As I am preparing to give a paper on empathy for a group interested in the relationship of attachment theory to psychoanalysis, I wondered what I could find in Bion and Foulkes, these two founding fathers of psychoanalytic group psychotherapy, on this subject. I have not yet made a full systematic search, but I do have some interesting findings to convey.
First here is Foulkes in his paper "My Philosophy in Psychotherapy (1974)", written not long before his death in 1976. (I was present at his death which occurred while he was taking a group in a very hot summer when he clearly should have been resting: he died in the service of his art and science).
"Undoubtedly we need to have the capacity for empathy with our fellow humans. We are involved far more than we usually know; too much so, perhaps. The idea of this empathy comes from a certain philosophical attitude, by seeing things in proportion, as part of the human problem in which we are all continuously involved. With that capacity and with maturity we can retain a certain necessary detachment, despite all empathy; these do not need to be in opposition to each other. The good therapist should, at the same time, be above the situation. Such an attitude will make it easier to see both the tragedy and the comedy of human existence, see the absurdity in certain respects. It allows a feeling for a sense of humour; if we have that, we are not merely better off ourselves, but also in our function as therapists. In this way our work becomes more interesting, more satisfactory and more effective for our patients."
In an earlier passage in that same paper he writes: "the true therapist has, I believe, a creative function - in a way like an artist, in a way like a scientist, in a way like an educator........ I have sometimes compared this function with that of a poet, especially in conducting a group. By this I mean the therapistis receptiveness, his ability to see a bit better, a bit deeper, a bit sooner than others, what his patients are really saying, or wanting or fearing; to help them to express this and sometimes, though rarely, to express it for them".
There is much else in this paper, in which he brings together his 40 years of experience as a psychoanalyst and group analyst. To my mind some other passages converge with fundamental aspects of Bionis conceptions. "I think that the real nature of mind lies in each individual's need for communication and reception, in every sense of the term". He writes about language, which in each individual is what goes on in his "own" mind, but at the same time it is a shared property of the group; the individual is forced into language from the beginning by the surrounding culture. But as well as by the use of language, individuals communicate without knowing it, through unconscious processes that are between them, which permeat each individual, "transpersonal processes". "Just as a mind is shared, so is what is social, not outside, but deep inside the person, as well."
Clearly we need a deep study of similarities and differences between the fundamental concepts of Foulkes and of Bion. Hopefully some of these may be explored in the book that I am in the process of editing with Robert Lipgar of Chicago entitled "Building on Bion". One of the contributions on Foulkes and Bion will be by my friend and colleague Dennis Brown who contributed a stimulating article on this subject to my earlier volume.
Now I turn to Bion. There are no entries in the indexes for empathy, so I extended my search to include sympathy and compassion, which are different concepts. I shall address that issue later. Now I found two very interesting contributions, both included in "Cogitations" (Karnac, 1992). On 11th February 1960 he writes on Compassion and Truth.
1. Compassion and Truth are both senses of man. 2. Compassion is a feeling that he needs to express. It is an impulse he must experience in his feelings for others. 3. Compassion is likewise something that he needs to feel in the attitudes of others towards him. 4. Truth is something man needs to express; it is something he needs to seek and to find; it is essential for fulfilment of his curiosity. 5. Truth is something he needs to feel in the attitudes of others towards him. 6. Truth and compassion are also qualities pertaining to the relationship that the man establishes with people and things. 7. A man may feel he lacks the capacity for love. 8. A man may lack the capacity for love.9. Similarly, he may feel he lacks a capacity for truth, either to hear it, or to seek it, or to find it, or to communicate it, or to desire it.10. He may in fact lack such a capacity. 11. The lack may be primary or secondary, and may diminish truth or love, or both.12. Primary lack is inborn and cannot be remedied; yet some of the consequences may be modified analytically. 13. Secondary lack may be due to fear or hate or envy or love. Even love can inhibit love.14. Applying (8) and (10) to the Oedipus Myth, the death of the Sphinx is a consequence of such lack, as the question posed was not intended to elicit truth, and consideration for itself (?self-empathy?) could not exist to erect a barrier against self-destruction.
Tiresius may be said to lack compassion less than regard for truth. Oedipus lacked compassion for himself more than he lacked regard for truth.
I am moved by this passage, by the counterpoint between truth and compassion. Though neither Foulkes nor Bion seem to have read much of each other's writings, I believe that Foulkes would have had no problem accepting his thesis. Incidentally, though we know that Foulkes had read "Experiences in groups", Sutherland whom I shall refer to shortly, writes in his chapter in my earlier book that he never heard Bion discuss Foulkes in his presence.
Another passage in "Cogitations" is a paragraph headed "Concern for Truth and Life" (p. 247).
"By "Concern" I mean something that has innate feelings of consideration for the object, of sympathy with it, of value for it. The person who has concern for truth or for life is impelled to a positive, not merely passive, relationship with both. ........ Concern for life does not mean only a wish not to kill, though it does mean that. It means concern for an object precisely because that object has the quality of being alive. ...... It means being curious about the qualities that go to make up what we know as life, and to have a desire to understand them. Finally, concern for life means that a person must have respect for himself in his qualities as a living object. Lack of concern means lack of respect for himself and, a fortiori, of others, which is a fundamental and of proportionately grave import for analysis."
These passages in which Bion writes about concern, compassion and sympathy, can be related to empathy.
So, now to empathy. The Norwegian philosopher Vetlesen (Perception, Empathy, and Judgement. Pennsylvania State University, 1994) writes "Empathy is anchored in a deep-seated human faculty, one disposing a subject to develop concern for others. Hence, empathy is a reduceably other-regarding or directed; whereas there is such a thing as self-pity or self-love, there is no self-empathy". (James Grotstein would not agree with this as he has written on self-empathy and in this I agree with him). Vetlesen goes on "In empathy there is always a thou, never only at me. Empathy sets up, indeed helps produce and sustain, a relation, the between or zwischen, involving subjects relating to another; its locus is the interpersonal as distinct from the intrapersonal. It is by virtue of this faculty that I can put myself in the place of the other by way of a feeling-into and a feeling-with".
Empathy not only turns on the ability to see; it also requires an ability to listen. Both seeing and listening mean paying attention to. They are characteristics of what might generally be called attentiveness. Perception always requires attentiveness, attentiveness is made possible by receptivity, by the capacity to view oneself as "addressed" by some situational incident.
In writing about addressing or being addressed I am reminded of the Russian philosopher Bakhtin's emphasis on speech communication as being that which addresses the other or through which one is addressed. In one sense one is clothed by the attention, perception and words of the other.
I searched through James Grotstein's "Do I dare to serve the universe?" for any mention of empathy. So far I have found it only in Grotstein's own chapter and by Frances Tustin's "This is what Grotstein says" (page 33).
"Bion emphasised the importance of the self, of the need for the self to have an empathic relationship by the self for itself, and believe that there must also be an object whose empathic containment of the self is of vital importance for the infantis welfare. Bion was therefore the first Kleinian to give metapsychological enfranchisement to the independent importance of an unempathic (non-containing) external reality. I shall never forget an interpretation he gave me once in my own analysis which began somewhat as follows, "you are the most important person you are ever likely to meet; therefore it is of no small importance that you get on well with this important person". So here Grotstein is equating containment and empathy. This is an interesting subject to be explored. As this containment is not passive but active, responding sensitively and appropriately to the infants needs, this is both empathy and sympathy, the action of being with the other.
To turn to Tustin; she frequently uses the term empathy in describing very early states of mind and with pathological states of mind that are present in autism. She states that Bion has added to her understanding of early infancy by drawing attention to the mother's capacity for empathic reflection for which she uses the apt term of "reverie". Through reverie the newborn infant is sheltered in what might be termed the "womb" of the mother's mind just as much as, prior to his physical birth, he was sheltered within the womb of her body. Tustin uses the concept of "flowing-over" as the process by which the illusion of primal unity is maintained. Tustin distinguishes between the "softness" of "primal unity" and the "hardness" of two-ness if the state of primal oneness has been experienced too early, harshly, suddenly.
Tustin evokes the empathic process when she describes what she calls "ecstasy". Ecstasy arises from states of intense excitement which are beyond the infant's capacity to bear and process alone. If the mother cannot hold the infant together in these intense states of excitement and cannot seem to bear the "overflow", and process it by empathy and understanding, the infant experiences a precocious sense of "two-ness" which seems frought with disaster. Then the infant feels adrift and alone and seeks pathologically to reinstate the sense of oneness. This leads to states of confusion with the maternal object.
In working with psychotic children Tustin attempts to describe elemental depths and elemental terrors as parts of everyone's infantile experiences through which we can be psychologically born through being "borne", that is carried, by maternal reverie and sympathy.
I raised the question of Bion's attitude to empathy with my co-editor Robert Lipgar, his opinion was that Bion was keen on individuation, adaptation, reality (working toward and learning or knowing which could approximate Truth and Reality) and not very impressed (?) with empathy. His interest was in how we think and how we learn, how we "know".
What now of sympathy? The scope of sympathy must be greater than that of love for the other; it rests on empathy which can be directed to persons who are not unique to us, not only our loved ones, to those whom we do not love. Sympathy is facilitated by the basic faculty of relating to others, which is empathy. Sympathy has a larger audience than the narrow circle of family and friends. The chief challenge to sympathy is indifference, which has often been described as being the opposite of love.
Sympathy as an essential feature of social animals, such as mankind, is receiving much attention in evolutionary psychology, as exemplified by the study of chimpanzee groups by Franz De Waal. De Waal, one of the worldis leading primatologists writes: "It's hard to imagine human morality without the following tendencies and capacities found also in other species".
1. Sympathy-related traits. Sympathy is shown when animals give care to or provide relief to distressed or endangered individuals other than progeny: this is called "Succorance behaviour". If we, or animals, are vicariously affected by someone else's feelings and situation, we are being sympathetic and this behaviour is shown in the individualised bonding, affection and fellowship of many mammals and birds. Animals are attached by emotional bonds, exhibit emotional contagion -they are affected by the emotions of others - and this leads to caring behaviour, to "cognitive altruism", behaviour in the interests of other. "Despite its fragility and selectivity, the capacity to care for others is a bedrock of our moral system, which functions to protect and nurture the caring capacity".
The other biological essentials for the social life of primates and ourselves are: internalisation of social rules; reciprocity; the capacity for Ôgetting along together'. The capacity to care for others is manifested through empathic understanding and sympathetic actions.
Both Bion and Foulkes view the process of psychotherapy as ways of helping persons to discover the truth about themselves. When we look at the group situation, Bion's thrust is that the uncovering of primitive regressive defences, the basic assumptions, releases the individual's capacity to work towards high levels of understanding, understanding-in-the-moment of truth. The therapist's task ends with establishing that capacity. His long-time friend and colleague J.D Sutherland wrote that Bion was an extremely caring person, but that he was not sympathetic or empathic towards the person's struggle to maintain a sense of safety of the self, the self imperilled by exposure to the group situation. Sutherland does not make direct comparisons between the approaches of Bion and Foulkes, but what he does write is: "Foulkes was convinced total group interactions had to be used in therapy, and I believe that Bion, had he done more group therapeutic work, would have accepted that position, though he would have insisted on what might be loosely put with more rigour and more depth, more attention to the primitive relationships." (page 83).
By total group interactions I believe that Sutherland is referring to mirroring, resonance and the other factors which Foulkes described as group specific. It is through such processes that persons come more deeply to recognise the truth about themselves through their work with others, through being seen, and seeing denied, split off unwanted parts of the self in others; accepting the vision of others about hidden aspects of the self which come to the fore in the interactions within the group situation.
Cheating is usually quickly uncovered. We can see through the defences of others in ways which we cannot see within ourselves. This has a direct impact upon defensive narcissism, the arrogance that Bion wrote about. Group therapy is in many ways a humbling experience, recognising how much we are made of common stuff, stuff that we hold in common with others, basic earthy material. Bion wrote about the importance of acquiring "common sense", that is all the senses working together to create a sense of unity and integration of the self. The capacity for detecting cheating is again a biological given: Cooperation in groups from primates upwards necessitates the capacity to detect cheating for otherwise the cheat would obtain unfair advantage from the labours of others. This form of detection is more intuitive than empathic; intuition leads to immediate grasp of the reality of a situation, whereas empathy is a much less immediate process. Kohut emphasized that prolonged empathic immersion in the experience of the other is the main tool of psychoanalytic understanding which is why the analytic process is so lengthy. If intuition was all that we needed to understand the other person and to translate understanding into action, therapy could be almost instantaneous.
As group members begin to recognise the truthful similarities and differences between themselves and the others, they can begin to appreciate the complexity of the personality, to see what is similar and what is different in the other person(s). This inevitably counters the primitive defences of splitting and projection which lead to other persons being perceived as all similar to oneself or totally dissimilar. This occurs particularly in inter-group conflicts when groups draw together to create a common identity that gives them a sense of strength and righteousness which inevitably leads to the other group being seen as dangerously dissimilar and a threat to security. This is a powerful force in ethnic political and religious conflicts, but when persons can recognise similarities and dissimilarities within their own group, and break down stereotypes of what they see in other groups, then progress can be made in reducing inter-group conflict. Both Bion and Foulkes would have wanted their work to lead in that direction. In the sphere of international tensions the psychoanalyst Vamik Volkan has done some very interesting work in the reduction of ethnic tension through group programmes that involve disputants, such as Greek and Turkish Cypriots, Israelis and Arabs, Russians and Estonians. My friend and colleague Patrick de Mare has led the way in the use of median groups which enable persons to progress towards a fuller sense of citizenship and an overcoming of primitive prejudices.
In conclusion, I am trying to show how we can make use of the insights of both Bion and Foulkes to create two vectors which have points of convergence and which help us to uncover the deeper truths which groups so often try to hide from themselves. The place of empathy, sympathy, compassion and pity continue to call for our attention. Human beings are capable of experiencing and acting upon those feelings; we also are capable of anihilating those feelings with the result that we become inhumane, arrogant, capable of horrific actions towards others whom we cease to regard as in any way being of the same common stuff as ourselves. Bion's experiences in WW1 immersed him in the horrors of front-line warfare and he never ceased to draw on this experience in his exploration of primitive psychic processes. Foulkes did not undergo such trauma as he was behind the lines in his post as a telephonist. I speculate that the differences in their war-time experiences are of significance for their contrasting explorations of individuals and groups.
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