In recent months, I have been fortunate to have spent considerable time traveling across the country and internationally, delivering workshops and working with therapists hungry to improve their group skills. In these travels, I have discussed with these therapists how they see overlap between culture, interpersonal relationships and identity in their setting, region or country. As I have been teaching, I wanted to make sure that any underlying principles, techniques and assumptions were always held in check to allow local therapists and systems to engage in rigorous questioning of when to adapt and when to adopt a model of working. Listening to them talk about their local issues has been fascinating and illuminating. Chinese therapists discussed the implications of a massive shift in their culture toward service industries and how this has increased stress on their population, leading to increased mental health problems. The government in England, my home country, has created a Minister of Loneliness to address serious national mental health problems that have been identified. America is struggling with issues of identity, culture and politics, with issues becoming increasingly polarized, leading to significant schisms in society.
Shifts within and between cultures create considerable stress on societies and individuals in those societies are constantly adjusting to meet them. However, we are at a point in history where these shifts are occurring so rapidly that our ability to meet them is stretched to the limit.
Social support is a major stress buffer to these forces. They can support our identity, help us manage stress, help us to emotionally regulate and can offset the need to engage in more self-destructive behaviors. Moreover, the impact of a lack of social support impacts more than just mental health. There have also been multiple articles and news reports recently, pointing out the research showing that loneliness can lead not only to mental health issues but also problems with physical health such as increased likelihood of heart conditions, diabetes, increased risk for dementia and overall mortality.
The problem has been identified. People are not able to generate the social support they need, and this is impacting not only mental health but physical health as well. The impact on people at the individual, micro level is obvious to therapists, as we see it every day in our offices. However, the societal, macro level impact of loneliness and lack of social support is now beginning to be identified by societies and their governments. This represents a major shift in thinking and a significant opportunity for group therapy to utilize its strengths.
The idea of what constitutes a group therapy has never been more germane. There are many types of groups that are essentially individual therapy in a group. They focus on individual techniques and strategies and can be enormously helpful. However, as I have travelled I have become even more convinced that group as a treatment modality, and not a delivery mechanism for other therapies, has a very significant role to play in helping world population health. Group has inherent power in helping people connect with others. Understanding and working on attachment styles, interpersonal inflexibilities, social skills, cultural identity, cross-cultural dialogue, and simply learning to bond and connect with other human beings, has a healing power that operates at many levels. It has lasting impact on the physical and mental health of both individuals and whole societies. It is time for group work to claim its place in the field not just of mental health but of global population health and to begin to assert its true worth.