Written by Morgan D. Love, MSW, Clinical Therapist at CAST Centers
Researchers report a rampant increase in rates of depression, anxiety, loneliness, and traumatic loss during the COVID-19 pandemic (Marmarosh et al, 2020). Empirical literature provides evidence that the increase in mortality rate, loss of economic security, systemic racism, and social distancing have had a profound impact on adults from diverse socio-economic groups. Group therapy is an evidence-based treatment that is effective in treating symptoms of depression, anxiety, grief, complex trauma and other stress-related disorders. Humans thrive in systems of attachment, to include belonging and community, which is an innate part of our biology in absence of mental health disorders. The bio-psycho-social model is a holistic model representative of self and the intersectionality of the external world.
The field of mental health is a complex system that utilizes the integration of biological, psychological, social and spiritual systems to theoretically explain the variation of genetic and environmental influences on human behavior. Empirical literature provides evidence that the complex structure of the brain is shaped by human transactions with the external world (Cozolino, 2014). The frontal lobes are the largest structures within the cerebral cortex of the brain (Cozolino, 2017). The cerebral cortex systematically organizes conscious experiences and environmental interactions (Cozolino, 2017). The maturation process of the cerebral cortex is contingent on life experiences. Research substantiates that chronic stress may result in impairment of executive functioning capacities.
Empirical literature provides evidence that experiences of chronic stress can result in the excess production of glucocorticoids, which interfere with the structural development and functioning within the frontal lobe of the brain (Cozolino, 2017). Glucocorticoids are steroid molecules within the end of the hypothalamic-pituitary-adrenal (HPA) axis, which plays a fundamental role in the balance of rest and stress in relation to homeostasis within the body’s central nervous system (Charmandari et al, 2015). Glucocorticoids play an essential role in the maintenance of cardiovascular tone, and also acts as an agent of influence over the quality of inflammatory and immune responsiveness (Charmandari et al, 2015). The “stress hormone” cortisol is a primary glucocorticoid produced in the adrenal gland, with the primary function of responding to danger and environmental challenges (Cozolino, 2010). Cortisol is active in increasing memory, recycling energy and restoring homeostasis within the body following a brief episode of stress. Chronic stress results in the continuous release of the cortisol hormone, which inherently weakens the immune system (Cozolino, 2010).
Scientific knowledge substantiates that early, and chronic, exposure to stress is connected to deficits in short and long-term memory, complexities associated with affect regulation, and changes in structural volume within the hippocampus and amygdala (Cozolino, 2010). This neurochemical activity within the human brain actively shapes our life experiences, from a perspective of style of attachment, cognitive processes of reasoning, judgement and problem solving, as well as an individual’s perception of overall safety and experienced wellness. Episodes of stress may also impair executive functioning (planning, problem-solving and decision-making) within the frontal lobe, as well as result in dissociation within the region of the hippocampus. Culturally, chronic stress is often normalized, which results in individuals coping through maladaptive attachments, such as addiction, unhealthy compulsive behaviors (gambling, excessive spending, pornography) and codependent unhelpful relationships. The goal of group therapy is to support an individual’s innate need to integrate into meaningful community, while empowering individuals to examine mood and stress-related disorders from a holistic lens, with the goal of cultivating positive mental health outcomes.
Attachment Theory, Childhood Attachment and Adult Outcomes
The theory of attachment is conceptualized as the clinical compass to identifying therapeutic outcomes for children with trauma and stressor-related disorders. Attachment theory identifies individual interactions, with attachment figures, as the psychological marker for determining a child’s ability to develop social connections and healthy relationships during adulthood (Classen et al, 2014). It is imperative for clinical professionals to approach trauma-focused intervention, and assessment, from a biopsychosocial perspective. Research suggests that early childhood trauma experiences, with attachment figures, inherently alters the neurological structure and chemical connectivity of the brain (Corbin, 2007). Childhood attachment experiences are psychologically hindered by the presence of pathogenic caregiving, absentee parenting or traumatic disruption of early caregiving environment (Corbin, 2007). Stated specifiers of childhood neglect inhibits the neurological response of the Hypothalamic Pituitary Adrenal axis, which significantly impairs the regulation of the brain’s responsiveness to stress (Corbin, 2007). Childhood trauma and insecure attachment patterns influence behavioral and psychological outcomes during adulthood. Adults with a history of childhood trauma, and attachment insecurity, struggle to navigate safety within interpersonal relationships, and often demonstrate passive themes of powerlessness, distrust, shame, guilt and cycle of abuse patterns (Classen et al, 2014).
Research supports that adult participation in group therapy promotes direct participation in skill building within a safe and inclusive community, as evidenced by manifestation of a safe space to practice coping with immediate distress and connecting with others who are struggling with similar symptoms and (or) life experiences. Group participation also informs the clinical treatment team of bio-psycho-social needs, which further supports the individualized treatment plan. DBT (Dialectical Behavioral Therapy) is a component of cognitive behavioral treatment that helps people feel more effective in meeting their life goals and aspirations, with the goal increasing skill acquisition within the 4 domains of: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. CBT (Cognitive Behavioral Therapy) is a scientifically tested form of psychotherapy that emphasizes solving problems and initiating behavioral changes. Group members learn skills in identifying unhelpful thoughts, restructuring cognitive distortions, with the goal of relating better to others, improving mood (emotional state) and reducing maladaptive behavioral response.
Group psychotherapy researchers and practitioners report the importance of group leadership and group cohesion in treating depression, anxiety, trauma and stress-related disorders (Marmarosh et al, 2020). Empirical literature reports that, given the mental and physical health challenges presented by COVID-19, online group and on-site group therapy interventions are becoming more prevalent. In an evolving and changing world, where do you find your solace? Please join us at CAST Centers for a warm cup of tea. The group space is where your healing journey may commence.