The science behind group therapy

At Flourish, mindfulness, polyvagal theory and attachment are core tenets guiding the work we do with our people.  Group therapy is an ideal environment to bring in these tenets as it opens up possibilities for participants to engage with others and experience emotional co-regulation.

Since we have several therapy groups at Flourish and hope to launch at least one more in 2022 we thought we would highlight work by Drs. Porges and Philips (2017) that describes how social engagement and interaction within a group therapy setting, facilitated by a relational and polyvagal theory trained therapist, can have a positive impact on group members both within and outside of the therapy group.         

Polyvagal theory establishes how the evolutionary development of the mammallian social engagement system relies on external cues of sight, sound, and implicit facial and tonal gestures from others to determine, unconsciously, if the environment is safe or dangerous. The cues we interpret as safe or dangerous are influenced by our emotional development from an early age and translated in one’s ability to regulate their emotional affect through the ‘vagal brake’. If our vagal brake is flexible and resilient, a person can recover quickly from moments that could trigger an internal ‘danger’ signal; if our vagal brake lacks the ‘tone’ needed to move with ease between danger and safety, physiological states of anxiety, depression or dissociation can occur and hang around for longer than we would like.

Group therapy can be an ideal environment for people to develop vagal tone because their nervous systems can experience a neuroception of safety, which then allows the body to enter into parasympathetic nervous system. The parasympathetic state is one of connection, openness, and curiosity. When we are in this state we thrive! We can laugh, enjoy socializing, concentrate and be productive, make love, enjoy and digest a delicious meal, and have access to strategic, analytical and creative thinking. When we are in parasympathetic while simultaneously in an intimate group setting where we feel safe and not judged, we can be vulnerable and share past or current pain and suffering which can ultimately help us to resolve and recover from it. Feeling heard, seen and even protected by others in the group usually leads to self confidence and acceptance of who we are and who we are not.

While individual therapy can help to uncover, integrate and even resolve early emotional regulation challenges, group therapy goes further to enlist the nervous system of others for co-regulation, attunement and comfort to express previously internally forbidden emotions. We have found that some of our people with depression, anxiety, and mood disorders can develop healthy emotional regulation, confidence and a sense of ease during periods of stress when they combine individual and group therapy.

Reference

Philip J. Flores & Stephen W. Porges (2017) Group Psychotherapy as a Neural Exercise: Bridging Polyvagal Theory and Attachment Theory, International Journal of Group Psychotherapy, 67:2, 202-222, DOI: 10.1080/00207284.2016.1263544