The Group Therapy Experience
I first became aware of interpersonal process groups in 2016, while completing a counseling externship at the Asheville Center for Contemplative Psychotherapy (a wonderful resource for clients and therapists alike, which, sadly, no longer exists). My supervisor there started to run process groups and asked if I’d like to join one. I was intrigued, but I couldn’t afford it, what with all the unpaid counseling work I was doing, and my only income being from a record store job that I worked three days a week. A few years later—perhaps as many as five—an acquaintance of mine mentioned being in one of my supervisor’s groups and loving it. And a couple years after that, during my Artist’s Way phase (which some of you might remember), I saw that same acquaintance at two different farmers markets in a row. So I figured the universe wanted us to hang out, and I asked if she’d like to meet up. We had a lovely conversation over coffee. At some point I asked if she was still doing group. She was, and she was still loving it.
So immediately upon getting home, I emailed my former supervisor about joining one of her groups. I had money now, and I was intrigued. And individual therapy had never felt helpful for very long; my first few sessions with a new therapist were usually spent crying more than talking, and for those that followed, I wouldn’t have all that much to say, or the therapist’s response to what I said somehow didn’t inspire me to say more. Maybe group would be different. And it would no doubt be a good addition to my spiritual practice. I mean, how spiritual are you really, if you can’t be with other people in an authentic way? And I’d recently had a Vedic astrologer read my natal chart and say that I came into this world already skilled at being alone; the thing I was here to accomplish—what I needed to learn in this life—was how to be in relationships. So I definitely had that admonition in the back of my mind when emailing my supervisor about group.
I went into it with a pretty good idea of what to expect. I’d taken a class on group therapy in graduate school and was especially familiar with the work of Irvin Yalom, who worked in the here-and-now, as my supervisor did. And a couple years prior I’d watched a YouTube series called Group, which my supervisor had been a consultant for, and which dramatized—in a largely improvised way—a few group therapy sessions in real time. The person playing the therapist is a group therapist in real life—Elliot Zeisel—and the members of the group are professional actors. I highly recommend visiting YouTube and watching that series if you’re at all interested in group therapy—especially that which focuses more on the present-moment process more than the content.
As a provisionally-licensed counselor-in-training, I’d learned all about process versus content. My supervisor hammered away at it, like any decent modern psychoanalyst should. She regularly referred to the “content du jour.” What happened to a client wasn’t nearly as important as how that client felt. And that notion applied to their experience of talking about content. (“What’s it like to talk about this?”) It also applied to my experience of the client. “How do you feel in the room with them?” was a question my supervisor asked a lot, and it was always much harder to answer than I wished!
I wholeheartedly endorse the here-and-now approach to therapy, because the present moment is the only one in which we’re actually alive, so if we can work with emotions as they arise, we’ll actually have a chance of effecting profound change. You can tell me about how mad you are at your spouse, but can you tell me about how mad you are at me, right now? Or how I’m failing to meet some essential need? Or anything, really, about how you experience me? Some fantasy you have about who I am, and what I think and feel about you?
Of course, it’s not as if a process-oriented approach would always have that level of intensity or always be focused on the client-therapist relationship. Any therapy I want anything to do with is always, ultimately, focused on how the client relates to themselves. Even if their presenting concern involves how they relate to others. Because how we relate to others is always 100% determined by how we relate to ourselves. And I don’t mean that if we hate ourselves then we will hate others. When I say self in this case, I’m really referring to emotions. Are there some emotions that scare us or otherwise make us uncomfortable? Have we developed techniques and habits to keep those emotions at bay? If we are human beings, then we absolutely have, and those techniques and habits are having a major influence on how we relate to others. For instance, if I’m not okay with feeling sad, then I will behave in ways to keep others from feeling sad, too. Or pick your emotion. Guilt is a big one. Many of us have formed entire personalities around avoiding the feeling of guilt.
Emotions are running the show. I think I’ve said that before.
And what are emotions, really? They are physical sensations that we ascribe meaning to. That is what has determined the bulk of human evolution (at least since we became “civilized” and collectively more secure about our basic survival). That is what keeps us in a constant state of international and sometimes civil war, and what feeds our need for evermore convenience, and what keeps us—perhaps most tragically of all—from giving voice to our true experience as a human being among other human beings on planet Earth. We feel a twinge of fear, for instance—a constricted throat or a racing heart that we interpret in a certain way, based on past experience—and we cannot say what we know we should. We cannot even say that we’re afraid.
Unless…we’re in therapy. And group therapy in particular, especially when process-oriented, provides a rich training ground for saying the thing we’re normally too scared to say. So scared, mind you, that we don’t even know we’re scared, because we’ve gotten so exquisitely skilled at turning away from that feeling within a nanosecond of its arising. You don’t realize how much of your inner experience goes unsaid, just as a matter of course, totally outside of your awareness, until you enter into a situation where you are expected to put that experience into words. And that is exactly what everyone in a process group is expected to do, regardless of how intense or subtle the emotions at play might be.
One of many things I learned through being in my supervisor’s process group for sixteen months is that my emotional experience is usually pretty subtle. So it’s easy to tell myself that whatever I’m feeling isn’t worth voicing. And then when I feel a strong emotion, it’s hard to push past the fear of expressing it. What if no one else in the group feels similarly? Or what if I hurt someone’s feelings by expressing my anger, sadness, annoyance, disappointment, boredom, what-have-you? What if it sparks a conflict, and they get mad at me, and I feel the need to defend myself? Defensiveness isn’t a good color on anyone...
But group therapy offers a chance to put our defenses aside. People get defensive when they feel the need to be right about something. But when the primary purpose of an interaction—specifically a therapeutic one—is to provide space for exploring emotions as they arise, then right and wrong simply don’t apply. All you’re doing is studying what is. You’re looking at the many ways in which you protect yourself from other people’s feelings, as if their feelings could actually hurt you! The only feelings that can hurt you are your own, and even those aren’t made of tooth and claw like we so often believe they are.
Anyway, I say all of this as an introduction. My experience of being in a process group from late August of 2022 through December of 2023 ultimately inspired me to facilitate a group of my own, which is slated to start on July 26th. In preparing for that, I have joined another process group as a member—this time in-person (the one my supervisor led was on Zoom); I attended a weekend intensive through the Center for Group Studies back in May (they offer three such trainings a year); I met with my supervisor and intend to keep seeking her counsel on a regular basis; I have twice rewatched the aforementioned YouTube series called Group, pausing it periodically to take notes; and of course I have been reading and reading and reading.
So far, my collection of group therapy-focused books consists of five titles: The Schopenhauer Cure, by Irvin Yalom; The Theory and Practice of Group Psychotherapy, by Irvin Yalom and Molyn Leszcz; Psychodynamic Group Psychotherapy, by Rutan, Stone, and Shay; Group: Six People in Search of a Life, by Paul Solotaroff; and The Group Therapy Experience, by Louis Ormont. I’ve read that last one twice and taken lots of notes, so it is the book I’ll focus on for the rest of this blog post.
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Louis Ormont was one of the earliest practitioners of group psychotherapy based on a psychoanalytic model. He facilitated over 20,000 groups and founded the Center for Group Studies (CGS) in New York City in 1989. According to the CGS website, “Dr. Ormont developed a theory of technique which highlighted the strength of the group as the primary agent of change. This technique moved the focus of the group from the leader to the group, minimizing the leader-centered approach as well as minimizing doing individual work in the group setting. His work is grounded in the concept that the group is a microcosm of the ‘real world,’ and that 'those successful in groups are successful in life.’”
Because of this microcosm aspect of group, it is, according to Ormont, “the ideal place to solve real problems.” Interpersonal process groups operate on the premise that people’s real-life problems will inevitably manifest in the group, and can be resolved in the group. Ormont says that the ultimate goal of this treatment approach is to have the group member (1) become aware that [they are] repeating some activity that miscarries, depriving [them] of certain fruits of life... (2) recognize clearly what [they are] doing, and experience [themselves] doing it in the moment; (3) ultimately discover why [they are] doing the thing; and (4) finally achieve mastery over it.” In broader terms, group therapy’s primary aim is for people to “identify and deal with their own emotional blocks and limitations... [to obtain] more inner comfort and a far better ability to realize [their] potential.” It should make people, he adds, “better able to love and work.”
How very Freudian of him! Which would make sense, given his psychoanalytic training. I can’t remember now where I read it, but I did read once upon a time that when asked what was most important in life, Freud responded, “Love and work.”
So how does group therapy make us better able to do those things? Well, both love and work tend to at least sometimes involve other people, and both challenge us in existential ways, as we want them to feel meaningful and nourishing, and they don’t always comply. Ormont cites four special benefits of group treatment: (1) it elicits self-destructive behavior (yes, that’s a good thing, because only when such behavior is actually present in the room, can it be worked with); (2) it enables the members to see how others respond to them; (3) it affords patients diverse views of their behavior (whereas in individual therapy, they only have their view and the therapist’s); (4) it affords the opportunity for on-the-spot self-definition; and (5) it affords the chance to practice new behavior.
Going back to number one: maybe you’re wondering what Ormont means by “self-destructive behavior.” It sounds intense, but it could be quite subtle. Maybe, for instance, you tend to apologize whenever you cry. But apologizing suggests that crying is wrong somehow; it’s you saying to yourself that you shouldn’t be crying. That is self-destructive. So is getting defensive when such defensiveness isn’t needed, because then you push well-meaning people away, essentially refusing their help, which may simply come in the form of feeling more connected to them. With conflict comes intimacy. I heard that on a YouTube lecture about group therapy, and it’s so true. Keep it in mind, all you conflict-avoidant types. You might tell yourself that you’re avoiding upsetting others, but it could be that you’re actually avoiding connecting with them.
The second benefit Ormont lists is self-explanatory: group allows members to see how others respond to them. Perhaps they respond in ways that feel familiar—ways that might go all the way back to childhood, to family-of-origin dynamics. Such discoveries then open the door to exploring how the client in question helps create the ways in which others respond to them. And as I already stated, having the multiple views that a group affords allows each member to see themselves from different perspectives. Ormont also says that “when a person speaks to many others and not just to one other individual, their own words echo in their mind more loudly.”
The fourth benefit of group treatment is that it affords the opportunity for on-the-spot self-definition. “[It] offers the members an opportunity for spontaneous introspection, [and] it enables people to label and capture their truly actuating feelings and motives.” In order to define ourselves—or to see with greater awareness how we’ve been defining ourselves without even consciously knowing it—we must study ourselves in great detail. As Ormont says, “There are endless forms of behavior that people engage in but do not ordinarily stop to examine, which group can halt and investigate.”
And lastly, the fifth benefit is also self-explanatory: [group therapy] affords the chance to practice new behavior. Say the thing you don’t normally say. Let fall the tears you normally hold back. Hold a gaze you’d normally glance away from. Translate feelings into words. Be courageous. Trust the process. Trust yourself. And notice how alive you feel. This aliveness, in fact, is a benefit I would add to Ormont’s list. He might call it “stimulating real consciousness.” You might not always enjoy how it feels to speak your truth, or to try and figure out what the hell your truth even is by thinking out loud with others who have agreed to actually listen and give a shit, but you definitely won’t feel dead inside. You will contact the thrumming physicality of yourself and all the emotions you’re made of, and you will be healthier—more human—for it.
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My interest in group therapy lies not only in the experience of being a group member, but also, of course, in facilitating groups. I see it as a supreme act of bravery, and spiritual bravery in particular. Spiritual because a group therapist must be even more skilled than an individual therapist at setting their ego aside when confronted with some really strong human emotions, projections, and resistances. If a group member accuses me of something—some version of not doing my job well enough—I have to be able to move toward that person (figuratively more than literally—although I might lean forward in my chair a bit), and ask them, with warmth and curiosity and total openness, to tell me more about their feelings. I cannot respond—or rather, react—in a defensive, conditioned way. As Ormont says, “To err is human, but to remain open when our errors are hurled in our face, that is the mark of the true group therapist… We must never punish a critic by removing ourselves emotionally.”
If you’ve read some of my other blog posts, you might have come across my favorite definition of spirituality: getting beyond conditioning. Facilitating an interpersonal process group strikes me as one of the most potent ways to practice this. I must use my body and its sensations, its emotions, as an instrument. I must be able to model for group members the in-the-moment translation of feelings into words. “This is what I’m feeling—toward you—right now. Let’s explore together exactly what’s happening.” Good group therapy should, in my opinion, be a kind of meditation. It requires an exquisite presence—a wholehearted embodiment of the here-and-now. Whatever happens, it’s just happening, and we’re here to observe it and learn from it. That is deeply spiritual work. That is showing up as my most authentic self, from moment to blessed moment. To quote Ormont, “Not until the therapist comes out of hiding can the members arrive at truly new discoveries or form new relationships.”
And along with being present for, and unthreatened by, my own emotional and cognitive experience, I must also be fully present with the group. Being fully present with just one person can be challenging—I speak from professional experience on that front. So doing it with five to eight people (or in some cases as many as twelve—or as was the case in my CGS weekend process group, seventeen!) is exponentially more demanding. It doesn’t just mean giving my attention to whomever is talking, but also scanning all the other faces to see how folks are responding, nonverbally. If someone makes an interesting face, or if someone sighs or clears their throat or crosses their arms over their chest, I might call another group member’s attention to it, thereby practicing the art of bridging.
Bridging is a group therapy technique whose aim is to evoke meaningful talk between group members, to develop emotional connections where they did not exist before; it’s a mode of getting people to expose their inner lives to one another; and it consists of bringing out the differences and the similarities between group members. In The Group Therapy Experience, Ormont names three opportunities for the use of bridging: (1) When a group is too quiet. (In this case I as the therapist might say, “George, how do you feel about Edna’s opening and closing her purse?”) (2) When someone is too talkative. (“Edith, why do you think Nate won't give you any time to talk?”) (3) When a subgroup dominates the room, like a group of women who only talk about their frustrations with unfeeling men. (I might say to the subgroup, “Which men in this room are unfeeling?”)
Ormont also names three methods of bridging: (1) Open-ended questions. (“What do you think Leslie is actually feeling when she purses her lips?”) (2) Directed questioning. (“I guess you are aware that Micky feels injured by what you just said?”) (3) Questioning a member about an interaction taking place between two others. (“What feeling is Pam hiding from Carlos right now?”) All of these wonderful concrete examples are a big reason why I like Ormont’s book so much. And hopefully they’re helping you start to see how the experience of a process group is profoundly different from our typical interpersonal dynamics. Ormont could ask Pam directly what feeling she is hiding from Carlos, and the ensuing conversation between the two of them might indeed be therapeutic in some way. But to ask another group member what Pam is hiding from Carlos takes it to the next level. The group therapist’s job—well, one of them—is to guide the members toward expressing new feelings toward one another. Every question they ask in a group should have “the aim of liberating new emotions in a member and enabling the members to relate in some new way.”
Ormont says, “Instead of asking people about themselves, we should ideally ask people about others [in the group], knowing that they are talking about themselves in the process.” How can we know that? Because projection. We don’t see things as they are; we see them as we are. (That quote has been attributed to several people but I prefer to think Anais Nin said it first.) Bridging is a way for the group therapist to both involve and engage the group when addressing an individual. Ideally, every time they address an individual they should involve and engage the group. That’s some Superman shit.
Granted, group therapists also spend a lot of time being silent. In many cases, this silence actually requires a lot of work on the therapist’s part. In all cases (ideally), it should be intentional. The therapist must have patience and a deep trust in the process in order to let a given group member see their own patterns. And patterns imply repetition. One must behave in a certain way over and over again in order to say, “Hey, I’ve done this multiple times before. This must be a pattern!” So the role of the group therapist, according to Ormont, “should be merely to bring to the surface our patients’ self-destructive activities—to help them see themselves... If we do more, they will do less.”
If we do more, they will do less.
Man could that apply to so many things in life! How we raise our children, for instance. And how we depend on machines, for another.
Later on in the book Ormont provides a corollary—or perhaps a correlative? or a sequela?—to this notion: “The more the group does, the more the group profits.” Which also seems like a metaphor for the macrocosm of real life.
But back to what the therapist does or doesn’t do. One big reason they will seemingly do nothing is because they want the group members as individuals to see their behavior over and over again, “so often that [they evolve] intimate familiarity with it.” In many cases, the therapist—and maybe other group members—will spot a particular person’s pattern before that person does. So why not tell that person, say, “Hey, I notice you do that sort of thing a lot.” That wouldn’t be wrong, per se. But Ormont argues that such an intervention typically has the effect of changing a certain behavior without changing the internal mechanism that drives the behavior. So it will basically assume a new form, show up in other ways. It’s much more conducive to real change for the person in question to discover the pattern himself. So the therapist should also try to keep the other participants from “diagnos[ing] and stifl[ing] a member's pattern before it is truly resolved,” lest the same failure result. Ormont suggests the therapist say something like, “Look, you people are trying to stifle this man instead of letting him be what he is. You people don't want to accept the feeling that you experience when John [behaves] that way.”
He uses the phrase “you people” quite a bit, which I find amusing. Sometimes group therapists have to “step in hard,” and they must be willing to stand apart from the crowd, rebel against a certain element of group culture. Group attempts to suppress an individual’s behavior necessitate this kind of rebellion, as such suppression runs counter to the whole point of a process group. Also, Ormont adds, “in not going along as one of the crowd, we benefit both the particular member and the group.” The benefit comes in the form of a real-life example of healthy interpersonal risk-taking. I am secure enough in myself to set my own course and think my own thoughts. The therapist must be able to model this behavior for the group. And of course members of the group can model this and other more functional ways of being. Referring to a fictional client named Henry, Ormont says, “Henry might seize a phrase from one person and a style from another, constructing a trait in the only way that people ever acquire traits—through conscious and unconscious imitation.”
Is that really the only way people acquire traits? Through conscious and unconscious imitation? It’s interesting to ponder…
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No exploration of any psychoanalytic approach to therapy—group or otherwise—would be complete without at least a mention of one key concept: resistance. People are pretty much always resisting something, and that way of being tends to get heightened in the therapy room. Ormont defines resistances as “activities whose aim is to keep truths from emerging. (Such truths as that I am afraid, or that I hate you, or that I have sexual feelings for you.)” Group analyst Edrieta Fried defined resistance as “the forces that curb attachment to the group, that interfere with sharing experiences, and that undermine solidification and consolidation.” I’m not going to get into the weeds of what those last two words mean in this context, but I will say that I have felt the forces within me that curb attachment to the group and interfere with sharing experiences. They are strong but freakishly subtle, I can’t see them coming, and once they’re in effect, it is very hard to overcome them. They almost always come in the form of me not knowing how I feel, not being able to contact my emotions. It seems the best way to overpower such a resistance is for a feeling to be very intense, because then I will at least start crying…
Getting to know your resistances is hard. They’re resistances, after all! They don’t want to be known. But that is exactly what must happen in order to overcome them for good (or at least in a meaningful way from time to time). Or rather, one must come know what truth a given resistance is concealing. Ormont says, “Resistances must be carried on in the dark, and, indeed, resistances may be said to manufacture darkness... Since the function of a resistance is to conceal a truth from oneself, if one knows fully what the truth is and how one conceals it, a resistance itself becomes worthless.”
And as with other behaviors that someone needs to change, those rooted in a resistance must be repeated again and again. “The more facets of a resistance that become conscious, the clearer the nature of the resistance becomes to the person... We need [them] to go through their whole repertory, not once but many times.” And the beauty of group is that a person’s resistance pattern can reveal itself in a variety of ways, due to there being a variety of people present. The same resistance might not reveal itself at all in the context of one-on-one therapy.
Resistances can occur in individuals, in pairs, in subgroups, and (heaven forbid) in whole groups. Ormont names two signs of group resistance. The first is that one or more features of the group contract are being broken. “The members refuse to talk, or inform us that they have talked about group matters to their friends or spouses.”
A word on this contract, or what I prefer to call “the group agreements.” They commonly (but do not always) include the following: agree to be punctual and present each week, and remain for the duration of the meeting; agree to work actively on the problem that brought you to group; agree to put feelings into words, not actions; agree to refrain from socializing outside of group; agree to remain in the group until the problems that brought you have been resolved; agree to be responsible for your bill; agree to protect the names and identities of your fellow group members; and agree to terminate treatment appropriately. So according to Ormont, any flouting of these agreements is a sign of group resistance.
Another sign is that I as the therapist feel ineffective. It is imperative that I recognize my own feelings of ineffectiveness, assume it’s they’re the result of a group resistance, and start a process of inquiry around what that resistance might be. Maybe I start to notice that the group never acknowledges my presence; I feel like a ghost. Ormont suggests I point it out by saying, “Why do I get the impression that I don't exist here?” Or [to incorporate bridging], “George, why is it that no one ever mentions me?” From there the group can start to explore that behavior as a group, and become more aware of it. And “only by becoming aware of their resistances...can our group members put [them] aside if they so wish.”
If members are chronically late, then I can show up late one day, thereby engaging in the resistant behavior myself. Then we can explore how my lateness made the group members feel. Ormont is quick to point out that we should only take this tack if we have absolutely no disdain in our hearts for the tardy people in question. If we can’t echo their behavior objectively, with nothing but the purest of therapeutic intentions, we shouldn’t even consider doing it.
I could say more about resistance, but I find myself resisting that. Another key psychoanalytic concept to which Ormont devotes many pages is transference, but I find myself resisting that, too. Maybe I’ll do another post on this endlessly fascinating topic. For this one, though, I just wanted to give you an idea of what process groups are like. And maybe inspire you to join one yourself? For the sake of humanity? Think about how much better the world would be if everyone practiced putting feelings into words instead of behaviors? (And sarcasm, by the way, counts as a behavior.) Of course I know the world isn’t going to get better, ever. But your little world could, and the worlds of the people around you…
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I’m going to wrap this post up with something Ormont says about progress. He says, “New challenges are an eternal cost of progress.” Isn’t that so well-put? It’s similar to saying that with every solution comes another problem. I always think of automobiles: they gave us a way to travel faster and not rely on horses, but in no time they polluted the air and necessitated the construction of interstate highways, just to name two of the problems they pose. And of course there’s the smartphone: it enables us to stay constantly “connected,” but most of us are addicted to them, and our children are more anxious than they’ve ever been. And don’t even get me started on AI and all the new challenges already resulting from that form of “progress”—which I put in quotes because I agree with Jerry Seinfeld that AI is stupid and its slogan should be the opposite of Nike’s “Just Do It”: “You just can’t do it.” Just stop trying to do anything and admit how pathetic you are and let the computers do it all.
Anyway, the progress Ormont is referring to does not require scare quotes. When a person is able to behave in ways they never have before, in vulnerable ways that deepen their here-and-now, real-life connections with other people, that type of progress should be spelled with a capital P. And it should be commented on and commended, lest that person not even realize that they’ve progressed. As Ormont says, “New challenges are an eternal cost of progress. But daunted by them, the member may not recognize that he has even accomplished anything, though from our vantage point, we can see that he has.”
It’s just how life operates: the second we clear one hurdle, another higher one presents itself. So it’s easy to forget—or to not even have time to notice—how beautifully we sailed over that last hurdle. To highlight a positive change in a group member, Ormont suggests asking questions like “What's the difference between what Richard is saying now and what he used to say?”, and “What's the difference between the way you feel about Linda now and the way you felt about her during that first year?”
Yes, sometimes people stay in the same process group for years. After all, life never runs out of challenges, each of which can evoke different parts of a person, which can then be explored with other people. It’s sacred business if you think about it, this curious and careful attention giving. When people commit to sit in a room every week for ninety minutes with people they don’t know (at least not at first), with the intention of putting their feelings into words and thereby deepening their self-knowledge and strengthening their ability to function lovingly and honestly in relationships, that is a special, gorgeous thing.
The healing potential in such an arrangement is limitless.
