Chapter 1 Theories and Assumptions
Beneath any ordinary interaction among a group of people lies a fascinating world of interpersonal process—a world we often let pass as we go about our lives. However, upon a closer look, stretches of interpersonal terrain often lay themselves bare in front of our eyes—a member shutting down in communication; another using anger to keep others at arms’ length; yet another constantly jumping in before others get an opportunity; and more.
We can neither confirm nor deny: festering within these exteriors might be certain perceived disapproval from others; flight from vulnerable feelings; evasion from anxiety; and what not.
The complex, fertile, and elusive nature of the interpersonal process in a group often baffles beginning group therapists, whilst keeping the most seasoned therapists on their toes, no less. Yet it is the very nature of its elusiveness that fascinates us, and it is the pursuit of the depth and richness of its underlying process that rejuvenates all involved.
From a pragmatic perspective, this pursuit also makes economic sense. Cost containment has become a major thrust in the healthcare industry. As a consequence, the length of group counseling and therapy is being cut shorter and shorter, and group therapists are increasingly called upon to search for therapeutic methods bringing forth client change in shorter and shorter timeframes. Placing interpersonal process at the heart of group counseling, we believe, is paramount to this end, as it maximizes group power within a brief time frame.
This text provides a comprehensive framework and a variety of methods through which you, as a group leader, can build your muscle in tackling the subtle and complex dynamics of a group. Through sharing our experiences, our treasure maps if you will, we hope you and your group can strike therapeutic gold.
This exciting journey will start with the base camp—the theoretical underpinnings—from which the interpersonal approach of this group work has drawn its origins. All leadership skills and intervention techniques in this text are solidly built upon the groundwork of the concepts and assumptions of the
following theories. Granted, these theoretical approaches are immensely complex; an in-depth discussion will be far beyond the scope of this section. We, hence, highlight only those ideas connected with the theme of our text.
Sullivan’s Interpersonal Theory
Harry Stack Sullivan was the first to present a systemic theory of interpersonal relationships in psychotherapy (Sullivan, 2013; Sullivan & Perry, 1971). His work has since spawned a lineage of interpersonal theories and studies (Kiesler, 1982a; Strupp & Binder, 1984; Teyber, 2000). Steering clear of the prevailing trend at the time of focusing on intrapsychic processes, Sullivan, instead, put an emphasis on interpersonal processes. This focus, indeed, proved to break new ground.
Major Notions of Sullivan’s Interpersonal Theory
To help you zoom in on Sullivan’s interpersonal theory, we condense Sullivan’s groundbreaking theory into the following major notions:
- Human behaviors are recurrent and recursive: Our idiosyncratic behaviors seem to be moded by “the relatively enduring pattern of recurrent interpersonal situations which characterize a human life” (Sullivan, 2013, pp. 110–111).
- We are driven by interpersonal needs: It is not the sexual drive but the need for control, affiliations, and inclusion (the three interpersonal forces) that influence human motivations and actions.
- Our anxiety is rooted in interpersonal disapproval: Anxiety in interpersonal relations is the central force that organizes human behavior. Most people have a pervasive anxiety rooted in the fear of being discounted, rejected, or disapproved of by others, especially significant others. Our behaviors are mostly motivated by our desire to reduce anxiety.
- Problems manifest themselves in interpersonal relations: Our problems are primarily embedded in disturbed interpersonal relations and often manifest themselves in handicapped interpersonal communication.
- We cocreate our interpersonal reality through a reciprocal feedback loop: Recurrent interpersonal patterns and communication styles create a reciprocal loop in our environment—a type of feedback loop wherein the effect and the cause become circular. Thus, we not only affect others but are simultaneously affected by our interpersonal cocreation.
From Sullivan to Yalom
Sullivan’s interpersonally oriented theory and practice represent momentous insights into the nature of human suffering and healing—insights that continue to influence contemporary theorists, including Irvin D. Yalom, the most influential figure in group psychotherapy. Many of Yalom’s concepts of group psychotherapy can be traced back in some form to Sullivan’s original concepts (Yalom & Leszcz, 2005).
As for us, Sullivan’s interpersonal theory deeply shapes the way we view group members’ behaviors as well as the way we formulate leadership skills and interventions. Beginning with Chapter 7
, we provide ways to explore the interpersonal patterns and coping strategies that play out in members’ interactions with one another. Chapters 9
discuss how to directly address these often difficult dynamics, making them the grist for the mill of group work. All over these chapters, Sullivan’s impact leaves its trace.
Another theoretical model that greatly contributes to our interpersonal approach to group work is experiential therapy: a therapeutic approach that places emphasis on the felt experience (Elliot & Greenberg, 2007; Lietaer, Rombauts, & Balen, 1990).
Clients Need Direct Experiences, Not Cognitive Explanations
Experiential therapy springs from the humanistic school of therapy (Elliot & Greenberg, 2007; Pascual-Leone & Greenberg, 2007), which assumes that growth and change happen naturally when experiences are not impeded. Taking this assumption one step further, the experiential therapy approach emphasizes that for change to take place, clients need direct experiences, instead of cognitive explanations (Greenberg, Rice, & Elliott, 1998).
For example, the prominent existential psychotherapist Rollo May once said, “The patient needs an experience, not an explanation” (May, 1983, p. 158). This statement highlights the therapeutic tenet of experiential therapy.
From this precept, enters this notion: To truly know something, one must achieve that knowing through a personal, immediate experience, not just through discussion, listening, or abstract processing (Bohart, 1993; Elliot & Greenberg 2007; Horvath, 1995).
Only when the experience is felt directly are people then able to access a myriad of thoughts and feelings.
From Disowning, to Owning Up, to Reclaiming
An experience cannot be felt unless it is owned by the person having it. And to group therapy with an experiential slant, this ability to “own up” to one’s experiences puts itself at the central point of the trajectory of its members’ growth and change:
- Clients begin the group stuck in processing experiences or disowning their undesirable experiences.
- Clients, gradually, allow themselves to own up to their own experiences, becoming able to immerse themselves in their experiences.
- Clients reclaim their ability to process experiences, reconstruct the meaning of experiences, and respond to experiences in new ways.
This unfolding process, from disowning, to owning-up, to reclaiming one’s self, is a process nothing short of splendid.
Learning Self-in-Relationship Skills Through Group Interactions
To apply experiential therapy in the group setting is to help members embrace what is happening; articulate what is unspoken or difficult to express; and reflect on the meaning of their here-and-now relationships in the group (Yalom & Leszcz, 2005). When emotionally engaged with their fellow members in this way, group members find themselves with a surge of energy and vivacity, inspired to reach deep within to uncover long-hidden issues, wounds, and emotions.
This experiential approach stands unsurpassed as a treatment choice through which members can learn self-in-relationship skills (Elliot & Greenberg, 2007; Furman, Bender & Rowan, 2014)—skills that are difficult to develop when one is alone, without others to practice with or to get feedback from. The experiential approach, with its built-in emphasis on here-and-now engagement, accelerates members’ pace of delearning and relearning these self-in-relationship skills.
In Chapter 13
, we provide a special kind of experiential therapy
useful for group counseling, especially when it comes to healing unresolved pain, loss, and trauma—psychodrama
. Packed with actions, basic techniques of psychodrama
group therapists flexible and adjustable methods, applicable to various group settings, and at the same time, powerful in healing members’ long suffered pain.
Object Relations Theory
A client’s issue is like an onion—multi-layered with each one closer to the core than the one before. Object relations theory helps therapists appreciate these many layers.
What Is This Obscure Term—Object Relations?
You may feel uncertain about the term object relations, but you need not. Simply put, object refers to people, including our internalized perceptions of people, while relations refers to relationships. Stripped down, object relations theory is precisely what we’ve been discussing thus far—interpersonal relationships.
Although object relations theory has been historically written about in obscure and impersonal terms, it is nevertheless a powerful theory. When fully understood, it can help therapists comprehend the core of their clients’ predicaments.
The Quest for Connection Is What Motivates Our Behaviors
Although similar to interpersonal theory, object relations theory takes issue with Sullivan’s postulation that human behaviors are motivated by our need to reduce anxiety. Instead, it believes that as humans, our ultimate motivation is to seek relatedness, attachment, and connection to others (Greenberg & Mitchell, 1983; Kohut, 2014; Sandler, 1981; Strupp & Binder, 1984; Teyber, 2000). Being crucial to our survival, attachment and connection play a central role in the ways we interact with our early caretakers, so much so that they tend to become internalized within us (Cashdan, 1989; Flanagan, 2016).
Our Internalized Others Are With Us Everywhere We Go
If our early caretakers are empathic and responsive to our needs, a sense of self-worth and trust will become the basic constituents of our psychic development.
On the other hand, when our caretakers and early home atmosphere deprive us of empathy and nurturance, this environmental deficiency can lead to a weakened, fragmented, or disordered self.
These childhood injurious and conflicted ways of interaction are deeply rooted within those who seek therapy. Impressed upon them and internalized within them is an enduring mode of perceiving—a cognitive schema—that shapes their relationships with others later in life.
Coping Strategies Are Just the Outer Layers of the Onion
Armed with object relations theory, therapists are equipped with a great tool to help their clients come to their recognition—their recurrent, problematic coping patterns are an upshot of their past unresolved issues, as well as a source of their current relationship difficulties (Greenberg & Mitchell, 1983; Kohut, 2014; Sandler, 1981; Strupp & Binder, 1984; Teyber, 2000). For example, people who come from a background lacking emotional nurturance, where their parents were emotionally unavailable, neglectful, or abusive, often felt immensely hurt and pained as children. The more their self and relations were injured, the more they felt disquieted and insecure, and thus, they chased affirmation and reassurance with a sense of urgency. When affirmation and reassurance are unavailable, the unbearable pain may drive them to apply more extreme coping strategies to up the ante.
If the process of therapy is like peeling the onion, then coping strategies are the outer layers, appearing in the form of intellectualization, rationalization, deflecting, caretaking, people-pleasing, dramatization, externalization, and impersonalization. Though initially useful, these coping patterns become problematic later in life.
In order to live productively, people need to develop new responses to manage the unique demands and tasks of each life transition effectively. The first step of developing new responses is to become aware that their entrenched coping patterns are getting them stuck in a rut.
Reaching the Reactive Inner Layers
Through the lens of object relations theory, group leaders have a deeper appreciation of our members’ problems. As a result, we gain great respect and compassion for the pain our members endure on a daily basis. At the same
time, we are inspired and encouraged to reach the heart of our members’ issues—their recurrent relational patterns.
Peeling the onion by slowly leading the group to touch on members’ more reactive inner layers represents a powerful way of working with counseling groups. Chapters 6
expound on processing method and leadership skills to reach to these reactive inner layers. This method fosters great insight, self-compassion, and motivation for ...