Group therapy as a way towards sound relationships

As I relocated my private praxis to Berlin, I was surprised how often I’ve heard my clients complaining that they were struggling with being emotionally connected in their relationships(if they had any) and that they were struggling to make their lives a joyful experience. They usually tend to be professionally very successful, creative, pleasant, witty, and yet they are unwantedly alone. They have so many abilities and skills, but it seems that they still do not know how to develop and/or maintain relationships. Some of them are alone for years, some of them are almost compulsively driven in using dating sites, and some of them are stuck for years in the mourning process after breaking previous (dis)functional relationships. They all have withdrawn into solitude as a shelter, but they still feel lonely, isolated, and depressed.

After having dated numerous persons, when a new date again failed, one of my clients desperately said: I’ll end up alone, I’m starting to lose hope. Maybe I’m born incapable of a long-term relationship.” Another client said that she’s been alone for more than five years because: “That’s me...I simply attract people who are not good for me and after all those years I gave up”-She was abused and neglected in her previous few relationships, but she couldn’t stop accusing herself for what she had been through. Another example is a client who was betrayed because his partner cheated on him and then broke up. The client tried dating a few new partners, but each time he ended up saying: “He(his ex-partner) took me everything that was worthy...now I’m empty and I’m nobody.“

Those are just some examples of people who are lonely, live alone, and use dating as a common pattern of finding a partner in everyday life. All clients described above and many others are suffering because they have a conflict between the way they apparently live and the way they emotionally feel have low self-esteem, feel insecure, inferior, worth no love, or doubt their own capacity to love...all those feelings lead to depression and anxiety and activate defensive mechanisms in order to cope with them. In my experience, clients use two main coping strategies: either they strictly stick to their well-known circle of people and hesitate to take any initiative in making new contacts, or they actively and often excessively use dating networks in order to find someone who would love them.

One way or another, they are trying to establish a safe enough distance that would enable the person to be surrounded by people, and at the same time provide a sort of escape to the realm of solitude when anticipation of closeness starts provoking intense anxiety. In other words, they are stuck between their own desires and anxieties and they find this safe-enough distance as the Solomon solution which would provide them a sense of control, so that they could precisely steer their own emotions, instead of being constantly overwhelmed. But safe-enough distance is, as one client said, “as if one would be living in a balloon- one can perceive everything, only one can’t taste, feel or touch it.” That’s why clients who excessively use dating sites usually say they don’t even know whether they are attracted to somebody anymore, or further, they frequently ask how they are supposed to know if they were completely detached from their own emotional experience.

While life in a balloon could be to some extent safe and painless, at the same time it is a life without joy, happiness, or love.

Although this safe enough distance could be worked through the client-therapist relationship in psychoanalytic psychotherapy or some other modality of individual psychotherapy, group analytic psychotherapy would be a therapy of choice for those clients. Change in a group would be:

far more faster - because in a group therapeutic factors are group members as well as the therapist

far more effective - since clients could learn from interpersonal experience with other members

more affordable- the price is usually half of the price for an individual session

than in an individual session.

Instead of a safe enough distance which makes one become emotionally detached or numb, in the group, they would have safe enough space for exploring their emotions and experiences in the “here and now situation”- with other members of a group and a therapist.

Clients usually come to therapy with some problems they detected and were conscious of, but once they have entered the therapeutic process, they start to slowly discover some deeper layers or even some problems they didn’t even know existed. This is particularly true with interpersonal problems because we usually know what is for us especially painful, inadmissible, or intimidating in relationships, but we barely know something if anything about how others perceive us.

Group-analytic psychotherapy was first introduced by S.H.Foulkes in 1940s, at Northfield Military Neurosis Centre, as a first concept of a therapeutic community, which has later been widely accepted and practiced. Group psychotherapy has been constantly changing and developing in order to meet new clinical symptoms and syndromes in clinical practice ever since. Parallel to classic, small-analytic groups, many homogeneous and applied forms of group psychotherapy emerged: groups for panic disorders, acute and chronic depression, eating disorders, the divorced, for the bereaved...

Nowadays group shape is highly influenced by Irvin D. Yalom, who is emeritus professor of psychiatry at Stanford University as well as an author of numerous scientific books and novels. In his novel “The Schopenhauer Cure” he vividly described how intense group dynamics could be and how interpersonal exchange between group members could become a corrective emotional experience.

The basic idea in group-analytic psychotherapy is that each member has their own history of interpersonal relations which they bring to the group and which will sooner or later be revealed. Once some dysfunctional or toxic patterns are revealed “here and now”, they could be analyzed, and interpreted, and in the upcoming group process some new, healthier, and more adjusted patterns could be explored and exercised first in the session, and then in everyday life.

Among more than 10 therapeutic factors in group psychotherapy, three of them proved as most important:

Instillation and maintenance of hope: Hope is crucial in any psychotherapy, but in the group, members could observe the improvement of other group members, which could encourage them.

Universality: Especially in the early stages of the group, the disconfirmation of the client’s feelings of uniqueness is a powerful source of disclosing concerns similar to their own, Clients usually describe this feeling as a “ we are in the same boat” experience.

Interpersonal learning: The group becomes a hall of mirrors, as members build mutual relationships with other members, give and receive feedback, and learn to accept themselves as well as others with all their virtues and flaws. In advanced stages of group dynamics, when old, dysfunctional patterns are unrolled, the group could become a corrective emotional experience for all participants.