It was Amber’s first day in the partial hospitalization program and initial small-group therapy session. It was also less than a week removed from the devastating sexual trauma she had experienced while strung out on heroin. If anyone needed to hear a constructive message, it was Amber.
In a flash of divinely inspired creativity minutes prior to the start of the session, I explained to her and nine peers, ages 18 to 24, that the focus of the group was on making a positive statement about oneself and then stating a positive observation about a fellow group member.
With the parameters made clear, the clients began, one by one: “I’m Travis and I see in me new coping skills and a willingness to grow. Tyra, I observe in you the assistance you are willing to give others and me.” Tyra said, “I see in me that I’m not afraid to share my opinions. Ricky, I observe in you helpful and positive insight.”
Others spoke of a growing ability to work every aspect of the 12-Step program, a sincere desire to stay sober one day at a time, self-motivation to stay clean, “being content with who I am,” and even doubts: “It’s not one of my strengths to discuss my positive attributes.” To which I responded, “Yet.” Eliciting positive affirmations from clients is a given when engaged in the “I See in Me and I Observe in You” group.
The overall aim is to counteract the affliction of often devastating poor self-esteem, a major factor perpetuating the misery of addiction. As I suggest to clients, poor self-esteem is a factor that fuels substance abuse, and substance abuse contributes to poor self-esteem. Negative messages repeatedly internalized from childhood and adolescence as truth are reinforced by the punishing consequences and shackles of active addiction. A complement to strength-based counseling, this group results in clients gaining valuable insight from one another. There is no substitute for the peer-to-peer positive reinforcement that comes from clients courageously sharing heartfelt observations.
Creating a safe container
From a therapeutic perspective, the necessary ingredient that has to precede the expression of oftentimes raw sentiments by clients is the safe environment that makes self-disclosure possible. This can be accomplished by the validation of client concerns, the invitation to all to share on an issue of their choosing, and encouragement that each person can be an advocate in his/her own promotion of healthy choices.
Thus feeling freed from self-inhibiting concerns based on past experiences of opinions that were neither sought nor valued if expressed, clients find their voices. The result is the expression of positive thoughts clients might never have chosen to express otherwise. The safe container created, and the confidence experienced in the group process, is made concrete. For after all, a client hearing his articulation of a solution to a perplexing core issue, and validation from peers that one is not alone in the struggle to recover, makes navigating the path to wellness more “visible” and achievable.
It makes intuitive sense that a person’s own expressions of hopeful solutions make change far more likely than a counselor’s or parent’s effort at convincing, nagging, trying to impose or even merely suggesting a course of action. Once one gives voice to an intended course of action, the inclination is to feel a sense of obligation to follow through because the words are out there. In the jargon of a young adult, “I don’t want to be a poser.” In the spirit of 12-Step philosophy, it is my responsibility to walk the walk and not merely talk the talk.
In addition, the group dynamic of emotional strength in numbers kicks in. Hearing fellow clients communicate specific strategies to overcome obstacles once considered insurmountable serves to reinforce a can-do attitude. In contrast, the “you shoulds” and “you oughts” leave clients cold and are tantamount to a figurative finger to the chest; they reinforce sentiments rooted in the disbelief of any ability to make prudent decisions. Equally destructive to the wellness process is the unintended “verbal confirmation” of the typical young adult’s skepticism of authority.
The genuine benefits clients derived from this exercise were evident by their enthusiastic participation and willingness to provide written input on the necessity and value of building a solid foundation for moving forward in recovery. “The group was very uplifting and gave me a sense of self-worth,” wrote one participant. “It felt good to compliment someone else on her strengths,” added another.
A bridge from the abyss of hopeless addiction to the shore of promise, optimism and possibilities was being forged. The freedom to be real, the initiation of the transforming process of individuation was seen in oneself and observed in others.
And Amber, relatively unknown to her fellow clients before group began, received a compliment that brought laughter. “Amber, I observe in you that you dress very nicely and combed your hair,” Corey asserted. After stating that she sees herself as surrendering to her disease, Amber put a cherry on the sundae for the nurturing group: “I felt welcomed. It was my first group and it was very encouraging to see how honest and open everyone is.”
Thomas M. Greaney, LADC, CCDP, has a private practice in Connecticut and Rhode Island and works with young adults at an outpatient treatment agency in southeastern Connecticut. His passion is creative approaches to group counseling, a subject on which he presents trainings. His e-mail address is firstname.lastname@example.org.