Abstract
This year the 8th Nordic Group therapy Symposium was held from the 6th - 8th of June in Moltes Palæ, Dronningens Tværgade 2 in the heart of Copenhagen. With over a hundred participants and a well organized programme it turned into three intense and rewarding days with the Nordic Matrix in the centre.
It is with excitement and expectation that I signed up for this year’s symposium. I looked forward to exchanging thoughts, feelings and fantasies, and concrete experiences in the group psychotherapeutic field. I also sensed a basic joy that Copenhagen would host the Nordic Group Therapy Symposium this time around. As always on these occasions I was motivated by the special combination of professional exchange, inspiring theoretical and professional sessions with workshops and papers, plus median and large group experiences. In the moments when the ingredients are mixed in the right combination something meaningful happens – something I know I would not miss.
The programme really indicated that a big effort had been put into the organisation of the event. It was dense and the items were promising.
The two plenary lectures were given by Christian Bjørnskov and Finn Skårderud respectively. Two substantial contributions, which each in their own way, explored the power of cohesion in Nordic societies. Christian Bjørnskov showed that the Nordic countries have a very high degree of social trust. The lecture discussed the implications of this in relation to themes such as welfare, integration and social and societal power of cohesion. Finn Skårderud focused on the dynamics that arise when humans fall outside the framework of the Nordic welfare states – illustrated by an analysis of Anders Breivik’s extreme actions.
Apart from the lectures there were three paper sessions including eight papers plus eight different workshops. The paper sessions had three main themes: culture, crisis and identity plus methods of treatment and research and special patient groups. The presenters were: Svein Tjelta, Helle Ø. Andersen, Per B. Knudsen & Randi Luggin, Johanne Stentoft, Per B. Knudsen & Annette Møller Jensen, Per Sørensen, Steinar Lorentzen, Eva Rosenlund, Marie Anter & Lena Wennlund og Pia Litzell Berg & Eeva Espalani. The eight workshops backed up the overarching themes very well. Steinar Lorentzen conducted a workshop with the focus on short-term Group Analytic Therapy with the title “Short-term group analytic therapy for out-patients with mixed diagnosis”. Fransisco Alberdi tuned in on Scandinavian self knowledge, taking as his starting point the headline “Scandinavian Dynamic Matrix in Perspective”. Catarina Asklin Westerdahl, Lena Wennlun & Ann Orhammer addressed the central challenges in ensuring that Sweden in the future has sufficient well qualified professionals in group analytic psychotherapy. Teresa von Sommarug Howard let culture speak through the workshop “Images from Let the culture Speak”, her experiences from a Median group, which has existed for 17 years. Michael Munchow offered his perspective on the “we”, pointing out how today’s understandings of groups and society is informed by, among others, Søren Kierkegaard and Pat de Mare. Tove Mathiesen & Peter Ramsing demonstrated how dream telling can be used as an informative and transformative source for the investigation of the individual and common perspective. Lars Bo Jørgensen & Søren Aagaard focused in their “Workshop on Group Analytic Concepts - project for a group analytic dictionary” on basic group analytic concepts through their project of a group analytic dictionary. Finally Goran Ahlin & Ulrika Segerkrantz focused on the Swedish and Finnish training model for group analysts.
There were a lot of other reasons to look forward to the symposium. In common with previous symposia a gala dinner was arranged, which took place at Borup’s High School and I, like most people, signed up for everything.
The main lectures surprised me, positively. Christian Bjørnskov was the first speaker after Hanne Larsson’s welcome and introduction. In contrast to Finn Skårderud, he chose to communicate his research results in English. It was annoying, however, that the sound-system was not tested before starting as the acoustics were abominable. Nevertheless, Christian Bjørnskov succeeded in getting his message across due to his strong charisma and clear way of speaking. A central point in his lecture was that social trust is a phenomenon which is transferred and established in the first years of life. In a time marked by relativism and constant accentuation of the discursive processes of negotiated meaning for our perception of reality this point seems provoking and reassuring. If we are to believe the research results, the degree of social trust changes minimally over time. Bjørnskov further showed us that there is a correlation between a high degree of social trust and wealth. On the other hand the high degree of social trust restricts our capacity to take in and integrate new perspectives. The explanation of this paradox is that the high level of social trust is accompanied by a high level of expectation. In other words, we are at risk of switching off because we are disappointed when our expectations of other people are not met. I was interested to see how Bjørnskov’s points would resonate in our symposium. With so much social trust gathered in one place it could, so I expected, only go wrong. As Bjørnskov emphasises we are, due to our high social trust leading candidates towards disappointment and its potential destructive effects. (How and why?) the last sentence is not clear.
I left Bjørnskov’s lecture inspired by the thought that we always talk about the value of good attunement of our mutual expectations, but seldom realise this state in practice. Maybe part of the explanation is that we suppose it is not necessary, because we trust that we can count on each other. This dynamic could mean that we often neglect meaningful differences and nuances in our mutual exchanges. This, in turn, results in us being disappointed by others and we lose the capacity for empathy.
When I sat in the first of two large group sessions, it became clear that Bjørnskov’s lecture had made an impression on all of us. Contrary to many of my former large group experiences this experience distinguished itself by a remarkably high level of activity. There were not many silent moments and it seemed that everybody was eager to have a go. Most of the energy of the group was directed towards the question of; which national language would dominate communication in the group. It was as if the whole group’s energy was directed towards answering the underlying question of how the group can clarify how to find enough mutual empathy in order to increase further contact and common understanding. The many remarks about the importance of national language for an authentic experience of one’s own feelings gave me a feeling of being alone. Maybe this experience tells us something important about the Nordic foundation matrix. We may have a tendency to take the Nordic fellowship for granted. We have maybe a basic trust, that we are so much alike, that we understand each other in spite of the differences in our National languages. Maybe that is why I sense a sneaking frustration that the group prefers to keep exploring which national language dominates, instead of asking what motivates this apparent need.
Just before our large group conductor said that time is up, it struck me that once again I had been part of a meaningful group analytic group process. I felt my own and maybe also the group’s frustration about the difficulty of connecting the global to the national level without losing the creative potential of the group.
On the second day median group sessions, papers and workshops filled our programme. After the first median group, which turned out to be a quite intense and rich experience, I chose to listen to Michael Munchow who conducted a workshop with the title: “Thinking about groups in relation to society, culture and spirituality against a background of theoretical and practical transitions in today’s Group Analysis.” A long title for a thought provoking and ambitious workshop.
Michael’s angle of incidences run along two axes. The one focused on the group as model for interpersonal relations, the other focused on the “we” that characterises a group or a society. The intention was to throw light on how for instance philosophy and other more spiritual discourses in the future can enrich group psychotherapy.
I noticed that Michael both invited us to think further about the potential for development and future directions underlying the development of the thoughts in the group analytic discourse, as well as reminding us that group identity and affiliations contain also essential spiritual dimensions.
It turned out to be a lively but also intellectually demanding time. First, we engaged in an etymological process, where we together went jointly on an archaeological exploration of Pat de Mare’s reading of the Greek concept koinonia, which can be paralleled to the Danish concept of “fellowship” or the Anglo-Saxon concept of community. Thereafter, we explored Tom Ormay’s reading of the Latin “nos”, which can be seen as a parallel to the Danish “vi” or the Anglo-Saxon “we”: Truth as a concept was also explored – “Truth is subjective and inter-subjective.”
I am getting aware of the importance of never forgetting that truth in the group analytic process is woven into complex inter-subjective processes, which both are of importance for how we perceive and interpret a situation and play a central role for the feelings and understandings we put into our experiences of fellowship in a group.
We also got around to Kierkegaard. In his work the truth concept plays a central role and subjectivity emerges through the special polyphonic narrative style of Kierkegaard. It is not a long way from Kierkegaard’s chorus of voices to life in the group, where it is mirroring and dynamic processes which shape our experiences of understanding the individual in the group and the group in the individual. When we rounded off the workshop I caught myself being ready to establish a reading circle - knowing that my own programme realistically does not leave any room for more appointments.
The paper-sessions took place immediately after lunch, which by the way is very good. I chose a paper-session with the headline: “The Large group in between dynamic and cognitive group psychotherapy”. After the intense philosophical workshop by Michael Munchow I needed to hear more about experience, the practice, which characterises daily clinical work. Per Knudsen and Randi Luggin from the psychotherapeutic unit at the Psychiatric Centre in Amager told us about their experience with a group model, that has been formed through a period of 11 years.
It is interesting because the presenters were capable of presenting a series of vignettes that described the experiences with a therapeutic method that builds on a combination of dynamic and cognitive thinking. At this moment I felt we were in the middle of something very essential. The circumstance that there is more that connects than separates the two psychological orientations is a pleasurable experience.
The next papers were a proper continuation of Per Knudsen’s and Randi Luggin’s introduction focusing on “Resilience Focused Psychotherapy: A clinical focus on strengths and resources in the treatment of personality disorders in hovedstadens psykiatri.” We were introduced to a qualitative analysis, that takes as its starting point the experience of 4 patients in a treatment package that also contains a group aspect. The basic substance in this method of treatment however builds on a design that is developed by Christine Padesky. The method is cognitively based and revolves around the use of case formulations. One operates with a sharp focus on understanding and encouraging the strengths and resources in order to promote resilience.
I especially noticed parts of the analysis which described the patients’ experience of resilience and strength in handling challenges and their experiences of the group therapeutic aspect of the course of treatment. Johanne Stentoft, Per B. Knudsen & Annette Møller Jensen delivered a clear Analysis that raised my interest and animated me to think more about the reductions in our contemporary treatment services.
The last presenter was Per Sørensen who asked “Does MBT Group therapy differ from Group analytic Therapy? Theoretical reflections and clinical experience.” Here too the starting point was clinical experience. The treatment method is the mentalization-based group therapeutic approach formulated by Sigmund Karterud (MBT-G). The patients are severely disturbed Borderliners. In spite of my tiredness, at this stage of the day, I got engaged in those aspects that touch on deliberations concerning what the specific clinical basis and the specific clinical model mean for the way one understand one’s patients the clinical work and not least the way you handle your interventions in the group.
The Day was rounded off by a median group session and a joint dinner at Borup’s Highschool. It turned out to be a lively evening with rich opportunities to study the Nordic Foundation Matrix in a new way.
The third day started with a very inspiring lecture by the Norwegian psychiatrist Finn Skårderud. The heading was: “Safety and Rage – the Norwegian Tragedy 22nd July. Afterthoughts about terror in the Nordic welfare state” I looked forward to this lecture. I had been told that Skårderud is intending to have a book on the way, which from all accounts will be based on the extreme terror actions which took place on that day at Utøya. I could not help thinking how my Norwegian colleagues would put up with this lecture. Everything pointed to this lecture being anything else but daily fare, which turned out to hold true.
Breivik, in Skårderud’s optic, is a person that could not cope with the complexity of the present time. Breivik is also a person who didn’t fit in with the framework of the welfare state and who ended with being the agent of a tragedy of incomprehensible dimensions. From there Skårderud took us on a journey, in which we lived through Breivik’s life story, his ambitions, his defeats, the countless failures from his environment and his crusade. All this was followed by an original and gifted analysis of the present age: our relation to solidarity; our conceptions of a successful life ( the goal is to be special); the monstrous masculinity; etc. Even if I could not quite follow all Skårderuds’s points, because of my difficulties in understanding the Norwegian language, it was clear that extensive work had been put into understanding, preparing and delivering this lecture.
When Skårderud rounded off his lecture we had heard so many facets and looked at Brevik from so many angles that a distant figure now had become a person, who attracted attention and help from the surrounding world, a society – and welfare system, that was not able to respond before. I was affected and most of all burdened by a feeling of powerlessness. How could we let this happen? Skårderud pointed to a basic human condition. We have to live with and understand that there is something we cannot understand – and that this is also the case with Breivik.
Skårderuds lecture belonged to one of the more rare experiences. I felt both enlightened and touched at the same time. Not only do I know more about Breivik and the present time, but my engagement in Society has also been corrected. I do feel myself more bound to and integrated into the community.
Later on when I sat in my median group I sensed a markedly different contact to the group. I felt grateful and privileged that we could share Skårderuds lecture and share thoughts, feelings and fantasies. It is in moments like this that the group finds a common focus driven by a feeling of being united in something beyond our profession and our National language.
In the large group, which marked the end of our symposium, I had almost the opposite feeling. Whereas the median group was subdued and caring there was a latent tension and aggression in the large group. A few people spoke several times and for a long time. Some of the voices were preoccupied with the way the police handled the Breivik assassinations – “The police should have acted earlier”, other voices were preoccupied with the question of what National language we are going to be communicating in at the next Nordic symposium. Others reflected on whether or not they were going to come next time.
I was thinking that by saying good bye we have to deal with the feeling of powerlessness and who is going to save us? Those three days at the Nordic Symposium offered a wealth of impressions. We had solved many different tasks together and each one by him/herself. What we missed maybe to share more collectively was that there is something we cannot understand and this is good enough.