Self-help therapy groups

1. Introduction

Version followed: Sheila Ernst & Lucy Goodison, In Our Own Hands: A Book of Self-Help Therapy (The Women's Press, London, 1981; US edition In Our Own Hands: A Woman's Guide to Self-Help Therapy, J.P. Tarcher, 1981), read alongside the leaderless practice of the London Red Therapy group (from 1974; pamphlet Red Therapy, 1978) whose experience the book drew on. Important limitation: the book itself and the Red Therapy pamphlet are not drawn on in this guide. Everything below about the group's principles is sourced to the pages cited; the step-by-step procedures are reconstructed from the parent methods the book is known to draw on and are tagged [uncertain] or [synthesis]. Check them against the book before relying on them. [source: Wellcome Collection record; Wikipedia, Sheila Ernst; MayDay Rooms]

What it is. This is not a single therapy. It is a movement and a how-to approach: groups of peers, with no paid leader, use humanistic and body-oriented techniques on one another inside a feminist and socialist frame. The book gives practical methods for running such groups. It grew out of the authors' experience of helping set up Red Therapy, a self-organised, leaderless radical therapy group that began in small informal meetings in London in 1974. Its members came from the women's liberation movement and the libertarian-communist group East London Big Flame. [source: Wikipedia, Sheila Ernst; MayDay Rooms pamphlet call; MayDay Rooms archive of the month] The book explored how people in therapy can make their own choices and keep their autonomy. It became a Time Out and City Limits alternative bestseller. [source: Wikipedia, Lucy Goodison]

Authors. Sheila Ernst (1941–2015) later worked at the Women's Therapy Centre in London (founded 1976 by Luise Eichenbaum and Susie Orbach), became a group analyst and developed a feminist group-analytic approach. Lucy Goodison (b. 1945) worked at the Women's Therapy Centre from 1977 to 1988. She is a body psychotherapist, therapeutic-massage practitioner and dance movement psychotherapist, and wrote The Dreams of Women (1995). [source: Wikipedia, Sheila Ernst; Wikipedia, Lucy Goodison]

How change happens. Distress is understood as partly produced by social conditions such as sex roles, class and the family. Members are treated as healthy people "trying to find their power", not as patients. Change comes from three things: emotional expression and bodily release in a safe peer setting; becoming aware of present experience (gestalt) and of the body (Reichian or bioenergetic work); and the group collectively linking personal feelings to their political context. Healing is treated as collective, not individual. [source: MayDay Rooms archive of the month (East London Big Flame's own account); MayDay Rooms pamphlet call] The mechanism as stated here is a synthesis of these sources. [synthesis]

What remains today. Leaderless self-help therapy groups of this kind are now mainly historical. Their descendants are co-counselling communities (e.g. Co-Counselling International, proposed in 1974), peer support groups, feminist consciousness-raising and group-analytic practice. A clinician today would mostly use this material to seed, consult to, or adapt a peer group, or to run a time-limited facilitated group that hands leadership over to its members. [source: AHP Self & Society 1974 (Heron, draft CCI proposal)] [synthesis]

2. Framework

The book is a toolkit, not a phased protocol. The phases below are a practical scaffold reconstructed from the sources and from how leaderless groups are known to run; none of it is quoted from the book. [synthesis] [uncertain]

Format (typical; check against the book) [uncertain]: a closed group of roughly 6–12 members meeting weekly for an evening session of about 2–3 hours, sometimes with weekend workshops. Groups were women-only, men-only or mixed. Red Therapy had no leader. Facilitation, timekeeping and "holding" roles rotate. Co-counselling pairs may meet between sessions. Red Therapy ran inside a wider political and community network (food co-op, claimants' union). [source: MayDay Rooms archive of the month for leaderless format and setting; AHP Self & Society 1974 for peer formats; group size and frequency [uncertain]]

Criteria for moving on are [synthesis]: the sources used give no formal progression criteria.

3. Guiding principles

• Leaderlessness / no infallible authority. Red Therapy "didn't believe in the group leader" as infallible. Practice: rotate the facilitator, timekeeper and helper roles. A professional who convenes the group says openly how and when they will step back. [source: MayDay Rooms archive of the month]
• Not sick, but seeking power. Members need not see themselves as ill to benefit. Practice: use the language of growth and power, not diagnosis, and do not label members. [source: MayDay Rooms archive of the month]
• The personal is political. Distress is placed in its historical and social context. Practice: in every cycle, ask how class, gender, race and family roles shape what came up. [source: MayDay Rooms pamphlet call; Wikipedia, Sheila Ernst]
• Collective rather than individual healing. Practice: the group, not one expert, holds the work. Members support one another and take part in each person's work. [source: MayDay Rooms pamphlet call]
• Reject liberal "stand on your own two feet" individualism. Practice: treat asking for help and depending on each other as legitimate, not as weakness. [source: MayDay Rooms archive of the month]
• Do not accept sex roles as given. Practice: notice and challenge gendered patterns in the group itself, e.g. who speaks, who comforts, who gets angry. [source: MayDay Rooms archive of the month]
• Autonomy and choice in therapy. Practice: the person working decides what to work on, which technique and when to stop. Others offer, never impose. [source: Wikipedia, Lucy Goodison]
• Client self-direction; the helper does not criticise, interpret or advise (co-counselling rule, as stated in 1974). Practice: the helper gives attention and suggestions that follow the contract the client asked for. [source: AHP Self & Society 1974 (Heron)]
• Experimental eclecticism. Red Therapy's practice was experimental. Practice: try techniques from several schools, then review together what helped. [source: MayDay Rooms pamphlet call]
• Body and mind are one. Goodison's work challenges the mind/body and thinking/feeling splits. Practice: include breathing, posture, movement and touch, not only talk. [source: Wikipedia, Lucy Goodison]
• Safety, consent and the right to stop [synthesis]. Practice: anyone can say stop at any time; physical work needs explicit consent each time.
• Shared time [synthesis, drawing on co-counselling's equal-time norm]. Practice: agree beforehand how time is shared, and track who has had time over several weeks.

4. Intervention inventory

Status of this inventory. In Our Own Hands is described as giving practical methods for running self-help groups, drawn from co-counselling, gestalt, body (Reichian/bioenergetic) work, psychodrama, dream and fantasy work, massage and encounter. The chapter list and exact exercises are [uncertain], because the book is not drawn on here. [uncertain] Each item below names the parent method it comes from. Steps are written in my own words as the standard form of that method, adapted to a leaderless peer group. [synthesis] All example language is illustrative and is not quoted from Ernst and Goodison. The co-counselling rules are the one exception: they are sourced to Heron's 1974 text. Physical and cathartic techniques carry risk flags; see section 5.

4.1 Convening the group and the ground-rules contract

• Purpose / when: before the first working session, and again whenever there is a crisis or a new member. A leaderless group depends on explicit agreements instead of a leader's authority. [source: MayDay Rooms (leaderless group; challenges of running one)] [synthesis for content]
• Steps: (1) The convenor writes a short statement of aims (e.g. a women's self-help therapy group using body and feeling work, plus political discussion) and circulates it. (2) An open meeting: each person says what they want and fear. (3) Decide on membership (closed or open, gender composition) and commitment (attendance, notice before leaving). (4) Agree ground rules. Typical ones [synthesis]: confidentiality (what is said stays; members may tell their own story outside but not others'); anyone may say "stop"; no violence to people or property (pillows, yes; people, no); no sex or romance between members while in the group, or disclose it to the group; no alcohol or drugs before sessions; each person is responsible for asking for what they need; feedback is given as "I" statements. (5) Agree roles and rotation: facilitator/timekeeper, "helper" or "counsellor" for whoever is working. (6) Agree how to get help in a crisis: names of local GPs and crisis services, and whether the group will contact anyone. (7) Write the agreements down and review them every few months.
• Example language (illustrative): "Before we try any exercises, can we agree what makes this safe enough? I'd like us each to name one thing we need from the group."
• Watch for: rules imposed by the most articulate person, which is hidden leadership; vague confidentiality; nobody holding crisis information. It's working when members refer back to the agreements unprompted.

4.2 Opening round (check-in)

• Purpose / when: start of every session. It lets each person arrive, shows who needs time, and spreads speaking evenly. [synthesis]
• Steps: (1) The facilitator for the night names a time limit per person (e.g. 1–2 minutes). (2) Go round the circle: how I am, anything left over from last week, whether I want time tonight. (3) No replies or advice during the round. (4) The facilitator then proposes how tonight's time will be split and checks agreement.
• Example language (illustrative): "Round: how you're arriving, and whether you want time tonight. No responses yet, just listening."
• Watch for: the same people always asking for time or never asking; rounds turning into discussion. Working when time requests spread across members over weeks.

4.3 Warm-ups (physical and contact exercises)

• Purpose / when: early in a session or at the start of a group, to shift from talking into the body and build trust. These are typical of humanistic growth-group practice. [uncertain whether particular exercises appear in the book]
• Steps (examples) [synthesis]: (1) Shaking out: stand, shake hands, arms, legs, whole body for a minute, then stand still and notice. (2) Walking the room: walk at different speeds, notice others, make or avoid eye contact on instruction. (3) Name-and-gesture round: say your name with a movement; the group repeats it. (4) Trust exercises with consent only: back-to-back leaning, or guided walk with eyes closed and a partner. (5) Brief sharing in pairs: "what did you notice?"
• Example language (illustrative): "Let's get out of our heads. Stand up and shake out your hands… now your shoulders… now everything. Stop. What do you notice in your body?"
• Watch for: members with mobility limits, trauma histories or touch aversion. Always give an opt-out ("do it in your mind, or watch"). Working when energy and talk in the room become more direct.

4.4 Co-counselling pairs

• Purpose / when: structured peer help between or within sessions. Each person gets equal, undivided attention; it builds counselling skills across the group. Co-counselling is "a two-way process among peers"; the client is self-directed; the counsellor intervenes according to the contract the client gives; the counsellor "does not criticise, interpret or advise". [source: AHP Self & Society 1974 (Heron)]
• Steps: (1) Pair up and set equal time (e.g. 20–45 minutes each). (2) The client states a contract: free attention only; or attention plus occasional suggestions; or the counsellor more active. (3) The client talks, moves and expresses feeling; the counsellor gives warm, relaxed attention. (4) If the contract allows, the counsellor makes brief suggestions, e.g. "say that again", "say it louder", or notices a gesture. These suggestions follow the client and offer no interpretation. (5) Signal the end two minutes before time. The client comes back into the present, e.g. by naming objects in the room or something they look forward to. (6) Swap roles. (7) Do not discuss the other person's material afterwards unless they invite it.
• Example language (illustrative): "What contract do you want, just attention, or suggestions too?" … "You clenched your fist as you said that. Want to stay with it?" … "Two minutes left. Tell me three things you can see in the room."
• Watch for: the counsellor advising or interpreting; unequal time; a client staying flooded at the end. Working when clients finish lighter or clearer and both partners keep the contract.

4.5 Individual "time" in the group (working in the middle)

• Purpose / when: the main working format. One member uses a block of group time for their own issue, with one or two members as helpers and the rest as witnesses and possible role-players. [synthesis, from gestalt-group and co-counselling-group formats] [uncertain re book's exact format]
• Steps: (1) The member asks for time; the timekeeper agrees a length (e.g. 15–30 minutes). (2) The member chooses a helper and states a contract: what they want to look at and which kind of help. (3) The helper keeps attention on the worker, offers techniques (4.6–4.16) as suggestions, and checks consent before any touch or any increase in intensity. (4) Others stay silent unless invited to role-play or support. (5) Warn at 5 and 2 minutes; close with grounding (4.18). (6) The worker chooses whether to hear brief feedback: only "I" statements about what others felt or recognised, no analysis.
• Example language (illustrative): "You've got 20 minutes. What would you like to use it for, and how do you want me to help?" … "Would you like anyone from the group to play your sister?"
• Watch for: helpers pushing their own agenda, and the group projecting onto the worker. Working when the worker reports a felt shift (relief, a new angle, a decision) and owns the direction taken.

4.6 Gestalt awareness continuum ("now I am aware…")

• Purpose / when: to bring talk back into present experience; useful at the start of time or when someone is intellectualising. [parent method: Gestalt therapy (Perls)] [uncertain re book wording]
• Steps: (1) The worker says aloud what they are aware of, one sentence at a time, starting "now I am aware…". (2) Include outer (sights, sounds), inner (sensations) and fantasy (thoughts, images). (3) The helper notices shifts to "why" or past-tense stories and invites a return to the present. (4) The helper picks up a strong sensation and suggests staying with it or giving it a voice.
• Example language (illustrative): "Instead of explaining, can you tell us what you're aware of right now? Start with 'Now I'm aware…'"
• Watch for: dissociation or numbness; slow down and ground (4.18). Working when speech becomes present-tense and the person contacts feeling.

4.7 Empty chair / dialogue between parts

• Purpose / when: for unfinished business with a person (parent, partner, boss), or an inner conflict (e.g. a "should" voice against a tired voice). [parent method: Gestalt therapy] [uncertain re book wording]
• Steps: (1) Place an empty chair or cushion. (2) The worker imagines the other person or part there and describes them. (3) The worker speaks directly to them ("you…"), in the present tense. (4) The worker switches seats and answers as the other. (5) Keep alternating; the helper suggests repeating, exaggerating or completing key sentences. (6) Stop when something resolves, or when the worker says enough. Then return to their own seat and say what they notice.
• Example language (illustrative): "Put your mother in that chair. What do you want to say to her that you never said?" … "Now go and sit in her chair. How does she answer?"
• Watch for: retraumatising confrontation with an abuser figure. Offer distance, e.g. put the chair far away or have a group member stand beside the worker. Working when the worker speaks more fully as themselves and something new is said.

4.8 Exaggeration, "being" a body part or gesture

• Purpose / when: a repeated gesture, tone or symptom seems meaningful. [parent method: Gestalt therapy] [uncertain re book]
• Steps: (1) The helper names the gesture neutrally. (2) Invite the worker to repeat it and make it bigger. (3) Invite them to give it a voice: "I am your foot, I…". (4) Follow whatever feeling emerges; link to 4.7 if a relationship appears.
• Example language (illustrative): "Your foot keeps tapping. Can you let it tap harder… if your foot could speak, what would it say?"
• Watch for: self-consciousness or shame; offer, don't insist. Working when the gesture yields a feeling or statement the person recognises.

4.9 Breathing and grounding (bioenergetic/Reichian body work)

• Purpose / when: to contact held feeling through the body. Goodison's later practice is body psychotherapy and massage. [source: Wikipedia, Lucy Goodison (her body-work orientation)] [parent methods: Reich, Lowen bioenergetics] [uncertain re book's specific exercises]
• Steps [synthesis]: (1) The worker stands with feet hip-width apart, knees soft, weight through the feet (grounding), or lies on a mat. (2) The helper invites slow, full breathing into the belly and chest, without forcing. (3) Notice where breath stops or tension holds (jaw, throat, chest, belly) and say so aloud. (4) Invite sound on the out-breath if it wants to come. (5) Follow emerging feeling into expression (4.10) or words. (6) Finish by standing, feeling the feet, and slowing the breath.
• Example language (illustrative): "Let your knees soften and feel the floor under your feet… breathe into your belly. Where does the breath seem to stop?"
• Watch for: hyperventilation (tingling, dizziness, cramping). If it happens, slow the breath, lengthen the out-breath and open the eyes. Watch also for panic or dissociation, or pain in people with heart, respiratory, pregnancy or seizure conditions; get medical clearance where relevant. [synthesis] Working when breathing deepens without strain and feeling becomes available.

4.10 Expressive release (pillow work, kicking, sound)

• Purpose / when: to let held anger or grief be expressed safely when a member is clearly holding it back. This is cathartic work typical of bioenergetic and encounter practice. [uncertain re book's exact procedure] Risk flag: catharsis can overwhelm and, in some people, intensify anger or trauma symptoms. Use only with consent, a clear contract and structure. [synthesis]
• Steps [synthesis]: (1) Agree the contract: what the worker wants to express, and that they may stop at any time. (2) Set up safely: a large cushion or mattress, space clear, others at a distance, glasses and jewellery off. (3) Kneel and hit the cushion with fists or a soft bat, or lie down and kick the mattress, or push against a helper's palms with consent. (4) Add sound and words ("No!", "Leave me alone!") if the worker wants. (5) The helper watches breathing and eyes and checks in. (6) Wind down slowly: slower movements, softer sounds, then stillness. (7) Ground (4.18) and make sense of it in words. Mark the end clearly.
• Example language (illustrative): "You've said you're furious. Would you like to try putting some of that into the cushion? You can stop whenever you say."
• Watch for: spiralling rage, a glazed or absent look, self-injury, re-enactment of violence, physical injury. Stop and ground if any appear. Working when the person feels relief and clarity afterwards, not exhaustion, shame or escalation.

4.11 Massage and safe touch

• Purpose / when: for comfort, body awareness and practising asking for and refusing touch. Goodison ran a 25-year therapeutic-massage practice. [source: Wikipedia, Lucy Goodison] [uncertain re book's massage chapter content]
• Steps [synthesis]: (1) Partners agree which areas are allowed and off-limits, and keep clothes on. (2) The receiver says what they want: pressure, speed, stillness. (3) The giver uses slow, simple strokes on back, shoulders, hands and feet, checking in at intervals. (4) The receiver practises saying "more", "less", "stop". (5) Swap. (6) Share briefly what it was like to ask, receive and refuse.
• Example language (illustrative): "Tell me where it's OK to touch and where it isn't. You can change your mind at any point."
• Watch for: sexualisation; freeze responses in people with abuse histories (some will not say stop, so check in verbally); gendered pressure in mixed groups. Working when members can state and change their limits.

4.12 Psychodrama enactment (scene, role reversal, doubling, sculpting)

• Purpose / when: to enact a scene, past or anticipated, with group members in roles. [parent method: Moreno's psychodrama] [uncertain re book wording]
• Steps [synthesis]: (1) The worker (protagonist) chooses a scene and briefly sets it: where, when, who is there. (2) The worker picks members to play the others and briefs them in a few lines. (3) Run the scene. The helper (acting as director) may ask the worker to swap roles (role reversal), invite a member to stand behind and voice unspoken feelings, with the worker accepting or rejecting each line (doubling), or ask the worker to sculpt the family by placing members in postures and distances. (4) Replay with a new ending if wanted (rehearsal). (5) De-role: role-players step out and say "I am not your father, I am Jo". (6) Sharing: members say what the scene stirred in them, not advice.
• Example language (illustrative): "Show us the kitchen. Who's there? Pick someone to be your father." … "Swap places: now you're him." … "Let's de-role. Everyone say who you really are."
• Watch for: role-players overplaying or getting caught up in their own material; incomplete de-roling. Working when the protagonist gains a new view of the other person or a new behaviour.

4.13 Dream work

• Purpose / when: a member brings a dream. Goodison later wrote a full book on exploring women's dreams. [source: Wikipedia, Lucy Goodison (The Dreams of Women, 1995)] The techniques here are standard gestalt and humanistic dream work. [uncertain re In Our Own Hands dream chapter]
• Steps [synthesis]: (1) Tell the dream in the present tense, first person. (2) Note the feeling on waking. (3) "Be" different elements, people or objects, and speak as them ("I am the locked door…"). (4) Run dialogues between elements (as in 4.7). (5) Optionally, others say what the dream would mean "if it were my dream", owned as their projection, and the dreamer keeps or discards each. (6) Link to waking life and social context, e.g. gendered images. (7) The dreamer may re-enter the dream in fantasy and change the ending.
• Example language (illustrative): "Tell it again as if it's happening now." … "Be the house. What kind of house are you?"
• Watch for: the group interpreting at the dreamer; nightmares linked to trauma, which should be grounded and not pushed. Working when the dreamer recognises a meaning for themselves.

4.14 Guided fantasy / visualisation

• Purpose / when: whole-group or individual exploration through imagery, e.g. a journey, a meeting with a wise figure, or a house. [parent methods: psychosynthesis and gestalt fantasy exercises] [uncertain re which fantasies the book gives]
• Steps [synthesis]: (1) Members sit or lie comfortably; eyes closed if they wish. (2) A member reads a slow, open-ended scene, leaving pauses and offering choices. (3) Bring members back slowly: notice the room, open eyes, move. (4) Pairs or the group share; drawing first is optional. (5) Anyone can explore an image further in their own time.
• Example language (illustrative): "Imagine you're walking along a path… notice what's around you… you come to a building. Take your time to notice what it's like."
• Watch for: frightening imagery, dissociation, trauma intrusion. Allow eyes-open participation and give a "come back any time" instruction. Working when images produce personal meaning and members return grounded.

4.15 Regression / early-memory work

• Purpose / when: to re-contact childhood feelings, used in some 1970s humanistic and primal-influenced groups. [uncertain whether and how the book includes it] Risk flag: regression in peer groups can trigger overwhelm and, with suggestive helpers, distorted or implanted "memories". A clinician should not encourage searching for unremembered abuse. [synthesis]
• Steps (cautious form) [synthesis]: (1) Work only with memories the person already has. (2) The worker describes a remembered scene in the present tense with eyes open or closed, while the helper keeps contact ("I'm here; you're in the room with us"). (3) Express what the child felt or needed. (4) The adult self or the group offers what was missing, in words or agreed touch. (5) Return fully to the present and to adult capacities before the session ends.
• Example language (illustrative): "Stay with the memory you've told us about, and keep one foot here with me. What does the little girl need?"
• Watch for: loss of present orientation, leading questions, abreaction that will not settle. Working when the person connects present reactions to past experience and feels steadier, not more fragmented.

4.16 Encounter-style feedback

• Purpose / when: to give direct, honest responses to one another about here-and-now behaviour; useful when tensions are unspoken. [parent method: encounter groups] [uncertain re book]
• Steps [synthesis]: (1) Ask permission: "Can I give you some feedback?" (2) Describe specific behaviour, then your feeling, using "When you…, I felt…". (3) The recipient listens, then says what fits. (4) A third member helps check that statements are owned, not attacks or diagnoses.
• Example language (illustrative): "When you laughed while Ann was crying, I felt uneasy. I wonder if that fits for you."
• Watch for: pile-ons and scapegoating (see section 5). Working when feedback changes behaviour and relationships deepen.

4.17 Political/contextual discussion (linking personal and political)

• Purpose / when: a regular slot, or after individual work, to place experience in historical and social context. This is central to Red Therapy and Ernst's later group-analytic work. [source: MayDay Rooms pamphlet call; Wikipedia, Sheila Ernst] [steps: synthesis]
• Steps: (1) Identify a common theme from the night's work, e.g. guilt about anger or caring for others. (2) Each member says how it shows up in their life. (3) Ask what in family, work, gender roles and class produces or rewards it. (4) Consider collective action or changes in the group's own practice. (5) Return to individual choices.
• Example language (illustrative): "Three of us worked on not being allowed to be angry. Where did we each learn that, and who benefits?"
• Watch for: discussion becoming abstract and avoiding feeling; members whose experience (race, class, sexuality) is unrepresented being silenced. Working when members feel less individually blamed and more connected.

4.18 Grounding and closing round

• Purpose / when: after every intense piece of work and at the end of each session, so members leave oriented and safe. [synthesis]
• Steps: (1) Stand or sit, feel the feet and body weight, breathe slowly. (2) Name things seen and heard in the room. (3) Closing round of one line each, e.g. "what I'm taking away". (4) Check that anyone who worked intensely is OK to travel home; arrange a phone check if needed. (5) Practical business afterwards.
• Example language (illustrative): "Feet on the floor. Look round and name three colours you can see. Now a last round: one sentence about how you're leaving."
• Watch for: someone leaving distressed or shut down; arrange follow-up. Working when members leave settled.

4.19 Process review meeting

• Purpose / when: regularly, e.g. every 6–8 sessions [synthesis], or whenever group dynamics hurt the work. It addresses "the challenges of running a leaderless self-help group". [source: MayDay Rooms pamphlet call] Walton's 1974 self-observation lens is useful here: notice feelings, posture, touch, and who looks at or avoids whom; notice group roles such as leader, scapegoat and wrecker, and recurring "games". [source: AHP Self & Society 1974 (Walton)]
• Steps [synthesis]: (1) Each member observes their own feelings and position in the group. (2) Round: who has taken leadership, who is silent, who rescues, who is blamed. (3) Look at time-sharing records. (4) Renegotiate agreements and rotate roles. (5) Decide on any concrete change.
• Example language (illustrative): "Let's take this session to look at us. I notice I've been the one starting things, and I'm not sure that's good for the group."
• Watch for: blaming individuals instead of looking at patterns. Working when roles rotate and participation evens out.

4.20 Endings and new members

• Purpose / when: a member leaves, the group closes, or new people join. [synthesis]
• Steps: (1) The leaver gives notice and attends planned final sessions. (2) Goodbye round: what each has valued and what each regrets. (3) For new members: a meeting to hear aims and ground rules, then a gradual start with rounds and pairs before intense work. (4) Revisit the agreements with the new composition.
• Example language (illustrative): "Before you go, let's each tell you one thing you've brought to this group."
• Watch for: abrupt drop-outs that leave unspoken grievances; new members being pushed into intense work too soon. Working when leavers go with a sense of completion and new members feel included.

5. Handling problems

The sources used confirm only that running a leaderless group brought challenges, and they name group roles such as leader, scapegoat and wrecker. [source: MayDay Rooms pamphlet call; AHP Self & Society 1974 (Walton)] The specific responses below are my own synthesis and are not taken from Ernst and Goodison. [synthesis]

• Hidden leadership emerging. One or two experienced or articulate members steer everything, which contradicts the rejection of an infallible leader. Response: name it in a process review (4.19); rotate the facilitator and timekeeper strictly; experienced members deliberately take the client role. If you are a professional who convened the group, set a date for handing over and stick to it. Until then, be explicit that you carry clinical responsibility. A group with a paid therapist is not leaderless, and your professional duty of care applies. [synthesis]
• Dependency on one member or on the convenor. Response: reflect it openly; build skills through co-counselling pairs (4.4); share crisis contacts so no single member is the safety net. [synthesis]
• Overwhelm, flooding, dissociation (especially in body, cathartic and regression work, 4.9–4.10, 4.15). Response: stop the technique; open the eyes; ground with feet on floor, naming objects and slow out-breaths; reduce stimulation; one calm helper speaks. Do not restart that night. Next session, agree a gentler contract. Members with known trauma histories should use titrated, eyes-open, verbal work first. [synthesis]
• Members needing more than a peer group (active psychosis, severe depression, suicidal thoughts, eating disorder with medical risk, substance dependence, current domestic violence). Response: agree at convening (4.1) that the group is not a crisis service. If risk appears, a member speaks privately with the person and asks directly about suicidal thoughts and plans. Help them contact their GP or crisis line, or emergency services if danger is immediate. With their agreement, support safe storage or removal of means at home. A clinician involved follows their usual risk-assessment and safeguarding procedures. [synthesis]
• Stuck client ("nothing happens when I have time"). Response: switch modality, e.g. from talk to body (4.9) or to imagery (4.14); work with the stuckness itself as a gestalt experiment ("be the wall"); or offer pair time instead of group time. Respect a choice not to work. [synthesis]
• Resistance to exercises. Response: in this tradition an opt-out is a legitimate choice, not resistance to overcome. Offer to watch, do it in imagination, or adapt. Explore the reluctance only if the member wants to. [synthesis, consistent with the autonomy principle (source: Wikipedia, Lucy Goodison)]
• Non-adherence: lateness, absence, unequal commitment. Response: refer to the agreed commitment; raise it in the opening round without shaming; agree a rule, e.g. three missed sessions triggers a conversation about staying. [synthesis]
• Scapegoating, pile-ons, a "wrecker" role. Response: stop the feedback; each person says what in themselves the scapegoated member stirs up; look at the pattern, not the person (4.19). [synthesis, using Walton's role list (source: AHP Self & Society 1974)]
• Ruptures between members (conflict, hurt, someone storming out). Response: someone contacts the absent member before the next session; open with a structured repair round of "I" statements, perhaps as a mediated pair conversation in front of the group; avoid taking sides. [synthesis]
• Sexual attraction, relationships and touch boundaries. Response: apply the ground rule on disclosure or abstention; keep massage and touch strictly consent-based (4.11); in mixed groups watch for gendered pressure, and consider single-sex groups. [synthesis, consistent with the principle of challenging sex roles (source: MayDay Rooms archive of the month)]
• Politics swamping feeling, or feeling ignoring politics. Response: timetable both, e.g. personal work then a contextual round (4.17), and check the balance at reviews. [synthesis]
• Members whose identities are marginalised in the group (race, class, sexuality, disability). Response: name differences of power explicitly; do not expect the minority member to educate the group; consider whether the group's aims really include them. [synthesis]
• Helpers interpreting, advising or imposing technique. Response: restate the co-counselling rule that the helper follows the client's contract and does not criticise, interpret or advise. [source: AHP Self & Society 1974 (Heron)]
• Implanted or suggested memories during regression. Response: no searching for unrecalled abuse; no leading questions; return to present-focused work; refer the person to a qualified trauma therapist if trauma material emerges. [synthesis]
• Group decline or ending. Response: hold an explicit decision meeting; plan closing sessions (4.20) instead of letting the group fade away. [synthesis]

Sources

Sources

• In our own hands: a book of self-help therapy (Wellcome Collection catalogue record)
• In our own hands: a woman's guide to self-help therapy (University of Pennsylvania library record, Tarcher US edition)
• Feminist Library catalogue record, In Our Own Hands
• Sheila Ernst (Wikipedia)
• Lucy Goodison (Wikipedia)
• MayDay Rooms pamphlet 03: Red Therapy (call for submissions describing Red Therapy and its 1978 pamphlet)
• MayDay Rooms: Archive of the month, East London (East London Big Flame and Red Therapy)
• AHP Self & Society, c. 1974, pp. 24–26: Heron, "Draft proposal: Co-counselling International"; Walton, "What's going on?"
• Goodreads, In Our Own Hands (publisher description only)

Further reading (not drawn on) [uncertain]: the Red Therapy pamphlet (1978), linked from MayDay Rooms and hosted by East London Big Flame; the British Journal of Psychiatry review of In Our Own Hands (Cambridge Core).

Further reading (not drawn on)

• Ernst, S. & Goodison, L. (1981). In Our Own Hands: A Book of Self-Help Therapy. London: The Women's Press. (US ed.: In Our Own Hands: A Woman's Guide to Self-Help Therapy, Los Angeles: J.P. Tarcher, 1981.)
• Red Therapy (1978). Red Therapy. London: self-published pamphlet.
• Goodison, L. (1995). The Dreams of Women: Exploring and Interpreting Women's Dreams. London: The Women's Press.
• Ernst, S. & Maguire, M. (eds) (1987). Living with the Sphinx: Papers from the Women's Therapy Centre. London: The Women's Press.
• Barnes, B., Ernst, S. & Hyde, K. (1999). An Introduction to Groupwork: A Group-Analytic Perspective. London: Palgrave.