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Group Analysis Therapy – a therapy for our time?

Much of what we know about groups and the power of group therapy we can ascribe to the pioneering work of W.R Bion and S.H Foulkes, during and after the second world war. With this in mind, is it time again, as we did then, to consider group therapy being a therapy of our time? Today, it is not the threat of totalitarian regime from overseas that drives the distress that people feel but a pervasive culture of distilled fear of the “other” proliferate by today’s political classes which permeates the self and instills such anxiety.

Whether it be: ‘The need for austerity’, ‘The war on terror’, the fear of ‘Mass Migration’ or attacks upon the so called ‘scrounging indigenous benefit claimants’. The results are the same – that anxiety is increased, our sense of wellbeing is eroded, relationships suffer and social cohesion is attacked. The threat may not now be now from the Nazi’s, but an enemy that threatens us regardless.

Whilst this fear of the other is perpetuated, it is an uncomfortable truth that narcissistically driven gain, with its associated personality traits, is often afforded the status of being the highest of personal achievements. Conversely, collective, relational or just groups that promote sharing or creative thinking within non-hierarchical, non-financial orientations are given something far less than the status they deserve.

With this in mind, is it time to think about the group and it’s power to both inspire and hold the most intense feelings once again? But also is it time to challenge the individual to think about their personal entitlements, fears and anxieties over and around the other? Perhaps now, such as then, reconnection to group processes is required.

It was S.H Foulkes who gave the greatest trust to the power of the group to hold the most distressed, and in turn gave us the best understanding of the origins of that distress and the processes that underlie it.

For Foulkes and his acolytes, in the early days of ‘Group Analysis’, often it would be group processes rather than individual that would be relied upon most heavily to manage the most distressed. In those days in the Northfield hospital, it was the trauma of war (what we now know as post traumatic shock disorder) that was being treated and it was the group itself that was the main therapeutic medium for that treatment.

To understand how this medium was and is so therapeutically useful, we have to go further into Foulkes’ theories of the individual and the construction of the self. Whilst Foulkes was a classically trained analyst in the Freudian tradition, he had within his theoretical model of ‘Group Analysis’ a radical concept and departure from the orthodoxy of psychoanalysis. This he called ‘The Matrix’- a symbolic and hypothetical web of unconscious communication and meaning that we are all a part of, that permeates and shapes the person from their earliest moments.

The importance of this concept was that he saw individuals not as individuals per se, but as connected to a much wider net of socio-political and psychological process, whereby the individual was influenced and created by the environment and relationships around them. With this, the individual was seen not to communicate solely for themselves but as a ‘nodal point’ of communication for the wider system that included the personal.

In fact, Foulkes struggled so much with the notion of the individual that he thought that distress and neurosis emanated from its very formation. Or as Foulkes himself put it:

The deepest reason why patients………. can reinforce each other’s normal reactions and wear down and correct each other’s neurotic reactions is that collectively they constitute the very norm from which they deviate.  (S.H Foulkes 1948).

Reading Foulkes, we can begin to understand the need for the group and people’s places within it. As the socio-political influences of the day reinforce the need for greater perverse individualism and narcissistic gain, both the individual and the society at large experience greater levels of neurosis, creating a self fulfilling negative feedback loop that feeds and consumes itself equally. For Foulkes, it was only connecting and remaking contact with those larger social processes that alleviated the personal and social neurosis.

In the therapeutic world, perhaps the harshest of criticisms is, rather cruelly, that of ‘denial’. And it is this Foulkes was charged with. Foulkes’ highly positive schema of the individual within groups, reconnected to the matrix that in their individual state they had deviated from and become distressed, was considered far too utopian for some of this contemporaries and followers. It is true to say that Foulkes had no schema for the anti-group or destructive phenomena that occurs in groups. It was perhaps W.R. Bion who could describe more fully the destructive elements within group life and with it present something of a dichotomy in group thinking.

Bion, in his theory of groups, was able to differentiate when groups were working and when they were not. When processes were creative and when they were stuck. Bion described this as the theory of “Basic Assumption Groups”. Using his theory to think about groups, we are able to differentiate when a group is working – engaged in its primary task of overcoming and understanding neurosis – and when it is not – that is, has become a “basic assumption group”. Bion, essentially an analyst trained in the Kleinian school, was able to identify when anxieties were high and the group had fallen into an unconscious defensive position. In such a position, the group relies heavily from within its number on dependency figures, in the unconscious hope that the individual or pair will rescue it from its neurosis. Differently to Foulkes, it was the personal unconscious stimulated by the presence of the group, and the imponderables therein, that inspired the group to amalgamate into a split position and defend against its primary work task.

While personally I find the theory of groups fascinating and could spend far more time exploring than this piece allows, I want to return to the central point that groups are both able to inspire and hold the a strongest of feelings. I asked the question, ”is group therapy a therapy for our time?” And whilst there is obviously no definitive answer to this question, what is important is that therapy in our time should have a way of reflecting on the type of processes that inspire the kind of anxieties that people suffer with and illustrate that their origins are not always from within. Our therapeutic understandings need to be able to place a person in the socio-political context that permeates the individual, and both give an understanding of what inspires anxieties and make conscious how those anxieties come to reside there in the first place.

In addition to this, therapy needs locate us within our own personal potential to split and inspire in us a greater understanding of what influences our splitting. There resides within us an understandable desire for a charismatic leader(s) to rescue us from our most primitive fears, a desire which drives us to project not just the worst of ourselves, but also the best of ourselves into the other – depleting our own internal resources. It is group analysis and group therapy that can most usefully offer this in my understanding.

Lastly, there is a brief point referred to earlier regarding narcissism. I made the point that in our time often what can be described as serious narcissism and self entitlement is celebrated and defended within our society – the banking crisis and the defence of those that maintain it, whilst scapegoating the poor, being the most obvious of the current examples of this. However, in groups it is my experience that narcissistic processes either within a group’s membership or within the therapist themselves remain unchallenged. Actually, group analysis has a unique unfathomable way of both inspiring a person’s narcissistic traits to be present and challenging them when they do. However, that is another paper altogether. But needless to say, the benefits of challenging the cult of narcissism would have far reaching positive outcomes.

I started with a point that what we know about groups was inspired by the need to treat the sufferers of the worst conflicts the world has known. Today, conflict – whist not as explicit as the wars of the 20th century – is waged in ideology and economics as much as conflict with weapons. As such, I believe the group is required to illustrate the processes that underpin the split positions that allows for such sadism, and at the same time acknowledges that, like then, there are many distressed people traumatised by those same processes. Groups are ideal to support and hold the most serious of traumas.

Michael Caton

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This entry was posted on August 29, 2014 by in Uncategorized.