Principles of Group Involvement

Each group member is vital to the work and participates as the surround that forms a safe container in which the work unfolds. Pre- and perinatal group therapy is unique in the ways in which we involve the entire group. Most group therapy can be classified in one of two ways. The most common modality is centered on the interaction with members mostly talking to each other as the therapist guides. The other modality is essentially individual therapy in a group context, where a group member explores an issue while the rest of the group watches and gives feedback at the end of the work. I learned in working with groups that it is vital to involve the entire group as a valuable resource for the person working. Also, as each person becomes involved, even in small ways, their own material arises, much like a yeasting process. As a by-product of the process, there is the potential to re-pattern old, dysfunctional beliefs and family patterns. So, in pre- and perinatal groups, the therapist guides the work and invites participation of group members in a variety of ways.

One primary principle of group involvement is that everyone is always working all the time. Work begins and continues on conscious and unconscious levels, from the moment one decides to participate in group therapy through the integration process. This is true, even if a group member is sleeping.

The rationale for group involvement is multi faceted. First, the person working needs the active support and energetic attention from the group. This is given following the client's lead, in amounts and ways that are appropriate to the situation. Often the client may need the group to come closer, sit in particular places and support in specific ways. This process helps the client to contain and raise their potency and move more deeply into their process. Movement is always done slowly and mindfully. Sometimes the client needs the group to withdraw their attention, to focus less intently, and/or to physically move away for a time. 

It is always interesting to note that whatever the group does almost always mirrors the family and/or birth dynamic for the client who is working. For example, Susan, an adoptee, was deep in her work when a member of the group stopped the process abruptly by saying, "I need to stop for a moment. I'm feeling angry. From where I'm sitting, I can't see Susan, and every time I move, someone gets in the way. I just want to see Susan." There was a time when I would have thought that group member's feelings should be contained until the end of the work. Now I know that if a group member is having a strong feeling, it is usually beneficial to voice it. Suspecting that this was an important statement for Susan to hear, I wondered aloud, "Perhaps there was someone then who was angry because she couldn't see Susan." Susan burst into tears and, for the first time, was able to sense how much her mother had wanted to see her at birth but was not allowed to.

Participants benefit from both giving and receiving support and feedback. As children, our support at important family moments was often shunned or ignored. Here, members of the surround are valued and asked to participate as a member of a "family" team in an important happening. Group members are also encouraged to track their own process and, at the end of a turn, to articulate how someone else's process affected them.

There are a number of ways a therapist can involve participants in the support process. Here are a few examples: Ask the group, "Has anyone ever experienced (whatever the client is working on)?" This is usually just a show of hands as you do not want to dilute the energy and focus of the person working, but there may be one person who has a brief story that can help the client feel less isolated.

A client will often make a comment that implies they are afraid of taking too much time in the group, or perhaps the group is bored with their work, or group members have a particular reaction to what they are doing. It is always good to verify this with the group with a statement like, "Would it be okay for me to check this out with the group?" Then allow the group members to make some honest and direct statements to the client.

When a client makes a statement, usually toward the beginning or end of the work, that you want to build on or affirm, it is good to ask them, "Could you say that to someone here?" This is often part of the integrating work at the end where the client is affirming what they have just experienced. Adding their name to the statement is an old Gestalt technique that is quite valuable. Turning to a group member, John might say, "I'm John and I'm safe." The group members may respond verbally or simply be a mirror.

There are many reasons to involve the group in a progression of movements that bring the group into closer proximity to the client. It fosters group cohesiveness and group support for everyone. For the client, it helps them feel and work with the contact boundary, become more resourced, deepen the work and create a womb surround. It may also provide a somatic experience of safety. To begin the process that allows and supports the client to move into a more regressed state, I begin the session by asking if I am sitting where the client would like me to be. It is often a closer position than where I was sitting in the group. If they do not want me to be close, that is good information, too. Later I may ask, at an appropriate moment, "Could someone here sit beside you and support you with ___?"  This brings another member into the closer surround. Often, the experience of somatic support, which is a resource, takes the client back to an early time when they did or did not feel supported or it may simply help them move to the next step.

As the work begins to deepen it is often good to ask, "Are we (indicating the rest of the group) sitting where you would like us? Would you like any of us to move a little closer?" It is good to model and coach the group to move slowly and check in each step of the way. Always ask, "Is this okay?" Check to see if a closer proximity feels more supportive. It may feel too fast, suffocating, or just too much. In this case, everyone adjusts slowly and you check in again. As the work continues to deepen, group members are used for physical support and touch as appropriate.

Your guidance of the session, including group involvement, will be based in part on the client's intention, their pre- and perinatal history, and their current life situation.