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Christine LaCerva on Environments for Emotional Development

On the future of mental health

Eric Maisel
Source: Eric Maisel

The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.


Interview with Christine LaCerva

EM: You work as a “social therapist.” Can you tell us what that means and what you do?

CL: Social Therapy is a postmodern group therapy that has at its centerpiece emotional growth and development. Essential to its practice is the philosophical exploration of how human beings have the unique characteristic of being able to simultaneously be who we are and be who we are becoming.

As a social therapist I am practicing a search for method. This activity is asking philosophical questions that provoke the group to create new kinds of dialogues that go beyond the status quo. Therapists and patients in social therapy groups work together to develop their capacities to live life creatively and investigate the conceptual frameworks that inform how we think and how we have come to feel the way we do.

Most importantly what emerges from these dialogues is how and what there is to do about it. The methodology of social therapy is an activistic performance of the organization and reorganization of how we live our lives. This requires the ongoing continuous exploration by the group of how we create being together. The collective focus of the group is on the activity of creating the conditions so the group can grow.

EM: You help clients build environments for their emotional development. Can you tell us what you mean by that and how you do that?

CL: Building environments for growth necessitates that patients explore their inherent sociality and cultural capacities. We are relational beings. The activity of the social therapy group is to challenge the biases and assumptions of how we understand that. For example, a client comes into a group session saying she is in enormous pain. She is in emotional distress. The group works to be included in how she is thinking and feeling about this, including her relationship to them.

The therapist points out that the tendency is for the client to relate to the pain as if it belongs to her. How did it become yours alone? What about the social cultural reality of who she is with her group? She is not in an emotional vacuum. As a social being she lives a relational life. The pain belongs to the group. We are living our lives together. The group works with the client to give over the pain. How can we do this together? Can the group take ownership of the pain of this difficult moment?

The group dialogue emerges as a conversation about the conflicts and responses of the group to the individual client. The clients are related to as emotional builders, as creators of the stages upon which they live their lives. How are we doing? In this process we examine what is in the way of creating something new together. Creating the environment is inseparable from embracing the sociality of how we create our therapy together.

EM: You take a special interest in autism. Can you tell us about your work in that area?

CL: I have been working with young people diagnosed on the autism spectrum for over thirty years. I have created multi-family groups as a new modality to enhance social communication and foster creative expression for all the family members involved.

The group has patients who have been diagnosed with a variety of labels. Some have no label at all. Mixing the group with young people that are on the spectrum, off the spectrum, have learning problems or are just generally having a hard time is critical to its success. The families come together, examine the assumptions and biases they bring into their lives, and create a space that challenges the often-ironclad identities of a diagnosis.

In these groups, families get the support they need to loosen their grip on the fears and anxieties about whether their children or teens will be able to fit into a biased society. What they discover through improv and performance exercises is that young people on the spectrum (and those who aren’t) can create new ways of being, new ways of seeing and feeling in working with others.

Most importantly, parents and young people alike have the opportunity to become powerful in how they are living their lives. They discover their creative potential and intellectual capacities to go beyond themselves. I lead performance games where young people get to play the therapist. Being related to as someone who needs assistance, young people on the spectrum welcome the opportunity to give their thoughts on what would be helpful others. Their strengths shine through, their labels become less important. Being powerful in life for parents and their kids becomes central.

EM: What are your thoughts on the current, dominant paradigm of diagnosing and treating mental disorders and the use of so-called psychiatric medication to treat mental disorders in children, teens and adults?

CL: As a practitioner of social therapy I do not diagnose the adults and children that come to see me. However they often arrive with existing labels from prior therapeutic work or in the case of children, required school assessments. In many cases there are initial conversations about the diagnosis. Some patients feel that it has been helpful to them. Others often say it is merely used to get reimbursement for sessions. Some want to get off of their meds but feel they cannot.

The conversations I work to have about diagnostics have more to do with what we as the patient and therapist want to do with it, if anything. I am only interested in it as far as it has had an impact on the client. I do not see it as an accurate or preferable description of who someone is.

As for psychiatric medications, I think in general mental health professionals can move too quickly to prescribe. I prefer to create new kinds of conversations that deconstruct and creatively reconstruct a variety of activities in group therapy and outside of it that can support the person’s ongoing development.

EM: If you had a loved one in emotional or mental distress, what would you suggest that he or she do or try?

CL: First and foremost I would let them know that I am here. I would invite them to play the creativity game. I would urge them to create a conversation with their friends, one that is philosophical, exploratory and playful. They can decide how they want to go through this painful moment with others. Where do they want to locate themselves in all of this? Who do they want to include in this moment as part of building a network of support. Can they be in a muddle with their friends at their side? Can being in pain help them grow? I would encourage them to build something with the pain – write a poem, sing a song, call a friend.


Christine LaCerva, M.Ed., is director of the Social Therapy Group in Manhattan and Brooklyn, where she has a highly diverse, group-based practice with clients of all ages. With Fred Newman, the late founder of social therapy, LaCerva has worked for over 34 years to advance a philosophically inspired, postmodern, performatory approach to emotional development, helping clients build environments (everywhere) for emotional growth.


Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Write Dr. Maisel at, visit him at, and learn more about the future of mental health movement at

To learn more about and/or to purchase The Future of Mental Health visit here

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