Vinny Malik Dehili & E Merten
What is Group Therapy?
Group therapy is life through real stories and relationships. Put simply, throughout life we connect through relationships and groups. As children, we enter the world attached to another and express ourselves through relationships. These real relationships cultivate an imagined sense of self, others, and give meaning to the world around us. As adults, group therapy may look like people sitting around a circle, introducing themselves to one another and sharing experiences with alcohol use, family trauma, or grief.
From a Western lens, one might describe group psychotherapy as a setting where 1-2 group facilitators lead a session with multiple people to help reduce symptoms that can range from anxiety, depression, trauma, and/or interpersonal distress. From an Eastern lens, one could describe group therapy as a practice of understanding one’s self, others, and the systems that influence the way their thinking, feelings, and actions. Understanding, as Thich Nhat Hanh notes, is love’s other name.
Relationships are what makes life worth living. It also, anthropologically, is a necessary building block for life to exist at all with neurobiological mechanisms in our bodies that requires us to have basic emotional needs met. Self-Psychology highlights a list of these various basic emotional needs that each of us has. They provide the understanding that presuming one day we will be grown up enough to not need to feel loved or held by others is equivalent to believing that when one grows up enough, one will no longer be dependent on the air to breathe since they’ll have gotten enough air earlier in life. Nature cannot exist in a vacuum and neither can any of us.
Group therapy, thus, can be a dialectic between these two stances. By being able to dialogue around our emotional experiences within ourselves, within our lives, and with others in the room, we begin to notice the meaning and purpose of our relational experiences and can seek to explore and find new ways to navigate the terrain of life with people alongside us. Group therapy can be a series of relationships where people sit in a circle and go on a journey agreeing to grow alongside each other into lands unknown in life.
What are Tabletop Roleplaying Games (TTRPGs)?
Tabletop roleplaying is life through imagined stories and relationships. Put simply, throughout life we connect through imagination and stories. As children, we enter the world through play and express ourselves through imagination. Those imagined moments cultivate a real sense of joy, creativity, and give meaning to the world around us. As adults, TTRPGs may look like people sitting around a table joking, laughing, improvising storytelling, and hearing the click-clacking of dice hitting the table with shouts of joy and terror depending on the result when picturing tabletop roleplaying games like Dungeons and Dragons (D&D).
There has been a huge mainstream shift in bringing D&D, alongside other TTRPGs, into the limelight and consciousness of the public through TV shows (e.g. Stranger Things, Vox Machina, Mighty Nein, etc.), video games (e.g. Baulder’s Gate 3), and online actual plays (e.g. Dimension 20, Critical Role, etc.).
Tabletop roleplaying games (TTRPGs) are collaborative storytelling experiences where players assume fictional character roles and are guided by a facilitator. The storytelling facilitator is the gamemaster (GM), plays the roles of non-player characters (NPCs) and uses narrative to paint a scene in the imagination of the players minds, sending them on quests and co-creating stories through improvisational dialogue, simulated combat, and rolling dice. The dice are random chance element to the game, where if there is a moment of chance that can take place within the scene (e.g., a player attempts to sneak around a corner and pickpocket a guards key) then the player rolls a twenty sided dice with a high roll or low roll leading to a different meaningful consequence. Colloquially, when players roll high they may view this as a success and when they roll low it is spoken as a failure, but in reality, there is no failure, there is just a different path that the story will now unfold or emerge into.
Similar to group therapy, the goals of Tabletop roleplaying can vary. One clear benefit of both of these modalities is having a ritualistic space where people in relationships craft meaningful stories with one another. With TTRPGs, these stories often involve the use of fantasy characters. These characters can represent parts of their hearts and minds while going on unique adventures through fantastical lands. As in group therapy, members grow alongside each other, support one another and fill in the gaps with each person’s unique skills and expertise being used to strengthen the group as a whole and each member within it.
What is Collaborative Roleplaying Integrative Therapy (CRIT)?
Recently, my colleagues and I published our second article in a series of three in the Eastern Group Psychotherapy Society’s GROUP journal. The first article reviewed the history of D&D as well as the historical context of TTRPGs within the field of mental health. The second article introduces CRIT which is a transtheoretical model that highlights the parallel curative factors in other group theories and how they overlap with TTRPGs. Similar to Yalom’s common factors, CRIT proposes nine dialectical therapeutic factors that encapsulate conceptual clusters of what makes these experiences meaningful contributions to interpersonal growth in members. The third article, being written currently, will focus on a transcript in-game to demonstrate the aspects of CRIT that can be seen within the roleplaying experience.
In CRIT, players/group members reflect on the stories of their lives and discuss what interpersonal armor they’ve forged due to the nature of the world around them. This begins the discovery process by making meaning and purpose out of the pain and suffering people have experienced. Rather than reflecting on resistances to change, CRIT emphasizes and buddhist-informed approach where one is encouraged to shine a light of awareness of how the systems, be that family, friends, or institutions have caused the group member to adapt in meaningful ways interpersonally to be able to survive and thrive by forging a certain kind of insulation and armor to protect them from harm and allow them to experience being “good enough” to be warmed by the fire of a significant other’s embrace. From there, we reflect on how this armor, like all armor people may be given by life, is protective and rigid, and invoke members to be curious about what is limiting about this armor and what could be useful about stretching themselves interpersonally not to rid themselves of the previous armament, but to allow an expansion to the class of skills and abilities they have at their disposal to tackle lives challenges.
From this, members reflect on understanding what narratives they hold in their minds about themselves, recognizing the only reason we have stories internally is because someone or some system has told or shown us that story externally. Group members then create a fantasy character that has parallels to their own life narrative, while highlighting the differences and contrasting the ways in which their character has adapted differently to them.
As an example, Clementine (pseudonym) was assigned male at birth and joined a CRIT group with the desire to own her identity as a woman, introducing herself to the group from the beginning with her chosen name and owning her feminine expressions and empowerment throughout the roleplaying process. This led to various memorable moments when her character, brimming with sass and confidence, would quip, cajole, and eyeroll, sparking joy and laughter among the group members who were able to feel pride in the way that Clementine was leaning into this novel expression of self. Each act of playful defiance within the group was celebrated as a parallel resistance to the oppressive force of societal transphobia. Clementine’s openness to challenging gender binaries also allowed an expansion within the other group members as more of them attended session with make-up and nail polish on, treating the therapy space as an opportunity to play with the fluidity of gender and discover their own authentic gender euphoria.
This case example demonstrates one (Play and Work) of the nine dialectical therapeutic factors of CRIT.
If you’re interested in hearing more about how CRIT can allow for greater client growth and self-expression, my coauthor, E Merten and I, check out our Substack, Critical Process, where we have created an overview of all the therapeutic factors as well as access tothe full article: