Integrative Psychotherapy Articles
Relational Group Process:
Developments in a Transactional Analysis Model
of Group Psychotherapy
Richard G. Erskine
This article portrays some of the principles of Relational Group Psychotherapy. Several models have influenced the development of relational group psychotherapy: therapy-by-the-group; therapy-through-the-group; therapy-by-interpretation; and therapy-in-the-group. The “feedback” and the “person-centered” trends are described and an integration of models is proposed. Relational Group Psychotherapy emphasizes the healing power of relationships between group members, the importance of phenomenological inquiry, affective attunement, validation, respect, identification, and each individual’s relational-needs. The leader’s tasks are to stimulate the flow of contactful dialogue and to teach about human needs and healthy relationships.
In Transactional Analysis in Psychotherapy: A Systematic Individual and Social Psychiatry, Eric Berne (1961) begins his chapter on “Group Therapy” by stating, “Transactional analysis is offered as a method of group therapy because it is a rational, indigenous approach derived from the group situation itself” (p.165). He distinguishes that a TA group is different from other groups that are based specifically on theoretical concepts of a group as a “metaphysical entity” (such as psychodynamic group analysis), or designed to force growth (such as encounter groups), or use “opportunistic techniques” (such as Gestalt Therapy groups).
Berne then goes on to describe what he means by a rational approach: “The objective of transactional analysis in group therapy is to carry each patient through the progressive stages of structural analysis, transactional analysis proper, game analysis, and script analysis, until he attains social control” (1961, p. 165). Berne’s “rational” perspective and structured approach makes sense when we consider that Berne’s examples in chapters 9 and 10 come from his experience with his “borderline women’s group” or from the hospitalized patients described in chapter 15 (David Kuffer, personal communication). Rational understanding and social control are essential early-therapy goals with such a patient population.
Eric Berne (1961) provided a conceptual foundation for a transaction-by-transaction approach for group psychotherapy. He described how he analyzed each group member’s actual transactions to identify life script patterns and to provide alternatives to psychological games. Berne’s writings about group psychotherapy illustrated a specific and very useful model of therapy through-the-group member’s interactions with each other. The central methods in Berne’s group therapy were his explanations of complementary, crossed, and ulterior transactions and his theoretical interpretations about the ego states involved in games, transference, and scripts.
What I find significant in Berne’s opening statement is the phrase “indigenous approach derived from the group situation itself”. This intriguing phrase has lead me to experiment with a number of ways to make use of the healing and growth-enhancing power that is “indigenous” in a secure and effective group situation. I have searched for models of group psychotherapy that are effective for clients suffering from prolonged stress, cumulative neglect, acute trauma, and/or repetitive humiliation. This article is written to portray various influences, experiments, and discoveries in searching for that “indigenous” growth-enhancing group therapy experience and in developing a Transactional Analysis model of therapy through a Relational Group Process.
Developments in Group Psychotherapy
The history of the development of Group Psychotherapy is a long and fascinating story comprised of many contributions, concepts, and models (Ormont, 2003; Rutland & Stone, 1993; Yalom, 1995). The annals of both the American Group Psychotherapy Association and the International Group Psychotherapy Association are replete with rich examples of the effective use of various models. Rather than describing a detailed history of the contributions of various models and concepts of group psychotherapy, I would like to describe just a few models of group psychotherapy that have influenced my professional practice as a Transactional Analyst. These models may be described as therapy-by-the-group, therapy-through-the-group, therapy-by-interpretation, and therapy-in-the-group. My experimentation with and application of these various models in psychotherapy, education, and organizational consulting have influenced the development of a fifth model: Relational Group Process.
Relational Group Process emphasizes transaction-by-transaction interpersonal contact, the processes of inter-subjective relating, and the reciprocal and mutual influence of each group member on the other members. Both the group therapist’s and group members’ focus is on the interplays between the present moment and the emergence of unconscious relational patterns that may be an expression of archaic experiences. Group members learn to relate to each other through the use of acknowledgement, phenonomological inquiry, validation, and normalization. The healing of anxiety, depression, cumulative neglect, and trauma becomes possible through the group members’ contactful, caring relationships that attend to each person’s subjective experience and relational-needs (Erskine, Moursund & Trautmann, 1999).
Models of Group Therapy
In the 1930’s Alcoholics Anonymous (AA) began as a leaderless group. AA is based on the theory that alcoholism is a disease and individuals need the support of the group in order to stop drinking. A Twelve-Step program shapes the methods of the group; every aspect of the group is determined by one of the twelve steps. Members are encouraged to practice one of the twelve steps daily and to tell their story in meetings, often over and over again, while members respectfully listen. AA is a prime example of therapy-by-the-group.
In the early 1970’s Hobart Morwer expanded the therapy-by-the-group concepts of Alcoholics Anonymous to the group treatment of depression and anxiety. Along with a focus on honesty and responsibility he placed equal emphasis on integrity and personal involvement of each group member in helping the other group members live up to the twelve-step program (1972).
Although Morwer’s Integrity Groups were originally designed for the treatment of acute depression and anxiety, his concepts and methods were also used in group therapy with a general adult population. For two academic terms Dr. Morwer and I co-led a group of university graduate students in which we experimented in using a combination of Integrity Group methods with the teaching of Transactional Analysis concepts. Each week the two-hour group would begin with a 15 or 20 minute introduction to a TA concept, such as ego states, crossed and ulterior transactions, games, or script. Then we would make use of a therapy-by-the-group model to apply the TA concepts in the group members’ lives. I have periodically returned to using the concepts of honesty, responsibility, and integrity along with some of the “twelve steps” when working with groups of couples in marital therapy.
At the University of Chicago in 1945, Carl Rogers and Robert Neville developed non-directive group therapy to treat war neurosis. This form of therapy-by-the-group, influenced by the work of Harry Stack Sullivan, emphasized a democratic process of equality and the encouragement of group members to share their traumatic stories and feelings with each other. By telling each other their stories over and over again, while receiving an empathetic response, the traumas of war were healed (Robert Neville, personal communication). In a non-directive group therapy, the leader’s role is to model empathy, congruence, and unconditional positive regard for group members. There is no interpretation from the leader. The therapy in a non-directive group is not determined by a theory of motivation, personality, or psychopathology but by the idea that people need to be authentic with each other about their own emotional experiences (Rogers, 1951, 1961). In my first two years as a group psychotherapist I used this model exclusively. Over the years I have often returned to this model when shame was a central issue, when the power of group members’ empathy and identity were essential for the healing of trauma and neglect, or when other models seemed too deterministic.
Non-Directive groups, Alcoholics Anonymous, and Integrity Groups represent what I refer to as “therapy-by-the-group”. They are very different from the psychoanalytic group therapies that emphasize the importance of the therapist’s interpretation. Several types of psychoanalytic groups began in the 1950’s under the initial influence of the Tavistock Clinic in England. The analyst’s task was to interpret group members’ behavior according to psychoanalytic theorists, particularly Sigmund Freud, Anna Freud, and Melanie Klein. Group members were encouraged to talk to each other and it was assumed that, in the course of the group’s discussion, each member’s childhood transferences and psychopathology would be revealed in their behavior.
The leader spoke only to make theoretically based, authoritative interpretations of group members’ pathological motivations for their behavior. For example, interpretations of an individual’s behavior might be attributed to unresolved aggression, envy, Oedipal sexual attraction, or infantile transference. In such psychoanalytic groups, the authority of theory appears to be more important than the group member’s phenomenological experience.
In my experimentation with this model I have found that the use of authoritative interpretation may have the positive effect of arousing group members to think about their motivations, behaviors, and transference. It may even produce some adaptive changes in behavior. However, such theory-determined interpretations may also have a negative effect in that they may be quite distant from the client’s subjective experience (hence not very useful), are often shaming to specific members, and may also provoke other group members to either withdraw or conform to some theoretical expectation or norm. It has been my practice to abstain from using a therapy-by-interpretation model and instead focus on an inter-subjective understanding of each client’s motivations, affects, and behaviors as well as a co-constructive understanding among group members about their interpersonal relationships.
The 1960’s were a rich time of development in group therapy. Three developments emerged, often overlapped, and influenced each other. During this time Eric Berne made use of a modified psychoanalytic model to analyze group member’s transactions in order to determine which were transferential and which were not transferential. He was primarily focused on the transferences between group members that resulted in psychological games and reinforced their life script. A clear example of Berne’s use of Transactional Analysis concepts in group therapy is depicted in his description of his weekly “group of mothers of disturbed children” at Atascadero State Hospital (Berne, 1961, p.176)
Different from the psychoanalytically-based group therapists of his time, Berne was verbally active in the group’s discussions by making theoretically based interpretations and explanations during the process rather than waiting until the end as in most psychoanalytic groups. Even though he was active in the group’s process and fostered a sense of equality by engaging group members in making contracts for behavioral change and in talking directly to each other, his primary methods were explanation and interpretation (Barbara Rosenfeld, personal communication).
Although Berne did not make psychoanalytically based interpretations about an individual’s pathological motivations, -- he focused instead on the group members’ transactions with each other -- both Berne’s Transactional Analysis groups and the psychoanalytic groups can be seen as a model of “therapy-by-interpretation”.
Also during the 1960’s Fritz Perls developed the concept of Therapy-In-the-Group (Perls, 1967, 1973). In this model the psychotherapist did individual psychotherapy within the group while group members observed the individual therapy. Group members participated both vicariously and through their supportive statements at the end of the work but there was little in the way of group interaction. The psychotherapist was highly directive of the individual’s psychotherapy by encouraging the client to do psychological experiments, to be expressive, and to explore unfinished emotional experiences.
Perl’s Gestalt Therapy Groups pioneered the concept of therapy–in-the-group and had a large influence on how Transactional Analysis and other forms of group therapy were conducted during the 1970’s. The use of a Transactional Analysis model of therapy-in-the-group is clearly illustrated in Changing Lives Through Redecision Therapy (Goulding & Goulding, 1979) and Integrative Psychotherapy in Action (Erskine & Moursund, 1988/2011). I have often used such individualized in-the-group-therapy methods, particularly in therapy marathons, to stimulate profound change in a client’s life script. Group members benefit by identification and through group discussion at the end of the work. However, in such a group there is a dearth of interpersonal contact unless the psychotherapist encourages whole-group interaction following the individual therapy.
The third trend of the 1960’s was influenced by the emergence of Encounter Groups that put emphasis on interpersonal growth and the development of human potential (Egan, 1970). Encounter groups began as a form of human relations training and were not originally proposed as a form of psychotherapy. Over time, the model of interpersonal growth was used in various clinical settings as a form of therapy-through-the-group.
The encounter group theory was based on a cybernetic model that we all affect each other in a myriad of ways. This theory is articulated in the concept that the behavior of one person in the group is a direct influence on the behavior of the other people in the group. We are all constantly influencing each other both consciously an unconsciously.
Encounter groups focused on various group members describing the behavior of each of the other group members and how that behavior affected them. Each member in the group was encouraged to give feedback to other group members and to be highly vocal, confrontative, or even aggressive, in describing the other’s behavior. Direct confrontation was seen as a form of authenticity. Both an individual’s behavior and their possible lack of emotional expression were seen as his or her “problem” –- a problem to be fixed through-the-group interaction. The theory is based on the idea that people are often out of touch with themselves and needed an intense encounter with others in order to become authentic (Egan, 1971). Unfortunately, the lack of respect that often occurred during “feedback” and a heavy focus on behavior change made these groups shaming and traumatizing to some participants.
I have often experimented in the use of dyadic, small group, and whole group encounter exercises (as well as physical movement, dance, and psychodramatic enactments) to facilitate clients’ discovery of their own potential and to heighten their awareness of how they impact others. I found it essential when using this model of therapy-through-the-group that the psychotherapist maintains a protective environment that clearly communicates respect for the uniqueness of each person.
The Feedback and Person-Centered Trends
By the 1980’s many group psychotherapists were influenced in some way by the variety of models that I have previously described. They were experimenting with different trends in interpersonal relationships and group psychotherapy. I too was influenced by the previous models and searched to find a form of group psychotherapy that was effective in changing the relational patterns of life scripts. I looked for a model of group therapy that was relational and co-constructive -- one that made full use of the therapeutic potential “indigenous” in the group members’ interactive processes.
I experimented in using Transactional Analysis both in the styles of a feedback and a person-centered approach to group psychotherapy. These two trends reflect important developments in group psychotherapy and represent opposing poles on a continuum of therapy-through-the-group. In the next few paragraphs I will describe these two trends and then go on to explain how we might integrate the feedback and person-centered approach to develop a Transactional Analysis relational group-process therapy model that is effective in preventing stress and in healing the wounds of trauma, neglect, and shame.
Many current transactional analysis and other theoretically oriented psychotherapy groups make use of a feedback approach to facilate group interaction. Although such an approach is interactive, it often either reflects the leader’s theoretical perspective or the opinion of a particular person or collection of people. Candor and bluntness are encouraged. The emphasis is on the speaker’s perspective –- a perspective that is considered bona fide and more significant than listening to and learning from the other person. The therapeutic intent of the feedback is to influence and modify the group members’ script determined behaviors and relational patterns. The social message is, “This is how you affect me”. The emphasis is on change.
Confrontation from the group leader or from one group member to another is considered to be essential to the therapy process. Such bluntness is often regarded as an expression of the speaker’s genuineness and the “reality of how I see you”. In a feedback oriented group the focus is on each member’s perception and interpretation of other group member’s behaviors. The feedback may not accurately describe an individual’s subjective and internal experience but it reflects how another group member perceives that person. Candor is often encouraged in such groups. It is defined as speaking in congruence with one’s own feelings, interpretations, and opinions of the other group member’s behavior. For example, a group member may describe or interpret another with a statement such as, “You are angry and withdrawn…you always feel superior”.
Theoretically, the advantage of the feedback model is that it is effective in providing the perspective and opinion of the group leader or of one member to another. When a group member makes a pronouncement such as the one described above, the receiving group member is expected to respond as though the original speaker is describing reality or the only truth. Self-reflection in accordance with the confrontation is encouraged; to explain one’s subjective experience may be defined as “being defensive”.
Among the disadvantages of a feedback oriented group is the fact that little attention is given to an individual’s inner processes (such as fear, shame, uncertainty, etc.) that may be manifested in the expressions of what seemingly appears to be anger, withdrawal, or superior behavior. A group that relies on a frequent use of a feedback model may change the members’ script-determined behavior but it may also increase members’ sense of shame and being misunderstood within the group. Rather than inviting inter-subjective connection and real interpersonal growth, the feedback approach may trigger either compliance or withdrawal.
In contrast, a person-centered psychotherapy group attends to how each member’s subjective experiences are manifested in the group. It places the therapeutic focus on each individual’s phenomenological process and the importance of sharing one’s subjective experience with an interested and involved listener. In a person-centered group one’s personal perspective, opinion, or interpretation is seen as inadequate in understanding each of the other people in the group. Therefore, there is an emphasis on inquiry, understanding, and attunement with the other’s inner experience -- a resonance with their affect, self-perspective, and how they make meaning. It is based on the leader and each group member making the assumption that “I know nothing about the other, my observation and interpretation are not enough to understand the experience of the other person”.
One of the principles of a person-centered group is to learn to see and experience the other as he or she experiences him or herself – to vicariously enter into the other’s subjective experience. Careful listening and respectful inquiring are seen as essential to know the other. Empathy with other group members’ stories and attunement to the others’ affect, rhythm, and mode of cognition is given central importance. Confrontation is generally not part of such person-centered group. In this approach to group therapy it is assumed that when people experience being truly known, without interpretation or ridicule, their level of stress and shame decrease and they can more freely express themselves and resolve psychological issues.
One of the disadvantages of this model is that it may overemphasize subjective experience and the importance of empathy. It may not sufficiently attend to the effects of a group member’s behavior on others. By emphasizing each member’s internal, subjective experience such a group may miss giving adequate attention to the person’s behaviors, such as: the effect of crossed transactions, projections and misinterpretations, the impact one member may have on another, or the behavioral dimensions of life-scripts. Another disadvantage is that the group members may become “nice” to each other rather than authentically expressing what they perceive. When the group is “nice”, significant aspects of group members’ script-determined behaviors my never receive therapeutic attention nor an opportunity for resolution.
My current practice of group therapy has been influenced by a professional desire to resolve the quandry between using a feedback or a person-centered approach. In my experience clients in group psychotherapy often require a therapeutic approach that includes what is effective in both a feedback and a person-centered approach to group therapy in order to relinquish the old relational patterns of life scripts. I think that the solution to the polemic between these approaches lies in the skillful integration of the two modes of conducting group therapy in order to have a therapy that is co-constructive and relational -- a therapy that is truly “indigenous” to the group.
Relational Group Process
When using a Relational Group Process model it is my intent to combine the best of both the feedback and person-centered models. One of the leader’s tasks is to encourage all the group members to attend to each person’s phenomenological experience and to actively participate by providing respectful responses. An important focal point of the therapy is in the creation of an inter-subjective experience wherein each member is fully involved with each other member.
I often begin a Relational Group Process with an accent on teaching the importance of a co-constructive mission within the group. This is accomplished by encouraging group members to be empathetic, to listen, to inquire, and to resonate with others. Group members learn, and hopefully appreciate, the others’ perspectives and feelings. Group members are encouraged to be responsive and to speak about their perceptions, feelings, and reactions to each other.
When group members are attuned to the affect and relational-needs of each other and are sensitive in their transactions with each other, the quality of feedback they provide becomes a valuable asset in promoting each person’s growth. An effective relationally oriented group will certainly include some feedback: “This is how I see you”. However, in an effectively run group the feedback is presented with an attunement to the other’s affect and with a sense of respect. This respect is based on the awareness that the comments made may not accurately describe the other’s experience. It is in integrating both the person-centered and feedback trends of working that we create a viable “Us”, a shared experience, rather than just a “You” or “Me” perspective.
This reciprocal process of active involvement with other group members’ perspectives and respectful reactions enables everyone in the group to both elaborate and enrich their expressions of their own experiences. Relational Group Psychotherapy provides a member with an opportunity to express one’s self, to be understood, to grow in emotional attachment, to develop one’s unique identity, and to express one’s own integrity.
The therapist has several tasks, including introducing principles and practices that normalize and validate each individual person and the multiple relationships in the group, providing a sense of cohesion, continuity and stability, and encouraging the group members to question and challenge their beliefs, fantasies and behaviors. The therapy is built on honest and respectful dialogue. Truth telling, about one’s self and how each person experiences the other group members (and the leader) is an important characteristic of Relational Group Process.
Effective relational group psychotherapy provides a contrast between an individual’s internal psychological processes of implicit and procedural memories, script conclusions and beliefs, projections and expectations, and archaic forms of self-regulation with the various group members’ sensitivities to relational-needs, the importance of phenomenological inquiry, and the reparative power of people’s genuine interest and involvement.
Another task for the leader involves teaching and emphasizing the importance of active listening, validation, and normalization. This is not a normalization that is placating or minimizing the significance of a problem. It is a normalization that recognizes the psychological- function of the person’s affects, fantasies, self-protective processes, script beliefs, and modes of coping as normal – a normal way of coping within an historically stressful, neglecting, or traumatizing family or school context.
Relational Group Psychotherapy takes the psychotherapist out of the task of interpreting and out of the role of working individually with each person; the leader’s focus is on facilitating the relationships between group members. The leader is a teacher about human needs and relationships, guiding and facilitating involved relationships among group members. The image I use of a Relational Group Psychotherapist is that of an orchestra conductor who maintains the rhythm, adjusts the volume, gestures to the various musicians when to play their solos, and facilitates the orchestra’s playing in harmony with each other.
A guiding principle of Relational Group psychotherapy is the respect for each person’s phenomenological experience. Through respect, understanding, kindness, and compassion, each member of the group establishes an interpersonal relationship that provides affirmation of the other’s uniqueness and integrity. Integrity is best defined in Shakespeare’s words, “ to thine own self be true, and it must follow, as the night the day, thou canst not then be false to any man.”
Contact between group members is the therapeutic context in which each person explores his or her feelings, needs, memories, and perceptions. This does not mean that a Relational Group Process is all about being “nice and superficial” with each other. On the contrary, when we truly engage in using the best of a feedback model (whether it be through the use of self-definition, making an impact, or initiating with another) it may involve uncomfortable discussions, challenges to the other person’s perspectives, or confrontations of their behaviors. Through the integration of the person-centered and feedback models, discussion, challenge, or confrontation done with honesty and respect for the other’s perspective, in a non-humiliating way, often builds trust in the relationship and continues to foster integrity.
Confrontation may be used but it is done with awareness for the potential shame it may cause. As a group psychotherapist I encourage members to get the other person’s consent before making a confrontation, such as, “I have something to say to you that may be uncomfortable. Do you want hear it and discuss your reactions?” I also lead group members to engage in phenomenological and relational inquiry following a confrontation: “How did you experience what was said to you?” “What meaning do you make of the fact that I said it now and not before?” “Is it possible that I have misperceived you and do not understand your experience?” When confrontation is accompanied with respectful inquiry into the current quality of interpersonal relationship, the possibility of shame diminishes; integrity is strengthened for each person involved in the exchange.
Healing relationships are based on caring involvement in the act of working together for a common benefit of each group member’s welfare. One of the many tasks of the group psychotherapist is to facilitate the group members to inquire about each other’s phenomenological experience and to draw out other group members who are not actively participating or who may be reluctant to talk about what they are feeling. An illustration of this occurred in a group session where Charles spoke about the stress he felt in the painfully protracted illness and eventual death of a dear friend. His grief was intense. He then thanked both the group members and the psychotherapist for their encouragement and support in talking about a topic in which he was hesitant to speak. Charles went on to describe the relief he felt after talking and crying about his pain with the group. He talked with each of the group members about how his grief had shifted to a sense of appreciation for how his life had been enriched because of the friendship.
With the group leader’s encouragement Charles then inquired about the experiences of two others in the group who had not spoken and had recently experienced the death of loved ones. They both said that they found it difficult to speak about death and their lost relationships because of the fear of being overwhelmed with intense sadness but, in witnessing Charles’ emotionally filled story, they were able to express some of their own grief. This led to the whole group talking about the importance of interpersonal connections, loss, sadness, and how they each had a history of distracting themselves from the intensity of their feelings. An important task of the group psychotherapist is in orchestrating the group members’ awareness of their own relational-needs while being respectful and responsive to the needs of others in the group.
In Relational Group Psychotherapy the therapist is not the only one to support, inquire, and encourage group members to express what they are feeling and thinking. Group members’ inquiry and empathy with each other, and their encouragement for everyone to be heard, may constitute important psychologically supportive transactions when they express a shared experience of similar loss, stress, neglect, or trauma. In an effectively conducted group several elements happen synergistically:
· group members talk authentically about their experiences, perceptions, and affect;
· other group members fully listen to each other and think about how the other individual’s perceptions compare and contrast with his or her own;
· new experiences emerge – communal experiences that are uniquely different from what each individual has previously known.
· new understandings come into view, old beliefs change, and new emotional experiences occur because old relational-memories are contrasted with what is transpiring relationally in the group.
These new experiences are uniquely individual and simultaneously uniquely relational. In creating a shared experience the group constructs a place that belongs solely to no one in particular and yet it belongs to each and all – a creative place of relationship.
Relational group psychotherapy often begins with recognition of each person’s needs and feelings. The leader will often encourage the group to focus on each person’s need for security -- the freedom to be “as they are” without criticism, ridicule, or putdown. One of the first steps in healing stress, in the undoing of cumulative neglect, and in the resolution of trauma is for each person to have an assurance of freedom from being shamed in the group. This is often accompanied by encouraging group members to talk about past humiliating experiences and how they were hurt, angry, or remain fearful in a group.
Often group members are invited to remember specific scenes from family or school experiences and to talk about their experiences and how they managed those experiences. It is these unacknowledged, implicit memories and archaic ways of relating that may be reenacted within the group. The emphasis may then shift to what the person needs from each of the group members in order to feel secure. Such conversation may move from one group member to another with a focus on the type of security each needs from the other.
One example comes to mind: in a group that had met for a few sessions, the discussion among the members seemed to become superficial. I began the next session by stating that no one had used the word “shame” in our previous sessions. The mention of “shame” was responded to with several minutes of silence and then each of the group members spoke of their own shame and how they often felt debilitated by their sense of “something’s wrong with me”. Over the next several sessions the entire group talked about how they were blamed or humiliated in school, in previous groups, and in their families. These discussions led group members to realize how each person needed safety in the group. They then pledged to each other that there would be no shaming transactions and, if such transactions inadvertently occurred, the group would be committed to resolving the conflict.
Often the discussion of security leads to someone’s need for validation and affirmation by other group members. For many people their behavior or way of making meaning was discounted, ignored, or in some way not validated in previous relationships. The lack of validation is often shaming and adds to stress. Validation is provided when we find value in what the other is saying. As mentioned earlier an important task of Relational Group Psychotherapy is to provide each member with a sense of validation. A case in point: frequently a group member will say something that is full of emotion and others will remain silent. This is often because group members think that they are being respectful. Yet, a silent response is often experienced by the speaker as a lack of validation of their affect or their sense of self. The person may begin to doubt themselves and what they are saying; internal stress, shame, and withdrawal may result. It becomes the leader’s responsibility to identify such moments in the group when there is a lack of validation and to encourage members to speak about what they are feeling in response to the person. Such feeling-based responsiveness provides indispensable validation.
Each of us needs to rely on others who are stable, dependable, and protective. The psychotherapy group can fulfill this need when group members consistently respect each person’s affect, fantasies and self-protective process. The group provides a protective function when there is a secure venue and the necessary attunement and involvement to understand the emotional expression or implicit memory that a member is experiencing. A third example: in some groups I identify the significance of the larger unconscious story that a member is enacting in his or her behavior and the importance of the group members’ patience and acceptance as a way to provide stability and dependability.
All of us have the need to have our personal experiences confirmed. Confirmation occurs when we are in dialogue with someone who understands because he or she has had a similar experience. The group leader watches for and encourages members to talk about how they identify with what a person may be saying that is similar to their own experience. Frequently the conversation then flows between several group members with each contributing the uniqueness of their own experience. It is in the shared experiences that people do not feel alone or worry that they are strange or crazy. Shared experiences are an important antidote to shame and an important reduction of stress.
In addition to shared experiences and similarities, each person in the group is uniquely different. People have the need to know and express their own self-definition and uniqueness and to receive acknowledgement and acceptance by the others in the group. Self-definition is the communication of one’s self-chosen identity through the expression of preferences, interests, and ideas without humiliation or rejection. The Relational Group Psychotherapist encourages each person’s expression of identity and integrity and the group’s normalization of the need for self-definition. In some family and school situations the child’s attempts at self-definition were ridiculed or punished. When self-definition is thwarted, internal stress increases. An effective group leader facilitates each individual in defining his or her self in relationship with others.
All people have the need to make an impact on others with whom they are involved. An individual’s sense of competency in relationship emerges from attracting the other’s attention and interest, influencing what may be talked about, and effecting a change of emotion or behavior in the others. Attunement to a group member’s need to make an impact occurs when the other group members allow themselves to be emotionally impacted by the speaker and to respond with compassion when the speaker is sad, to provide an affect of security when the person is scared, to take the other seriously when he or she is angry, and to be excited when he or she is joyful.
Many people in group need the others to initiate contact, to have the others reach out in a way that acknowledges their presence and demonstrates their importance in the relationship. The group psychotherapist models initiation, teaches about the importance of initiation, and encourages members to initiate with each other. So often people are hesitant to initiate because they imagine that they may be invasive or rescuing, or they remember rules from school that prohibited children from talking to each other during class. The various initiations that group members make with each other often reduce group members’ stress or sense of being alone. For example, a group member may say to another, “I noticed that you have been silent for a while. I would like to know what you are experiencing”. This initiation is an invitation to be fully involved together in the therapeutic process.
The need to express thankfulness, gratitude, or to give affection is important in human relationships. When group members provide a sense of security, validation, stability and dependability, a shared experience, an opportunity for self-definition and impact, and show initiation with each other, individuals are often grateful and want to express their affection. The effective group leader facilitates members in expressing their thankfulness and gratitude.
In my years of experimentation with group psychotherapy I have found that a group based on these principles of Relational Group Process is the most effective means of communicating the concepts of Transactional Analysis. It is through the progression of trust, a shared relationship, validation, consistent reliability and security, and ongoing responses to each individual’s relational-needs that the “indigenous” healing and growth-enhancing power of the group is actualized in the lives of every member. Such respectful group involvement puts an end to group members’ sense of shame, rectifies cumulative neglect, dissolves chronic stress, and heals trauma.
Berne, E. (1961). Transactional Analysis in psychotherapy: A systematic individual and social psychiatry. New York: Grove Press.
Egan, G. (1970). Encounter: Groups for interpersonal growth. Belmont, CA: Brooks/Cole.
Egan, G. (1971). Encounter groups: Basic Readings. Belmont, CA: Brooks/Cole.
Erskine, R.G. & Morusund, J.P. (1988/2011). Integrative psychotherapy in action. London: Karnac Books. (Original work published in 1988 by Sage, Newbury Park, CA).
Erskine, R.G. Morusund, J.P. & Trautmann, R.L. (1999). Beyond empathy: A therapy of contact-in-relationship. NY: Burnner/Mazel.
Goulding, M.M. & Goulding, R.L. (1979). Changing lives through redecision therapy. New York: Brunner/Mazel.
Mowrer, O.H. (1972). Integrity groups: principles and procedures. The Counseling Psychologist, 3:7-33.
Ormont, L. (2003). Group psychotherapy. New York: Jason Aronson.
Perls, F.S. (1967). Gestalt therapy verbatim. Lafayette, CA: Real People Press.
Perls, F.S. (1973). The Gestalt approach and eyewitness to therapy. Palo Alto, CA: Science and Behavior Books.
Rogers, C. R. (1951). Client centered therapy. Boston: Houghton Mifflin.
Rogers, C.R. (1961). On becoming a person. New York: Houghton Mifflin.
Rutan. J.S. & Stone, W.N. (1993). Psychodynamic group psychotherapy (2nd ed.). New York: Guilford.
Yalom, I. D. (1995). The theory and practice of group psychotherapy. New York: Basic Books.
Keywords: Relational Group Process, group therapy, attunement, confrontation, person-centered, relational-needs, respect, shame, Eric Berne, phenomenological inquiry.