The Theory and Practice of Group Psychotherapy (31 page)

PROCESS FOCUS: THE POWER SOURCE OF THE GROUP

The focus on process—on the here-and-now—is not just one of many possible procedural orientations; on the contrary, it is indispensable and a common denominator of all effective interactional groups. One so often hears words to this effect: “No matter what else may be said about experiential groups (therapy groups, encounter groups, and so on), one cannot deny that they are potent—that they offer a compelling experience for participants.”
Why
are these groups potent?
Precisely because they encourage process exploration. The process focus is the power cell of the group.

A process focus is the one truly unique feature of the experiential group; after all, there are many socially sanctioned activities in which one can express emotions, help others, give and receive advice, confess and discover similarities between oneself and others. But where else is it permissible, in fact encouraged, to comment, in depth, on
here-and-now behavior, on the nature of the immediately current relationship between people?
Possibly only in the parent–young child relationship, and even then the flow is unidirectional. The parent, but not the child, is permitted process comments: “Don’t look away when I talk to you!” “Be quiet when someone else is speaking.” “Stop saying, ‘I dunno.’”

Consider the cocktail party. Imagine confronting the narcissistic self-absorbed individual who looks through or over you while talking to you, searching for someone more attractive or appealing. In place of an authentic encounter, we are most likely to comment, “Good talking with you . . .” or “I need to refill my drink . . .” The cocktail party is not the place for
process
. Responding authentically and in a process-oriented fashion would very likely thin out one’s party invitations.

Process commentary among adults is taboo social behavior; it is considered rude or impertinent. Positive comments about another’s immediate behavior often denote a seductive or flirtatious relationship. When an individual comments negatively about another’s manners, gestures, speech, or physical appearance, we can be certain that the battle is bitter and the possibility of conciliation chancy.

Why should this be so? What are the sources of this taboo? Miles, in a thoughtful essay,
⁵
suggests the following reasons that process commentary is eschewed in social intercourse: socialization anxiety, social norms, fear of retaliation, and power maintenance.

Socialization Anxiety

Process commentary evokes early memories and anxieties associated with parental criticism of the child’s behavior. Parents comment on the behavior of children. Although some of this process focus is positive, much more is critical and serves to control and alter the child’s behavior. Adult process commentary often awakens old socialization-based anxiety and is experienced as critical and controlling.

Social Norms

If individuals felt free to comment at all times on the behavior of others, social life would become intolerably self-conscious, complex, and conflicted. Underlying adult interaction is an implicit contract that a great deal of immediate behavior will be invisible to the parties involved. Each party acts in the safety of the knowledge that one’s behavior is not being noticed (or controlled) by the others; this safety provides an autonomy and a freedom that would be impossible if each continuously dwelled on the fact that others observe one’s behavior and are free to comment on it.

Fear of Retaliation

We cannot monitor or stare at another person too closely, because (unless the relationship is exceedingly intimate) such intrusiveness is almost always dangerous and anxiety-provoking and evokes retribution. There exist no forums, aside from such intentional systems as therapy groups, for interacting individuals to test and to correct their observations of one another.

Power Maintenance

Process commentary undermines arbitrary authority structure. Industrial organizational development consultants have long known that an organization’s open investigation of its own structure and process leads to power equalization—that is, a flattening of the hierarchical pyramid. Generally, individuals high on the pyramid not only are more technically informed but also possess organizational information that permits them to influence and manipulate: that is, they not only have skills that have allowed them to obtain a position of power but, once there, have such a central place in the flow of information that they are able to reinforce their position. The more rigid the authority structure of an organization, the more stringent are the precautions against open commentary about process (as in, for example, the military or the church). The individual who wishes to maintain a position of arbitrary authority is wise to inhibit the development of any rules permitting reciprocal process observation and commentary.

In psychotherapy, process commentary involves a great degree of therapist transparency, exposure, and even intimacy; hence many therapists resist this approach because of their own uneasiness or anxiety. Moving into process means moving into recognition that relationships are jointly created by both participants and has a mutual impact.

THE THERAPIST’S TASKS IN THE HERE-AND-NOW

In the first stage of the here-and-now focus—
the activating phase
—the therapist’s task is to move the group into the here-and-now. By a variety of techniques, many of which I will discuss shortly, group leaders steer the group members
away
from outside material to focus instead on their relationship with one another. Group therapists expend more time and effort on this task early than late in the course of the group, because as the group progresses, the members begin to share much of this task, and the here-and-now focus often becomes an effortless and natural part of the group flow. In fact, many of the norms described in the last chapter, which the therapist must establish in the group, foster a here-and-now focus. For example, the leader who sets norms of interpersonal confrontation, of emotional expressivity, of self-monitoring, of valuing the group as an important source of information, is, in effect, reinforcing the importance of the here-and-now. Gradually members, too, come to value the here-and-now and will themselves focus on it and, by a variety of means, encourage their fellow members to do likewise.

It is altogether another matter with the second phase of the here-and-now orientation,
process illumination.
Forces prevent members from fully sharing that task with the therapist. Recall the T-group vignette presented earlier in which Robert commented on process and thereby set himself apart from the other members and was viewed with suspicion, as “not one of us.” When a group member makes observations about what is happening in the group, the others often respond resentfully about the presumptuousness of elevating himself or herself above the others.

If a member comments, for example, that “nothing is happening today,” or that “the group is stuck,” or that “no one is self-revealing,” or that “there seem to be strong feelings toward the therapist,” then that member is courting danger. The response of the other members is predictable. They will challenge the challenging member: “
You
make something happen today,” or “You reveal yourself,” or “You talk about your feelings toward the therapist.” Only the therapist is relatively exempt from that charge. Only the therapist has the right to suggest that others work or that others reveal themselves without having to engage personally in the act he or she suggests.

Throughout the life of the group, the members are involved in a struggle for position in the hierarchy of dominance. At times, the conflict around control and dominance is flagrant; at other times, quiescent. But it never vanishes and should be explored in therapy both because it is a rich source of material and also to prevent it from hardening into a source of continuing, fractious conflict.

Some members strive nakedly for power; others strive subtly; others desire it but are fearful of assertion; others always assume an obsequious, submissive posture. Statements by members that suggest that they place themselves above or outside the group generally evoke responses that emerge from the dominance struggle rather than from consideration of the content of the statement. Even therapists are not entirely immune from evoking this response; some clients are inordinately sensitive to being controlled or manipulated by the therapist. They find themselves in the paradoxical position of applying to the therapist for help and yet are unable to accept help because all statements by the therapist are viewed through spectacles of distrust. This is a function of the specific pathology of some clients (and it is, of course, good grist for the therapeutic mill). It is not a universal response of the entire group.

The therapist is an observer-participant in the group. The observer status affords the objectivity necessary to store information, to make observations about sequences or cyclical patterns of behavior, to connect events that have occurred over long periods of time. Therapists act as group historians. Only they are permitted to maintain a temporal perspective; only they remain immune from the charge of not being one of the group, of elevating themselves above the others. It is also only the therapists who keep in mind the original goals of the group members and the relationship between these goals and the events that gradually unfold in the group. The group therapist is the principal standard bearer of the group culture, supporting and sustaining the group and pushing it forward in its work.†
⁶

• Two group members, Tim and Marjorie, had a sexual affair that eventually came to light in the group. The other members reacted in various ways but none so condemnatory nor so vehemently as Diana, a forty-five-year-old nouveau-moralist, who criticized them both for breaking group rules: Tim, for “being too intelligent to act like such a fool,” Marjorie for her “irresponsible disregard for her husband and child,” and the Lucifer therapist (me) who “just sat there and let it happen.” I eventually pointed out that, in her formidable moralistic broadside, some individuals had been obliterated, that the Marjorie and Tim, with all their struggles and doubts and fears, whom Diana had known for so long had suddenly been replaced by faceless one-dimensional stereotypes. Furthermore, I was the only one to recall, and to remind the group, of the reasons (expressed at the first group meeting) why Diana had sought therapy: namely, that she needed help in dealing with her rage toward a nineteen-year-old, rebellious, sexually awakening daughter who was in the midst of a search for her identity and autonomy! From there it was but a short step for the group, and then for Diana herself, to understand that her conflict with her daughter was being played out in the here-and-now of the group.

There are many occasions when the process is obvious to all the members in the group but cannot be commented upon simply because the situation is too hot: the members are too much a part of the interaction to separate themselves from it. In fact, often, even at a distance, the therapist, too, feels the heat and is wary about naming the beast. Sometimes an inexperienced therapist may naively determine it best that some group member address an issue in the group that the leader himself feels too anxious to address. That is usually an error: the therapist has a greater ability to speak the unspeakable and to find palatable ways to say unpalatable things. Language is to the therapist what the scalpel is to the surgeon.

• One neophyte therapist leading an experiential group of pediatric oncology nurses (a support group intended to help members decrease the stress experienced in their work) learned through collusive glances between members in the first meeting that there was considerable unspoken tension between the young, progressive nurses and the older, conservative nursing supervisors in the group. The therapist felt that the issue, reaching deep into taboo regions of authority and tradition, was too sensitive and potentially explosive to touch. His supervisor assured him that it was too important an issue to leave unexplored and that he should broach it, since it was highly unlikely that anyone else in the group could do what he dared not.

In the next meeting, the therapist broached the issue in a manner that is almost invariably effective in minimizing defensiveness: he described his own dilemma about the issue. He told the group that he sensed a hierarchical struggle between the junior nurses and the powerful senior nurses but that he was hesitant to bring it up lest the younger nurses either deny it or attack the supervisors, who might be so wounded that they would decide to scuttle the group. His comment was enormously helpful and plunged the group into an open and constructive exploration of a vital issue.

Articulating the dilemma in a balanced, nonblaming fashion is often the most effective way to reduce the tension that obstructs the group’s work. Group leaders need not have a complete answer to the dilemma—but they do need to be able to identify and speak to it.†

I do not mean that
only
the leader should make process comments. As I shall discuss later, other members are entirely capable of performing this function; in fact, there are times when their process observations will be more readily accepted than those of the therapists.

A greater ability to recognize process in interactions, perhaps a form of emotional intelligence, is an important outcome of group therapy that will serve members well in life.† (Often, students observing a mature group at work are amazed by group members’ high level of psychological-mindedness.) Hence, it is a good thing for members to learn to identify and comment on process. But it is important that they not assume this function for defensive reasons—for example, to avoid the client role or in any other way to remove themselves from the group work.