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Author: Jeremiah Donigian
Many group therapy models developed from individual psychotherapy. Thus, change usually took place as a result of the therapist conducting individual therapy in the group. Hence, crucial elements for change were limited to the dynamics of the interaction between therapist and client. It is my belief, however, that for group therapy to be a unique system for change, it must escape from its earlier roots and be conceptualized as a social system. As such, it can be divided into three subsystems which will be referred to as elements: l) member, 2) leader, and 3) group. Each element is equally important in the group process.
Group therapy occurs as the result of the interactive process between the three elements. It is, therefore, important to consider all of the elements in interdependent relationship to each other. A change in one effects a change in the other (von Bertalanffy, l968). Consequently, it is incumbent upon the student of group therapy to focus upon the transactional processes occurring among and between the elements of the group. Using linear thinking to understand the dynamic interactive process of the group will not work. Simple cause and effect relationships do not exist. This leads to the following assumption: Since therapy groups are living social systems, then regardless of where the therapist makes an intervention, its effect will be felt (have an impact upon) the rest of the system. Therefore, the therapist needs to consider how an intervention will effect not only the element being focused upon but how it will affect the other two. In essence, to touch one element is to touch all three; which in turn elicits or releases group processes.
Types of Group Processes
Member behavior can elicit group processes. For instance, a member in one of our groups was talking about her sense of "emptiness." The more she talked and described her emptiness, the more involved members became by sitting forward, some crying, some touched deeply. Group behavior would have depicted eight members "leaning" towards the talking member. The female member by talking in such a way about her "emptiness" acted as an emotional stimulant to the group eliciting the group property of emotional contagion which elicited the involvement of the group at an emotional level.
Becoming experientially involved in a group leads automatically to conflict. It is an unavoidable consequence. Generally, conflict pervades each element at varying degrees of intensity and throughout the life stages of the group. The conflicting issues often are over such existential matters as significance, authority, autonomy, attraction, intimacy, dependence, growth, change, power, control and loss. These issues cut across and through each of the three elements. Neither the group, individual members nor the leader(s) are exempt from experiencing them. Experiencing conflict is what the leader holds in common with the members of the group. However, the difference for the leader is to have come to terms with these issues. By acknowledging or recognizing their existence allows for the leader to have access to what provides for the emotional intensity that ultimately powers the therapeutic process.
Anxiety is a state of continual tension resulting from unsuccessful attempts to cope with internal conflicts, the roots of which lie in earlier conflicts occurring in our first group - our family of origin. When confronted by conflicts presented in a therapy group (for example a member revealing how she was abused by her father), in response, members may experience internal rumbling inside their stomachs, or a sudden sense of emptiness that will not go away. When this state of tension persists, members want to make it go away and may employ restrictive solutions (Whitaker & Lieberman, l964) such as changing the subject of group discussion, attacking the talking member, ignoring the member, detaching themselves from group or talking at an intellectual level. If successful in reducing the tension in this manner, a member interferes with another member's learning, the group's development, as well as self growth.
If on the other hand, members employ enabling solutions (Whitaker & Lieberman, l964), such as allowing themselves to listen more openly to other members, experience the anxiety and talk about it, then anxiety can be a friend. A step in the right direction is to allow oneself to talk about feelings in response to the other members.
Several assumptions can be drawn regarding the role of anxiety and its impact on group process. First, specific issues or themes relevant to members' concerns can arouse anxiety in all the three elements. Second, either member(s), leader(s) or the group will attempt to curtail the level of anxiety by enacting restrictive solutions. Third, anxiety, in general, should be distributed among group members and not vested in one group member. Fourth, anxiety is a mobilizer of group process. The more distributed and intense the anxiety, the more evident the solutions acted out by group members. Thus, more therapeutic data and clues are available to the group therapist.
A group with minimal anxiety will typically result in minimal interactions and involvement. Without tension in a group, a therapy group is rendered useless and dominated by restrictive and few enabling solutions.
One of the most significant values of group therapy is that it provides an opportunity that is not available in individual psychotherapy for checking one's behavior out with other persons and receiving feedback from the group as opposed to a single individual. The primary function of the group is to facilitate individuals to gain effective interpersonal skills for coping with their other social environments. The group provides a setting where the leader's views may be openly called to question and confronted. It is an important moment when authority figures are challenged and can simultaneously be validated as to their purpose in the group. Similarly, the group as a whole can receive validation from individual members and the leaders as to the facilitative value or lack thereof of its behaviors. Nowhere else can we find ourselves saying this about a therapeutic relationship.
The notion that all human beings are similar is not new. Yalom (l985) has stated that once members of the group begin to interact, they soon discover that they have more in common with each other than not. This further supports why it is important for leaders to use all of the skills they can muster that will lead to getting members to interact with themselves. The more leaders are able to help members recognize the similarities of their experiences and feelings during the early stages of the group, the more they will be also facilitating group unity.
One's family of origin and childhood conflicts never cease being an influence on current behavior in the group. In many ways, the group resembles a family. There are the parent figures (co-leaders) who represent authority and there are the members who easily can represent siblings. It is quite common to observe and expect that members will play out old family scripts, including assuming the same that was held in the family; as well as facing unresolved issues with authority. Recognizing that this occurs and when it occurs can provide leaders with the opportunity to help the member(s) work through these old emotional impasses and unfinished family business by having the member(s) test new approaches to dealing with these issues in the group. By helping the member(s) to take a more here and now focus, the leaders can avoid engaging in the past (there and then) and have the reality of the current interaction with members (and even the leaders) receive the focus of attention.
Instillation of Hope
Those who come to therapy are in all likelihood feeling hopeless. They probably have made many attempts to solve their problem(s) and all have failed. In such cases, patients seek out or find themselves in therapy and see it as a last resort. The task of the leaders is to believe in the value of their work and in the power of the group (Yalom, l985). For as members of the group manage to come to terms with their own issues, they model for others the possibilities for their own success.
Leaders need to reframe the way they think group. It was proposed that therapy groups are to be viewed as living social systems and that what distinguishes interactive group therapy from individual therapy is the presence of group process. These group processes evolve as a result of the interdependent interaction that occurs between the member(s), leader(s) and the group. It is the recognition and management of these processes; as well as understanding how they are generated and influence group development that play a vital role in effective group leadership.
Malnati, R., & Donigian, J. (In Press). Systemic interactive group therapy: A three element approach. Pacific Grove, CA: Brooks/Cole.
von Bertalanffy, L. (l968). General system theory. New York: George Braziller.
Whitaker, D. S., & Lieberman, M. (l964). Psychotherapy through the group process. New York: Atherton Press.
Yalom, I. (l985). The theory and practice of group psychotherapy (3rd Ed.). New York: Basic Books, Inc.
Jerry Donigian, D.Ed., is Professor of Counselor Education, SUNY College at Brockport, Brockport, NY.
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