What is Process Group Therapy?

January 21, 2020 My Modern Therapy

Since you have made it to this article, I assume you may know a thing or two about the therapy world’s most famous offering: individual psychotherapy (I will use the term therapy and psychotherapy interchangeably throughout this article). I bet you may not be as familiar with individual therapy’s cool older sibling, group psychotherapy (to get clinical, the interpersonal process group, or process group for short).

At Modern Therapy, it is rare that my clients have had any experience with group therapy, and I hope this article will open your eyes to an interesting and effective approach, that though somewhat harder to find than individual therapy, is well worth the effort to seek out.

Let me give you an idea about what group therapy is like: imagine having a group of people that you see weekly, where the typical rules that govern “polite” social interaction are intentionally set aside to help promote intensive, authentic, and honest interactions that help you learn more about yourself than you have ever before. I have joked to friends and family that being in a psychotherapy group is like being transported to another planet. Raw transparency in the name of growth?? There is just an eerie sense that this space cannot be here on earth. It is powerful stuff!

Process Group Therapy 101

Before going too much deeper into what a process group is, we need to talk about two other types of therapeutic groups: support groups and psychoeducational groups. Support groups are designed to give people a safe space to share their experiences with others who have been through similar things, and to receive feedback or help if desired. The prototypical support group is Alcoholics Anonymous where alcohol related issues are the common experience that binds the group members together. If a therapist is present in a support group, their role is to keep time, help anyone who becomes emotionally dysregulated, and ensure that everyone gets an opportunity to share. Support groups can go on forever, or they can be structured for a certain number of weeks or months.

Psychoeducational groups are basically classes that focus on psychological topics. They typically involve a therapist leading attendees through a set, pre-planned curriculum. HumanHQ, Modern Therapy’s sister company, is a specialist in providing top-notch small groups that are a hybrid of support and psychoeducational groups. Check out https://humanhq.org/ for more information.

Now to the star of this article: the process group. Process groups typically run for a minimum of 6 months (though shorter term groups are effective as well, and 12 week therapy groups are what we currently offer at Modern Therapy. Longer term are to come).

How Are Process Groups Structured?

They are intentionally unstructured to allow for each group member to reveal the organic patterns they go through when trying to build and maintain relationships.

The major focus in an interpersonal process group is less on the there-and-then (i.e. think your relationship with your partner, your early life experiences, stress at work) and more on the here-and-now (i.e. the reaction you are having to your fellow group member or the therapist, reactions to sitting in silence in the group, noticing what type of role someone seems to be falling into in the group, or learning about the impact that your way of speaking is having on your fellow group members).

This is what makes the process group experience feel so unique. In day-to-day life, most conversations are focused on the there-and-then: the weather, what happened last week, what is coming up in the person’s life, etc. Focusing on the here-and-now in day-to-day conversation would mean processing the annoyance that arises when with someone who regularly crosses boundaries, in talking about the joy that arises when seeing a loved one, or “calling someone out” by commenting on their body language or tone of voice.

Focusing on the here-and-now is just one way that therapy groups provide incredible learning, healing, and personal development opportunities. The next few paragraphs are going to be an exploration of the many ways that process groups benefit participants!

How is Process Group Therapy Viewed?

One major opportunity is to heighten awareness of psychological defenses that sabotage the ability to meet a fundamental human need: connection.

One way to view group therapy is as a group of people coming together with a mutual interest in learning to care for each other as fully and freely as possible. Unfortunately, most people have been hurt in their connections in important relationships, which leads them to unconsciously protect themselves - aka to develop defenses. The mirroring through interpersonal feedback available in group is a great way to discover and work through these defenses. At any time during a session, a group member can ask the other group members for how they are coming across in group by a simple, “I wonder what reactions you all are having to me?” This can also be helpful for you to learn why you may chronically be unable to sustain romantic relationships or friendships, if your attempts at being kind are perceived as invasive or fake, or if you may unconsciously be expressing anger or being passive aggressive when you think you are being open. In group, insight into defenses leads to deeper opportunities to connect than ever before.

Process Group Therapy as a Social Labratory

Another opportunity in a process group comes from it being a social laboratory. By this I mean that it gives people a chance to experiment with new behaviors that may normally feel uncomfortable to try out with people currently in their life.

For example, let’s say a client joins a process group and knows that they tend to have a passive communication style and want to focus on developing more skill in using assertive communication skills. Inevitably in the group, someone will say something that will rub this client the wrong way and voila, they have the chance to practice sharing their feelings and working through any resulting conflict all under the care of a therapist and with other people who have committed to keeping the group safe. Tend to be spontaneous and want to work on controlling impulses better? Maybe spend a whole group not speaking! Tend to overuse an aggressive communication style? Maybe spend a whole group only saying kind and empathetic things to everyone. There are limitless ways to experiment with new interpersonal patterns in the group setting.

Yet another opportunity in a therapy group is to learn more about your unique “lens” or “filters.”

As a result of cultural conditioning, each person’s unique biology, and family-of-origin experiences, everyone develops a mental filter that tends to distort reality in unique ways. For example, my mind tends to interpret the world through a belief that I do not belong. I first learned about this filter in a group setting, and noticing it has given me so much freedom to make choices as if I belong even if my mind is telling me that I do not. In group therapy, the heavy emphasis on giving and receiving interpersonal feedback and observations about the group process gives plenty of opportunities to compare perceptions with other group members. WIth all of this information about how the group is perceiving what is happening, distortions in perception become apparent VERY quickly. Welcome to new insight!

Another way to use group is to learn about transference (what we interpersonally “give off” in our connection style).

Transference is a clinical word for emotional reactions that happen in the present moment that are related to old wounds, traumas, or experiences arising from relationships with parents, siblings, past romantic partners, etc. Groups are made up of people of various ages, races, genders, and/or sexual orientations, all of which provide rich opportunities to project transference issues into the room. As a male therapist, it is not uncommon for clients to project transference related to old experiences with people in positions of power or father figures onto me and to react to me like I am that person instead of who I actually am. By identifying the origin of these reactions, they can be understood, healed, and they will no longer influence behavior.

In going back to the emphasis on the potential diversity of types of people in group (i.e. sexual orientation, gender, age, etc.), group therapy provides wonderful opportunities to learn to connect with people different from you. Disconnection and hate due to judgment/fear of various groups is a rampant issue in the modern world, and seeing the common humanity across various differences is an essential, learnable skill. Group therapy provides the opportunity to work through any personal biases to see the commonalities instead of differences.

The here-and-now, provides an excellent opportunity to explore what works and does not work in promoting closeness in relationships.

There are thousands of books on how to have satisfying relationships, and though they are great, I think they pale in comparison to basing one’s learning on experience. In practice, this looks like a group therapist asking a question like, “I wonder how the interaction that just happened impacted the level of closeness in the group? Do you all feel closer or further away from each other?” Checking in on this question throughout a group experience, while benefiting from therapist and group member suggestions and modeling can work wonders for improving one’s ability to notice when distance is being created in important relationships and teaching skills to move closer in relationships. .

Another way to use group is to imagine it as a social microcosm.

A microcosm is anything that on a smaller scale encapsulates characteristics on a larger scale. For the purpose of group therapy, this means that the way any one group member interacts with other group members and the therapist, or what role they end up taking on in the group, tells a lot about their behavior in groups outside of the therapy room. This is the reason that group therapy is so effective for promoting behavioral change outside of the therapy room. If a group member can gain insight into the way they contribute to taking on the same old role they always do in the therapy group or creating the same old problems in their relationships with other group members that always seem to happen in their life, and they can learn to recognize their contribution to re-creating these issues, the opportunity arises to change these patterns first in the group, and then in their life.

A final opportunity in group therapy, particularly in a short term group, is to participate in generating a group of relationships that support honesty, authenticity, and supportive care that can last beyond the end of the group.

Typically, for the duration of a therapy group, group members will be discouraged from interacting with each other outside of group sessions. The purpose of this is to give each group member access to the same information as everyone else, and to inhibit the detrimental impact of gossip, cliques, and avoidance of conflict in the group. Upon completion of group, all of that hard work on relationships with other group members can result in the creation of deep friendships, or not, depending on the wants of each group member.

At this point, I hope you feel both nervous and excited about the prospect of joining a therapy group! All the feelings you are feeling are normal and 100% expected when considering joining a group. I hope you choose to take the leap.