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Is a Therapy Group Right for Me? Am I Right for a Therapy Group?

Are you finding it hard to know if group therapy is what you need or want? Below, I outline a few of considerations that might be helpful when thinking about joining a group.

Considering a Therapy Group?
You may have had a group suggested to you or know someone who is in or has been in a group. Perhaps you are aware of difficulties arising for you in groups and want to explore these further. And/or maybe you have had individual therapy in the past or recently and feel you have explored what you needed to in that work.

Whatever has led you to think about joining a therapy group, the idea is likely to feel a new and unknown prospect for you.

Group Therapy and ‘Real Life’
Group Therapy is often described as being closer to ‘real life’ than individual therapy. The other people in the group are not there in a professional role and although the group therapy culture is one of respect and support, members are also encouraged to respond and relate in authentic and spontaneous ways to each other. For some people this is off-putting but for others this is an attractive proposition and seen as a way of more directly experiencing some of the relationship dynamics they might have struggled with in the past or present.

The constant mirroring in groups between members offers ongoing feedback (what happens in groups: mirroring). Many people find this helps them develop a stronger idea of who they are in relation to others. If you are aware that you struggle with your sense of self or identity you will likely benefit from being in a therapy group where you can experience feedback from others as well as observe for yourself your similarities and differences.

Group members tend towards being supportive to each other but do, when the group is working well, offer a realistic mix of positive and challenging responses to each other. Some people who feel particularly fragile in the face of less positive feedback from others can find this too threatening a prospect.

Is this the right time for a group?
If, for example, you have had a very recent trauma or bereavement you may feel you need some more focussed one to one help on your individual circumstances and a group may not therefore be the place at this stage for you. However, this might not feel clear cut and the group therapist would be able to explore this with you. They might even be able to offer to work with you individually over your recent experiences until you feel ready for a group.

Groups and Belonging
Group therapy can be particularly helpful for people who have conflicts around belonging. This might relate to their family history, perhaps feeling they were always outside the family for different reasons, or it might connect to other aspects of their history or identities. Groups give a powerful sense of belonging. Once you join a group you are always part of it. Even after people leave, they are remembered as part of the group’s history. Groups also allow members to move in and out of experiences of outsider and insider-ness. This can offer experiences of, and help understand, relationships to belonging.

Isolation and shame
Like issues around belonging, groups can be particularly helpful for those who feel trapped by feelings of shame and alienation (shame). Most people find an immediate relief in a therapy group when they start to share their worst feelings and thoughts. The chances are always likely that at least someone in the group (and very often the majority) will feel similarly. Usually new members find that shameful thoughts, feelings or experiences become quickly normalised by the rest of the group.

For some though, the idea of making public what feels shameful is too big a step. Some people might benefit from seeing an individual therapist first where they can ‘test out’ their secret feelings, if the idea of speaking in a group feels too frightening.

Some feelings of isolation are easier to dispense with than others. Being in a group does not necessarily stop the individual having these feelings, and indeed the public nature of the group can heighten them. However, it is this very nature of group therapy that creates an opportunity to directly understand and address these difficulties.

The Therapy Group as Alternative Family System
Being in a group can feel like being in a family. Group members can start to represent family members to each other.
Families have their own ‘systems’, but the group creates an alternative (generally more benign and authentic) system which challenges the unconscious assumptions of members’ family systems.

This aspect of groups includes the opportunity to explore dynamics from past and present with siblings (Sibling Rivalry Part 1 and 2). Group members can often feel strong sibling-like feelings towards each other.
People who have had difficult family dynamics growing up, in my experience, gain a lot from the way the therapy group offers this alternative family system and allows explorations of sibling relationships.

What if you don’t like Groups…
If you do not like groups and the idea of being in a group scares you, you may, understandably, not want to join one. However, this might well be why a group could be the right kind of therapy for you. I explored this in more depth in another blog called ‘if you don’t like groups, could it be time to join one‘.

Commitment and Ambivalence
Joining a group requires making a commitment from the outset. Most group therapists will ask that you agree to a minimum of between 6 months and a year. This is an important requirement because someone arriving and leaving quickly can disrupt the group. So, I end this piece with the first question you perhaps need to ask yourself – can you practically make this commitment at this time.

This is a different question than having mixed feelings or ambivalence which is very normal and common when thinking about joining a group.

If you are not sure about whether you can or want to make the commitment, the group therapist can explore your uncertainty with you and help you decide.

Summary
This piece touches on some of the different considerations about joining a therapy group. I have not covered all aspects but focussed on those dilemmas and considerations that, have come to light most often in my experience of helping people think about joining a therapy group.

 

To enquire about psychotherapy sessions with Claire Barnes, please contact her here, or to view our full clinical team, please click here.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

The Problem with Change

What is it like being in a Psychotherapy Group? Case study – Joe

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

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What The Role of the Therapist in Therapy Groups?

This piece is part of a series offering thoughts on the experience of being in a therapy group. It may be helpful to read if you are thinking about joining a group or running groups or if you are already in a group. 

When I am discussing with someone about joining a group, a common question is often around my role as therapist in the group.  Below I outline different aspects of the group therapist’s role as I see it. 

Dynamic Administrator

One important aspect of role of the therapist is to take care of the administration of the group. This includes managing boundaries and making decisions that maintain the group as a safe therapeutic space. This is called Dynamic Administration. 

This role includes assessing and deciding who will be in the group and establishing a physically safe and uninterrupted space for the group to meet in. It also includes setting out and maintaining boundaries for the group to keep it operating safely, consistently, and therapeutically.  

Group Preparation

The group therapist will also help the individual prepare for joining a group. As part of this, they will invite the potential member to speculate what kinds of experiences could be helpful, and what might feel more challenging, in the group. This can sometimes be a general discussion but is particularly useful when based on what the therapist and individual already know about their history – especially their history of groups. (see How important are our groups?)

The Group Therapist in the Group

One of the things I always say, in response to questions about how I will be in the group, is that I follow the group rather than lead it. This rejection of the role of group ‘leader’ is central to group analysis and its democratic principles. Instead of being called a leader, the therapist in Group Analysis is called a conductor. 

In group analysis, the therapist as is viewed as another member of the group. This does not mean they are not present in the role of therapist but more that the task of therapy is also shared with the group. 

The therapist as another member also refers to the concept of a network that all the members create together through their communications and relationships in the group – consciously and unconsciously. The group therapist is a part of this network and influences it – and is influenced by it – like every other member. 

Although they are a member of the group the conductor is very much there as a therapist and not a patient. So, they will act in similar ways to a therapist in individual work. They will not – or very rarely – disclose personal information and their focus is on the therapeutic needs of the group and the individuals in the group. 

My experience as the group therapist or conductor is that I move in and out of different positions in the group process. Sometimes I feel very central and very much a part of discussions, other times I am more in an observer’s role. When I speak it can sometimes be to the group as a whole or other times to an individual or individuals in the group.

As a group develops and becomes more used to working therapeutically together, I find how I take up my role often changes as well. What the group might want from me at the very start is often different as time shifts. And these changes can also take place from session to session. Individuals also might need or want different things from me as they do from other members, and this changes as well. 

Summary

This is a brief account of the role of the group therapist or group conductor, but I hope it has been able to give a flavour of what it might be like in a therapy group in relation to the therapist. I have described three aspects of the group therapist’s role – dynamic administration, preparing the individual joining a group, and the role of conductor in the group. 

 

To enquire about psychotherapy sessions with Claire Barnes, please contact her here, or to view our full clinical team, please click here.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

The Problem with Change

What is it like being in a Psychotherapy Group? Case study – Joe

Silences in Therapy

Sibling Rivalry – Part 1

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What happens in Group Therapy: Mirroring

In this and other blogs I try and describe and discuss what it is like being in a therapy group. Here, I focus on the phenomenon of mirroring in groups which is an important group analytic concept, process, and experience.

Mirroring and Early Development

To understand why mirroring is important in any therapy, it is helpful to understand its role in early childhood development. Early in life, the baby relies on the care giver/s to provide ‘mirror reactions’ – that is, responses mirroring back their self. An obvious example might be a baby smiles and a parent mirrors back the smile they see the baby making. This helps the infant develop a distinction between ‘what is me’ and ‘what is not me’. In other words, a sense of self. Many of us have not had enough or effective enough mirroring early on in our lives and one of the key therapeutic elements of all talking therapies seems to be the corrective experience of having oneself mirrored back.

The Therapy Group as a Hall of Mirrors

Mirroring is a particularly important experience in group therapy and Foulkes (a founder of group analysis) likened groups to ‘a hall of mirrors’.

In a therapy group, members constantly reflect their responses to each other, while at the same time see themselves reflected, or not, in the behaviours and communications of others. As an individual in the group over time these reflections and reactions help to create a picture of oneself in relationship to others. As Foulkes put it:

A person sees themself, or part of themself – often a repressed part of themself – reflected in the interactions of other group members. They see them reacting in a way they do themselves, or in contrast to their own behaviour. They get to know themselves … by the effect they have upon others and the picture they form of them. 

Foulkes p 110 Therapeutic Group Analysis (my changes from masculine to neutral pronouns)

Vignette

To give a picture of mirroring at play in a group, below is a fictionalised account of a fictional group discussion between 4 members A, B, C, D

A is talking about his childhood and his experience of his disapproving father. B comments that the way A describes his father reminds her of sometimes how he is in the group. A goes quiet.

C says to B that she felt she came in too critically towards A, she often seems to be down on him. B says that A reminds her of her own critical father.

C says she is always much more struck by A’s vulnerability and wonders why B can’t see this. She’s worried now that he’s become silent.

A says he’s remembering last week an argument with his son who was angry he was always on his back. He realises he can be like his father at times.

D points out how C herself had jumped in to defend A. C wonders about it in terms of her own father who she felt was bullied by her mother. C says she envies how B seems to be able to say what she thinks. She always feels she needs to protect the other person.

A recognises he can be disapproving sometimes in the group and in his family. But he has never thought of himself as vulnerable. He feels moved by C’s protection, but it also feels new and strange to him.

In this vignette you can hopefully see the analogy of the hall of mirrors at play. The group members are constantly reacting to each other. The more the group allows openness and spontaneity the more can be revealed.

For example, the members reveal two different aspects of A seen by B and C. A is familiar with one but unaware or in denial of the other. He is moved when his vulnerability is seen but also disconcerted. B and C while having genuine but different responses to A also then recognise the parts of themselves or not that they are seeing in him – and for C what she also sees in B.

Responses to Mirroring

Mirror reactions can reveal ‘truths’ which may then be responded to by the individual in a range of ways. Mirroring in group therapy often operates at a complex and spontaneous level and can go on consciously and unconsciously, verbally and non-verbally. This experience is then hopefully utilised therapeutically by the group and the group therapist.

In my constructed vignette, the group members’ observations and responses are conscious and easy to verbalise. They are all able to make use of their responses to each other and the discussion is constructive and productive. It’s perhaps easy to see how their insights could lead to further therapeutic explorations in relation to past and current relationships. In a live group session however, responses to feedback can be more varied and complex.

“affect, understanding or intuition seen in or associated with others, can reveal truths about the self that may be welcomed, opposed, taken flight from or attacked.

Schlapobersky p 255 From the Couch to the Circle: Group Analytic Psychotherapy in Practice

Some ‘truths’ are deeply unconscious and like in the case of A can feel disconcerting when exposed. Others are harder in other ways to receive and may take time to be utilised, if ever.

Conclusion

The process of mirroring is only one aspect of what goes on in groups. However, it plays a key role in the group therapeutic experience. Many people seem to find group therapy particularly helpful for their confidence and sense of identity. While this will be down to many factors, mirroring between group members plays an essential part, helping the individual develop a sense and understanding of who they are.

 

To enquire about psychotherapy sessions with Claire Barnes, please contact her here, or to view our full clinical team, please click here.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

What is it like being in a Psychotherapy Group? Case study – Joe

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

What is loneliness?

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The Problem with Change

When people come into therapy it is usually with the wish or hope for something to change. If not, they want help with adapting or stabilising following a major change.

It is a paradox that change is such a constant in our lives. As we age our bodies inevitably change and if nothing else this makes living itself a profoundly transitional experience.

Changes in our lives can come in many forms. For example, there are key developmental milestones at various life stages – adolescence and mid-life are perhaps the most discussed of these.

Significant events in life can also impact and bring about profound change in ourselves. These changes always involve beginnings and losses and can lead to crisis. Crisis too can bring about change. Even positive changes – like getting married or starting a new job for example – are often cited as highly stressful, so societally we very much recognise the equation of change and crisis.

Psychotherapy and psychoanalysis have had huge influences in how we might understand changes and crises in life stages and events.

For example, Elliott Jaques, a Canadian psychoanalyst, coined the term ‘midlife crisis’ in his 1965 paper (1). Jaques wrote about how this crisis repeats earlier intense transitions from adolescence and infancy and explored what he saw as a tendency for the individual to lose or discover creativity as a response to this life-stage.

And it is largely due to Winnicott’s seminal work (2) that we understand the level of intense feelings that typifies adolescent transitions, when the young person is caught in a fraught conflict between childhood and adulthood.
In psychotherapy we think about therapeutic change, meaning an internal change for the better. I think most people come into therapy welcoming this idea of inner change and certainly those who are assessed as being suitable for psychotherapy will partly be so on the basis that they recognise the need for some internal change.

Initially in therapy, changes are often experienced as positive. Being heard and supported and gaining insight generally increases confidence and a sense of self. At the same time people can find quite that more negative feelings towards themselves seem less extreme. These changes are important and real. However, deeper changes that take place in therapy, in my experience, are not always so welcomed. This is partly because of the disruptive nature of change and its relationship to crisis.

Undergoing the kinds of powerful changes that therapy can offer can feel destabilising and bewildering. As mentioned earlier, change always involves loss of some kind. What might need to be given up may be experienced – consciously or more often unconsciously – as vital to the person’s sense of self. Even unwanted aspects to one’s psyche and behaviour are still familiar and what is known is experienced as safe, even when it is also recognised as harmful and self-limiting.

While we might recognise the likelihood, even perhaps inevitability of crisis in change, experiencing this in therapy can, for some people, feel understandably counter-intuitive.

Many people who come through therapy find a way of tolerating and working through these unsettling if not disturbing experiences of therapeutic change. But some become too frightened or overwhelmed and may then leave suddenly.

In my experience, those who stay are able, with the support and help of the therapist, to recalibrate and restabilise – much as after major life stages and events. As things settle, they can then experience and enjoy the positive benefits of the internal work and changes they have undertaken. However, inevitably and necessarily, in time the problematic process of change will be repeated.

 

To enquire about psychotherapy sessions with Claire Barnes, please contact her here, or to view our full clinical team, please click here.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes –

What is it like being in a Psychotherapy Group? Case study – Joe

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

What is loneliness?

 

References – 

Death and the Mid-Life Crisis. Elliott Jaques, 1965
Contemporary Concepts of Adolescent Development and their Implications for Higher Education, from Playing and Reality. Winnicott, 1971

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What is it like being in a Psychotherapy Group? Case study – Joe

In my experience, when exploring joining a therapy group, people often ask what it will be like. I thought it might be helpful to write a fictional narrative to give a flavour of the therapeutic experience of being in a group. This ‘case’ is not based on a real individual although some of the conflicts and difficulties will undoubtedly feel familiar to many. To keep this blog as a short read, I have simplified the details, and have focussed on just one aspect of a person’s history, difficulties, and group experience.

Joe

Joe would always say his childhood was fine. Nothing bad or traumatic happened. No real problems. As an adult, however, Joe felt increasingly alienated in his life and relationships.  In particular, he had struggled to maintain long-term relationships, which was causing him pain, disappointment and worry about the future. 

After his last relationship ended in a familiar way, Joe came into therapy with a sense of loneliness and emptiness. Through discussing this with the therapist, Joe came to feel that a group might be helpful for his difficulties.

Early stages

Once in the group, Joe found that by listening to the way others talked about their experiences, and hearing their feedback to his own, he could start to formulate some different perspectives on himself. 

Particularly new for Joe, was an insight into the ways he had felt neglected as a child. Joe began to connect old memories and recall new ones which gave a picture of a lonely child overlooked by two busy and distracted parents. It was a shock to recall this vulnerable and neglected younger self.

Joe was immediately struck by the supportive and open atmosphere in the group. At first, he found the curiosity and empathy that other group members showed towards him strange. Over time the other members pointed out how often he dismissed his emotional experiences, and the ways that he avoided being taken care of in the group.  Joe realised this was the first time in his life where he felt his emotional needs might be important. 

New Insights

Accepting that his early experiences might have been difficult and impactful was the first step for Joe. He began to realise how he had developed an emotional independence as a means of survival and had therefore set out to deny the needy part of himself. Keeping his needs at bay also required creating a distance between himself and others. Joe was desperately fearful of this defensive system falling apart, and of being thrown back into the loneliness of his childhood. 

A few months in to being in the group, Joe had an important insight that his relationships often began to fall apart around the same time that he started to feel an emotional commitment. Joe’s break-through was heightened by being able to link this to what he was discovering about himself and the feedback he was getting about the way he pushed people away in the group.

As time went on, Joe was able to open-up more in the group. He explored the patterns of relationships failing and was also able to learn from others who also reflected on their own historical and current relationship struggles, as well as developments and successes. 

Making External Changes

After about 18 months Joe was feeling settled in the group. He had started a new relationship, and with the support of the group was more conscious of what was getting stirred up in him and mindful of his impulses to escape the intimacy this person offered him. 

Crisis

The group had helped Joe get in touch with the painful experiences of his childhood that he had tried to deny and avoid. He found himself increasingly in touch with emotional needs that he had not had sufficiently met as a child. This made it harder to tolerate the times in the group where he felt unheard or overlooked. The more Joe opened himself up to his need, the more he felt wounded and frustrated when it was not met. 

Joe announced very suddenly that he was going to leave the group. The group members questioned the timing of this decision and Joe agreed to give it more time and thought.

The group and therapist helped Joe to think about the parallels with the times in his life where he tended to finish a relationship just as it was beginning to be. Joe realised that the frustration and upset he had been feeling in the group was bound up with intimacy. He started to see that leaving at this point was another way of avoiding the frustrations of having intimate relationships. Being able to make a link between what was happening to him in the group and his pattern of relationships helped Joe to properly understand himself on a profound and deeper level. 

3 years on, Joe is still in the group. Last week the other members and therapist were delighted when he told them he and his partner have decided to get married. 

Discussion

Joe benefited enormously from the therapy group from the outset and had been able to make significant progress and changes in his life, However, it was when his ‘problem’ manifested in such a live way in the group that something was able to transform on a deeper level. Joe’s frustration with the group was a turning point in his therapy as he had to confront pain reminiscent of his childhood and see how his habitual strategies of ‘ending’ relationships was a way of avoiding the reality of intimacy. 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

What is loneliness?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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“Should I stay, or should I go?” What does easing the lockdown mean to you?

I have found the Clash’s song of this title playing over in my mind when thinking about the current easing of the social lock down in the UK. It seems to me that we all, to some degree or another, now face a dilemma whether to stay or go.

Straight away, it is important to acknowledge the relationship of this dilemma to levels of freedom and privilege. It is true that some people have little or no choice about whether to go back into their workplace.  We all face very differing health concerns, with those in the ‘extremely vulnerable clinical group’ likely to feel greatest levels of concern and anxiety about going outside.  There has also been concerning, though unsurprising, expositions of inequalities in terms of health risks, with poorer and BAME people having greater chances of fatality.

However, in my experience these will not prevent them from experiencing similar kinds of conflicts at this time. It is a reality that a great many of us will, to some degree or another, be starting to wonder about how or when or whether we return to ‘normal’.

I have been wondering myself about this dilemma but I am also interested in how it might tap into broader questions about how we think about ourselves in relationship to our worlds – both outside and inside.

There is no doubt this has been a strange and disturbing time and of course we are no way through it. The sudden exponential growth of the virus and pandemic was frightening, and many felt traumatised by the level of crisis and what felt like an intense threat to our mortality. The war metaphors and imagery referenced by our government, while perhaps intended to help rally a ‘blitz spirit’, in all likelihood, simply added to the terror already felt by many.

The orders to lock down came as a relief for many people. We had permission to retreat and protect ourselves against what had suddenly become a hostile world. This was and is a necessary response but one that also exacerbated the fear of the outside world engendered by the virus and the rhetoric used about it.

We all responded differently to the retreat and this of course varied at different times. There are those who found and continue to find the lock down liberating, others who found and find it oppressive.  Of course, we are also living in different circumstances which add or detract from the benefits of the protection it offers. For example, it has been widely reported that incidents of domestic violence and abuse have increased during this period. Many were able to work easily from home, many were not and there was, and is still, differences between the level of risk for those going into work. And many have lost work or continue to face this as an increasing prospect.

External factors aside, our relationship to the pandemic and the lock down response will also key into aspects of our own internal worlds. A reluctance to move out of lock down could arise for those of us who tend to use retreat as a defence. It makes sense that the bubble offered by the lock down could tap into and heighten historical ways of managing difficult realities through strategies of self-seclusion. At the same time, those of us who have particularly found the lack of purpose and activity in the lock down difficult may have developed defences around keeping busy as a means of warding away difficult or painful feelings.  This could lead to a manic response to the easing of restrictions – perhaps a rushing quickly back into the world and ‘normality’.

Of course, both states may be at play in us at different times, but I am wondering about our overall tendencies that will shape how we are likely to interpret, and respond to, this shift in government advice.

Reflecting on my starting title, I wonder now about the aptness of the Clash song. It seems the transition from lock down to ‘normality’ (whatever that means) is not going to be as either/or as staying or leaving a relationship. It looks likely anyway that we are going to experience further Covid outbreaks with many expert views suggesting the current easing as premature and a second wave imminent.  We can therefore most probably anticipate more lock downs, perhaps even soon.

So, it feels more appropriate to think about a dialectic in/out situation we find ourselves facing requiring complex navigations. How we proceed and find our way through these difficult and disturbing times and those ahead, will be dictated by many external factors but also our own internal worlds and their responses, conscious and unconscious, to the different experiences of this pandemic.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2e

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Silences in Therapy

Silences are an inevitable and potentially helpful part of the therapeutic process. However, a number of people I see as a therapist express a feeling that they are not getting something right when a silence arises in our work together. The psychotherapy world (in particular the psychoanalytic and group analytic fields) has also had some difficulties historically with accepting the value of silence.

A few years ago, I wrote about silence in relation to group analysis (Barnes, 2015) I felt compelled to do this as I had been working with a psychotherapy group that was gripped for some time by long, crippling silences. These silences affected the whole group and were intensely paralysing – for the group members and for me. I found it hard to help the group but also wasn’t helped myself by the general absence of clinical literature on this subject.

In my paper I made a case for the value and role of silence in therapy and specifically therapy groups. I explored how silence is a part of speech and that all speaking relies on pauses and breaks for our communications to make sense (this is, perhaps, most obviously understood in music). These rhythms and patterns in our communications are particularly important and central to the processes of therapy.

By just seeing silences as unhelpful we lose the opportunity to be curious about the different kinds of silences and what they might mean.  Below are some of the kinds of silences that can come up in the therapy relationship.

  • A common silence in therapy arises when both therapist and patient, or members of a therapy group, pull away from verbal interaction and retreat into a more internal space. Often, in my experience, this is when a discussion then moves onto a deeper level.
  • Sometimes silences are used to protect from scrutiny. Using silence as a defense can be bound up with early experiences of intrusion or a difficulty in asserting one’s self in interpersonal relations – the only protection then is to withdraw.
  • Then there is the paralysed silence, like the one that seemed to incapacitate my group for so long. People often say they can’t think in this kind of silence. When we’ve explored it more it seems they feel increasingly self-conscious in the silence and under pressure to break it – like it’s all too much responsibility. This seems to me bound up with shame.
  • But sometimes words just fail and just don’t feel enough. Silence can be used to convey this. Or to show a respect for the enormity of what is being felt.

In thinking about silence and speaking it’s also important to bear in mind the thoughts of French psychoanalyst Andre Green who pointed out how “behind the noise of words speech can be silent” (Green 1972). At times we talk in order to silence something uncomfortable, or just too painful.

Holding a silence can be a way – perhaps sometimes the only way – of staying with what feels difficult and communicating this.

References –

Barnes 2015 ‘Speaking with Silence. An Exploration of Silence and its Relationship to Speech in Analytic Groups’, Group Analysis, Vol 48 number 1

Green 1972’ On Private Madness,’ reprint Hogarth Press 1986

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

What is loneliness?

50 years on, how free are we from homophobia?

If you don’t like groups, could it be time to join one?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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How important are our Groups?

“Each individual – itself an artificial though plausible abstraction – is basically and centrally determined, inevitably, by the world in which he lives, by the community, the group, of which he forms a part.”  Foulkes, S.H. (1948, p 10, Introduction to Group Analytic Psychotherapy, Karnac)

The above quote is from Sigmund Foulkes who was the founder of Group Analysis, a widely disseminated group psychotherapy approach used in this country and internationally.  It might seem an extreme position to suggest that the individual is not real, but an ‘abstraction’. So, what does this mean?

Partly, it means we are all part of a complex network of human relationships. Our identities are formed in and through these relationships. Even when we are alone, we are relating to others in our minds.

More radically, it means that our context (i.e. culture, society, networks, relationships) creates us. This process involves our earliest experiences of our social world which we internalise unconsciously from birth through our key relationships and groups. This continues throughout our lives as we are always relating in and to our networks, existing as they are, outside and inside us.

So, the groups that you will have lived in, and continue to live in, will be inseparable to who you are.

On a broad level your ‘group’ will include your community, your country, your ethnic and cultural group – past and present. But on a more personal level your groups include: your original family (including wider family and past generations); current family relationships; friendships – child and adult, past and present; past and current romantic and sexual relationships; other relationships and networks in schools, colleges, communities, neighbourhoods, clubs, societies; workplace; support or therapy groups. The list could go on.

Everyone you relate to in your groups are connected to and shaped by their own networks and bring those into that relationship. Thinking about ourselves as a nodal* point in these complex networks it’s possible to see just how connected we all are and that the idea that we can possibly be understood as an individual alone is, as Foulkes also said, like thinking about ‘a fish out of water’ (ibid p 14)

Often the difficulties that bring someone into psychotherapy originate with a breakdown or disturbance within their relationship/s in their early group or groups. Group analysis is so effective because it understands the central role of groups in who we are and who we can become. When someone joins a therapy group they become part of a new network which they will also help shape and be shaped by.  Group therapy reconnects people with their world of relationships and helps restore a fundamental sense of themselves and their groups.

Group Analytic Psychotherapy Groups are offered at Brighton & Hove practice. Currently, we have two once weekly groups on a Monday and Thursday evening.

*denoting a point in a network or diagram at which lines or pathways intersect or branch.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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The Pain of Decision-Making

Our decisions navigate us through, and throughout, our lives. This blog is not intended to be a comprehensive explanation about decision making, neither is it a guide for how to make better decisions. I simply offer some thoughts about what I see as some of the reasons that decision-making can feel hard or even painful. And why some of us avoid or delay making decisions or get paralysed in the process.

Either/Or

There may be times when a decision is a stark choice between two different things. However, often what happens is we create an either/or split in our minds when making a decision, particularly when we’re anxious.

It is from Melanie Klein’s work that we get the concept of paranoid-schizoid position. This refers to a very early life stage when – as small infants – we were overwhelmed with intense anxiety and developed protective mechanisms, for e.g. splitting experiences into opposing good or bad. Klein thought that this stage never left us and in times of stress and high anxiety we tend to return to this paranoid-schizoid ‘position’. When we’re in this state of mind we return to defences such as polarising. Of course, far from helping our anxiety this kind of stark splitting generally makes decisions harder to make.

The referendum on Brexit is a good example of an either/or paranoid-schizoid type of decision that was created possibly to manage, but more to avoid, complex and painful issues the UK and its government was (and of course still is) facing.

Loss

Some decisions are easier than others. Usually, this is either because they don’t have a significant role in the shape of our future, or they are reversible, or repeatable. Generally, these decisions don’t put us in touch with profound feelings about loss.

Life decisions particularly stir intense feelings, and quite real experiences, of loss. Each step we take in one direction involves relinquishing those leading us in others. The older we get the more our lives narrow in direction and focus as we need to accept giving up ‘other’ options. This parallels a growing awareness of our own mortality.

How painful and paralysing the loss of ‘other’ life choices is will partly depend on our relationship with loss and whether or how we are able to tolerate the feelings stirred up by it.

Regret

Our decisions are our responsibility. We can all look back on certain choices we’ve made in our lives and wish we had taken a different option.

Bound up with our feelings about this is our relationship to regret. Regret can be a very frightening prospect for some people. This is because of the way they might punish themselves if they feel they’ve made a mistake or got something wrong.

Freud called the part of us that can be self-punishing, the Super-Ego. This is the rule-bound, conscientious part of us and is developed in the main from early experiences of authority figures, particularly parents. We will all normally experience our super-ego at times as restrictive – in a way this is its job. Ideas about

the super-ego have developed over the years to understand how persecutory it can be at certain times and for some people more than others. The degree and constancy to which we feel punished or even tormented by our super-ego will affect how frightening it can feel to us. This fear might generate such an anxiety about making mistakes that it can paralyse us from making even the smallest decisions.

Conclusion

We are making decisions all the time, often without thinking about it. Some decisions are obviously more significant than others and need to be considered carefully. This process can be painful as it means taking responsibility for our choices and sometimes accepting losses. We don’t help matters when we allow our anxiety about this to polarise our options with either/or thinking or attack ourselves with our regrets about past choices.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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What is loneliness?

Loneliness is an experience that people coming into psychotherapy often talk about struggling with. It is an uncomfortable and often painful state and usually linked with feelings of sadness, loss and emptiness.

But maybe loneliness isn’t necessarily just a bad experience. Below, I will explore possible causes and suggest there are some positive and helpful aspects to feeling lonely.

Loneliness through circumstances

Loneliness could be characterised as feeling disconnected from others and profoundly alone. This might well be circumstantial – for e.g. someone who has just moved to a new city and doesn’t know many people could reasonably be expected to feel lonely. Their loneliness might indeed help push and motivate them into making some social connections and friendships.

Feelings of loneliness can also be triggered by losing a significant other through separation or death. In these circumstances loneliness will feel bound up with the loss of this person and part of the experience of grieving.

In both these examples we would think a loneliness as a normal response to circumstances of being suddenly alone or losing someone close.

Loneliness and disconnection

Chronic loneliness is often caused by an intense and ongoing sense of disconnection from others. This may not necessarily bear any relation to the presence of other people. In fact, it is often reported that this kind of loneliness is most painfully felt in the company of others.

Becoming so disconnected and lonely is usually linked to a history of emotional withdrawal. Often this comes about originally as a form of self-protection. Self-isolation can be a way of avoiding the painful and difficult feelings that interactions with others can bring. This defensive strategy might start early in life and create its own momentum. It may be deployed all the time – leading to extreme isolation – or at certain times or in more nuanced ways.

In some people, this emotional withdrawal might be obvious, e.g. a literal keeping away from others. In many cases though the withdrawal is more of an internal distancing which may not be obvious at all, even to the person themselves. So, although the individual may have relationships, the quality of all or most of these relationships – i.e. the level of intimacy and genuine closeness – may not be enough to create or sustain feelings of real connection.

While this describes more entrenched or extreme experiences of chronic emotional disconnection and loneliness, it’s important to say that of course we can all find ourselves at times emotionally withdrawing from others and becoming lonely as a result.

Can loneliness be healthy?

Loneliness can be a horrible even desolating experience, but it can also be helpful to pay attention to it.

Earlier, I suggested it might motivate someone to seek out social connections in a new situation. On a socio-political level, a general state of loneliness can be generated by living in an, arguably, increasingly alienated and alienating world. Recognising our own experiences of social disconnection may move us to reach out to others in local and wider communities.

In my view, loneliness most importantly reveals a longing for greater intimacy and closeness and at the same time the absence or loss of this. Loneliness reminds us of our innate connectivity as human beings and its importance to our wellbeing. Where people have a pattern of disconnecting or withdrawing internally to deal with emotional pain, an awareness of lonely feelings can be a positive sign. It can mean the beginnings of a realisation that defensive distancing is no longer working.

Loneliness can indicate something needs to change, or is already starting to.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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What is Sibling Rivalry? – Part 2

Over two blogs I have focussed on one area of sibling relationships, namely rivalry. In part 1, I looked at some aspects of sibling rivalry as they can surface in childhood. In part 2, I will suggest how these might impact on ongoing struggles in adult life, before suggesting ways in which problematic issues with rivalry can be helped.

Sibling Rivalry in Adulthood

Feelings of competition and rivalry are perfectly normal and to be expected in adulthood. However, when childhood rivalry has been particularly problematic and unresolved, this can shape and lead to intense struggles later in life. Below are some thoughts about sibling rivalry and adulthood.

An obvious impact is in relationships to competition. Difficulties might particularly arise at work, socially, in educational settings, or any other situation where competitive feelings are heightened. This might lead to over competitiveness at the expense of other experiences – for example friendship, fun, comradeship etc. The rivalrous person may be driven towards success, however, often these feelings just seem to cause paralysis, procrastination, and low-self-esteem, as the individual constantly measures themselves against others.

As siblings are the earliest relationships they become a kind of template for later relationships. If feelings have never really got beyond negative experiences of aggression and dislike, this can make it hard to establish positive, caring and cooperative adult relationships.

Siblings who hold onto intensely rivalrous feelings, may be unable to establish a good adult relationship with each other. They therefore lose out on what these uniquely close alliances can potentially offer.

Sometimes sibling rivalry that’s not overt in childhood later manifests in adulthood. This can often be triggered through a change in the family dynamic. The most common is the serious illness or death of one or both parents. In these circumstances, feelings of rivalry can intensify or, if latent, can suddenly manifest. This is particularly common if there are issues around sharing responsibility or care for the parent, or around inheritance.

Fair shares and mutual concerns

Dennis Brown, a group analyst, wrote a paper entitled ‘Fair shares and mutual concern: The role of sibling relationships’ (1998). He explored how these rivalrous battles with siblings belong to an early stage in the individual’s development and that in healthy childhood psychological growth there is a shift to a more cooperative position towards siblings and therefore later relationships.

Our relationships with our siblings are usually the earliest experiences of grappling with love and hate for our peers. It’s important that aggression, jealousy and rivalry can be countered by experiences of love, companionship, and affection. Achieving this in childhood helps this balance of positive and negative feelings in later relationships.

The potential for change

But if this change hasn’t taken place in childhood can anything be done in adulthood? Below are some suggestions of how to work towards resolving the more crippling preoccupations with ‘fair shares’ towards a greater feeling of ‘mutual concern’ for and with others.

One way forward is to try and develop an adult relationship with your adult sibling. Sometimes family members get stuck in a narrative belonging to the past. We carry the child templates of our siblings inside us without perhaps getting to know the adult version. This is particularly compounded if relationships don’t develop outside of the family environment, for example when siblings only ever see each other in the presence of the rest of the family, particularly parents.

During or after times when you find yourself preoccupied with doing better than others, or having painful feelings of inadequacy or exclusion, it can help to reflect on links between this experience and what you may have felt as a child in your family. This can help you step away and separate from those past dynamics, reminding you that this is no longer the actual situation you find yourself in.

I mentioned earlier that sibling rivalry can worsen or manifest after a major family dynamic change such as brought on by the illness or death of a parent. Sometimes the opposite shift can happen. For example, the loss of one or both parents, or other family events, can suddenly bring problems of historic rivalry between some siblings to a natural end.

The Role of Group Psychotherapy

Group psychotherapy is particularly helpful in working through the difficulties arising from unresolved sibling rivalry.

Being in a therapy group stirs feelings of rivalry for everyone in it. In this way, it tackles rivalry in a way that individual therapy (where you have all the attention to yourself) can’t. Bringing these feelings alive and to the foreground means they can be worked with head on in the safety of a therapeutic environment.

In a therapy group, members find that each other remind them of their siblings, some more obviously than others. This offers an opportunity for working through difficulties that they may have had growing up with actual siblings. Members can then develop the kind of affection and closeness with rivals that might not have felt possible growing up or since.

Group members often find that the group feels a bit like an alternative family. This gives the opportunity for everyone – including ‘only’ children – to have different kinds of ‘sibling’ experiences than those they grew up with.

Conclusion

Preoccupation with ‘fair shares’ is symptomatic of a world where we feel pitched against each other and encouraged to see ourselves as alone. These feelings can be particularly heightened if the conflicts of our earliest peer relationships have not been resolved. Psychotherapy and counselling give the opportunity to explore and understand these deep rooted and painful experiences and how they may continue to have impact. Psychotherapy groups emphasise our connectivity as human beings. This challenges the notion that we are on our own, offering a direct release from the paralysing grip of rivalrous conflicts, towards greater co-operation, affection, and ‘mutual concern’ in our relationships.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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What is Sibling Rivalry? – Part 1

The importance and role of sibling rivalry

Siblings are the longest standing relationships in most of our lives. As we grow older they increasingly serve to keep a connection to our families of origin, reminding us of our parents and our younger selves. Most of us share genetic material and family histories with our siblings. They have a significant place in our origins and narratives and an important role in shaping us. We don’t choose our siblings in the way we do our friends and sexual partners but, in many ways, they are our closest peers.

Over two blogs I have focussed on one area of sibling relationships, namely rivalry. In part 1, I will look at some aspects of sibling rivalry as they can surface in childhood. In part 2, I will think about how these might impact ongoing struggles in adult life, before suggesting ways in which problematic issues with rivalry can be helped.

Sibling rivalry in childhood

Sibling rivalry is part of growing up. Children who have sibling/s share their parent’s love and attention and feelings of rivalry are naturally going to arise. While squabbling and fighting can disturb the family atmosphere, it is important that we are aware of these feelings and struggles are normal. These conflicts around competition are also ways in which young children prepare for managing later peer relationships.

However, feelings of rivalry can become particularly exacerbated for different reasons. For example, if there are unresolved difficulties in the parent’s relationship to competition and rivalry. Fighting between siblings that gets out of control or dominates the family can be often be traced back to some difficulty for one or both parents.

Other family dynamics may also play a part in complicating and exacerbating rivalry. Below are some examples where sibling rivalry might become heightened, and complex.

  • One example is when a parent is particularly enmeshed with one child. This means all other relationships, including other children, are pushed outside of this unhealthy coupling. This can create huge difficulties for everyone in the family and can heighten and complicate rivalrous feelings between the siblings.
  • A large age gap might mitigate rivalry in some ways but not in others. It may be particularly hard for the older sibling to allow or express jealousy or rivalrous feelings towards a much younger sister or brother. This younger sibling may be getting a kind of affection that the older brother or sister has had to relinquish but still misses.
  • The much younger sibling can feel the older one is closer to the parent/s as they’ve perhaps reached an age where they are being treated on more equal terms. This can also become bound up with the difference in capabilities due to age-difference. So, rivalry can feel linked with feelings of inadequacy.
  • Children who are born close in age may have had to share their mother’s/main caregiver’s attention and care as babies. Feelings of competition and rivalry may be experienced on a primal level – originating very early in life –  and this could make them particularly hard to articulate.
  • Children who have siblings with a disability or illness may feel ashamed and guilty for having negative feelings towards the sibling/s. This dynamic gets further compounded by the extra attention the sick or disabled sibling may well get from parents and others.
  • Harder still to express, manage, or even feel, is the rivalry and jealousy that might be felt towards a sibling who has died. In the psychotherapy field there is particular concern about children who may have been conceived to ‘replace’ a child who has died, and the very particular – often unconscious – pressures they come under.
  • Relationships and rivalry between half and step-siblings can sometimes be less intense if, for example, they do not live with each other. There will likely be a parent the child can claim as their own who is not shared biologically and emotionally. However, these half/step-sibling relationships can also feel complex and painful, as they are often bound up with parents’ separation and families splitting into ‘new’ and ‘old’.
  • One of the more unconscious ways families often manages rivalry is by assigning different roles and attributes amongst siblings. For example, the ‘clever’, ‘sporty’, ‘artistic’ ‘musical’ one; or ‘quiet’, ‘sociable’, ‘troubled’ etc. These might work to mitigate rivalry some of the time, in some families, and for some individuals. However, they can also stir up further complex feelings of rivalry, imbuing them with restrictive self-expectations and feelings of inadequacy.

Do only children have it easier?

Based on the accounts above we could think that the only child is the most fortunate. Certainly, ‘only’ children do not usually have to compete with early peer relationships for their parents’ love and attention and therefore avoid some of these more painful and destructive experiences of sibling rivalry. However, those who have grown up as only children often report a pervasive feeling of loneliness and isolation. Being the sole focus of parents’ love (and often therefore need) can feel very burdensome as a child and an adult. It is also no coincidence that only children often describe particularly acute difficulties starting nursery or school where they suddenly encounter the rough and tumble of peer relationships and rivalry.

The jostling and competing for space and attention that siblings engage with, prepare them for later experiences. However, it is important that children are also able to develop feelings of concern and companionship towards their siblings. In this way, the intense and more hateful feelings of rivalry can be moderated and managed. While feelings of sibling rivalry never fully go away they need to be resolved enough to establish healthy relationships with peers in adulthood.

In part 2, I will the potential impact of unresolved sibling rivalry in adulthood and look at ways of helping.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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50 years on, how free are we from homophobia?

This year has marked the 50th anniversary of the (partial) decriminalisation of male homosexuality in the UK. This has been responded to with a slew of television and radio programmes exploring current and past personal and political experiences of LGBT individuals and communities in the UK and elsewhere. This output has been matched by a large number of broadsheet and online articles on this subject. Some of these commentaries have pointed out how in our celebration of social progress we shouldn’t overlook the social and state owned prejudices that have caused much harm and damage to LGBT people.

For those interested and sensitive to these matters, it is perhaps clear that trans-phobia is still very much alive in our society. However, increased acceptance of homosexuality could give an impression that homophobia may no longer be an issue for people with same-sex identities and orientations in the UK.

This blog focuses on the continual difficulties for specifically LGB identified people due to past and continued impact of homophobia. Prejudices have become more submerged and hidden. There is now an added challenge for therapists to continue to recognise how these might be interplaying and undermining their LGB clients’ social and internal worlds.

Homophobia today

While open hatred towards lesbians and gay men is now less widespread, as a recent BBC documentary testified, it still exists.

Violent attacks aside, people in same sex relationships will still scan their environment before doing something as natural as holding hands in public. In many parts of the UK, being affectionate in this way with a same sex partner is still not deemed either comfortable or even safe enough. In other parts of the world, being openly gay is still very problematic. In some places, it is criminalised and extremely dangerous.

Homophobia refers to hateful (and possibly fearful) feelings towards people with homosexual orientation. When we talk about homophobia, we perhaps think about it being overt. However, this kind of social discrimination operates on many levels. More subtle, and sometimes unconscious, expressions and feelings of homophobia can be harder to tackle, understand, and talk about.

Despite social and legal progress, people with homosexual identities and orientations continue to feel excluded, marginalised, and unseen in this society because relationships are still regarded in the mainstream as heterosexual. How this continues to operate on a social level is complex and often unconscious. This mechanism is known as ‘heteronormativity’, meaning the norm is assumed to be heterosexual.

These social processes are similar to ways in which other groups can be discriminated against, for example on the basis of gender, ethnicity, disability, etc. These prejudices operate in such a socially ingrained way that they are mostly only visible to those in the minority group (and not always to them.) This makes it very hard to challenge or change them.

Internalised homophobia

Broadly speaking, internalised homophobia refers to homosexual self-hatred in relation to sexual orientation. These feelings have been absorbed, like everybody else’s, by living in a homophobic, heteronormative world.

Many LGB people still struggle with overt negative feelings towards their sexual orientation. These feelings might be particularly heightened prior to or grappling with ‘coming out.’ However, feelings of self-hatred, self-disgust, inadequacy and low self-esteem in relation to sexuality can surface at any time in the lives of those with same-sex desires or identities.

Like homophobia, internalised homophobia often seems to be discussed in terms of overt feelings. It is important that we are able to think about these internal processes on a more complex level to understand the less visible ways in which they may continue to undermine the well-being and confidence of gay and bisexual people. LGB individuals living in our current society may well find themselves struggling with less conscious sources of self-hatred that they may not recognise as having any link to homophobia.

This level of internalised homophobia is very difficult to tackle, as it seems likely that it begins early in childhood. In contemporary psychoanalytic thinking about sexuality, theories have emerged that support the idea that our sexualities begin to shape and orientate very early on in our lives (Lemma, Lynch 2015). In this context, it is suggested that responses from parents will heavily influence how all individuals feel about their expressions of sexuality at a young age. These parental attitudes may well be unconscious and shaped by prevailing social prejudices which again can be covert.

Impact and trauma

For some journalists writing on this subject in recent months, the damage has already been done. While things have improved in this country, past state and social attacks through criminalisation, arrests, unequal legal rights, stigmatisation and verbal and physical abuse have left individuals and communities hurt, angry and traumatised. In this way, we might think about the post-traumatic distress that some LGB people may still be struggling with.

Even without these traumatic after-shocks of the past, the negative impact of being gay in a modern society which still consciously or unconsciously operates as if everybody is straight should not be underestimated. Living in a world that marginalises or ignores who you are and who you love can be stressful and tap into earlier experiences of feeling unseen and overlooked.

While ‘coming out’ is less obviously problematic for gay people than it used to be, the experience of many working in specialist services is that it continues to be a struggle for many. Acceptance of one’s self may or may not be echoed by acceptance of friends and family. Cultural and religious differences may also continue to make this more of an ordeal for some than others.

We also certainly know that young people who identify as gay continue to be a highly vulnerable group in relation to homophobic bullying. This can lead to an increased risk of  self-harm, suicide, and the misuse of drugs and alcohol.

LGB people who have accepted their sexual orientation and worked through overt negative feelings are not invulnerable to social forces of internalised homophobia working unconsciously. These internalised feelings can exacerbate and complicate other difficulties such as shame, anxiety, anger, problems around sexual drives and body image. It is widely thought that homophobia can also play an important part in difficulties for same-sex couples.

Therapists working with homophobia

It seems to me in these more liberal and sexually fluid times, therapists need to be even more alert to the ways prejudices and other repressive forces continue to undermine our LGB clients. Homophobia and hetero-normativity operate on multiple levels in our societies. The internalisation of past and current social scapegoating, marginalisation and hatred can be emotionally problematic for even the most confident individual.

An increasing number of lesbians and gay men who come for therapy these days do not regard their sexual identity or orientation as a major problem. However, it is important that we bear in mind the social context in which they are experiencing the difficulties they do bring. These social mechanisms need to be understood as operating both externally and internally and on complex and often unconscious levels. While they may not need to be the focus of therapeutic work, there are likely to be areas where their influence will need to be recognised and actively engaged with.

Many lesbians and gay men continue to feel caution about the potential sensitivity and understanding of therapists towards sexual difference when seeking psychotherapy. Of course, any therapist seeing clients with same-sex desires and identities needs to be very aware of the ways in which homophobia might operate within themselves – whatever their sexual orientation.

In my view, affirming and supporting an LGB client’s sexual identity is essential but insufficient without being also vigilant to the hidden and sophisticated ways that homophobic processes, outside and within the individual, might work to exacerbate or create obstacles to their emotional development and wellbeing.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

Reference: Sexualities. Eds  Lemma, Lynch 2015

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If you don’t like groups, could it be time to join one?

It is notable that people seeking therapy who would most stand to benefit from joining a therapy group are often the least keen to do so.

For some people, difficulties with being part of a group are not the main reason they’re seeking therapy. However, the thought of being in a therapy group may be problematic enough for them to turn down the chance to join one, even if this is recommended as the most helpful therapy for their particular issues.

There are also those whose difficulties with being part of a group present major obstacles in their lives. They may be prevented from making relationships and leading fulfilled social and working lives. Of course, it is understandable that a therapy group may feel the last place they want to be. However, group psychotherapy is likely to have the best impact in helping them overcome their social problems.

Below, I want to put the case for why those who hate/dislike/can’t stand/fear groups might still consider one as a therapy of choice.

Problems with groups

Groups are difficult. By their nature, groups can stir up intense feelings, often in a raw and sometimes unsettling way. It is natural and normal to feel anxious or even frightened in a new group situation, particularly one where you feel unknown or alone.

Some people find these uncomfortable feelings to be intolerable, and they struggle to get beyond the negative experiences of being in a group. This means they miss out on the very positive experiences of being part of a group, whether social, friendship, work or otherwise. Groups can also be wonderful, creating strong feelings of connection and belonging.

Chronic problems with groups often arise out of social or relationship difficulties. Unfortunately, any tendency to try to avoid them generally exacerbates feelings of loneliness and isolation. Repeatedly not allowing yourself to experience groups can make them feel even more bewildering and frightening when, inevitably, you find yourself in one.

Stressors and underlying factors

Some people find that group problems can manifest in all situations. For others, specific types of groups or settings are difficult. One person may be fine in small social groups but highly anxious in larger parties. Another person may feel that the anonymity of a larger group is safer than the pressure of intimacy and being in the ‘spotlight’ in a smaller gathering. Some people are relaxed in social situations but find work groups problematic, and so on.

It can be helpful to locate and explore where the difficulty in the group may be for you. For example, it could be that you find groups most difficult when you’re just with your peers. Alternatively, perhaps peer groups are fine until an authority figure joins in. Maybe both situations feel hard? Or neither, but something else?

Some people find that their anxieties are particularly stirred when they don’t feel sure of their position or role in a group. It is normal for us to want to know our place in groups. However, the potential loss of identity in groups can lead some individuals to taking unhelpful roles to feel secure. Some examples of these include always being the helper or listener, being the clown, staying silent, keeping on the edge, or performing all the time.

These kinds of ‘roles’ can often be traced back to the original family and the position or role given or taken up by us as children. These roles perhaps help the individual feel less insecure in a group, but can come at a cost, particularly when they become rigid and restrictive.

An inhibiting feeling sometimes associated with groups is shame. This often relates to earlier experiences of becoming conscious of having a public and private self and how these were responded to by others. Many group difficulties can be located in early groups, like the family, and school. Some can be clearly remembered, for example, bullying at school, while others might be less so. Sometimes, painful feelings and experiences from past groups that have been partly or fully buried can suddenly surface in group situations and feel overwhelming.

How do therapy groups help?

Therapy groups are deliberately made to feel safe.  This environment is created by having firm boundaries, confidentiality and a general commitment of all members to be supportive and helpful to each other. The experience of being in this kind of group can be reassuring if you usually find groups to be frightening, threatening, or potentially humiliating. Over time this can get absorbed and applied outside, so all group situations start to feel easier.

A therapy group can become like a laboratory for testing out and understanding the kinds of anxieties and feelings that certain group dynamics stir up. This allows you to become aware of how groups operate and how you respond. This can then be explored with the help of the other members in various ways.

Testing out new roles

As the group becomes a place where feelings and dynamics can be explored, it also becomes possible to test out other roles than those restrictive ones that have been taken in the past. So, for example, the ‘helper’ may be able to stand back and allow themselves to be helped. The ‘clown’ can be taken seriously. The silent member learns to use their voice. The person on the edge can be central at times, and the performer can give themselves a break. These shifts are connected to increased self-esteem as members realise they have value in all their aspects and a place in the group, whatever role they take up.

In conclusion

Most problems that bring people to therapy are, at root, connected to a difficulty at some point in their life with relationships. Very often, this includes earlier ones. It makes sense to explore these struggles through current relationships with others in the way that therapy groups allow and contain.

These are some examples of how therapy groups might help to develop a different experience of a group environment. A final point to make is that in our modern world, we have arguably become increasingly alienated from those around us. The therapy group places us firmly back in a social environment and reconnects us with each other. In this sense, it can potentially have therapeutic benefits for us all.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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Shame

What is shame?

Shame is hard to talk about, as we tend to manage it through secrecy. We hide what we are most ashamed of about ourselves. Unfortunately, shame is bound up with our bodies and so moments of feeling ashamed can often be accompanied by physiological responses which feel exposing and so exacerbate our shame further. Shame is a social experience as it seems to rely on the presence – in reality or in our minds – of an observing other or others.

Shame can also be linked to social differences, such as class, sexuality, ethnicity or disability. This is because at a social level, certain groups are made to feel shame for the rest of society. In this way, shame is also connected to power. Shame can be culturally specific – i.e. what might be regarded as shameful for one culture may be less or more so for another.

Potential origins of problematic shame

Shame is thought to be bound up with feelings about the ‘self’ and identity. It arises at an early stage in childhood when we realise there is a gap between our experience of ourselves from within and how we might be seen from outside. Shame is therefore linked to self-awareness and how we might appear to the ‘other’. Early in childhood this ‘other’ will be main caregivers and their responses provide a blueprint for later experiences of being ‘seen’. How early family relationships mirror back to the child approval or disapproval is likely to shape their relationship to shame.

Shame does have positive functions. It helps us know about appropriateness in our relationships with others. Shame is normal and a part of being human. In an ideal world, we would all be able to experience shame fleetingly.

However, chronic shame is highly problematic for many people. As shame is very inhibiting, it can prevent healthy openness and authenticity. Whatever is felt to be shameful in the person must be covered up.  This protective mechanism further complicates the damage shame can do to healthy development and the quality of relationships. Examples of this might include; vulnerability hidden away behind a veneer of toughness or aggression, angry feelings that are disguised and managed by over-compliance, sexual desires that need to be suppressed and protected by prudishness or disgust. This list could go on.

How psychotherapy and counselling can help break the cycle of shame

Individual psychotherapy can often be the starting point for the individual to test out and expose their hidden shame. Sometimes, people are very aware of what shames them. However, this is not always the case and not all areas of shame are fully known about. It can be a surprise, during psychotherapy or counselling, to realise certain memories, experiences, thoughts, or feelings produce intense shame. The therapist helps investigate and tackle shame through their specific type of therapy. In this process, it is also their non-judgmental and accepting attitude that helps to undo earlier experiences of disapproval and criticism.

While the idea of a psychotherapy group can feel intimidating for people struggling with experiences of chronic shame, the non-judgemental atmosphere of the group can dissolve shameful feelings powerfully. Because shame is based in the experiences or fantasies of disapproving other/s, stepping into a social domain such as a group can help engage with and counter these feelings in a very direct and immediate way.

Secrecy fuels and exacerbates shame, however, it can also feel that it is the only way to protect the self from the experience of being seen in a shaming way. The safe and non-judgemental relationships offered in individual psychotherapy or group psychotherapy can provide the opportunity to take tentative first steps towards breaking out of the destructive cycles of secrecy and shame.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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