An Introduction to Groupwork A Group-Analytic Perspective: Barnes
Contents
Foreword 1
Chapter 1 Introduction: Looking at groups 2
Chapter 2 The Individual and the group 3
Part 1 Drawing Ideas from psychoanalysis 3
Part 2 Applying group concepts to the individual 5
Chapter 3 Growing a group 5
Chapter 4 What happens in a group 6
Chapter 5 Working in the group, negotiating boundaries 7
Chapter 6 Working in the group 9
Chapter 7 Differences in Group: Heterogeneity and Homogeneity 11
Chapter 8 Working Together 12
Chapter 9 On becoming a group therapist 13
Foreword
3 phases of group
The prejudicial start: this will fix me, conductor cold
fish etc
Confusion and uncertainty: increase of problems with the
heterogeneity of the group. Silence or incessant talking
Then the fog clear and things make sense.
Bion pairing: hope for a saviour
Bion dependency: unconsciously believe they need a saviour.
The framework is the where the emotional life of clients
gets played out.
Complex\hierarchical bureaucracy gives the impression in the
face of organisational anxiety that something is being done
Team: heterogenous group, with a common purpose, managing
difference, and orchestrating well.
Bureaucracy gives the impression if only procedures are
followed problems go away. Paperwork and procedures are the attempted stand in
for the emotions of the group.
Irony: the more the group can face its weaknesses the
stronger it becomes.
Negative aspects of the group will be held by one or two and
disowned by the whole group.
Psychiatry, the psychic equivalent of the medical waste
department, where difficult feelings can be located so the rest of the hospital
can carry on in a sterile manner.
A ward needs clear
leadership, good communication and
mutual respect. Mixed in with warmth, fun,
and acceptance.
DSH and OD a communication strategy which replaces other
open communication strategies.
Chapter 1 Introduction: Looking at groups
Group training: develop your preexisting knowledge of
groups.
In group therapy you can develop your understanding of how
groups work, your schemata.
To have a group you need a boundary, those who are not in
the group.
You need a purpose?
The cohesion of the group might be due to a fear of attack
at the boundaries. Individual differences might be submerged to keep others
out.
Groups
Type slow open, didactic, free dialogue
Type of member
Purpose of group
Chapter 2 The Individual and the group
Part 1 Drawing Ideas from psychoanalysis
UCS as hidden part where we can keep a stable identity of
ourselves, even though consciously we may want to change it.
Life as a compromise between all the conflicts, from
external forces, internal forces and the conscious.
Free association gaining access to the UCS. UCS access
through dreams, transference, jokes and
parapraxis.
Group members have free association between them and
transferential relationships with each other.
Two interpretations:
One an individual therapist approach so what’s the
transference between individual an conductor.
Two , facilitating communication between group members all
speaking different language.
Classic psychoanalysis: Counter transference as the conductor’s
response to the clients transference.
Freud: Individual to sort out the conflicts between the instincts
and the societies attempt to restrict them and reality.
Bowlby, no individual baby, but baby in relationship
Winnicott: mother provides a fantasy environment of containment
for the baby.
There’s the physical environment, the holding, but it points
to something much more
Without this holding environment of empathy, a baby
development of their own continuity is hampered. Without the psychic resources
to deal with an intrusion the baby feels annihilated. The baby can then develop a false self to
allow its true self to develop.
The initial containment is giving the impression that the
baby is out in a social womb, and that gradually that illusion disappears and
they realise that they are a separate person from their mother.
The baby needs to test the environment to see if it can
withstand his strength, so tries to destroy the other object, the mother,
to see if they can withstand their attack.
To find if they are strong
Knowing that the world is strong enough to withstand their
force, leads to the baby being able to play
Many people come to therapy unable to play. They
are the omnipotent baby, in control, needing to comply and please, in a fantasy
world, rather than wanting to live (in relationship). They weren’t
reassured by the strength of the other, and the therefore inclusion of them in
their world.
Attachment bond, is a primary drive, it is not secondary to
drives for food\affection etc.
New attachment figures are brought into an existing from
childhood model
Having a secure base with the therapist allows the client to
be more exploratory in the world, takes time.
The group needs to provide the holding environment in Winnicott’s
language, or the secure base in Bowlby’s.
Bion: container.
Infant’s bad experiences evacuated into the mother, she
detoxifies them and returns them in a manageable form: there you were a bit
angry weren’t you but I’ve got your dolly back for you.
Containment: providing ability to process the unmanageable
Holding: the practical matters, the frame.
Part 2
Applying group concepts to the individual
Foulkes: environmental and social effects on the psyche. So,
group is a good place to explore\replay these.
Disturbance: tension between the individual and the original
group (family\community)
Aim is to restore disturbed communication
Group therapy is not individual therapy with 8 people. Nor is it group therapy where the group is
looked at as an organism, with behaviour, pathology etc. Foulkes asks the conductor to keep in mind
what is happening for the group and what is happening for the individual.
Taking on thoughts of Gestalt where it’s the figures relationship to the ground
which is impactful. So, relation of the individual, to the group, to the
subgroup.
Individual and piece in a jigsaw puzzle, someone joins a
group, it changes the puzzle
Group as developing a matrix to talk about complex
relationships between individual, subgroup
The group does not help members of the group by talking
about their problems, but rather through being part of the group process.
Chapter 3 Growing a group
The line drawn around a group makes creativity possible:
boundary.
Form and content of therapy. Form the frame. Exclusive focus
on content, is uncontained. Exclusive focus on form might be making an
excessive point out of life, which has no intrinsic meaning.
An external holding environment becomes internalised (does
it?)
Suitability of group members, including ability to see
problems interpersonally. So people think in within person models, I’m an
addict, can they think relationally so my problem emerged as my mother demanded
I live in a certain way, I didn’t want to, and she didn’t encourage any other
approach or exploration , alcohol made sense as a way to both escape her
demands and to punish her through my failings. Or even just relating internal problems to
external events, that would be a problem for group.
Does a client have responsibility for their difficulties or
do they externalise and blame everyone else. The latter isn’t a good candidate.
Can they manage distress between session
For group membership, similarities 2 by 2 is a good
approach, so no one is left out and scapegoated. For dissimilarities then difference is good
to build peoples perspectives.
Difficulties for new therapists
1.
Experiencing group pressure
2.
Not tolerating getting something wrong and
looking a fool
3.
People dropping out, or forming subgroups,
fearing the end is nigh
4.
Not being aware of the phases of groups.
Start of a group, is like the earliest years of a child,
unintegrated, and its life is at stake. What’s most needed is just holding
Chapter 4 What happens in a group
Group as forming, storming, norming and performing
Forming
Group creates a communication matrix, how the nodes interact
including the conductor
Early stages of a group like a child, needs careful holding
and boundaries, and uncertainty management.
Manage distress options: by restriction, e.g. restrict open
communication, reduces threat.
Ambivalence all people face, authority and intimacy,
dependence vs independence.
Development can only happen if there is conflict in the
group (?)
Avoid simple solutions to conflict, dependence on an
authority\scapegoating or flight from the group.
Storming
Exploring self or relationships?
Energy in group which can be redeployed to looking at
relations.
Focus on internal\external events, relations. The former
seems more therapeutic, the latter more understandable.
Difference and its relation to individuation, denying
difference, demanding conformity, restricts individuation.
Greater intimacy can be attained if storms can be weathered,
and the group can manage anger and hostile feelings.
Foulkes: 4 levels of communication
1.
Current
2.
Transference
3.
Projective
4.
Primordial.
Chapter 5 Working in the group, negotiating
boundaries
Anxieties of joining or being joined to can be allayed by
group games
Principles of conduct required (Inner boundary)
• Regularity
• punctuality
• discretion
• abstinence
• no outside contact
Abstinence (eating, drinking etc): avoid any tension
reducing activity, so feelings are verbalised not acted out.
Outside contact: in group, relationships are analysed and
understood, outside world things are just acted on, on tried and tested ways,
so new understanding is short circuited.
Conductor should focus on process not content.
New person= jealousy of the new baby, or relief to not be
the youngest anymore. Hope that the new person might be the solution to the
groups\individuals difficulties
Clients can sometimes break boundaries to express
something that cannot be put into words. that cannot be put into words.
Anxiously attached respond to loss with anger\self-reproach
or depression
Compulsively self-reliant with anxiety and guilt.
Separation pleasure in autonomy, loss of childhood grandiosity,
needing a strong frame of reference to cope with that.
Splitting into opposites happens during termination to
idolisation and to devaluing.
Omnipotence of the small child knowing adults are there
just for her.
Transitional object, as the first not me possession which
can be controlled, and an external reality separate from a symbiotic
relationship.
Idealisation as a defence against individuation and
grief.
Idealisation as a desire to return to the sublime state
of bond with mother, of omnipotence.
Denial of loss\ending, can result in identification,
copying, or trying to keep the relationship alive somehow. I don’t know if I agree with this, if you
separate from someone then you learn from them, take things with you that
become you. This doesn’t need to be a denial of loss rather than a learning,
and your being affected by another.
Boundary incidents enable new experiences rather than old
defensive strategies. As opposed to destabilising the group.
Balance to be struck between secure but limiting
boundary to exciting growthful boundary
breaks
Chapter 6 Working in the group
What does a conductor do, how is it done and when?
Group process vs individual process
Managing when the communication process gets blocked\stuck
In the silence of a member what takes them to
withdraw, what is not being said
Stuck treating someone as group patient
Group universality: reduce isolation, see yourself in others
(normalising), understanding difference.
You want a cohesive permeable group, this can be
achieved, through group exercise, or naturally by the group’s engagement with
each other. It can be shown by how much group members imitate each other or the
conductor. This shows their sense of
belonging.
Imitative behaviour may also be a way to avoid personal exposure.
Whilst catharsis can make clients feel better, expression
without reflection, doesn’t lead to change
Does one person’s expression of strong emotion, develop
trust in the group for them to show strong emotion.
Communication
Can be enhanced by resonance and mirroring
Conduction should facilitate the process of communication
not the content.
Symptom as autistic communication, that mumbles longing to
be heard.
Resonance as identifying with a similar event\aspect in
your own way
Mirroring: seeing aspects of yourself mirrored in the other
Mirroring as the opposite of projection, realising what you
identify with in others that you can’t stand, that you project.
In being aware and tolerating the behaviour of others, you
are working with yourself.
Things that stop communications in the group
1.
Scapegoating
2.
Having one client as the patient\or
specimen to be explored
3.
Someone monopolising
4.
Having subgroups
Basically, any time there’s one person\sub group dominating
the group somehow
Subgroups can hold different emotions, each exploring a
different one. They can split on polarities , e.g. gender, or psychological
polarities.
With the people that don’t talk, what is not being said?
Silent member taking observer position.
Group silence=>what do you think the silence is
about=>inappropriate conductor intervention, withdrawal, fear of attack.
People aren’t safe?
Catching out clients and confrontations may be more about
the conductor showing their power.
Transference to the past, may be about avoiding the present.
Classifying and categorising enhance difference.
The ideal time to interpret is when someone is on the
edge of interpretation themselves.
The conductor needs to at times, raise things from the
background, bring things grom the group tip of the tongue. It’s both Winnicott,
small enough to be digestible, and also noticing what’s just out of sight, and
its freeing up communication in the matrix, so the group can work.
Solutions:
Enabling, reduce distress and allow work to continue
Restrictive: reduce distress and stop work
Maintain anxiety underneath the level where defensive
solutions are used.
Restrictive solutions can sometimes lower anxiety levels.
Healthy systems are semi permeable, so can take new
information in, and shut down if necessary to protect from unwanted things
coming in.
4 perspectives
1.
Person
2.
Member Role (as member of the group)
3.
Group role (the group requires certain roles,
acting for the group)
4.
Group as a whole
Conductor cannot maintain empathic resonance with each group
member but rather moves from one to the other, when their figure arises from
the ground.
Empathic responsiveness is maintained by the whole group
including the conductor.
So, the first task of the conductor is to create the groups
working alliance, where all members of the group can empathically attune and
resonate with each other.
Chapter 7 Differences in Group: Heterogeneity and Homogeneity
Being part of a tribe of similar, universality can give a
sense of belonging although you may lose a sense of yourself and your
difference.
Differences can make you feel, isolated, deprived, jealous,
envious, competitive or snobbish
Fear of being merged, can lead to you defining your
difference more strongly.
Bollas: parliamentary order, different aspects jostling to
be heard. When things are good, ambivalence, plurality, dynamic moving from
this voice to that. When not, then bad projected onto the other, good on self
(but depleted).
An isolate speaks of their group, blackness, but that
assumes whiteness doesn’t bear speaking about.
Difference you choose, that happens to you, or you are born
with and can’t change.
Homogenous groups, allow people to be understood and
validated, and develop their own language for their problems.
Homogenous groups as sharing similarities, transition and
change being more frightening and related to a heterogenous group.
Translating symptoms into metaphors and words.
Homogenous groups can lead to people developing an identity
as a person with a specific problem.
Chapter 8 Working Together
Work as a machine, a brain, an organism.
Plato’s cave as the organisation: people create imperfect
realities and then become trapped by them.
Elliot Jacques: socially constructed defence mechanisms.
Individuals use the same objects for their projections.
Difficulty of a patient as in need of care, and in need of
control, i.e. forensic.
You can get a splitting here, where you get two camps the
carers and the controllers, and each denigrate the other, without trying to
face the difficult question of care and control.
Obtaining security from anxiety needs a powerful leader, or
a set of rules: control.
Bion basic assumption
1.
Dependency
2.
Fight flight
3.
Pairing
Bion, groups oscillate between basic assumptions and work.
Nurses managing anxiety by dehumanising patients.
Consultants are hired to help clarify problems not with
specific expertise to solve the problem.
An organisation asks for help when they are stuck hanging on
to unproductive behaviour to avoid mental pain. There can be ambivalence cure
us but don’t change us
Consultant invited in so the mob can vent spleen at them,
and it will all be their fault. Likewise,
can be asked to undermine the manager, or sort out the staff.
What is the primary task of the work group and do its
behaviours help or hinder this.
NHS as the container of anxiety for death, decay, and the
projection of omnipotence
Chapter 9 On becoming a group therapist
Fiction as a way of understanding reality that knows itself not
to be reality
Myth being a fiction that sees itself to be real
We are not alienated from others by roles that separate us,
but rather we don’t inhabit roles that allow us to collaborate.