Group Analysis

This paper proposes an ontological model of group-analytic process, that of the aesthetic transformation, where individual change is seen as the re-establishment of an equilibrium between internal and external worlds. The individual shares in the process of the group becoming itself, by participating in the transforming experience of the perception of beauty in the matrix.

This paper was presented to the Institute of Group Analysis, London, in July 1990, at the end of the qualifying course. It describes the work of a once-weekly group for psychiatric outpatients in a hospital setting. The therapeutic process is discussed in terms of Donald Winnicott's theory. Included also are comments on the author's personal and professional development during the course of training.

For the group-analytic conductor the question of control is ever-present. In its simplest guise it is how to tread the line between over-control of the group on the one hand, and outright abdication on the other. But it is clear that the conductor's conscious intention is not the only, or even the most significant, force controlling the group: forces within subgroups, the group as a whole, or pressure from other individual members may be much stronger. The conductor may even become aware that his or her own position and actions are not relatively independent and objective, but are a function of larger unconscious forces in the group. In this paper I take a clinical example in which control issues become explicit, and then examine four approaches to group theory—M.A. Lieberman's description of effective styles of leadership; A.P. Beck's system theory; S.H. Foulkes's group analysis, and W.R. Bion's psychoanalytic approach—in an attempt to clarify the nature of `appropriate control'. This suggests some approaches to the problems of over-control versus abdication, the need to deal with other sources of power in the group, and the pressure on the conductor to act out the group's unconscious conflicts.

Dream interpretation presents the group analyst with a theoretical as well as a practical (therapeutic) challenge. The classical Freudian interpretation that the manifest content disguises the latent content through symbolization, condensation and displacement, comprehended within a drive-discharge theoretical model, cannot be properly applied in groups since the very activity necessary for such an interpretation contradicts the role requirements of the group analyst. Emphasis on a technically complete and `correct' understanding of dreams tends to reinforce a dependency on the group conductor. This paper describes a study based upon investigation of all dreams reported in one of the author's own group-analytic groups over a period of four years. The quantitative data are illustrated by a case report from a period of the group that was particularly rich in group dreams.

In the USA and Canada inpatient group psychotherapy is widely practised, although rarely with the kind of sophistication required to conduct such a complicated form of treatment. In most hospitals, groups are usually led by clinicians with the least training. At major training centres, psychiatric department residents may or may not conduct such groups, but even when they do they invariably receive inadequate supervision (Yalom, 1983). Under these circumstances, unsophisticated, pragmatic approaches have won popularity: it is easier to control patients when simple formulas are applied. This paper describes the evolution of inpatient group psychotherapy in North America and summarizes current trends. Then a more dynamic approach is presented, its principles grounded in object relations and general systems theories.