Hey, the Therapist Is Interrupting! (An up-close look at a social therapy group in action)

In my last post, I described the workshop “Therapy Interrupted: Performing Social Therapy” which I led recently with Pal Carlin at the Beyond the Therapeutic State conference in Norway.

Workshop participants asked what social therapy is like in practice—a reasonable question quite difficult to answer. I reach for words, phrases, concepts that describe or characterize what a group is doing and come up short. Embedded in the very language we use are traditional modernist conceptions of therapy (and life) that overdetermine how we see and understand what we do. For example, in most therapeutic approaches the individual is seen as the primary unit of growth. In social therapy our patient is the group. But what do I mean by “group?” Not a bunch of individuals, not a “thing” but the performance activity of diverse human beings coming together to create their mental health.

This is an important conceptual shift. We relate to people as fundamentally social because we are! As a social therapist I am working to organize and reorganize the relational life of the group—how they are talking, relating and performing with each other. It’s a performatory activity that brings to the forefront the capacity we have as human beings to be who we are and at the same time perform ahead of ourselves—be who we are not.

What we did at the conference was to invite participants to perform transcripts of actual social therapy groups from my practice at the Social Therapy Group in NYC:

The curtain opens. The lights come on.

A long time group member, Mary, begins: I am really happy. I am so glad to be here. I’ve been spending every weekend with a guy named Joe – a new boyfriend. We go the park, have fun making up stories and hang out. It’s so great.

Group member: This sounds terrific. How did you meet him?

Mary continues to tell the story of her weekends with Joe and mentions she met him online.

Group member: Wait a minute. Did you just say you’ve been seeing him for four months? And you haven’t said anything to us about this? Are you kidding? You’re not including us after all the disasters you’ve had in relationships?

Other group members express their disappointment in Mary for choosing not to share this new relationship with them.

Group member 2: I think this is great.

Group: We’ve been down this road before – how could you think this is great? Mary always gets into abusive situations. We’ve been working on this for years. I can’t believe she is doing this again. What’s so great about that? We know what’s going to happen. Why are you doing this Mary? This is self destructive. You are leaving us out.

I begin to wonder what the group is doing. They’re passionate about Mary and quite critical. They’re doing what culturally we are taught to do—make assumptions, explain and predict what will happen. My sense is that we have lost the performance of building the group. Do I want to say something? What could I say that would help? I am quiet.

Group member 2 (standing her ground): I‘m happy for Mary.

Group (directed to me, the therapist): Aren’t you concerned?

Therapist: I am concernedabout the group. Here’s my concernHow come you’re doing therapy tonight?

In asking this question I’m performing outside of regular therapeutic discourse. I’m a performer/director helping to create a new kind of therapy play. I offer a weird question to challenge how the group is organizing itself. I have interrupted their traditional notions of therapy.

Group: What? What are you talking about?

Therapist: How come you’re doing therapy tonight?

My question here is a provocation, a response to the group’s activity of searching for the cause, getting to the bottom of it all, finding the explanation that will help Mary see the light.

Therapist: I am simply asking you, the group, to look at how you’re organizing your therapy. Create poetry together. Say things that we don’t know how to say.

Group member: Here’s my poem. Let’s be happy for Mary.

Group member (crying): I am not sure why I’m getting so emotional here. Something feels really uncomfortableand goodabout this. We got so caught up in interpreting what Mary was saying and what it all means. It’s confusing. I think I like it. I’m not sure.

Lights dim. Curtain closes.

Maybe you’re feeling like Mary at this point. You’re not alone. The audience at the conference didn’t quite know what to do with all of this. It’s clearly a departure from the social constructionist position that the patient is the expert. It’s also a departure from psychodynamic approaches that the therapist is expert. In social therapy, there is no expert. The patient and the therapist are co-creators.

The approach shared here is not based on what people are saying but on how they’re saying it. We encourage people to create new ways of talking to each other that are not based on causality (“You are this way because”), interpretation (“I know what it all means”) and prediction (“This is what will happen”). Together we discover that creating conversations is an intimate activity that allows people to have a different experience of emotionality and a continuous challenge of what our conception of therapy is.

What’s your experience in reading this transcript? How does it challenge you?

I look forward to your responses.

Christine LaCerva