Group Therapy: How a Method Few Know About Heals Loneliness.

Overcoming Loneliness through Group Therapy

According to Vox: In her late 20s, Kristi Tate struggled with profound feelings of loneliness, bulimia, and suicidal thoughts. Everything changed when she had a conversation that became pivotal in her life. A friend suggested she try group therapy.

Like many others, Tate initially believed that therapy was solely a matter between two people: the therapist and the patient. She had already attended individual sessions, but found little benefit from them.

Group therapy turned out to be something completely different. Every week, Tate, along with a few other participants and a therapist, gathered to discuss their lives and analyze their interactions with one another.

At the time, her problems seemed endlessly painful and complex. She felt she couldn't find common ground with people, even though she didn't know why. But the other group members observed her behavior from the outside. After a few months, they began to show Tate “all the ways I was isolating myself,” she said. “These are all the ways I was avoiding situations or retreating out of fear, shame, or inability to express my needs.”

The group is a social microcosm — every participant ultimately behaves in the group as they do in life.

The group supported Tate when she decided to stop dating unavailable men, changed her relationship with food, and ultimately got married. For Tate, author of the memoir The Group: How One Therapist and a Circle of Strangers Saved My Life, group therapy became a true breakthrough. Even after more than 20 years, she continues to attend this group. However, most people are still not aware of the possibility of group therapy.

Despite psychotherapy becoming a true trend — with active discussions about emotionally immature parents, a rising demand for chatbot therapists, and the popularization of psychotherapy on TikTok — most attention remains focused on individual methods. According to the American Psychological Association as of 2023, less than 5 percent of all therapeutic sessions in the U.S. are devoted to group therapy.

However, studies indicate that group methods can be as effective as individual therapy for many issues, from depression and anxiety to eating disorders and chronic pain.

Why Most People Don't Attend Group Therapy

In the summer of 1905, American psychiatrist Joseph Pratt organized groups of tuberculosis patients to monitor their condition. He found that the support among participants was no less important, and perhaps even more influential, for their recovery than any information about the disease.

Group methods continued to gain popularity after World War II thanks to English psychoanalyst Wilfred Bion, who worked with traumatized veterans. Bion aimed to reduce the hierarchy that gave psychiatrists power over patients and facilitated the ability of groups to form — and reform — their own structures.

By the 1960s, the demand for encounter groups skyrocketed. It seemed everyone, from congregants to New England enthusiasts, was actively attending groups.

Unfortunately, some of these groups encouraged emotional disclosure without limits or fell under the control of authoritarian leaders. Soon, reports began to emerge about participants experiencing breakdowns, rapidly ending their marriages, or even committing suicides.

In contrast, therapeutic groups adhering to gentler approaches with principled leaders and evidence-based practices continued to exist, particularly in healthcare settings such as hospitals and day treatment programs for various disorders. However, the popularity of group therapy declined compared to the 1970s.

Even if you have heard about group therapy (and have access to a reliable group), there are many reasons not to join. Meeting schedules often do not accommodate the needs of all participants. It should also be considered that participants must share time with others, and some may not have the opportunity to express themselves at all in certain weeks.

Being in a group can be daunting. Participants must give up some of their privacy and open up to uncomfortable feelings like shame. Therapists strive to be warm and compassionate, but not all participants may welcome you. One therapist's opinion may seem dismissive, but when the entire group agrees that your behavior is unacceptable, it's hard to argue that they're all wrong.

“Not everyone needs such intensity,” Tate said. “It's like a powerful cleansing, and you might just need gentle.”

How Group Therapy Works

The number of participants in a group is three or more. But what makes an ordinary gathering a therapeutic group?

Firstly, a therapeutic group is not just a collection of random people. The therapist selects participants who can interact with one another or provoke constructive conflict. They consider potential difficulties such as individuals who may not speak or those who cannot stop talking, and attempt to avoid gathering such individuals together. Clients who could benefit more from individual therapy, including those who might disrupt the group dynamics, are also excluded.

Finding acceptance can be healing in itself. Finding acceptance in the face of conflict is even more powerful.

The first few group meetings are critically important. A group that works for a long time is similar to the ship of Theseus; over time, it may almost completely renew itself as individual participants leave. However, the early dynamics, according to psychiatrist Irvin D. Yalom, may remain unchanged. Facilitators must demonstrate norms of openness and respect from the very beginning.

Yalom argues that the group is a social microcosm — meaning that every participant tends to behave in the group as they do in life. That’s why participants are encouraged to discuss what’s happening between them during the session.

For author David Payne, individual therapy focused on his past pains. In contrast, “group therapy helped me see who I am now, sometimes a traumatized adult I became.”

This social microcosm can also operate in reverse; how you behave in a therapeutic group may reflect your behavior in life. “The group is a laboratory,” says psychotherapist Jackie Darby.

It’s no coincidence that these gatherings are often called “process” groups. Interactions are secondary, and conflicts can be beneficial for the entire group. A well-resolved conflict benefits everyone. Even an observer of the conflict can quickly understand how they want to deal with it.

The group is also marked by support and generosity. “Many people expect that groups won’t be kind to them,” notes psychiatrist Moline Lesch. “Finding acceptance can be healing. And acceptance during conflict is even more powerful.”

“I can be angry with you and still love you,” said one of Tate's group members. “No, I really didn't know that,” Tate thought. But over time, she learned.

The Group in the Age of Loneliness

In 2023, former U.S. Surgeon General Vivek Murthy pointed to isolation (physical distance from others) and loneliness (a feeling that can arise even in a crowd) as among the greatest threats to Americans' health. Approximately one in three adults reports feeling lonely every Sunday.

The issues caused by loneliness are numerous and nothing is more self-perpetuating. Studies show that lonely individuals are more likely to perceive threats in social interactions. When a lonely person most needs others, they often find it hard to return to them.

Thus, group therapy may be the last resort for a lonely person. But the path to improvement is not individuality but community. Sharing time in group therapy can be uncomfortable, but at the same time it's a wonderful practice for living among others.

At its best, as Tate said, the group can become greater than the sum of its parts. Members may feel embarrassed or nervous, but “the group knows.” Such wisdom is not found in a therapist or anyone else, but only in the connections between people.