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Median group: training and supervision
Pisani R.A.*, Colangeli G**., Giordani A**., Popolla P.**
Dipartimento di Scienze Neurologiche, Università di Roma
La Sapienza, Viale dell'Università 30, Roma, ITALIA
The authors summarize the main theoretical concepts concerning groupanalysis. With regard to the Median Group an experience of training and supervision is reported. The trainees participated for three years as group members in a Median Analytical Group. Further they participated as co-therapists in a Median Group for two years performing weekly groupanalytical supervision.
The Authors take into consideration mirroring as a basic phenomenon in the supervision process in a Median Group. Some very meaningful sessions of the supervision group are reported.
Key words:groupanalysis, median group, training,supervision.
Before speaking of the specific theme of training and supervision in the Median Group, we must first summarize some fundamental notions concerning group analysis.
The individual system, which we can make coincide with the tripartite structure of the mind into Id, Ego and Superego, is closely related to the mother-child system, in its turn related to the family system, which is related to the social group and vice versa.(Diagram 1)
As Foulkes says (Foulkes S. H., Antony E. J., 1965), the child is determined by its parents who in their turn are determined by their family, region, culture, religion and nation, that is to say, by the relational context, which in its turn it helps to determine as it grows.
Diagram 2 shows the interdependence between the intrapsychic, the interpersonal or interaction network and the transpersonal or group matrix.
The interaction network means that the individual intrapsychic equilibrium is structurally linked to the equilibrium of the interpersonal relations and that every breakdown, or individual alteration, involves a breakdown or alteration of the entire network and vice versa (group dynamic).
Group matrix means that this communication and relation network contains some contents that consist of the biological and cultural heritage individuals have in common.
Group analysis is a psychoanalytical psychotherapy.
We speak of psychoanalytical psychotherapy when we take into consideration:
1) The unconscious;
2) The content of the unconscious: that is, the Id's instinctive drives, the repressed unconscious, the defence mechanisms and the archetypes of the collective unconscious;
3) Analysis is all the work that is done to make the unconscious conscious and to bring about a change.
Psychoanalysis operates on a dual relationship, based on transference-countertransference.
Instead, group analysis operates on a multipersonal relationship based on multiple transference but also on many other factors that are not transferential but are more concerned with the here and now: that is, mirroring, resonance, corrective emotional experience, Ego-Self training in action, socialisation. (Diagram 3).
INCONSCIO: PULSIONI ISTINTUALI,RIMOSSO
MECCANISMI DI DIFESA
ARCHETIPI DELLINCONSCIO COLLETTIVO
ANALISI. TUTTO IL LAVORO FATTO PER RENDERE CONSCIO LINCONSCIO
PICCOLO GRUPPO DI FOULKES : 7-8 MEMBRI
T= t + x
t= TRANSFERT MULTIPLO
x =HIC et NUNC:RISPECCHIAMENTO ,RISONANZA, ESPERIENZA EMOTIVA CORRETTIVA,
EGO TRAINING IN ACTION, SOCIALIZZAZIONE
The total situation of therapy (T) includes transference (t) and all the other factors of the here and now (x).
Group analysis is a psychoanalytical psychotherapy performed by the whole group, under the guidance of the conductor, through communication and the work of translating the meaning of what is communi-cated.
This work leads to the maturation of the group matrix, which in its turn produces the individual change. The individual's maturation is to the further advantage of the group matrix, in a dynamic and circular continuum (Diagram 4).
De Mares Median Group is a development of Foulkes Group Analysis and it is placed in an intermediate space between the small group and the large group, much closer to the social context.
It has a dimension of between 12-30 members. The principles are the same as Foulkes group analysis but applied in a wider setting.
We can summarise Pat de Marés main ideas as follows (Diagram 5).
CONTESTO SOCIO CULTURALE COME OGGETTO DI TERAPIA.
ENFASI PIU SULLOUTSIGHT CHE SULLINSIGHT.
CONFLITTO INDIVIDUO-GRUPPO DI FONDAMENTALE IMPORTANZA.
OBIETTIVO: PIU UMANIZZARE IL CONTESTO SOCIO-CULTURALE
CHE SOCIALIZZARE LESSERE UMANO.
METODO AFFINE A QUELLO DEI PICCOLI GRUPPI:FACCIA A FACCIA,
UNICA FILA DI SEDIE IN CIRCOLO, DISCUSSIONE LIBERA,
TERAPEUTA NON DIRETTIVO, ETC.
TRASPOSIZIONE CULTURALE PIU CHE TRANSFERT.
FOCUS SU HIC ET NUNC: RISPECCHIAMENTO, RISONANZA,
ESPERIENZA EMOTIVA CORRETTIVA, EGO E SELF-TRAINING IN ACTION.
ODIO PRIMARIO RECIPROCO TRASFORMATO, ATTRAVERSO IL DIALOGO,
IN COMPARTECIPAZIONE, COMUNIONE, CONDIVISIONE (KOINONIA).
In the Median Group the therapist is non-directive and remains relatively dis-engaged, refraining from setting topics or goals. His purpose is to put individuals in a position to dialogue. Dialogue constitutes the transformative process that converts what does not make sense into understanding and meaning. It is a matter of cultural transposition rather than transference. The focus is more on here and now. The non-trans-ference aspects are much vaster than in the small groups. Mirroring, as it has already been analysed well by Pines M. (1984, 1998 ), in the small groups, is particularly in the foreground, together with Ego-Self training in action.
Whereas in the small group the conductor is a transferential figure and the principal projection of parental figures, in the median group the group as a whole constitutes the canvas onto which the Superego is projected. The convenor himself supports more the role of individuals at an Ego level, encouraging freedom of dialogue and interpreting the nature of social and cultural pressures.
In the Median Group the individuals learn how to speak and how to deal with the emotions aroused, which becomes a very active exercise for the Ego (Ego training in action), which learns how to stand up to the repressive forces and emotions aroused. The individual Ego gradually learns how to speak and think spontaneously. The relations between Id and Ego on the one hand, and between Ego and Super Ego, on the other, are modified in favour of a great liberty and strength of the Ego.
At the beginning the danger of persecutory attack by the group towards the individual, or of the dissolution of the individual into the mass, gives rise to panic of near psychotic intensity. Fear of speaking and losing identity leads to a narcissistic isolation, which engenders the primary mutual hatred.
But if dialogue continues, identity (the Self) arises from the Koinonic atmosphere of social interaction. Dialogue encourages the fall of the defence mechanisms and free individual expression (Pisani, 2000a, b). It allows the individual narcissistic barriers towards the outside world to be overcome. The primary mutual hatred is transformed into Koinonia: sharing, participation, communion, company (cum panis: those who eat the same bread).
Dialogue with the outside allows a re-organisation of the inner dialogue. The individual comes to know himself through the reaction he causes in others and the image that is sent back to him (mirroring).
Unconscious aspects of the Self are discovered through interaction and dialogue with others.
The individual differentiates through a constant comparison of similarities and differences with others (Brown D.G., 1986)
In short, the group analytical relation is expressed in a work of individuation through recognition and rejoining of the split parts of the Self (Self-training in action).
Group analysis has moved the focus from the individual to society, or rather, it has put the individual in relation to society. With the creation of the developing and maturing micro-community and the micro-culture, the Median Group represents a further step forward towards an analysis of society.
TRAINING AND SUPERVISION
The debate on the group analysts training is of topical relevance and very vast (Behr, Hearst, etc.). In our opinion training, as for the psychoanalyst, requires a personal groupanalytical therapy, theoretical seminars and a period of supervised conduction of groups, both for the small group and for the median group.
Therefore the convenor of the median group should have solved his own personal neurosis or at least have acquired a good awareness of it, something that is fundamental for the development of his capacities for intuition and empathy.
As in the small group, the conductor sets in motion and fosters the process of maturational communication in which the whole group participates and which is translated into individual maturation. He therefore participates personally as a member of the group. He has one foot inside and one foot outside.
As we have said, in the median group the attention shifts definitively onto the social aspect or rather onto a closer correlation between the intrapsychic and the social context.
Phenomena of transference become less important so that they almost disappear. Instead, those of the here and now and especially of mirroring are prominent.
Mirroring includes the most precocious mechanisms: denial, splitting, projection,introjecton, identification and projective and introjective identification.
In the median group, more than in the small group, the human mirrors offer perspectives of ourselves and of how others see us allowing one to observe the different facets of human development, conflicts and the various attempts to solve them .
In psychoanalysis and in the small group we speak of transference and countertransference. Racher describes countertransference as the instrument for understanding the patients mental processes (therein including above all his transference reactions), their content, their mechanisms and their intensity. Consciousness of countertransference helps us to understand what needs to be interpreted and when (Racher H. 1968).
In the small group and in the median group as the transference phenomena gradually decrease, until they almost disappear, it no longer makes sense to speak of countertransference. Instead it makes more and more sense to speak of multiple mirroring on the part of the therapist, who participates in the groups multiple mirroring.
The members of the group are parts of him and from this viewpoint any intervention on the therapists part corresponds to specular reactions. Foulkes speaks of counter-reactions (Foulkes S.H., 1990). The group matrix incorporates the therapist, who has conscious or unconscious reflex emotional responses to individuals or the group as a whole.
The therapists personal mirroring helps him to understand the mental processes of individuals and of the group.
Mirroring is implicit also in the traditional concept of transference and countertransference.
Racher speaks of concordant and complementary countertransference.
Concordant countertransference comes from identification with some aspects of the patients images of himself and is therefore a resource for the therapist, an empathic understanding of aspects of the patients inner world.
Complementary countertransference comes from identification with an object of the patients inner world and is based on the mechanism of projective identification (Prodgers A., 1991).
These concepts clearly coincide with the concept of mirroring. Also Bion, speaking of projective identification and projective counter-identification, refers implicitly to specular phenomena.
Groupanalytical supervision must therefore make allowances for conductors mirroring.
We present a report on two sessions of the Supervision group composed of the convenor (R. Pisani) and three co-convenors of the median group in the Outpatients Department of the Department of Neurological Sciences, Rome University La Sapienza.
The supervision group met over a period of two years after each weekly session.
SUMMARY of the SUPERVISION SESSION of 9.2.2000
P. (co-convenor) opens the session and describes a dream that goes back to the previous session when the subject of separation from the mother was discussed in the median group.
P. is in a flat somewhere in Rome, where F*. and C*. (female-members of the group) are celebrating something. P. has to go to work and she leaves the party. F. offers to accompany her because she has to take her daughter to the fun fair. F. walks along the street hand in hand with a girl of about 12. P. does not know the area, but the road seems too long. F. suggests they take a shortcut that crosses a gypsy camp. She asks her whether she has anything of value with her. P. has her keys and credit card in her handbag. F. reassures her because she knows some of the people in the camp. They enter the camp, but they find they are in circus with jugglers, trapeze artists and lion tamers. F. warns her to hold on tightly to her bag because she sees some gypsies who are working in the circus, but in actual fact they are thieves. Two coloured clowns, but unpleasant and sad clowns, who want her bag, approach them. P. refuses, they insist, so with determination P. pushes F. and the child towards the exit. Outside they celebrate their lucky escape.
The convenor points out the mirroring aspect with regard to two women in the group.
P. (co-convenor) associates the Roman district in the dream with a colleague who lives there; she too is called F. She reminds her of an interfering maternal female figure, who does not, however, correspond to her mother.
A. (co-convenor) wonders which parts of P. the two women represent. for G. (co-convenor) the interfering mother is the mother that P. would have liked. The convenor indicates the reassuring aspect of trusting C*. and F. in the dream, as mirrors of feminine aggression in the group, with the expectation that they can be guides in the gypsy camp where a thief may steal her bag.
With reference to the days median group session, G. (co-convenor) emphasises the irritation she felt before the excessive talking of a male member who, in her opinion, the women in the group did not want to repress. The convenor wonders what G.s mirroring is regarding her anger towards the female group that remains silent and leaves the entire period of time for the male who enslaves women and makes them become prostitutes, as had emerged in previous sessions. He remembers that the theme of the session, introduced by a woman member, was difficulty in falling in love with a man (father) because he is a sadistic rapist or a thief who steals your bag. He asks G. why she did not intervene as co-convenor and stresses her identification with the groups silent members (passive aggression), who observe, as spectators, a common theme on various levels, oral, anal, Oedipal, with characteristics that depend on personal history. G. reflects that she would have liked to intervene to ask the women in the group if fear of confrontation with the male could conceal fear of betraying the mother.
The convenor ends by pointing out the importance of considering the gestalt: the whole in which we are implicated. The dream reflects the group theme. P. places her trust in an aggressive/punishing woman-mother in order to cross the gypsy camp: it is the group camp, which she still does not trust very much. The risk is that being in the group context a thief may arrive, the familiar male figure (father, husband...) that is superimposed on the convenor. Facing the male, who can rape, steal keys and money, put you on the streets, P. assumes the role of saving guide.
SUMMARY of the SUPERVISION SESSION of 31.3.2000
G. (co-convenor) starts by pointing out that during todays session, in which a discussion on homosexuality emerged, she had difficulty in maintaining her identity as co-convenor, while it was easier for her to assume her identity as a member of the group. They discuss the negative attitude of some male members of the group regarding the presence of M. (homosexual), who is the collective representation of homosexuality. The convenor points out that it is necessary to consider the group as a whole. It is important to realise that if we marginalise M., we marginalise a part of ourselves.
A. (co-convenor) considers that M. acts as a mirror: he reflects our homosexual part, which frightens us. She points out how the convenors intervention has helped M. and allowed him to recognise a harmless paternal authority which has restored a correct balance to the image of severe judge projected previously on the convenor.
The convenor asks the co-convenors how they feel their homosexual aspects and connects their silence during the session to these. Referring to the invitation the convenor addressed to a woman member of the group asking her to speak about her homosexual aspects by fantasising about them, G. explains her own fears in establishing a homosexual relationship even though she discovers a part of herself that loves women, observes them and takes a delight in their beauty. The convenor wonders how much anxiety regarding homosexual aspects have prevented her from entering the session as co-convenor. A. (co-convenor) wonders how the positive aspects of the female figure should be presented to the group. The convenor points out the importance of focalising the fact that women are not only terrible mothers, but that the origin of life comes from them. A. reveals that the invitation to fantasise about a woman has placed her before a void, as if she could not relate to her homosexual part. G. considers she cultivates this part by maintaining female friendships with whom she shares many aspects of herself. A., cultivating a friendship with a man who has many female characteristics, although he is not homosexual, points out how what one cannot find in the maternal figure, is sought in the paternal figure.
The convenor concludes by referring to the Jungian viewpoint which expresses the basic concept in which the male projects his anima on the woman in order to be able to take her into consideration, just as the woman, projecting her animus on the male, can go out to meet him halfway. Coupling is therefore simultaneously heterosexual and homosexual.
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*Rocco A.Pisani is Psychiatrist, Groupanalyst
Head of the Outpatient Department, Department of Neurological Sciences
La Sapienza University, Rome, Italy
Full Member of the Group Analytic Society, London
Full Member of the I.A.G.P.
Authors address: Via Latina 166-00179 Rome, Italy
**Colangeli G., Giordani A., Popolla P. are Psychologist, Psychotherapist, Groupanalysts trained as Median Group Convenor
Full Member of The Group Analytic Society, London
e-mail: Colangeli G.: firstname.lastname@example.org
Popolla P.: email@example.com
Giordani A.: agior @in wind.it
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