Meaningful group structures are co-created within the long-term outpatient psychotherapy group through a hermeneutical interaction between structure and immediate experience of structure by individuals embedded in personal and collective contexts. Co-created meanings expand original group and self understandings and further evolve structures that are stable yet do not exist independently of the narratives and affects of the members who interact with them. Group structures do not reduce, expand, or dissolve but change in connection to the experiences and meaning attributions within the group. This intersubjective process mediates the emphasis within group theory upon leader responsibility for culture building that risks over promoting certain psychotherapeutic cultural intentions over others. Three examples of long-term psychotherapy group intersubjective hermeneutical interaction lend insight into global, cultural, and societal groups.