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RBC Letter

Vol. 74 No. 3 — May/June 1993 —
A Room and a Coffee Pot

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Support groups have been springing up everywhere lately to strengthen people's ability to cope with personal problems. They activate the healing power of faith, hope, and charity. They also prove an old theory: that you can't do good for another person without doing good for yourself...

It is insufficiently recognized in the news of all the bad things that are going on in this world that a lot of good things are also happening. God knows the human race has problems - new and different ones, it seems, every day. But the problems are not, as in the past, simply being allowed to take their course; people are resisting them, coping with them, trying to eliminate or mitigate their causes. And in this way, good is coming out of bad, bringing hope to countless individuals who otherwise might be doomed to a life of misery.

There could be no better example of this phenomenon than the support group movement which has grown up in recent years to help people to cope with personal afflictions. In the English language the movement also goes under the heading of "self-help" a term that is somewhat misleading at first glance. In a great many cases, people turn to these groups precisely because they cannot help themselves: they have surrendered control over their own behaviour to an addiction or other form of inner compulsion. They need the help of others to restore their personal autonomy.

There is, however, some validity to the term when you consider the psychological process that takes place when people decide to join support groups. First, they refuse to let a problem run rampant without fighting back. Then, rather than handing the problem over to a professional, as a litigant would hand a law suit over to a lawyer, they take responsibility for dealing with their own cases in association with fellow-sufferers. Most well-established support groups welcome professional counsel, but professional participation is ancillary to their "do-it-yourself" approach.

The concept of self-help originated in the United States in 1935 with the formation of Alcoholics Anonymous. In those days little help was available for alcohol addiction outside of hospitals. AA's founders developed a step-by-step program of recovery from their addiction centred on meetings at which alcoholics related their experiences and compared notes on how to stay sober. They set up a system through which members could call on the moral support of their fellows in moments of weakness at any time of day or night.

Of course, the idea of mutual support was not new: on the contrary, it goes back to the very beginnings of civilization. The first human settlements were built by people who faced common hardships and dangers and realized that their burdens were lightened when they were shared. People formed religious congregations which brought the strength of unity to the task of aiding the weaker members of their society. At the centre of it all was the extended family, consisting not only of parents and children, but of grandparents, cousins, uncles and aunts.

What was new about AA was that it responded to the needs of a society in which the role of the family was diminishing. Today the extended family, with more or less all of its members in one place, has largely become a thing of the past. In North America, mobility is part of the culture. When people are scattered all over the map, they become less likely to turn to their families in times of trouble than if they had stayed in their places of birth.

It is interesting that one of the founders of Alcoholics Anonymous was living away from home when the movement started. He was a stockbroker from New York City working in Akron, Ohio, on a business deal. The venture failed, and he was tempted to resume drinking after a long spell of sobriety. He sought out another alcoholic, a local physician, and helped the latter overcome his own drinking problem. Soon both were permanently sober, and together they laid down the principles of AA.

The word "Anonymous" originally referred to the idea that not being required to disclose one's name or other personal details encourages a healthy process of "opening up" about one's feelings and failures. But it also carries echoes of the isolation and alienation that have led to so many human problems in modern western society.

Simply admitting to a problem is a big step
towards recovery

Recent years have brought a rash of family breakups along with the decline of the family-based community as a result of the steady migration from rural to urban areas. Fewer and fewer people actively practise religion, more and more of them are living alone, and vast numbers of children are being raised in the absence of one of their parents. All these trends detract from the emotional stability which individuals once found among their families, neighbourhoods, and communities.

Still, people today tend to romanticize and mythologize the old- fashioned way of life, forgetting that the cosy little towns of yesteryear could be very cruel to those who did not conform to their orthodoxies. In such a milieu, men and women with personal problems either kept them hidden or ran the risk of being ostracized, bringing disrepute to their families as well.

The advantage of a support group over a community in dealing with aberrant behaviour is that members of support groups are unlikely to take a censorious view of human frailties. Their own knowledge of how easy it is to succumb to weakness prevents them from making severe judgments. If a member falters and goes back to the old destructive ways, he or she is more likely to be regarded as a salutary negative example than as a failure to be despised.

As for the family, the emotional support offered by self-help groups goes beyond what any family can be expected to offer. "Self- helpers" find they can express thoughts and feelings to their peers which they could never reveal to their most intimate or sympathetic relatives.

Indeed family relationships are among the main sources of the troubles that drive people to seek help in the first place. Several years after AA was founded, a group of its members formed Al-Anon, designed to help the spouses of actively alcoholic partners. Now called Al-Anon Family Groups, it has become an umbrella organization covering the companions, relatives, friends and children of alcoholics.

The original "anonymous" movements have since been emulated by a large number of groups: Gamblers Anonymous, Narcotics Anonymous, Divorce Anonymous, Debtors Anonymous, Overeaters Anonymous, and Emotions Anonymous, to mention a few of the more prominent ones. Anonymity is by no means universal among support groups, but it is considered useful in situations where people are embarrassed by their problem because society attaches a stigma to it.

Anonymity also helps to make at least some group members feel that they can talk sincerely about themselves, withholding nothing. To cover up addictions and personal pain, people in trouble become adept at deceiving those around them, and deceiving themselves into the bargain. Therefore self-help programs entail a "searching and fearless moral inventory" which is best accomplished in the company of people who have had similar experiences. They are not likely to be shocked by frank revelations, or duped by lies or partial truths about oneself.

"No person is ever made better by having someone else tell him how rotten he is; but many are made better by avowing the guilt themselves," wrote Bishop Fulton J. Sheen. The popular Roman Catholic churchman obviously had a keen appreciation of the curative properties of the confessional. For many, the cathartic effect of admitting to others that they have a problem at all is a big step towards recovery.

People are conditioned to feel ashamed of personal problems that are serious enough to call for outside help, and trying to cover their shame tends to isolate them from society. Merely "coming out with it" brings a liberating feeling of relief which is intensified by the realization that other group members have behaved just as self-destructively, and hurt as many others while doing so, as oneself.

Individuals who keep telling themselves "how rotten they are" are likely to find others in their group who are clearly not rotten at heart, but who nevertheless have been down the same grim road as they have. It is strangely encouraging to know that one is not alone in having a particular problem. To know that others can muster the strength to fight it stiffens one's own resolve to persevere.

The toughest obstacle to personal reform is the fatalism that whispers inwardly, "I'll never be able to change, so it's no use trying." It dwells in people who have unsuccessfully attempted to " kick" their habits so many times that they have given up struggling with their own personalities.

But usually they have tried to do it alone, forgetting that they have become expert at fooling themselves - at rationalizing their behaviour and finding excuses for persisting in it. We all make our own worst role models, whereas support groups provide living examples of deeply troubled souls who have succeeded in remodelling their personalities.

It is part of their continuing therapy to help others do the same. One of the tenets of self-help for addicts is that addictions are never conquered, merely arrested. Like the stockbroker co-founder of AA, many addicts find that the best way to avert a relapse is to work with others in attempting to deal with their common plight.

Being called upon to support others may bring out hidden strengths

The dynamics of support groups confirm the saying that you can't help another person without helping yourself. In the exchange of experiences, feelings and practical techniques for getting along in life, every helper becomes a "helpee."

New members meet people they can honestly respect; not case studies in a textbook or metaphorical figures in a sermon, but living human beings who "know what they're talking about," who have "been there. " This empathy goes a long way towards making support groups work, particularly among those who initially had their doubts about joining. When they see individuals like themselves who are living normally and enjoying it, they realize that the problems that have dragged them down are not insoluble for anyone.

In the process of give and take, people who had lost their self- respect because of the degrading nature of their habits can regain it. Men and women who have come to think of themselves as spineless may discover untapped sources of spiritual strength when they are called upon to support others. In extremely damaging cases of addiction, a loss of self-respect is half the problem. When participation in a group helps to bring it back, half the battle is won.

"The people who influence you are the people who believe in you," the Scottish writer and lecturer Henry Drummond wrote. Confidence in every person's inner strength is the philosophical backbone of any support group. Of course, not everybody follows a program through to success; in Alcoholics Anonymous, for example, roughly one-third never drink again, one-third lapse and later resume the program, and one-third resume drinking permanently. But the failure rate does not contradict the concept. The concept is that, though not everybody changes, everybody has the latent capacity for change.

At the stage in their lives when people resort to joining addiction- based groups, they are usually in fairly desperate condition. Even at that, addicts will sometimes relapse into their addictive habits several times before they shed them for good. It is common practice in traditional self-help programs for members to "hit bottom" before they finally recover. But lately the movement has entered a new phase in which the healing power of mutual support is being extended to individuals who have not lost control over their lives, but who nonetheless need support.

In the past few years, literally hundreds of new groups have sprung up in North America and Western Europe. They form a distinctly late- century phenomenon which owes much to urbanization and advanced technology. Through modern communications equipment and access to the media, people with mutual problems are able to arrange meetings and keep in touch with one another in ways that were impossible a few years ago. Telephones, faxes, answering machines, electronic billboards and the like have enabled people with unusual problems to seek each other out.

An example is alopecia areata, the total loss of hair. Men, women and children who felt they were alone in having to live with this condition now find comfort and confidence in groups that include spouses and parents besides themselves.

While a variety of physical problems are being dealt with by recently-formed groups, family disorders continue to figure prominently in the list of those concerned with psychology. Adults who have never been able to get over the distress of growing up in dysfunctional families have joined together in groups like Adult Prisoners of Childhood Anonymous and Healing the Inner Child. There are groups for the spouses and children of the mentally ill, for victims of family sexual and physical abuse, for violent parents, and for the parents of difficult children. There are groups for spouses suffering bereavement, and for the families of people who have committed suicide.

Usually the first thing anyone learns after joining such groups is that there are a great many others in the same situation. This helps to answer the poignant question, "Why me?" For example, the parents of teenagers who have committed suicide feel less singled out for tragedy when they sit down with others who have suffered through the same trauma. They are able to discuss their feelings of failure, shame and guilt in a way which they could not do among friends and neighbours, who are prone to pretend that nothing happened. Among themselves, the parents are able to talk about "the things we don't talk about."

In western cultures the leading taboo subject is death, especially when it comes to talking to people who are expressly threatened by it. The support group has proved to be an ideal vehicle for coming to terms with the mental turmoil, fear and alienation of conditions like cancer and AIDS. Not only can fellow-sufferers lend comfort and moral support to each other, they can gather practical information on the medical aspects of their diseases. Cancer patients trade notes on the side-effects of various treatments, and the AIDS and HIV-positive groups act as clearing houses for new information concerning AIDS.

Do new groups encourage recruits to find reasons
for self- pity?

The pragmatic functions of support groups should not be discounted. When, for example, a group was established in Toronto for recently widowed men, home economists were invited in to offer tips on how to prepare meals and do housework, things some members had never done before. Groups for the hearing-impaired conduct workshops in lip reading and sign language. Those devoted to obsessive- compulsive disorders combine behaviour therapy with experimental medication. When support group members with respiratory ailments meet, they take physical exercises to help them breathe more easily.

Though groups such as these are only too glad to have professionals around to lend them their expertise, there is an anti-professional element in the self-help movement. In fact, some groups have grown directly out of dissatisfaction with the professional care offered in their fields. There are those who accuse the medical and social work professions of a lack of both imagination and sympathy in dealing with their particular interests. Some maintain that no one who has not suffered as they have is in any position to help people like them.

The answer to that from the professional point of view is that you don't have to have appendicitis to treat appendicitis. Following this line of reasoning, many doctors are less than enthusiastic about self-help groups. Some psychiatrists see them as purveying a kind of psychological self-medication through which people seek to escape from their problems rather than work on the resolution of them. Professionals also express concern that participants with truly serious problems may not obtain the expert assistance they need because they are using self-help as a substitute for formal care, rather than as a supplement.

Critics of the movement say that some groups have been formed to deal with ridiculously trivial complaints which were formerly ranked among the normal tribulations of living. In this way, the critics charge, they encourage people to search for reasons for feeling sorry for themselves.

Addressing the spiritual aspects of psychological and medical ills

The movement does seem to have spawned a few "groupies" who flit from one group to the next, but they may merely be attracted by the socialization that inevitably arises. Support groups are not totally consumed by expressions of angst; laughter has a large and healthy role to play when people talk about their common woes. They have their dances, their pot-luck suppers, their birthday cakes. The kind of conditions that call for the formation of support groups often condemn their sufferers to painful loneliness. Enjoying themselves among kindred spirits may give them the confidence to resume more normal social lives.

The aims of support groups vary far and wide, but they all have one thing in common: they mobilize the wonderful psychic power of human sympathy. It is the rare paid professional who can be expected to drop by a person's home, have a cup of coffee and a heart-to-heart talk, and leave with a word of encouragement and a hug. Support group members do that. The type of therapy they offer cannot be duplicated by scientific methods. There is no substitute for personal concern and warmth.

In broad social terms, the support group is an idea whose time has come. In a society of urban strangers, it provides precious opportunities to reach out and touch others in a special way. In addition, campaigns to reduce government deficits have brought drastic spending cuts in the medical and social welfare systems, so that less professional help is available than formerly. The resources that remain clearly should be husbanded for those who need them most.

The do-it-yourself approach is ideally suited to the age of public austerity. Instead of the expensive facilities provided in the public sector, all you need to start a support group is a room and a coffee pot.

No reasonable person in the movement would contend that support groups can take the place of the established medical or social service system. Still, they have proved to be a valuable adjunct to an institutional system which, for all its sophistication, is often ill-equipped to cope with the spiritual dimensions of psychological and medical ills. Support groups bring to bear on human problems the spiritual values of faith, hope and charity. And whenever these virtues have been applied to the human condition, they have never failed to have a healing effect.

 

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