An Examination of Group Work with Old Lesbians Struggling with a Lack of Intimacy by Using a Record of Service
by Kris Drumm, MSW

  SUMMARY

This article portrays the struggles old lesbians face in creating intimate friendships by using a Record of Service (ROS) of a support group. Using the ROS as an analytical tool, this paper demonstrates
the efficacy of group work with this client population. The article also offers an explanation of the uses and mechanisms of the Record of Service and proffers it as a tool for accountability, practice examination,
and skills improvement. Two sessions of a weekly support group for lesbians over sixty-years-old, conducted at SAGE (Senior Action in a Gay Environment), are excerpted to give the reader a personal view of this unique population as well as the practice of group work and the use of ROS. In the concluding analysis, the author critiques her interventions as well as the progress of the group.

Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH.
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© 2004 by The Haworth Press, Inc. All rights reserved.
[Haworth co-indexing entry note]: “An Examination of Group Work with Old Lesbians Struggling with a
Lack of Intimacy by Using a Record of Service.” Drumm, Kris. Co-published simultaneously in Journal of
Gerontological Social Work (The Haworth Social Work Practice Press, an imprint of The Haworth Press,
Inc.) Vol. 44, No. 1/2, 2004, pp. 25-52; and: Group Work and Aging: Issues in Practice, Research, and Education (ed: Robert Salmon, and Roberta Graziano) The Haworth Social Work Practice Press, an imprint of The Haworth Press, Inc., 2004, pp. 25-52.
Digital Object Identifier: 10.1300/J083v44n01_03 25

KEYWORDS. Record of Service (ROS), old, lesbians, senior, group work, intimacy

INTRODUCTION

This article brings the voices of old lesbians to the reader in the form of a Record of Service (ROS). It provides a unique glimpse of a weekly support group for lesbians over sixty-years-old at SAGE (Senior
Action in a Gay Environment), which is located in New York City. Using the ROS as a lens, this paper will examine the efficacy of group work with this client population. The article also offers a description
of what a Record of Service is and explains its uses and mechanisms, and proffers it as a tool for accountability, practice examination, and skills improvement.

BACKGROUND

Old lesbian activists at SAGE (Senior Action in a Gay Environment) have instructed me to use the word “old” instead of “senior” or other euphemisms because they are reclaiming “old” as a positive term rather than a pejorative one. In an ageist and heterosexist culture, they are often faced with pejorative images of themselves. According to a report, issued by the NGLTF Policy Institute, on lesbian,
gay, bisexual, and transgendered (LGBT) aging, nursing homes in this country document widespread homophobia among those providing care. As a result old LGBT people don’t access health care, affordable housing, and other social services (Cahill, South,&Spade, 2000). Berkman
and Zinberg (1997) discuss heterosexism and homophobia as the personal bias that social workers name as the hardest to overcome in providing services. A need for education and sensitivity about the lives of LGBT people is evident. While many strides are being taken in the liberation and civil rights of
LGBT people, LGBT people still face rampant homophobia and heterosexism. This oppression is manifested in verbal and physical assault on the street, discrimination in employment and housing, loss of custody and visitation rights of their children, and abandonment by family and friends (Greene, 1994). It is only within the last decade that LGBT people are beginning to see themselves more positively in media images, and those are young, white, and middle-class. It was not until 26 Group Work and Aging: Issues in Practice, Research, and Education this past year that the Supreme Court decriminalized same sex relationships.

Old LGBT people grew up in a society where laws disempowered, marginalized, criminalized, and pathologized them. Medical and mental health institutions often served as oppressive enforcers of these laws. In 1973 and 1988 respectively, the American Psychiatric Association removed the diagnosis of “homosexuality” and “ego dystonic homosexuality” from the DSMIV. Cahill, South, and Spade (2000) estimate that there are anywhere from one to three million LGBT seniors living in the United States.
However, since this population is made hidden and invisible by heterosexism and homophobia, it becomes difficult to validate these figures. Along with their more personal issues, the women’s voices heard in the record of service to follow reflect the impact of being old and “queer.”

THE RECORD OF SERVICE

Garfield and Irizarry (1971) designed the Record of Service (ROS) to be used as a tool for examination of social group work practice. The need for accountability and a systematic method of quality control were factors motivating its development. Since its inception, the formulation of the ROS has been honed by group social workers and teachers of group work to include a particular examination of the interventions that are used by practitioners in satisfying the purpose of the group (Getzel, Kurland, & Salmon, 1987). The skills described and discussed by Middleman and Wood (1990) are used for this purpose. Supervision, selfassessment, recordkeeping of group and individual progress, and quality control are uses for the ROS (Garfield & Irizarry, 1971; Getzel, Kurland, & Salmon, 1987). Today, managed care has forced social workers to a new level of accountability and is pressuring them to employ “evidence-based practice” (Pollio, 2002, p. 59). Records of Service provide a performance measurement of the progress of the group, the individuals, and the worker. Group work is complex with a myriad of considerations. Social group workers simultaneously must attend to four entities: the group, the individual, the relationship to each, and their relationship to worker. Each group is a unique organism, with its own life cycle of stages and role assumptions (Northen & Kurland, 2001; Shulman, 1999). The stage that a group is in will determine the amount of control the practitioner exercises as well as her expectations of work from the group (Shulman, 1999). These complex dynamics are created within the context of the agency and the milieu of culture, positionality, and individual developmental stages. An understanding of power relationships, commonalities, and differences is gained in applying critical consciousness to these contextual elements (Reed, Newman, Suarez, & Lewis, 1997). Positionality locates people within the societal hierarchy of privilege and power, which determines to what degree participants experience external and internalized oppression (Reed et al., 1997). In examining our practice, locating our own positionality as well as our client’s expands our awareness about the biases and assumptions, or the standpoints our relative experiences have given us.

Basic Procedure for Records of Service

In creating a social group work ROS, the worker begins by specifying the group type and purpose, the number of participants and the gender and age range of the group (Garfield & Irizarry, 1971; Getzel,
Kurland&Salmon, 1987). The group task is then identified. Four major group tasks categorize the collective work of a social work group (Garfieldm& Irizarry, 1971; Getzel, Kurland, & Salmon, 1987). They are as follows: Group formation–which includes beginning stage problems such as establishing purpose; group structure–deals with more of the middle stage group issues, such as dealing with conflict and problem-solving processes; relation to environment–problems that concern the group’s interaction with outside organizations or the sponsoring agency; and the fourth category, group needs satisfaction–helping the group deal with common identified themes. This specificity in delineating and defining the problem enables the practitioner to clearly conceptualize the issue they wish to focus
on in the ROS. After the group type, purpose, demographics, and group problem task are noted, the practitioner relates how the problem came to their attention, and how the group members are experiencing it. Following the problem identification is a summary of work wherein the practitioner
excerpts as accurately as possible, interactions that portray the problem and the workers’ response. Interactions that are the most challenging for the worker are purposefully detailed. The temptation to put only one’s shining moments on paper must be resisted for the ROS to be fully effective. Reid (1997) suggests that in group work, one must display qualities including courage, honesty, self-knowledge, and humility (pp. 98-99). These attributes are necessary in creating an objective Record of Service. The summary of work looks at how the problem is dealt with in a single session or many sessions. Ideally, interactions to be focused on have been documented immediately following each session while the content is fresh in the worker’s mind. In creating a ROS, workers underline each intervention they make to differentiate it from their description which identifies the technique and skill used by the worker in that moment (Getzel, Kurland, & Salmon, 1987). The identification of skills is placed in italics above the underlined passages. By identifying the skills that are employed in each intervention, social group workers are forced to think analytically about their responses and their lack of responses (Getzel, Kurland, & Salmon, 1987). The workers are then able to objectively evaluate their patterns, strengths and weaknesses in practice as well as their many clients’ progress and patterns. The next step taken in the ROS is comprehensively identifying the next steps to be taken (Garfield&Irizarry, 1971; Getzel, Kurland,& Salmon, 1987). In addition to determining next steps, the ROS requires conceptualizing the theory behind the practitioner’s use of skills. The following ROS offers a frozen tableau that allows the observer to study how the SAGE Women’s Support Group is grappling with the issue of emotional closeness as well as the effectiveness of my responses as the worker.

RECORD OF SERVICE

Group Type and Purpose. Old Lesbian’s Support Group. An open, ongoing mutual-aid group whose purpose is to provide a place where lesbians over sixty can talk personally about issues affecting their lives and get support from each other.
Demographics. Age range is sixty- to eighty-years-old. Primarily white, mostly middle-class, lesbians. Numbers of women attending the group are usually between nine and twelve.
Group Task. Group needs satisfaction. Problem. To help members identify and overcome obstacles that prevent them from being emotionally close with others.

Loneliness and Longing: How the Problem Came to My Attention
In the course of my four years tenure at SAGE, Senior Action in a
Gay Environment, the issue of loneliness and desire for more “meaningful” friendships was a theme often mentioned by individual and group clients. Many of their friends have died or moved away. One
woman spoke to the group about losing her partner of thirty-two years, and the strangeness she felt in reaching out to people now. This is not uncommon. Ruth, who is in her eighties, told the group she lost her partner of forty years and she “forgot how to make friends.” Other members of the group echoed similar feelings. Some lesbians, gay men, bi-sexual and transgender SAGE members report not “coming out” as LGBT people until their later years, and losing family and community support upon doing so. For others, retirement created time they never had before, time often punctuated by a sense of loneliness and isolation. The desire for more meaningful and intimate friendships was identified by all members of the women’s support group as a crucial one that they wanted to explore.

Summary of Work

This record of service documents excerpts from two sessions of the group. At this time, the group has met weekly for four months and a core membership of ten to twelve women has been established. The group is primarily in the dynamics of middle stages (see Kurland & Salmon, 1998; and Shulman, 1999, for a discussion of the middle stages of group development), although the SAGE Women’s Support group is an open group, and therefore swings between beginnings, middles, and end stages rapidly at times.
Living through an era that persecuted gay and lesbian people and discouraged women from speaking their true feelings has made personally revealing themselves a challenge for most of the women in this group. Many of the women support group members are also members of peer-led discussion groups where the group norms discourage personal sharing, so it is taking a long time to develop new norms where personal sharing is encouraged, and is indeed, expected. Additional challenges are posed by the nature of an open group wherein new members drop in and out. We have been talking about friendships for weeks. Defining the term has proved to be a slippery objective. Marjy and Carol said friends were
people “who were there for each other,” Sheila and Barb experienced friendship as an emotional bond irrespective of time and deeds, and Edith, Gloria, and Joyce viewed it as a relationship that took a very long time to develop.

30 Group Work and Aging: Issues in Practice, Research, and Education

It was interesting to me that even though almost all of the group members lived in New York City most of their lives, and many of them have known each other for decades, there was little sense of community
among them. They seemed to have developed a guarded approach to each other based on assumptions, experiences, and perceptions developed over scores of years. As group leader, I have been reflecting their
desire for more meaningful friendships to them and challenging them to look at some of their contradictory perceptions. By assisting them to communicate with each other in a deeper way, I hope members of the group will see themselves in relation to each other in a new light.
In the following excerpts, I refer to myself as worker. Specific terms put forth by Middleman and Wood (1990) are used in the majority of the descriptions of the skills engaged. Frequently, more than one skill is incorporated in the worker’s comment. For the purposes of analysis, the
skills being employed are listed above the excerpted comments of the worker.

SESSION 1
At the close of last session Gloria said, “I realize how much baggage we have when we are older. I think that our childhoods and all the abuse and stuff we lived thru are all stuff we don’t want to talk about. And the more we don’t talk about it, the less we have to say.” When I asked her if it was keeping her from getting close to people she said it was, but she did not want to “go there and open all that up.” Since Gloria is extremely quiet and withdrawn, I took particular notice of her divulgence. In the following session, I try to bring the group back to that point.

Summarizing, Partializing Information, Preserving Continuity of Work, Giving Feedback, Checking Inferences

Worker–We’ve been talking about friendship, and it has been so interesting. I want to share that I’ve heard the obstacles different women say are challenges to more meaningful friendships. Some of you identified fear of rejection, some are afraid the person will want too much, will ask for money, or something we don’t want to or can’t give. Some women said that when they started to get close to someone they found things that turned them off. Carol talked about being more critical and discriminating as she
gets older, and identified being less critical as a goal of hers. Getting in relationships and not having time was mentioned as an issue as well. Gloria introduced something last week we hadn’t mentioned before, which is the possibility that the baggage we carry and are unwilling to talk about gets in our way. We don’t want to talk about past abuse or pain and we silence ourselves in other ways. Is that what you said, Gloria?
Gloria–Yes. I think that we get used to keeping things to ourselves and then we don’t share anything about ourselves.

Reaching for Information, Identifying Personal Goals

Worker–It sounds like that is your struggle.
Gloria–Yes it is.

Reaching for Information

Worker–Do you want to say more?
Gloria–Not really. I don’t like talking about my past. Please focus on someone else.

Verbalizing Group Purpose, Validating Feelings

Worker–I understand–it is an obstacle you identified, so it makes perfect sense it would be hard to do in the group. Remember we are here to listen if you decide you’d like to open it up.
Terry–This group helped me clarify that I don’t want any friends. I love community and sharing, and these groups are divine. But that is enough, I don’t want closeness. I love having coffee but I don’t have time to cultivate friendships. Period.
Edith–You are so impersonal. You need to be personal to have friends. You are so cold.

Reaching for Information, Reaching for Feelings

Worker–Edith, it would be great if you talked about yourself. What are your thoughts and feelings about how you make friends or what you would like your friendships to be like?

32 Group Work and Aging: Issues in Practice, Research, and Education

Edith–Last week I said I was looking for friends and I realize you can’t look for friends, they just develop. I have people in my life that have adopted me, made me family. And I didn’t have to ask for it or connive to
get them to recognize my birthday. And I get gifts anyway. I send cards to people because I know they like getting them. Friendships take time to develop. That is why they are hard at our age. Time and trust. (Joyce is exclaiming yes, I agree with you, smiling approvingly)
Gloria–I agree with Edith. It takes a long time to create friendships. And we erect barriers that are harder to pull down when we get older. Like what I talked about last week. All the things that happened to us in our
lives.

Reaching for Feelings

Worker–And not being able to talk about them . . .
Gloria–Yes. And not wanting to.

Checking Inferences, Reaching for Feelings, Getting with Feeling

Worker–That must be very painful–keeping hard things in.
Gloria–It becomes a way of life.

Reaching for Feeling Link

Worker–Does anyone else feel like Gloria does?
Rachael–Gloria,maybe you are right . . . us oldwomen have baggage . . . friends don’t come easily and neither do lovers. I might never have a lover again, or a good friend and I need to acknowledge that. I was with my partner for years and spent little energy on friends. Now I am alone and I am thinking about them. And I think I find them secondary in my life. I am not so sure of their importance. I never learned the art of developing friendships. I’ll connect with people and take people’s numbers and then I don’t call them. And like Terry said . . . do I evenwant friends? How important is it really? But I have to tell you; I had a beautiful connection with someone who when we were sixteen we played music together. I just ran into her last week! She came over and we made music like when we were sixteen. It was the best time I have had in so long.

Confronting Distortion, Contradiction
Worker–Well if it was the best time you had in so long, maybe friends are important.
Rachael–Well the real reason I don’t make friends is because maybe they are into different things than me, and when we get to know each other we won’t have anything in common, and they’ll think I am stupid
. . .

Reaching for Information, Giving Reality Check, Confronting Distortion

Worker–Did you find out they have different interests and did they convey that they thought you were stupid? Or is it your fear?
Rachael–My fear . . . yes . . . my perception. I know it is about my self image.

Reaching for Information Links and Feeling Links, Universalizing

Worker–Mmmmmm . . . it is something for all of us to think about . . . what stops us sometimes . . . perception versus reality. Rachael raises a good point; that self image can be an obstacle to closeness if we perceive people not liking us because we don’t like ourselves. Self image . . . so powerful . . . What about other people in the group . . .?
Carol–Rachael–here is another story about misperceptions. I wanted to say that when I was in the bathroom Barb passed me and didn’t say hi and I thought she was mad at me. It turns out she is sick. You see how we can misjudge? We think everything is about us.
Sheila–Us old folks are more suspicious than when we were young. We ask for more and give less. We worry too much. We need to lighten up.
Gloria–Rachael reminded me of a great experience I had recently and forgot about. I ran in to an old friend I haven’t seen in ten years, we are into the same things, she is a Cancer and we went to this thing together
and it was so nice and we didn’t have to tell each other everything. We just were enjoying the time together.

Group Work and Aging: Issues in Practice, Research, and Education Reaching for Information

Worker–Are you seeing her again?
Gloria–Yes–
Terry–That is great, Gloria–you see, you are making friends.
Marjy–Rachael, your story makes me want to share something that happened to me. I had a friend who I used to play musicwith. I would play and she would sing. (Marjy’s voice starts to tremble. I don’t know
if I can do this, she says.)

Attending to Feelings, Verbalizing Norms

Worker–Its okay to cry. We are here to support you.
Marjy–We were close and she got breast cancer and was very sick. And right before she died we got together and she asked me to play this song and I did, even though I hadn’t played in years. (She starts to cry) I can’t do this.

Attending to Feelings, Verbalizing Norms

Worker–Take your time, she was important to you, this is important, you can cry . . . it’s okay, take your time. (Ann echoes me and leans towards Marjy comfortingly.)
Marjy–OK. I played the whole thing beautifully. I never could play it again and I think it was my desire to do it for her that enabled me to do it. She died shortly after. I will never forget it.
Terry–What a beautiful story, Marjy. (Others chimed in echoing.)

Giving Feedback, Getting with and Validating Feelings, Scanning, Amplifying Subtle Messages<

Worker–I appreciate how hard that was and that you were willing to share that with us. Thank you for sharing it with us. It is very moving. I see tears in almost everyone’s eyes.
Marjy–I think it is amazing that I could play that one time. I never could since.
Carol–In the 20 years I have known you I never saw you emotional.
Joyce–Yeah, Marjy, you are one tough cookie. It was so great you let yourself show emotion.
Ann–I love this group, the level of intimacy we are sharing. I hope we all come every week.
Terry–This was a good group.
Ann–We owe it to Kris (the worker)

Verbalizing Norms and Purpose, Fostering Cohesiveness, Voicing Group Achievements

Worker–No. We owe it to all of us. I think we are doing great in creating this group to be a place to share on a meaningful level. We created a process together, it wasn’t just me.
Joyce–I am glad we don’t have to talk about process anymore. Remember how we used to talk endlessly about the ground rules? Ugh.

Verbalizing Norms, Voicing Group Achievements

Worker–It is paying off. Every group has a life of its own.
Terry–In fact every group has a soul. Durkhein said that ages ago. I think this group had a special soul from the beginning. We are really a support group.

SESSION 2

Edith–Last week after group, I was in the bathroom and when I came out no one was here. Everyone fled! And we are talking about friendships. It is all a bunch of bullshit. It is a crock of shit, no one wants to
create friendships in this group. And Terry too, I am angry at her. We were walking and left the center and all of a sudden she takes off. (Ann is very empathetic, indicating to Edith she is with her.)

Redirecting Message

Worker–Why don’t you address the group?
Terry–Yes, Kris didn’t take off on you, don’t yell at her.
Edith–Well I think everyone is all talk . . . “blah blah blah” about friendship. Hah. And Terry every time, running away. . .
Terry–I said goodbye–I told you I like to walk alone. Everyone knows I am like this. (Marjy is agitated, rolling her eyes and motioning to me to move this along.)
Edith–Oh yeah, walk alone, you like to do everything alone.
Marjy–Hey, this isn’t a place to work out problems between the two of you.

Summarizing, Partializing Information, Giving Feedback, Referring to Purpose, Encouraging Group Responsibility for Process

Worker–There are a few things happening here. Edith just expressed a lot of anger directly to the group and I want to give everyone who is anxious to talk the opportunity to respond. I would like to point out that the issue of the group leaving Edith and the dynamics of her and Terry’s relationship are
separate; at the same time, Terry’s leaving after the group left would provoke
feelings about desertion. Edith, you felt deserted twice in ten minutes! The third issue on the table is whether the group is a place to talk about interpersonal relationships.

Use of Authority, Choosing Format, Scanning

Worker–Jo Ann and Barb are all raising their hands to talk–looks like there’s a lot of feelings opened up here. This is important and that we should hear each other out.
Jo Ann–Edith, you can’t just come into the group and expect everyone to be friends. Friendships are very rare and take a long time to cultivate. You can’t just expect each person in the group to want to be friends right off the bat. It doesn’t work that way.
Edith–I have known Terry for years and she is still avoiding me.
Jo Ann–I don’t want to listen to your problems with Terry. That isn’t appropriate.
Terry–That is what a support group is about. We are supposed to be real in here.

Breaking Taboo, Encouraging Direct Communication

Worker–Edith brought a new dimension to the group. Before she came no one directly challenged anyone in the group before. I appreciate your honesty, Edith. I think the group is being more real since you came. It might not be comfortable but we are being more real.
Marjy–Ever since Edith came into the group she has focused on Terry. They should work it out together outside of the group. Obviously your feelings are hurt by Terry, Edith. Maybe you should realize she doesn’t want the same kind of relationship you want.
Edith–I don’t want any relationship and I don’t want anything from this group, except civility. “Good-bye Edith, see you next week.” No one said anything to me after the group last week. And then Terry goes
sprinting away like a marathon runner. And I am a marathon runner and couldn’t keep up with her!

Reaching for Feeling Link

Worker–Can anyone relate to what Edith is feeling?
Barb–You know, I used to come and hang around after groups waiting to be asked to go along when people went out after group. I was never asked. It felt really bad. Then one day someone said, “how come you never go out with us after group?” I said I was never invited. They said, “You don’t need a special invitation.”

Partializing Issues, Summarizing, Reaching for Information

Worker–I just want to point out that there are two issues on the table. The issue of what happens socially after groups in general and what happens in this group when people have interpersonal issues. Barb
brings up another good question. How do new women, like Edith, learn about the group culture?
Joyce–You just figure it out, that’s all.
Ann–You know, we come from an era of not talking. We aren’t brought up with very good communication skills. That’s why we are so uncomfortable with all this . . . some of us are too shy to invite someone, and
definitely too shy to invite ourselves.
Carol–Well I am very picky about who I spend my time with. I have a right to go out with whoever I want.
Terry–I have always hated the after group scene, who goes with who, who is invited. I find cliques unacceptable. It is why I don’t go out after groups.
Jo Ann–What do you mean? You want everyone to go together?
Terry–Yes, I think everyone should be asked.
Jo Ann–Like I said, you don’t just become friends by going to a group.
Edith–I don’t want to be friends with everyone and go out like the last supper. That is not what I meant.
Gloria–Personally I like one-on-one contact.
Edith–Me too. Exactly.
Joyce–I was in a clique after the Tuesday night group, now that I think about it. We called it the clique mobile. It was funny. I try to sit between the people I find interesting. If I am stuck next to someone I don’t like I usually get up and leave.
Marjy–I was a part of that group and found it very juvenile, and sorority- ish. A lot of women were hurt deeply. One old woman used to go searching for that group who would leave her and not say where they
were going. She would go from one restaurant to the next, looking. It was so sad. That clique stuff is damaging. It is disgusting.
Barb–Yes I agree–it was pretty hurtful. I wasn’t a part of it and I used to feel like something was wrong with me.
Joyce–but we weren’t exclusive! Anyone could come!
Marjy–Sure, right. That is what a clique is. Exclusive.
Joyce–but we didn’t exclude people.

Rephrasing, Confronting Distortion

Worker–Maybe you didn’t mean to, but can you hear that Marjy and Barb felt that the clique excluded people?
Joyce–We didn’t!
Ann–It doesn’t matter if you didn’t think so. That is how women felt about it. It hurt some of us. Period. You don’t need to defend the clique.

Giving Feedback, Reaching for Feeling Link, Preserving Continuity, and Group History

Worker–It is so interesting. Here is the issue of perception again, and the issue of rejection. The things we talked about theoretically months ago are being enacted in the group now. Remember this came up before; fear of rejection was talked about a lot. Now Edith is experiencing feeling rejected. It
seems like Edith’s experience is one that everyone can relate to.
Terry–I belonged to a group once and we would all go out after. We would get so silly. I think silliness is important. You get close when you get silly. I want to share something. I realized after last group that I am
very afraid of being abandoned. And that I run out of every group first, so I have control, and no one can hurt or reject me. My friend told me if I don’t let myself experience pain I cannot experience joy. And I
love joy. So I decided to risk it. I told myself that tonight I will not be the first to leave. (In fact she was second.)
Barb–I was scared to death when I came here. If you are shy you might not stick around. Who wants to be hurt?
Marjy–(tells a story about a birthday party after a group that only invited a select few.) That had ramifications for months. Women were mad or sad about it. A lot of women!

Giving Feedback, Reaching for Information

Worker–This does hit home, doesn’t it. I wonder–we are all so afraid of being rejected and abandoned . . . and easily hurt when we think that is happening . . . Do you think it goes back to childhood trauma? Does
anyone remember the first time they felt this stuff?
Barb–When I was a kid my parents were drunks and yelled and fought and the police were always there and I was on the street a lot. The kids on the block started calling me “Poison Ivy-Iodine.” They would laugh and point and yell, “Poison Ivy-Iodine” whenever I came near them. I was only seven but I can still hear them.

Reflective Listening, Giving Feedback

Worker–Ouch . . . and fifty some odd years later you still hear them.
Ann–I know my first rejection. My mother was so jealous of me, and my relationship with my father. She hated me. So she would try to hurt me by being buddy-buddy with my friend, and lavishing her with love
and affection. None for me. I have this memory of them walking way ahead of me. And I felt I was nothing. And I thought if I am nothing I will say nothing. And so I didn’t for a long time.

Waiting for Feelings, Waiting for Information, Letting Silence Be
(There was a silence that I let grow as women digested this.)

Terry–well you are making me remember. When I was six, me and my twin were put in boarding school. Pushed out of the door. All of a sudden we were left to our own devices. And we would have to have a partner to walk with from school to the church and if you didn’t have a partner it was humiliating and horrible. It meant no one wanted to be your friend. And I had to look out for my sister. I learned that if I were the leader, I would not be left alone. So I became a leader.
Barb–Me too! I did that too, become a leader.

Giving Feedback, Encouraging the Work, Reporting Own Feelings

Worker–It is so fascinating, how we learned to protect ourselves. And what defenses we developed. You became leaders, Ann stopped talking . . . that is three groupmembers who can remember specific childhood hurts. It is stimulating memories for me too. I’m not sure what defenses I created, do any of you know what defenses you created in response to the hurt?
Ann–I learned to scapegoat myself. Look the lion in the mouth. I would provoke people to see the worst. Masochistic I guess.

Reaching for Information

Worker–Can you say more?
Ann–If I was in a Jewish camp I would say I was Christian. I don’t do it anymore.
Gloria–My mother would say if abortion was legal when I was young she would have aborted me. It was hard to hear. And it didn’t help that we were scattered all over the world . . . I was born in India and we
moved all the time. I was alone a lot. I learned to sabotage my relationships so I wouldn’t have to get close to them. I regret pushing people away, but I did.

Reaching for Information

Worker–And now?
Gloria–I still do it. I also sabotage myself. I always used to push my friend to get out there and I never would accept any praise myself. I was always pushing others in the spotlight. I never let myself do anything. I was never encouraged. I would say I still sabotage myself.

Scanning, Amplifying Subtle Messages

Worker–Marjy you are nodding–it seems like you are relating to what Gloria is saying?
Marjy–I am. I have done that too. I think I am afraid of success and sabotage myself if I get close to succeeding.
Gloria–Yes! Me too . . . so I don’t succeed.
Marjy–I was always on my own too, Gloria. And I feel like my entire family abandoned me. I had to do everything for myself.
Jo Ann–My mother hated me. I always had this cleft palate. She told me she wishes she aborted me, so I know what that feels like, Gloria.
Once she came after me with a knife. I was desperate for love. I would climb on my relations, my grandparents, or anyone who would let me and beg for it. It saved me actually.
Barb–Yes, I know that desperation. I left home when I was fifteen. I knew if I didn’t either I would kill my mother or she would kill me. I would find families and worm my way in. Families with little kids, I would help the mother and become indispensable. And I would get some love. And as an
adult I attached to my lover’s family. My lover’s mother treated me so special. My lover would get jealous, because her mother would cook for me special.
Ann–you were the friend I hated. Well not hated, but were so jealous of.
Carol–Well my mother never was physically violent. She did her violence with her mouth. She was so verbally abusive. She made me want to fail . . . I’d rather fail than succeed. I remember at my graduation
I was at the top of my class and she was giving me the worst sneer. I remember my first bad rejection. My mother sent me to camp, but after it was already going for a month . . . so I was the only newkid, and
was paired up with a retarded kid everyone hated. I never did fit in, was never one of the group. They all knew how to swim. Not me. (Carol then tells a story about a camp counselor who tricked her into
jumping off the boat after hours of Carol refusing.) I never fully trusted anyone again.

Giving Feedback, Summarizing, Voicing Group Achievements,
Preserving Continuity of Work

Worker–I’ll bet trust is an issue for everyone, after all that painful stuff that happened . . . This is amazing . . . I can’t believe it is after five. So much happened here today. Edith, I want to thank you again for your
honesty. I think it helped us move forward. The sharing was really deep and important I think. I appreciate everyone’s willingness to be vulnerable. I am sure you are all thinking about other ways you were hurt or
rejected. I know I am. I think it is so awesome that people are figuring out how they adapted and the defenses they created as a result. Let’s keep thinking about how we have had to respond to so much pain. I think this stuff is core to why it is hard to be intimate, and to create meaningful friendships. What a great group . . . Good work everyone . . . great personal growth work. . . . I am impressed with all of you. . . .
Edith–I wasn’t going to come back. I am so glad I did. See, Gloria–it is
good to talk about these things!

ANALYSIS

As a white middle-class lesbian, I share the skin and class privilege of most of the group members. This similarity makes me especially vulnerable to countertransferences. In fact, Edith reminds me adversely of
my sister, who I see as negative and difficult. I know this, so I work at staying open to Edith, and her confrontational style proves to be invaluable to the group. As a forty-nine-year-old lesbian I have suffered homophobic attacks, but the homophobia of my lifetime was not as punitive as what many of the group members have endured. I have not endured the ageist discrimination they have, and I am careful not to assume that I understand their experiences even though I share the same gender and sexual orientation.


Session One

Edith is new to the group, and her newness combined with her forthright personal and confrontational style help push the work of the group forward. Edith has a speech impediment and dresses in “corporate career style” clothes which are in contrast to other group members’ casual style of dress. In these sessions she assumes the roles of deviant and scapegoat for the group (Shulman, 1999). The group is challenged, as these particular roles create uncomfortable feelings for all of us. Difficult group members are often group workers’ allies. If allowed, they may show us feelings that other group members harbor and avoid, as well as provide opportunities for buried conflicts to surface (Shulman, 1999). In this case Edith deviates from group norms by breaking taboos and directly addressing Terry, forthrightly displaying her anger about being rejected. This is threatening, as fear of rejection has been identified by several group members as a major barrier to intimacy. I immediately depersonalize the conflict, asking Edith to generalize her feelings. I am nervous because Edith is angry and I do not allow her to voice her feelings
about wanting Terry’s friendship. This was a missed opportunity to nurture an honest exchange of feelings. This error deprived the group of an opportunity to work through difference and expand their capability for giving mutual aid (Bernstein, 1973; Northen & Kurland, 2001; Shulman, 1999).
Social group work theorists elucidate a widely-used problem-solving process based on the work of John Dewey (Northen & Kurland, 2002, Kurland & Salmon, 1998). Diagnosing and exploring “ruptures” to the
group flow is critical (Kurland & Salmon, 1998, p. 215). At times I rush or sidestep the process, as in the dynamic described above. Working through my tendency to avoid conflict is a rewarding challenge, as each time I succeed, the work of the group grows deeper. Conflict avoidance is a problem, because when a worker does not address conflict the group will avoid conflict as well, possibly feeling shame at their feelings (Bernstein, 1973). The record shows that for a time following the above dynamic, I am
responding after each expression by a group member instead of looking to the group for their responses. Most likely this stemmed from nervousness as I realize I have just made a mistake by steering Edith away
from confronting Terry. “Thinking group” is essential for a group social worker (Middleman & Wood, 1990). Establishing reciprocal sharing between members is an essential element of the work and volleying responses from the worker can prevent mutual aid from occurring. In this session Rachael questions whether friends are really important and then shares her delight in a recent encounter with an old friend.
When I face her with the contradiction, she admits it is her low self-esteem that keeps her from pursuing friendships. Terry also asserts that she does not need friends, although she loves to have coffee with people, and comes to every group. These contradictions provide insight into these women’s use of denial to avoid vulnerability. Rachael’s sharing opened the way for Marjy to tell a personal story
that made her cry for the first time in years. Marjy’s stated intent in coming to the group was feeling her feelings, and this was a great step for her and for the group. The mutual aid process was fully illuminated and engaged in this interaction, enhancing feelings of cohesiveness and intimacy for the group. Expressions of feeling and empathy embody the desired group goal of members providing mutual aid to each other (Shulman, 1999).

Session Two

I approach the following session with a “warm and fuzzy” feeling left over from the last session. I am surprised when Edith challenges the entire group in the opening go-round. She vocally expresses her anger and pain at being left by the group and then by Terry, making group members uncomfortable. Marjy responds by insisting the group is not the place for Edith and Terry to deal with their issues.
Marjy often assumes the role of gatekeeper by diverting attention to the “appropriateness” of the issue or group process. Gatekeepers try to make sure the group does not go into too deep or painful territory
(Northen & Kurland, 2001; Shulman, 1999). I know it is easy for me to collude with Marjy to avoid conflict, so I deliberately ask the group for their responses after partializing the issues. Group members are angry at
Edith and I show appreciation to her and name what is happening. I do so because I want her to feel supported and to demonstrate support and encouragement of direct communication. Edith’s behavior initiated an honest exchange in which women shared feelings about some members going out socially after sessions without inviting them. This work progressed and led women to share deep painful memories of early rejection in a personal way. Gloria finally disclosed some painful information about her past. It was a significant step for her. It is ironic that Edith, the instigator, was the only one who did not share an experience. It becomes clear in the second excerpted session that early experiences of rejections left deep scars of fear and pain in the psyches of members of this group, scars that keep them from forming meaningful friendships scores of years later. The communicating they are doing with each other in the group is exciting and moving, as I can see them supporting each other in ways that bring them closer.
The practice skills that I frequently use to engage the work of the group are summarizing, partializing the issues, reaching for feelings and information, validating feelings, modeling empathy, pointing out
contradictions, confronting distortions, inviting full participation, scanning, amplifying subtle messages, and verbalizing group purpose and achievements (Middleman & Wood, 1990).
Mutual aid is a cornerstone of the empowerment model of the eighties as well as a concept central to feminism. In fostering a group where peers support each other, group workers empower members by providing space, skills, and opportunities to understand and support each other. The work of assisting and enabling these old lesbians to support each other and communicate honestly and supportively enriches and expands their lives. The practice of looking to group members to collectively establish their purpose reinforces the strengths-based concepts of empowerment, and respects the “nothing about us without us” principle that old lesbian activists purport (OLOC, 1992). This strengths perspective is based in principles found in feminist, eco-systemic, wholistic, and ecological perspectives. Incorporating a cognitive approach assists people in identifying contradictions, core beliefs, and distortions in their self-regard. I have found it helpful to encourage group members to set goals and identify their issues so they can take responsibility to change.

Next Steps

• Encourage group to continue looking at experiences that have shaped their beliefs and behavior in response to rejection.
• Work at going toward conflict and bringing differences into the open (Bernstein, 1973).
• Engage group to explore their relationships and roles, perhaps utilizing role-plays.

Group, Psychodynamic, and Sociocultural Concepts Used

Two streams of literature engaged in the work with old lesbians include theoretical perspectives in group work literature and the theoretical underpinnings of feminism. The value systems and conceptual
foundations of both are completely compatible. An important goal for the support group illustrated in the Record of Service was creating a bond conducive to the reciprocal support known as mutual aid. Mutual aid has been alluded to as the most important concept of group work (Northen & Kurland, 2001; Shulman, 1999; Moyse- Steinberg, 2004). Mutual aid creates the conditions in which people can support and assist one another with their personal goals. Being able to recognize and empathize with others, to listen to others as well as express one’s self, and see the commonalities with other group members empowers participants to interact more effectively in their varied social milieus (Schwartz, 1971; Shulman, 1999). The empowerment that stems from reciprocal sharing challenges the patriarchal conditioning that teaches dependency on authority and individualism. This empowerment was pivotal for the women in the old lesbian support group who were overcoming hindrances created by ageism, sexism, and homophobia.
The work of feminists including Pharr (1988), Brownmiller (1975), Dworkin (1989), Davis (1981), and Lorde (1984), provide an understanding of the dynamics of sexism, racism and other oppressions. Their
works illustrate how a paradigm of privilege and power-over has disadvantaged and disempowered women, people of color, and lesbian, gay, bisexual and transgender people. The required power sharing that the group worker must exercise in creating mutual aid groups such as the old lesbian support group contradicts the power-over paradigm and strengthens participants’ sense of self-determination (Middleman, 1990; Gitterman & Shulman, 1994).
Group methodology is further empowering in its avoidance of the dependency inherent in the dyad of a patient-therapist relationship (Shaffer & Galinsky, 1989). Underlying the efficacy of group work are
principles and dynamics that are antithetical to the dualistic social functioning which is the dominant culture’s milieu. Group work principles of inclusion, breaking and naming taboos, mutual aid, and shattering false dichotomies are central to the power of group work, and to the success
of this particular group of women (Shulman, 1999; Kurland & Salmon, 1992). Group work also addresses the disempowerment of isolation which is a tactic of oppression, and abuse (Pharr, 1988). Participating in a group of people with similar issues can help heal the effects of internalized oppression, the learned belief of the negative messages society promulgates via stereotypes, discrimination, and slurs. Internalized oppression destroys oppressed people’s self-esteem and can create negative selffulfilling prophesies. This concept is elaborated on in the work of social theorists such as Pinderhughes (1989) and Davis (1983). In “Look Me in the Eye,” Macdonald and Rich (1991) exposes the oppression that old lesbians face, and formulates a feminist analysis of ageism that incorporates an exploration of how homophobia compounds age-related discrimination, and how ageism prevents the lesbian and gay community from supporting old lesbian and gay people. Macdonald’s work challenges me as a younger lesbian to examine my own beliefs about aging and old people, and my positionality in reference to them. Positionality is the understanding of where one fits on a continuum of privilege and oppression and how one’s identities affect one’s relationships to those in other membership categories (Reed et al., 2000). For example, as a white, middle-class, middle-aged lesbian, I have privilege based on skin color, class and age, at the same time as being subjected to the oppressions of sexism and homophobia. To provide culturally competent services, I had to be aware of the power imbalances that are inherent within our system of hierarchies (Pinderhughes, 1989). By participating in a group, people receive validation from others like them and self-esteem is increased (Northen, 1987). Group work bestows a sense of belonging that is central to Maslow’s (1962) theory on the stages of self-actualization which posits that a sense of belonging is a universal social need.
Belonging and relating to a peer group reduces anxiety, increases self-expression, and willingness to try new ideas (Northen, 1976; Shulman, 1979). Northen (1987) attributes an improvement in members’
self-esteem to the discovery that others who have the same problem are likeable. Group work’s emphasis on inclusion and validation of each person’s contribution echoes concepts that are Frierian in nature, as they share an understanding of the reciprocal nature of learning and teaching, and the idea that monologue is oppressive, while dialogue is liberating (Friere, 1970). Groups such as the old lesbian support group foster the understanding that one is not alone in one’s suffering by universalizing the issues
members face (Shaffer & Galinsky, 1989; Northen, 1987). Empowerment and strengths-based principles of the social work profession are fundamental in a membership perspective which conceptualizes
the client’s involvement as co-creators with the social worker (Falck, 1983). Empowerment is also conveyed by group work’s message that each individual has something constructive to contribute
(Kurland & Salmon, 1996; Dies, 1995). A reduction of symptoms is attributed to the validation members receive in groups as well as their opportunity to ventilate (Northen, 1987; Shulman, 1999). One factor of group work contributing to its efficacy is that of breaking taboos. Social group work practitioners develop the ability to say the things people have the hardest time saying, and name the “pink elephants” in the room. At times the things that some individuals regard as shameful, deviant, or abnormal are normalized by the practitioner’s ability to break taboos (Shulman, 1999). It is liberating to finally share “secrets” with the support of peers, as made evident in the sessions recorded above. The overall goal for group participants such as this group of women is to become more effective in their lives within groups and systems to which they belong (Dies, 1995). Schwartz (1971) defines social works’ function as mediating the “process thru which the individual and his society reach out to each other thru a mutual need for self-fulfillment.” These objectives place group work as foundational to the social work paradigm, and were paramount with this group of old lesbians.

CONCLUSION
The task of uncovering the barriers to creating meaningful relationships is an especially significant one for old people whose circle of friends decreases with losses due to death and relocation. This is particularly
true for old lesbian, gay, bisexual, and transgendered people who are isolated by homophobia in addition to ageism. Social group work is an ideal medium for enhancing relationships and social competence as it provides a “relationship laboratory” for people (Northen & Kurland, 2001, p.73). The ROS in this article illustrates the progress that these particular group members are making in moving towards each other and engaging in meaningful exchanges of mutual aid. Creating a ROS to view this work as a whole provided me with a model of my own practice to deconstruct and learn from, and insight into the lives and experiences of the women I work with. It was an honor and an inspiration to work with this group of old women who are bravely seeking to look at their fears and feelings, and to become closer and more vulnerable with each other. They taught me to face conflict, to be patient with the problem-solving process, to appreciate being a lesbian in the twenty-first century, and to embrace my own aging.

REFERENCES
Berkman, C., & Zinberg, G. (1997). Homophobia and heterosexism in social workers. Social Work, 42 (4), 319-332.
Bernstein, S. (1973). Conflict and group work. In S. Bernstein (Ed.), Explorations in group work (pp. 54-79). Boston: Milford House Inc.
Brownmiller, S. (1975). Against our will: Men, women, and rape. New York: Simon and Schuster.
Cahill, S., South, K., & Spade, J. (2000). Outing age: Public policy issues affecting gay, lesbian, bisexual, and transgendered elders. New York: The Policy Institute of the National Gay and Lesbian Task Force.
Davis, A. Y. (1983). Women, race, and class. New York: Vintage Press.
Dewey, J. (1938). Experience and education. New York: Macmillan. In H. Northen & R.
Kurland (2001) Social work with groups (3rd ed., pp. 191-213). New York: Columbia University Press.
Dies, R. R. (1995). Group psychotherapies. In A. Gurman & S. Messer. (Eds.), Essential psychotherapies: Theory and practice. New York: The Guilford Press.
Dworkin, A. (1974). Woman hating. New York: Dutton.
Falck, H. (1988), Social Work: The membership perspective. New York: Springer.
Friere, P. (1970). The pedagogy of the oppressed. New York: Continuum.
Garfield, G. P., & Irizarry, C.R. (1971). The record of service: Describing social work practice. In W. Schwartz & S. Zalba (Eds.), The practice of group work (pp. 242-261). New York: Columbia University Press.
Garland, J., Jones, H.,&Kolodny, R. (1973). A model for stages of development in socia work groups. In Saul Bernstein (Ed.), Explorations in group work (pp. 12-51). Boston: Milford House, Inc.
Getzel, G., Kurland, R.,&Salmon, R. (1987). Teaching and learning the practice of social group work: Four curriculum tools. In Social group work, competence, and values in practice (pp. 35-50). Binghamton, NY: The Haworth Press, Inc.
Gitterman, A. (2003). The meaning, scope, and context of the concept of social justice in social work with groups. In N. Sullivan, E. S. Mesbur, N. Lang, G. Goodman, & L. Mitchell (Eds.), Social work with groups: Social justice through personal, community, and societal change. Binghamton, NY: The Haworth Press, Inc.
Greene, B. (1994). Lesbian and gay sexual orientations: Implications for clinical training, practice, and research. In B. Greene & G. Herek (Eds.), Lesbian and gay psychology: Theory, research, and clinical applications (pp. 1-24). California: SAGE.
Kurland, R.,&Salmon, R. (1998). Teaching amethods course in social work with groups (pp. 65-69). Alexandria, VA: Council of Social Work Education.
Kurland, R.,&Salmon, R. (1992). Group work vs. casework in a group: Principles and
implications for teaching and practice. Social Work with Groups, 15 (4).
Lorde, A. (1984). Sister outsider. Trumansberg, NY: The Crossing Press.
Macdonald, B., & Rich, C. (1991). Look me in the eye: Old women, aging, and ageism. San Francisco, CA: Spinster Books.
Maslow, A. H. (1962). Toward a psychology of being. Princeton, NJ: Van Nostrand.
Middleman, R., & Wood, G. G. (1990). Skills for direct practice in social work. New York: Columbia University Press.
Moyse-Steinberg, D. (2004). The mutual-aid approach to working with groups: Helping people in groups learn to work better together and help each other! New York: The Haworth Press. Inc.
Northen, H. (1987). Selection of groups as the preferred modality of practice. In J. Lassner, K. Powell,&E. Finnegan (Eds.), Social group work: Competence and values in practice. Binghamton, NY: The Haworth Press, Inc.
Northen, H., & Kurland, R. (2001). Social work with groups, 3rd ed. New York: Columbia University Press.
Old Lesbians Organizing for Change (1992). The facilitator’s handbook: Confronting ageism for lesbians 60 and over. Houston, TX.
Pharr, S. (1988). Homophobia: A weapon of sexism. California: Chardon Press.
Pinderhughes, E. (1989). Understanding race, ethnicity, & power: The key to efficacy in clinical practice. New York: The Free Press.
Pollio, D. (2002). The evidence-based group worker. Social Work with Groups: A Journal of Community and Clinical Practice. Vol. 25 (4), 57-68.
Reed, B. G., Newman, P. A., Suarez, Z. E., & Lewis, E. A. (1997). Interpersonal practice beyond diversity and toward social justice: The importance of critical consciousness. In Charles D. Garvin, & Brett A. Seabury. Interpersonal practice in social work: Promoting competence and social justice (pp. 46-78). Massachusetts: Allyn & Bacon.
Reid, K. (1999). Social work with groups; A clinical perspective (pp. 98-99). Pacific Grove, CA: Brooks/Cole Publishing Co.
Schwartz, W. (1971). On the use of groups in social work practice. In W. Schwartz & Z. R. Zalba (Eds.), The practice of group work.New York: Columbia University Press.
Shulman, L. (1999). The skills of helping individuals, families, groups, and communities (pp. 437-473) (4th ed.) Itasca, IL: F. E. Peacock Publishers, Inc.
Steinberg, D. M. (2002). The magic of mutual aid. Social Work with Groups, 25 (1/2). 52 Group Work and Aging: Issues in Practice, Research, and Education

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