Do Psychotherapy Models Underestimate Groupthink?

Source: Wikimedia Commons: People_Think_But_Not_In_Groups_ by Alexej Savreux WC, CC Share Alike 4.0

Some of today's common psychotherapy models, in my opinion, seem to put too much emphasis on the causes of most people’s diagnosable psychological syndromes as being primarily either deficits in their thinking (such as their ability to "mentalize" or understand others correctly) or in the way they process emotions (i.e. they have poor "distress tolerance skills" and lead to learning better "anger management" through “mindfulness"). The effect of ongoing reinforcement of their problematic behaviors through interaction with kin and ethnic group members may not always be given its proper due.

Human beings are the most social of all organisms and are often highly invested in fitting in with their groups. In doing so, they often adopt a sort of party line to explain or even describe their and their family’s behavior, especially if it is repetitively problematic. In doing so they may keep quiet to outsiders like therapists about relevant factors that may be going on behind closed doors. They also may act willfully blind to certain information that might contradict the family’s accepted story. So-called groupthink is one of the most powerful psychological forces in everyday life.

To see this clearly, think about what is going on in the U.S. today that is a constant focus in the press, talk shows, podcasts, and other media venues: the polarization of political life. Just look at the almost cult-like behavior on both sides, from the QAnon conspiracy theories on the right to the habitually offended community of social justice warriors on the left. Free speech, supposedly a cornerstone of the United States ethos, is attacked relentlessly by both sides without any irony or sense of awareness of the inherently contradictory nature of some of their viewpoints.

Yet therapy models may not always recognize the prevalence of groupthink in their client’s descriptions of their beliefs and behavior. Family systems therapy was somewhat of an exception, and it was big in the '80s and '90s, it has since fallen out of favor, particularly with psychologists.

When I first started looking for clues about what was really going on in the lives of my patients when listening to them free-associate in the psychoanalytic sense (back then, most psychiatrists still did psychotherapy and were analysts), I began to focus on such things as logical fallacies. I, like most people, just thought those were common, somewhat accidental errors of thinking. I would start to express confusion about what the patient was actually meaning to say, and eventually happened upon information patients had not before volunteered. This lead me to start asking questions that my psychoanalytic supervisors never taught me to ask: “What does your mother think about this?” And I meant in the present, not when the patient was a child.

What I didn’t know then: The use of logical fallacies is one of the hallmarks of groupthink; when I questioned them I was finding a way to get at what they really thought, not what they were supposed to think. As Gregg Henriques has pointed out, logic evolved not to get to the truth, but to justify group norms.

The more I got into it, the more I realized there were a whole lot of other “markers” that told me when I was hearing family groupthink and not the patients’ true thoughts and feelings. The following is a list of them, and there may certainly be others:

• Logical fallacies
• Defense mechanisms (as listed by psychoanalysts)
• Irrational, self-scaring thoughts (as listed by cognitive therapists)
• Willful blindness (the refusal to even look at data that may challenge the group’s “wisdom”)
• Plot holes (like when you are seeing a movie and you get the feeling that such characters would never have said something as they did in the script, or that one of the characters seems to know something they should have no way of knowing)
• Ambiguous language (in which a sentence can mean two completely different or even opposite meanings, or a word has several different definitions and I couldn’t be certain which one the patient was using); this phenomenon is very familiar to people who solve crossword puzzles
• Going off on tangents without returning to a main point or problem
• Circular reasoning
• Spouting proverbs or maxims to justify behavior is often a marker for a family myth: “the grass is always greener”
• Mixed messages such as those exhibited by the infamous, so-called “help-rejecting complainer”