Opening up group, session 1

For many years I have run two kinds of "training group" for clients.  One teaches what can loosely be thought of as "stress management skills".  The latest version of this is the "Life skills for stress, health & wellbeing" course that I have been describing at some length in blog posts over the last three months.  The other kind of group that I regularly facilitate focuses on relationships.  As this group has evolved over the years it has been given various titles.  For quite some time I called it the "Relationships & emotional intelligence" group.  It was an accurate description of what we focused on, but it was kind of clunky as a label.  I've now reverted to simply calling the course "Opening up".  The publicity leaflet reads:

what is this course about?  This course is about relationships and emotional intelligence.  It involves working in a small group of 6 to 8 people (plus the facilitator Dr James Hawkins) over seven evenings and a full day session.  We will be looking at relationships in three areas - in the group itself, in our lives generally, and in our pasts.  The aim is to help us understand better and improve how we relate with others.    

why take time to look at relationships?  It's worth taking the time because relationships are such a huge part of our lives.  Past relationships deeply affect how we feel about ourselves and how we interact with others.  Current relationships can be a great source of joy, warmth and support, or of loneliness, frustration and unhappiness.  Human beings are social animals.  In many ways we are the sum of our relationships.  As adults, we don't have to just accept how we learned to relate when we were younger.  We can look at our interpersonal style and how we connect with our emotions.  We can get feedback from others.  We can decide what patterns we are happy with and what we'd like to improve on.  The group gives us the opportunity to do this and a chance to practise new ways of being with others.  We can change how  we are in relationships.  In doing so we change ourselves, our worlds, and the way we affect those around us.

how does working in the group help?  There are specific personal characteristics that are crucially important in allowing us to develop really nourishing relationships.  Our upbringing, education and society in general often actively inhibit this emotional intelligence.  With care, hard work and the right situation, these qualities can be encouraged to develop.  One of the mechanisms for this is by opening up.  The diagram below illustrates how feedback and self-disclosure can allow us to share more deeply, opening the ‘window', and providing us with a chance to learn and change.

The so-called "Johari Window" illustrates the way that being more genuine allows others to get to know us better, while feedback helps us to learn how we actually affect those around us - in Burns' words "O wad some power the giftie gie us to see oursels as ithers see us!  It wad frae monie a blunder free us, an' foolish notion."  The Johari diagram was developed by Jo Lufts and Harry Ingham many years ago and is a nice illustration of "opening up" (if you want a copy of the diagram, here are downloadable PDF and Powerpoint versions)

So yesterday was the first evening of the current "Opening up" course.  I went to my first interpersonal group - a weekend "Encounter group" - back in 1972.  It blew me away.  I just hadn't realized people could be so open and honest with each other.  I'd been brought up in a traditional, caring, good British family.  I kind of felt the world would fall apart, and the walls smeared with blood, if one allowed such open expression of feeling.  Not true!  I dived into this group therapy world and have a pretty huge experience of many different types accumulated over nearly forty years.  I can be a fairly questioning cerebral animal, and I've certainly done a good deal of reading and thinking about group processes.  I've run many groups and I train other therapists in these approaches as well - see for example the five day course scheduled to run for the University of Strathclyde and Caledonian University next March (pages 15 & 16 of their "Psychological therapies knowledge exchange programme").

What I'd like to do over the eight sessions of this "Opening up" group is jot down some thoughts and reflections triggered by the different meetings.  It's crucial that group participants feel as safe as possible in sharing personal material.  I get everyone to sign a "Confidentiality agreement" on joining the course and I'm certainly not going to use this blog post to share anything about the work of individual participants.  However reflection on the group is typically very useful, so I hope this series of general reflections will be helpful both for participants and would-be participants in "Opening up" groups - and for others who are interested in this format for therapy and personal growth.

The first session of a group can be quite challenging.  Preparation of participants before they even walk through the door is important - why is coming to this group personally relevant for them, in what way might the group be helpful, what is the group interaction likely to involve?  The American Group Psychotherapy Association website is a useful resource.  It has a publicly orientated "About group psychotherapy" section, and a more therapist orientated set of "Practice guidelines for group psychotherapy" with pieces on a series of topics including "Creating successful therapy groups" and "Preparation and pre-group training".  I wouldn't accept anybody onto an "Opening up" group if I hadn't already seen them one-to-one.  I have also sent out a set of handouts which include a couple I've particulary asked them to read before the first meeting - "Group therapy, background information" and "What it's usually helpful to talk about in the group".  Other handouts and pre-/post-assessment measures are listed in two previous blog posts - "Interpersonal groupwork 1" and "Interpersonal groupwork 2".

So we started with welcomes and gentle ice-breaking - an exercise in pairs "How did you feel coming to the group this evening?" with possible extensions into what this says about me more generally and the kinds of patterns I have relating with others.  I've been in a lot of groups where we all sat around in more or less frozen silence for quite a while before anybody said anything.  They have their value, but here in the "Opening up" group I'm strongly influenced by the early, and still relevant, findings on the kind of group facilitator style associated with better outcomes.  Key facts are illustrated by this six-slides-to-a-page Powerpoint handout - also available as a PDF handout.  These slides highlight particularly the importance of "caring" and of "meaning attribution" in how one facilitates groups.

A little later we moved on to a pair exercise exploring what each of us personally most want to achieve, or change, or learn more about in this group.  This was then distilled down into one or two key sentences and I wrote each person's intentions up onto A1 flipcharts which will remain visible throughout all future sessions of the group.  Participants may adapt or change their key intentions over the course of the group, but it can be very helpful continuing to relate what happens in the group to what each member particularly wants to be working on for themselves.  Plenty of friendly, opening discussion.  I sometimes see the early part of the group as constructing a safe enough, caring enough, strong enough "cooking pot" that will be able to contain the future group process as it heats up emotionally.  And finally in the last ten or fifteen minutes I ask everyone - including myself - to fill in a "Reflection sheet" (see too the related "Background" description).  This filling-in-of-reflection-sheets is scheduled at the end of every meeting.  Later in the week I will copy or scan the reflection sheets, and all participants get copies of all sheets in time to look through before the next meeting.  This can enrich the group and the learning process in all kinds of interesting ways.   A good first session ... the boat is leaving harbour ... 

See next week's post "Opening up group, second session" for more on how the group develops.

Opening up group, session 2

I posted last week on the first meeting of this "Opening up" group.  The reflection sheets everyone had filled in after the initial meeting had been copied and sent to all participants, so we already had more material to work with as we started this second session.  I've experimented with different ways of beginning interpersonal group meetings over the years.  In peer groups I usually bid to start with a few minutes of silence.  I find it seems to help people "arrive" and then to engage more deeply, more quickly - it certainly does this for me.

Often then there would be agreement that everyone who wants to "checks in".  I usually start interpersonal groups I'm leading with this round of check ins too.  I suggest that if bigger issues start to emerge, the person involved considers flagging the issue as something to return to once everyone has had an opportunity to briefly say how they're doing.  Strong emotion however typically "trumps" other structures so - if someone is pretty charged up - I would usually make space for them to work straight away.  This is both about going with the general guideline that strong emotion usually highlights that an issue is worth looking at, and about going right ahead to focus on "emotional elephants in the corner of the room" rather than have them distract everyone from other less charged work.

So we checked in.  Good.  Then issues were picked up both from the reflection sheets and from what had been said as people checked in.  We're working on three relationship domains in these groups - relationships in our pasts & how they've affected us, our current relationship networks & what's going right & wrong with them, and relationships in the here-and-now of the group.  Good discussions.  People raised important issues in their lives.  Others responded with their experience, insights, and feedback.  Caring and open; increasingly so.  Learning to trust.  Feeling accepted.  Seeing others take risks in self-disclosure and taking risks oneself - and finding out it's OK.  Important, especially at this stage of the group.  The handout on "Therapeutic factors in groups" highlights that the benefits of group therapy come in a whole series of ways.  Typically interpersonal factors (both expression & feedback), catharsis and especially group cohesiveness are rated particularly highly - but it varies with the stage of the group and with the psychological robustness & emotional intelligence of the participants.

The here-and-now relationships in the group are a particularly rich potential source of learning - partly because we've all witnessed the development of these "group relationships" and can give each other well-informed, eye-witness feedback.  I now asked people to pair up (there was one group of three) to talk more about this in-the-group relationship domain.  I introduced the "Needs, beliefs & behaviours" model that highlights how our past experience of relationships can so strongly colour our current relationships out "in the world", and also our here-and-now relationships in this group.  It's a model I've described more fully in a series of blog posts - "Our life stories ... part one, needs", "Our life stories ... part two, beliefs", "Our life stories ... part three, behaviours" and "Our life stories ... part four, relationships".  So the pair exercise was to talk with one's partner about how experience in past relationships (especially early in our lives) is affecting how we're relating here with others in this group - and to talk to about what each of us wants to change in our "interpersonal styles".  Paraphrasing Alice Miller "The walls we build to protect ourselves become the prisons in which we live".  This is jailbreak time! 

See "Opening up, third session" for a description of next week's meeting.

Opening up group, session 3

We had the third session of this "Opening up" group last night.  I wrote last week about the second session.  There are seven of us in this group - six other participants and myself.  My impression over many years of group work done in different time chunks (evenings, single days, weekends, residentials lasting several days) and in different group sizes (approximately four to forty participants) is that the larger the time chunk, the larger the group size that it's realistic to work with.  I'm talking here about interactive interpersonal groups.  Obviously if one is teaching skills to a structured group (especially if one limits sharing by group members), one can work effectively with much bigger numbers than this.  There are also psychodynamic interpersonal groups that "work" with over a hundred participants.  Somewhat different kinds of issues seem to come up in different sizes of group - there are different lessons to be learned.  Three people hardly even qualify as a group.  Four to maybe mid-teens (higher numbers here preferably put into bigger time chunks) seem quite "family", while above mid-teens pushes towards "village".  I've written previously in some detail about my experience of working in a four day peer group of 37 people.    

Well yesterday our group of seven was further diminished as one member was abroad for the week and another was ambushed by a baby sitting crisis.  Only five of us.  Maybe it was no accident that in this smaller group a couple of people used the evening to share more deeply - than we've reached so far in the group - about what has been going on in their lives over the last months and years.  To me it really does feel a privilege and a gift to be trusted like this - to have a person talk so openly about their life and the struggles they have been going through.  As the song goes "To know you is to love you".  I can feel my heart open and, as facilitator particularly, I'm at times also trying to sense "Is this person getting their needs met?  How does this relate to how they might open up to friends or family in their larger social network?  Are there any patterns here to help with?  Are there new experiences/learnings to acknowledge?"  It's not dramatically different from working as a one-to-one therapist, but the pool is bigger to swim in.  There's more going on. 

Many group therapists like to work with a co-therapist.  This is an issue well explored in Irvin Yalom's great book "The theory and practice of group psychotherapy".  I personally much prefer to work as a solo therapist for a bunch of reasons - organizational, personal & therapeutic - but I can see many benefits of working with a colleague, especially in one's early years in groups.  Important too not to be stupidly arrogant here.  Often the most helpful interventions aren't made by the "therapist" anyway.  It's one of the many joys of groups - the way that we can all help each other.  In some situations, caring and challenging between group members can be more powerful than anything the therapist can offer.  And a group member who finds that what they're saying is valued by those listening - this then loops back to validate & nourish the speaker as well.  I'm reminded of O'Laoire's "An experimental study of the effects of distant, intercessory prayer" where those doing the praying seemed to benefit at least as much as those being prayed for.  A more recent example is Barbara Fredrickson's fine study showing that regular practice of loving kindness meditation (with its focus mainly on wishing others well) produces very worthwhile wellbeing benefits for those practising the meditation.  As the Dalai Lama has been quoted as saying "If you want others to be happy, practise compassion.  If you want to be happy, practise compassion".

Sharing more deeply: the group bonding more strongly.  A couple of apparent paradoxes I've regularly come across in groups.  One is that participants often fear sharing much about themselves because they're concerned they'll be judged and rejected.  In fact the opposite is usually the case - the more one vulnerably, bravely, honestly shares about oneself, the more one is typically accepted and cared about by others in the group.  Another paradox is that the more one plunges down into deep, personal, emotional experiences - the more these experiences can transform (in almost Shakespearean terms) into archetypal challenges that others can more easily resonate with.       

See "Opening up, fourth session" for a description of next week's group. 

Opening up group, session 4

I wrote last week about the third session of this "Opening up" group.  Yesterday evening was the fourth session.  The "cooking pot" of the group (a metaphor I used at the end of the post about our first group session) is getting stronger.  Group members seem to be feeling more trusting, more ready to share deeply.  And this produces a "virtuous circle" of taking more interpersonal risks, developing more care for each other, so feeling safer to be vulnerable, and then still more understanding and kindness.  Being part of this gives me hope for us as human beings.  We're surely capable of so much cruelty & ignorance, but we're also so capable of sensitive, gentle caring for each other.  I've participated in many "spiritual/meditation" retreats as well as many of these "interpersonal/emotional" groups.  I've more often plunged to deeper feelings of connection and love in the interpersonal groups than I have in the spiritual/meditation groups.  "To know you is to love you". 

So precious to be able to take this kind of vulnerable, caring, openness into our families and close friendships.  Not, of course, all the time ... but able to visit this kind of gentle "looking after".  Familiar and trusting of these emotional/interpersonal states in varying levels of depth.  Able to "colour" our relationships.  So valuable to develop these wider "palettes".  It reminds me of the recent research study "Eavesdropping on happiness" that used digital audio recorders to unobtrusively track real world behaviours.  The authors reported clearly that " ... the present findings demonstrate that the happy life is social rather than solitary, and conversationally deep rather than superficial".  Highly relevant for happiness & wellbeing (see too the self-determination study "Daily well-being: the role of autonomy, competence, and relatedness") and for stress resilience, and even more bluntly for survival itself.  For more on this "hard end point", see the recent post "Strong relationships improve survival as much as quitting smoking".  In the journal editorial commenting on this major meta-analysis, the authors stated "Quite remarkably, the degree of mortality risk associated with lack of social relationships is similar to that which exists for more widely publicized risk factors, such as smoking.  Arguably, such a level of risk deserves attention at the highest possible level in determination of health policy."  Nice to think these interpersonal groups could dovetail into " ... the highest possible level in ... health policy".  I joke, but I'm also absolutely serious.  Working in interpersonal groups to learn to improve my relationships has been of immense value to me.  It has also contributed deeply to the precious levels of wellbeing I feel in so many of my close relationships ... with my wife, my children, my friends ... and it has clearly helped me become a better therapist. 

As an aside, a while ago I thought it would be fascinating to find out whether health professionals who had been to the peer interpersonal groups I've been involved with for many years felt that what they had experienced had been useful for their work helping others.  I sent out a simple survey to 46 people who had been to these groups, asking "Please give a number somewhere between 0 and 10 to indicate approximately how helpful you feel these groups have been for you as a health professional, where 0 stands for ‘not helpful at all' right up to 10 which stands for ‘very helpful indeed'."  I had 45 responses.  They gave an average score of 8.4 out of 10, suggesting that this mix of doctors, psychologists, counsellors, nurses and other health workers found the experience very useful for their work with others.  For more on this see the last ten slides of the presentation "The alliance is crucial. What are the implications?"    

So after the check in, again people shared more.  One brave soul especially talked so openly about pain in a key relationship in their life.  Touching, so much so.  And the domino effect.  One person's brave sharing makes it easier for others ... even others who may have done very little opening up like this before in their lives ... even others whose childhoods had taught them the hard, hard lesson that showing vulnerability is likely just to lead to more pain.  Very special to begin seeing, experiencing that it doesn't have to be this way.  In one-to-one therapy, I can explain this.  They can begin opening up to me.  There's something so powerful though, such a big addition to see opening up by others in real time.  To experience, to feel, to witness that it can be OK, that it can be much more than OK.  Tremendous.  This can be real healing.  And I feel a little tearful just remembering it.

One of the handouts everyone in the group has had is the well known "Experiencing scale" with its emphasis on the value of allowing real emotional experiencing to help therapeutic change.  I mentioned in the group that three powerful ways I recognise of deepening emotional involvement in interpersonal groups are what we have been doing these last two evenings (sharing very openly and honestly about strongly felt experiences in our past or current lives), and secondly risking exploring how we are relating with each other here in the group, and thirdly coming down into the here-and-now of feelings in our bodies - our hearts & guts.  The next group meeting (the fifth one) is a full day session.  I like to do this, to have a full day together.  It's not typically as rich as a residential weekend (which I've scheduled into some groups I've run), but it's easier to arrange and a good compromise solution in the attempt to make a bigger "pool" for us to swim in.

Like "real life", the group river is likely to flow deeply and shallowly, fast and slow, smoothly and turbulently.  "New weather always unfolding out of the same sky".  Part of becoming a competent group facilitator or group member is learning this, beginning to develop "faith in this process".  Faith - and also the courage and knowledge to help the deepening and connecting processes.  Who knows what will happen in the next meeting?  Nobody.  Can we navigate the river to make it more likely that we benefit?  Certainly!

I'll write soon about the next - full day - session.

Opening up group, session 5

I wrote just a few days ago about the fourth session of this "Opening up" group.  This fifth session was a full day meeting.  Good to have a whole day together.  A bigger pool to swim in, more time to explore.  Nice too to share food together - we all brought contributions for lunch.

We began the group a bit differently today.  I suggested we took 10 minutes while we all wrote starting with the words "If I pushed myself a bit harder in the group, I ... ".  I asked them to write deeply and honestly and spontaneously.  I said that they wouldn't be expected to read out what they wrote.  The important thing was for us all to really dig down and explore how we could open and use the group more fully.  We then paired up to share what had emerged.  People were welcome simply to talk about the general sense of what they'd written, or they were free to read it to their partner if they wanted to.  I asked as well that they discuss how they could help each other work with the possibilities that had come up in their writing, as we went through the day.  There are quite a few blog posts about therapeutic writing on this website, and it's a useful ingredient to introduce into groups every now and again.  Fascinating how, even in groups where participants are very honest with each other, still material emerges with writing that doesn't emerge in the same way with just talking.  We didn't do this today, but a precious thing to try is for everyone to write on some theme for say 10 minutes, then go round sharing (talking about what emerged, or in groups that are OK with this openness - simply reading it out), then (without any further discussion) everyone writes again for another 10 minutes, and then we go round to read again.  Typically people's first time round explorations trigger thoughts/feelings in others that then enrich the group's second round of writing.  

Jamie Pennebaker, the "godfather" of expressive writing, has said that it can be a bad idea to read what you've written to others.  Quite rightly he points out that expressive writing isn't meant to be balanced or careful, and that reading it out may give the listener an unbalanced picture which they may well react to unhelpfully.  Alternatively, if the writer knows that they will be expected to read out what they've written, they are likely to start inhibiting how spontaneously and freely they write.  I think Jamie is generally correct about this, but I also know that in groups which "know what they're doing" and which already have a culture of considerable openness, simply reading out what one has written can be fine and helpful.

So we then came back to the full group, shared a bit about what had emerged from the writing exercise and pair discussion, and went on to check in more generally.  We were the full group today (7 of us).  We made time to discuss how the people were who had shared particularly deep personal material in the previous couple of groups.  Someone who had been feeling dubious about the whole group process also had the opportunity to share this, to be heard and valued, to realise that others too - at times - shared similar feelings.  So important in these interpersonal groups to watch out for people becoming peripheralised.  So important to care for and make space for the inevitable doubts and distancing that will sometimes emerge.  In one-to-one therapy, "micro-ruptures" occur regularly in the therapeutic process/alliance.  Very important to keep one's eyes open for this and try to work through such difficulties.  The same is true in group work.  Honouring and validating individual's points of view.  Being inclusive not exclusive. 

And eventually to lunch.  Yummy!  Good food.  Good company.  And a chance to walk for a little in the autumn sunshine.  And back in the group for the afternoon, reminding them of the point I made in the blog post about last session - "One of the handouts everyone in the group has had is the well known "Experiencing scale" with its emphasis on the value of allowing real emotional experiencing to help therapeutic change.  I mentioned in the group that three powerful ways I recognise of deepening emotional involvement in interpersonal groups are what we have been doing these last two evenings (sharing very openly and honestly about strongly felt experiences in our past or current lives), and secondly risking exploring how we are relating with each other here in the group, and thirdly coming down into the here-and-now of feelings in our bodies - our hearts & guts".  And later in the afternoon I set up a couple of exercises that more involved our current in-group relationships and helped to focus us on how we were feeling in the here-and-now.  The first I call "The gaze exercise".  I can't remember where I got it from - I've been using it for years.  The way I work with it is to get people to pair up.  It can also be done in threes, but on the whole it probably fits more easily as a pair exercise.  Usually easiest if each pair positions themselves so they're pretty much at the same eye level.  Distance is negotiable.  "Not too far apart" is quite a good instruction.  The exercise involves 4 minutes of silence.  The first 2 minutes one simply looks at the other person.  This isn't an eyes-locked-together kind of exercise.  One is given full permission to "look them up and down".  Yes, look at their eyes, and also their face, their hands, their clothes, hair, bodies.  It's an awareness exercise.  How do I feel as I look at them and they look at me?  How do I hold my body?  What happens to my breathing ... to my expression?  What thoughts come up about them, about myself, about the situation?  What are my emotions?  Do they stay the same or change?  What do I observe?  What do I remember?  What associations do I have?  What do I fantasise?  2 minutes can be a long time.  Then the 3^rd minute, everybody closes their eyes.  What happens?  The request is to notice how one now feels, senses, thinks - with eyes closed.  Then the 4^th minute is a repeat of the first 2 minutes - eyes open again, looking at the other person.  So this is a real time, awareness/relationship exercise.  After the 4 minutes, the request is to share with your partner what has come up.

People vary a lot in how easy or difficult they find it to do this exercise.  It's an awareness meditation - helping us realise how much is potentially going on as we're relating with another person.  It's also a challenge noticing what emerges, and having the courage and emotional intelligence to put words to the experience in an authentic, possibly challenging, but constructive way.  Again it comes back to the person centered, I-Thou, three legged stool of genuineness, empathy, and caring.  If one or other leg of the stool is short, it wobbles.  The close relationship typically lacks something of importance.  I've done this exercise many times - in groups and also with friends.  Rich.  I love it.  It's like savouring fine wine, really taking time to taste relating to another person.  Quite a few people hate it.  Too close.  Too challenging.  Too intimate.  Too artificial.  For someone who wants to explore close relationships, how to relate more truly, how to develop this intelligence - this can be a good exercise to try.  So people took quite a while to share their experience in their pairs, and then we came back to talk a bit about it in the full group. 

I commented that it can be very interesting to go right on to do "The gaze exercise" with another person.  It helps one see what about one's experience one transfers across in a similar way from one of these exercises to another exercise, and what seems more particular to the specific person one happens to be doing the exercise with.  Am I more in touch with thoughts, or sensations, or feelings?  Am I more aware of the other person or more aware of myself?  What difference does it make if there a man or a woman?  Am I able to stay present with what's going on?  As with pretty much all "real life" relationships too, it can be helpful to consider three overlapping domains that are involved.  One domain is myself.  What is this exercise demonstrating about me - maybe my self-consciousness, or vanity, or dominance, or carefulness, or sexuality, or kindness, or past life experience.  Another domain is the other person.  What feedback can I give this other about their face, their expressions, their posture, their hands, their body, thoughts about them, intuitions, memories, images, associations.  And the third overlapping domain is our relationship.  How do I feel with this person?  Is this how I expected to feel?  Maybe it's as expected, or quite possibly it's richer and more complex than I expected.  So much in 4 minutes!  And of course then the huge question about what I remember, what I'm prepared to share, how vulnerably and honestly and constructively I share it.  Maybe find a friend and try this exercise!  Preferably when you're both clear-headed and not misted by, for example, alcohol.   

A lot of discussion can come out of this 4 minute experience.  Maybe allow 20 minutes to discuss in pairs.  Once we had talked about the experience in the full group, I queried whether people would like to go straight on to trying it again with another partner.  There wasn't a clear majority wanting to repeat it straight away.  I suggested we try a related but somewhat different sequence - "The space between us exercise".  This one most people probably find a bit easier than the "Gaze exercise".  It's also simpler to introduce it into conversations with those we're close to.  It's just a somewhat formal way of asking questions like "How are we doing together?", "How do we feel about each other just now?", "How's our relationship going right now?".  This interesting way of asking this kind of question comes from Irvin Yalom's book "The gift of therapy" (see too Yalom's website).  He suggests one simply asks "How do I (and how do you) feel about the space between us right now?"  The form of words can feel a bit awkward & artificial to me, but I also find it helpful.  It helps me to focus both on what's going on within me ... "How do I feel ... ?"  Emotions are physical things.  What am I feeling in my heart, my gut, my face, my posture ... what am I feeling here being with you?  And how is that intertwined with how we're relating right now ... and how we've related in the past?  Not just "How do I feel?" but "How do I feel about the space between us right now?"  My experience is that it's easier to hide in words with this exercise than in the silence of the "Gaze exercise", but it's also, in some ways, more useful, more practical.  I've probably used this exercise, this focus, suggested it with many of my closer friends.  It's easily transferable ... in a café, a bus, walking.  Fun to use.  Fascinating to use.  Yalom talks about using the exercise often in therapy with clients.  He is a different style of therapist from me.  However, particularly in longer term work, I will sometimes suggest trying this exercise.  See the blog post "Needs, beliefs & behaviours - part 4, relationships" for more on why this can be useful.  I will pretty much always offer to speak first and, pretty much always, my client will accept my offer.  Now here's a challenge.  The point of therapy ... what it all rests on ... is to focus on what is likely to be helpful for the client.  And this exercise can be very helpful.  And it demands of the therapist a good deal of "real time", emotional intelligence.  Often I can very honestly express my fondness and respect for the client.  Especially if we've been working together over some time, this can be so important.  I know with my own son, how important it has been to express not only my love for him, but also my respect for how he is leading his life.  I may think that he would know this, not need it spelled out in so many words ... but spelling it out in so many words can be immensely precious.  Sometimes, of course, there are not just "positive" feelings around to be expressed.  But difficult feelings can often be even more helpful to speak through than "positive" ones.  It's how they're expressed.  Les Greenberg has written interestingly about this - see the handout "Honesty, transparency & confrontation".

Enough!  Time to draw this rather long blog post to a close.  And the full day meeting also came to a close.  As usual we finished by writing reflection sheets.  It seemed to me that it had been a good, helpful day.  I was slightly uneasy about how "prescriptive" I'd been offering three structured exercises across the day.  Quite a lot of structure.  But it seemed to have worked well.  Blessings.

For a description of our next meeting, see "Opening up group, sixth session".

Opening up group, session 6

Yesterday evening was the sixth session of the "Opening up" group.  It had been a longer gap than usual - ten days since our full day meeting at the fifth session.  As we often do, we began with a round of "checking in"; an opportunity for all of us to say briefly how we were feeling.  Like two or three others, I had been particulary busy in the preceding few days.  Great how present-time, honest interaction with a group of others brings me out of all that brain-busyness into being more here-and-now.

There was some untangling to do from last session.  I was concerned that I had upset someone with feedback I'd given them at the end of last time.  My experience in this kind of interpersonal group is that sometimes this kind of "upset" can be very helpful, but probably only if it's understood and digested.  Also, although I'm the facilitator of this group and have most experience in this kind of work, I'm also a group member.  My take on things may sometimes have value, but it's certainly not some kind of direct line to reality - other group members' impressions are so very important too.  Partly because the person I felt I'd upset had earlier said they were interested in getting more feedback from others in the group, this seemed a good time to encourage a "hot seat" exercise where they had the opportunity to get this.  It was also potentially a helpful way of putting anything that I had felt & said into a broader context.  They courageously agreed to go ahead with this and, in fact, expressed concern that people might be too "nice" in their feedback.  I suggested people tried phrasing their feedback as both something that they had particularly appreciated or celebrated about the person in the hot seat, and also something that they'd found a bit of difficulty with or wanted the person to think about or be aware of.  This "mixture of colours" way of giving feedback can sometimes make what's shared more valuable (although I think there's a danger that the person receiving the feedback may remember the "difficulties" and forget the "appreciations").  Maybe this "hot seat" exercise is something we could all try at the last session of our group in a couple of weeks' time?

As an aside to any group facilitators or potential group facilitators reading this post, I personally would consider it incompetent to encourage another group member to do this "hot seat" exercise without knowing what it might feel like through having experienced it myself.  I've probably been in the "hot seat" in this kind of way at least fifteen to twenty times over the years.  It ain't easy - rich, interesting, intense, but not easy.  And if at the last session we do go ahead to have everyone get a chance to be in the hot seat, I will certainly take my turn receiving others' feedback.  In this kind of interpersonal group, I deeply believe it's not OK to stand on the side of the swimming bath shouting suggestions to real swimmers.  As group facilitator I too need to be a "real swimmer".  See the recent post "A quiet rant to group facilitators & would-be group facilitators" for more on this.

And if we do focus on this hot seat exercise at the last session, I will encourage there to be someone scribbling a record of what's said to each person and will encourage people giving feedback to do it while holding a microphone.  This way everyone receives both a tape containing feedback from everyone else in the group and a written sheet noting the points that have been made.  I don't force this hot seat exercise onto groups but, if they're ready to go with it, it can be very precious. 

As I mentioned when describing the first group session, this is "Johari Window" territory (see below).  We're increasing the open area of the window.  When else do we get genuine, caring, face-to-face feedback from a range of other people who have similar experience of being with us and observing how we are interpersonally over many hours of interactions?  This group has now been together for six sessions (five evenings and a day) - 16 hours of uninterrupted, undistracted time relating with each other.  This is an immensely rare opportunity.  As Burns wrote "O wad some power the giftie gie us to see oursels as ithers see us!  It wad frae monie a blunder free us, an' foolish notion."  

If you want a copy of this diagram, here are downloadable PDF and Powerpoint versions.

And the focus of the group moved on.  In earlier sessions people shared "back stories" and that can be very valuable.  In the last couple of meetings, we've moved to more present time interactions "in the room".  I've mentioned the importance of working at moderately high levels of emotional engagement.  If it's too emotionally intense people may not be able to take it in, if there's too little intensity there may not be much of importance to take in anyway.  However people in the group vary over what's "too much" or "too little" intensity for them.  Part of the group facilitator's challenge is, in group selection, to try to select people who have approximately equal ability at swimming in emotional waters.  However this ability isn't just about experience of groups.  It's about life experience more generally, about attachment security, about emotional/social intelligence, about commitment and courage, all kinds of things.  As "swimming instructor" part of my job is to notice if someone is either "swallowing too much water" at one end of the spectrum or isn't particularly stretching themselves as they "swim in the group pool" at the other end of the spectrum. 

There is much that can be involved in these "in the room" interactions.  A metaphor I described in the handout "What it's usually helpful to talk about in the group" suggests "We're like musicians - a ‘chamber orchestra' or ‘jazz group' - who have gathered to play music together.  The instrument each of us plays is ourself - allowing who we are and how we feel & think to sound out awarely and truthfully.  Sometimes we'll be very much in tune with others and feel that we're seen clearly, valued & strengthened in who and how we are.  Sometimes we're out of tune with others.  This can be particularly valuable.  By looking at these ‘out of tune' times - times when we feel irritated, misunderstood, suspicious, or upset - we can often learn a lot about how we're perceived and what we might benefit by being more aware of.  The handout "Honesty, transparency & confrontation" gives more details of how we can work constructively with ‘out of tune' times".

And this is what we continued to do.  One person in particular was able to feel and have the courage & skill to articulate a difficulty they were having with how another person often expressed themself in the group.  This is important territory that many people never visit much in interpersonal relationships - or if they do, it's so often with attack/defence, blame/denial, distancing/resentment.  It's what many people mean when they talk about confrontation, but it might be better seen as "self-disclosure" - not so much attacking as vulnerably & caringly opening up.  It can be so hugely useful to explore how to do this as well as one can.  And this led as well to looking a little at how one knows what one feels - at how one can talk a bit less from the head and a bit more from the heart and gut.  The handout on "Emotional awareness" addresses this issue, as too do Daniel Goleman's books on emotional & social intelligence, "Expressing emotion" by Kennedy-Moore & Watson, and many of Leslie Greenberg's books including "Emotion-focused therapy: coaching clients to work through their feelings".  These are important aspects of emotional & interpersonal competence! 

For a description of our next meeting, see "Opening up group, seventh session".

Opening up group, session 7

So this was the seventh - and penultimate - meeting of this "Opening up" group.  I wrote about the sixth session last week.  Sadly, because of family crises, a couple of people hadn't been able to get to this evening's meeting.  In fact, of the five of us at this session, one arrived late.  Rather than simply get going and possibly want to update the late arrival once they were with us, or wait for them rather than getting started, I used a method that often seems helpful when somebody is a little late.  So instead of starting with a verbal check-in, I suggested we all take ten minutes to write about how we were feeling now at the start of this evening, at the penultimate meeting of this group.  As usual I explained that I wanted them to write very freely and deeply about their emotions and thoughts, but that they would then be totally free to share as much or as little of what they'd written as they wanted to.

Happily the latecomer arrived half way through this process and was able to do some writing before we moved onto the sharing phase.  When we each took a bit of time to talk about what we'd written, various issues emerged.  One of the issues was someone's doubts and unease about being in the group.  One of my functions as group facilitator is to keep my eyes open for people becoming too isolated or sidelined.  This can happen in a whole series of ways and it's a risk factor for someone being "damaged" by the group experience rather than gaining from it.  I talked a bit about this in my post about the first session of this group when I explained what kind of facilitator style I would be using and why.  I have been heavily influenced by the findings from Yalom et al's research.  They commented, in a major trial monitoring the effects of 18 therapy groups, that "In some groups, almost every member underwent some positive change with no one suffering injury; in other groups, not a single member benefited, and one was fortunate to remain unchanged." 

As the researchers reported "All meetings were observed (and tape recorded) - trained raters analyzed and coded all leader behaviours & statements; participants also completed questionnaires about the leaders.  The therapeutic school that the leader represented (e.g. gestalt, psychodrama, transactional analysis, etc) had very little bearing on their behaviours/statements in the group.  Factor analysis of what the leaders said and did highlighted four important leadership functions which had clear and striking relationships to outcome - these are emotional activation, caring, meaning attribution & executive function."  Optimal outcomes were associated with leaders who were "middle of the road" for emotional activation and executive function, but very high on caring and meaning attribution.  These research findings are described more fully in the following Powerpoint and PDF handouts.  

I sometimes think of a good therapist as being like a good musician.  You need to have put in hours of work practising, reviewing, digesting the knowledge and skills involved.  This is a bit like the musician, the pianist, putting in thousands of hours of practice working on their fluidity and technique.  Then in the concert hall - when actually playing with others - all these skills are at the service of something much more heartful, emotional, connected.  It would be nice to think that sometimes I can work as a one-to-one or group therapist with a similar interconnection between head, heart & gut - and an underlying foundation of hours of background work, exploration & practice.  And it isn't entirely different for anyone else hoping to be "skilled" or sensitive or deeply able to connect & navigate through a series of different interpersonal situations.  It does take years to become an expert, but one needs caution.  Better therapists - and people who are more facilitative & nourishing for others more generally - are not always the most experienced.  If I interact badly, the fact I've done it this way many, many times may mean I've had a lot of experience - but the experience has been in becoming deeply entrenched in doing things the wrong way.  This is one of the many reasons why feedback from others - as in this type of group - can be so important. 

So we made space for the person who was having doubts about the group to share their thoughts and feelings.  Important to hear and honour their position.  Even though people's experience of the group may often mirror problems they struggle with and want to change in their everyday life, making this link isn't something to be done by a facilitator in a "one up" or defensive way.  And the person involved and the group connected, softened, moved forward encouragingly.  And a challenge for me - when group members are "swimming" in the group with quite varying degrees of ease & confidence - how to encourage everyone to "work" at a level that stretches them.  And it's a subtle, at times controversial, issue how much it's my "job" to "activate" and how much it's my job to sit back and let people find their own way.  My understanding is that my task is to steer a middle way here.  Good as well for me to understand my own personal character style.  I tend to push forwards, take risks in my own life.  This can be fine, but as facilitator, it's the group's wellbeing that I need to focus on.  Rich challenges.

So some people worked very authentically exploring their here-and-now relationship in the group, some talked about their cautious exploration into trusting the group & other people more and how they were succesfully experimenting with being more open in their outside relationships, and some linked their current group experience to difficulties & pain from early in childhood and looked at how that might change.  Precious.  So much, so many opportunities for helpful learning in the multiple interweaving interactions of groups.  A little like playing chess, I think the good facilitator needs to have general guidelines in the back of their head for what directions it's likely to be productive to steer in, and what kinds of situations should be given priority - while at the same time being present and responding to the never-before-experienced newness of what's emerging in the here-and-now.  It's not a surprise that recent work suggests that encouraging psychotherapists to practise forms of mindfulness meditation increases their helpfulness as therapists - see Grepmair et al's research "Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: a randomized, double-blind, controlled study" and other more recent qualitative and quantitative studies.  It seems very probable that the same findings would apply more generally to non-therapists hoping that mindfulness practice would - amongst other benefits - help to nourish their interpersonal relationships.

Opening up group, session 8