THE JOURNAL
Illustration by Mr Tommy Parker
The modern image of group work tends to spring from an Oregon psychiatric hospital in 1975. There, Nurse Ratched explained, “The purpose of this meeting is therapy. Group therapy,” and Randle McMurphy responded, “Yeah, yeah, the hell with that crap! The World Series is goin’ on right now an’ that’s therapy also.” One Flew Over The Cuckoo’s Nest is a world away from mutual support organised via WhatsApp, but the movie cast a long shadow over the public perception of collective therapies. Despite Nurse Ratched’s cultural resonance, a combination of technology and a shortfall in available one-to-one care have led to an explosion in both official and community-led groups for a multiplicity of causes. For many of us, as McMurphy might have been pleased to note, these groups are as much a part of our social realm as sporting fixtures – and some are even entwined.
The writer Mr Sam Delaney, whose football podcast Top Flight Time Machine spawned a mental health offshoot, The Reset, admits, “I’ve always found it easier to stand up and talk in a big room of strangers than a small room of people I know.” Turning that tenacity towards discussion of emotional issues was less instinctive, however. “Years ago, when my friends and I found out one of us was a member of a self-help group, I just thought, ‘Oh my God, mate, what is the matter with you? Why are you in an organised group to talk to other men?’ Whereas now, I sort of love that.”
The connection between traditional friendship groups and more overtly therapeutic gatherings is something Delaney believes is on the rise. “I encountered these Hibernian fans who have a podcast called Longbangers. They’re all working-class lads from Leith and they said to me, ‘We started a mental health WhatsApp group in lockdown. There are 20 other guys in the group. One of them will always get back to you with something just to make you feel like you’re heard or you’re seen or whatever.’ More and more people started joining and so they made a spin-off podcast about mental health called Heidbangers. I went on it and I just thought they were absolutely brilliant. Now, I don’t know how successful it is, but the very fact that it exists is a sign of the times to me.”
“I’ve always found it easier to stand up and talk in a big room of strangers than a small room of people I know”
At the more formal level, Ms Sharon Shaw, an analyst, clinical social worker and licensed group therapist in the US with more than 40 years’ experience, offers that a group “provides a living laboratory, really. You are in the room, not only with your therapist, but with six or seven other patients and so you have the benefit of a group of people, instead of one individual, who are responding to parts of yourself that you may not even have been aware of.” With frontline experience of the deficit in access to individual therapy, “I’m turning people away, as are many of my colleagues.” Shaw is enthusiastic about the group alternative’s role in making up the numbers, while having serious caveats about how such things are run. “Anyone who wants to go into group therapy should be sure that whoever’s leading is well versed in group leadership, so that they feel safe. And that is important, by the way, the safety of the group.”
For people in certain kinds of crises, however, the absence of official leadership is very much part of their programme. “I was just not happy inside,” says Vitor, a seven-year recovery veteran of the 12-step method, which is based on established traditions, but with no one person in charge. “The support group gave me, you know, support. People shared the experience on how to solve the problem, how to live better as well. And it’s more fun than doing it by ourselves. We feel like we are being helped, we are accountable for our actions and for turning up every time or every day, but also we feel like people are there to support us. And when things get really difficult, there’s nothing like having a human to turn to and just say, ‘I need help’, or, ‘I can’t do this’, or, ‘I’m struggling’. And to celebrate the achievements as well.”
The collision of the pandemic and digital technology has driven accessibility to the point where, Vitor says, no one in need of a recovery group need be excluded or has an excuse not to come. “If somebody really wants, they can find it. [If you can’t attend in person] there’s the internet, there’s Zoom meetings you can access globally at any time. The key to change and the key to turning one’s life around is for them to really want it and then go and look for it. Where there is a will there’s a way.”
“You are in the room, not only with your therapist, but with six or seven other patients and so you have the benefit of a group of people who are responding to parts of yourself that you may not even have been aware of”
A more recent cinematic descendent of the Cuckoo’s Nest model is 2013’s Starred Up, a painfully realistic prison drama that pivots around scenes of intense group work with violent inmates and based on the real-life work of its screenwriter, the therapist Mr Jonathan Asser. In Wandsworth prison in southwest London – a remand jail where issues with violence were further complicated by the high turnover of inmates – Asser developed a practice known as Shame/Violence Intervention (SVI).
“I was running group discussions,” he says. “And it became popular with violent prisoners. They would come to the sessions to get into the escalation. They enjoyed it. But the irony of it is we never had physical-contact violence in any session and never had physical-contact violence between sessions involving active participants. So that meant that if you had a dangerous, violent-threat prisoner and he connected with SVI, he was essentially safe towards others in SVI while doing so, and he was high up the pecking order. So he then was a role model. Then everybody feels safer, because the really bad guys can live on the same wing without hurting each other. It sends a message to the whole prison that we’ve got a different way of dealing with violence. So that protected victims, even in terms of just feeling more comfortable on the landing.”
In the kind of ironic doublethink that can typify public policy, Asser’s groups were discontinued because they “no longer met the specific needs of that establishment”. In this baffling example, the power of the group is typified, perhaps. If a group can embarrass the very institution whose shortcomings caused it to be, then it must be working.
The efficacy of groups to soothe our most troubled souls and circumstances is apparent, be that grief, addiction, bereavement or isolation. The abundance and rise of these alliances tells its own story. Access or formation is just a Google away. In an atomised society pulling itself together post-Covid, confronted with a reduced landscape of health and social care, the groups we form and join for our wellbeing might be the best rebuttal of our own sometimes unhelpful inclinations, as well as systems presently unable to cope or care.
