Group Therapy: Pros and Cons

Group therapy became popular in the nineteen forties. It started out with enthusiastic support from most counselors in the field of psychology. Its popularity waned when long-term individual therapy came into style, but in the sixties, it regained popularity, particularly in the field of addiction. At that time—theoretically at least—patients had to reach the very bottom of the barrel of misery in their lives before they could begin the long climb back up to normalcy. Like shock treatment, this worked for some people, and failed miserably for others. The method was strongly endorsed by some counselors, and strongly condemned by others.

The main mistake in some group therapy sessions was the concept that the group could listen to one participant’s troubles and then tell him what was wrong with him, and what he needed to do—without bringing in personal vendettas (often ones that were subconsciously aimed against themselves.) Their words might have held a modicum of truth, perhaps even the entire truth, but the people who were indulging in the critique were people with severe problems themselves, and sometimes carried criticism too far. Mob rule, which seems to spring up readily, even in supposedly balanced groups, certainly had no trouble taking over in group therapy.

Therapists quickly realized that the practice needed modification. When one patient interacted with another, the discussions had to be firmly monitored and kept within the realm of the first patient’s personal problems. The therapist, in other words, regained control, and guided the meetings.

Alcoholics Anonymous is a good example of group therapy reaching its potential. Members are expected to speak honestly, and if they don’t, they’ll be called on it. Alcoholics themselves are much harder to trick than even the best therapist. They’ve been there, done that…and they know all the moves. More than that, knowing the truth, they accept the patient as he is. Empathy is there in abundance, but without the allowance of any excuses for the behavior.

It is encouraging for a patient of mental illness to understand that there are many others who have gone through the same things he is suffering from, and that while the others still struggle, they’ve managed to achieve a good life. One of the worst things about mental illness is the isolation it brings with it. The act of trying to hide symptoms (what is perceived by the patient as a weakness,) is exhausting. Hiding from society, in one form or another, gives the illusion of relief—but only temporarily.

Humans are by nature herd animals. Herd animals, though, are expected to behave in certain ways in order for the group to survive. When one acts “irrationally” in the group’s mind, he is ostracized. To avoid that, mental patients often isolate themselves before this happens, attempting to hide the illness. Group therapy changes that.

Unusual and/or debilitating physical illness is also a good area for support groups, whether with therapists or just with a group of sufferers supporting one another. The knowledge that other people are suffering in the same manner relieves the stress of isolation. Being able to discuss symptoms, and to receive boundless sympathy, helps people get past the first step of understanding what’s happening to them. It releases their energy for the next step, that of working towards relief, if not full recovery.

Group therapy allows patients to feel that they’re helping themselves. They have the benefit of idea exchanges, as well as explanations of what to expect—and what is causing the problem—either physically or mentally. When dealing with an authority figure, such as a doctor or counselor, there can be a sense of lack of control on the part of the patient. They tend to expect the doctor to handle their troubles. Group therapy, however, places people on equal footing, and puts the patient in the position of taking over control of his life and problems.

Grief support groups are a perfect example of the good side of group therapy. “I know how you must feel…” actually means something when it comes from someone who really does know. Participants learn to understand that when the overwhelming, prostrating grief turns into anger, it is normal. They realize that time does heal wounds in some ways, but that one not only doesn’t “get over it”, he doesn’t have to. But he does have to learn to cope with it in the best way possible.

Group therapy is not always the best first step. Individual therapy is often needed, either alone or in conjunction with group therapy. Counselors should be the best judges of what is best for the patient at the moment.

It is surprising how readily shy, angry, and isolated people will respond to group therapy, even when their first response is to refuse to participate. It has been a wonderful adjunct to conventional therapy, and it is constantly developing and changing for the better as new methods are discovered.

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