Rationale for Group Versus Individual Therapy

When a client has enough ego strength, can have healthy interactions and boundaries with others, is resourced and can make and keep commitments, I highly recommend pre-and perinatal group therapy. In my experience, a good process intensive group experience can have a tremendous impact on one's healing and ability to sustain meaningful contact with others.

Prenatal and perinatal group work simulates the family/womb surround for both the person working and other participants. In this modality, one can experience various family roles and repattern family experiences and norms. It is also a good modality for working with and changing current family dynamics.

Because we are dealing with the very foundation and building blocks of the self on all levels, pre- and perinatal work is very intimate, probably one of the most intimate one might experience in a professional setting. In pre- and perinatal individual therapy transferences often escalate and can become detrimental for the client, (and therefore for the therapist.)  On the other hand, I've also seen that, because the work is so intimate, both therapist and client either have to work at deepening the therapy or either may unconsciously sabotage deep pre- and perinatal work in one-on-one sessions. The group experience diffuses transference and helps create peer support. Appropriate touch becomes less personal, less fearful and safer physically for the therapist and everyone concerned.

The group tends to help the client create self-support and provide modeling and feedback in ways that are not possible in individual therapy. Within the context of the group, members are encouraged to try new behaviors with a lot of support. They also receive modeling from other group members relating to similar situations. In addition, things happen spontaneously in a group that are very healing. For example, in one group, a woman was experiencing an overwhelming fear of spiders. Another member spontaneously jumped up, became a larger-than-life exterminator to protect her. At that moment, from her very young state, she was able to receive protection in a new way. She later expressed, "That was the first time anyone ever just protected me for me, because I needed it. And I didn't have to pay her to do it. She just did it."

Another advantage of group work over individual work is, in Gestalt therapy, called coat tailing. During group sessions each person's work triggers images and experiences for other participants. When they experience the unique working through of a fellow participant, they are in a very real way doing some of the work for themselves. As the work builds, it has a cumulative effect on the group as a whole and on participants who relate to the developing themes. For example, when one client works on an issue involving a loss, it is likely to trigger issues of loss in many of the other group members. This grows, and as participants feel safer, they are able to touch places within themselves they might never have reached in individual therapy, and may be able to follow someone else's lead in taking risks.

This work is safer for the therapist in groups because it is conducted in a larger social context. It is also often video taped so there is a record of what occurred.