“Get Groupy!”

I really enjoy being an individual therapist.  I like the personal and intensive nature of individual therapy.   Whether the sessions are in person or virtual, a one-on-one session with a client can be a very powerful medium for growth and change.  There really is nothing quite like working with or participating in traditional therapeutic mono e mono relationships.

With the above said, I believe groups can be just as, if not more, influential for client growth.  I am a teacher at heart.  My goal right out of high school was to be a teacher. I studied education in college and began working in the field as soon as I graduated.  I taught for 8 years.  I worked with very difficult populations.  In some of these positions, I had to become an expert in lesson planning and content delivery.  Anything less and my desire to transmit learning was diminished.  After I left education, I embarked on a number of other endeavors.   Somehow, I always found a way to weave education into what I was doing.  As a therapist now, I am doing the same thing.

Groups are awesome!  As a leader, not much fills me with more joy than seeing clients light up and respond in a group setting.  Groups are an excellent vehicle to deliver safe spaces to process issues along with camaraderie.  I think participants in groups are often unaware of the impact the group experience is having on them.  Groups, by the very nature of their dynamic often stick with clients in a way that individual therapy cannot always.  In a group you are getting to know others.  Some of these people may be similar but also very different.  These sorts of dynamics light up the brain in unique ways.  There are all sorts of interesting neurological events happening during a group session.  Reading each other’s experience – noting responses – witnessing body language and others engagement … this all registers in the brain.  As a participant in groups in the past, I can still remember the words and behaviors of other clients as if it were just the other day.

Generally, two things happen in the group setting.  Groups process.  Processing is basically manifesting in either thought or words (spoken aloud) the present time experience.  Processing can involve engaging with memories, planning, expression, evaluation, judging, questioning, speculation, and a host of other events.  Processing can occur as a response to a prompt given by the group facilitator.  Processing can also occur as a response to other group members’ participation in the group.  The other primary component of groups is “psychoeducation”.  This is exactly what it sounds like.  Education that includes psychological content.

Processing is a great group dynamic.  Listening to what other group members say resonates greatly.  Psychoeducation not only often resonates but spawns learning new information.  One of the most common pieces of feedback I get from group participants is their appreciation for taught psychological content.  They tend to “eat up” even the most casual “lectures”.  I truly geek out when I see a client pull out a notepad and start writing in response to the material covered.  My personal teacher neural network lights up big time.  The content does not always have to be deep and personal.  I often cover basic “psych 101” content.  I also use diagrams and visual examples to deliver education.  Many clients draw the diagrams with the intention (I hope) to review outside of the group and further process.

Group therapy can be an integral part of psychological growth and development.  There is simply no substitute for a therapeutic group experience.  In vivo (real life) group experience is dynamic and novel.  The day-to-day experience group members often trump best laid plans bring with them.  In today’s world – more than any time before – people complain of disconnect though in some ways we are more connected than ever.  I believe the group experience can break down the barriers of disconnect and quickly establish familiarity with our fellow humans.  Groups give people who might not otherwise meet, a chance to meld and co-experience.  In our current societal state, groups serve such an important function that there may not be a better way to communicate or learn from one another out there.

 

A.L.F.A.S

Working in private practice is a unique experience.  I find myself needing to pull different “tools” out of my toolbox in sessions based on how my clients present.  In one session I might be using a structured approach – based on what we call a “theoretical orientation”.  In another I may be “freestyling” -  implementing multiple strategies to meet the client’s needs.  I like the idea of having some structure though.   It helps me focus the therapy when there is a need for direction, and it informs how I might delve into deeper levels of processing.  At my core, I am an educator and student.  Becoming a therapist has given me an opportunity to educate clients as well as learn from them.  What I have learned is that no two clients are exactly the same.  Using one uniform approach to treat each individual client is less than optimally productive.  At the same time – a formula or approach is especially useful when it comes to conceptualizing the person sitting across from you.

To that end, I have been developing a sort of formula or process by which I orient my therapy.  Full disclosure, I “borrowed” some of this inspiration from a book I have been reading lately.   The conceptualization is an acronym, ALFAS. 

A = attachment

L = love

F = fear (and anger)

A = abandonment

S = security

The basic idea is the therapeutic process involves addressing at least one or more of these phenomena.  Attachment obviously concerns childhood connections and adult lifestyles of attachment.  It can also mean the things we cling to for either reward, safety, or comfort.

Love can address a whole host of meanings – romantic love, love for family, love for other people, friends, even pets and inanimate objects (e.g., “I love this painting”)

Fear is one of the most fundamental experiences to process.  Not only does fear “infect” many areas of our lives, but it also relates to anger which is an experience that every human being experiences to different degrees.

Abandonment refers to the very disruptive experience of losing something that you come to rely on.  Abandonment can also include topics like neglect – never getting something you should have.

Finally, security refers to all things that we come to rely on as “needs” in order to be sound and stable.  Threats to security cause unsteadiness and discomfort.

The basic idea is that we can “tease” apart any topic a client is dealing with and find elements that relate to one or more ALFAS.

Relationships are a common cause for individuals seeking help.  When exploring the dynamics of any relationship, it is usually pretty clear to narrow down what is being activated.  It is the fact that a client has an unusually needy disposition in relationships.  The client might be uncertain what the concept of love in a relationship is supposed to be or feel like.  The client might fear being wrong about something and anger erupts as a response to contradictory evidence (often in arguments).  The client might have come to rely on something the partner was giving at one time and has now withdrawn.  Finally, the client may only find security if they and the partner only spend time at home together.  These are just a few examples.  The list of variables that exist in any given relationship is almost infinite.  Yet, the ALFAS helps us narrow down, hopefully quickly and efficiently, what is really happening.

As I said, this is a program/procedure that is currently in development, and I may very well find myself redefining or restructuring parts.  In the meantime, I hope to use it to assist my clients in finding the support they need to reach the goals that they brought to therapy with them.