Written by Ryan Slobodian, B.A., M.C., C.C.C., Clinical Counsellor at EHN Edgewood Nanaimo.
Group therapy has been shown countless times in movies and in television, particularly support or addiction related groups. Most recently, 2020 Academy Award winner, Rocketman, incorporated Elton John’s experience in group therapy during his stay at a residential addiction treatment facility as a significant aspect of the film’s narrative structure. Many people have a rough idea what group therapy is: the chairs are formed into the shape of a circle, the group is usually led by a therapist asking questions or inserting comments, and people share details about themselves to other members. Yes, the practice of group therapy is widely known, but why is it important? Why is group therapy such an important aspect of addiction treatment structure?
(1) Group Therapy Is Cathartic
Expressing and processing difficult emotions—or simply, getting something off one’s chest—is a form of catharsis, which prominent Stanford psychiatrist Dr. Irvin Yalom describes as one of the key beneficial factors of group therapy (Yalom, 2005, pg. 2). The truth is that unpacking and expressing feelings helps reduce a great deal of emotional pain. Research indicates that consistent suppressed emotional pain has a lasting negative effect on the body, leading to various forms of disease and health issues (Mate, 2003). One way to release emotional pain is to talk about and process difficult emotions and experiences with others; specifically, learning to express emotion to others in a healthy way can have lasting positive psychological and physical health benefits. This concept is particularly salient in addiction treatment, as often drugs and alcohol are used to suppress or numb emotional pain, rather than process it in a healthy manner. A patient once said to me, “it feels like a weight has been lifted off of me and I can actually breathe,” after telling a difficult story of developmental trauma. The patient was right, a weight of intense emotional suppression was lifted, and it had positive physiological and emotional benefits. Group therapy offers a healthy way for individuals to process this difficult emotional pain and experience a release.
(2) Group Therapy Gives Hope
Installation and maintenance of hope is crucial regarding the efficacy of the treatment process, and keeping patients engaged in the therapeutic process (Yalom, 2005, pg. 4). Many patients come into treatment feeling hopeless and trapped in a cycle of seemingly inescapable addiction. They may even want to leave treatment to go back to a life of using. In a lot of ways patients may not envision a fulfilling life without the use of substances or process addictions, as their addictions serve an important purpose to numb negative emotion, while also providing a temporary sense of relief or happiness. When a patient is stuck in life or hopeless about the possibility of successful treatment and recovery, one of the most powerful therapeutic processes is witnessing change in other peers in recovery. Seeing other people with similar issues make significant shifts or make positive changes in behavior, promotes hope for the future and allows others to be open to the possibility that they also might change. At Edgewood, our clinical team deems group therapy and Alcoholics Anonymous type groups of utmost importance, because by attending, our patients are granted the opportunity to hear success stories from people in recovery. When our patients are surrounded by positivity and hope in group therapy, their belief in the treatment process deepens and the window of possibilities of a positive future in recovery widens.
(3) Group Therapy Shows the Universality of Experience
Active addiction puts significant strain on the many close relationships in an addict’s life, which as a result, promotes isolation. Furthermore, delusion, and self-centeredness are often problems in an addict’s life upon admission into a residential treatment program. When an addict is experiencing a combination of isolation, self-centeredness, and delusion, the result is often a maladaptive thought process that instills the belief that they are unique in their various problems, fantasies, addictions, thoughts, behaviors, and impulses. Group therapy provides an environment for addicts to relate to, and ultimately disconfirms the addict’s sense of uniqueness, which provides a powerful source of psychological relief (Yalom, 2005, pg. 6). Once a patient’s experience is validated and accepted and they hear other group members disclose experiences or problems similar to their own, patients often feel a greater sense of closeness to others and the world around them. Closeness to others shatters the self-destructive behavior of isolation and becomes an asset in a person’s ongoing recovery. It turns out that the cliché, “we’re all in the same boat,” packs a heavy therapeutic punch.
(4) Group Therapy Fosters Belongingness
Feeling that one belongs is one of the most essential aspects of human experience, and it remains a need that is pervasive across various cultures, time, and situations (DeWall, Deckman, Pond Jr, & Bonser, 2011). The powerful feelings of love and acceptance associated with having meaning and value in relationships cannot be underestimated. In many cultures across the world isolation is the most severe form of punishment, as belongingness is understood as one of the greatest human needs for happiness and survival. Studies have also demonstrated that severe psychological injury can occur when inmates are stripped of belongingness and are put in isolation or solitary confinement (Haney, 2018). Group therapy offers a safe space for self-disclosure, giving and receiving feedback, and change, which creates empowerment within the individual and effectively combats isolation. Even in relationships with families, friends, co-workers, or classmates, many addicts entering treatment have struggled with feeling a sense of true unconditional love or belongingness within a group context. Group therapy acts as a powerful corrective experience, providing disconfirming evidence to disarm negative core beliefs by providing a space for connection and belongingness.
(5) Group Therapy Creates a Space for Interpersonal Learning
Addiction creates a world of isolation, chaos, and disconnection. Group therapy creates an opportunity for a person to connect and learn about healthy relationships and intimacy. For some individuals, this may be the first time in their lives that they have shared their emotions and experiences honestly with peers. Most people have spoken in a group context. Usually conversations are centered around something superficial such as work, sports, current events, or the mundane activities and moments of daily life. Rarely, do people speak openly and honestly with their peers about traumatic or difficult experiences that shape inner thoughts, emotions, and behaviors. Discussing a traumatic experience would be uncomfortable to share with a regular group of people, and most times it wouldn’t be situationally appropriate. Group therapy, however, offers a supportive space to learn how to communicate in a healthy manner, resolve conflicts, and speak vulnerably about emotion without the fear of judgement.
Putting Together the Pieces
Speaking to a group of strangers about festering emotions and experiences that have been locked inside for years is difficult and anxiety-provoking for most people. However, group therapy provides a unique opportunity to do so constructively. The experience of sharing emotions in a group setting provides a space to learn and practice healthy communication, feel validated and accepted, gain a sense of hope, experience the release of shame and difficult emotion, and sometimes experience a physiological release of tension or pain.
Some tof the most comforting words in the universe are ‘me too.’ That moment when you find out your struggle is also someone else’s struggle, that you’re not alone, and that others have been down the same road.
—Unknown
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If you would like to learn more about the eating disorder support programs or counselling services offered by EHN Canada, or if you have any other questions about addiction or mental health, please call us at one of our numbers. Our phone lines are open 24/7—so you can call us anytime.
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References
DeWall, C. N., Deckman, T., Pond Jr, R. S., & Bonser, I. (2011). Belongingness as a core personality trait: How social exclusion influences social functioning and personality expression. Journal of Personality, 79(6), 1281-1314. https://doi.org/10.1111/j.1467-6494.2010.00695.x
Haney, C. (2018). The psychological effects of solitary confinement: A systematic critique. Crime and Justice, 47(1), 365-416. https://doi.org/10.1086/500626
Maté, G. (2003). When the body says no: The cost of hidden stress. Toronto, ONT, CAN: A.A. Knopf Canada.
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY, US: Basic Books.
