In the world of therapists, it’s hard to find someone who is not familiar with Irvin Yalom ‘s 11 Therapeutic Factors in Group Psychotherapy (Yalom, I. The Theory and Practice of Group Psychotherapy, 5th edition, 2005.). Although there are some ways in which a support group differs from a therapy group, some of the factors that make a support group healing are the same
Taking the time to understand what exactly makes a support group healing can help clinicians better explain the healing power of a support group to clients who might be hesitant to join.
For the past 7 years, I have run a support group for parents who have terminated pregnancies for medical reasons (TFMR.) I have had many opportunities to see group factors at work. The factors that I will address are applicable to all PAL support groups.
Altruism is a big factor in PAL support groups. This means that the members help each other. They do this by sharing their narratives of loss, giving concrete advice when appropriate, and by sharing experiences that have facilitated healing. In my group, members often share ideas about how to best memorialize a baby who died. Or, altruism takes the form of emotional support. I often hear group members reassuring others that their feelings are valid or encouraging others to be less self-critical. Sometimes, prospective group members worry that they will be judged by others for their choices. I have yet to see this happen in a PAL support group.
Catharsis happens when a person experiences relief following the free and uninhibited expression of emotion. This happens all the time in PAL support groups. The tears flow freely and often group members will grab some tissues before we get started. I expect and welcome this in groups. It tells me that people feel safe enough to allow themselves to feel their feelings. Some clients who are considering the support group express to me the fear that they will leave the group feeling more sad than when they arrived. Of course it can feel heavy to sit with so many stories of loss. For most people, the benefits of group outweigh the drawbacks. Readiness is a big factor and some people may need to work through feelings of their own before they feel ready to join a group.
Universality—Pregnancy loss still does not get talked about as much as it should. TFMR losses are even more shrouded in shame and secrecy. Sitting in a room with others who have had parallel experiences can be incredibly healing. The power of being with others who have “walked in one’s shoes” can be transformative. Although the numbers tell us that pregnancy and infant loss is common, it does not feel that way to the parent who just experienced a loss. In-person support groups can reduce the feeling of being alone. Creating a space where clients can hear stories directly from others who have also had losses is a powerful way to facilitate healing.
Installation of Hope—When women who have had a loss become pregnant again, group members are typically supportive. Although jealousy is a common reaction to news of someone else’s pregnancy, I have found that group members are very happy for others who announce a new pregnancy in group. Many of them know the struggle of trying to get pregnant following loss and feel that “If she can do it, I can, too.” Even when no group members are currently pregnant, sitting with others who are farther from their loss, chronologically-speaking, can help people feel optimistic about their own grieving process. They see that the acuteness of the grief immediately after the loss transforms into something different. This allows others to see that there can be light at the end of the dark tunnel.
It is not always easy to organize and coordinate a PAL group, but the effort is well worth it. I have witnessed many people move through their grief and find comfort in the groups I offer. Many geographic regions do not have such groups. If you are a clinician, please consider offering a PAL support group in 2016 if you are able to do so.