Nearly every clinician-led online group expects cameras on. It’s one of the few firm norms, and people frequently experience it as arbitrary.
Why groups ask
A black rectangle isn’t a member. The others can’t tell whether you’re present, affected, agreeing, or making dinner. Speaking into a void changes what people are willing to say, and one dark square measurably lowers what the whole group discloses.
The leader can’t see how you are. A substantial part of running a group is noticing the person who has gone quiet and tight. With the camera off there’s nothing to notice until you disappear from the group entirely.
Fairness. Everyone else is visible and exposed. Being the only one who can see without being seen is an asymmetry the group will feel even if nobody names it.
And it’s frequently the pattern. This is the uncomfortable one. Turning the camera off at the difficult moment is, for a lot of people, exactly what they do everywhere — withdraw when things get close. A group is where that becomes visible and workable rather than automatic.
The setting that helps
Hide self-view. Every platform supports it and hardly anyone uses it.
Watching your own face for ninety minutes is the single most anxiety-producing feature of video groups, and it is self-focused attention made literal — the exact mechanism that maintains social anxiety. Turning it off changes the experience substantially and costs nothing.
If you’re in a group for social anxiety, do this in week one.
When off is reasonable
Most leaders will accommodate, and the honest ones say so.
Briefly during something overwhelming — crying is the usual case — is fine in nearly every group, though many leaders will gently encourage staying visible, because disappearing at the hard moment is the thing rather than the solution.
A connection genuinely too poor for video, an occasional session taken from a car, a new parent during a feed or a nappy change. Say so rather than leaving people to guess.
When it’s worth raising properly
If you can’t bear being on camera at all, that isn’t a technical preference — it’s material, and it’s worth saying at the screening call rather than negotiating in week three.
Some groups will accept a phased approach: camera off for the first sessions, on later. A good leader will treat that as a plan with a direction rather than a permanent arrangement, because the direction is the point.