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Group Psychotherapy in a post ‘Pandemic World’

I wonder how you have coped with the forced isolation imposed on all of us during the corona virus.  Has the weekly hand clapping made you feel more part of your local community providing some small contact with others during the week? Or have you been part of a family meeting on Zoom or with friends?

Now, that we are beginning to return to more familiar routines you may be wondering if joining a psychotherapy group might help with the re-adjustment to the ‘new norm.’

Our relationships with family, friends and fellow workers can be a source of inspiration and support; however, often it is these relationships that baffles us.  Joining a group can offer a space for you to share experiences and gain an understanding of yourself.

 

Why should you join a group?  Ask yourself, what are the difficulties I need to address?  These usually fall into one of two groups:

Emotions and feelings – which disrupt life including general performance of daily living skills. You may be taking medication to treat the affects of a disorder.  Common symptoms include anxiety and depression, obsessive-compulsive disorders, eating disorders and social anxiety.

Relational Challenges – we are dependent on our relationships with others to live a happy and secure life.  However, these often challenge us in ways we do not understand. The signs and symptoms above are often caused or cause problems in relationships both personal and at work.

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What happens next?  When you contact Brighton & Hove Psychotherapy, your enquiry will be passed onto me.  I will then contact you via your chosen method of contact to discuss your concerns.  We will then set up an appointment to meet.

The initial Session – at this first meeting, you and the psychotherapist will have a discussion in order to get to know you. If you both feel joining a group would be helpful another session will be set up.  A questionnaire will be sent to you to complete.

Follow-up – at the next session, we will use the questionnaire to follow-up your history, which will have formed the bulk of the first session. What are you hoping for by joining the group? Depending on your needs for preparation prior before starting the group will be agreed.  I will ask your permission to share your name with the group in order to check out whether there are any boundary issues i.e. you do not know personally anyone in the group already.

Usually there will be at least one more session before you join the group.

The first Session – joining the group for the first time is always a challenge, you already know the psychotherapist and the names of the group members.

There is no set agenda, the group runs using free association.  The boundaries of the group are – (1) always start and finish on time, (2) it will meet in the same venue, (3) it is a confidential space which each person agrees to before joining the group and (4) the members of the group do not have contact outside of the group. It provides a predictable space and time every week for a minimum of 40 to 42 weeks a year.

 

FAQ’s

Can I be in a group and continue with my individual psychotherapy?

No, the group is the primary therapy for the whole time the person is in the group.  A process called splitting can occur if group members are attending psychotherapy outside of the group.

How does Group Psychotherapy work?

The group provides a space to explore relationships in action.  As we all come from families or experiences of care in our young life, these influences stay with us and shape how we are later on as adults.  The small group offers a space to reconnect with that experience and re-work, often-traumatic events, in a safe and secure environment.  In addition to making connections to the past, we can explore current relationships in our families, couples, social and work life. Change of this sort takes time therefore you will need to make a commitment of time for processing and integration.

How confidential is the group?

The group is a confidential space where members of the group are asked not to have contact outside of the group or to share what happens in the group outside of the group space.

How many people are in the group?

A small group has a maximum of 8 members, 9 with the conductor.

Why is the Group Psychotherapist called a Conductor?

This relates to the role of the psychotherapist in the group.  As the group matures the group members become familiar with each other; they know each other’s stories and begin to see the patterns each one may be playing out in their lives.  The role of the psychotherapist will be to bring together the voices much the same way as the conductor in an orchestra brings in various instruments during a performance.

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Dorothea Beech is a Group Analyst with many years experience working in the UK and overseas.  She worked as A Group Analyst in South Africa as a Lecturer at Cape Town UCT and at Kwa Zulu Natal University in Durban, lecturing on a Masters Program in Group Work.  Her MA in Applied research was on Eating disorders. Her interests are in cultural diversity and trans-generational influences on the individual.  Thea is available at our Brighton and Hove Practice.

 

Further reading by Thea Beech

Termination and endings in Psychotherapy

What is Social Unconsciousness?

Crossing Borders – Group Analytic Society Symposium, Berlin 2017

What is a Psychotherapy Group?

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Termination and endings in Psychotherapy

We have just celebrated the ending of the year, welcoming in a New Year. It provides a shared / collective opportunity to reflect on the past, think ahead to the future. Likewise, psychotherapy invites us to think about the past, how it contributes to who we are, what is important to us, how the past can provide an understanding of previously unconscious material that has been repressed in order for us to reconcile the past and choose what is taken into the future.

This segmentation of time helps to contain a complex worldview. I suggest the break or holiday from psychotherapy offers us a chance to reflect on how we manage our internal world in the absence of the secure base represented by the clinical setting. The break provides an opportunity to see how we feel without the weekly hour or hour and a half in the session or group.

How important are endings in psychotherapy?

The therapeutic alliance between the therapist and the client provides a safe, secure and consistent base for attachment to a reliable figure for working through trauma. Childhood experiences of adult caregivers, depicted most vividly in fairytales of giants and powerful forces that impact on our emotional security; in adulthood leave traces of emotional trauma that can distort our judgment of reality haunting us as adults. Trauma inhibits the development of neurological pathways that lead to self-regulation of emotional states. Attachment styles will influence how we react to stresses in the environment, the challenge of psychotherapy is to find a way of reaching our fears and understanding how these shape our lives. The biological changes in the brain required to establish new pathways takes time and can leave us feeling confused and bewildered.

Neuroscience has given us a greater understanding of the effects of child hood trauma’s and a method of working that bring about changes in how we process feelings and thoughts.

Through our interactions in the therapeutic setting, either individual or group, enables us to experience /observe our defenses at work in a safe and containing space/ in the individual session or through the group matrix of interactions. This results in a re-working of the internal working model originally created to cope with trauma to enable change to occur. We begin to integrate more adaptive responses to our emotions and feelings. To gain mastery over long held ways of relating, the internalized working model that shaped our attachment style is revised.

What part then do breaks and endings play in this process? Jeremy Holmes suggests that different attachment styles require different approaches to endings. (See paper European Psychotherapy on termination of psychotherapy /psychoanalysis)

I suggest that some knowledge of the theory is useful to clients like a comforting diagnosis helps people feel more in control. It is what mindfulness can do for all of us used in the service of our need for regulation during times of heightened arousal / stress.

Whenever we make an attachment be it to a therapist, a working environment or an intimate relationship we are faced with separation. This is why falling is love is so disorientating; the object of our love leaves us fearing loss, jealousy, envy etc. etc. If our love is reciprocated then we are both preoccupied with one another. It becomes a joke when the love struck people are in a group of friends and only have eyes for each other.

So attachment and separation are present and unavoidable; we are social beings who seek closeness and intimacy throughout our lives. (The exception is when we are preparing for the end of life.)

Ending a relationship or needing to adjust to changes in others in our lives such as our children going from being a child to an adult requires an ability to face the often painful and difficult process of change.

Breaks in therapy offer an opportunity to try out our internalized therapeutic capacity for self-regulation. Ending therapy or a good ending requires work on understanding the capacity we have to deal with life outside of the safety and security of the therapeutic alliance.

 

Thea Beech is a UKCP registered Group Analyst, full member of the Institute of Group Analysis and a Training Group Analyst.  Her work in psychodynamic psychotherapy spans 20 years in the NHS and for the last 10 years overseas in South Africa.  Thea is available at our Brighton and Hove Practice.

 

Further reading by Thea Beech

What is Social Unconsciousness?

Crossing Borders – Group Analytic Society Symposium, Berlin 2017

What is a Psychotherapy Group?

Group Psychotherapy: The Octopus and the Group – what do they have in common?

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What is Social Unconsciousness?

Social unconsciousness is a term used by Earl Hopper to describe the effect of living in a world where we are connected by our common histories, culture and social, political and economic environment.   

But how does this affect us? With so much taking place in our ever-changing world, this has a place in our experiences in the present such as Brexit as well as in our past.  When it then comes to looking at the therapeutic relationship we have, the focus tends to be on our close relationships.  Very rarely do we take time to look at our minds and the effects it has on it.

It is clear however, that economics does determine whether we can reach our potential.  The daily commentary on Brexit is primarily focused on the damage of fiscal instability on wealth, employment and the ability of the state to provide for those unable to look after themselves.  This is turn creates fear and division resulting in anxiety, which, as a community we are suffering from. All this change creates dissonance which we need to learn to tolerate and adapt too.  In a pluralistic society, psychological robustness is essential as we need to tolerate living and coping with the differences.

It is often questioned if part of the increased level of mental illness is due to the disturbances in the social matrix?  Does it form part of our experience of the social unconsciousness?  I personally wonder if social media and its potential to invade our personal space means we are unprotected from the outpourings of hatred, once confined to the mind where these thoughts can be reflected upon but has now spilt out onto the page for all to see.

We all need to take a moment and remember that not everything has to be shared publicly.  We need to reflect on contextualization and take time to examine it against reality and critical thinking.  The clinical space, its boundaries of time and location, can provide the holding and containing for our disturbance and anxiety in order to gain a better understanding of ourselves.

Thea Beech is a UKCP registered Group Analyst, full member of the Institute of Group Analysis and a Training Group Analyst.  Her work in psychodynamic psychotherapy spans 20 years in the NHS and for the last 10 years overseas in South Africa.  Thea is available at our Brighton and Hove Practice.

 

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How are you going to Spend Your Emotional Currency in 2019?

Perhaps it seems odd to you to even think of emotions having an intrinsic value, isn’t it all rather cold and controlling.  However, alongside purchasing a house, a car or other valuable object our relationships will need energy and investment of time to make them work well.  

So in the next twelve months, wherever you are in the partnership process, there will be things to consider that will require the investment of emotional energy. If you are single you maybe considering looking for a partner or hoping love comes along, whichever way you approach this, a life-long partner will be one of the most important emotional investments you make. 

Although many of us go about this in a haphazard way, without giving sufficient thought to what we need to make a commitment to another person. Often we are under pressure from parents or peer group and the ever-present biological clock to get on and find someone or consolidate an existing relationship.

Some of us who are members of a religion will have priests or clergy to go to for advice and preparation before entering into a full commitment.  However, this usually occurs after the couple have met and decided to enter into a long-term relationship.  At this point the intention has been shared with family and friends, when it is more difficult withdraw, if the preparation phase uncovers areas of incompatibility in the relationship.

I have wondered, through working with couples, whether this should be done earlier in the relationship as soon as couples find they are talking about their future together.

Falling in love is an intense emotional, biological and physical experience, at times expressed as akin to madness.  Delightful though this period of time is, it does hinder good decision-making.

Couples will come after a crisis, wanting help to mend a relationship after an event or betrayal has injured the mutual trust in the relationship.  Or they come when a life event, such as the birth of the first child, loss of a job, children leaving home, retirement, illness or bereavement.  All of these events put demands on the relationship, and people handle them in different ways.  It helps to have a supportive family or friendship network around to contain and hold the couple as they navigate their way through these life-changing processes. All require the expenditure of emotional energy to maintain the relationship on an even keel.

So ideally we could envision a couple coming to relationship counselling before they finally decide this is the person they feel able and want to make this commitment to for the rest of their lives.

Dorothea Beech is a UKCP-registered Group Analyst, full member of the Institute of Group Analysis and a Training Group Analyst providing long and short-term psychotherapy to both couples and groups in Hove and Lewes.

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Group Psychotherapy: The Octopus and The Group – what do they have in common?

On my way into work the other day I happened to be listening to the radio when a program called “Inside Science” was playing.  The theme for the program was “Alien Minds”.  A man called Peter Godfery–Smith was talking about his book “Other Minds”.  He described how we assume the existence of a central nervous system, like our own, a brain commanding the peripheral nervous system.  He then went onto describe the Octopus, whose decision making processes, not sure this is the right word, are distributed throughout the body, the tentacles can act separately to the rest of the body.  He describes the research that discovered this; the podcast is available for you to listen to on BBC podcasts.

 Why did this stay with me? And why is it relevant to the group? When talking about groups we hear about a group mind, or the social unconscious (Hopper) using the symbol of something central acting on the individual, however, the description of the octopus would perhaps provide a better metaphor for group processes.  As individuals we like to think we are free to act from an autonomous position, however when we begin to think about all the influences around us, some known, others we are not aware of, we realize life is more complex than we thought.

When you join a group or team you have access to many minds working together, it multiplies the opportunity for self-awareness, for sharing experiences, for helping others as well as being a help and understanding.  Of course on the other side of this is what you are told might be difficult to hear, emotions connected to competition and rivalry, challenges long-held ideas, exposure to others who do not think as you do emerge.  However, if we are to build the resilience we need to face these difficult emotions in order to reach our potential.  

As the group develops, like the octopus, the group is held together through its biological connections that make it an integrated organism.  In the group, a matrix of interactions forms from the histories each member brings to the group, which cross from generation to generation as part of transgenerational processes, the social context with its vast variety of influences, economic, political and familial.

 As this plays out in the group each person has the opportunity of gaining insight and understanding into how they have been shaped by the many groups they have encountered throughout their lives and shared history. Relationships evolved, often unconsciously, to influence how we behave in the present, repeating patterns that may not be healthy and need adjustment to enhance our mental wellbeing.

Thea Beech is a Group Analyst, full member of the Institute of Group Analysis and a Training Group Analyst and works from our Hove practice.  She is currently running an psychotherapy group which is accepting new members.Facebooktwitter

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