support groups Archives - Brighton and Hove Psychotherapy

June 10, 2024 by BHP Leave a Comment

Should I seek therapy?

Many stressors can impact on our emotional wellbeing such as financial pressures, time pressures, loneliness, physical health problems, insecurity of housing, insecurity of job contracts, loss, bereavement, relationship problems, work stress, family, caring for others, a trauma, adverse childhood experiences, etc. The list is endless.

The build-up of these stressors can often result in mental health difficulties such as stress, anxiety, depression or low self-esteem. We can often feel that we are out of control. Anxiety and depression are very common problems in mental health, with one in four people experiencing this at any one time. Two in five GP appointments (that’s 40%) involve mental health difficulties (https://www.mind.org.uk/).

It can be very hard to admit to having a mental health difficulty and asking for help. Too often we think we should be able to cope. We put unrealistic expectations and pressure on ourselves. We expect ourselves to manage whatever life throws at us. We take responsibility where perhaps it isn’t all ours to take, and struggle to implement boundaries for ourselves. We can consider ourselves weak if we feel that we are not managing and need some help. We think others will judge us negatively, either thinking that we would be burdening others if we were to say something, or, that others would think differently of us if they knew.

However, would we apply this same dialogue that we give ourselves, to others? Would we think less of a friend if they shared with us that they were struggling and could do with a bit of support? Would we think differently of them if they were to say they had decided to get some help and had linked in with a therapist? Would we not think it shows courage, strength and bravery rather than weakness?

Life isn’t easy and managing day-to-day stress can be a struggle. Reaching out for support or therapy and taking responsibility for our mental wellbeing is not only a big step but important in valuing ourselves and looking after ourselves.

All too often when people finally reach out it’s because they’ve hit rock bottom and they don’t know what else to do. They’ve been suffering in silence for some time. If we were to encourage each other to reach out for support and help sooner, we may see benefits in mental health and emotional wellbeing. Talking therapies such as CBT are widely used in the treatment of anxiety, depression and low self-esteem. CBT is one of the National Institute for Health and Care Excellence (NICE) guideline treatments for anxiety disorders and depression and is the most widely used. Interpersonal Psychotherapy (IPT) is also a NICE guideline treatment for depression. However, there are many different approaches that can be of help.

When asking yourself should I seek therapy, these are some of the considerations you might make:

Have I struggled to be myself lately?
Am I feeling low or have I been worrying more?
Is day-to-day life feeling harder?
Am I finding it difficult to enjoy the things I normally would?
Am I more withdrawn, struggling to be around people?
Am I struggling to cope with a particular problem or change?
Do I often find myself comparing myself to others and not feeling good enough?
Do I have a confidante I can talk to or am I struggling to talk about how I am feeling with anyone?

You may be someone that has never considered taking the step of seeking therapy because you have always been the one to cope, the strong one, the one that others go to when they need support.

What is important to remember is that you’re not alone. Everyone needs help sometimes so take that step forward in looking after yourself. Of course, therapy itself is challenging as it is about making changes and talking about things that perhaps you haven’t before. However, it can also be life-changing and lead to profound benefits.

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults. Rebecca is available at our Brighton and Hove Practice.

Further reading by Rebecca Mead –

How does CBT help with low self esteem?

How does CBT work?

Practical examples for ‘food and mood’

Food and mood

Online vs in-person therapy

April 8, 2024 by BHP Leave a Comment

What happens in groups: free-floating discussion

There are many overlaps and similarities between what happens in one-to-one and group therapy. There are also many differences. Below I am going to talk about a group process called ‘free-floating discussion’ (Foulkes 1964, pp 40, 126).

In any group session, individual members are likely to bring in something for attention from the group. For example, this might be a problem, a narrative from the past or present, a dream, a dilemma, or a difficult feeling or experience, and so on. The group will generally respond to whatever is being presented in a similar way to an individual therapist. For example, by focussing on what is being said and offering a mix of interventions such as empathy, understanding, questions, reflections, links, and insights.

However, therapy group members are also encouraged to associate with what they are hearing and disclose what is being brought up for them. Here the group departs from individual therapy where the therapist is very unlikely to join in in this way and even if they did, they would not generate the multiple responses that a group can. If the group members can let themselves engage spontaneously with their associations and thoughts, the conversation can then start to move and flow between different members. In other words, into a free-floating discussion.

Those new to the experience of group work can sometimes find this disconcerting, ‘I don’t want to make it about me’ or ‘I don’t want to take it away from you’ are not uncommon comments. While socialised inhibition and politeness may be at play, group members used to one-to-one work might also feel reluctant to move away from what can be seen as essentially an individual therapy model – that is that the group acts together as the ‘therapist’ with one person as the ‘patient’.

However, this concept of free-floating discussion was developed from a Freudian idea of ‘free association’ for individual work. Freud encouraged his patients to let their thoughts, feelings and fantasies wander and move from one association to another in a session, and to disclose these as spontaneously as possible. Freud believed this process allowed him and the patient to get closer to the unconscious.

Free-floating discussion in group therapy is a similar idea. The more freed up the group is to move from one association to another, the richer the conversation becomes. Group members can therefore move more deeply into less ‘known’ areas of understanding and profound emotional connectivity, opening the potential for a transformational, therapeutic experience.

What happens in groups: blog series by Claire Barnes

This blog is part of a series, in which I look at what happens in group analytic groups. I hope that this will give a sense of what it might be like to be in a therapy group and what are the ideas that underpin group analytic therapy.

Other blogs in the series include:
How psychotherapy groups can help change our internalised family systems
What is the role of the therapist in therapy groups?
What happens in group therapy: mirroring
What is it like being in a psychotherapy group? Case study – Joe

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice. She also offers couples therapy at BHP.

Further reading by Claire Barnes

It’s not me… It’s us!

What are the benefits of a twice weekly therapy group?

Understanding feelings of guilt

A new psychotherapy group

The process of joining a therapy group

May 8, 2023 by BHP Leave a Comment

What are the benefits of a twice Weekly therapy group?

Most therapy groups run once a week. In our practice at Brighton and Hove Psychotherapy, we also offer a twice weekly group, but how does having a second session in the week help?

Emotional bonds
An essential aspect of any group therapy is building emotional relationships between group members, enabling strong attachments to form. This creates an enhanced sense of belonging which, in and of itself, is therapeutic.

In addition, because psychological difficulties tend to originate in some form of breakdown in early childhood relationships, group psychotherapy also emphasises the relationships in the group as an essential means of understanding oneself and others.

These relationships are both real and transferential (the latter, meaning other members and the conductor can ‘stand in’ for important relationships, especially in the original family). In this way, therapy groups offer all kinds of opportunities to explore the complexity of relationship dynamics, both past and present. This helps the individual to develop insight into their patterns of relating and what ‘went wrong’ early on, as well as the potential to find resolution and transformation in ongoing relationship problems.

Any functioning therapy group will enable these emotional bonds and dynamics to grow between members but in a twice weekly group these relationships are likely to be particularly intensified and strengthened.

Depth
Group analytic psychotherapy is concerned not only with reaching depth in relationship to others but also in relationship to oneself. In this approach, we are interested in what is known and conscious but also, and arguably more importantly, what is unknown and unconscious.

It has long been assumed and agreed, in the analytic professional field, that greater frequency of sessions will reach greater depths in the psyche. When the gaps between sessions are shorter there is less time for defences to build up. This is as true for group work as it is for individual work.

Continuity
It is perhaps obvious to say that a more frequent therapy model will provide greater sense of continuity from session to session. Shorter gaps means that threads and conversations can be picked up, carried forward and explored. This facilitates the emotional intensity and the depth outlined above but can make the group also feel more containing.

This helps because therapy work can be anxiety-inducing. To be successful, therapy will always touch parts of ourselves that we don’t see, or don’t want to see, or don’t want others to see.

The more frequent contact also reduces anxieties that inevitably arise in making any close relationships. On the occasions friction or conflict in the group arises, the opportunity to return and repair is only a short time away.

Who would benefit from twice weekly group therapy?
Returning to my original title/question, you may be wondering if you are someone who might benefit from twice weekly group therapy?

Finances and Time
Of course, there can be practical considerations. A twice weekly group essentially involves greater time and financial commitment than once weekly groups. Currently, for example, the twice weekly group I run works out at £60 a week (2 sessions of £30 twice a week). This is £20 a week more that my once weekly groups.

However, it is worth noting that in relationship to individual work, £60 a week is a lower fee than that charged by many psychotherapy practices, including my own and those at BHP, for individual therapy.

In addition, if you feel you would benefit from working in a more frequent way, doing this in a group is financially far more cost effective than in individual work.

The time commitment is also something that some people find they need to think about. My experience is usually once people have made connections in the group, it becomes a part of their life and network and so easier to accommodate.

There is also a good argument that the intensity of the work speeds up the process and that, in the long term, more frequent psychotherapy tends to achieve results more quickly and more lastingly than once weekly. There are, of course, exceptions to this in both ways but my experience has certainly been that changes tend to come about more quickly and with greater tenacity in twice weekly groups.

Who might benefit?
So, who might benefit from this more intensive, in-depth, group work? Well, this is much the same as for any group therapy – see Is a Therapy Group Right for Me? Am I Right for a Therapy Group? – Brighton and Hove Psychotherapy
And, beyond that, I would say anyone and everyone!

It seems to me that the advantages, as outlined in this article, will have a special appeal to some people. This may be for different reasons; according to individual struggles, where people are in their lives, and what they feel drawn to. But ultimately, if you are looking for an in-depth and impactful psychotherapy with an emphasis on exploring your relationship dynamics and patterns, that is also cost effective, then this may well be a good option for you.

Additional note
My focus here is on the ‘twice weekly’ element of this question, but if you are interested in reading more about group therapy, and its benefits, below are some links to some blogs and webpages.

(Further reading can also be found under ‘blog’ and then ‘groups’ on our homepage)

Group Analytic Psychotherapy

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

How psychotherapy groups can help change our internalised family systems

Claire Barnes is a group analyst and training group analyst. She runs 3 groups at the practice,
Twice weekly: Mondays 4.15-6.45pm, Wednesdays 7.15-8.45pm
Once weekly: Thursday mornings 10.15-11.45am
Once weekly: Thursday evenings 6.15pm-7.45pm

If you are interested in exploring the possibility of joining any of her groups, please contact through the enquiry form.

August 22, 2022 by BHP Leave a Comment

A New Psychotherapy Group

Starting a new psychotherapy group always gives me a sense of excitement. Until everyone is in the room together you never quite know what’s going to happen. And of course, that’s just the beginning.

Growing a group

In group analysis we often talk about ‘growing’ a group. It’s a useful way to describe the process. Tilling the ground, adding nutrients to the soil, planting seeds, watering, feeding; all these gardening activities symbolise the tasks involved in trying to create a nurturing environment for individuals to come together and flourish as a therapy group.

Firstly, finding a good setting is very important. (I am lucky to already have a lovely group room at Brighton and Hove Psychotherapy in which my two current groups meet, so this isn’t a task I have to be concerned about).

After the setting I settle on a regular time and day of week for the group to meet. And then I see if I can find individuals who might be interested, can make that time, and who I feel might benefit from a group.

Suitability for group therapy

Although exploring who will join the group means giving time and support for potential members to work out if a group will be right for them, I will also be thinking about their suitability for group therapy, and this particular group.

A fundamental question in my mind will be about the level of interest the person might have in themselves and others. Curiosity is vital for individuals to benefit from the group and, also, for the group to benefit from them.
And it needs to be the right time. For e.g. someone who has had a very recent trauma or bereavement, might need to get help with this first before they are ready to be in a group.

The joining process – boundaries and culture

The group culture is important in making the group feel safe and therapeutic so there are certain boundaries that people need to agree to – e.g. confidentiality etc – before joining.

See my blog on The Process of Joining a Therapy Group for more detail about this and other aspects of the joining process.

Differences between joining a new group and an established one

There are certainly some differences in joining a new group than an established one. One of the features – if not advantages – is that you are at the core of the experience from the start and will inevitably have influence in shaping how the group forms early on. It’s perhaps akin to being the oldest child, as opposed to children who come after who may never quite fully share and know all the family history.

The first session

The first session of a new group is nerve racking for everyone – including me! Generally, it goes much better than people expect. Inevitably it can feel a bit awkward at first, but once these initial steps have been taken people usually do start to feel comfortable enough to begin opening up. Often people are surprised by how intimate it can feel so early on.

Common ground is usually found and, for many, it’s a major relief from the outset to see how their worries and fears become quickly normalised.

New group starting

I will be starting a new psychotherapy group later this year, running Thursday mornings on a weekly basis. If you’d like to find out more or explore the possibility of joining, do get in touch with me through my practitioners’ page.

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 process of joining a therapy group

What is ‘othering’ and why is it important?

How psychotherapy groups can help change our internalised family systems

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

What happens in Therapy Groups? The role of the Therapist

April 18, 2022 by BHP Leave a Comment

The Process of Joining a Therapy Group

Below, I am going to outline the process for joining a therapy group. It is important to say at the outset that I am describing my own practice and while the underlying principles will generally be shared by other group analysts, the specific processes and procedures will be variable.

Taking the First Step

People come into my groups in a variety of ways. Some people get in touch because they have decided for themselves that group therapy might be helpful for them; they may even have been in a therapy group in the past, or a group might have been suggested to them.

If you fall into this category, the chances are you will have already been thinking about the benefits of a group and are now ready to take that next step in joining one.

Others come with a little more uncertainty. They may have had a group suggested to them by their therapist or been assessed and a group strongly recommended. If someone hasn’t been thinking about a group before and doesn’t know much about group therapy, this suggestion can come as a surprise and, for some, take some getting used to.

If you fall into this category, then you may be feeling a little more cautious and might need more time to think about this idea of group therapy.

Initial Consultation

When anyone gets in touch with me, with an interest in joining a group at the practice, I offer a short, free telephone consultation. This usually takes around 20-25 minutes and gives us both an opportunity to think about; why they are considering a group, whether group therapy is suitable for them and what spaces are available in which groups here at our practice. I may also ask a few questions about their background, current situation, and particular issues and most likely, we will touch on what might be beneficial and challenging about being in a group for them.

This telephone conversation can lead to a range of outcomes. For the purposes of this article, I shall focus solely on what happens if we agree that a group appears to be timely and suitable for the person and I have a group space at a time they can make.

Assessment

While the telephone conversation is useful in clarifying any immediate obstacles to someone joining one of my groups, it is not an assessment. Therefore, the next step would be to have a face-to-face assessment. This is done in-person if possible – unless of course it is an online group we are considering.

This session will explore in greater depth what we would have covered briefly on the telephone. I will also ask more about the person’s history and encourage some thinking about their relationship to groups, such as, family, school, friends, work etc. As in all psychotherapy assessments, I will want to find out a bit more about the person’s relationships, problems, needs, risks, medication, previous psychological input, and levels of function.

This session also gives them the opportunity to think in more depth about the idea of being in a group. This is helpful to get a firmer sense of why a group might help but also what challenges a group might present to them.

Sometimes we need more than one of these assessment sessions before we’re clear that the person is ready and wanting to join a group.

Finding a Time to Join

Once we’ve agreed that someone is ready, we need to think about when they will join. In a new group this is relatively straight forward – I give all prospective members a start date and they all join at the same time.

Joining an established group is a little more complicated as the group also needs to be ready to accept a new member. These groups are called ‘slow’ and ‘open’ which means while people join ongoingly we make sure this happens at a slow pace. This helps the group continue to feel stable and secure.

As well as this factor, before the individual joins the group, they also need to be ‘ready’ and they will need some help in preparing for this.

Preparation and Contracting

I have generally found that anyone joining a group requires at least 2 or 3 preparatory sessions. Some need more and some decide to do some individual work with me first before joining the group.

The preparatory sessions offer an opportunity to explore further the themes picked up in the assessment process. In addition, people often find it helpful to make some space for any anxieties that might arise.

This preparatory stage also allows me to talk about what is expected of group members. To keep the group therapeutically safe, all members are asked to agree to certain boundaries. An obvious example is confidentiality. Another is that members do not have contact with each other outside the sessions. These and other boundaries can be seen as making a contract with the group to keep it safe and therapeutic.

First session

The first session can feel daunting, even for those relatively confident in groups.

In a new group there can be a lot of anxious feelings in the group which can take several sessions to start to properly settle. However, everyone is in the same boat and often people find that reassuring and helpful. It can also feel important for some to feel that they have been in a group from its earliest inception.

In an established group, being the new person is always going to feel challenging to some extent and likely to bring up earlier experiences of being new (for e.g., starting school). However, the atmosphere is likely to be much calmer and less anxious than that of a brand-new group. Established members will also be able to help the new member settle in. Some people can also enjoy the feeling of being special that their newness gives them.

Despite the expected anxious feelings new members are often surprised how quickly they form bonds and get to know other members of the group. This process is helped by the preparatory work and the boundaries agreed to by the members.

Conclusion

Whatever the experience of joining a therapy group the likelihood is it will feel powerful and tap into earlier histories and experiences of both groups and beginnings. The emphasis on stages of initial consultation, assessment, preparation, and contracting, are all in place to hopefully help and support the new group member in their own joining process.

Joining a Group

If you are interested in exploring joining one of the groups mentioned above, please do contact me through the enquiry form.

Groups run by Claire Barnes

Claire currently runs two groups at Brighton and Hove Psychotherapy

once weekly group on Thursday evenings
twice weekly group on late Monday afternoons, and Wednesday evenings.

She is also now taking referrals for a new face-to-face group, to run on Thursday mornings at the same practice and address.

Further reading by Claire Barnes

What is ‘othering’ and why is it important?

How psychotherapy groups can help change our internalised family systems

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

What happens in Therapy Groups? The role of the Therapist

What happens in Group Therapy: Mirroring

July 5, 2021 by BHP Leave a Comment

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

June 14, 2021 by BHP Leave a Comment

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

May 17, 2021 by BHP 1 Comment

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?

December 14, 2020 by BHP Leave a Comment

Groups for Mental Health

“What we cannot hold we cannot process, what we cannot process we cannot transform, what we cannot transform haunts us. It takes another mind to help us heal ours. It takes other minds and hearts to help us grow and re-grow the capacities we have to transform suffering.” Joseph Bobrow

I would like you to consider the above quote in relationship your mental wellbeing. Are you confused by your reactions to thoughts, emotions and feelings, do they seem to come out of the blue? In a group you have a space, with others, to connect with and explore where these feelings and emotions are coming from.

In Group Analytic Psychotherapy, we learn to identify emotional states of mind, fear, anxiety, anger, love, and hate whilst we experience the biological reaction in our bodies; the mental and physical experience of trauma and stress.

At the present time we are facing the daily trauma of living through a pandemic that is killing people worldwide. We are bombarded with information through social media. We try to make sense of what is true/real and what is not. The social and collective nature of what we are experiencing impacts on our relationships with those close to us. The social matrix is changing rapidly we feel out of control, we look to those in power to take control and feel angry when they seem to let us down. This leads to greater divisions in the social matrix divisions occur that lead to greater anxiety and chaos, which, can predispose us to difficulties with regulating our reaction in our work or close intimate relationships.

The group provides a space for the transformation of our thoughts and preoccupations, working through our experiences, creating understanding through thinking, talking and feeling the emotion behind anger and stress. The group space, with an experience group conductor, can hold and contain you through this process.

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

July 20, 2020 by Brighton and Hove Psychotherapy Leave a Comment

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

June 15, 2020 by Brighton and Hove Psychotherapy Leave a Comment

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.

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.

May 27, 2019 by Brighton & Hove Psychotherapy Leave a Comment

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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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