Reader Dilemma: 'A psychiatrist has suggested I try group therapy, but the idea terrifies me'

Having had a very anxious and upsetting time recently, I was referred to a psychiatrist. She suggested that I try some sort of therapy and as I can’t afford one-to-one therapy, she advised that I attend a group, which is much cheaper. I am terrified enough of therapy, but the idea of a group really frightens me and sometimes I can’t sleep for worrying about it. And yet I’m sure the psychiatrist is right and it would help to get to the bottom of my problems. How can I overcome this fear just to attend one session at least?

Yours sincerely,

Hattie

I can well imagine your anxiety. I remember feeling much the same way when I attended group therapy meetings years ago. All I can say is that if you think you’re frightened, it’s nothing as to how frightened all the others in the group felt when they first arrived.

My advice is to resolve barely to open your mouth during the first session. If you’re encouraged to speak, you can simply say that you’re feeling very nervous and would like, for the first meeting, just to watch to see how it works before jumping in with both feet. That would seem a perfectly normal answer and everyone will understand.

No one in the group will press you to speak. Because the problem with group therapy is that it’s rather like being in a room of squawking babies. Everyone wants to have their voice heard, and the less you speak, the more time there is for everyone else. And the leader of the group – because remember, there will be one – won’t be badgering you to contribute if you explain the situation.

This leader is also there to allay your fears. I think what everyone imagines, when they first go to group therapy, is that everyone else will gang up on them and tear them to pieces. I’ve never seen this happen, and on the whole, the other people in the group are incredibly sympathetic and kind to other members because they themselves are so screwed up and they know all about panic, anxiety and paranoia. And if – which is very unlikely – there were any element of “getting at you”, then the group leader would be sure to make certain that you weren’t made into a victim.

It is difficult for group therapy ever to help anyone dramatically, and I feel that, with individual and deep-seated personal problems, only one-to-one therapy can help. But what group therapy can do is make you realise how desperately insecure and unhappy most other people actually are. You’ll leave the group and look at everyone in the street as you go home and wonder if they, too, aren’t suffering with intolerable emotional stresses and worries. And you’ll probably be right. Hearing other people’s often immensely peculiar fears does put yours into some kind of perspective. And you’ll be able to see how, underneath their confident exteriors, nearly everyone in the group is a bag of nerves, suffering, tormented, lonely and wretched.

After the first few sessions, when you’ve got to know everyone’s idiosyncrasies and vulnerabilities, you may well find that you actually look forward to meeting again. Group therapy is not just about delving into your inner psyche. It’s a comforting experience, being in a gang of like-minded and, usually, very sympathetic sufferers.

Go along, say nothing, and only speak when you feel like it. Soon, you may well turn into a group-groupie.

A group could change your life

I introduce reluctant people to group-analytic therapy several times a year, in the NHS and in private groups. Your terror is understandable. Bear in mind that most of the other members will have experienced this, too, and will be sympathetic. The therapist should also prepare you. I don’t know which kind of group therapy you intend to join. I conduct group analysis and such groups welcome the new member and want to help reduce the level of fear you write of. Many people come, as you do, deeply sceptical or defended, yet after some weeks see the benefits beginning to accrue. It is cheaper, in private work, than individual, true, but it will give you all you need and more if what you want is beneficial change for yourself. Group analysis reaches parts that no other therapy reaches.

Kevin Power

Principal psychotherapist, KMPT NHS Trust

You must find what’s right for you

You should not go to group therapy simply because it is cheaper, but only if it actually is the best treatment for your anxiety and upset. Group therapy may well be right for you in the longer term. But if the idea of this sort of treatment makes you even more anxious and upset, is it best for you initially?

Firstly, go back to either your GP or your psychiatrist, whichever you find the more sympathetic, to revisit beforehand your anxieties about group therapy. Secondly, find a charity that works with people in a similar situation to yourself, or a general-purpose charity such as the Samaritans. These organisations often offer therapy or counselling on the basis of charging what you can afford – though you do need to check that counsellors are professionally qualified.

When it comes to therapy, you need to find somebody who will not only give you the correct treatment promptly (NHS please note: promptly), but with whom you will also get on at a personal level.

Frederic Stansfield

Ramsgate, Kent

Push for one-to-one help

I know that NHS mental health resources are stretched, but it appears that group work is not appropriate for you at this time. One-to-one sessions would help build up confidence and provide ways of dealing with anxiety. You could then step up to attending a group. I would push for individual sessions and do more research into services offered in your area. Good luck.

Wendy Robinson

Skipton, North Yorkshire

I’m a single, divorced woman of 35 and I’ve got a good – and eccentric – friend, aged 78. He’s a platonic father figure – he’s very supportive and gets on with all my friends, even though we only see each other a couple of times a year. But recently, we were at a party and both got rather drunk. As I was bending over, he pinched my bottom. I exploded and the next day he rang and said he was sorry, it just came over him. But he didn’t realise how humiliated, violated and abused I felt. Despite his apology, I feel I never want to see him again. He says I’m being ridiculous. What do you think?

Yours sincerely, Carole