Group therapy is a recognised means of helping people to develop self-awareness and overcome their problems. Unfortunately, there are a number of factors that can hamper the individual and the group process. Resistance is a major issue that often emerges in group therapy. In this essay the nature of resistance and the reasons for its prevalence will be explored, together with strategies the facilitator can implement to manage this issue within the group process and dynamics. Before this can be achieved it is important to provide an overview of group process.
According to Corey, group process consists of six stages. These are the formation (pre group issues), initial (orientation), transition, working, final stages and post group concerns including evaluation and follow-up issues (Corey, 2004). Corey goes on to explain the stages. In the formation phase the facilitator is preparing the group, announcing the group, formatting and structuring the group, recruiting, screening and selecting members.
The initial stage consists of the group members spending time in becoming oriented with the group and exploration within the group context (eg. building trust, self-identity within the group, identifying goals etc). The transition stage is about dealing with resistance, conflict, defensiveness and other behaviours that may arise in the group participation. In the working stage, is a more in-depth exploration of significant problems and issues in order to bring about changes that better address the personal struggles of group members.
The final stage is about consolidating and integrating what has been learned in the group and putting it into practice in the group member’s every day life issues. The last stage, the post group issues, looks at the evaluation, termination and follow-up aspects of the group.
“The concept of resistance began to take shape in psychology with the development of psychoanalytic theory” (Buetler et al, 2001: 431). The Oxford English Dictionary defines resistance as “withstand the action or affect of. Try to prevent by action or argument. Refrain from (something tempting). Struggling against” (Oxford English Dictionary). Corey develops this in the group context, noting that: “The term ‘resistance’, as applied to a client’s behaviour, implies the refusal to co-operate or change and is a form of active opposition to the therapist’s influence”. Resistance can be classified as a behaviour that can keep members from exploring personal issues or painful feelings in depth (Corey, 1995: 16).
Resistance is a common struggle or problem within the context of group dynamics and process. This behaviour can occur at any stage of any group process and can impede the group dynamics and process and can be projected in many and various ways. Human beings are all different and all develop different coping mechanisms. The different ways in which we cope or do not cope in various situations, become ingrained into our beings.
There are many different reasons and causes of a group member’s resistance, as well as different levels of resistance within that. Egan suggests that: “Many socio-psychological variables such as sex, prejudice, race, religion, social class, upbringing and cultural and subcultural blueprints can play a part in resistance” (Egan 1982: 297). Examples of this kind of resistance include, for instance a man resisting being helped by a woman, a black person resisting help from a white person and vice versa.
Resistance may occur in all stages of group process, but mainly occurs in the earlier stages and mostly in the transitional stage. Members are starting to self-disclose, find their place within the group, build trust and out of this conflict and tension may arise. My own experiences of resistance occurred in the early stages of group process (from the beginning), especially in finding my place within the group and self-disclosing. However, resistance may also occur later in the group process, such as the working stage, where individuals within the group, or the group as a whole, do not want to deal with anything that is uncomfortable, or when vulnerable issues may arise.
Resistance to a therapeutic process may take many forms. My own major struggles are inadequacy and feeling incompetent. These may stem from a negative self-concept. In my experience, feelings of inadequacy within a group context can lead to major resistance, such as fears like, “I am not good enough. If I say that, it will sound stupid”.
This problem may also lead into the issue of a group member struggling with self-disclosure. Self-disclosure is a vulnerable process, but is the common thread that steers group interaction and process. An individual’s resistance to self-disclosure makes it a difficult experience for the person involved and other group members. Corey suggests that: “If people are unwilling to share of themselves, they make it very hard for others to care for them” (Corey, 2004: 114).
Anxiety may also develop within the group member, and is a major struggle that can lead to resistance. Anxiety can occur when fear arises. It may be fear of being judged, criticised, misunderstood, confused or condemned. I tend to use humour within the context of anxiety. Consequently, I found it interesting and somewhat consoling in Bovey and Hede’s findings showing that individuals who have a tendency to use humour to cope with feelings of anxiety were less likely to resist organisational change (Bovey & Hede, 2001). Fear of change can be a major aspect of resistance. The members or member of the group may have a desire to change but fear can trickle in causing resistance.
The group members desiring to change and wanting to change may experience resistance as the change process involves going from the known into the unknown. Therefore, it is quite natural in the change process that a person will encounter resistance and it is to be expected (Bovey & Hede, 2001).
The group member dealing with resistance can tend to withdraw or not participate in the group involvement, interaction and may use the form of silence as a way of protecting themselves and the issues and conflicts that are stirring within. They may develop hostility towards the facilitator or other group members. Transference is another common response of group members.
This may be a positive or negative experience. Transference is a projection on other group members or the facilitator of an experience or experiences of a particular member from a significant figure of the past. For example, transference may occur when a group member is projecting onto the facilitator the need and longing for the good or bad parent they never had. Another common behaviour when resistance occurs is not dealing with confrontation.
The resistant group member or the group as a whole may employ behaviours that are conflicting or at times are blocking the group movement (Hansen, Smith and Warner, 1976: 396). Other resistant behaviours may include changing the topic, passive or active aggression towards others or the facilitator, sub-grouping, missing sessions, power struggles and manipulation.
Because of such resistance and avoidance, there can be a block and a restriction in the dynamic of the group so that learning and change can become distorted or held back (Heron, 1999: 178). When dealing with resistance, facilitators need to do so immediately. Resistance is also a form of avoidance and Eagan says that facilitators need to understand the principles and mechanisms underlying avoidance behaviour (Egan, 1982: 298). Having a clear idea of what are fruitful and unfruitful member behaviours is paramount to helping group members to require the necessary skills to function as an effective group member and experience positive group dynamics.
The facilitator can also help the group members experiencing resistance by accepting that there will be resistance within the group and that is a natural part of group process. Kottler quotes Unger (1990), stating: “Leaders should plan for group resistance before it ever begins”. He encourages facilitators to negotiate and clearly define the goals for the group so that there is ownership of the group rules and agreements (for example, “physical and emotional abuse will not be tolerated”) (Kottler, 1994: 166).
The facilitator should try to create an atmosphere that encourages the group members to be open and acknowledge any individual or group resistances. Group members need to also be encouraged to talk about their resistances and avoidances, so that they are not being held back from change and learning new ways of coping with their everyday life issues. Analysis of resistance can help the group members gain insight into it and other behaviours (Gladding, 2005: 24).
Mahalik quotes Schuller et al (1991: 198) as saying that: “successful handling of resistance is important because it helps the patient feel that he or she is safe and understood by the therapist, and it provides the patient with a model for dealing with more difficult issues” (Mahalik 1994: 65). Buetler et al note that that: “Treatment is most effective if the therapist can avoid stimulating the patient’s level of resistance” (Buetler et al, 2001: 431).
Lakin discusses the ethical dilemma a facilitator may face in dealing with resistance. He questions whether or not the facilitator should “pull” for affective expression or “push” for deeper self-exploration (Lakin, 1991: 154). This is interesting and challenging for the facilitator as most would say that the timing is an important issue. When and how much should the facilitator take on the “pull” or “push” effect as Hansen, Smith and Warner state: “One of the most important skills a group counselor needs to develop is a sense of timing. None of his interventions will be beneficial unless his timing is appropriate” (Hansen, Smith & Warner, 1976: 396).
The facilitator can also evaluate and examine their own styles of behaviour and interventions to determine if the resistance is coming from their facilitation and leadership. The group as a whole can experience resistance, when there is an unqualified group facilitator, conflict between the co-facilitators, a dogmatic or authoritarian leadership style or lack of preparation or lack of trust bought about by the leader (Corey 2004: 100).
Group facilitators also need to have adequate and consistent supervision for such things such as countertransference, dealing with their own resistances and other behaviours they may struggle within leadership and their personal life.
Resistance in the group therapy situation can come in many shapes and sizes. A good facilitator will be aware of this and seek ways to minimise the impact of these on others, and help the resistant member to overcome their resistance. A clear knowledge and understanding of the different forms of resistance, and where they come from is important here.