Magazine article Addiction Professional

Don't Shut out Contact outside of the Group

Magazine article Addiction Professional

Don't Shut out Contact outside of the Group

Article excerpt

In the March/April issue I offered an overview of boundaries in group psychotherapy. Examining some of these boundary issues in more detail, this column takes a look at the various boundaries that have been applied to contact outside of the group, both between members and between member and therapist.

Classical psychodynamic group therapists often have advocated a very tight boundary concerning contact outside of the group. In theory, this position helps to maintain members' focus on examining all their relationships to one another in the presence of all group members and the therapist. When group members come from different social and professional realms, this boundary is workable, as long as the group meets in a relatively large metropolitan area and the therapist is vigilant about checking members' social and professional networks before they arrive in the group. When the inevitable situation arises where members of a group do have a common tie outside of the group, the therapist who uses this kind of tight boundary removes one of the individuals with the common tie.

For most of us working with recovering addicts, such a tight boundary is neither easy to practice nor necessarily the most useful tool in our work. Groups that are conducted in residential treatment centers that draw from a large geographical area may have group members who have never met one another prior to treatment. However, in this setting, any attempt to restrict members' contact outside of the group is clearly futile; members will be eating meals together and will have many opportunities during the day to engage in other therapeutic activities. In such groups, a common guideline is for members to bring into the group any significant contact outside of the group--particularly contact that has generated conflict or intense feelings.

Productive aspects

If we view relationships in the group as a mirror for how group members relate in the world outside, then bringing outside contact into the group can be used to enhance the group's appreciation of the consistency of each member's role inside and outside of the group. Particularly in working with recovering addicts, contact outside of the group may be much more likely than with group members who are not attending 12-Step meetings in addition to group therapy. With the possible exceptions of the largest metropolitan areas, the recovering community is still small enough that maintaining even one degree of separation between group members may pose a significant challenge.

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In addition, the isolation that characterizes most of our group members is not ameliorated through attempts to limit access to one another outside of group time. Indeed, some of the most useful work we can accomplish in the group involves examining the group's resistance to bonding more effectively.

One argument traditionally raised against contact outside of the group is that without the therapist present, dysfunctional dynamics between members may threaten their emotional and even physical safety. This argument assumes a somewhat paternalistic role for the therapist. It reinforces the illusion that the therapist is somehow powerful enough to protect the group from feeling hurt--or even that protecting the group from such feelings is useful. The alternative approach is to welcome these opportunities to examine how group members have sabotaged relationships by shaming and blaming others or by withholding direct expression of feelings when they feel hurt. …

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