The Power of Group Dynamics in Therapy:

Nurturing Connection, Support, and Here-and-Now Processing 

Introduction: The Power of Group Dynamics

Group psychotherapy provides a unique setting for individuals to come together and, within the supportive environment established by the group therapist, work toward personal goals.  At its core, group therapy offers a culture of safety in which members are free to explore their thoughts, feelings, and interpersonal tendencies in a collaborative and non-judgmental space. This is especially important for those who feel isolated or misunderstood, who struggle with relationships, and/or who have been taught or conditioned in previous social contexts to take on adaptive defenses or roles not in alignment with their authentic selves.

The power of group therapy – and what distinguishes it from individual therapy – are the interpersonal dynamics that evolve over time between the group members and with the group therapist.  These group dynamics inevitably reveal important aspects of each member’s psychology and relational tendencies.  With the supportive atmosphere cultivated by the group norms, members are afforded the opportunity both to discover their interpersonal patterns and to experiment with new ways of communicating and relating.

Scientific research has shown that group psychotherapy is beneficial for reducing the symptom intensity of a range of psychiatric issues, and for increasing one’s ability to address interpersonal problems and challenges within numerous social contexts including the workplace, with friends/family, and in romantic/intimate relationships.

Drawing from Freudian concepts including the notion of repetition compulsion, unconscious motivation, and defensive adaptations employed to counteract the effects of early relational trauma, process-oriented group psychotherapy is particularly effective at helping members expand their emotional intelligence and capacity to engage with others more flexibly and successfully.

Group therapy is, in its essence, a social activity.  Consequently, the strong connections and mutually informative experiences that characterize each group’s unique journey foster among its members a deeper awareness of their common humanity, fallibility, and resilience.  These shared experiences can promote lasting change and transformation, sometimes more readily than in individual psychotherapy.

Understanding the “Therapeutic Community”

Groups are primal and ubiquitous.  As children, most of us were raised in and by the family group, which may have included one or multiple parents, as well as siblings, grandparents, etc.  And, further, as development advances, groups constitute most of our formative experiences across the lifespan — whether in school, at work, or in the community.

Most types of group therapies, especially psychodynamically-oriented process groups, replicate this communal experience to accomplish therapeutic goals.  Originally referring to community-based treatment programs designed to address substance abuse and addiction, the term “therapeutic community” may now be applied to any group of individuals who meet on a regular basis to share their experiences and utilize the emerging dynamics of the group, and the interactions between its members, as a vehicle for personal discovery and change.  Healing and growth occur through shared experience within the therapeutic community and the notable interactions that arise among its members.

One of the key elements that makes group therapy so effective is the sense of belonging to a community in which each member is treated with respect and acceptance.  Being validated by other group members who may also, themselves, resonate with what is being described or has been experienced is referred to as universality.  An important component of all group therapy approaches involves the recognition of shared experience, which reduces feelings of isolation and stigma and promotes self-acceptance.

Creating a Safe and Supportive Environment in Group Therapy

Perhaps the most important element of the therapeutic community that exists within the group, and the key determinant of how successful any group will be, is creating the circumstances necessary to promote the authentic expression of thoughts and feelings.  Unlike most groups in “real life” that are steeped in censorship, deference, acting strategically or politically, and adopting certain personas, group therapy is mobilized by an atmosphere of safety that encourages members to speak freely, take risks, and be vulnerable.

For each member, entering a group may be somewhat anxiety-provoking as there are often fears of being viewed or judged as “strange” or “abnormal.”  One may also fear being swept up in negative or even traumatizing dynamics that have characterized previous social experiences.  Yet, a successful group therapy ultimately provides each member the opportunity to tell his or her story and have the other group members consider it with acceptance, curiosity, and empathic resonance.

In fact, the members’ capacity to shift out of the usual kind, polite, and deferential quality of interaction (sometimes referred to as the “nice group”), and advance into more vulnerable and riskier communications, marks the group’s transition into what is known as the “work group.”

The primary role of the therapist is to create a sense of acceptance within the therapeutic community of the group and promote numerous conditions and factors that are frequently referred to as therapeutic mechanisms of change.  Some of these mechanisms of change include cohesion among group members, vicarious learning by observing other group members, insight, and here-and-now processing.  Due to the communal nature of the group, members who often feel alone and isolated benefit from receiving validation by others who also share similar struggles; this feeling of belonging is a vital therapeutic factor in group therapy.

The Group Contract 

Creating a supportive, validating environment that allows group members to feel comfortable expressing themselves, sharing their experiences, and exploring their vulnerabilities is aided by the therapist’s careful attention to several important factors especially relevant in group therapy.  These factors are typically laid out in the “group contract” that is introduced to potential group participants even before they become members.

The group contract presents ground rules that set the tone for group interactions.  The contract’s guidelines establish norms designed to foster a sense of psychological safety within the group and serve to establish and maintain a culture of mutual respect, confidentiality, and non-judgment. The norms are consistently emphasized by the group therapist throughout the duration of treatment, especially during times of change (e.g., when a member leaves the group) or turbulence (e.g., when there may be some significant conflict or challenge within the group).

Group contracts typically include some version of the following items regarding attendance, participation, confidentiality, and outside-of-the-group interactions:

• You are expected to attend every group session, be on time, and remain throughout the session. If you cannot be present, call the office so your absence can be announced at the beginning of session.  
• Most group members stay in treatment for a significant amount of time to make progress on their goals. This is not a requirement, however, and you should not remain in the group if you feel you are not benefiting from it.  If you find yourself experiencing a lack of progress, it is important to discuss this in session.
• All sessions will be charged for, regardless of the reason for absence, as the group is based on a tuition model.  If you expect a prolonged absence because of work commitments, illness, etc., you may request an exception to this rule, and this will be discussed directly in session. 
• Central to group therapy and perhaps the most important norm/expectation is to always attempt to put your thoughts and feelings into words, not actions. You are expected to take responsibility for sharing your feelings, especially about what is occurring in session, even if it may seem “negative” or tangential.  All feelings about group members, and about the therapist, are important to express. 
• Any interaction between group members outside of the group is important to the group process and will be considered group business to be discussed in session. Sub-group secrets tend to impede group members’ progress. The relationships made in group are to be used therapeutically, not socially. 
• Material revealed within the group sessions is privileged and confidential. Discussion about the group with others should be restricted to a description of your own reactions and experiences. It is each member’s responsibility to protect the names and identities of fellow group members. 

In addition, a final item often discussed by group therapists when presenting the group contract to potential members is interpersonal sensitivity (i.e., regarding such domains as gender, age, ethnic and racial identity, etc.). By prioritizing sensitivity and mutual respect in these domains, the group therapist seeks again to facilitate a therapeutic environment that nurtures acceptance, respect, and trust.

The Role of Group Dynamics in Fostering Connection and Here-and-Now Processing 

As psychological safety is established by the group contract, and consistently reinforced by the therapist, the dynamics of the group begin to emerge.  Group dynamics typically refer to two interrelated elements of any group:

(1) factors which encourage or block the degree to which members can authentically connect with and relate to each other;

(2) factors that enable or inhibit significant interactions between members during a session; when these interactions occur and are appropriately managed, here-and-now processing allows for relational learning, the most important therapeutic factor of group treatment.

To elaborate on these elements of the group dynamics, first, connection occurs as group members share their experiences and vulnerabilities and are actively engaged with and listened to by other group members.  Over time, a sense of trust, openness, and mutual respect occurs, with certain members resonating and identifying with the situations and problems of other group members.  An experienced group therapist will, in fact, emphasize and encourage these connections by actively pointing them out in session, i.e., by saying things such as Joseph, Karen sems to really understand where you are coming from in the aftermath of a breakup. By harnessing these connections and emphasizing the commonalities between members, these positive group dynamics set the stage, and potentiate, the group’s transition into here-and-now processing.

In the beginning stages of group therapy, most members speak in session about what is known as “there-and-then” material, i.e., issues going on for them at work, at home, in their relationships, etc.  These are problems and challenges faced outside of the group.

As psychological safety and interpersonal connections are established in group, the focus gradually shifts from there-and-then material to here-and-now processing.  Here-and-now simply refers to significant feelings (either “positive” or “negative”) that arise between two or more group members (or between a group member and the therapist) and are expressed directly in session.

For example, Sally may experience Henry as condescending or patronizing in the group, and, given the norm of putting one’s thoughts into words, will hopefully be able to express her sentiments at some point.  When here-and-now moments such as these arise, the attention shifts from what is going on for members outside of the group to what is occurring directly inside of the group.  These moments represent an important therapeutic opportunity: the skilled clinician will capitalize on them by attempting to “freeze-frame” the situation and encouraging an open, honest examination among all group members about what is happening between Sally and Henry and its potential meanings.

Because it is so unusual and generally unavailable in regular day-to-day living, here-and-now processing can obviously be difficult and challenging but is ultimately the most instructive aspect of group therapy.  Members are able to learn from the group how they are perceived, what characteristics or tendencies may be “read” by others in certain ways and not in other ways, and, of course, what emerging dynamics with other group members (e.g., Henry being experienced at times as patronizing or condescending) may reflect situations encountered in the “real” world (outside of the group).

Through the ongoing and potentially diverse feedback from all group members, each member can deepen his or her understanding of their core relational issues.  Further, group therapy provides the space for expanding one’s relational repertoire.  In the example of Henry, he may ultimately learn how to communicate more effectively, advance his empathic and conflict resolution skills, and discover the underlying reasons for his style of interacting.

Techniques for Facilitating Group Dynamics  

Groups are not meant to be individual therapy (with the therapist addressing each specific member) simply performed within a group format.  This is a common mistake among therapists who are not specifically trained to facilitate group therapy.  Instead, the experienced group therapist relies on facilitating and supporting the dynamics of the group first, in order to then capitalize on these dynamics as vehicles for insight and change.

To this end, the primary attention of the group therapist should not be on any individual group member per se, but on the “group-as-a-whole.”  This means that the group therapist’s primary focus is on supporting the developmental transitions of the group, i.e., advancing the group dynamics from fear and defensiveness to deeper interpersonal connections and here-and-now processing.  Like any living organism, the group is “alive” and should be approached by the therapist as needing certain kinds of interventions early on that are then supplanted, as the group matures, by different and more refined interventions.

Skilled therapists employ numerous techniques to promote the development of the group-as-a-whole and prepare members for more advanced here-and-now processing.  Here are some effective techniques for supporting the role of group dynamics to facilitate successful therapeutic intervention:

1. The group contract and its norms are consistently used by the therapist as a mechanism for observation and exploration.  For example, if a member consistently arrives late to session, the group contract’s stipulation to arrive on time can be referred to as a way to discuss the potential meanings of this specific member’s tardiness and its significance for the entire group.
2. The group therapist provides the first and perhaps most significant model for here-and-now processing.  That is, from the very beginning, the therapist must actively invite members to talk about their feelings and reactions to how the group is going and about their impressions of the therapist.  Both “positive” and “negative” feedback must be welcomed by the therapist and received with curiosity and non-defensiveness.  If the group therapist is not open to feedback, then how will the members themselves feel safe enough to be vulnerable and share (and receive) authentic communications from other members?
3. The skilled therapist models active and empathic listening.  Again, a major component of good group therapy is that members feel heard and understood.  The therapist consistently adopts a stance of careful listening and also restraint regarding offering advice, suggestions, or solutions to specific problems members raise.  The therapist’s own humility in this regard sets the tone for prompting and encouraging each group member to seek out more insight, creativity, and flexibility in order to address his or her uniquely personal circumstances.  The group therapist’s merely pontificating ideas or brainstorming solutions is usually counter-productive and may even be off-putting for certain group members.
4. For the skilled clinician, everything that occurs in the group therapy experience is “grist for the mill,” i.e., is approached with curiosity and assumed to carry meaning.  For example, outside-of-the-group interactions between group members, however casual or spontaneous, almost always suggest the presence of feelings, reactions, etc. that, for any number of reasons, cannot be expressed in front of all group members and the therapist.  Additional phenomena that are “grist for the mill” include specific tendencies of group members that may be characterized as problematic (including silence/hesitation to speak; need to have the floor/be dominant; play the role of the jokester, etc.).  These tendencies not only suggest the manifestation of constricting social roles but may also point to broader group dynamics at play.   For example, as John attempts to take up more and more air space in session, the therapist may suggest to him that, for one reason or another, the group needs him to take center stage so that others can stay out of the limelight.

Conclusion: Harnessing the Power of Group Dynamics for Healing and Growth

The therapeutic environment groups offer is unlike any other treatment modality.  An effective group therapy begins with a set of norms consistently promoted by the therapist.  These norms create the organizing structure and support the emergence of psychological safety that allows individuals to come together and explore the problems and challenges of their lives.

A sense of belonging to a therapeutic community, being empathically listened to and validated, and recognizing the shared experiences that interlink members of the group are significant therapy benefits in and of themselves. Yet these benefits also set the stage for the gradual transition into the developmental phase known as the work group, which is characterized by more advanced forms of interpersonal learning through here-and-now processing.

The freeze-framing and exploration of pivotal moments between group members, and between group members and the therapist, advance each member’s understanding of his or her psychological and relational tendencies, often revealing roles and patterns of interacting that originated in childhood.  As these patterns of interacting are revealed, the group becomes a “laboratory” of experimentation, with members trying on new ways of being with each other and with themselves.