By Emma Rayfield
Change and transitions are at the heart of our work as psychotherapists as we strive to help our clients move forward in their lives. Sometimes we support them through a difficult situation by helping them see the changes they need to make in their lives; at other times we help them rediscover the potential for fulfilment in their existing lives. Psychotherapy is often about the relationship that people have with themselves. As psychotherapists, we can support them by helping them understand who they are and why they act in certain ways. Or we can help them learn to live with parts of themselves they were unaware of, or have rejected or ignored. Ultimately, we help our clients move forward in their lives by bringing them a different perspective.
One-To-One Counselling/psychotherapy And Group Psychotherapy
Whilst one-to-one counselling can help start this process, group psychotherapy is particularly powerful in its ability to offer an almost seamless transition from psychotherapy into the real world. Indeed, the beauty of group therapy is that it offers clients a piece of the real world, within a totally safe environment led by a group conductor. S.H. Foulkes, a psychiatrist and psychoanalyst developed group analysis as a method of treatment following his observations of patients waiting to be seen by him in a waiting room. He was struck by the way his patients interacted with each other sharing their experiences and once in consultation with him often the dynamism dissolved. He developed his ideas and Group Analysis was born.
Group psychotherapy usually consists of once or twice weekly 90-minute sessions. Typically the psychotherapist/group analyst will begin with one-to-one sessions with a client in order to build a relationship, to begin to know each other and start to understand the problems. There will come a point when it will be clear how a person could benefit from group analytic therapy. Most people do, and there are very few contraindications. However, not everyone will feel themselves to be ready to join a group, preferring to stay in individual therapy.
It is important for the psychotherapist to work with the person to help them to understand the potential benefits of working in a group environment and discuss their thoughts about it. Part of this discussion is about how the psychotherapist – known as a ‘conductor’ in a group environment – holds the boundaries of the group. Confidentiality in the group is of crucial importance and the conductor will hold time and content boundaries and continually revisit these through the life of the group. If group members should happen to bump into each other outside of the group session this is asked to be talked about in the group to maintain safety. Membership is checked in a way to maintain anonymity of current and new group members prior to the individual joining the group. This minimises the risk of knowing someone in the group. There will usually be a lead into the group through a series of individual sessions, during which the psychotherapist will spend time understanding their client’s problems and working out how and what type of group therapy might help them. Such initial consultations are crucial to ensure a client feels comfortable and ready to join a group.
Both group and individual psychotherapy offer an opportunity to explore different problems and issues relating to both the past and the present. The main difference between group and individual therapy is that work in a group focuses on the interaction between yourself and others. In a one to one therapy a similar process occurs, though the focus is different. What happens between you and your therapist is what brings about change. Meeting regularly for periods of 50 minutes, a trusting relationship develops over time between you and your therapist. This allows problems to come to the surface. The relationship between you and the therapist is of great importance in the work of any therapy.
The Advantages Of Group Analytic Psychotherapy
Working within a group is a fantastic opportunity to learn about oneself as well as about other people. As humans are essentially social animals, many personal issues will be better revealed and understood within the dynamics of a group. By creating a group scenario, group psychotherapy gives people an opportunity to work on problems as they emerge and come alive in the room. The emphasis is very much on the “here and now”. But, unlike the real world, where social interaction will focus on an occupation or a task at hand, where there is no time to focus on one’s interactions with others and where the individual will often feel vulnerable, group psychotherapy offers a supportive, confidential and safe social environment led by a group conductor. It is a safe place where defences can be analysed, conflicts bared, and insights gained into why one tends to behave in a particular way.
In group therapy, individual problems and propensities, and all the baggage of past experience, come alive in a way that they wouldn’t in one-to-one therapy. What is fascinating is that, without fail, problems will emerge and become tangible, and individuals will spot certain patterns in the way they interact with the others or how others behave in the group. This can be more or less pleasant, but from a therapeutic perspective it is fundamentally positive because it brings issues to life in a real social scenario and allows individuals to deal with them in a safe and supportive environment with the help of the conductor. It is an eye-opening and empowering experience. It provides many opportunities for people troubled with things like feeling different to others, difficulty maintaining good relationships, anxiety, depression, and it is also very beneficial to the socially isolated.
Group Analysis is a form of psychotherapy by the group, of the group, including its conductor. It aims to achieve a healthier integration of the individual in his or her network of relationships.
Open-Ended Groups Vs. Closed, Short-Term Groups
There are different types of Group Analytic groups: for example open-ended groups and closed short-term groups. Open-ended groups tend to be general, but specific themes will surface and whilst the issues individual members are dealing with may be very different, commonalities will emerge. Closed groups will usually have a time limit and once started will not be open to new members.
In an open-ended group, people will negotiate a point when they feel ready to “leave” the group. This might be when they feel better and more equipped to manage their relationships with others and themselves in a more fulfilling way. A person leaving a group will undoubtedly affect the rest of the group, as people get to know each other and are supported and valued by one another. Thoughts about leaving the group are always encouraged to be discussed in the group and a period of time negotiated in which to leave. Whilst open groups tend to be fluid with different members joining and leaving at different times the conductor maintains consistency in membership by introducing new members at specific time points. This helps to ensure the group remains balanced and stable.
Short-term, closed groups tend to be homogeneous, bringing together people dealing with very similar problems or situations. The type of issues that can be explored within short-term group therapy are wide-ranging, and include themes such as bereavement, divorce, teenage pregnancy or even something more general such as learning to cope with change and transitions.
Group psychotherapy can change one in surprising ways, transforming the way one interacts with others. During and after group work, clients will often find that people react to them differently, reflecting the deep changes that have occurred within. Or they may feel very differently in a specific situation, another sign of the profound inner transformations.
About Emma Rayfield:
I hold clinical qualifications in Psychodynamic Psychotherapy, and Group Analysis from the Institute of Group Analysis, London. In addition to my formal training I have had many years of experience in group analytic work. I have also undertaken a significant personal therapy in individual and group analysis.
I am registered as a Psychodynamic Psychotherapist and Group Analyst with the United Kingdom Council for Psychotherapy (UKCP). I am a professional member of the Institute of Group Analysis, London.
As well as my private practice here at The Practice Rooms in Salisbury I have clinical experience in various health settings: having worked as a psychotherapist in outpatient NHS psychotherapy departments, and for GP’s in a Health Centre. I am involved in the training of counsellors and psychotherapists with Wessex Counselling Service and facilitate experiential groups there and support students individually. I am also leading a project funded by The Big Lottery and local donators to provide a counselling service in Frome for young people aged between 15 and 18 years who may find it difficult to access counselling. I am a qualified nurse and have substantial experience in community and hospital settings with individuals with physical and mental illness, their families and carers.
If the idea of working in a group has inspired you, or you know others who you think might benefit, please do get in touch. I am looking to start an open-ended therapy group at The Practice Rooms in Salisbury and welcome any enquiries.