Group as Family

Group therapy, a term coined by Jacob Levy Moreno in 1932, has become a ubiquitous feature of modern life. Therapeutic groups exist in most communities for the purpose and function of healing and coping. Twelve step groups, smoke-enders groups, groups for cancer patients, survivors of sexual abuse, Alzheimer's patients, spiritual seekers; groups for the recently divorced, the intellectually challenged, the recently hospitalized; the list goes on. Groups of like-minded people continue to gather in search of...what?

Change.

But not just any change. A therapeutic shift through a group experience follows a particular process that has been studied and understood to have features that aid the progression of healing. These elements have been called by many names, but perhaps the best accepted of these is the label "therapeutic factors." There are many, but central focus of this article is about the fact that groups most often function like healthy families. Groups give support, honest feedback, guidance, hope, and rules. Group becomes our family of choice or family of need. Often features missing or deficient in our families are available in groups. We are seen, acknowledged, or understood in a way we weren't in our family. Our families are the first group, and we learn how to be people based on what they teach us. If our family teaches us that chaos is the norm, we will typically go out and look for chaos, or bring chaos to a situation. If our family teaches us that alcohol is the way to cope, we follow that lead.

We bring this learning from our family in subtle and not so subtle ways into the group. The behavior from our family of origin is revealed through our interactions with others as our psyche tries to make the new group our family. But here is where the healing can begin. Each person tries to act in the group like they are in his or her family. The group and/or facilitator will see the attempt, and offer feedback to the person that the behavior they bring from the family isn't needed in the group. Sometimes this behavior is obvious, and sometimes not. Here is an example:

A woman, lets call her Anna, was the 10th person to join my therapy group. She attended each week and yet rarely spoke up. She watched and listened as other members of the group expressed their needs, frustrations, and desires. One night snow began late in the day and was heavy. Instead of 10 members only 4 showed up. Anna was one of them.

She chatted incessantly. She spoke of everything that was bothering her, and asked for help from the group. I considered it a break-through. The following week everyone in the group returned and Anna went back to her silent self. She barely said anything about her sharing the week before.

It snowed again the following week. This time 3 people showed, and Anna again shared deeply. The next week the entire group was there, and Anna was silent. When I asked her to talk about the differences she revealed to the group she was 9th in a family of 9. She always felt like her brothers and sisters had more power and more needs than her, and learned not to speak up. When the snow fell and only a few members were present, the usual restriction implied by the size of the group matching the size of her family was gone, and Anna blossomed. Armed with this insight Anna went on to find her voice each week in the group -regardless of how many members showed up.

Like Anna, the change most people will find in a therapy group is an authentic voice. Sometimes this will happen systematically as the result of following clear and well-defined steps. Other times the change will happen suddenly, as if it had just fallen out of the sky.