Why group therapy works for men like you

There is a moment that happens in almost every group we have run, usually in the first few sessions, that I have come to think of as one of the most clinically significant things that occurs in this work. It is not a technique. It is not an exercise. It is a moment of recognition.

A man says something honest about his experience, something he has carried privately, something he assumed was specific to him and would not be understood. And another man in the room says, in some form: yes, that. I know that exactly. I thought it was only me.

That moment of recognition is not a warm-up to the therapeutic work. It is some of the most important work there is.

That moment of recognition is not a warm-up to the therapeutic work. It is some of the most important work there is. And understanding why requires thinking carefully about what shame does, and what it specifically needs in order to begin to shift.

What shame requires to survive

Shame is specifically a social emotion.

Shame is not like other difficult emotions. Sadness can be sat with alone. Anxiety can be managed privately, to a degree. Shame is specifically a social emotion. It evolved in the context of groups, of belonging and exclusion, of being seen and found wanting. And it requires, for its full destructive power, a particular condition: secrecy.

The experience of carrying something alone, of being the only one, of knowing that if the people around you knew the truth they would withdraw, is not just a feature of shame. It is its primary mechanism. Shame tells a man that what he is carrying is uniquely bad, uniquely his, and uniquely disqualifying. And as long as it remains unspoken, it cannot be contradicted.

This is why disclosure, which sounds like the most frightening thing imaginable to most men before they do it, tends to produce relief rather than the catastrophe that was anticipated. Not because the thing disclosed was not real, but because the isolation that shame depends on is broken. The weight that was heaviest partly because it was carried alone is now shared, and in being shared it changes.

Why group therapy specifically

Individual therapy can provide much of what I have described: a space to speak honestly, a listener who does not withdraw, a gradual process of making the unspoken speakable. It is valuable and for some men it is the right starting point.

But it cannot provide the specific thing that a group provides. The experience of other men.

The reason this matters is rooted in the particular quality of the shame that compulsive sexual behaviour tends to produce. It is not just about the behaviour. It is about the fear of being seen as the only man who struggles in this way, by other men, in a world where men are supposed to be in control. Individual therapy involves a professional whose job is to be non-judgmental. That is important. But it is not the same as the experience of being honest about your sexual struggles in a room full of men who are not professionals, who have their own versions of the same experience, and who respond not with clinical neutrality but with recognition.

The moment of recognition, I thought it was only me, is only available in a group. It cannot be replicated in individual work. And it is, in my clinical experience, one of the most powerful single interventions available in this territory.

What the group actually provides

The group provides several things simultaneously that are difficult or impossible to replicate elsewhere.

Universality: the direct experience of not being alone in the struggle. Not as a concept, not as reassurance from a therapist, but as a lived reality discovered in real time.

Witnessing: the experience of being seen by other men who understand from the inside. This is qualitatively different from being seen by a professional or by a partner, because it removes the two most common fears about disclosure; that the listener will not understand, or that the listener will judge. The men in the room know what you are talking about because they have been there.

Modelling: seeing other men who are further along in the process, who have done the work and experienced change, is evidence in a way that no amount of clinical reassurance can be. It makes change feel possible in a way that is specifically difficult to produce in individual therapy.

Community: the experience of belonging to a group of men with whom something genuine is shared. For many of the men I work with, this is the first experience of male community that does not require the performance of strength or the management of how they are perceived. The group is a space where the actual self is welcome, not a curated version of it.

The research on group therapy

The case for group therapy in this context is not just clinical intuition. The published outcomes from the programme this work is drawn from, showed significant reductions in compulsive behaviours across multiple cohorts of men, most of whom had previously tried other approaches without sustained success. The group format, with its specific combination of psychoeducation, skill building and the relational processes described above, produced change at a level and consistency that individual therapy alone tends not to match for this particular presentation.

I include this not to make a sales pitch, but because men who have tried individual therapy without success sometimes conclude that nothing will work for them. The evidence suggests a different conclusion: that the modality matters, and that for compulsive sexual behaviour specifically, the group is often where the change becomes possible.

What it feels like to arrive

Most men arrive at their first group session carrying a version of the same thing: the anticipation of exposure, the fear that what they carry is worse than what anyone else in the room is carrying, and the conviction that they will feel more alone after the session than before it.

Almost universally, that is not what happens.

What happens instead is that the room turns out to contain men who understand. Some of what is said turns out to have been thought by other men. The silence that has made the struggle feel so specifically isolating turns out to be a silence that several men in the room have also been keeping. And the relief of that discovery, the particular release of no longer being the only one, is the beginning of something that is very difficult to produce any other way.

For more on the loneliness that brings men to this work, see The loneliness behind compulsive sexual behaviour and Why men struggle to talk to each other.

Information about applying to the programme is on the apply page.

Dr Michael Yates is an HCPC-registered Clinical Psychologist and Psychosexual Specialist. He is an EFS-ESSM Certified Psychosexologist and COSRT-registered Sex and Relationship Therapist.