Tag: Here-And-Now

Vitality and Belonging part 2

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I considered naming this post, “Why Every Therapist Should Run A Group,” but the truth is, group isn’t for everyone.

Most people don’t want to be challenged. This applies to therapists as much as anyone else. We all have a natural predilection to maintain what is familiar, comfortable and predictable, even if this tendency exacts a large cost.

Some of us have a lower tolerance for suffering than our peers, or we’re fortunate enough to have suffered sufficiently to be willing to change.

Change is not guaranteed to improve the situation, it just makes it different. But different experiences can lead to new thoughts and feelings, novel attitudes and connections.

You might spare yourself a lot of grief if you embraced this idea alone: if you don’t like your situation, do something different.

Groups can be incredible catalysts for change if run well. If run poorly, well, misery loves company and it can be deliciously seductive to have a whole bunch of people with whom to preserve the status quo.

To run a group well, you have to embrace change. You need to be more excited by the possibility of learning something new than you are scared of being hurt and disappointed. Of course, you will be hurt and disappointed at times, but if you’re open to it, you’ll learn a lot from those moments.

I run a process group for adults on Tuesday evenings. The members have all been in therapy and are psychologically sophisticated. They take risks, share vulnerability, actively engage in the process of learning and change. It’s a place of intimacy and courage.

As the steward of the space, I keep two values in mind, Vitality and Belonging.

Vitality is something you experience in yourself, how engaged are you, how interested? Are you learning something new about yourself, being challenged, growing? Does the present situation feel meaningful to the rest of your life–your life outside the consulting room and the future? Many of us are conditioned to override our need for vitality.

Most schools and workplaces teach us to be quiet, sit in our seats, direct our attention to the instructed subject regardless of our natural curiosity and inclination. The pandemic of ADHD diagnoses is a reflection of this intolerance for intrinsic motivation.

Vitality is closely related to doing what you want to do in a deep and meaningful way. This doesn’t mean a reckless pursuit of mind-numbing pleasure. What you truly want to do may not be pleasant at all. Escaping danger or confronting an adversary are examples of intense vitality. So is any adventure or drama that captures your imagination, provides a sense of risk-taking and discovery. Vitality requires a degree of freedom, the ability to approach the edge of your comfort zone and explore new ways of being.

It’s in this liminal, unknown territory that you gain access to parts of yourself that you didn’t know you possessed.

Belonging provides the safety required for this kind of heroic enterprise. Belonging is experienced with others, in the sense of connection and shared purpose. We all have dark places inside us that are too scary for us to venture into alone. Therapy provides the support and companionship to see and touch what would otherwise overwhelm us. When there is belonging, there is a feeling of kinship and protection– “They have my back.”

Balancing these two values is the dance of leadership. It’s an art and a science that is never mastered, only studied and integrated through our own therapy, experience and training.

 

What is the “Here-and-Now?”

There’s a story about a fish who went as a prophet among the fish folk, speaking of an almost mystical, all-pervasive substance called water. Of course she was scorned for her teachings, her piscine friends and family too busy with their swimming to entertain fantastical ideas.

Talking about the Here-and-Now, I feel like a little as that prophet fish must have felt.

What is the Here-and-Now?

It is simply what’s going on between people who are in contact. In other words, it’s interpersonal mindfulness. 

Mindfulness has become a very sexy word, a catch-all for a quality of awareness, paying attention to one’s physical sensations, noticing the thoughts and images passing through one’s mind, attending to emotions, etc. The Here-and-Now refers to all of that, especially as it corresponds to being in the presence of other people.

In individual therapy, it refers to the underlying, often unspoken dynamic between the therapist and the client. In Group, the Here-and-Now may refer to what the group is doing as a whole, or any dynamic between any members and/or the leader.

For example, someone comes 15 minutes late to an individual appointment with me. During those 15 minutes I have all sorts of thoughts and feelings as I wonder what may be going on with the client and with the treatment. Did I say something they didn’t like last week? Perhaps they were offended? Are we getting to something deep that they don’t want to examine? Maybe they’re thinking of ending our work together…and so on.

When they do come, it would be easy to ignore the previous musings and focus on what the client wants to talk about. In non-therapeutic settings, this is what usually happens. The late person would apologize, blame traffic or some last minute distraction, and the conversation would move on. But there is something lingering between us. Working in the Here-and-Now refers to bringing into awareness and discussion this subterranean element.

Ideally, the Here-and-Now inquiry is linked to something the client says, so when the client mentions not feeling like they’re accomplishing much at their job, we can ask something like, “do you sometimes feel like you’re not accomplishing much in our work together?” or even, “how is that not-accomplishing-much feeling happening right now in the session today?”

But Here-and-Now can also be used more bluntly and without so much finesse: “I’m thinking about your coming late and wondering if there’s something between us that we should talk about–something that you’re not liking about our work together?”

Working in the Here-and-Now is powerful. It redresses the experience of many people who grew up in families where there were elephants-in-the-room, walking-on-eggshells moments, secrets and unsayable thoughts. It is powerful for another reason as well.

Fractals.

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The idea of fractals is that the smallest part echoes the same overall pattern. 

Our personality is structured similarly. Whatever issues and difficulties we may have in our lives outside of the consulting room, the patterns that create discontent in our lives are manifesting in the room as well. It could be in a tone of voice that causes someone to lose interest, a way of avoiding eye contact that prompts feelings of abandonment, a particular gesture that evokes a fear of being hurt. When we can bring into awareness what’s happening in the present moment with the other person, we can make a change in that interaction that will reverberate through the whole personality. 

Working in the Here-and-Now is accessible, visceral, immediate. It offers a way to disrupt patterns of disconnection that haunt people’s lives. It is invigorating for the clinician and the client. In Group, everyone is invited to work in the Here-and-Now, and the result is what I consider one of the key values of Group: Vitality.

 

If you’d like to learn more, I invite you to attend this workshop.

 

Why isn’t there a structure in Group?

Why isn’t there a structure or a theme or something in Group? It feels like there should be…

A colleague of mine likes to joke that we try to avoid “shoulding all over ourselves.”

Why should there be a structure? What kind of structure would you like?

Some groups are more structured than others. In the groups that I run, other than a designated start and end time and an agreed upon contract, I try to be as unstructured as possible.

Why?

The short answer is Here-and-Now.

What is Here-and-Now?

Here-and-Now refers to the immediate thoughts, feelings, sensations and intuitions that you are experiencing in the present moment. In Group, we try to understand these reactions as interpersonal communication–some kind of information that you consciously or unconsciously want the group to know about you.

Imposing a structure, such as turn-taking or spending a certain amount of time on a particular exercise, suppresses the Here-and-Now.

Here’s an example. The group decides to go around and “check-in,” each person sharing whatever is relevant to them. Suzy talks about her fear that the other people at the barber shop are judging her. This reminds you of your sister calling you judgmental last week. Your curiosity is piqued, you’re intrigued, wondering if an interaction with Suzy might help you with your strained relationship with Sis. Before the thought if fully formed, Roger is talking about his dog needing pancreatic surgery. That’s less interesting to you because you want to speak with Suzy. Then William is talking about his mother again and now it’s hard for you to remember what exactly you wanted to say to Suzy. Even if you do remember, you’ll need to wait for five other people to share before you can explore your desire.

Now, this may happen even in an unstructured group. It can be very hard to break into the flow of conversation and say what you need to say. But at least in an unstructured group, you’re allowed and encouraged to do so. Every piece of structure hampers the immediacy of the group. Sometimes structure may be necessary, but it’s in the immediacy that we feel most alive.

What is Group Therapy?

What is Group Therapy?

People ask this over the phone, thinking Group might be for them. They ask at parties and networking events. Sometimes group members themselves ask.

What do you think it is? I ask them.

Well, like a support group?

Not quite.

The main difference in the groups that I run is that they are process groups.

What is a Process Group?

A Process Group is a space where members are invited to express their immediate, here-and-now thoughts and feelings towards and about other members. If your first reaction to this is “why would anyone subject themselves to such an environment?” you are not alone.

In a process group, members are encouraged to abandon many of the social norms of polite discourse.

Group members are asked to put into words any and all reactions they have including anger, sexual attraction, fear, hurt, and affection. As group progresses, members learn to express their sentiments in a way that focuses on their own experience:

  • “I feel frustrated and angry when you yawn while I’m speaking.”
  • “I feel hurt and scared when you yell at me and call me that.”
  • “I feel very attracted to you.”
  • “I feel a lot of affection for you and I’m angry because I think you’re making a bad decision.”
  • “I want to say something but I’m anxious that you will judge me.”

This feedback about members’ effect on other people is hard to come by.

Friends, family and acquaintances are rarely so direct, preferring either to avoid unpleasant conversations, or relying on unhelpful habits of criticism and blame.

Even individual therapists may struggle with sharing a perspective that is difficult and uncomfortable for their clients to hear.

Process Group members learn to access and express their own emotions and to comprehend and respond to the emotions of other people.

They discover how they might sabotage relationships and explore how to create and sustain intimacy, to ask for what they need and to receive it.