The History of Self-Help Groups and Reflections on A Modern Self-Help Meeting

Part I

The concept of mutual aid, which has evolved to encompass the self-help phenomenon that has swept the nation since the 1960s, is a practice that has leveraged groups and communities to their survival throughout recordable history. The self-help groups of today, as descending from the self-help movement that gained incredible momentum in the 1960s and finds historical emergence as far back as the industrial revolution in England, delivers peer to peer help and insider-expertise in the balance of support, education and the facilitation of change. Self-help groups assist countless individuals to cope and positively emerge from the hardships and trials associated with an endless list of trying topics that may unite suffering individuals under the common flag of struggle. Through experiential wisdom and a peer-to-peer support platform, self-help groups assist individuals to transgress the suffering associated with their mutually endured topic, such as chemical dependency, disease, addiction, substance abuse, social deviance, etc.

Due to their nature and design, self-help groups create community within the ranks of similarly afflicted and suffering individuals who, through the sharing of resources and narratives specific to their common ground, find the support to cope or change. According to Kurtz (1997) self-help groups can best be described as “a supportive, educational, usually change-oriented mutual aid groups that address a single life problem or condition shared by all members” (p. 11). While much research has been devoted in an effort to differentiate between self-help groups and traditional counseling psychology groups, Kultz (1997) demonstrates that the distinction between the two is not necessarily represented by a disparity in therapeutic value. Yalom (2005) identifies the “eleven distinguishing therapeutic factors of group psychotherapy: Installation of Hope, universality, imparting information, altruism, Corrective Recapitulation of the Primary Family Group, Development of Socialization Techniques, Imitative Behavior” (pp. 1-18). Through interviews and surveys with the participants of various self-help groups, Kurtz (1997) finds that seven of these factors are prevalent therapeutic trends of self-help groups while the remaining five can be noted as potential secondary benefits to those major therapeutic highlights (p. 19). As opposed to traditional modalities of aid, “self-help is highly personal, nonhierarchical and without division of labor, and self-help favors experience over expertise” Kurtz, 1997, p.11). Self-help is defined by its supportive group setting and its focus on resource-sharing and change, it can more appropriately be distinguished by its divergence from the traditional and formal institutions of support

To understand the history of self-help and the evolution of its practice into its current context, we must track the evolution of a general pattern of mutual aid and its prominence throughout history, across continents and where ever cultures of people have survived the trials of being. Before emerging into a modern context and before it’s dubbing ‘self-help’, similar practices of mutual aid and collective benefit are attributing factors in the survival of ancient tribal and clans people where other groups had perished (Katz, 1976, p. 267). These survivalist practices of mutual aid can be traced through the coping mechanisms of the European working class in response to the horrors of industrialization, and as a backlash to the shortcomings of the welfare state. Here, groups of similarly suffering individuals banded together in mutual support, forming friendly societies and unions to ease associated hardships (Katz, 1976, p.266). In America, practices of mutual aid are initially noted in the neighborliness of colonists who banded together in the production of necessities and against hardships of weather and conflict (Katz, 1997, p. 270). These practices undoubtedly enhanced their ability to survive together.

Self-help, as a brand of mutual aid, made its debut in America in 1935, with the establishment of Alcoholics Anonymous (Alcoholics Anonymous, 2013). It was not however until the post-war era that self-help emerged into the public forum as a popular and powerful alternative to conventional human service paradigms because of its utilization of peer-support and mutual aid. In the aftermath of WWII, and as a consequence to the changes brought about by the civil rights movement, Vietnam war and the war on poverty, a legacy of crisis remained in America that demanded the establishment of mutual aid and collective assistance for the beneficiaries of the time (Katz, 1976, p. 277). The parents of ill and handicapped children were the pioneers of popularizing self-help groups in the post-war era. With the civil rights movement contributed a general air of ‘power of the people’ and a faith in informal and collective power, other affinity groups quickly followed suit (Vattano, 1972). Key literature also emerged at this time, attempting to dissect the theory and relevance of this burgeoning trend. Articles by major social theorists like Alfred Katz, Leonard Borman, and Morton Lieberman addressed the emergence of self-help which further solicited and popularized its practice.

Since gaining momentum in the 1960s, self-help groups have become a major source of support for individuals struggling to transgress their afflictions. According to a 2000 study by the American Psychological Association “more Americans try to change their health behaviors through self-help [groups] than through all other forms of professionally designed programs” (Davison, 2000, p.205). In 2009 the U.S. Department of Health and Human Services reported that “five million people across the nation attended a self-help group in [that] year because of their use of alcohol or illicit drugs” (U.S.D.H.H.S, 2009). The sheer number of individuals seeking the support of self-help as a form of healing is a testament to its wide-spread prevalence in today’s society as a vibrant therapeutic practice.

Part II

In my journey to understand the merits of self-help, I attended a support group for the friends and family of individuals affected by Mood Disorders at the Bernstein Pavilion Center in New York. I chose to attend this group because I had previously visited the Institute with clients and had appreciated staff members for their attentiveness and respect. I was interested in this group because of the prevalence of mental health issues in the HIV positive community in which I hope to serve. Although there have been great advances in technology and retroviral medication, many individuals who are HIV or AIDS positive also struggle with some underlying physical or mental health issues. It is common for HIV positive individuals to suffer from feelings of acute emotional distress, depression, and anxiety, as these ailments have a tendency to accompany adverse life-events.

Many things went through my mind as I listened to the narratives of the group’s participants. Initially I found myself considering the theories that we had discussed in class, namely the pro’s and con’s information. I was intentional about class themes and reminded myself to listen, observe, respect and connect. As the group spoke freely about issues of general depression and mood disorders, I started to consider the dilemma that family members face as caregivers to the mentally ill. Through the stories shared, I was able to understand a bit more about some of the pressure that caregivers experience while in this role. Few participants addressed the need to mask or hide their own feelings in order to effectively support those who are sick, but I pondered this as well. As I sat there listening, I considered the potential for parallel experiences between my HIV clients and those who suffer from mental health disorders. Due to the nature of morbid illness and the complexity of coping with adverse life events, issues of mental health often accompany HIV and AIDS diagnosis. I considered the family of mental health suffering patients in this scenario and the potential for their suffering of similar expressions of grief and rage in their journeys to provide support to the ailing and bear witness to their woes. I thought about the potential toll on a loved one when receiving word that a brother, son, husband or wife is mentally ill. I considered the seamless transition of denial into fear, guilt, or anger, and the inevitable sadness and hopelessness that ensues when a loved one grieves for their failure to notice behavioral changes that may have prompted intervention. This brought about concerns regarding the way loved ones share equally in the distress of the afflicted, about their tendency to believe that they could have stalled the advancement of illness had they only noticed its progression earlier. I considered the potential for loved ones to respond to mental health issues in some manner that is consistent with family practices, and as I listened to the group, I noticed that some folks avoided speaking openly about the issues at hand out of what appeared to be fear. Perhaps a negative experience in the past where family members had taken that route had prompted this fear. In these cases, individuals sounded angry and sad and exuded an air of hopelessness. A participant described a situation in which a family member had developed an illness and they became the focal point for the family from that point on. Suddenly the family concern was monopolized by the struggles of this one individual and the family developed a tendency to forget about those who suffered as caregivers. Through these stories, I noted that additional burdens present themselves when coping mechanisms are deployed and suffering individuals manifest severe expressions of doubt, insult, and rage. Some group members admitted that their experience as caregivers had prompted their embracing spirituality to help cope with hardship and that they had found peace and hope therein. I was surprised to note that none of the participants expressed anger with God or a higher power.

A specific observation that I made of the group was the fact that only one out of eight participants seemed capable of separating the person from the illness. This successful separation was expressed through the narrative of a woman who was caring for her husband through his battle with high-level bipolar disorder. She allowed him to maintain his denial of the illness when in crisis and gave him the space to go through his process so that when he regained his baseline mind he was spared the feelings of guilt, sadness, and confusion that could potentially accompany his behavior. As a Case Manager I have experienced similar encounters with clients. They can be prompt to express anger when they are not obtaining services as fast as they would like or in the manner in which they prefer. Although I strongly considered sharing my experience as a means to share perspective, I maintained my role as a visitor and observer with respect for the integrity of the group.

I was pleased to note that the support group followed the same rules and guidelines as our class discussions. The facilitator opened and closed the meeting and was responsible for setting the tone of the discussion. The facilitator helped members to learn how to listen and offer support to one another and was effective in the interception of any and all problems that arose during the meeting. The format of the discussion was as follows: welcome /introduction; re-articulation of group rules; re-articulation of the weekly time and place of meetings; acknowledgment of participants; summary of speaking terms to help individuals clearly convey their personal experiences and emotions; breakdown of terminology for newcomers; confidentiality terms; summary by facilitator of conversations; honor all members chance to speak; last minutes questions and discussion opportunity; and a closure which involved a wrap-up speech and an invitation to attend future groups.

In reflection of this experience on a personal level, this opportunity has helped me to understand a bit more about the struggles that I have in my relationship with my daughter. This insight was enabled through my connection with the story of a woman who struggled thought out the years with her younger brother and the manifestations of his suffering from a low stage bipolar disorder. There were many common threads that I found woven through our individual stories, although I never spoke mine. What I took from her narrative was quite simple: to renegotiate my rules as mother is not necessarily a bad thing. This helped me to understand, on a personal level, and to really connect with the merits of self-help and in talking issues through. I could imagine myself finding comfort in communicating my frustrations with individuals who, through experience, understood exactly what I was going through. From this woman’s story, I learned that to resist the temptation to take my daughter’s behavior personally, I would be making a positive decision for our mutual relationship. This realization was essential for me in my personal life, but also paramount to my connecting professionally and theoretically with the spirit and virtues of self-help.

In professional reflection, I have learned that self-help groups bring together individuals who collectively suffer from similar and specific issues and concerns. This common ground may relate to the pains associated with illness, addiction, deviance or any other factors that may unite affected individuals. Self-help groups enable folks to share their feelings and experiences in a way that is therapeutic and meaningful for themselves and others. Support groups help individuals to identify and connect with others who are experiencing similar challenges, encouraging them to ‘come out of hiding’ and enabling their relation over shared experiences with one another. This helps people to avoid the feelings of isolation that may accompany the struggles inherent to their afflictions. This process may help to promote healthier coping tactics while talking honestly and openly in a group setting can help to reduce and combat stress, depression and/or anxiety. Along with countless merits, support groups propose an inexpensive and effective method for individuals to cope and change alongside the support of their peers.

In additional reflection, my attendance at this meeting was pivotal to my understanding of the meaning and manifestation of support through the context of self-help and alternatives to traditional aid. As a student of social work, the opportunity to bear witness to the struggles of others in an outsider and non-professional capacity was invaluable, as was the opportunity to be humbled by the expertise of experience that is essential to the healing that occurs in the peer-support model of therapy.

References

Alcoholics Anonymous. (2013). The history of alcoholics anonymous. Retrieved from www.aa.org

Davison, K. P.; Pennebaker, J.; Dickerson, S.S. (2000). Who talks? The social psychology of illness support groups. American Psychologist, volume 55, 205-217.

Department of Health and Human Services. (2009). Self-help groups and recovery. SAMHSA News, volume 17. Retrieved from http://www.samhsa.gov/samhsanewsletter/Volume_17_Number_1/SelfHelpGroups.aspx

Katz, A. H.; Bender, E. I. (1976). Self-help groups in western society. Journal of Applied Behavioral Sciences, volume 12, 265-282.

Kurtz, L. F. (1997). Self-help and support groups: a handbook for practitioners. Thousand Oaks: SAGE Publications.

Vattano, A. J.(1972). Power to the people: self-help groups. Social Work, volume 17, 7-15.

Yalom, I.D. (2005). The Therapeutic Factors. In The Theory and Practice of Group Psychotherapy (pp. 1-18). New York: Basic Books.