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PSYCHOMEDIA
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GROUP TREATMENT
Group Psychoanalysis
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ANALYTIC GROUP TREATMENT
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".
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