The Therapeutic Relationship In Group Work

Jimmy Judge

The therapeutic relationship at its best can be a unique, powerful and
 transformational experience, carrying in its essence a particular flavour and quality
 we are unlikely to encounter anywhere else in our lives. I can share with a close
 friend the most intimate aspects of my being, the darkest areas of my soul and the 
most perplexing difficulties in my life, which is a great relief and brings much 
needed comfort and acceptance. However, when the same experiences are shared 
and explored in the therapy room, they take on a whole new meaning, feel quite 
different, and are experienced and processed at a different frequency, yielding a 
whole new set of insights, openings and new territories to discover and be 
acquainted with. Generally speaking, most people accept that whilst close
 friendships have great potential for healing to occur, they are different and can
 never take the place of the therapeutic relationship – and vice versa of course. We
 have all experienced to some degree or other, the relief, hope and healing
 supportive energy available through a one-to-one therapeutic relationship, and we
 would all more or less agree that whilst sometimes painful and frightening, overall 
it is a valuable life changing experience. This whole process is amplified and
 expanded when we enter the realms of group therapy, not instead of a one-to-one 
relationship, but more an extension, a broader aspect of personal growth and
 healing. So, the remainder of this article will focus on the therapeutic relationship
 as encountered in a therapy group, both from client and therapist’s perspective – as 
they are interchangeable and deeply interconnected. The therapeutic relationship 
is one in which the client is honoured, respected and met with nothing other than 
unconditional love and acceptance for who he or she really is, or is struggling to 
be. This can only take place when the therapist also allows his/her struggle for
 personhood to emerge into being.

There are many forms of group therapy, and each has its own unique quality an d
identity, whether that be a short-term, task-oriented group, or an ongoing process 
style group. Within each group setting the group energy can be influenced by a
 therapist’s style, philosophy, personal belief system, and in my own experience, by 
the way you look, you wear, right down to accent and vernacular tendency. The 
point I’m getting at here is, that clients generally prefer their therapist to be 
qualified and have an acceptable level of accreditation: we all accept that, however,
 (and this is powerful in group work) clients are often more interested and
 fascinated by the kind of person you are, your preferences in life, strengths and
 weaknesses, if you really care etc. I am highlighting this point because in group
work, the very nature of a group of human beings gathered together gives rise to  
otherness, comparison, checking other people out, measuring stuckness or progress 
via other people’s reactions and so on. The people who tend to be most scrutinised
 in a group situation are the therapists! This creates an extremely challenging 
opportunity to engage in a therapeutic relationship with a group of people and a co- therapist if you’re lucky enough or burdened to have one, as the case may be. I’ll 
say a little bit more about the co-therapist relationship later. As with one-to-one 
therapy, the group therapist must be a real person (this is more of a challenge in a 
group as it’s impossible to fool eight wounded people – that’s sixteen bullshit 
detecting eyes!). So, if you enter the group arena hiding behind professional
 cliches, offering sterile, patronising solutions, I’m sure you will be about to 
experience true humility and what it really means to learn about psychotherapy 
Irvin D. Yalom is considered by many to be the godfather of group therapy, this is 
what he has to say about genuineness in group therapy:

“underlying all considerations of technique there must be a consistent positive 
relationship between therapist and patient. The basic posture of a therapist to a
 patient must be one of concern, acceptance, genuineness and empathy. Nothing,
 no technical consideration, takes precedence over this attitude.”

So you see that everything we are learning about being a humanistic and
 integrative psychotherapist comes into direct focus when we are attempting to establish therapeutic relationships with individuals who have come together as a
 group to ease the suffering of life and somehow develop a more positive fulfilling
 lifestyle.

Group therapy has been likened to a microcosm of society, emulating all the
 struggles, powerplays, rituals and ways of being we are part of on a daily basis.
 The group therapist needs to maintain a strong awareness of this dynamic as he/she 
facilitates the flow of energy from one aspect to another. While all of this is going
 on, for obvious reasons, the group can also begin to mirror the family, both the 
individual client’s family with all of the unique background that may have, and also
 the formation of a new family, a place where new ways of being can be practised,
 a place (perhaps unlike my own family) where I can really be myself, have a strong
 opinion and notice that others actually can cope – they don’t die and neither do I. As you can see there are many different dynamics unfolding in the group process.
 Some obvious, some more subtle, some conscious, some unconscious. The 
therapist needs to remain aware of all this, while at the same time relating to each
 person with respect, uniqueness and care. It can be quite demanding to engage in 
a therapeutic relationship with each individual whilst at the same time being tuned 
into the overall group mind or energy. Yalom describes it this way:


”Sometimes I think of the therapy group as an enormous dynamo, often the 
therapist is deep in the interior, working, experiencing, interacting [and being
 personally influenced by the energy field), at other times the therapist dons
 mechanic’s clothes and tinkers with the exterior, lubricating, tightening nuts and
 bolts, replacing parts.”


The therapeutic relationship (which is a healing relationship) requires extra 
wisdom, sustenance and heart in the realms of group work. You are constantly being challenged, criticised, seduced, supported, rejected, idealised and ridiculed…
just like most parents or guardians are. This dynamic can be assisted beautifully 
or complicated beyond description by the presence of a co-therapist, which I will 
talk about next.

There are many different views and opinions as to whether a group needs a co-
therapist, some consider the notion superfluous, others think of it as a luxury. My 
own experience has been varied and interesting. Working in a residential treatment
 facility, it is a practicality to have two therapists per group; due to the intense 
nature of such groups, there is a need for one of the therapists to have time off etc.,
 whilst the other attends to the group needs of that day. Having a co-therapist can
 enhance and augment the quality of care available in group therapy. This means 
being open to the various differences that may exist between you. Attending to 
issues such as: who does what, fear and jealousy if the other therapist seems to be
 competent and able, disagreements about basic therapeutic procedure, and much, 
much more. To engage in a co-therapist relationship requires open communication.
 If this is not clear and honest you are subject to all kinds of problems, and of course
 this affects the therapeutic relationship and the group sense it immediately 
(Mammy and Daddy aren’t getting on again). This will happen even if the
 therapists have a surface agreement – the group are highly sensitive and will tune 
in at a more subtle frequency, and inevitably, will begin to parent and guide the two 
therapists. So, honest communication between two therapists who are not 
threatened by each other’s skills, beliefs and philosophical frameworks is essential 
if the group is to benefit from the therapeutic alliance. If this is not in place many 
people end up getting hurt (including the therapists). Constant supervision, pre and
 post group meetings, and a sincere commitment to their own therapy, are pre
requisites for a healthy co-therapist relationship – it can also be useful if they like
 one another!

Finally, I would like to say a little about the potential group therapy holds to 
support healing, transformative relationships. If the therapist or co-therapist as the 
case may be, are open minded, genuinely concerned individuals, who share 
experience, knowledge and understanding of the complex dynamics of group 
therapy, and who also believe that human beings share an insatiable desire to heal 
themselves and be okay and happy in the world, group therapy is an extraordinary
 setting for this to occur. Most people come to therapy to attain some kind of
 personal freedom and enlightenment. These natural god given rights have been 
thwarted by unhappy families, experiences of abuse, addiction, marginalisation,
 isolation, to name but a few of the various pains that motivate people into seeking 
help. If a person can begin to feel safe, accepted, supported and esteemed in the 
context of a group, then that person is well on the way to achieving a sense of 
meaning, purpose and value in the world. When an individual can learn to share
 their deepest, most shameful thoughts and feelings, and those thoughts and feeling s
are supported by therapist and group alike, the individual is then in a more 
advantageous position to change self defeating behaviour or whatever it was that guided them into therapy initially. I have seen it time and time again, a person 
straggling for acceptance in a group, and the sheer joy and liberation that
 accompanies such disclosure and acceptance; the therapeutic relationship is
 definitely intensified in a group situation – therefore the possibilities for personal 
and group healing are boundless. I would like to finish with a quote from Judith
 Lewis Herman, author of Trauma and Recovery. In her brilliantly written book she 
captures something of what I am trying to say here:


”The core experiences of psychological trauma are disempowerment and
 disconnection from others. Recovery, therefore is based upon the empowerment of
 the survivor and creation of new connections. Recovery can take place only within 
the context of relationships; it cannot occur within isolation. In her renewed 
connection with other people, the survivor recreates the psychological faculties 
that were damaged or deformed by the traumatic experience. These faculties 
include the basic capacity for trust, autonomy, initiative, competence, identity and 
intimacy. Just as these capabilities are originally formed in relationships with
 other people, they must be reformed in such relationships.”

As you can see from this quote, the therapeutic relationship in group work can
 provide a safe, loving environment, where people can learn to be re-empowered,
 and of course, learn to connect with other human beings. That in itself is a
 powerful healing process, and one worth all of the challenge and stamina required 
to be part of a therapeutic relationship.

Bibliography

Irvin D. Yalom, The Theory and Practice of Group Psychotherapy, p. 112, Basic
 Books Inc. Publishers, New York.

Judith Lewis Herman, Trauma and Recovery, p. 133, Pandora.

Jimmy Judge is a psychotherapist working in the New Day Counselling Centre and 
in the Rutland Centre.