Foulkes and Intersubjectivity: A Pioneer in Uncharted Territories

Abstract

Since the 1940s Foulkes developed his theory of group analysis. Originating from Freudian psychoanalysis, Foulkes—through his experiences with groups—developed new concepts about human motivation, pathogenesis of mental illness and therapeutic options. In contrast to drive theory, he postulated relationality, search for contact and exchange, and belongingness as central motivations. In a sometimes surprising congruence with Foulkes’ ideas, the intersubjective-relational paradigm came into being during the 1980s and has since, as ‘intersubjective turn’, substantially influenced contemporary psychoanalytic theorizing. It could serve as a bridge between different psychoanalytic schools as well as between contemporary psychoanalysis and group analysis.

Basic tenets of group analysis and relational psychoanalysis are demonstrated, differences and similarities pointed out.

Keywords

group analysis intersubjective-relational paradigm intersubjective turn relational psychoanalysis

1. Introduction: The Revolution of 1948: Foulkes’ First Book

When Foulkes’ first book An Introduction to Group-Analytic Psychotherapy (1948) was published, it was a milestone in several ways: it marked the birth of the theory of group analysis, created a bridge between social sciences and psychoanalysis, and openly questioned the heretofore valid psychoanalytic conceptual model. Foulkes had known about Trigant Burrow’s first experiments with group therapy and had long been thinking about how groups might be understood and used for psychotherapy. He reported about his experiences with therapeutic groups in his private practice in Exeter and the treatment of war neurosis at the Northfield Military Centre. In his private practice in the countryside, he introduced group therapy to patients who he also treated in individual sessions. Increasingly, he abandoned the individual sessions, as he discovered that he could achieve even better results using his ‘group analytic therapy’ only. This new approach considered the group to be the primary relational unit.

At the same time Foulkes proclaimed his perfect loyalty to Freudian psychoanalysis, somehow showing an ambiguous attitude towards his own discoveries that was to remain.

According to him, the group setting provides an opportunity to observe the defence mechanisms, with which we are already familiar in psychoanalysis, from a different perspective—and additionally to observe and study specific traits or tendencies that emerge only within the group analytic situation. The group conductor is inside the group as well as being outside the group, in contrast to the traditional model of the detached analyst who serves primarily as a ‘mirror’ or ‘surgeon’ (Freud 1912: 114; 117).

Foulkes considers the interpretation of unconscious material to be less relevant for the cure than open communication. In his clinical examples, he appears to be very active, encouraging, demanding, and openly expressing his personal standpoint. He also shows how the organization of a military hospital according to group analytic principals brought about surprising therapeutic success with war-neurotics.

2. The Further Development of Foulkes’ Theory

In the years that followed, Foulkes continued to develop his theory of group analysis which he published in various books, articles and presented in lectures (Foulkes, 1948; 1957; 1964; 1975 and 1990). Although he continued to work as training analyst, he wrote nothing directly pertaining to individual analysis any more. Foulkes the traditional Freudian training analyst and Foulkes the revolutionary group analyst stood side by side without really sharing much common ground¹.

With respect to group analysis, he cautiously sketched the outline he had drawn in his first book and his more precise formulations indicate how far he had distanced himself from the Freudian drive theory. He considered the group as a system of its own, which should be examined for itself and within a larger context.

The group and the individual are open systems, i.e. systems oriented towards the environment (Bertalanffy, 1950). The individual is part of an object-related world right from the beginning (being born into his primary group, the family). This is in contrast to Freudian metapsychology, where there is first the stage of objectless primary narcissism, later on the instincts attach secondarily to objects: ‘the object . . . is what is most variable about an instinct and it is not originally connected with it, but becomes assigned to it only in consequence of being particularly fitted to make satisfaction possible (Freud 1915: 121)’². This decisive paradigm shift affects all of the component parts of Foulkes’ theory, as will be described in greater detail later on. He writes, ‘The group, the community, is the ultimate primary unit of consideration, and the so-called inner processes in the individual are internalizations of the forces operating in the group to which he belongs (Foulkes 1971: 212).’ He also said, ‘What in later development is usefully abstracted as superego, ego and id arise from a common matrix, beginning at birth or perhaps even prenatally (Foulkes, 1973b: 236).’ So even the id—the core of drives in Freudian theory—is acculturated. ‘The basic human problems with which psychoanalysis is so much concerned I therefore see as being more transmitted than inherited, although the two are never watertight and apart (Foulkes, 1974: 276).’

All in all his basic theoretical constructs anticipate central tenets of the intersubjective paradigm in psychoanalysis, which were crystallized only 30 years later.

I would like to suggest that Foulkes is an early intersubjective theoretician whose central tenets have a great deal in common with and share a great similarity with the intersubjective-relational theories of contemporary psychoanalysis.

To a large extent, due to the separate development of group analysis and psychoanalysis during the last decades, the intersubjective paradigm, the major elements of which Foulkes had already discovered in the 1950s, has only recently been ‘rediscovered’ as the hidden link between contemporary psychoanalysis and group analysis (Aviv 2010; Billow, 2003; Potthoff, 2012; Schulte, 2000 and Weegman, 2001).

3. The Intersubjective Turn in Psychoanalysis

The so-called intersubjective turn in psychoanalysis was initiated in the 1980s, resulting from the dissatisfaction of many psychoanalysts with the then dominating ego-psychology paradigm. Already the first object-relational theorists, i.e. Ferenczi (1933), Winnicott (1971) Balint (1968) und Fairbairn (1952), had taken new paths. Whereas Winnicott und Balint were diplomatic and restricted their new ideas to specific groups of patients, Fairbairn, who was more scientifically oriented and unbiased, openly criticized the basic tenets of psychoanalysis and proposed a revision of Freud’s theory. This took place concurrently with the developing interpersonal psychoanalysis movement in the United States, which had already distanced itself from the Freudian school of psychoanalysis in the 1930s and 1940s by attributing a greater to influence individual environmental and cultural factors (Thompson, 1950; Sullivan, 1953). As interpersonal psychoanalysis was considered superficial and non-analytic for a long while, it was rejected by the mainstream psychoanalysis approved of by the IPA. Due to the emphasis interpersonal psychoanalysts placed on environmental influences, they turned their attention also to psychological processes beyond the couch setting and developed new strategies for treatment, including treatment of severely disturbed patients like psychotics (Searles, 1965). There are two streams in the contemporary psychoanalytic scene—mainly in the USA—that advocate the intersubjective approach. First the intersubjectivists of the Stolorow group, originating from academic psychology, who integrate also certain concepts from self psychology. Having devised their own theoretical system with a terminology of their own there is not too much linking with usual psychoanalytic theory.

Second, there is relational psychoanalysis, whose founders (Mitchell, 1988; 1993; 1997; 2000; Aron, 1996; Bromberg, 1998 and Hoffmann, 1998) were mainly trained as interpersonal psychoanalysts and have increasingly integrated the British object relational theory of the independent group, psychoanalytic feminisms (Benjamin, 1988), post-Kleinian approaches (Baranger and Baranger, 2008; Ferro, 2003), attachment theory (Bowlby, 1988), self psychology (Kohut, 1977) and the research results of by the so-called baby-watchers (Stern, 1985). Some post-Kleinians/Bionians (Ferro, 2003; 2005; Ogden, 1994) and post-Freudians (Jakobs, 2005) have intersubjective dimensions in their theories, too.

What do these different schools of psychoanalysis have in common? Stolorow et al. write:

Psychoanalysis seeks to illuminate phenomena that emerge within a specific psychological field constituted by the intersection of two subjectivities. . . Psychoanalysis is pictured here as a science of the intersubjective, focused on the interplay between the differently organized subjective worlds of the observer and the observed. The observational stance is always one within, rather than outside, the intersubjective field. Psychoanalysis is unique amongst the sciences in that the observer is also the observed. Patient and analyst together form an indissoluble psychological system, and it is this system which constitutes the empirical domain of psychoanalytic inquiry. Both psychological development and pathogenesis are best conceptualized in terms of the specific intersubjective contexts that shape the developmental process. (Stolorow et al., 1994: 131)

It seems that the theory of intersubjectivity offers one of the few concepts, which could form a consensus between psychoanalysts of divergent persuasions, so partially minimizing psychoanalytic pluralism without making it completely redundant. As a bridge concept it could also connect with group analysis. Considering the analytic couple, the basic unit requires a new orientation of all psychoanalytic concepts which extends far beyond a simple revision of object relations theory.

3.1. Short Outline of Relational Psychoanalysis

The analytic situation is understood as a co-created field which is determined by both parties, but—due to the setting, the analyst’s greater experience and his competence—it is also an asymmetric relationship—at least for the most part. Mitchell, one of the main relational theoreticians uses the term ‘relational matrix’, obviously not being familiar with Foulkes’ concept and terminology. The central motivational force is the search for a relationship with all that this implies. Sexuality is recognized as an important kind of relating and plays a special role in relationships. Aggression is also a very important clinical factor, but not considered to be a primary motivation, rather as a reaction to frustrating situations or to the threat of disintegration, and as an attempt to stabilize the self and to re-assert autonomy.

The relational model places communication and reciprocity in the foreground: the analyst is no longer ‘thoroughly analysed and omniscient’, but more like a partner in a dialogue, the old transference-object as well as someone who provides the relational experience of a new object–subject. Old transferences are played out and dissolved and a new relational experience is created. The analyst is more present as a real person, showing some of his subjectivity, and at times stepping out of the ‘classical’ position of detached observer. The new relational experience becomes internalized and modifies the structure of old, internalized, relational configurations.

So the experience shifts subtly from the past to the future of the new relational experience. The analytic couple and its reciprocal transactions are the unit of investigation. The analyst considers his activities and attitudes as substantially contributing to the process—and not only as countertransference that is essentially provoked by the transference of the patient. One of the key elements of the elucidation of the co-created intersubjective situation is self-disclosure, which is used in different ways: ranging from an almost blatant disclosure of one’s personal feelings and reactions (Renik, 1993) to cautious hints using selective, carefully chosen information about one’s personal feelings and fantasies as elicited in the analytic session. There is consensus, that the analyst’s personal situation and problems are to be kept out. As the analyst presents himself more as a real person, concepts like neutrality and abstinence take on a new meaning. Enactments that repeat trauma in the therapy are often inevitable. They take place far more frequently than has been heretofore generally assumed. The usual course of relationships is understood as a cyclical series of disruptions and reparations followed by other disruptions (Benjamin, 1990). Implicit–procedural, unsymbolized patterns of ‘being with others’ (Boston Change Process Study Group, 2010) underlie mature symbolization and shape dominant relationship structures that evolve later.³

4. Intersubjective Concepts of Group Analysis

a. The Matrix

The matrix is the continually developing network of the group members’ conscious and unconscious thoughts and feelings as they relate to each other. Already in the title of his article, The Group as Matrix of the Individual’s Mental Life 1990 Foulkes sums up the radical-intersubjective stance writing about, ‘transpersonal processes, that is mental processes, which, like X-rays in the bodily sphere, go right through the individuals composing such a network’ (Foulkes, 1971: 224). Further, ‘The mind that is usually called intrapsychic is a property of the group, and the processes that take place are due to the dynamic interactions in this communicational matrix (Foulkes, 1974: 277).’

Thus all that happens in the group needs to be referred to the group as the overarching intersubjective system. Thomas Ogden’s concept of the ‘analytic third’ (Ogden, 1994) may be considered as the psychoanalytic version of the matrix .

b. Communication

Communication is the motor of development. Psychic health is defined as the ability to communicate freely and to develop relationships in a comprehensive way. This is a different perspective from Freud’s goal, ‘Where the Id was the Ego shall be’. Whereas for Freud rediscovery is placed in the foreground, Foulkes aims at something entirely new. The group conductor’s primary function is to ensure that the communication within the groups keeps flowing. The preferred technique is not interpretation in the strict psychoanalytic sense—making the unconscious conscious—which is rarely used, but instead questioning, encouraging, confronting, responding empathically, or just being present in a very specific way.

c. Free Group Associations

Although the concept of free association is considered to be the equivalent to free association in psychoanalysis, Foulkes really aims at something different. Free group association is not something that lies within the individual, but something that is commonly created solely within the group by all of the members of the group together. Like the matrix, free group association is one of the intersubjectively emerging properties of group life that have a curative effect on the individual.

d. Resonance

Resonance explains the spread of free association in groups. Ideas or feelings emerge and grow within the group through mutual induction, in which each member of the group represents only one facet of the group as a whole, which is dependent on his individual developmental stage, individual needs, dominant defence mechanisms etc. Without resonance there can be no intersubjectivity in groups. Resonance is often unconscious—in the group, change precedes insight. Relational analysts think along similar lines.

e. The Conductor

Foulkes repeatedly emphasizes the key role played by the group conductor. His personality exerts decisive influence on the culture and the development of the group. He is intersubjectively connected to the group being simultaneously inside and outside the group. The conductor is endowed with magic qualities. He should withstand the temptation to satisfy the dependency needs of the group. At best, he moves from the position of the conductor of the group to the conductor in the group, thus fostering self-empowerment of the group. He should follow the flow of the group and actively intervene especially when resistances and defences arise that threaten to disturb the flow.

f. Foulkes’ Model of Therapeutic Change

Therapy takes place in the group through the group. The group analyses itself together with the group analyst who acts as a catalyst. Change takes place, and when communication becomes more open, multiple transferences are acted out and analysed, and different value systems clash, and—last but not least—new relational experiences are made with the other members and the group analyst. Change is preceded by both the invalidation of former object experiences (transference analysis) and the development of new patterns for object experiences, which tend to play a considerably greater role than the analysis of transference. Foulkes considers transference interpretation as less important and places greater emphasis on the facilitation of communication within the group. Ultimately, changes of inner and outer relational structures are the main objective of therapy. The group takes on the task of ‘re-socialization’ by affording each group member the opportunity to take his place within the network of interpersonal relationships in a way different to the situation before beginning therapy.

5. Where are Foulkes’ Deficits and Contradictions?

As Freudian training analyst, and at the same time founder of group analysis, Foulkes had a somewhat ambiguous position that also influenced his theorizing.

Although being revolutionary, there are remarkable contradictions and splits. The group model of primary sociability of man and Freud’s drive theory with the individual moving from primary narcissism to ‘variable objects of instinct’ are not easily reconciled. So Dalal (1998) speaks of an ‘orthodox’ and a ‘radical’ Foulkes.

As Nitsun (1996) points out, Foulkes minimizes the significance of aggression and advocates what appears to be a somewhat naive faith in the group, placing his trust in the power of the group when all else seems to fail. While Foulkes emphasizes the significance of aggressive phenomena (death instinct), particularly in the form of auto-destructive super-ego structures, he argues simultaneously that the source of the super-ego lies in social influences. When he finally defines the Id as being culturally determined, he obviously contradicts Freud’s model of the archaic heritage of the human animal. Group processes such as scapegoating are not understood as a result of what is actually happening in the group, namely as certain characteristics that surface within the group, but rather as a displacement of aggression actually directed towards the group conductor, the archaic father, onto a specific group member who is predestined to take on this role. There seems to be no need to explain exactly why this particular group is inclined to act this way.

In a similar fashion, Oedipal phenomena are understood as the result of an accumulation of individual pathologies. While a consistent intersubjective perspective would not ignore the individual dispositions, it would explain group phenomena as a new emergent characteristic of the system as a whole.

Although Foulkes emphasizes the importance of the group conductor, we are not told how his personality affects the group. There is only one article, where Foulkes illustrates more in detail how he thinks the conductor influences the group using examples such ‘the assistant or the shadow of the conductor’.

However, in these examples, he refers primarily as to how the group assimilates the split-off parts of the conductor’s personality. He mentions his enormous influence only briefly and remains vague about how the analyst positively influences and encourages the group. It seems as if the conductor influences the group through his personality, to a certain extent, through a kind of intersubjective flair. Similar questions about the analyst’s influence continue to be a major topic in the discussions of relational analysts today.

Foulkes developed his theories with utmost caution to avoid a rupture with mainstream psychoanalysis. The discouraging examples of Ferenczi, Reich and, to a certain extent, Fairbairn and Bowlby might have played a role here. At the same time, Foulkes is also a theoretician whose broad ideas are sometimes vague and lacking in detail. He writes about his method of conducting a group, how he prefers to leave sentences unfinished, and the problems that arise in the group unresolved. This approach intends to further the group process and is surprisingly congruent with the approach advocated by many relational theoreticians.

Unfortunately, but perhaps understandably, Foulkes rejects the object relation theory. In two of his works, he mainly deals with Fairbairn (Foulkes, 1957; 1975), the most radical representative of the object relations theory, who later proved to be an important precursor of relational psychoanalysis. Although Foulkes vaguely agrees with him, he still remains a staunch defender of Freudian theory. According to Foulkes, Fairbairn misunderstands Freud by interpreting drives in a broader context and, in so doing, abandons the central concepts of the libido theory, such as sublimation, displacement, etc. He fails to see that, while Fairbairn does not deny the known clinical phenomenon, he does interpret them differently. Foulkes calls the theory of internal objects ‘suggestion and exorcism’, which exculpates the individual from any responsibility for his own behaviour.

These phenomena become clearly visibly only, when one member of the group is placed under extreme pressure, but it is usually expressed indirectly in the form of projection onto the other members of the group. In contrast, he advocates a theory which focuses on the relationship of whole persons, thus failing to deal with the psychopathology of many severely disturbed patients.

One could justifiably also criticize him for his failure to take an interest in diverging ideas about group analysis. He mentions them now and then but focuses his attention primarily on the similarities they share with his own model.

6. A Group Situation Interpreted from an Intersubjective Viewpoint

This out-patient group existed in this constellation for one and a half years during which an astonishing stability had developed, albeit with an inclination towards a kind of still stand. Many members of the group had a history of severe trauma (sexual abuse, suicide of the mother, torture, imprisonment in the German Democratic Republic by the infamous Stasi, i.e., State Police).

Trauma was mentioned only with great caution while the group concentrated on maintaining solidarity and harmony and sometimes resembled rather a self-help group. There were no silent phases, and several members of the group took up lots of space to describe their individual situation. Sometimes critical remarks were made about the group, calling it a social get-together. I often felt shut out, superfluous, above all thwarted when I mentioned the dynamics within the group. My comments were often ignored, and if I insisted on being heard, I was told that everything was quite alright the way it was, they did not understand what I wanted from them. However, nearly all of the members gradually and perceptibly developed. I was disappointed because I wanted a group with more lively exchange, tossing the ball back and forth, and not a polite turn-taking of the players. In retrospect, I think that this was the way the group regulated the enormous neediness and, to a certain extent, created a protective membrane. Perhaps I was too focused on working through conflicts and failed to grasp and attend to some of the more structural problems.

When I saw young woman with a terrible history of abandonment and neglect (adoption, alcohol dependency, a series of sado-masochistic relationships, failure to maintain a permanent job), I considered group therapy because this person seemed somehow isolated and unaffected by relationships with others. I felt that she could benefit from a positive experience in a group despite (or because) her pronounced interpersonal deficits and lack of good experiences with peers (during puberty she had been involved with juvenile delinquents and drug addicts). I immediately thought of this group, which seemed at that time to be so stable and somehow motherly. I also thought of individual therapy, considering the symptoms and the severity of the current urgent problems, but I had no vacancies for individual sessions.

Ms. D had a turbulent start in the group. Within just a short period of time, she was embroiled in arguments with all the group members, and the theme of being ostracized quickly became concrete. When she was absent from a session, the group bitterly complained about her. One man, who up until that time had been very inactive, suddenly became vociferous: ‘She belongs in X!’ (the rough neighbourhood in the nearby town with the highest crime rate). In addition to this, they accused me of intentionally choosing her for the group to get something going—which was entirely unnecessary in this case! I did not have to think long about this, the facts could not be denied and I confirmed that this accusation was not wholly unjustified (self-disclosure). The group reacted with humour and a better understanding and discussed my interpretation of this when I said that I was surprised about how quickly the group determined to exclude one of the members.

Mr. H. began to work on his difficulty to deal with conflict. Later on a sort of an extended family therapy for Ms. D was developed to deal with her multiple problems which she threw at the group, never hesitating to debase or to project onto others. At the same time she proved herself capable of permitting the others to address her in a similarly drastic fashion, which made her increasingly accepted. The neediness in the other members, which had been warded off, became more alive and could now be worked through, and many were able to discover through her, their own past experiences as neglected children, and some were eventually able to terminate their treatment. In retrospect, I would now speak of an unconscious interplay and enactment, which in the long run had positive effects. I had put the group up to the challenge, the group had accepted the challenge and developed well.

A few months later when I took the liberty—again not entirely ‘innocently’—to introduce another, younger, female patient into the group—Ms. D. was at first outraged, only to realize somewhat later: ‘Now I am 35 years old and should slowly grow up’. From then on—similar to the group as a whole—she was increasingly able to oscillate between the childish and the more mature position—from an intersubjective point of view attain greater tolerance and integration of different self-states. Looking back, I think that at first both the group and I avoided very existential problems and then acted them out, and in so doing enabled the development away from the structured-neurotic surface towards the basic, underlying questions.

7. Concluding Remarks

If we continue along Foulkes’ path we arrive at a cross-path between group analysis and contemporary intersubjective–relational concepts. If we include Kaes’ concept of the internal group existing within each group member, and relate this to the concept of internalized self-object units of contemporary psychoanalysis, we will discover several common intersections between these theories. Unfortunately, at present there is little discourse between psychoanalysts and group analysts, which is certainly detrimental for both. At this point in time it is important to foster an exchange and hopefully to come to appreciate each other’s ideas. We could profit from each other’s work more if we presented case studies in greater detail and by focusing on the subjective experience of the group analyst. Here psychoanalytic literature with its very detailed description of clinical situations is a good guide.

Footnotes

Notes

Peter Potthoff a consultant psychiatrist and consultant in psychosomatics and psychotherapy and works in private practice in Ratingen/Germany. He is a training analyst for the German Psychoanalytic Society, group training analyst of the German Group Analytic Society and member of GAS. Since 2009 he has been a group analyst, supervisor and teacher in the workshops of the International Arbeitsgemeinschaft für Gruppenanalyse in Altaussee (IAG). He has written on mentalization based treatment in groups, supervision and relational psychoanalysis in groups and in the psychoanalytic setting. Address: Straßburgerstraße 13, D-40878 Ratingen, Germany. Email: Dr.med.Peter_Potthoff@t-online.de

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