Group Therapy

What is an interpersonal men’s therapy group?

An interpersonal therapy group is a group of people (usually six to eight people) who meet together weekly with a therapist to work through relational issues that lead to psychological symptoms or dissatisfaction in relationships. Each group session lasts for 90 minutes.

What are some reasons why a person may join an interpersonal therapy group?

Men who join an interpersonal therapy group usually want to be able to relate better with others and to feel better about themselves. Reasons for joining group include:

• Often feeling angry, frustrated, or dissatisfied in relationships
• Having difficulty trusting others
• Struggling to forge close (or meaningful) relationships
• Feeling that one often has to please others
• Relying on alcohol or drugs to socialize
• Struggling to communicate one’s thoughts, feelings, and needs directly
• Being controlling (or easily controlled) in relationships
• Feeling that one’s relationships are shallow
• Experiencing anxiety in social situations
• Frequently experiencing loneliness
• Manipulating others to get one’s needs met
• Having trouble with self-esteem

While not exhaustive, this list is intended to capture the broad range of issues that might lead one to join an interpersonal group.

How does an interpersonal therapy group work?

Interpersonal therapy groups are unstructured groups in that there is no formal agenda for each group meeting. The leader does not begin the session with a question and group discussions are not topical in nature. Instead members are encouraged to pay attention to their thoughts, feelings, and reactions as they occur moment to moment as the group takes place and to report on what they notice. While this seems very simple, people often have a difficult time with this task. Most of us are so accustomed to acting on our thoughts and feelings that we seldom slow down to notice what is going on “behind the scenes” in our minds. Nevertheless, what goes on in the back of our minds has an impact on how we interact in our everyday lives.

What does paying attention to my thoughts, feelings, and reactions do?

By paying attention to our thoughts, feelings, and reactions as they occur in group we:

• Notice more clearly the emotional patterns and thoughts (the mental scripts) that guide our behavior but often occur at the edge of our awareness.
• Learn about the relational patterns we are prone to creating with others and why we create these patterns.
• Develop greater flexibility in how we relate to ourselves and others.
• Deepen our empathy for others’ experiences.

Importantly, we develop the ability to experience and understand what is going on in our minds and bodies without immediately acting upon what we experience. Through our experience in the group we also come to understand that it is not only okay, but healthy, to experience the range of our emotions without having to respond automatically to what we feel. Over time we become free to choose how we respond in various situations, and this freedom helps us to create the outcomes we desire in relationships.

How will my relational patterns play out in the group?

It is important to see how group is a social microcosm of what happens in everyday life. People who avoid connection in life avoid connecting in a group, people who consistently experience anger in life experience anger in a group, people who avoid conflict in life avoid conflict in a group, and people who have difficulty with trust in life struggle with trust in a group. The unconscious relational patterns that govern our lives outside of group (which we have learned over the course of our life) govern our lives in group. The important difference between everyday life and group is that in group we are given the opportunity to become aware of how these patterns play out and why, which over time allows us to begin to make different choices about how we relate with ourselves and others. Quite simply, this process can be very freeing.

Do I need to be in individual therapy to be in an interpersonal group?

Not necessarily.  Some people benefit from continuing to see their individual therapist, and they participate in group because it provides the opportunity to try out what they may be working on in individual therapy. Being in a group can also help stimulate things to work on in individual therapy. That said, a person does not have to be in individual therapy to be in a therapy group.

Will I be forced to cry, share, or give feedback?

No. You will not have to do anything you do not want to do. Like a lot of things, though, the amount of effort you exert in group will be reflected in the outcome you obtain. Everyone is encouraged to be as present as possible and to be engaged in the process. By being present and engaged you not only help yourself but you also help other group members.

How do I know things will remain confidential?

Members in the group make an agreement to keep what is said in group completely confidential. Members are allowed to talk about their own experience in group with whomever they like but agree to refrain from talking about other group members. The group therapist is required to keep everything said in group confidential as he or she would with things discussed in individual therapy.  Some interpersonal groups are time-limited which makes the ending of the group obvious. When a group is ongoing, members discuss openly with one another if they are thinking about leaving. Often this brings up important material for the group to process.

How long do I need to be in the group?

As a general rule, I encourage people to be part of the group for at least three months, though people usually want to continue for longer. Depending on the situation, a person might spend a year or more in a group to experience the full benefit of their participation. You can always leave the group. All I ask is that you let the other group members know about your intent to leave and give the group enough time (preferably at least several sessions) to process your departure.

Is getting accustomed to the group challenging?

The honest answer to this question is yes and no. Usually in the beginning, as a group is forming, there is a certain amount of discomfort among everyone as things can be a little formal as men are trying to get a sense of their place in the group. After a period of time, though, the group gets traction and collectively figures out how to make use of the opportunity they have together. Members become more open, compassionate, and honest about their moment-to-moment reactions and develop greater comfort with authentic engagement. In fact, sometimes when members leave the group they develop out-of-group friendship, given the strong connections they have forged with other group members.

TEN SUGGESTIONS TO HELP YOU GET THE MOST OUT OF INTERPERSONAL GROUP THERAPY

1. Pay attention to your moment to moment experience. Often we have thoughts and feelings that are outside our awareness yet guide our behavior. Taking care to notice what we are thinking and feeling in the context of the group provides the opportunity to better understand how these subtle aspects of our experience relate to events from our past and have an impact on our relationships.
2. Assume spontaneity and authenticity are valued and encouraged. In group, we are encouraged to set aside everyday social filters in the interest of honest and direct communication. It would be well within the norms of an interpersonal group to say something like, “I noticed myself wanting to interrupt you when you were talking, but I’m not sure why.”
3. Observe how you communicate non-verbally. Communication always takes place explicitly (the words we say and their associated meanings) and implicitly (the non-verbal aspects of communication such as our facial expressions and tone of voice). Noticing what we communicate non-verbally heightens our awareness of what we are feeling and the messages we are sending to others.
4. Maintain an attitude of curiosity about your behavior. Curiosity about how we relate with other group members encourages exploration about the relationships we create with others and, in turn, opens our awareness to alternative ways of connecting that are healthier.
5. Avoid asking questions and focus on making statements about your experience. Questions certainly have a place in interpersonal therapy groups, but they can also be very disruptive to the group process. Making a statement such as, “I imagined you were angry when Jim came in late” as opposed to asking the question “Were you angry when Jim came late?” serves to keep one reporting on their own internal process which is vitally important to effective group work.
6. Be aware of what you avoid talking about in the group. Noticing the things we avoid talking about in group (e.g., feelings of sadness, anger, happiness, frustration, appreciation, etc.) can be instructive as we learn more about ourselves. By talking about the things we typically do not bring up we are able to develop awareness of the things we have trouble discussing and to expand our ability to relate with others.
7. Ask for feedback and be willing to give feedback when requested from other members. The opportunity to give and receive honest feedback, especially from non-therapists, is a hallmark of group work and is one of the main reasons group therapy can be so helpful. Feedback helps us develop awareness of our blind-spots and gives us important information about the ways we affect others.
8. Notice and talk about the relational patterns you find yourself creating with others. In group, we notice how the relational patterns we engage in with other group members mirror relationships with important people in our life such as our partners, parents, siblings, and friends. This awareness helps us better understand unhealthy and healthy dynamics we are prone to creating (e.g., protecting people from feeling sad, being attracted to people who need help, etc.) and creates opportunities to practice engaging in healthier ways.
9. Share the things you think are illogical or that make little sense to you. It is typical for us to refrain from sharing our thoughts and feelings until they are well formed. In group, it can be helpful to share thoughts and feelings you are experiencing that are not quite clear. Exploration within the group facilitates understanding these not yet fully developed ideas.
10. Bring up any concerns you have about the group in the group. It is very common for people in groups to have concerns or frustrations about different aspects of their group experience (e.g., one member talking too much, the leader not talking enough, not feeling accepted by some group members, etc.). Bringing up these concerns during the group, while anxiety provoking at times, can be very helpful to the overall group process.