Is Your Support Group Supportive?
By: Beth McHugh 2008
Many people participate in support groups for a number of different health conditions. For the most part they play an important role in the recovery or acceptance of that particular medical condition. The fact that there are so many support groups for the myriad of health ailments that plague us is a testament to their popularity and value.
This is especially so when it comes to support groups for mental illness. Nothing beats the comfort of being able to talk freely about your depression, your anxiety disorder, your mood swings, or your irrational thoughts. Knowing that you are not alone in your disorder can bring a peace of mind that not even the kindest friend or family member can supply. The realization that “I am not alone” is so powerful that it often signals the beginnings of the recovery process.
I often encourage my clients to join support groups knowing that these groups supply an ongoing form of support that every sufferer from mental illness can benefit from. However, these groups can cause problems in some circumstances, and occasionally actually add to the stress load of the participants. Let’s have a look at some real examples of problem group dynamics.
The first group problem scenario that springs to mind is when one member develops sexual feelings towards another and acts on those feelings. Although the attraction may be mutual, dating a person in your support group is the mental health equivalent of dating someone in the office – only with the potential for greater fallout. When it all goes wrong, one of the members inevitably has to leave the group. However, because both parties are emotionally fragile, this scenario can be devastating because the resulting heartache can result in a setback in recovery or even another breakdown. This is the last thing a recovering person needs.
Thus it is important for a group member to not act on their sexual attraction towards another member until such time as one or both participants have left the group. Group leaders need to keep a look out for such behavior and, while they have no power to stop the relationship developing, some cautionary words or a suggestion to attend different groups is in order. This is where strong group leadership is so important.
Many groups have rules prohibiting such relationships forming within the group since the potential for problems, both interpersonal and intergroup, are significant. Of course, feelings of sexual attraction cannot be stopped, however a wise group insists on requesting that partners be in separate groups. This benefits the partners as well since they are then free to comment on problems they are experiencing within their relationships. The group members are not expected to become relationship counselors to two people who are actually in the room and actively arguing. The latter can become distressing for already stressed group members and hence detrimental to the health both of individuals and the group itself.
Another problem in a support group is the group dominator. This person is so consumed with their own problems that they not only take up most of the weekly session with their own agendas, but they have little empathy for other people’s problems. Week after week, this behavior can snowball into a huge problem if not checked. It may often lead to people leaving the group because they feel they are not being heard. Again, strong leadership skills are required to keep this person in check, otherwise the group will suffer.
Another problem common to support groups is that of the group saboteur. The group saboteur comes in various guises, all of which are destructive.
Ann had come to the group suffering from depression, but it soon became obvious that she had considerable problems other than depression – problems that threatened the stability of the group. An accomplished academic, Ann liked to talk about her problems, but she also liked to talk about the other members of the group behind their backs. Extremely sensitive to perceived criticisms, which in fact were merely suggestions by group members to help her, she reacted to this “criticism” by using the time-honored tool of “divide-and-conquer.”
She would phone individual group members and try to get them on her side. Using her considerable persuasive skill as a professional mediator, she was able for a short time to manipulate individual group members to being “on her side.” Having gained the confidence of one member, she would move onto another and denigrate the first member in order to gain the “love” of her next victim.
Ann likely had little insight into why she was doing this, although she certainly was aware of this behavior. Common in elementary school playgrounds, this sort of behavior is the mark of an extremely insecure person. Unfortunately for Ann, this behavior only succeeded in getting her the exact opposite of what she wanted, which was closeness and friendship.
When group members quickly became alert to her actions, she was correctly challenged. The level of rage she exhibited was distressing to group members, but typical of a person with her disorder. However, Ann was sensible enough to realize that this particular group was not going to let her get away with this behavior, but it would allow her to discuss what was driving it. With effective external counseling, Ann has now moved ahead in her recovery, is only occasionally tempted to sabotage the group, and is honest enough to talk to group members within the confines of the group as to how she is feeling.
This is one of the many successful outcomes that can occur in a well-structured group in conjunction with client-centered counseling.
Another type of group saboteur is the “excuse maker”. These folk come to support groups with genuine problems and they genuinely want to be free of them. However, there is a resistant attitude to any form of change and consequently they frustrate the remainder of the group due to their refusal to try any suggestions.
Lyn is very good at coming up with plausible excuses as to why she cannot carry out a given suggestion by group members. It can be difficult to initially pinpoint a person with this problem but the sheer repetitious nature of their refusal to budge is a clear indicator as time goes by. Lyn suffered from social phobia and came to the group as part of her therapy requirements. It was a big step for her to attend the group and explain her problem to group members, but she found that the group was accepting and gave her lots of praise for her effort.
But that is where it stopped. Claiming she wanted to “get rid of her social phobia” she rejected every single suggestion for change that was offered to her. She had all sorts of excuses for not phoning her fellow members, and not going to social events even though other members offered to accompany her and help her out. She was certainly sabotaging her own recovery. But she was also sabotaging the wonderful group dynamic that had existed before she arrived.
As Lyn became sicker due to financial and family problems, her problems in the group escalated but she shot down every single attempt to help her. Some group members found that they were becoming increasingly frustrated with Lyn and that she was rejecting all their efforts to help her. Boundary problems within individuals in the group meant that some members experienced burnout and stopped coming to meetings just to get away from Lyn.
This is a situation where the group needs to survive over the individual and Lyn was asked to leave until such time as she was truly ready to make changes in her life. This provided a much-needed break for both Lyn and the group members. After two months, Lyn was back and willing to work, albeit slowly, on her problems.