Psychodynamic group therapy -- a good investment?
October 15, 2014 10:26 AM   Subscribe

My therapist suggests I would benefit from psychodyamic group therapy. I am intrigued, but also reluctant. Is group therapy worth it?

I am in the U.S. I've been seeing my talk therapist for about three years. I like her and trust her enormously, but I am fairly stuck in my life and making slow progress on some of my goals. She has suggested that I join a local psychodynamic therapy group, particularly to work on the interpersonal issues I have (making more friends, dating, feeling closer to family, establishing deeper emotional connections in general). I've spoken with the psychologist who leads the group a few times. The phone interactions we've had have been positive, and my therapist (also a psychologist) has a high degree of respect for him.

He says the group is run in such a way where he participates very little, and the group itself creates the dynamic that can lead to insight and change. I am suspicious of this and feel like it is a waste of my time if the "expert" doesn't contribute, but my therapist says this setup is quite normal.

The group is about 5 people, ranging in age from 30s to 70s, and is of mixed gender. I am a female in my late 30s. It meets weekly, and all members are there to deal with relationship issues.

The therapist who leads the group is out-of-network for my insurance. He asks for a minimum 3-month commitment to the group, though my current therapist says a year-long commitment would be ideal. My current therapist would like me to continue seeing her at least once/month in addition to the group therapy. Paying for all this would be a financial strain, but not impossible.

I am intellectually intrigued by the idea of group therapy. If the therapist were in-network, I think I would try this. But since he is out-of-network, the financial commitment makes me pause.

Have you ever tried psychodynamic group therapy? Was it worth your time and money?
posted by megancita to Human Relations (9 answers total) 3 users marked this as a favorite
I did psychodynamic group therapy as an inpatient, but it was mostly useless because we didn't share diagnoses. The schizophrenic guy wearing a diaper and the chick who liked to set fires didn't have much to contribute to my particular situation, nor did I have much to contribute to theirs. The "acting" parts were... weird and uncomfortable for me. I do not like the spotlight and I have social anxiety. "Playing parts" was just incredibly stressful and I hated it. There was lots of yelling and getting called out. Self-harmers would actively self-harm during the group due to the stress, then get called out. At one point they made me sit in a garbage can and mocked me for not trying to get out as a way to illustrate the ridiculousness of my "refusal" to get better. (I was diagnosed with bipolar disorder several years later, so my "refusal" was more of a "normal reaction to misdiagnosis and lack of treatment.")

Since then I've been encouraged to attend a psychodynamic group for bipolar people. Nope, not gonna.
posted by xyzzy at 11:08 AM on October 15, 2014 [1 favorite]

I've sent you a mefi mail.
posted by hz37 at 11:56 AM on October 15, 2014

A good group can be invaluable. It can be especially helpful with problems involving relationships with others. That the leader doesn't participate much probably means that the group functions well and doesn't need much intervention. The reason for the commitment is because a group requires a stable committed participation for all its members so that they feel safe and so relationships in the group have time to develop. And also so a "bad experience" doesn't cause people to vanish before detailed processing of what took place. (Note: the group leader is also taking a risk on you.)

That said, I have no way of knowing if this is a good group. Does s/he run many groups? How large is it? How long has the group you would join been in existence? How long has this therapist been running groups? What is his training?

Will the fee have a significant effect on your financial life? Or are you just concerned about being/feeling ripped off? Is the leader willing to negotiate with you on the fee?

Groups with a schizophrenic guy wearing a diaper are the exception, not the rule. Similarly for "playing parts." (There are particular "schools" which would be more likely to find such a thing appropriate.)

You could discuss your fears further with your own therapist. Ultimately, there's a risk in anything unknown and you need to decide with incomplete knowledge, but if you trust your therapist's recommendation and liked what the group leader had to say on the phone, there's a good chance it will work out.

(Depending on your location, there might also be other groups available and possibly one which takes your insurance though most insurance plans do not "cover" group and the therapist bills them illegally.)
posted by Obscure Reference at 12:12 PM on October 15, 2014 [6 favorites]

Group therapy can be extremely helpful, and in a very different way than individual therapy, however, considering the financial investment, it is a risk. One way to mitigate that might be to see if there are any support groups run by reputable organizations in your area. For particular mental health issues, the National Alliance for Mental Illness ( often has free support groups, which offer many of the same benefits of other types of group therapy. There are also often support groups centering around other topics (grief, substance use, etc.) that can offer opportunities to work through issues and build relationships. It may be that this group is the only option, but it might be worth exploring other possibilities before deciding for sure.
posted by odayoday at 12:49 PM on October 15, 2014

I am suspicious of this and feel like it is a waste of my time if the "expert" doesn't contribute, but my therapist says this setup is quite normal.

What else are you generally suspicious of? Think about that.

My mom gained an enormous amount of insight from sitting in a circle with other abuse survivors and I did the same for my PTSD. You feel like only you feel these things and then a bunch of other people are speaking your thoughts and then things start making sense. It's cathartic. Try it.
posted by Mr. Yuck at 12:59 PM on October 15, 2014 [2 favorites]

I just started going to a local "men's group" group therapy, and so far it has been awesome. It's not, to my understanding, "psychodynamic group therapy" in that we're not dealing with the same issue(s), although our counselor/group leader always does ask us to name our connection to whatever someone is saying. No one that I can see is suffering from acute mental illness which makes them act out in any way; I think they would not really work in this type of group.

We do a fair a bit of psychodrama, and even though I have a bit of social anxiety, I've (amazingly) really enjoyed it. Everyone else in the group has been there for a long while and so I get the idea that a commitment would be nice, but at the same time it seems unreasonable to ask that from the get-go. After my first session, the group leader took me aside and said, "What did you think? Do you want to come back? Should I bill you for this session?" There's never been any required commitment.

What I have found is that you have to be committed to being on for every session. Actively present and listening the whole time, and ready to participate without whinging. So it's challenging, but the respect and attention I've received from these former strangers has also left me with an incredible sense of gratitude. And getting multiple perspectives has been really a centering experience too. It often feels like: Oh yeah, people are all a lot more alike than we care to think. (Intellectually you may know this, but it still hits home over and over again in group therapy).

The lack of leadership that you mention is the main thing that would scare me off. Our group leader is highly active in guiding each session and I don't think it would work in a healthy manner without that guidance.
posted by bennett being thrown at 1:57 PM on October 15, 2014 [1 favorite]

An analogy that made a lot of sense to me when I was considering this was to think of group therapy as the "lab" portion of your theoretical coursework. It's a safe and supervised place to actually try out the things you're learning about yourself in therapy and get near-real-world insight into patterns and behaviors that your friends and loved ones might not be able to observe and/or articulate in useful ways. Individual therapy can't provide this in the same way.
posted by judith at 3:24 PM on October 15, 2014 [4 favorites]

Give it a try, see if you gel. Groups are each different. My Dad ran groups for years and often I sat in the corner and read. I thought the ones where the participants were at different places on their journey, but all on the same road were great. Women's process group was helpful for me as a young feminist. The methadone ones were fucking hilarious! Some were just strange with some really dreadful people and obnoxiousness.

Ask to try a few sessions and see where you are. If you like it, keep going, if you don't, don't.
posted by Ruthless Bunny at 6:42 PM on October 15, 2014

My one experience with any kind of group therapy was extremely negative. It was run by a husband-wife team who seemed to have a 'control' thing going on. It may well have simply been an incompatibility between myself and the other members of the group, but I never felt very welcome. The group seemed largely composed of people who seemed very bitter. I eventually raised the point that I didn't feel like I was getting much out of 'group', and one fellow said "I get a lot out of group, I've been coming here for 9 years and it's helped me a lot". And it was at that moment that I decided to leave group and never come back.

I'm not going to condemn all group therapy as bad. But I think that you need to keep your eyes open. I think groups are not unlike therapists: they're all different, and it might require an effort to find one that's good for you.
posted by doctor tough love at 8:45 AM on October 16, 2014

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