Group Therapy: Healing in the Presence of Others

By Matthew Kirshman, MA, MSW, LICSW

Sometimes loneliness shows up even when you’re not alone.  Even among friends and intimate others, a sense of disconnection surfaces.  You feel misunderstood or blamed, or you hold yourself back, or in some nameless way you feel unseen and insecure.

Why do I keep getting in my own way?

You come to individual therapy looking for self-understanding.  The inner work with your therapist can be rich with insight and tools.  But over time, another element might emerge.  Your relationships with others hit the same old walls of self-protection, rejection, and resentment.

Group therapy doesn’t replace individual therapy—it adds another way of doing the inner work.

Group therapy rests on a simple premise: much of what we struggle with is relational; therefore, healing can (and should) happen within relationships.  Psychiatrist Irvin Yalom described the therapy group as “a social microcosm.”  The patterns that shape our lives don’t stay outside the group therapy circle—they show up within it.

The ways I hold back.

The ways I try to be seen.

The ways I expect others to respond.

In group therapy, these patterns don’t need to be imagined or analyzed from a distance.  They’re directly felt, recognized, identified, and ultimately understood.

This can happen in minor moments.

Imagine: a client sits back quietly while others speak.  When invited to share, she shrugs and says, “I don’t really have much to add.”  A few sessions later, another member reflects that he’s been wondering what she’s thinking.  “Your silence feels distant,” he says.  “Don’t you care about the people here?”

She pauses, then says, “I didn’t think anyone would notice.”

That moment was a subtle shift.  Her guard went down, and she began to process out loud a part of herself that she usually keeps submerged.  The group offered her reflections on how she pulls back, avoids conflict, and struggles to stay connected.  The dialogue allowed her to share and see herself more clearly in the presence of others.

While this kind of feedback is hard to ask for in everyday life, it’s the heart of group therapy. Moments like these accumulate and awareness deepens.  Automatic relational patterns become more pliable.  You start to recognize the how and why of your behavior in relationships; with that awareness, you glimpse new avenues of relating.

The group is a place to try something different:

• To speak more directly about how you see yourself and others.

• To stay present when discomfort surfaces.

• To experience how others respond to your patterns.

• To take the risk of being seen without your guard up.

Group therapy takes different forms depending on what you’re looking for.  Some groups are long-term and process-oriented, focusing on the relationships that develop within the group itself.  These groups move at the pace of their members, with attention to what is happening in the present moment.  Other groups focus on specific concerns like eating disorders, substance use, parenting, etc.  There are also groups organized around shared experiences—grief, medical issues, life transitions—where the common thread offers a place to explore, grow, and heal.  Each format brings its own approach, yet each shares a foundation: the belief that we come to know ourselves more fully in the presence of others.

Group therapy can feel unfamiliar at first, because it asks you to stay present in a shared space while feeling challenging emotions.  Within this process, you can step out of old, unwanted patterns of disconnection.

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Reflection Prompts

• When you’re with others, what do you tend to hold back?

• What do you hope others will notice about you without you having to say it?

• When you feel misunderstood, what do you imagine others are thinking?

• What feels most risky about being seen or known?

Let these questions open something within, rather than trying to resolve them.

Resources for Further Reading:

• American Psychological Association: https://www.apa.org/topics/group-therapy

• Irvin D. Yalom, The Theory and Practice of Group Psychotherapy