapy, a participant benefits from watching another participant with a similar problem in therapy, a phenomenon called spectator therapy. Imitative behavior helps a person “unfreeze” (the process of loosening the old belief system) by experimenting with new ways of behaving, appropriating effective ones and discarding unnecessary ones. The most important role mimic behavior plays at the beginning of therapy, when group members identify with other group members or with its leaders.

Interpersonal learning is an all-encompassing and complex therapeutic factor. We live in a matrix of relationships, a person becomes understandable within a variety of relationships, this “intelligibility” is provided by interpersonal interactions in a psychotherapeutic group. Usually, in a psychotherapeutic group, the following sequence of interpersonal interactions is observed: demonstration of a symptom (a group member demonstrates his behavior) - with the help of feedback and self-observation, group members better observe their behavior, assess the influence of their behavior on the feelings of other people, on the opinion that is formed among others, on their own opinion of themselves. The members of the group, realizing this sequence, also begin to realize their own responsibility for it, for the fact that everyone himself creates his own world of interpersonal relations. In the future, participants begin to change, they take risks, experiencing new ways of interacting with other people. When change occurs, participants feel grateful that the fear was in vain and that the change did not lead to disaster. The therapy group is a two-way street, not only the peculiarities of interaction outside the group are manifested in the group, but also the behavior learned in the group is transferred outside the group. A spiral of adaptation is gradually launched, first in the group, and then outside of it.

Another therapeutic factor is group cohesion and its importance to the participants. The outcome of group therapy is positively associated with the degree of group cohesion. With understanding and acceptance, group members form meaningful relationships within the group. In the conditions of acceptance, self-esteem, the ability to free self-expression and self-exploration increase.