8 Psychotherapy8.5 Group therapies
8.5.1 Group processes and the anti-group
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Written by Resident Doctor Committee · Published
New in the 2027 syllabus
The College added this topic for exams from January 2027.
Group size and communication
Small groups let members talk to each other directly and repeatedly, so interpersonal patterns can be watched closely.
Large groups make it harder to take part and to be recognised by others. They can heighten anxiety about identity, belonging and authority. Members feel more pressure to stay anonymous or to split into opposing camps (polarisation).
The group matrix is Foulkes's term for the network of communication and relationships through which shared meanings develop.
Processes between members
Process | What it means | Clinical implication |
|---|---|---|
Mirroring | Recognising parts of yourself in another member or in their response | Feedback can make an interpersonal pattern easier to see |
Resonance | One person's material stirs up related feelings or experiences in others | Shared themes can emerge without identical histories |
Scapegoating | Unwanted feelings or qualities are placed in one member | Explore the whole group's part in this rather than confirming the blame |
Subgrouping | A smaller alliance forms within the group | Ask whether it supports belonging or shuts others out |
The anti-group
The anti-group, a concept associated with Morris Nitsun, describes destructive forces that threaten the group's cohesion and its ability to work.
Anti-group processes include contempt, repeated attacks, disengagement and undermining the group. They are not limited to one member who has been labelled as difficult.
Responding therapeutically
The conductor (the group therapist) notices the emotional climate, protects boundaries and explores what an interaction means for the group.
Containment lets difficult feelings be thought about without allowing intimidation or harm.
Interpretation looks at shared anxiety and at the group's task. Keep each member's own vulnerability in mind too, so that a group-level explanation does not hide what one person needs.
Repair means acknowledging real exclusions or failures, not only unconscious processes. A complaint is not automatically resistance.