Group Psychoanalysis


by Marco Longo
(translated in english by Laura Selvaggi)

In a therapeutic group, as in every kind of human group joining around a shared purpose, it's easy to find since the beginning phase the presence "between" the members of a strong emotional activation, mostly an unconscious one, with an illusory rather than realistic quality. This phenomenon not only concerns individual members' interior, but encloses in a sort of "shared emotion" the whole group field. It's an emotional atmosphere, all the members contribute to activate it, but it doesn't depend upon the mere sum of individual "in-tensions". It's something more than the contributions coming from single "I", it's the first outline of a "We", of an "esprit de corps" (Bion).

Such a shared emotion is perceptible especially in groups with analytic function, where the participants are combined in a setting devoted to working on themselves as patients, aware that they're in a self-chosen situation, on the basis of the common need for caring some aspects of the Self. Within this setting they probably keep on meeting, periodically, in the same space-and-time dimension, for a long time, trying to give shape to the possibility of meeting and knowing each other, of sharing, besides space and time, the thought (feelings, memories, fantasies, and so on).

This emotion can be easily noticed during sessions, when group is actually working, in those space and moment where a shared sense of "We" is more present . Yet it's perceptible at its dawning stage also before the sessions, in the waiting room, where patients comment their experiences about life or about the group they're taking part of. It's in some way a "crescendo in meeting again" or a "warming up before group". Similarly this emotion is present after a session, when patients linger together for a short time before breaking up and coming back to their daily lives, as if they were trying to accompany and relieve tensions about separation occurring in the icy moment of parting.

Over the years I became more and more convinced about the hypothesis that, in order to understand and use for analytic and therapeutic purposes such an emotional activation, it's necessary to bear in mind three particular components:

a) First, patients tendency - especially at the beginning - to idealise, consciously or not, their attendance in an analytic group, in a group work, a kind of work coped by the strength of a group. The group whole is bialy regarded, wrongly or rightly, as more capable than individuals to succeed in every effort, particularly in searching and conquering the sought after, but alas illusory "miraculous recovery"

b)second, the enthusiasm due to the sense of being contained, supported, accompanied and protected in an "area of belonging " (C. Neri) and mutual listening. This enthusiasm probably represents an overt expression of a particular "request", largely latent and unconscious, coming form patients themselves: a request not only for recovery from symptoms, but also for a psychotherapeutic help in a broader sense;

c) third, the fact that in therapeutic groups all the patients feel each other - alternatively (at first) or contemporaneously (later) - so much similar and so much different. They're all suffering from something really similar and, at the same time, so differently showed in any of them, that allows the hope for a prompt recognition, a recognition as separate and autonomous individuals.

Usually, there's a problem for every patient, partly related to the understandable need for emancipation from symptoms, concerning the management of a overbearing personal need for individuation and autonomy together with a parallel need of learning again how to relate to others. That is to say how to live relationships feeling and returning deep affects without flying away or being caught in symbiotic or adhesive situations, where relationship declines to a manipulatory level.

The more patients are oppressed by their symptoms, the more they express the need to find within the group an emotionally warm situation, where they can interact and communicate each other ideal expectations and difficulties actually met, their hopes and anxieties. Driven by such a need, patients often appear as wanting to realise, within the space for meeting and confrontation offered by analytic group, both their wish for a curative and maturative experience, and the possibility of concretising the fantasy (mostly unconscious) to re-build - within the shared mental field - a "group of affective belonging". This is a group really capable to provide its members with a loving support, to contain and accompany them in living together the difficult experience of a therapeutic path.

Very soon all the patients realise that there are two parallel aspects in group. There's so often a pleasant and reassuring similarity of contents between individual representations and communications of anxieties and conflicts, even if each member's linguistic and idiomatic means seems different. At the same time, there're also some oscillating movements between trust or confidence and the renewal of distrust in group and in others. This betrays a resistencial attachment to one's defensive and symptomatic attitudes. Thus, on one side various symbolic representations emerge, meet and join each other; these representations, born in different social and cultural contexts, so often appear as they could be superimposed, they are different but provided with a common denominator. All that fosters an ongoing development in group of a pleasant sense of belonging (of being together with) and of existence (being Self). On the other side, there are mournful emotions, narcissistic and isolationistic drifts, which can increase the fear of a new fragmentation in group and in oneself.

Analysing together with the conductor these dynamic elements, by the course of group work, patients succeed in feeling more distinctly the co-presence, within themselves and the group, of contrasting tendencies to integration and disintegration. They live together the tumultuous oscillation between the seductive charm of a "fusion with the others" and the terrible catastrophic anxiety of a languages "confusion", a babel-like explosion of the group, a new psychosomatic disintegration. As time goes on, it become evident as the desired sense of cohesion could be linked to and influenced by the need to find, in other members and in the group as a whole, achievement and fulfilment of primary affective necessities, as well as a protection against loneliness and exclusion, especially for those who, after all, self-secluded themselves. At the same time nostalgia for symptom and mournful emotions seem connected to the perception of impossibility to fulfil these affective needs in group, thus the impossibility to really concretise fusional illusion.

Passing through and working out - with deeper and deeper awareness - the emotional storm originated by this situation of continuous oscillation, group gradually achieve such a level of functioning to allow its members to stand better and better these critical situations arising, walking together along the way to integration, which always involves an increased capacity for bearing frustration.

In all this material, there's a cue for my first remark. It seems to me that, with specific reference to analytic group conduction, this marked situation of strong emotional activation we are enquiring on , requests anyway the necessity to foster an analytic work capable to lead the group to work out both a great illusory component (mostly due to the powerful expectation or to primary needs) and a delusional one of the same power, largely connected to the ri-emerging of denied difficulties, to the suffering always coming with the attempts to catch and communicate to others the meaning of what we feel arising within ourselves. It's also connected in group to the clearer and clearer perception of human limits themselves, present in this kind of setting, and also of spatial-temporal limits affecting the degree to which an analytic work can be made in group.

Analysis is also an experience of limits, in all kind of setting. In effects patients in group realise soon that desire for joining in group is a different thing from carrying on together a group work. Furthermore, that the need for belonging to a group, or for combining in one mass with others, is not the same as fostering and using together all members' creativity, through the activation of an open spirit of co-operation, giving everybody a free hand to put at others' disposal his most original and personal contribution. This is one aspect of therapeutic opportunity offered by analytic groups, or - in Bion's words - the opportunity of "learning from experience".