Operative Groups: The Latin-American Approach to Group Analysis

Operative Groups

The International Library of Group Analysis Edited by Malcolm Pines, Institute of Group Analysis, London

The aim of this series is to represent innovative work in group psychotherapy, particularly but not exclusively group analysis. Group analysis, taught and practised widely in Europe, derives from the work of SH Foulkes. Other titles in the series The Evolution of Group Analysis Edited by Malcolm Pines ISBN 1 85302 925 4

International Library of Group Analysis 16

Cicular Reflections Selected Papers on Group Analysis and Psychoanalysis Malcolm Pines ISBN 1 85302 492 9

International Library of Group Analysis 1

The Large Group Re-Visited The Herd, Primal Horde, Crowds and Masses Edited by Stanley Schneider and Haim Weinberg ISBN 1 84310 097 5

International Library of Group Analysis 25

Relational Group Psychotherapy From Basic Assumptions to Passion Richard M. Billow ISBN 1 84310 739 2

International Library of Group Analysis 26

Traumatic Experience in the Unconscious Life of Groups The Fourth Basic Assumption: Incohesion: Aggregation/Massification or (ba) I:A/M Earl Hopper ISBN 1 84310 087 8

International Library of Group Analysis 23

The Social Unconscious Selected Papers Earl Hopper ISBN 1 84310 088 6

International Library of Group Analysis 22

Building on Bion: Roots Origins and Context of Bion’s Contribution to Theory and Practice Edited by Robert M. Lipgar and Malcolm Pines ISBN 1 84310 710 4

International Library of Group Analysis 20

Building on Bion: Branches Contemporary Developments and Applications of Bion’s Contributions to Theory and Practice Edited by Robert M. Lipgar and Malcolm Pines ISBN 1 84310 711 2

International Library of Group Analysis 21

INTERNATIONAL LIBRARY OF GROUP ANALYSIS 24

Operative Groups The Latin-American Approach to Group Analysis Juan Tubert-Oklander and Reyna Hernández de Tubert Foreword by Malcolm Pines

Jessica Kingsley Publishers London and New York

All rights reserved. No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London, England W1P 9HE. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher. Warning: The doing of an unauthorised act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution. The right of Juan Tubert-Oklander and Reyna Hernández de Tubert to be identified as authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. First published in the United Kingdom in 2004 by Jessica Kingsley Publishers Ltd 116 Pentonville Road London N1 9JB, England and 29 West 35th Street, 10th fl. New York, NY 10001-2299, USA www.jkp.com Copyright 2004 © Juan Tubert-Oklander and Reyna Hernández de Tubert Library of Congress Cataloging in Publication Data A CIP catalog record for this book is available from the Library of Congress British Library Cataloguing in Publication Data A CIP catalogue record for this book is available from the British Library ISBN 1 84310 094 0 Printed and Bound in Great Britain by Athenaeum Press, Gateshead, Tyne and Wear

For our children Hector, Sandra and Rodrigo Ivan, Mara and Eduardo

Contents FOREWORD

9

Malcolm Pines, Institute of Group Analysis, London PREFACE AND ACKNOWLEDGEMENTS

1

2

3

A Historical Perspective

11

15

Group analysis and operative groups

15

Enrique Pichon-Rivière: pioneer and outcast

25

Fundamental Concepts of Operative Groups: Enrique Pichon-Rivière

37

An attempted definition

37

The task

39

Operations research, decision making and strategic planning

42

The Conceptual Referential Operative Schema (CROS)

47

The individual and the group

52

The group process

56

A new profession

59

Fundamental Concepts of Operative Groups: The Authors’ Point of View

61

On the existence of groups

61

The individual and the group

66

A revision of the concept of CROS

74

The problem of context

82

The social and institutional dimension

85

Communication, thinking, learning and change

88

Summing up

99

4

5

6

7

The Learning Operative Group

101

Introduction

101

The transversal description of sessions

105

The longitudinal description of the group process

114

On workshops and laboratories

131

Conclusions

139

Training of Psychotherapists, Psychoanalysts and Group Analysts

141

The transmission of the analytic experience

141

On group supervision

146

A clinical example from a supervisory group

154

An experience in the training of group-analytic family therapists

166

The Approach to Institutions and Society

185

The individual, the group, and the community

185

Working with nurses in a public institution

191

A reflection group in a therapeutic community

197

The case of the multifamily group

208

The use of operative groups in social research

215

A Re-evaluation of Operative Groups and Group Analysis

227

NOTES

231

REFERENCES

237

SUBJECT INDEX

253

AUTHOR INDEX

265

Foreword

For many years my Latin-American colleagues in psychoanalysis and group analysis have frequently told me that in Latin America Enrique Pichon-Rivière was the great pioneer in our field, that his ‘operative groups’ – to me a mysterious concept that was never properly clarified – were closely related to Foulkes’ group-analytic groups, as were their basic ideas. The few papers that set out to illustrate Pichon-Rivière’s work were stimulating but insufficient, snacks rather than a substantial meal. Now we can feast on the substance of this remarkable, important book. I was delighted to meet Juan and Reyna at a meeting of the International Association for the History of Psychoanalysis. I found how knowledgeable they were of Foulkesian group analysis and that they had a mission to bring Pichon-Rivière’s work to the attention of the Anglophone world. I already knew that in Mexico there existed a strong group movement which had hosted a meeting of the International Association for Group Psychotherapy during my presidency in 1984, but I had not previously known these authors and their scholastic and clinical abilities. Combined, they have tremendous clinical experience and a most impressive knowledge of psychoanalysis, group analysis and the Latin-American schools of group psychotherapy. When Foulkes began his first group in 1940, he had already been thinking about a group-analytic approach to human mentality and therefore to psychotherapy. His work with Kurt Goldstein after World War I had introduced him to ideas about the human network and its basis in the network of central nervous system; perhaps his work during that war as a telephone operator had shown him the fundamental importance of communication through the functioning network and the effects of disruption on the 9

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network, similar to the disruptive effects of brain injury to the network of the brain. Also influential in his thinking were the ideas of historico-cultural processes on mentality developed by his friend Norbert Elias, who also had worked in communication networks during the war, creating and restoring telegraphic networks in the front line. Trigant Burrows and Paul Schilder’s writings on group psychotherapy were also important for Foulkes. Then came World War II and Northfield. But Foulkes did not have to face Pichon-Rivière’s huge problem of how a single psychiatrist can work effectively in an under-staffed asylum of 4500 patients. It was this challenge that Pichon-Rivière met through developing trainings for nurses and patients in action-oriented operative groups. Pichon-Rivière was a radical reformer who studied and influenced social organisations, at one time even attempting to work with a network of a whole city, Rosario. The Latin-American lifestyle of meeting in cafes late into the night with ardent discussions is in marked contrast to Foulkes’s more conventional London lifestyle. What is fascinating is the convergence of their ideas, part of the developing network of psychoanalytic and socio-psychological knowledge of the mid-twentieth century. The present book is a major contribution to the network of group-analytic knowledge at the beginning of the 21st century. I am indeed grateful to the joint authors for the dedication to the task of lifting the language barrier between the Spanish-speaking and English-speaking worlds in the field of group psychotherapy. Malcolm Pines, Institute of Group Analysis, London

Preface and Acknowledgements

Group analysis developed in Britain from 1940 onwards, starting with the pioneering work of S.H. Foulkes, and under the leadership of the Group-Analytic Society. But there has been another independent school of group analysis, which was born in Argentina, beginning in 1938, as a result of the work and teachings of Enrique Pichon-Rivière, who was therefore a true pioneer in this field. These two approaches to group analysis are fully compatible and complementary. However, Pichon-Rivière’s conception of operative groups is hardly known outside the Spanish-speaking countries, since his writings have never been translated. This book has a threefold objective: 1) to introduce Pichon-Rivière’s conception of operative groups to English readers; 2) to present our own ideas and experiences in this field, which stem from and are included in the operative group tradition, but have also been deeply influenced by the work of Foulkes and his group; and 3) to clearly illustrate the way in which theoretical and technical concepts are used in real-life work with concrete groups. The present text is the outcome of many years working with groups. Juan Tubert-Oklander was born in Buenos Aires, Argentina, where he studied medicine and group psychotherapy in the Institute of the Argentine Group Psychology and Group Psychotherapy Association. In 1976 he moved to Mexico, where he trained as a psychoanalyst at the Mexican Psychoanalytic Association, and later became a Mexican citizen. He has been working with groups since 1971 and he has written a previous book in Spanish on The Learning Operative Group (Tubert-Oklander 1990–92). Reyna Hernández de Tubert was born in Veracruz, Mexico. She studied medicine and psychiatry at the National Autonomous University of Mexico, trained as a group analyst at 11

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the Mexican Analytic Group Psychotherapy Association, and then as a psychoanalyst at the Mexican Psychoanalytic Association. She has been working with groups for almost two decades. We have been working together for the past ten years, both in conducting clinical groups and in writing many papers of psychoanalysis and group analysis. This volume is a greatly enlarged, revised and updated version of the ideas that were put forward in Juan Tubert-Oklander’s previous book in Spanish (Tubert-Oklander 1990–92). It is also a presentation of a particular point of view that we have developed in our conjoint work. We have endeavoured to make it useful for English-speaking readers, by building the conceptual bridges that bring together the group-analytic and the operative group traditions, as well as including, whenever possible, the necessary references in English. As the works of Enrique Pichon-Rivière have never been translated into English, we have had to rely on our own translation and paraphrasing of his ideas. Chapter 1 of the book presents a historical introduction, in which we compare the approaches and concepts of Foulkes and Pichon-Rivière, and draw a brief biographical sketch of the latter. Chapter 2 introduces Pichon-Rivière’s fundamental concepts of operative groups. Chapter 3 is an exposition of our own theoretical point of view on the subject. The rest of the book is devoted to a presentation of our own approach to the clinical practice of operative groups. We have dedicated Chapter 4 to the learning operative group; Chapter 5 to the use of operative groups in the training of psychotherapists, psychoanalysts and group analysts, and Chapter 6 to the use of operative groups in social research. We had intended to include instances of our work with therapeutic groups and families, but this proved to be materially impossible, since it would have required too large a volume. We therefore decided to leave these most interesting subjects for our next book. Chapter 7 offers a final review of operative groups and group analysis, vis-à-vis psychoanalysis. In this brief text we pose our present position, advanced in Chapter 1, that considers group analysis to be a natural development of psychoanalysis. Finally, we would like to acknowledge and deeply thank a number of people whose contributions have had a far-reaching influence on the writing of this book. First and foremost is our friend Malcolm Pines, who encouraged us to write it, and offered his sympathy and support along the way. Next, we are bound to mention four towering figures whom we never met in the flesh, but who are ever present in our thinking, through their spirit that still breathes

PREFACE AND ACKNOWLEDGEMENTS

13

in their writings: Gregory Bateson, W.R. Bion, S.H. Foulkes and Enrique Pichon-Rivière. We would like to acknowledge Robert D. Hinshelwood for helping us to get our historical data right on the Northfield Experiment, and Mara Tubert-Brohman for her support and her technical help in preparing the final manuscript. Our thanks go also to María del Carmen Álvarez and all the members of the Hermosillo group, as well as to everyone who has participated in our groups, both therapeutic and non-therapeutic, thus teaching us not only about groups, but also about the human condition. Juan Tubert-Oklander would like to thank the four teachers from whom he learnt most of what he knows about groups: Alejo Dellarossa, Guillermo Ferschtut, Jorge García Badaracco and Jorge N. Weil. He also appreciates Earl Hopper’s contribution, both in his writings and in several most pleasant and stimulating conversations. Elizabeth Goode de Garma and Marco Antonio Dupont Muñoz gave him the opportunity to discover psychoanalysis, and for this he will always be grateful. He also owes a debt of gratitude to Antonio Mendizábal, who gave him the opportunity to coordinate for five years the operative group of the technical staff in his psychoanalytic therapeutic community, the Mendao Institute; and to Vidalina Ramos de Moreno Corzo and Luis Moreno Corzo, who shared with him an inquiry on the supervisory group, which is included in Chapter 5. Reyna Hernández de Tubert thanks José Luis González Chagoyán, the pioneer of group analysis in Mexico, for having taught her to understand and value groups, as well as all her teachers during her training as a group analyst. Also, she expresses her gratitude to Juan Vives Rocabert. We are also most grateful to our children, Hector, Sandra and Rodrigo, for their patience and support, spiced with a dash of humour, whenever we were too busy or overwhelmed with the writing of this book. Finally, both of us wish to thank each other for the privilege of sharing our lives, our work, our thinking, and our writing. Juan Tubert-Oklander and Reyna Hernández de Tubert Mexico City, March 2003

CHAPTER 1

A Historical Perspective

For this brief historical survey, we have selected two historical papers, both read at the Meetings of the International Association for the History of Psycho-Analysis. The first one (Tubert-Oklander 2000a) studies the simultaneous birth of group analysis in Britain and of operative groups in Argentina, while at the same time trying to define the particular point of view shared by both developments. The second one (Tubert-Oklander 2002b) deals with the biography and personality of Enrique Pichon-Rivière, the creator of operative groups. 1

Group analysis and operative groups Group analysis

Sigmund Freud (1921) started the psychoanalytical study of group processes when he wrote, in 1920, Group Psychology and the Analysis of the Ego. There he stated, in no uncertain terms, that there is no real difference between individual psychology and social psychology. Each is always included in every psychic movement or development. This is, of course, the foundation of object relations theory, but it is hardly a basis for group analysis. The truth is that Freud never worked clinically with groups. What he did was to apply psychoanalytical theory to the interpretation of group and social processes. This is applied psychoanalysis, but not clinical analysis, and the development of a truly analytical approach to groups had to wait for a couple of decades. The cradle for the development of group psychotherapy in Britain was Northfield, in the early 1940s, and all its later development, and the schism that followed among British group therapists, bear the imprint of the conflicts 15

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and tensions that then emerged (Hinshelwood 1999). In 1940, Wilfred R. Bion and John Rickman wrote the ‘Wharncliffe Memorandum’, which contained a project for a therapeutic community. In the autumn of 1942, they applied these ideas for a six-week period in Northfield Military Hospital, thus starting a revolutionary social experiment (Bion and Rickman 1943). When Bion was put in charge of the training wing of this military psychiatric hospital, he adopted the view that ‘in the treatment of the individual, neurosis is displayed as a problem of the individual. In the treatment of a group it must be displayed as a problem of the group’ (ibid. p.11). He therefore turned the training wing into a relatively non-structured social space that would allow the patients to develop their own path. He also used the noon parade, manifestly intended for making announcements and conducting other business of the training wing, as ‘an occasion for the men to step outside their [social] framework and look upon its working with the detachment of spectators’ (ibid. p.16). This reflective activity was to be the first step towards the elaboration of therapeutic groups. The results were most encouraging: the men abandoned their previous attitude of passivity and destructive criticism, all sorts of activity groups were developed spontaneously, there was an astonishing improvement in morale, and the relationship between the men and the officers became friendly and cooperative. This experiment, however, lasted only six weeks, and Bion was summarily dismissed from his post. What had happened? Tom Main (1983) believes that it was the inability of the commanding officer of the hospital and his staff to tolerate the ‘early weeks of chaos’, as a consequence of the attempt to develop self-management, that brought about the crisis. Of course, Bion’s refusal to accept total responsibility for the disorder in his ward did not help either. His point of view was utterly alien to the military tradition, and it could not fail to enrage his superior and the military staff. The fact is that he did not attempt to understand them and their plight, and so his project became anti-therapeutic for the total system. This is pointed out by Main in the following terms: at the level of the higher hospital system this first experiment had been a technical failure although a brilliant success at the lower ward system. Bion had been therapeutic for his ward, but anti-therapeutic for the military staff, successful in his ward, a lower-order system, but highly disturbing to the hospital, the higher-order system. To put it another way, he had failed to work at and get and maintain social sanction for his deeds. Thus anti-social in the wider sense, he had been the author of his own social downfall. (Main 1983, p.206)

A HISTORICAL PERSPECTIVE

17

Harold Bridger further develops this analysis when he points out that, even though Bion had clearly established his own professional and technical approach to the situation at hand and the unit he was to command, ‘he had not sufficiently appraised the effect it would have in its contrast with the psychiatric and organizational approaches of all the other psychiatrists and administrators (including the commanding officer) in the hospital’ (Bridger 1983 p.96). He believes that, even though Bion was fully aware of the widest social context, represented by the social situation of a country at war, he neglected, and even rejected, the immediate institutional environment and its needs. The result was that, even if he considered his ward as a whole and managed it very efficiently, according to his therapeutic goals, he failed to take the wider context into account. Robert D. Hinshelwood (1999), on the other hand, suggests an even more complex interpretation. From his point of view, Bion’s approach was strictly military, stemming from his experience as a tank commander during World War I. This led him to approach war neurosis as a problem of morale, and his goal was to lead the inmates as soldiers in a battle against a common enemy – neurosis – which hindered them from fulfilling their duty as citizens when their country was at war. This generated a clash of cultures between the collective military outlook that he was promoting, and the care-centred hospital culture which prioritized the health of the individual. But this set him in a conflict, not only with his medical superiors, but also with the military authorities, who were not so keen on mere medics posturing in military ways. The result of this double conflict was, of course, Bion’s dismissal from his post. Thus ended what was to be known as the ‘First Northfield Experiment’. The second, and much more successful, Northfield Experiment began in 1944 when Harold Bridger took over Bion’s post in commanding the rehabilitation unit, and S.H. Foulkes turned from being a doctor in charge of a ward to become the senior group therapist in the hospital, and a ubiquitous visitant in every group activity in the community. Coming from the teaching of mathematics and having had the experience of command, Bridger decided that he should ‘work in some dynamic form with the institution as a whole, while also being prepared to consult and collaborate with those parts of the organization which showed a readiness for responsibility in attempting to achieve the health of an enterprise, however small, or to create some entity which could grow’ (Bridger 1983 p.99). He therefore had discussions with every section of the staff of the hospital, including building and maintenance engineers. He also decided that he

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should have some functional role for the ‘hospital-as-a-whole’, besides taking command of the rehabilitation unit. He thus expected to avoid the conceptual and social isolation that put an end to Bion’s effort. Therefore he took over the role of the ‘social therapist’, who held responsibility for the distribution of all the recreational material. Of course, Bridger was a layman, and his collective approach was a continuation of Bion’s ill-fated experiment. So, there was a need for someone with the disposition and the skill to develop a therapeutically oriented group process, and this was S.H. Foulkes. Foulkes had been steadily developing his therapeutic group approach in Northfield, since his arrival in March 1943. He therefore knew nothing, at the time, of Bion and Rickman’s first experiment. (Indeed, he used the term ‘the Northfield Experiment’ to refer to the 1944–45 experience. Later (S.H. Foulkes 1964a), he changed it to ‘the Second Northfield Experiment’, to avoid confusion.) Siegmund Heinrich Foulkes was the senior psychiatrist at Northfield, and the only one who had had previous experience with therapeutic groups. This German-born psychoanalyst had started his practice in group psychotherapy in Exeter in 1940, wrote his first paper on group analysis in 1942, and published his book An Introduction to Group-Analytic Psychotherapy in 1948. Four years later, in 1952, he founded the Group-Analytic Society in London, whose president he was from 1952 to 1970. He died in 1976. Foulkes was obviously considering that the therapeutic process should not enter into conflict with social and institutional requirements. This had been a part of his thinking from the very beginning of his involvement with groups. In his first paper on group analysis, written jointly with Eve Lewis, he had stated: The concrete realization of the part which social conditions play in their troublesome problems, the social front of inner conflicts, so to speak, sets people thinking in a critical way and makes them experience the part they themselves are playing, both actively and passively, as objects as well as instruments of these conditions – an altogether desirable contribution to their education as responsible citizens, in particular of a free and democratic community. (Foulkes and Lewis 1944)

And what was true for ordinary civilian life should also be true for the peculiar characteristics of a military environment during wartime: one of the main goals of therapy should be the development of responsible citizens – in this case, good soldiers.

A HISTORICAL PERSPECTIVE

19

Soon after the beginning of this Second Northfield Experiment, Foulkes set up a seminar on group therapy in the hospital. He was the conductor of the group and, as he was the only one who had had a prior experience of group therapy, he took the role of educator. Hinshelwood (1999), who painstakingly studied the minutes of these meetings, suggests that there was a growing tension between Foulkes and his followers and other attendants, such as Bridger and Main, who made it quite clear that they were not coming to learn 2 from Foulkes, but to promote their own point of view. Unlike Foulkes, who advocated verbal discussion groups with a therapeutic aim based on expressive communication, Bridger and Main used activity groups with the aim of fostering good morale, team spirit, cohesion, and the personal experience of belonging, which was assumed to be the main therapeutic factor. In other words, they were following Bion’s early approach. These disagreements were never actually faced or clarified, and this resulted in a schism among analytic group therapists in Britain: those who followed Foulkes’ proposal would conceive themselves mainly as therapists who would nurse and nurture the group process, in order to benefit the individual members, while those who followed Bion would induce the group members to turn their meetings into an inquiry about the group, as this research, in itself, was considered to have curative properties in advancing the maturity of the members who took an active part in this endeavour. From these experiences, Foulkes developed a completely new approach to the understanding of human life within the social context. He called his method ‘group analysis’. The rationale for this term was that psychoanalysis scrutinized the individual psyche, while group analysis studied the mental phenomena in the group. Group analysis started as group-analytic psychotherapy, but it has since developed into a fully fledged concept for the understanding and conducting of a wide range of group processes. Its principles have been applied to the conducting of groups in higher education; to various kinds of training and research groups; to the treatment of diverse natural groups, including institutional groups, working teams, and family groups; to large and median groups, and to therapeutic communities.

Operative groups While group analysis has flourished mainly in Great Britain, under the leadership of the Group-Analytic Society, it has also developed in several countries in Europe. In North America, the dominant trend in group

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psychotherapy has been the psychoanalytic treatment of individuals in groups, while Latin-American group therapists have been mainly interested in the psychoanalytic approach to the group-as-a-whole, taken as an equivalent of an individual patient. There has been, however, an independent school of group analysis, which developed in Argentina. It stemmed from the work and teachings of the Swiss-born Argentine psychoanalyst Enrique Pichon-Rivière. This thinker conceived a group-centred approach which, although not directly influenced by Foulkes’ work, was fully compatible with it. Pichon-Rivière coined the name ‘operative groups’ for his theory and technique. Unlike Foulkes, who moved from therapeutic groups to non-therapeutic applications, Pichon-Rivière started with learning, training, and discussion groups, and then applied to group therapy the principles he had developed for those purposes. He felt that there was an essential identity between the processes of teaching and learning, on the one hand, and of therapy, on the other. He believed in a continuum of feeling, thinking, learning, understanding, and healing, which was organized around the axis of rational action. For him, that was the crux of the matter: only action was able to modify reality, and the goal of dynamic groups was to create the basis for an effective operation, both for the group and for the individuals that composed it; hence the name ‘operative groups’ (Pichon-Rivière 1971a; Tubert-Oklander 1990–92). This is perhaps the only essential difference between Pichon-Rivière and Foulkes, since the former always emphasized the group task as the main organizer for the group process, while the latter maintained that in group-analytic psychotherapy there was no formal task, since such a conscious endeavour would act as a resistance. Perhaps this insistence in rejecting any task for the therapeutic group was a remnant of the tensions between the ‘therapeutic’ and ‘activity’ subgroups in Northfield’s staff. Pichon-Rivière, on the other hand, considered that a therapeutic group was a group whose common task was to attain the healing of its individual members. Foulkes, however, always emphasized that one of the main therapeutic processes in group analysis was what he called ‘ego training in action’, so that both writers stressed, in slightly different ways, the importance of action in working through. Both also considered that the group situation allowed for the development of ‘action research’, in which the dynamics of change and development would be studied from the vantage point of the group analyst as a participant observer.

A HISTORICAL PERSPECTIVE

21

These two schools of group analysis share a common conception of man, of group processes, and of group-analytic psychotherapy. They differ, however, in some of their concepts and in the focus of their interests. We believe that both have a lot to learn from each other. But the interchange between them has been scarce, on account of the language barrier. There have been only a few Spanish translations of the work of Foulkes and his followers, and some of them have been inadequate. The work of Pichon-Rivière and his co-workers has not been translated into English. There has been a growing interest, among English-speaking group analysts, in knowing more about operative groups, since some South-American colleagues have trained and practised in London, and shared with their peers their knowledge of the Latin-American approach to group analysis. Group analysts in the United States have had no such opportunity to learn about this Latin-American school of group analysis. Pichon-Rivière developed his ideas from his experience as a psychiatrist in the Hospicio de las Mercedes, a traditional insane asylum for men, later to be known as the Tomás Borda Neuro-Psychiatric Hospital. When he started to work there, in the late thirties, there were 4, 500 inmates in the asylum. Sixty per cent of them were in a state of complete isolation. Nobody visited them, and they were maltreated by their male nurses (Zito Lema 1976). Pichon-Rivière’s reaction to the situation was to create training groups for the nurses. He realized that their abuse of the patients was a result of their ignorance, for they truly knew nothing about mental health and disease. He therefore proposed this project to Dr Gonzalo Bochs, who was at that time the director of the asylum and who approved the initiative set forth by the young doctor. As he was the chief of the admission ward, Pichon-Rivière was dealing with the first contact between patients and the hospital. One of the difficulties was that the nurses were not able to give any sort of explanation, either to the patients or to their relatives. He therefore set out to teach the nurses how to speak to them. This implied the transmission of a therapeutic ideology that included the idea that mental disease was not incurable, and that recovery depended on a collective effort, comprising everybody from the nurses to the ward chief. This technique – which may also be compared to Balint’s seminars (Balint 1957; Balint et al. 1966), since he based their training on the psychoanalytic discussion of individual cases – was the beginning of what he would later call ‘operative groups’.

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After that, Pichon-Rivière had to face a new emergency. His ward was deprived of nurses, for political reasons. He then started a brief training course on nursing for a small group of patients whose condition was not so bad. He also conducted this new project by means of group techniques, focused on the analysis of stereotyped roles (the ‘patient’, the ‘doctor’, the ‘nurse’), in order to foster the development of a new functional leadership. The new non-professional nurses turned out to be even more competent than the professional ones. The patients were now well cared for by the patients-turned-into-nurses, who were of course more empathic towards their companions. Besides being able to help, their mental health improved significantly. In Pichon-Rivière’s words, ‘they showed a new dynamic adaptation to society, especially because they now felt useful’ (Zito Lema 1976, p.73). Over the next few years, Pichon-Rivière created the first adolescent ward in the hospital. But his unorthodox practices generated a strong enmity among the old-time psychiatrists. He became the target of much criticism, and even slander. In the end, he was forced to resign. Although there were no concrete charges against him, his activities were strongly opposed by some reactionary and very powerful political groups. It took all of his negotiating power to avoid a riot among the patients, who were ready, armed with a few knives, to face the gun-carrying authorities, in order to protest against his dismissal. After leaving the asylum, Pichon-Rivière applied his ideas and technique to working with groups in various institutions and communities. In 1958, with a group of colleagues, he conducted a large-group and multi-group experience at the University of the Argentine City of Rosario. This so-called ‘Rosario Experience’ became the paradigm of his technique of ‘operative groups’ (Dellarossa 1959, 1979; Pichon-Rivière et al. 1960). This social laboratory included teachers, university students, self-taught people, artists, sportsmen, and general public. There were large groups, and heterogeneous and homogeneous small groups. One of the homogeneous groups was formed by some of the most famous boxers of the time. Pichon-Rivière, who had always been interested in sports, also conducted groups of football players and wrote extensively on the subject (Barrera 1975). (This experience is further described and analyzed in the second section of this chapter, and in the subsection on social laboratories in Chapter 4.) In the 1970s Pichon-Rivière supervised Nicolás Espiro, a psychoanalyst who was working with operative groups in a factory (see Espiro 1975). One of their conclusions was that this sort of group is only feasible if the social

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analysts agree with the ideology of the institution in which they are working. If this were not the case, the results of the group-analytic intervention would turn out to be disruptive for the institution, even though they might seem a positive development, from the analysts’ point of view. This agrees with Tom Main’s description of a ‘successful […intervention for] a lower-order system, but highly disturbing to…the higher-order system’ (Main 1983, p.206). Although Pichon-Rivière’s sojourn in the asylum lasted for fifteen years, his work with the group of male nurses began in 1938; that is, before the outbreak of World War II and Foulkes’ and Bion’s first groups. He was therefore a pioneer, in the true sense of the word. Foulkes’ first groups were conducted in 1940, while he expected call-up for war service and practised in Exeter, both in his private office and at the Exeter Child Guidance Clinic (Pines 1983a). Bion and Rickman wrote the ‘Wharncliffe Memorandum’, which contained a project for a therapeutic community, in the same year, but the First Northfield Experiment took place in 1942, and it lasted only six weeks. Maxwell Jones was also beginning to hold explanatory group discussions with his patients in 1940 (Trist 1985), and the Second Northfield Experiment covered 1944–45. It is thus clearly established that Pichon-Rivière’s clinical experiments began two years previously. The lack of international recognition for his work stems from the fact that he was not much of a writer; according to his former students, his best teachings were delivered in informal settings, usually during a late supper. The publication of his works and lectures was left for other people, much as in the case of Harry Stack Sullivan, and these papers and books have not been translated into English or other languages.

The group-analytic inquiry Group-analytic psychotherapy is an intensive form of treatment of individual patients in small groups. It is now only a part of the wider field of group analysis, as developed by Foulkes in Britain and Pichon-Rivière in Argentina. This form of psychological treatment is based on psychoanalysis, since it incorporates psychoanalytic discoveries and insights, and it can be considered as a natural development of the kind of inquiry into the meaning of human affairs that started with Sigmund Freud. It is definitely not, however, the application of psychoanalysis to a group, but a set of theory, method, and technique based on the dynamics of the group (E.T. Foulkes 1984). It should therefore be clearly distinguished from the psychoanalytic treatment of the individual in the group, or of the whole group, taken as a ‘patient’. Such

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unmodified application of the theory and technique of psychoanalysis to group therapy does not take into account the group-specific features of collective treatment, nor does it include an understanding of the peculiarities of the group context. Group analysis is also a research tool for the analysis of mental processes in a group. The group analyst is a participant observer who analyzes everything that happens in the group situation, much in the same way as the psychoanalyst analyzes the two-person situation of which he is a part. Group analysis does not apply an unmodified psychoanalytical theory to the group field, but rather uses the analytical tool to develop an inquiry in its specific field, and then creates its own concepts in order to interpret and explain its clinical experiences. Foulkes introduced his concepts of the ‘context’, the ‘network’, ‘mirroring’, ‘resonance’, and ‘ego-training in action’, among others (S.H. Foulkes 1948, 1964a, 1975a; Foulkes and Anthony 1957; Hernández Hernández 1994; Hernández de Tubert 1995). Pichon-Rivière also introduced new concepts, such as ‘affiliation’, ‘belongingness’, ‘pertinence’, ‘cooperation’, the ‘group task’, ‘operativity’, and the ‘dialectic spiral’, as well as his understanding of the individual as the ‘spokesman’ for the group. One of the greatest assets of the group-analytic approach is that it does not restrict its inquiry to what can be readily seen from an intrapersonal vertex. Instead of gazing at the shadows of human life like Plato’s cavemen, group analysis oscillates between individual and context, fantasy and reality, idiosyncratic meaning and concrete interaction (Hopper 1982, 1985). Thus it integrates the study of the individual and his relations, with that of the group, the institution, and society as a whole. And all this is accomplished without relinquishing the momentous contribution of Sigmund Freud’s work to the understanding of the human condition. The whole group-analytic endeavour can therefore be considered as intrapsychic, since it does not identify the intrapsychic with the intrapersonal. The field of unconscious intrapsychic phenomena includes the intrapersonal, as well as the interpersonal and the transpersonal (S.H. Foulkes 1964a; Hernández Hernández 1994; Hernández de Tubert 1995). Group analysis is therefore a natural extension of the psychoanalytical method, and amplifies its power as a tool for therapy and research. Group-analytic theory does not attempt to replace any part of psychoanalytic theory, but rather complements it with its findings and concepts acquired from another vantage point. Thus we believe that these two theories should be considered as two chapters in the wider account of the analytic approach to the study of the human being.

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Enrique Pichon-Rivière: pioneer and outcast

There have been some thinkers in the history of ideas who have left very few writings. These are people who love the spoken word; they thrive in the living discussion of ideas in statu nascendi, and this makes them superb teachers but poor writers. Their teachings have been preserved in the notes taken by someone else. Such is the case of Socrates, George Herbert Mead, Ferdinand de Saussure, Harry Stack Sullivan, and, in Latin American psychoanalysis, of Enrique Pichon-Rivière. Pichon-Rivière was a pioneer in so many areas that it is very hard to summarize his contributions. In the 1940s he set the foundations for the psychoanalytic approach to psychoses and psychosomatic medicine in Latin America. He wrote extensively about schizophrenia, manic-depressive psychosis, epilepsy and various psychosomatic disorders, as well as about art and poetry. He argued poignantly for a new conception of psychiatry that included both the psychoanalytic and the socio-political dimensions. He also developed a comprehensive study of groups. His conception of what he called ‘operative groups’ comprised the study and conducting all sorts of human groups, including learning groups, family groups, institutional groups, and therapy groups. Enrique Pichon-Rivière always believed that a thinker’s referential scheme is not only a conceptual organization, but that it is built on a motivational foundation, out of living experiences. This he says in his prologue to his collected papers, From Psychoanalysis to Social Psychology, published in 1971, in the following terms: Through these [living experiences], the researcher will build his internal world, inhabited by people, places, and relations, which will be articulated, with their own tempo, into a creative process, thus shaping the strategy of 4 discovery. (Pichon-Rivière 1971a, p.7, our translation)

This unexpected connection between the internal world and the characteristic pattern of an author’s thought can be better understood if we bear in mind that Pichon-Rivière believed that thinking was the expression of a dialogue among the internal objects that make up the ‘inner group’ (Pichon-Rivière 1965). We shall begin, then, from the man’s childhood, in order to understand his later life and work. Enrique Pichon-Rivière was born in Geneva on 25 June 1907. His father, Alphonse Pichon, was a Frenchman, who had been expelled from the Saint-Syr Military Academy on account of his socialist ideas. His family then sent him to Manchester, to study the textile industry. Finally, however, he

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moved with his wife and children to Argentina and settled in the Chaco jungle, where he tried to raise cotton. His son never knew whatever drove him to such an unusual decision. Alphonse Pichon was very much of a dreamer, quite unsuited for business. The result was that his venture did not prosper. Enrique used to tell a most characteristic episode: Nature did not help, to the extreme that a swarm of locusts devoured even the hay roof of the bungalow where we lived. And we were all suddenly exposed to the elements. I shall never forget that, at the precise moment when the roof disappeared, my father exclaimed: ‘How beautiful, how blue is the sky!’ (Zito Lema 1976, p.16)

His mother, Josephine de la Rivière, was also French. She had studied at a convent, but she was quite atypical for that time. She was a very brave woman, a true fighter, always ready to face any type of difficulties and prejudices. At a time of a state intervention in the church, she took the risk of taking all the nuns to one of her family’s estates. She had also been the first woman in her group to smoke and wear slacks, acting in a play. She loved the theatre, and recited Corneille and Racine by heart. In Goya, in the Province of Corrientes, where they moved to after the demise of Alphonse’s operation in Chaco, she founded several elementary schools, a high school and a professional school. She also worked as a teacher of languages, singing and handicrafts. She was a beautiful and elegant woman, who never accepted the role of poverty. Enrique’s early experiences in Chaco left an imprint for life on his character, his interests and his thinking. He believed that his vocation for the human sciences derived from the attempt to solve the obscurities of a conflict between two cultures. As a result of his parents’ immigration, he was, from his fourth year onwards ‘a witness and a participant in the insertion of an European minority group in a primitive life style’ (Pichon-Rivière 1971a, p.7, our translation). In fact, the conflict must have been among three cultures, not two: his first language was French, his second was that of the Guaraní Indians, which he learnt from his father’s foreman, and only third was Spanish, learnt by the time he started school. However, he was, from that time on, forever split between two conceptions of the world. One of them stemmed from his European roots: it was strictly rationalistic and found its way in scientific research. The other was derived from his contact with the Guaraní culture, which was magical and mythical, and it was expressed in his love of poetry, and his passion for surrealism and the uncanny poems of Lautréamont. It was

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only when he found psychoanalysis that he was able to reconcile these two worlds. The Guaraní conception of the world was especially attractive to him. This is how he described it: It is a mythical world, with an essentially magical conception of thought, and it is obvious that everything related to death is of a great value to them. There is also a deep poetry that underlies everyday actions, myths and legends. All of this is clearly perceptible, for example, in the Guaraní folklore, which is not only one of the main elements of this culture, but also the most beautiful thing I have known in my life (Zito Lema 1976, pp.28–29). The discovery of a continuity between dream and the waking state, which was present in the myths that accompanied my childhood and in the poems that bear witness to my first creative attempts, fostered in me, under the double and basic influence of Lautréamont and Rimbaud, from my adolescence onwards, my vocation for the uncanny. …There, any approach to a conception of the world is magical in character and ruled by guilt. The notions of death, mourning, and madness frame the general context of the Guaraní culture. (Pichon-Rivière 1971a, p.8)

Death was a constant presence in Pichon-Rivière’s childhood. He lived in a jungle, and this implied risks. There were many wild animals: felines such as the puma; the yacaré or South-American crocodile; and snakes, including boas. There was also the menace of the malones, which is the Argentine term for Indian raids, by Guaraní Indians, who attacked small villages and isolated houses in the countryside. Such danger might have been more of a legend, based on the recollections from previous violence, but the fact is that it was quite real for young Enrique. Actual catastrophes included the wreckage of a boat, in which he almost drowned, and his experience of river floods, in which he faced collective panic for the first time. Many years later he was to write a note on psychological reactions to disaster, based on these early experiences (Pichon-Rivière and Quiroga 1970). But there was one concrete experience of danger that induced in him a reaction that was to become customary in his life. This is how he told it to Vicente Zito Lema, who wrote a book on his conversations with Pichon-Rivière: One evening I experienced panic when I was dazed by the eyes of a puma, but I was also under a kind of fascination… [The puma is a very beautiful animal…] but it can also kill… I improvised a behaviour that I would later

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use, in equally critical circumstances, with the mentally sick: I stayed absolutely rigid, without showing any feeling, and without displaying or attempting any act of defence or attack. The puma went away… (Zito Lema 1976, p.20)

This very same behaviour saved him, years later, during a police raid in a theatre that was showing an anarchist play. He was utterly paralyzed, and the police, who were hitting and arresting everybody, never noticed him and he was able to abandon the theatre unhindered. Another time, in the Hospicio de las Mercedes, the Buenos Aires asylum, he was attacked with a knife by one of the inmates. Once again, he stayed immobile, looking unblinkingly at him, until the patient dropped the weapon, which stuck by its sharp point in the floor. Young Enrique’s fascination with death can be readily seen in his very first poem, written in French in 1924 when he was barely seventeen. It is called Connaissance de la mort, and it depicts his feelings towards the ‘dear little old cemetery’ of his village, where he ‘learnt to play with the dead’ (Pichon-Rivière 1971a, p.7). This attraction to death was not only due to his experience with the Guaraní’s vision of the world, but also to a personal feeling of sorrow. This came about as a consequence of a family secret: his father had married his own sister-in-law. That is, his first wife died, leaving him with five children, and he then married her sister. Enrique was the only child of this second marriage. It was only when he was six or seven years old that he found out that he was the only half-brother in the family. This he called his ‘first sorrow’, a feeling of sadness that would never leave him. It was related to the genesis of his vocation as a physician, psychiatrist, psychoanalyst, group and family therapist and social psychologist, as he mentions in the following quotation: Sadness has been with me all my life, perhaps that’s why I do not remember any special sorrow in my childhood… At first I felt sadness as something that was present, fixed, always hurting me, and never knowing its true motive. And ever since I have done nothing but study it in order to be able to reveal something of my own mystery. […Now, I know about sadness] enough to understand that, regardless of my attempts, it shall never leave me. That very first sorrow originated from the family situation, in the characteristics of my father’s second marriage, in the fact that I was the only half-brother among the six of us… First I had an intuition of this, then I knew the cause. (Zito Lema 1976, p.27)

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This attempt to understand and work through childhood experiences is certainly behind any psychoanalyst’s vocation. In Pichon-Rivière’s own words: ‘once again…an experience lived in my first years became a matter for my research. The mystery, the unexpected have got hold of me, and I try to decipher them with the tools that I have acquired as a man’ (Zito Lema 1976, p.22). By the time he was eight, Enrique left Chaco with his family and went to Goya, in the Province of Corrientes. There he stayed until he finished high school, ten years later. In his adolescence Enrique, who had always been keen on adventure and physical activities, became very much of a sportsman; in this he followed in his father’s footsteps, since Alphonse had been a great boxer and fencer. The young Pichon-Rivière was then absorbed by sports, and became a cycling champion; he also practised swimming, soccer, tennis, and he even became a juvenile champion in featherweight boxing. His love for soccer, which had started as a child, was to last all his life. In later years he was to use the football team as a metaphor, in order to understand the process of cooperation in groups. At that time he also became friendly with Canoi, the janitor of the local brothel. This man gave him a bunch of magazines and in one of them he found an article on psychoanalysis; this was his first contact with Freud. When Enrique and his friends founded a soccer club, its first president was Canoi. Pichon-Rivière was also one of the founding members of Goya’s Socialist Party, which was founded in the very same brothel. The madam was the local leader of the Conservative Party, but she let them have their way. ‘It’s all kids’ things’, she used to say. When, at the age of eighteen, Pichon-Rivière went to the city of Rosario to study medicine, he suddenly fell upon his first job: he was to teach ‘manners’ to the Polish prostitutes at Madame Safo’s brothel. A Frenchman who lived in the same boarding house had to leave, and asked Enrique to substitute for him, since ‘Frenchies’ were supposed to know about manners. A few months later he fell ill with pneumonia and had to go back to Goya but, as soon as he was well again, he left for Buenos Aires and entered the School of Medicine of the University of Buenos Aires. There, in another boarding house, he met ‘the strangest types’, who became his best friends. One of them was the famous Argentine novelist Roberto Arlt, a few years his senior, with whom he shared the exploration of the nightlife of the city. In 1932, while still a medical student, he started his psychiatric practice in the Torres Asylum for the mentally retarded, located in the outskirts of Buenos

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Aires. There one of his jobs was to organize a soccer team with the inmates. He also investigated the sexuality of the mentally retarded, and he was able to demonstrate that about sixty per cent of the three thousand five hundred inmates had a special kind of retardation, which was not related to any kind of organic disturbance, but was due to an affective retardation. In those years, he also worked as a journalist for the popular newspaper Crítica. He was finally fired after writing a humorous column, in which he made fun of the ‘hat-bearers’ who entered the offices of the more serious newspapers. (By this he meant wealthy and powerful upper-middle-class visitors, readily identified by their formal apparel, which always included a hat.) Apparently his note had created some discomfort among the ‘hat-bearers’, and the hat-makers who paid for advertising in the newspaper. He also founded the ‘Solidarity Committee with Republican Spain’, and was very active in its operation. In 1936 he graduated as a physician, and immediately won a competitive contest for a position in the Hospicio de las Mercedes, the Buenos Aires asylum for the mentally ill, where he stayed for fifteen years, until he was removed form his post for political reasons. There began his first experiences with a group technique that would later become what he called ‘operative groups’ (Pichon-Rivière 1951, 1965, 1969; Pichon-Rivière et al. 1960; Zito Lema 1976). At that time he was chief of the admission ward, that is, he was in charge of the very first contact of the patients and their families with the institution. But the male nurses were not able to give them any sort of explanation; so he created discussion groups in order to train the nurses. This is how he narrates this experience: In those groups I discussed with the nurses the various cases that we had, in order to give them a general view of psychiatry. The nurses’ learning was astonishing. They had a vast accumulated experience, since most of them had worked for years in the Asylum. Their difficulty was that they could not conceptualize; therefore, that experience was of no use to them. When they began to understand the dynamics of mental illness and its origins in depression, they acquired a much greater lucidity and, consequently, their treatment of the patients improved. These started to feel that they were being well cared for; they were no longer ‘some poor madmen’. (Zito Lema 1976, p.72)

Soon afterwards, for strictly political reasons, his ward was deprived of nurses. So he started a new ‘nursing course’ with some of the patients who were in better conditions than the rest. The results were remarkable, since these

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patients-turned-nurses became even more efficient than the professional ones, and as their capacity for operation improved, their symptoms diminished. Ever afterward, active adaptation to reality – i.e. the instrumental appropriation of reality in order to transform it – became for Pichon-Rivière the landmark of normality and mental health (Pichon-Rivière 1965; Zito Lema 1976). He was later to repeat this experience with medical students (Pichon-Rivière 1951). At the same time he continued studying Freud, and started to meet with other young physicians who were also interested in psychoanalysis. When the Spanish psychoanalyst Ángel Garma arrived at Buenos Aires, with a full psychoanalytic training, Pichon-Rivière did his training analysis with him. Soon they founded the Argentine Psychoanalytic Association, and he was appointed as a training analyst in 1942. The founding members were Garma, Pichon-Rivière, Arnaldo Raskovsky, and Celes Alberto Cárcamo, who had trained in France. In the 1940s Pichon-Rivière made a large number of contributions to psychiatry and psychoanalysis, which can be found in the second volume of his collected papers, A New Set of Problems for Psychiatry (1971b). He wrote papers and delivered lectures on schizophrenia, manic-depressive psychosis, chronic psychoses, epilepsy, psychosomatic medicine, the body scheme, and psychoanalytic psychopathology and technique with all these extreme conditions. He began to develop a personal theoretical point of view about psychopathology, one which derived all pathological manifestations from a basic depressive situation. This later became what he called the ‘single disease theory’ (Pichon-Rivière 1965, 1970a). Small wonder for a man whose melancholic personality structure had led him to a life-long interest in sadness! He also developed extensive psychoanalytic studies on art and the creative process, published in the third volume of his collected papers (Pichon-Rivière 1971c). He held a special interest in the life and writings of the poet Isidore Ducasse, better known as the ‘Count of Lautréamont’. As Ducasse had been born in Montevideo, Uruguay, Enrique was able to investigate his early life and uncover completely new information about him. Lautréamont’s uncanny book of poems, The Chants of Maldodor, fascinated Pichon-Rivière all his life. In 1951 he travelled to Europe and met Melanie Klein, who had an important influence on his thought. In Paris, he gave an impromptu lecture at the Place Blanche Café to André Breton and his surrealist friends, about his investigations on Lautréamont. The very next day he repeated this address to Jacques Lacan and the poet Tristan Tzara, at the former’s apartment. He then

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gave a keynote address on the transference of psychotic patients at the XIV Conference of Romanic Language Psychoanalysts (Pichon-Rivière 1952). In the following years he continued his distinguished career as a teacher of psychoanalysis, supervisor and training analyst. However, when reviewing Pichon-Rivière’s personal history, one cannot help thinking that this is a rather unlikely profile for a psychoanalyst. Indeed, even though Pichon-Rivière was teacher, supervisor and training analyst to many generations of candidates, he remained an anomaly in the association that he had founded. He was a man of action in a profession that emphasizes passive reflection. He remained a psychiatrist at a time when most psychoanalysts felt that there was an essential incompatibility between psychoanalysis and psychiatry. He kept working in mental institutions, while most of his colleagues were restricted to private practice. He was politically active and a socialist, in a rather conservative group that demanded full neutrality from the analyst. He was passionately devoted to the understanding of social affairs and to the development of techniques for social intervention, in an association that stressed the importance of the individual unconscious and the role of instinctual drives as the main, or perhaps the only, determinant factor for all human experience and behaviour. He was committed to group-work, in a professional milieu that believed only in individual interventions. As a university teacher, he was also quite unusual. Ricardo Avenburg, who was his analyzand and student in the 1950s, remembers well his first meeting with him: I was introduced to him by a relative, at my request, in a hotel in Mar del Plata, during the summer of 1955. I wanted to talk to him because I was interested in doing something that was not very clear to me, but that had something to do with Psychiatry or Psychoanalysis. …I was finishing my medical studies, and having a contact with any Full Professor of the School of Medicine was something as unlikely as a soldier having a direct access to a general… I was instantly impressed by his affability, and what really astonished me was that he took the trouble of getting me a chair (which was as inconceivable in the case of a professor as it would have been with a general). I told him about my interests and Pichon explained the psychoanalytic training to me. He told me about his view of psychiatry; of this I remember that he said that it had nothing to do with what we had been taught at the University. (Avenburg 1987, pp.359–350, our translation)

A few months later, Avenburg went to see Pichon-Rivière in order to ask to be considered for starting his training analysis with him. Others had told him

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that this usually implied a two-year waiting period. He was surprised when the analyst said that he would have to wait only one month, until his return from the Geneva International Psychoanalytic Congress. When Avenburg finally dared to tell him that he had not yet graduated, and that he had no money to pay for the session, Pichon-Rivière said not to worry, that they could start anyway, and that they would later see how he would manage to pay him. In those years, Pichon-Rivière had a group of students, candidates, and young analysts who worked and studied with him at the Asylum. Estela and José Remus (Remus, E., 2002; Remus, J., 2002), two senior Mexican psychoanalysts who trained at the time in Argentina, recall their experience there with him as their teacher and supervisor. Pichon-Rivière devised a therapeutic technique for working with psychotic patients, which required that a team of three therapists work with a group of several patients. In the transference, the therapists took the roles of the ‘father’, the ‘mother’, and the ‘uncle’, and their other responsibilities in the management of the ward matched these roles. The results were surprisingly good. Pichon-Rivière had also founded, in 1953, the Argentine Institute for Social Studies (IADES). There he worked with José Bleger, David Liberman, Edgardo Rolla and Fernando Taragano, all of them psychoanalysts. From there they planned the ‘Rosario Experience’, which was the landmark for the development of his technique of operative groups (Pichon-Rivière 1971a, Pichon-Rivière et al. 1960; Tubert-Oklander 1990–92). In this ambitious endeavour, he attempted to analyze a whole city – Rosario, which was the third largest city in Argentina – by means of an intensive interpretative work with small groups. This experience, which took place in 1958 at the University of Rosario, was organized and conducted by Pichon-Rivière and his team. It was designed as a social laboratory, and it was open to anyone interested in participating. The Rosario Experience started with a lecture by Pichon-Rivière, who acted as the general coordinator, and then the audience was divided into small, heterogeneous discussion groups, which were conducted by analysts. This was followed by a meeting of all group conductors with the general coordinator, a second session of the heterogeneous groups, and a new meeting of the team. After that, Pichon-Rivière had a new plenary address, with a larger attendance. He intended to bring back to the large group what had been discussed in the small groups, and to help their members to see themselves in a wider perspective. This session brought an astonishing change

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in the audience, since they started to behave as members of a large discussion group, and not as passive spectators. Then there were sessions with homogeneous groups: five groups on psychosomatic medicine, three on psychology, one on statistics, one of painters, one of boxers, and one of insurance salesmen. This experience was again discussed in the team meeting, and its results were brought to the final plenary meeting with the members of both homogeneous and heterogeneous groups. This experience generated several new groups that kept on working on some of the city’s problems, under the supervision of Pichon-Rivière’s institute (IADES). This was an attempt to turn a focal group experience into a community process. It was also the basis for a new conception of psychoanalytic work with groups, both therapeutic and non-therapeutic. This was akin to Foulkes’s ‘group analysis’ (S.H. Foulkes 1948, 1964a, 1975a), which developed in Britain and on the continent under the leadership of the Group-Analytic Society, but it had its own particular point of view that has not yet been fully introduced in English-speaking countries (Hernández Hernández 1994; Hernández de Tubert 1995). Pichon-Rivière’s emphasis on the social and political aspects of human existence, and his contention that they were fundamental for the construction of the subject and his inner world (Pichon-Rivière 1979), set him increasingly apart from the set of ideas that prevailed at the time in the Argentine Psychoanalytic Association. This created a distance from the institution he had founded, even though he never left it. In 1968 he went again to Europe, this time to give a keynote address at the International Congress of Social Psychology. This became a turning point in his career, since, from that time onwards, he used the term ‘social psychology’ for his own analytical approach to human affairs. His aim was ‘to democratize psychoanalysis’ (Zito Lema 1975, 1976) – hence the title of the largest collection of his writings and recorded classes: From Psychoanalysis to Social Psychology (Pichon-Rivière 1971a, 1971b, 1971c). We believe, however, that he was mistaken here. His work is really a breakthrough in psychoanalytic theory and practice. It is a major contribution towards the development of a new paradigm of the human being that we so sorely need. What happened to Enrique Pichon-Rivière? In his life as a man and as a psychoanalyst we can very well see the conjunction of a personal history with the social and political environment, superbly described in his theoretical writings. His early migrations must have represented for him emotional losses that, together with his experience of a particular, hidden, family situation,

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nurtured his bent for depression. The transcultural and multilinguistic nature of his childhood environment gave birth to a firm conviction about the relativity of all systematic knowledge, and a tendency to look always for a fresh point of view, even when dealing with apparently well-established knowledge and theories. The early identification with his father turned him into a dreamer and a sportsman, with an adventurous character, but ill-fitted to deal with the practical aspects of life. In 1976 he declared: As for me, I was screwed up. I never earned money. I always adapted to the patient’s needs. Besides, for many, many years I dedicated all my time to work in the asylum or in research. But I am happy that I had such an attitude, which was fully conscious. (Zito Lema 1976)

From his mother he incorporated her love for poetry, her initiative and social sensibility, and her rebelliousness towards mores and authority. His identification with her must have contributed to his vocation as a teacher. All this led him to a way of life that could only shock his fellow psychoanalysts. His omnivorous reading of, and references to, every possible book in science, technology, management, history, philosophy and literature, implied that psychoanalytic theory was not in itself enough to gain a full understanding of human affairs. This was unacceptable for a professional group that was struggling to find acceptance in a social environment that regarded it with antipathy and mistrust. His assertion that all scientific accomplishments stemmed from everyday knowledge, and that active life experience was essential for true understanding, defied the assumption that science was based only on a detached, rational evaluation of facts. Besides, he was certainly not very discreet about this, in declarations such as the following: Personally, I feel that my contacts with the Guaraní culture, my knowledge of brothels and of the night-life of Buenos Aires, as well as my studies about Lautréamont and Artaud, and my friendship with [the Argentine novelist] Roberto Arlt, for example, have been much more useful to me, in order to deal with [mental] illness, than my knowledge of Freud or of medicine. The opposite attitude – that is, moving in isolated compartments – is equal to rejecting, from the beginning, a knowledge of man, this historic, concrete, everyday subject, with whom we intend to establish a therapeutic relation. (Zito Lema 1976, p.80)

Everybody in the Argentine Psychoanalytic Association respected Pichon-Rivière, but they did not know what to do with him. The fact is that he did not behave as is expected of a senior analyst and a founding member. He refused to be solemn, he insisted in discussing politics, and he always

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seemed to be putting into question the omniscience of psychoanalysis. In the end, this created a gap between the association and its founder. Besides, his melancholic traits finally overtook him, and projected him into a prolonged illness that hindered his capacity to teach and write. He died on 16 July 1977, as a respected founder of both the Argentine Psychoanalytic Association and the School of Social Psychology, which still exists in Buenos Aires and has branches in several Latin American countries. In the twenty-five years that have passed since his death, he has been largely forgotten in the world of psychoanalysis. Even though his name still rings a bell for young psychoanalysts, his works are rarely read or quoted in psychoanalytic papers. His books on groups and social psychology are also ignored by many analytic group therapists, even though they are mandatory reading for those with a social bent. Outside Latin America his work is known mainly in Spain, since it has not been translated into other languages. There is, however, a growing interest in his approach to groups among British group analysts. We believe it is high time for us to recover his memory, contributions and ideas now, at the beginning of the third millennium, when we urgently need to reformulate our theory and practice in order to encompass those dimensions of human existence that have previously been left out.

CHAPTER 2

Fundamental Concepts of Operative Groups: Enrique Pichon-Rivière

An attempted definition It is not easy to define what is an operative group. For some reason or other, most people in the field hold a misconception about it. They tend to think that ‘operative groups’ are one kind of group that should be distinguished from others, such as therapeutic groups, teaching groups, and so on. This is not true. ‘Operative groups’ is the name given to a whole conception of life in groups and the best way to conduct them. This encompasses every kind of work group, if its operation is conducted according to this philosophy. Pichon-Rivière wrote, on several occasions, a definition of what is implied in this term: The group technique that we have created – called operative groups – is…explicitly centred on a task, which can be learning, healing (thus including therapeutic groups), diagnosing difficulties in a work place, creative work in an advertising company, etc. Under this explicit task lies another implicit task, which tries to break, by means of elucidation, the stereotyped patterns that impede learning and communication, thus acting as an obstacle to any progress or change. (Pichon-Rivière 1969, pp.152–153) An operative group is a group that is centred on a task, whose aim is to learn to think in terms of solving the difficulties that are generated and expressed in the group field, and not in that of every one of its members, as this would be an individual psychoanalysis in a group. (Pichon-Rivière 1965, p.128) 37

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This is, of course, quite similar to the standard definition of group analysis as derived from the work of S. H. Foulkes, as we can see in the following quotation from Elizabeth T. Foulkes: Group analysis or more specifically, group-analytic psychotherapy, is an intensive form of treatment in small groups. The term group analysis also includes application of the principles both within and outside the therapeutic field. While fully based on psycho-analytic insights it is not an application of psychoanalysis to a group but a method and technique based on the dynamics of the group. It is therapy in the group, of the group and by the group, the group providing the context in which the individual person is treated. Intra-psychic processes are seen as interacting within the mental matrix of the group as a whole. (E.T. Foulkes 1984, p.5)

There is one difference, however. For Pichon-Rivière, the main characteristic of an operative group is that it meets in order to carry out a common task, and this becomes one of the main organizers of its dynamics. This is clearly depicted in what is perhaps the tersest definition of an operative group, written by José Bleger, one of Pichon-Rivière’s closest disciples: ‘an operative group…is a set of people with a common goal, which they try to approach by acting as a team’ (Bleger 1961, p.57, our translation). This would seem to be in contradiction of Foulkes’ contention that there should not be any explicit goal in group-analytic groups. We believe, however, that this apparent opposition is only circumstantial, since both authors’ points of view, theoretical developments, technique and group practice can be shown to be fully compatible. So, an operative group is a collection of people who meet in order to attain a common goal, and they intend to do so by means of team work. This implies a conscious effort to identify, understand and overcome the obstacles that always arise when several individuals try to work together. Such effort can only be an application of the scientific method. The group conductor – whom Pichon-Rivière called the ‘coordinator’ or ‘co-thinker’, inasmuch he coordinated the efforts of the members of the group and helped them to think, by thinking with them – fosters the development of a more scientific approach by the group members. This he does through interpretations of the group dynamics, which invite the members to reflect together on the difficulties they find in tackling their common task. Thus there is an evolution of thinking in the group, which goes from ordinary or common thinking, to scientific thinking; this solves the apparent contradictions and establishes a genetic and dynamic continuity between them (Pichon-Rivière et al. 1960).

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The task As we have just seen, Pichon-Rivière believed that every group joins in order to do something, and that there is always some work being done in the group at any particular moment. Such work is a thinking process, which can be carried out as ordinary thought or scientific thought. In this, he seems to have been 1 influenced by Bion (1952) , who put forward these ideas as follows: In any group there may be discerned trends of mental activity. Every group, however casual, meets to ‘do’ something; in this activity, according to the capacities of the individuals, they cooperate. This cooperation is voluntary and depends on some degree of sophisticated skill in the individual. Participation in this activity is only possible to individuals with years of training and a capacity for experience which has permitted them to develop mentally. Since this activity is geared to a task, it is related to reality, its methods are rational, and therefore, in however embryonic a form, scientific. Its characteristics are similar to those attributed by Freud to the Ego. This facet of mental activity in a group I have called the Work Group. The term embraces only mental activity of a particular kind, not the people who indulge it. (W.R. Bion 1952, p. 442)

Bion (1948–51, 1952) suggested that there were two levels of mental activity in the group: the ‘basic assumption group’ and the ‘work group’. This was clearly an application of Freud’s (1900) concepts of the ‘primary process’ and the ‘secondary process’. The transit from the former, which was irrational, to the latter, which was rational and scientific, would be mediated by interpretation. Pichon-Rivière, however, took a sociological and epistemological approach. He believed that scientific thought stems from ordinary thought, and that scientific knowledge evolves from the kernel of truth contained in common knowledge. This, of course, derives from his own experience in having learnt so many things from the magical culture of the Guaraní Indians, long before studying medicine or psychoanalysis; but the result was that he always looked for the ordinary sources of knowledge, showing their genetic connection with the more sophisticated knowledge that emerged when scientific method was applied to its forerunners. So, Pichon-Rivière’s approach to group involved not, like Bion’s, the idea of overcoming a more primitive mode of thought, but, on the contrary, that of studying and developing this pre-scientific knowledge, so that the group’s thinking, decision-making and action-taking methods become more rational and suitable for their aims. This requires a detailed investigation of the

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members’ previous assumptions and beliefs, as well as of their problem-solving strategies. As we have seen, the group task has two dimensions. The first one is the external, explicit, formally agreed task – i.e. the productive work aimed at achieving the manifest goal of the group, such as study, therapy, decision making, solving some specific problem, etc. Then, there is the internal, implicit task, which at the beginning is only apparent to the coordinator. This is the set of operations that have to be carried out by the group, in order to establish, maintain, and develop the same group as a working team (Ahumada, Dellarosa and Koltan 1971). The difference between the internal and the external task could perhaps be better clarified if we compared the internal task with the organism’s basal metabolism – i.e. that continuous work that our body has to carry out, just to keep on living, even when it is in repose – and the external task, with the additional energy expended by our organism whenever it starts to ‘do something’. This is a useful analogy, inasmuch it emphasizes the fact that every group has to carry out a certain amount of work in order to take care of itself, even though it would appear to be a waste of time from the point of view of someone who only takes into account the external task that the group members have agreed on. But this comparison has its limits (like every analogy) for, whereas the human organism may stay in repose for a long period, doing only the work of living, a group cannot do only an internal task. Both tasks are complementary, since neither can be carried out without the other. It is impossible to do only the external task since, without some degree of internal task, which may even be unconscious for the members, the group activity is rapidly degraded and its productivity is minimized. Nor is it possible to do only the internal task, as this only makes sense in relation to the external task and, without the latter, the internal task becomes a mere ritual and the group’s productivity is again minimized, as it wastes its energies in an empty and sterile activity. Pichon-Rivière has described the evolution of the group task. This takes the form of a cycle, which is repeated every time the group tackles a new problem and consists of a series of moments and stages: 1. The pre-task moment. 2. The task moment, which is divided into; (a) the dilemma stage

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(b) the problem stage (c) the decision stage. 3. The new project moment. The pre-task is the first moment of a group session, in which there is a very strong resistance to change, and the group members deploy all sorts of manoeuvres in order not to do what they have agreed to do (the task) – i.e. there is an unconscious conspiracy to keep the status quo. In other words, they are wasting their time. For example, if the group’s task were to discuss a certain piece of literature, they might use the time of the session to express their disagreement with the reading material that has been assigned to them, their discomfort with the design of the whole project, their criticism of the coordinator’s behaviour, and so on. This is a regressive moment in which the members resort to the various primitive defence mechanisms, such as splitting, denial, omnipotence, idealization, denigration, and the primitive forms of projection and introjection. These are moved by intense fears: the fear of confusion (confusional anxiety), the fear of being damaged by the new knowledge, habits, or relational patterns (paranoid anxiety), and the fear of loss of the previous knowledge, habits or relational patterns (depressive anxiety). These unconscious conflicts must be worked through, either by the group members’ spontaneous insight or through the interpretative interventions of the coordinator, aimed at exposing the underlying anxieties and defence mechanisms. When this initial moment of resistance is overcome, it is time to go on to the next phase. The task moment begins when the group starts to deal with the problem of attaining their manifest goal. It is divided into three stages. At the beginning, the group members tackle their assignment in a dissociated form: they state the question in terms of absolute opposites, without perceiving their interdependence. So, the discussion takes an ‘either–or’ turn, demanding an impossible choice between two partial understandings. This is called the dilemma stage. The group’s task is no longer being split off from the discussion, but it undergoes an internal split that blocks any progress. Interpretations at this stage try to show the splitting process and its motives, and help the group to perceive the partiality and complementariness of the apparent opposites. When this split is finally solved, the group enters the problem stage, in which it can approach the task from new and diverse points of view, thus bringing about a new creativity. Now the members are able to define the question in workable terms, use all available information, cooperate in the discussion instead of wasting their efforts in sterile confrontations, identify

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the variables and options, check them against their resources, and finally arrive at a decision, which opens the way to the final stage. This is what Pichon-Rivière calls the ‘scientific method’. The project stage is the time for the group to conceive a new course of action, based on a realistic analysis and according to the newly found, shared interests. The realization of this new task may transcend the limits of the formal sessions with the coordinator. This usually happens when the latter is working with a real-life group, such as a family, an organization or a working team, or when the members that were originally assembled to form the group agree to become one. Thus ends a cycle of group activity, opening the way for a new one (Gear and Liendo 1974; Pichon-Rivière 1965; Pichon-Rivière and Bauleo 1964; Tubert-Oklander 1990–92).

Operations research, decision making and strategic planning Pichon-Rivière was an omnivorous reader and he found useful analogies in almost any field of knowledge. Being a man of action, he was particularly interested in finding ways to improve the individual and the group’s action vis-à-vis reality. He found instruments for this end in several disciplines that might have seemed very remote from the fields of psychoanalysis and group analysis. These were: 1) operations research, 2) action research, and 3) military strategy. We shall now see how he managed to apply these models to the conducting of operative groups.

Operations research Operations research (also called ‘operational research’, ‘management science’, or ‘decision science’, sometimes abbreviated as ‘OR/MS/DS’) is the scientific study of the decision-making process in order to improve it. This new discipline was born in 1938, when a group of scientists met in Bawdsey under the leadership of Patrick Maynard Stuart Blackett, winner of the 1948 Nobel Prize in Physics, to work together in finding an optimal strategy for the organization of the radar system, as a protection from enemy air raids. This was from the beginning an interdisciplinary venture, inasmuch it gathered a group of people who were familiar with the scientific method, but had no special knowledge of radio (Dellarossa 1979, pp. 97–98). Even though operations research usually constructs mathematical models of the problem at hand, it is not necessarily a mathematical discipline, since real-life practical problems do not readily fit within neat disciplinary boundaries. Even designing a machine

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cannot leave aside the psychological and sociological study of the people who are going to operate it. So the study of such complex problems must needs be approached from multiple vantage points. The operations research analyst is not usually the manager who has to take the decision. Therefore, the decision maker becomes the client of the analyst. The process of consultation starts when the client poses his problem to the analyst. As real-life problems tend to be unstructured, the first task for the analyst is to diagnose and reformulate the problem in more definite terms. He also has to diagnose the client’s decision-making process, trying to identify its shortcomings. The OR/MS/DS approach to decision making includes the diagnosis of current decision making and the specification of changes in decision process. Diagnosis is the identification of problems (or opportunities for improvement) in current decision behavior; it involves determining how decisions are currently made, specifying how decisions should be made, and understanding why decisions are not made as they should be. Specification of changes in decision process involves choosing what specific improvements in decision behavior are to be achieved and thus defining the objectives. Foundations of Good Decision-Making Process: When one talks of ‘foundations’, usually it includes historical, psychological, and logical aspects of the subject. The foundation of OR/MS/DS is built on the philosophy of knowledge, science, logic, and above all creativity. (Arsham 1994–2001)

These experiences and concepts made a great impression on Pichon-Rivière, and he immediately tried to apply them to his own field. He therefore conceived the group coordinator as an operational research analyst, who would diagnose the problem-solving strategies of his client-group and group members, trying to identify where they have gone wrong, and helping them to find a better strategy. He therefore conceived and carried out, in 1958, his famous ‘Rosario Experience’, in which the Argentine Institute for Social Studies that he had founded was to be the analyst, and the whole city of Rosario would be the client (Pichon-Rivière et al. 1960). From that experience stemmed his conception of ‘operative groups’.

Action research Pichon-Rivière was also interested in Kurt Lewin’s approach to social science (Lewin 1948, 1951; Mailhiot 1967). He found an essential similarity between Freud’s and Lewin’s work, since both of them had shown the

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essential identity between investigating a state of affairs (inquiry) and acting on it in order to modify or correct it (operation). This proved that there was no ‘pure’ research. Inquiry is never innocuous, since it always has an effect on the reality that it is studying. Pichon-Rivière’s operative technique aimed at integrating the false opposition between theoretical and practical work into a concrete praxis, understood as a perpetual coexisting of inquiry and operation, in a complementary and mutually enriching relation (Pichon-Rivière 1965). Lewin’s conception of an action research, which gave the social scientist an opportunity to know and understand a social system from within, while he is acting to modify it, was very much in tune with his own approach to research, ever since his first psychiatric experiences with retarded patients in the Torres Asylum. Also, the idea of training ‘agents for change’ had an essential affinity with his own experience of training psychiatric patients as nurses in the late 1930s. And perhaps the affinity was even deeper, since the published descriptions of Lewin’s personality and leadership style are very similar to those of Pichon-Rivière. Let us see, for example, Bernard Mailhiot’s depiction of the former: Another trait of Lewin’s personality that helped to create an exceptional climate of intellectual fervour…was that he demanded that everything should be discussed, explored, and decided in the group: hypotheses, objectives, methodology, experimentation. He appeared as little as possible as the great chief, and had the most democratic attitudes towards everyone, as he established equitable relations with his co-workers. He paid attention to every opinion and suggestion, no matter where they came from; he was very respectful of people, always ready to give himself…in order to help his students in their first attempts to initiate their own research. …[Another characteristic] which is very typical of Lewin’s personality and a key to the fecundity of his intellectual work, is his lack of dogmatism. He has never aspired to found a Church, become its Pope, and stay in that position, as many of the most illustrious psychologists of his time did. (Mailhiot 1967, pp.14–15, our translation)

This portrait might have been Pichon-Rivière’s. Lewin is one of the authors most frequently quoted by Pichon-Rivière, who seems to have been very much stimulated by his work. Even the design of the Rosario Experience was clearly inspired by Lewin’s conception of the ‘social laboratory’. After Lewin’s death in 1947, however, his group moved away from his traditional attitude of the somewhat more experienced leader of a cooperative group research, towards the more clinically oriented attitude

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of a neutral and ambiguous conductor who interprets the projections of the group (Benne 1964). Pichon-Rivière, on the other hand, was proceeding from traditional psychoanalysis to a more socially oriented conception. Hence the name of his book, From Psychoanalysis to Social Psychology (Pichon-Rivière 1971a, b, c). One aspect of Lewin’s work that attracted Pichon-Rivière was his study of decision-taking and change in social systems. He pointed out that, for Lewin, the problems of group decisions were derived from the relation between motivation and action, and with the effect of group culture and functioning on the individual’s willingness to modify or preserve his behaviour patterns. The real problem is how to modify the behaviour of a group, so that it does not fall back on the previous pattern that has apparently been left behind (Pichon-Rivière et al. 1960). The crux of the matter of change in groups is to arrive at a group decision, as a result of the articulation between motivations – understood as a conflict between wishes and anxieties – and individual or group action. Decision-taking is necessarily the last step before action, so that it heralds the transit from the task to the project, which requires a new phase of strategic planning. And this is where the concepts of military strategy come in.

Military strategy As the psychoanalytic situation requires a suspension of decision taking and 2 action, psychoanalysis has not developed a theory of action. Therefore, Pichon-Rivière had to look for this elsewhere, and he found it in the theory of military strategy. Military operations require careful planning, in order to attain the greatest benefit with the least expenditure, so that they must always take account of reality. Therefore, they can be a very useful metaphor when we are trying to think about corrective interventions, such as psychotherapy or teaching. Pichon-Rivière was fascinated by this metaphor. He liked to think of his work as if it were a commando operation against a very powerful enemy. Some colleagues have taken exception to the idea of comparing the task with an enemy to be defeated. We must remember, however, that ‘task’ implies work, and this is always an expenditure of energy, which is used to overcome an obstacle. In our case, the obstacle is resistance to change, which in a group takes the form of an unconscious conspiracy to keep the status quo, and this amounts to a strategy for sickness. (It must be remembered that for Pichon-Rivière this term did not necessarily imply a definite psychiatric

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disorder, but anything that hindered creativity, growth, development, integration, learning, knowledge, and truth.) This must be fought by means of a strategy for health. Thus the conspiracy was the enemy to be defeated; but it was a very clever enemy, so that the group coordinator had to discover its secret operations and intentions, in order to neutralize them by exposure, i.e. interpretation. Military theory traditionally differentiates between strategy and tactics. The former refers to the overall direction of a war, while the latter is the command of specific encounters with the enemy. This is stated by Clausewitz in the following terms: ‘According to our classification, therefore, tactics is the theory of the use of military forces in combat. Strategy is the theory of the use of combats for the object of the War‘ (Clausewitz 1978, p.173, author’s italics). This means that strategy is always more general and comprehensive than tactics, while the latter is always more particular and concrete. Strategy should always have the lead over tactics. When this is not so, we run the risk of sharing the fate of King Pyrrhus, who coined the phrase ‘Another victory like this and we shall lose the war’. But strategy (designing an overall plan for our intervention) and tactics (deciding the circumstances in which we intend to work, choosing the terrain for our encounter with the enemy, we might say) are not enough. We must add two more elements. The first of them is technique. Pichon-Rivière uses this term in order to refer to the set of decisions to be taken about the specific instruments and operations that will be used when intervening in particular situations. Such instruments may be, for example, ‘interpretation’, ‘frequency of sessions’, ‘psycho-dramatic exercises’, and so on. The sequence strategy–tactics–technique goes from the more general to the more particular decisions. Therefore, tactics must always be subordinated to strategy, and technique to tactics. Pichon-Rivière et al. (1960) give an example of the application of this scheme, referring to the Rosario Experience: ‘In Rosario we used as a strategy the creation of a social laboratory situation; as tactics, the group approach, and as technique, that of task-centred groups of discussion and communication’ (p.111). The second element to be included is logistics. This is, for Pichon-Rivière, the last of the stages of operative planning. This is the comparative evaluation of the nature and magnitude of the problem to be tackled, and of the resources available for the agents of change. This is essential for our planning to include reality.

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So, strategy, tactics, technique and logistics should be viewed as the four moments of operation. When the group manages, during the project stage, to apply them adequately, its action becomes truly operative. On externalizing the strategy, it is turned into tactics; according to the instruments to be used in operation, [the group] will be using a technique. When the moment comes in which it can evaluate its own potentiality, in comparison with the adversary (logistics), it shall attain the highest possible operativity. The team shall then be perfect, and it will thus become an operative group. And if we add to this the three basic principles that govern the structure of every human group: belongingness, cooperation, and pertinence, we shall attain the most operative model of a group, which will be capable of achieving 3 success on the basis of previous planning. (Pichon-Rivière 1965, p.127)

Once the corresponding actions are carried out, the results should be evaluated, and this should lead to a new diagnosis that either ratifies or rectifies the original one. This mutual regulation between theory and practice is what Pichon-Rivière calls praxis, and it takes the form of an ever-widening dialectic 4 spiral.

The Conceptual Referential Operative Schema (CROS) The origin of the concept The concept of the Conceptual Referential Operative Schema (CROS) is essential in Pichon-Rivière’s thinking. It is the attempt to integrate one’s ideas into an organized open system, which has a dialectic relation with reality. It is therefore part and parcel of the thinker’s personality, a summary of his journey in life. As far as we know, the first published reference to this concept was in his official lecture in the First Latin American Congress of Group Psychotherapy, held in Buenos Aires in 1951. In this paper, called ‘Applications of group psychotherapy’, he asserted that ‘the referential scheme is the whole of knowledge and attitudes that each of us has in his mind, and which he uses in working in his relation to the world and to himself ’ (Pichon-Rivière 1951, p.80). This implies that its core can be consciously identified and known, to a certain extent. Consequently, anybody who wants to approach any given field of knowledge should try to examine, more or less consciously, the conceptual elements that he regularly uses in order to perceive, think and operate. It is by no means coincidental that the concept of the CROS appeared in Pichon-Rivière’s work when he started to write about groups. When people

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meet in order to do something together, it is essential that they manage to understand each other. And this requires that they share a common code, so that they may accurately decode their mutual communications. But, at the beginning of a group, each one of its members has his own conception of things and, therefore, his own code. This leads to misunderstanding. So, Pichon-Rivière thought, the group conductor’s task should be to induce and help the group members to inquire into their various frameworks for thought, and to construct a common conceptual framework for their use as a team, thus turning the original misunderstanding into understanding. This was the construction of a group CROS. Since a large part of the group members’ CROS was unconscious to them, the coordinator’s task was to interpret this to them – i.e. to utter an explicit formulation of what had previously been a set of implicit assumptions. This is not an easy task, since each one of them feels that his own personal assumptions about reality are necessarily true, they are nothing but ‘the way things are’, and this breeds dogmatism. The mere discovery that other people perceive, think and work from contrasting assumptions opens the way for the development of critical thought. So, one of the main tasks that a group has to face is to build a common group CROS. We shall now analyze each of the terms included in the CROS concept. In this we shall try to stick to Pichon-Rivière’s ideas, while our own concepts will be expounded in Chapter 3.

‘Schema’ Why ‘schema’? Pichon-Rivière does not clarify his choice of the term. If we study the various connotations of the word ‘scheme’ (which I take to be fully 5 6 equivalent to ‘schema’) , taken from Webster’s dictionary , we can see that two of them are pertinent to this discussion: 1) ‘a body or system of related doctrines, theories, etc.’ and 2) ‘any system of correlated things, parts, etc., or the manner of its arrangement’. Apparently, Pichon-Rivière was using the term to refer to a complex structure of interrelated ideas that served to orient perception, thinking and action. He seemed more keen on clarifying the ‘conceptual’ part of the CROS than on analyzing the structural implication of this term, as we can see in the following quotation: …the S stands for ‘Schema’, which is understood as an articulate body of knowledge. ‘Conceptual Schema’ means to us a system of ideas that attains a vast generalization. They are more or less general syntheses of propositions that establish the conditions for the mutual relation among empirical

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phenomena. It is an aggregate of knowledge that provides paths for work and research… A conceptual schema is an organized assortment of universal concepts that allows an adequate approach to the particular object. This helps us to tackle the concrete situation that is to be inquired or solved. This is why Kurt Lewin says that: ‘There’s nothing more practical that a good theory.’ (Pichon-Rivière 1970b, p.7)

Although Pichon-Rivière never says this explicitly, we believe that this concept is implicitly related to that of the ‘body schema’. He had been writing and teaching about this concept during the 1940s and 1950s (Pichon-Rivière 1971b), and theorizing about it. He had been impressed by Schilder’s (1935) definition of the body schema as ‘the three-dimensional image that each of us has of himself ’, and includes a new dimension in it: time, so that it becomes ‘the four-dimensional image’ (Pichon-Rivière 1959). Let us see how he described this structure: He [Pichon-Rivière] conceives it [the body schema] as a social structure that gives shape to the notions of space and time, and that rules many aspects of the bond with the other [p.163]… This image is built on the basis of the multiple sensations that are dynamically integrated into a Gestalt of the body. It is a structure in continuous disintegration and re-structuring. (Pichon-Rivière 1959, p.171) The author suggests the term self schema as a conceptual, referential and operative schema that includes the three dimensions [of experience] – mind, body, and external world – working with a time and a bond that includes the 7 subject, the object, and their [mutual] communication. (ibid., p.172)

This is, as far as we know, the only reference in Pichon-Rivière’s published writings that explicitly connects the CROS with the body schema. There is, however, a great similarity between these concepts: 1) they are both structures built from the accumulation and integration of experience; 2) they both influence the way in which new stimuli are organized into experiences; 3) they are both largely unconscious, and 4) they are in a constant state of dynamic flux. The implications of this correspondence will be dealt with in Chapter 3, since they are a part of our own theoretical understanding of operative groups.

‘Conceptual’ As we have noted before, Pichon-Rivière focused especially on the conceptual aspect of the CROS. If this was a schema, it was clearly a conceptual schema for

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him: an organized structure of interrelated concepts that were to be used in perceiving, understanding and acting on reality. In this, the author’s use of the CROS concept is rather ambiguous. Sometimes he uses it to refer to the set of our assumptions in dealing with reality – prejudices, we might say, inasmuch they are judgements made before the fact, preconceptions that are usually unexamined by the subject. These ought to be critically examined, if the members of the group are to develop a common framework for their understanding and operating on the problem at hand. On other occasions, Pichon-Rivière used the term CROS for the new set of common theoretical assumptions that is constructed by the group, after having examined the individual members’ assumptions, their contradictions and misunderstandings. It is therefore an explicit, conscious construction that results from the common work of the group. If the group discussion has been systematic and rational, if it has included a reflective observation of the members’ mental processes, and if it has mercilessly tested each concept against the concrete results of their use of it in operating with reality, this reconstructed CROS should be more scientific, reliable, and useful in dealing with the world. This is what Pichon-Rivière calls ‘going from ordinary thinking to scientific thinking’. This reconstructed CROS can be easily transmitted to other people, so that it can be readily taught and learnt. It is a model that becomes useful in dealing with reality: We might say that the CROS is a model. A scientific model has been defined as ‘a simplification or an approach to the natural facts that are to be studied, that is logically constructed in such a way that it enriches our understanding of those facts.’ The model is therefore an instrument that allows us to understand, by analogy, certain realities. That it to say, the model is an instrument for the apprehension of reality. (Pichon-Rivière 1970b, pp.7–8)

But this conceptual framework is clearly not to be dissociated from action in dealing with reality, or from the underlying emotions that motivate behaviour in its three areas: mind, body, and external world – so that the CROS is not a mere abstraction, since it has its roots in the physical and emotional existence of the group members, and in their constant interchange with their physical, human, and social environment. This is clearly stated by Pichon-Rivière, in the following terms: Every conceptual, referential, and operative schema has both a super-structural aspect and an infra-structural one. The super-structural side corresponds to the conceptual elements, and the infra-structural one, to the

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emotional, motivational elements – i.e. what we would call the ‘verticality 8 of the subject’ , elements derived from his own experience of life, which determine the modes for approaching reality. A consistent analysis of our CROS always compels us, as social operators, to try to clarify both its super-structural and its infra-structural aspects. (Pichon-Rivière 1970b, p.10)

The ambiguity that results from using the same term in order to refer to an actual psychological structure and to its logical reconstruction must needs bring about some degree of confusion. This is the same problem that we face when we try to discriminate between the actual logic of our thinking processes, and their conceptual reconstruction as a logical model. Abraham Kaplan (1964) suggests the terms ‘logic-in-use’ to refer to the actual coherence of an individual’s cognitive style, and ‘reconstructed logic’, for its explicit formulation as a conscious scheme. Perhaps we should likewise speak of a ‘CROS-in-use’ for the actual framework of assumptions of any given individual, which is a psychological structure, and ‘reconstructed CROS’ for an explicit attempt to formulate the essential theoretical assumptions consciously used by an individual or group in order to attain a more effective 9 operation.

‘Referential’ The CROS is referential because it refers to a certain sector of reality. This is fundamental: no conceptual scheme can cover the whole of reality. So, every CROS is necessarily partial: it refers to a certain section of the world in which we are operating. That is why we use the word ‘sector’, which means ‘a designated defence area, usually in a combat zone, within which a particular military unit operates and for which it is responsible’ (Webster’s Dictionary), thus emphasizing the relation between the operative group and the problem area that is being tackled. Therefore, the conceptual schema can only be understood in the context of the problem situation, including the people, the time, the place, and the circumstances of the operation. The fact that the CROS is always referring to a concrete situation, and that it is being used as a guide for action, determines that it is always being tested against reality. When direct observation shows facts that are concordant with the conceptual schema, the latter is ratified; when they reveal facts that had not been included in it, it should be rectified. Therefore, the CROS has a dialectic relation with experience: on the one hand, it gives meaning and form to every new experience; on the other, it is always being corrected by such experiences.

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It is a dynamic structure, which constantly evolves though its relation with experience and the evaluation of the consequences of action. The whole process takes the form of an ever-widening dialectic spiral, and this process of theorizing experience and letting experience correct the theory, in a continual cycle of perception–reflection–action–new perception, is what we call praxis. In operative groups, this cycle takes the form of a particular sequence: existent–interpretation–new emergent. The existent is the group manifestation or phenomenon that is to be understood. The interpretation is a verbal communication by the coordinator, to the group, of whatever he feels he has 10 understood. The new emergent is the new phenomenon that appears as a reaction to the conductor’s interpretation. This is then taken as an existent, and the cycle starts over again, in a new turn of the spiral.

‘Operative’ We have already seen that the whole CROS revolves around the axle of rational action, an action based on a previous scheme, and whose results are perpetually being evaluated, as a corrective feedback for the scheme. In Pichon-Rivière’s CROS, operativity – i.e. the capacity to attain the expected results – is the criterion for the winnowing of ideas. Whereas the traditional criterion of science and philosophy is that of truth – i.e. the correspondence between thoughts or statements, on the one hand, and the perceived attributes of the object, on the other – here the only criterion is effectiveness. This is clearly related to William James’ (1907) pragmatism, even though Pichon-Rivière never mentions this precedent. But pragmatism is, of course, implicit in some of his most cherished sources, such as Kurt Lewin (1948, 1951) and George Herbert Mead (1934), as their underlying philosophy. Therefore, for Pichon-Rivière, theories are not valid in themselves, but should always be evaluated in their relation with concrete human beings and their constant interchange with their environment. They are instruments for action and research, and their validity is derived from their effectiveness.

The individual and the group There is always, according to Pichon-Rivière, a dialectical relationship between the individual and the group. There is no point in asking whether a certain communicative act during a group session is an expression of the individual or of the group: it cannot fail to be both at the same time. This is

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particularly clear when the group is a family group: there the identified patient is expressing both his own problems and the group’s; he is therefore a spokesman both for his own conflicts and for the group’s unconscious fantasies. The coordinator must interpret in both directions: first in a vertical direction, indicating the individual’s inner problems as the result of his own personal history and conflicts; and then in a horizontal direction, showing how his behaviour is an expression of a present conflict that is active in the group, but is unperceived by its members. For Pichon-Rivière, the difference between the technique of operative groups and other analytic group techniques is that here interpretations are made in two different directions, and in two steps. In his technical scheme, the coordinator would begin by interpreting the spokesman’s behaviour as a result of his personal history, which has made him particularly sensitive to the underlying problem in the group situation, so that he acts as a ‘radar’, detecting and making explicit the group’s unconscious fantasies. After having interpreted the individual’s idiosyncratic reaction to the present situation, the coordinator would point out that what has been made explicit is also the manifest expression of a group’s implicit problem, which is derived from the interaction among the group members, and with the coordinator. This is perceived and expressed by the spokesman, as a result of a subliminal process of identification (Pichon-Rivière 1965). The individual internalizes the other people with whom he relates, the groups of which he is a member, the institutions of which he is a part, and society, with its culture, values, traditions, roles, and conflicts. The now internalized objects become an internal group, which stands for and interacts with the external group. The internal group is, of course, a schema, in the same way as the body schema and the CROS. Thinking is really a dialogue with the internal group. That is why the development of a meaningful and reflective dialogue among the external group’s members can teach them how to think, as the dialogue is internalized. This is an essential part of Pichon-Rivière’s conception of groups. One of his definitions of a group is: ‘a limited collection of persons, joined by temporal and spatial constants, and articulated by their mutual internal representation, who decide, either explicitly or implicitly, to tackle a task that becomes its goal, by interacting through complex mechanisms of role assignment and assumption’ (Quiroga 1977). In this, Pichon-Rivière is following George Herbert Mead’s (1934) suggestion that self-consciousness stems from the identification with and

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internalization of other people’s roles in their interaction with the subject. When one has internalized the others’ roles, attitudes and behaviour, one becomes proficient in interacting with them. Pichon-Rivière, ever a sportsman, was delighted to find Mead’s description of group interaction in a football team, which is organized and integrated by the internalization of the ‘generalized other’. This term is used to refer to the organized community or social group – in our present case, the team – that gives the individual a sense of unity – i.e. of self – by being a part of this whole. For example, in the case of football ‘in each player there is a representation of the eleven adversaries, of his ten companions, and also of himself participating in the action’ 11 (Pichon-Rivière and Quiroga 1970–85, p.186). Pichon-Rivière, who had played football for many years and organized a football team with the retarded inmates in the Torres Asylum, took enthusiastically to this metaphor. He felt that, in order to play adequately, or even superbly, a football team would have to play the game first on the ‘inner playing field’, before going to the ‘outer field’ (Pichon-Rivière and Quiroga 1970–85; Barrera 1975). He envisioned a football team that operated without any significant interpersonal tensions, because its members had internalized the other members’ playing style. This could be achieved by means of operative groups with football teams, a true, task-centred therapy of a 12 pre-formed group. So, the football team was both a concrete endeavour and a metaphor for every other kind of group. The fact that sport games represent a practical enterprise by a group could not fail to captivate the attention of two red-blooded pragmatists like Mead and Pichon-Rivière. The litmus test for a football team is winning the game and, for Pichon-Rivière, the proof of an operative group is the offspring of its action – i.e. the effective tackling of its task. And these can only be achieved when all the group members manage to act collectively as a unit, as a result of their internalized, mutual representation. So much for the football team model, but there are other models that were used by our author, in order to clarify the mutual relations between the individual and the group. One of them was the dramatic model (Pichon-Rivière 1965; Pichon-Rivière et al. 1969). Pichon-Rivière believed that the operative group model and the dramatic model were essentially the same. He studied extensively Aristotle’s Poetics, in order to find the isomorphism between the two models. This led him to plan and supervise an operative group with the teacher and students of a course in theatre direction. The group coordinator

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had no previous information about the theatre, but he soon found that it was easy for him to shift from the language of operative groups to that of the theatre, since the operative model and the dramatic model had a similar internal structure (Pichon-Rivière et al. 1969, p.146). This similarity stems from the concept of an inner group, which implies that an inner drama, resulting from the conflictive interaction among internal objects, underlies all mental processes, including thought, and interacts with the actual external group, thus determining the group experience. The spokesman in the group can be compared with the protagonist of a tragedy, and his relationship with the other members is similar to that of the play’s hero and the chorus. The spokesman is the tale bearer who reveals and expresses the secrets of the group through a process of expressive delegation, which is ‘the deposition of the fantasy, action, thought, or emotion, on someone who will manifest it in some fashion of un-covering’ (PichonRivière 1965, p.134). This dramatic expression is used by the whole group as a catharsis of their repressed feelings, through the identification with the spokesman-hero. This was described by Aristotle as follows: ‘dramatic creation [is] an art which purports to improve men by means of the evident and spectacular example of the evils that happen to others, which can also happen to us’ (Aristotle, quoted in Pichon-Rivière 1965, p.135). The spokesman depicts by his behaviour, both verbal and nonverbal, an unconscious fantasy of the group, and his action thus becomes role-playing. ‘Drama’ means ‘action’ in Greek, and action is the very stuff of both theatre and group life. It is interesting to note that this comparison between theatre and the group, on the one hand, and psychic structure, on the other, is another of the similarities between Pichon-Rivière’s thought and that of S. H. Foulkes. The latter expressed this idea in the following terms: The group is like a model of the mental apparatus in which its dynamics are personified and dramatized. A process analogous to this may be seen in the theatre where the characters not only represent themselves but also stand proxy for the audience both in their individual and community reactions… [After analyzing the text of Sophocles’ Oedipus Tirannus, with an especial reference made to the relationship between Oedipus and the chorus, in which the former represents the id and becomes the scapegoat, while the latter plays the superego] we find similar configurations in our own groups, though more often the leader or conductor is felt to be in the role of the superego. Group members may also play the part of the superego, ego and id in relation to each other… These…clinical observations show how person-

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alization, displacement and location take place in our groups. [S.H. Foulkes 1957, pp.112–114]

In Pichon-Rivière’s work these group processes are described as a process of deposition, by which an interpersonal unconscious bond is configured, and which corresponds to the theory of the three Ds: the interaction among the depository, the depositor, and that which is deposited. This is related to role assignment and role assumption. In everyday life we are always assigning roles to others and assuming the roles they assign us. This is the basis of the bond, which is a structure of interpersonal relationship that includes a subject, an object, the subject’s relation to the object, and the object’s relation to the subject, where both parties are fulfilling a function within the context of a social situation. This is a perpetual dialectic interchange which underlies all social relations. The conductor of an operative group has to identify the roles that are being assigned and assumed in the group, and interpret them to the members, so that they become explicit, and therefore subject to a critical analysis, thus turning the original irrational bond into a rational bond (Pichon-Rivière 1979).

The group process When the group members meet with the conductor within a certain setting (Bleger 1967) which includes the place, the time, the task and the rules, this sets the group process going. The individuals start to assign and assume roles, thus creating individual bonds and a group bond. This sets the basis for communication. If all the participants assume the roles that have been assigned to them, this results in understanding; if some of them fail to perceive, understand, or assume their roles, the result is misunderstanding. It is the conductor’s responsibility to interpret this situation, so that the block in communication may be overcome, and the whole process takes again the form of a dialectic spiral of communication and learning, which paves the way for a greater operativity (Pichon-Rivière et al. 1960). This spiral process of development is a communicational one, which corresponds to the similar processes of learning and healing. These are paralyzed by anxiety, which takes the form of two basic fears – the fear of being attacked and the fear of losing the object – and sets in motion a series of defensive manoeuvres, which amount to a resistance to change. The result is that roles become stereotyped, relations become rigid and are maimed by mistrust, and 13 communication is blocked by misunderstanding. In such situation, there is

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no learning from experience. In the individual, this rigidity corresponds to 14 the traditional clinical pictures of neuroses and psychoses. In operative groups, there is a conjunction of teaching and learning, which are conceived as the two sides of a single process. José Bleger (1961) relates 15 that some of his groups coined the neologism teachlearning to describe it. In this type of group work, teaching and learning are identical with inquiry, research, discovery, reflection and theorizing. And the learning experience must needs be shared by the members of the group and the coordinator. If the latter finishes his job without having learnt anything, the whole process has failed, because there has been no modification of the stereotyped roles of ‘teacher’ and ‘student’, or ‘therapist’ and ‘patient’. The final goal of operative groups is, therefore, to attain a higher-order learning which transcends the mere acquisition of information and the development of skills. This experience of a praxis gives the members an opportunity to learn to learn and to learn to think. This amounts to a major change in their personalities and their interpersonal and social relations. Learning is identical with communication: ‘we might say that learning follows the path of communication, and vice versa’ (Pichon-Rivière et al. 1960, p.116). In the same vein, healing in a therapeutic group should be considered a learning process. This is a consequence of equating pathology with a learning blockage. When the group transcends a stereotyped, dogmatic, repetitious functioning, its individual members reassume their process of mental, emotional and social development that had previously been paralyzed by conflict and defences, thus allowing its members – when the group’s task is healing – to modify their inner and outer bonds. This generates a more flexible approach to the problems of life and an active and creative approach to reality, which finally turns into a personal project (Pichon-Rivière 1965). When stereotyped roles become less rigid, the result is a greater heterogeneity in the individuals, and a greater homogeneity in the group task, which takes advantage of the various and contrasting personal experiences and abilities, cognitive styles and previous knowledge among the group members. This is what Pichon-Rivière calls ‘interdisciplinary teaching’. From this is derived what he conceives as one of the basic laws of his technique: ‘the greater heterogeneity in the members and the greater homogeneity in the task bring about a greater productivity’ (Pichon-Rivière 1969, p.151). This process fosters an evolution of the forms of interaction in the group, which determine the quality of group membership. The individuals’ participa-

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tion in the group evolves from mere affiliation, which is a rather superficial identification, to a much greater commitment, distinguished by the presence of three phenomena: belongingness, pertinence, and cooperation. Belongingness (in Spanish, pertenencia) means that the individuals are now perceiving themselves, and are being perceived by the other members, as belonging to the group, instead of merely ‘being there’. Pertinence means that the individual members have already internalized the group task, so that their acts become relevant to the group’s purpose. All this leads to cooperation, which is a result of the members’ mutual internalization, and of the construction of a group CROS. Once all the members of the group are bound by their mutual representation and by sharing a common framework for their thought, communication, decision taking and action, a new homogeneity ensues. This does not imply that the individual members are equalized, but, on the contrary, that all their individual differences in personality, experience, previous knowledge and training, and points of view, are all integrated under a common CROS, in order to further the group task. This homogeneity in the task does not require that the group members become friends, or that they share any outer interests or values. Pichon-Rivière loved to illustrate this with examples taken from football. He frequently referred to what is popularly known in Argentina as River Plate’s ‘Machine’. River Plate is a famous Buenos Aires soccer team, and the ‘Machine’ is the nickname given to a certain group of players who were members of the team for several years, and who had such a superb performance that they became a legend, and were known as ‘the goal-making machine’. Pichon-Rivière believed that such outstanding accomplishment was the result of the players having internalized their companions’ playing style, so that they did not have to look around to see where another player was at any given time, they just ‘knew’ where he was: In football one acquires a language, learns a role, and communication is constantly nursed. Through the game, an image is created of oneself and the other… In the playing subject, by means of a process of internalization, there is a representation of the various players, as if there were an inner field in which one’s own team and the rival are playing; this is what we shall call the ‘generalized other’. The core of the personality creates, in the interaction with other characters, a representation that is similar to a Greek tragedy. And this action is what makes planning possible. When watching a football game, one may capture a transient aesthetic experience, attained through a feeling of harmony and accuracy in the game, that always appears after moments of disorganization and rupture.

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Then football becomes ballet. River Plate’s legendary ‘Machine’ was an example of such plasticity. (Pichon-Rivière and Quiroga 1970–85, pp.72–73)

When Ulises Barrera (1975) published his column on Pichon-Rivière, in which he mentioned the latter’s hypothesis about the ‘Machine’, there was an outraged response from one of the readers, who wrote a letter in order to refute what he felt was just a bunch of psychoanalytic nonsense. His argument was that it was a well known fact that two of the forward players of that team hated each other and were not on speaking terms. This, of course, is not a valid objection, since Pichon-Rivière’s argument refers only to the internalization of the other players’ functional role, and not to what one might consider a ‘good’ interpersonal relationship.

A new profession With this set of concepts and models for the understanding of groups and their operation, Pichon-Rivière developed his personal approach to group coordination. He felt that this could be applied to every kind of group, including therapeutic groups. He also believed that the experience of participating in such groups would turn the members into agents-for-change, who would have a transforming influence on their own social environment. This is why his School of Social Psychology accepted as students people from all the professions, even without any previous formal study, who would study to become ‘social psychologists’. These would be a new kind of problem-solvers, who would help individuals, groups, families and institutions to diagnose their own problems, plan a corrective intervention, train their members to carry out such interventions, effect their plan and evaluate the results of their actions, thus following a spiral process of development. Such interventions would also serve as a combination of research, learning and therapy. Since Pichon-Rivière’s death the school he founded has continued to operate, under the direction of Ana Pampliega de Quiroga, and has fostered the creation of other such schools in several Latin American countries. The particular kind of research propounded by this school is the inquiry into the hidden meanings and sources of everyday life, in order to free the social actors from their ideological subjection. In this, Pichon-Rivière’s project was not only scientific and therapeutic, but also political. From his point of view, the greater development of the individual’s personality is

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rooted in his participation in collective projects, and therefore requires a social change, in addition to the individual and the group change. Other group therapists who adhere to the traditional scheme of training only physicians or psychologists in the practice of analytic group psychotherapy have taken exception to this revolutionary project. The evaluation of its results will certainly take some time. However, we believe that Pichon-Rivière’s concepts and techniques on operative groups deserve attention from all group therapists, even if they do not share his political views and aims.

CHAPTER 3

Fundamental Concepts of Operative Groups: The Authors’ Point of View

On the existence of groups Do groups exist? One of the frequent criticisms of the group approach can be summarized as a denial of the existence of groups. It is not unusual to hear individual therapists saying things like: ‘Why should we do group therapy? After all, it is the individual who seeks help, and we must never forget it!’ or ‘What is the use of seeing a marriage or a family together? If they have problems, let them all go to an individual treatment, and things will be solved.’ Also, there are some teachers who, when facing some difficulty in a class, say: ‘There is nothing wrong with the group; it is the students who are lazy.’ Unfortunately, things do not work out well when we approach them only from the individual point of view. One of the experiences that convinced us of the need for family therapy was the observation of families in which every one of their members was in psychoanalysis, but they could not solve their conflicts and problems. And these could be readily identified and tackled when we decided to see the whole family together. In the case of therapeutic groups, it is a common observation that, when we take to a group a patient whom we know well from years of individual therapy, we are surprised to find a new person, with other capabilities, limitations, and conflicts. The same thing happens when we transfer a patient from group to individual therapy. It seems that the relations and the context define 61

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how an individual will appear in any given situation, and also that individual, group and family therapy act on different areas of the personality. But it was the experience of learning groups that finally convinced us of the urgent need to take a group approach to teaching and learning. A seminar is conceived as a discussion group, whose members should come to the sessions having previously studied the text that has been assigned, in order to profit from their active discussion of it. It is a common occurrence, however, that the group members progressively tend to study less and less, and to listen passively to the teacher’s explanations. The latter feels that something wrong is going on, and he usually tries to compensate for their lack of study by explaining things that the students could easily have acquired at home, in order to get the discussion going. This, of course, stimulates the members’ passivity even more, and the whole sequence goes on. The result is that the group becomes less operative as time passes, and this frequently leads to its dissolution. But the individual members are all adults, intelligent people, with extensive previous study, who are used to discipline and hard work. So something is happening to them, and this must perforce be connected with the group context.

The Freudian point of view Sigmund Freud (1921) approached this problem from the hypothesis that the group situation induces a regressive process in the group members. This accounts for the fact that there is a lowering of intellectual activity in the group. But Freud never actually worked with groups. His point of departure was Le Bon’s book (1895) Psychologie des Foules, which should not be translated as ‘group psychology’, but as ‘mob psychology’, and a group is not 1 necessarily a mob. Freud noticed this, and he solved it by using McDougall’s (1920) concept of an ‘organized group’, which would try to preserve an acceptable level of ego functioning by means of subdivisions, rules and procedures, in spite of the crowd’s natural tendency to primitivism and disorder. It is to be noted, however, that this point of view could be easily reversed, and so Freud (1930) depicted, in Civilization and its Discontents, an image of a clearly primitive and antisocial individual who was barely and superficially civilized by his participation in the group culture. Such polar views suggest that splitting may be a part of our relation with groups. There seems to be 2 something traumatic in belonging to a group, and the most frequent reaction to this threat is to deny that groups exist.

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Bion (1952) clearly framed such denial in the following terms: The belief that a group exists, as distinct from an aggregate of individuals, is an essential part of [the members’] regression, as are also the characteristics with which the supposed group is endowed by the individual. Substance is given to the phantasy that the group exists by the fact that the regression involves the individual in a loss of his ‘individual distinctiveness’ (Freud 1921), indistinguishable from depersonalization, and therefore obscures observation that the aggregation is of individuals. It follows that if the observer judges a group to be in existence, the individuals composing it must have experienced this regression… [The word] ‘group’…[means] an aggregation of individuals all in the same state of regression. (W.R. Bion 1952, p.142, our italics)

All these approaches share a clearly ideological point of view: that all that is developed, complex, or sophisticated in the human being corresponds to the individual, and that groups are necessarily primitive, unrefined, irrational and somewhat pathological. This is akin to the élite’s contempt for the populace. But the fact that these concepts have ideological undertones does not automatically refute them. So, we are in need of further analysis before we either discard or accept them. The first thing to note about these authors is their method. They try to develop a rational analysis of the individual–group relationship by contrasting two polar states of being: a lonely thinker who cogitates in his splendid isolation, like Descartes, and a disorderly horde, crowd, or mob. What is lacking in this analysis is the consideration of the phenomenon of small groups, and this is not merely a question of rational thought but also, and mainly, of direct observation of what happens when a few people meet in order to attain a common goal. This approach had to wait for a new generation of social scientists, such as Bion, Foulkes, Lewin and Pichon-Rivière, who studied small groups from the vantage point of a participant observer. The case of Bion (1961) is worth noting, on account of his contradictions. On the one hand, he reproduced, as we have just seen, Freud’s contentions about the individual and the group. On the other, he set out to see for himself what actually happens in small groups, and to develop his own ideas on the subject. What he found out is that there were two sets of group phenomena, which he conceived as levels or trends in the group’s mental processes. One of them was primitive, irrational, and magic; this he called the basic assumption group. The other was purposive, rational, reality-anchored, and based on

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cooperation; this he named the work group. In his series of articles named Experiences in Groups, published between 1948 and 1951, he stated that: My experience in groups, indeed, indicates that man is hopelessly committed to both states of affairs… In the group the individual becomes aware of capacities that are only potential so long as he is in comparative isolation. The group, therefore, is more than the aggregate of individuals, because an individual in a group is more than an individual in isolation. (W.R. Bion 1948–51, p.90, our italics)

Life in groups, just like every other human situation, offers opportunities for both regression and progression. A panicking crowd is unquestionably a primitive phenomenon, but is difficult to think of a well-oiled soccer machine, like that described by Pichon-Rivière, as ‘an aggregation of individuals all in the same state of regression’. So, whatever happened to Bion? Why did he show such flagrant contradictions, inconsistent with the deep and acute thinker that he was? How are we to understand that in the period between 1948 and 1951 he believed that ‘the group…is more than the aggregate of individuals’, and that in 1952 he wrote that ‘the phantasy that the group exists…obscures observation that the aggregation is of individuals’? We believe that the answer is to be found, precisely, in group phenomena. When he became the main psychiatrist at the Tavistock Clinic in 1947, and began his experiences with groups, Bion was truly a rogue thinker, who followed his own path and insisted in keeping his individuality in every circumstance. He had already started, however, a psychoanalysis with Melanie Klein, and was on his way to become a member of the psychoanalytic community. By 1952, when he wrote ‘A revision of group dynamics’, he was already a member of the psychoanalytic institution, and he also belonged to Klein’s inner circle. It is possible that such affiliations may have induced him to adopt a more orthodox point of view on the subject of groups. In support of this hypothesis there is John Sutherland’s report to Phyllis Grosskurth, when she was researching for her biography of Melanie Klein, that the latter did not approve Bion’s writing of Experiences in Groups and somehow pressurized him to adopt a stricter adherence to psychoanalysis, at a time when he was still her analysand (Grosskurth 1986). If these inferences were true, this would clearly be a case in which ‘an individual in a group is more than [or less than, but certainly different from] an individual in isolation’. Bion’s immersion in the culture of a new group – or two groups, if we consider both the British Psycho-Analytical Society and Klein’s circle – would have made him sway in the

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direction of orthodoxy, at least in this area, and he never again worked with groups.

Two conflicting conceptions of the world Of course, the argument posed in the previous section is only an interpretation, but a plausible one. There are, however, other reasons for such staunch adherence to the belief in the non-existence of groups. These are related to an underlying Weltanschauung. A conception of the world is a set of unexamined assumptions about the existence or non-existence of entities, as well as their relations, value, meaning, and the ways is which all of these may be known (Hernández de Tubert 2000a, 2000b, 2003; Tubert-Oklander 2000b, 3 2001c, 2003). Such assumptions are the basis for the common-sense view of the world, so that they are not usually questioned, but uncritically accepted as ‘the way things are’. One of these assumptions is that only material objects are ‘real’. This was clearly expressed in the Newtonian model of the universe as large empty expanse in which there were only inert objects, called ‘matter’, and dynamic forces that acted on them, called ‘energy’. In such an archetype there is no room for the existence of relations, patterns, or contexts, since such entities cannot be conceived as either matter or energy. And when all reality is mapped according to these assumptions, it becomes obvious that groups cannot exist, since only individuals are ‘real’. But there is another way of approaching the question of the reality of groups, and this is the pragmatic point of view (James 1907). From this perspective, whatever has an effect is real, and this applies to relations, patterns, contexts and beliefs. Thelen (1959) suggested that, if the members of the group share a belief that the group exists, this implies that there is such thing as a ‘group’, since this belief alters their behaviour in the group context. This argument, however, implies only that subjective beliefs have an effect on the behaviour of individuals, and that when several individuals share a common belief, this is bound to induce some uniformity in them. The contention that groups are real goes much further than that. It rests on the axiom of Gestalt theory that ‘the whole is more than the sum of its parts’ (Katz 1943; Koffka 1935; Merleau-Ponty 1942). But wholes are not only more, they are different from and previous to the parts that can be distinguished when they are dismantled, decomposed or atomized. In the case of groups, this implies that a given group may evolve, develop and continue to exist, even if the individual members were to be replaced over time. This can

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be readily seen in the case of a football team, a theatre company, an army unit or a school. All of them develop a group culture that determines a particular way of acting, a distinctive style that can be unequivocally recognized by an observer, and this is transmitted to and rapidly acquired by the new members of the group. This is perhaps the strongest argument for the existence of groups: group phenomena can be perceived and identified by independent observers. Of course, this sometimes implies that they should be trained observers, but this is a common requirement for scientific research: no one can adequately perceive, describe or interpret a microscopic preparation, a radiograph, a heart murmur or an animal behaviour, without a proper training. This is crucial: relations and patterns are primary observational data, just like objects, movements and transformations, and this opens the way for the study of group phenomena.

The individual and the group Two ways of conceiving the relationship Once we accept the contention that groups really exist, we face the need to clarify the relationship between the individual and the group. Freud suggested in Group Psychology and the Analysis of the Ego, that there is no real opposition between ‘individual psychology’ and ‘group psychology’, since in the individual’s mental life someone else is invariably involved, as a model, as an object, as a helper, as an opponent; and so from the very first individual psychology, in this extended but entirely justifiable sense of the words, is at the same time social psychology as well. (Freud 1921, p.69)

However, such a statement only amounts to recognizing that, although mental life may be instinct-ridden, it is always object-anchored (Khan and Sutherland 1968), and does not fully acknowledge the impact of the group, the institutions, society and culture on the individual’s inner organization, behaviour and experience. Moreover, it says nothing about the existence of group processes that act beyond, over, in spite of, and through individuals. Freud’s stance on this issue is to behold group and social life through the eyes of the individual. This is akin to the plight of Plato’s cavemen, who were doomed to see only the shadows projected on the wall, but would never stroll the wide world that lies beyond their prison (Plato 1956). But was Plato right in his description of the human condition? Is it true that we have no direct

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knowledge of the world around us? This should at least be considered a matter for discussion. It seems obvious that there are some ideological assumptions that underlie this issue. Such assumptions are part the various authors’ conceptions of the world (Hernández de Tubert 2000a, 2000b, 2003; Tubert-Oklander 1999a, 1999b, 2000b, 2001c, 2003). Those writers who approach this problem from the perspective of linear causality must necessarily fall into one of two extreme positions: either they hold that only the individual is ‘real’, and that group and social phenomena are nothing but a consequence of the behaviour of single agents, or they claim that the individual’s actions and subjective experiences are only an expression of society’s values, culture, norms and institutions. Other thinkers frame their observations and reflections in terms of interactions, circular causality, and complexity (G. Bateson 1972, 1979; Morin 1990). Such point of view demands a multilevel analysis of human phenomena, as we can clearly see in the following quotation from Hopper (1985): Clearly, I am making a plea for the development of a more sociologically informed theory of object relations, one which requires an inter-personal model of the mind and a recognition of social facts. Organisms, persons and groups are not the same order of phenomena. Statements about one do not necessarily apply to the others, although they must be consistent. Psychic facts presuppose the prior and simultaneous existence of social facts as well as of organic facts. In other words, organisms, persons and groups must be viewed as open systems… It would be impossible to derive this perspective from the Platonist epistemology which Bion acquired on his journey into the Cave, where many of his disciples remain, and thereby risk the entombment of group psychotherapy – not to mention psychoanalysis itself. (Hopper 1985, p.345)

In Freud, ‘the other’ appears as an object of love, hate, fear, or desire; as a witness, a mirror that reflects our own demeanour, or as a point of reference that helps the subject to define himself, by opposition – i.e. ‘someone else’. But there is another way of conceiving this relation, as we can readily see in one of the most famous quotations in the English language, taken from John Donne’s well known meditation, written in 1624:

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No man is an island, Entire of itself. Each is a piece of the continent, A part of the main. If a clod be washed away by the sea, Europe is the less. As well as if a promontory were. As well as if a manor of thine own Or of thine friend’s were. Each man’s death diminishes me, For I am involved in mankind. Therefore, send not to know For whom the bell tolls, It tolls for thee. This quotation refers to a deeper relation. It is not now the case of the others acting as an opposite to my self, which is thus defined by contrast or similitude, but that we are not really separated. Just as an island is only apparently an isolated entity, since it is, under the water, connected and continuous with all other fragments of dry land, the ‘individual’ human being is continuous, at a deep level, with all others, thus becoming a member of society and humankind. In this, Donne’s idea is quite clear: the individual is an illusion, since he is really an integral part of the community, just as every island is truly connected to the mainland by the bottom of the sea, which is only hidden by the deep waters. We, as psychoanalysts, should well know it, since this concept is part and parcel of our theory of the unconscious. All of our hard earned individuation, just like every other differentiation, is only true for a very superficial stratum of the mind, ruled by what Freud (1900) called the ‘secondary process’. In the deepest layers of the unconscious, ruled by the ‘primary process’, there is a symmetrical identification of a class and any of its members (Matte-Blanco 1988), which justifies the view than any human being stands for the whole of humankind (Hernández de Tubert 1999b). Strangely enough, the standard view of psychoanalytical theory, technique and practice has been based on an uncritical acceptance of the asymmetrical, differentiated account of human experience by the secondary process. We have emphasized that true psychoanalysis deals exclusively with

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the investigation and interpretation of the individual unconscious, and have excluded the study of all interpersonal, group and social phenomena as being ‘merely conscious’, ‘non-analytical’, or even ‘anti-analytical’. In group analysis and operative groups, on the other hand, the imaginary ‘others’ become real others – without quotation marks. Not only they are facing me, as my counterpart, but they are also actively calling me, by tolling the bells, urging me to join the community in someone else’s burial. In such a view, ‘object relations’ become interpersonal and transpersonal relations. Therefore, we are faced with a set of multilevel phenomena, with a hyper-complex, four-dimensional network of circular interactions. In such a network, it not possible to define any part of it as a ‘cause’ of all the rest that happens, since any one phenomenon can be seen as either a ‘cause’ or an ‘effect’ according to the way one decides to ‘punctuate’ a sequence of events (Bateson G. 1972; Watzlawick, Jackson and Beavin 1967).

The network and the matrix The metaphor of the ‘network’ is especially suitable for referring to such complex phenomena. The neurologist Kurt Goldstein (1939, 1940, 1948) used it to refer to the fact that the nervous system is better understood as a complex entity that reacts as a whole, and not as a complicated sum of individual neurones. From his point of view, the network of manifold connections was the nervous system, and the individual neurones were the nodal points of such network – i.e. the loci where several pathways intercross. He also believed that illness should not be thought of simply as a localized disorder of the functions of some circumscribed parts of the organism. Not only was the organism to be considered as a whole – and that meant taking into account the personality of the patient – but also its environment, both physical and human – i.e. social – was to be included in the diagnosis and treatment of any disease. S.H. Foulkes, who studied with Goldstein in Frankfurt in the mid-1920s, took his teacher’s concept of the network and applied it to his own understanding of groups. To him, a group – and this term included small, median, and large meetings, families, institutions, and society as a whole – should be conceived as a network of multifarious relations, and the individuals were to be the nodal points of such network (S.H. Foulkes 1975a, 1975b). This gossamer tissue of communications, in which individual human beings are embedded is what Foulkes called the matrix. Of course, we can either focus our attention on the individuals, or on the group-as-a-whole. In the first case, the individual is the figure that stands

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against the ground provided by the group. In the second instance, the group becomes the figure, and the individuals, the ground. These are two widely different ways of constructing our experience of human interaction, and of course they bring about diverging results. Such subtle shifts in emphasis radically transform the overall picture, and give a different meaning to its elements. When we focus our attention on the individual, he or she seems to be an independent variable and the group processes appear as a dependent variable. This creates the illusion of a linear, causal relation. On the other hand, when we focus on the group configuration and processes, these take the place of the independent variable and the individuals that of the dependent one. In the first case, it seems as if the individuals determine the group, and in the second one, the individuals appear as determined by the group. A fuller understanding of what is happening in the group field requires that the observer oscillate between both points of view. Of course, this is not just a question of ‘a way of looking at things’, but a serious attempt to describe things that we believe are actually happening in the group. Any description is, of course, partial and it clips off a section of a complex, circular, multilevel interaction. Thus we construct the concept of the ‘individual’ by actively disregarding the group context in which he is embedded. Once we have created this artificial entity, a series of deceptively simple ‘causal’ relations soon become apparent, but these can only be adequately evaluated when they are reinstated to their original group and social context (Hopper 1982, 1985, 2002). This phenomenon is similar to the results, described by Goldstein (1940), of artificially isolating some part or organ of the body in order to study its properties, which is regularly done in physiological experimentation. Such parts are studied in an abnormal situation that resembles pathology, and the results can only be used for the understanding of the activity of the normal organism if we identify the ways in which this isolation modifies normal function, and take the necessary measures to compensate for such distortion. The same is true in the case of human life, since the individual in isolation is an abnormal occurrence. Both normal and pathological functioning always occur in a relational context, and they can only be fully understood within such context. Even Robinson Crusoe (Defoe, 1719), who had been severed by accident from his whole social environment, tried to go on behaving as a British citizen: he kept a calendar – even though he suspected that he had lost a day or two – and celebrated Christmas and the King’s birthday. And, as soon as he found himself a native, he readily turned him into his servant! It seems

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that the participation in a social network is essential for maintaining sanity, even in isolation. This Gestalt point of view integrates the organic, psychological and social aspects of human existence. This was the way Goldstein and Foulkes understood the human being, but it was also Pichon-Rivière’s. The latter never quotes Goldstein, but it is quite clear that he had incorporated this perspective from the study of Paul Schilder’s (1935) The Image and Appearance of the Human Body, in which the author analyzed – in terms of ‘a psychology that necessarily puts the stress on action’ – the physiological basis, the libidinal structure and the sociology of the body image. Pichon-Rivière turned this into his conception of the ‘tree areas of behaviour’: the mind, the body and the external world (Pichon-Rivière 1959; Bleger 1963–69). Foulkes coined the metaphor of the matrix, in order to describe the relation between individuals and the network of communications of which they are a part. He formulated the following brief definition of this concept: The Matrix is the hypothetical web of communication and relationship in a given group. It is the common shared ground which ultimately determines the meaning and significance of all events and upon which all communications and interpretations, verbal and nonverbal, rest. (S.H. Foulkes 1964c, p.292)

Metaphors are useful to convey hyper-complex meanings, as a result of what Bion (1964) called their ‘penumbra of associations’. We should therefore examine the multiple connotations of the word ‘matrix’, in order to attain a better understanding of the concept. This word is derived from the Latin ‘mater’, which means ‘mother’. Apparently, Foulkes had this meaning in mind when he chose the term to refer to ‘the common pool of meaning, the network of communication, the matrix of the group’, the ‘central core of a basic universal language’ that gives a meaning to all communications that take place in the group (S.H. Foulkes 1975a, pp.121–122). This word, however, has a few other connotations, which are worth considering: 1. In English and French it is an archaic name for the womb. In other languages, such as Italian and Spanish, the word is still used for the uterus. 2. It also has the connotations of ‘origin’ and ‘container’, clearly derived from the previous meaning. In Webster’s Dictionary, its first meaning is ‘that which gives origin or form to a thing, or which serves to enclose it’. This can either be a concrete material source or enclosure, or more

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abstract root, as in the phrase ‘Rome was the matrix of Western civilization’. In biology, the term refers to a formative tissue or to the intercellular substance that envelops the cells. In geology, it is the fine-grained portion of a rock, in which coarser crystals or rock fragments are embedded. It is also a mould used to cast or form a solid object, both in printing and in engineering. 3. In mathematics, it is the rectangular arrangement, in rows and columns, of the symbolic elements of a set, or a set of sets. The order of the elements is subject to fixed rules, so that, if any element were missing, its nature could be inferred from the general structure of the matrix. This property of matrices has been used in psychology for designing intelligence tests, such as Raven’s or ‘the Dominoes’, in which the subject has to deduce which are the missing parts of a series of matrices of increasing complexity. In Foulkes’ work, it is the metaphor of nurture and growth that prevails (Powell 1994). This is clearly related to the biological connotations of the term. The matrix is the fons et origo of everything that happens in the group. Nevertheless, the metaphors of the container and the shaper are also implicit. The individual is thus both contained and shaped by the group matrix. The metaphor of the symbolic matrix in mathematics has not, to our knowledge, received much attention, but we believe it can be very useful for understanding the properties of the group matrix. The mathematical matrix shows striking similarities with Foulkes’ description of the matrix of a web of multiple relations of meaning that intercross and determine each other. Such relations – which are both symbolic and emotional at the same time – go through the individuals, thus determining their inner structure and the ways in which they interact: the interacting psychological processes are seen as taking place in the group matrix while at the same time involving the various individuals in different specific ways and constellations. Just as the individual mind is a complex of interacting processes (personal matrix), mental processes interact in the concert of the group (group matrix). These processes relate to each other in manifold ways and in a variety of levels. (S.H. Foulkes 1975a, p.130)

The group matrix develops from the encounter of several individuals’ personal matrices within a given context. This interaction is possible because it is rooted on a common ground for all the members of the group. This Foulkes called the foundation matrix, a common endowment of means of expression

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and understanding that is derived both from the biological properties of the species and from culturally firmly embedded values and reactions (S.H. Foulkes 1975a, 1975b). This led the author to select the members of his groups from similar social groups, in terms of language, class, and education, in order to facilitate communication among them. This kind of selection focuses the group discussion on the members’ personal experiences, conflicts and problems, but impedes the analysis of ideological and political factors, which are obscured by the very fact of being common to the group members (Hernández Hernández 1994a; Hernández de Tubert 1995). This will be further discussed in Chapter 6, on ‘The Approach to Institutions and Society’. Foulkes’ description of how the dynamic matrix evolves from the interaction of the members’ personal matrices, on the basis provided by the foundation matrix, can be fruitfully compared to Pichon-Rivière’s account of the process of integrating the group members’ individual CROS into a group CROS. Such process amounts to a partial and temporary loss of the members’ individuality, in order to turn the group into a highly effective team in the tackling of the group task. But such loss cannot but imply an experience of mourning, as we shall see in Chapter 4.

Roles and functions in the group The term ‘role’ in social psychology is a metaphor, derived from the theatre. Just as an actor plays a part or character in a play, an individual has a part to play in the group, the family and society. These roles depend on various factors, such as age, origins, profession, social class, status, among others. Shakespeare was fond of the metaphor of ‘life as a stage’, as shown in the following famous quotation: Duke:

Thou seest we are not all alone unhappy; This wide and universal theatre Presents more woeful pageants than the scene Wherein we play in.

Jaques:

All the world’s a stage And all the men and women are merely players; They have their exits and their entrances; And one man in his time plays many parts, His acts being seven ages. Shakespeare, As You Like It Act II, Scene VII

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But the parts to be played may be described in diverse ways. An actor playing Macbeth is the protagonist of the play, but he may also be called the ‘traitor’, the ‘usurper’, the ‘King of Scotland’, the ‘cruel tyrant’, and so on. Macduff, on the other hand, is the antagonist, but he may also be named the ‘avenger’, the ‘bereaved husband and father’, or the ‘man who was not of woman born’. In other words, a role may describe either a function or a character. The same is true in the case of social psychology. The literature on roles usually focuses either on the function that an individual plays in the social structure, or on certain prescribed characters that are to be played by individuals in ‘this wide and universal theatre’ (Banton 1965). When observing and describing individual behaviour in small groups, we may say, for example, that a group member is the ‘pro-task leader’, the ‘chronic monopolizer’, or the ‘scapegoat’, thus emphasizing his or her function for the group structure and dynamics. But we may also say that a woman member is the group’s ‘orphan’, or its ‘Cinderella’, or that a man is its ‘godfather’, either in its classic religious sense, or in its present-day Mafia associations. These two ways of using a same term correspond to two professional traditions. Sociologists and anthropologists tend to stick to the functional implications of roles, while social psychologists and group analysts are more keen on their dramatic connotations. The truth is that, from a psychodynamic point of view, an individual learns to fulfil a social function by identifying with a certain character in his immediate social environment – e.g. a child may learn leadership or authority by identifying with a strong and decisive parent, relative or teacher. The group-analytic inquiry is able to dissect the constitution and functioning of an individual’s roles, by understanding both their origin in early identifications and their function in his original family’s structure, as well as their social meaning in the context of the present group, institutions and society-at-large.

A revision of the concept of CROS The importance of schemas We have already pointed out, in Chapter 2, the relation between the Conceptual, Referential Operative Schema and the ‘body schema’. This latter concept was introduced by the neurologist Sir Henry Head in order to better understand and explain the way in which the cortex interprets, relates and integrates the sensations that come from the lower levels of the nervous system by way of the afferent nerves. He rejected the idea that these sensations

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were compared with pre-formed images of the body in order to turn them into definite perceptions, and suggested that the whole of our experience of ourselves was synthesized into an unconscious, abstract description of our body, which he called a ‘schema’. Such body schema was in a state of constant dynamic interchange with new experiences, thus being recreated with every new sensation. He explained this concept in the following words: Every recognizable (postural) change enters into consciousness already charged with its relation to something that has gone before, just as on a taximeter the distance is presented to us already transformed into shillings and pence. So the final product of the test for the appreciation of posture, or of passive movements, rises into consciousness as a measured postural change. For this combined standard, against which all subsequent changes of posture are measured before they enter consciousness, we propose the word ‘schema’. By means of perpetual alterations in position we are always building up a postural model of ourselves which constantly changes. Every new posture of movement is recorded on this plastic schema, and the activity of the cortex brings every fresh group of sensations evoked by altered posture into relation with it. Immediate postural recognition follows as soon as the relation is complete. (Head 1920, pp.605–606, quoted in Bartlett 1932, pp.199–200) The sensory cortex is the storehouse of past impressions. They may rise into consciousness as images, but more often, as in the case of spatial impressions, remain outside central consciousness. Here they form organized models of ourselves which may be called schemata. Such schemata modify the impressions produced by incoming sensory impulses in such a way that the final sensations of position or of locality rise into consciousness charged with a relation to something that has gone before. (Head 1920, p.607, quoted in Bartlett 1932, p.200)

The research psychologist Sir Frederic C. Bartlett (1932), who had extensively discussed these ideas with Head during World War I, applied them to the study of memory. He ‘strongly disliked’ the word ‘schema’, since he found it ‘at once too definite and too sketchy’. This he argued as follows: The term ‘schema’…suggests some persistent but fragmentary ‘form of arrangement’, and it does not indicate what is very essential to the whole notion, that the organized mass results of past changes of position and posture are actively doing something all the time; are, so to speak, carried along with us, complete, though developing, from moment to moment…

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‘Schema’ refers to an active organization of past reactions, or of past experiences, which must always be supposed to be operating in any well-adapted organic response. That is, whenever there is any order or regularity of behaviour, a particular response is possible only because it is related to other similar responses which have been serially organized, yet which operate, not simply as individual members coming one after another, but as a unitary mass. (Bartlett 1932, p.201)

The Swiss biologist-turned-psychologist and epistemologist, Jean Piaget, used this hypothesis as the basis of his theory of cognitive processes. From his point of view, no piece of knowledge, not even perception, is a simple copy of reality, since it always includes a process of assimilation to previous structures. This is what confers meaning on anything that is perceived or conceived. Such previous structures are what he calls ‘action schemes’, since for him ‘knowing is not…copying the real, but acting on it and transforming it (either in appearance or in reality), in order to understand it as a function of those transformational systems to which such actions are related’ (Piaget 1967, p.7, our translation). In other words, all cognitive processes imply a construction, based on previous experience (Maturana y Varela 1984; Varela 1988; Watzlawick 1981). The action scheme is therefore always interposed between the stimulus and the response, as a representative of the organism’s previous experience. There is, however, a learning bonus to be gained from every new experience, since, after assimilating the new stimulus to a set of old knowledge, the action schemes have to incorporate what is truly new in this occurrence. This modification of the pre-existent scheme is called ‘accommodation’. The action scheme accommodates to the new circumstances, and this is the basis of all learning from experience. When such ideas are applied to psychoanalytic theory, we obtain a very different view of psychic structure and functioning. García Badaracco (1968) used the concept of the schema, quoting both Head and Piaget, in order to gain a clearer comprehension of the elusive concept of the ‘internal objects’. These he understood, in terms akin to Fairbairn’s (1952) point of view, as a living structure created from the internalization of a bad relation with an unresponding or hostile external object. Years later (García Badaracco 1986), he described what he called the ‘maddening internal objects’ in psychoses and other severe personality disorders, formed as a result of the introjection of invasive or intrusive external objects.

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Fairbairn’s (1946) contention that the personality is made of inherently dynamic structures, instead of inert structures which have to be activated by ‘psychic energies’, seems to be related to Piaget’s emphasis on action. Of course, any psychoanalytic theory of unconscious schemata must needs include the cardinal function of affects, as well as action and cognition. This is clearly related to Pichon-Rivière’s definition of the CROS as the ‘collection of experiences, knowledge, and affects that the individual uses in order to think and act’ (Pichon-Rivière et al. 1960, p.110).

The CROS and the Weltanschauung We have already noted, in Chapter 2, that the term ‘CROS’ is used to refer either to ‘the set of our assumptions in dealing with reality–prejudices, we might say, inasmuch they are judgements made before the fact, preconceptions that are usually unexamined by the subject’, or to its explicit conceptual reconstruction. The first usage clearly implies an actual psychological structure, while the second alludes to a formal system of conventional symbols, which may exist independently from any given individual thinker – i.e. in culture, tradition, written language or any other form of information recording. This is what Sir Karl Popper (1979) named an ‘epistemology without a knowing subject’, describing it as belonging to the ‘Third World’ of language, culture, science, philosophy, and art. (The First World is that of objective facts, studied by the natural sciences, while the Second World corresponds to thoughts, feelings, perceptions, emotions, and other subjective states, processes, or experiences, which are studied by psychology.) One of us (RHT) has been developing, during the past few years, an ongoing research about ‘psychoanalysis and the Weltanschauung’. In this she attempts to link our psychoanalytical understanding of such set of assumptions with Dilthey’s (1911) theory of the conceptions of the world (Weltanschauungen). The German term ‘Weltanschauung’, which can be translated as ‘conception of the world’, usually has two possible meanings. The first one corresponds to ‘a view of the world, according to some basic idea or leading intuition’ (Ferrater Mora 1994, p.2481, our translation). Such a definition emphasizes the systematic and unitary nature of the Weltanschauung. Besides, when such a view is phrased in terms of a rational discourse, such a system becomes mainly conscious and is articulated according to the laws of logic. An example of this is the Christian conception of the world, which is then systematically formulated in Christian theology. This is the sense in which Freud (1933) used

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this concept, and from this he derived his opinion that psychoanalysis cannot, and should not, become or originate a Weltanschauung. The other possible meaning refers to a rather indefinite and loose view of the world that may include diverse elements, such as scientific results, religious beliefs, poetic intuitions, rationalizations of social habits, ideals, aspirations, etc. Such a complex set of ideas includes not only descriptions, concepts and explanations, but also values, ideals and aspirations, which become a guide for action in life. These two definitions of the Weltanschauung appear to be quite distinct, but this is not really so. The unitary and systematic view of the world is in fact a conscious, symbolic product, which is usually referred to as ‘ideology’. But conscious ideology is rooted in a much wider and diffuse mental structure, which is mainly unconscious and non-systematic. The fact that the mayor part of the Weltanschauung is unconscious makes it a suitable subject for psychoanalytic – or group-analytic – research. Unlike its formal reconstruction, such a vision of the world is a psychological structure, not a logical one. We all have a conception of the world, even if we do not know it, and are not necessarily capable of expressing it in words. Some of us take the trouble of reconstructing, in logical terms, a part of our Weltanschauung, in order to share it and discuss it with other people, but it is still essential that we differentiate between the actual conception of the world and its logical reconstruction (Kaplan 1964). As Alfred Korzybski (1941) used to say, ‘the Map is not the Territory’ – i.e. the symbol is not what it symbolizes, the representation is not the thing that it represents, the portrait is not the person it depicts. Therefore, the reconstructed Weltanschauungen enounced by philosophers, theologians, and (sometimes) scientists, are only attempts to develop theoretical, schematic re-constructions of a much more complex, real and concrete conception of the world, which organizes the whole of our experience and understanding of reality. The Weltanschauung is therefore a real mental structure, which is originally and mainly unconscious, and includes a whole set of assumptions, values, beliefs and representational and procedural codes, which take part in the construction of our experiential ‘reality’. So, it not only determines how we are going to interpret our perceptions and experiences, but also participates in their very genesis. The Weltanschauung is a structure which is both collective and personal. Even though it is true that every human being has his or her own conception of the world, this personal Weltanschauung is always inserted in the context of a

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collective Weltanschauung, which belongs to the society, the culture and the time in which the individual has been born and raised. The individual aspects of a person’s Weltanschauung are therefore only a relatively small part of it, and are always subordinate to its collective aspects, which include: a) the view of the world held by his culture, b) that of his social class, c) that of the institutions in which he takes part, and d) that of the family in which he was raised. The personal conception of the world is derived from early emotional experiences, and is shaped according to all the above-mentioned influences. Psychoanalysis, as it is usually practised, reveals only those layers of the Weltanschauung that correspond to the individual’s personal conception of the world and to that of his family. Those psychoanalysts that take into account cultural and social factors tend to identify the levels of social class and institutions, but they usually do it as an application of their previous knowledge of sociology and anthropology, rather than as an actual inquiry by means of the psychoanalytic method. The level of culture regularly remains invisible in most psychoanalytic treatments, since it is shared by the analyst and the analysand. It does, however, become visible when a psychoanalyst undertakes the treatment of a patient who comes from another culture, or when the analyst has been trained in anthropology and has had the experience of living in diverse cultural contexts (see, for example, Devereaux 1967). Group analysis and operative groups, on the other hand, push social and cultural factors to the fore, clearly revealing their existence and significance, and opening the way for a deep inquiry into their dynamics. But, since perception is always based on comparison, this requires that the group be heterogeneous; hence Pichon-Rivière’s aphorism that ‘the greater heterogeneity in the members and the greater homogeneity in the task bring about a greater productivity’ (Pichon-Rivière 1969, p.151). It is, then, surprising to find that Foulkes’ criteria on the selection of the group members required a homogeneity of their social backgrounds. This was in sharp contrast with his insistence on attaining ‘a “mixed bag” of diagnoses and disturbances which are blended together to make a well balanced and therapeutically effective mixture’ (Foulkes and Anthony 1957–65, p.66). In this he goes so far as to affirm, very much in agreement with Pichon-Rivière, that ‘the greater the “span” between the “polar” types, the higher the therapeutic potential, if the group can stand it’ (ibid., our italics). But, when dealing with the social and ideological composition of the group, he advocates a truly homogeneous group, in the following terms:

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One of the most important points to take into account is that their general background is compatible, that they are within a certain range of education, of social background, of intelligence, of age. This is far more important than their formal diagnoses which we prefer indeed to be heterogeneous. (S.H. Foulkes 1975a, p.70)

This set-up seems to have been planned in order to push the members’ character traits and personal conflicts to the fore, while leaving in the background their social, political and ideological characteristics, in accordance with the therapeutic aim of the group. This was explicitly stated by Foulkes in the following terms: ‘In the group-analytic situation the personal problem is in the foreground, the institutional aspect in the background, discussion is free-floating’ (S.H. Foulkes 1964b, p.270). We believe, however, that a deep and thorough inquiry into the social and institutional contexts of the group and its members is essential for group-analysis, even in therapeutic groups. We therefore try to combine in our groups people who differ in their education, social background, marriage status, religion, political orientation and age. This pushes their differences into the foreground and gives the opportunity for an on-going analysis of their – and the analyst’s – conceptions of the world. For example, Foulkes and Anthony (1957–65) suggest that one of the preconditions for composing a viable group is ‘that the cultural background is similar, which means among other things that there is agreement as to what is desirable normal behaviour: what is sick, good, bad, and so forth’ (p.24). In our groups, on the other hand, the issue of values becomes in itself a subject for scrutiny, in order to uncover the often unconscious assumptions that underlie our agreements – or disagreements – about what is ‘desirable normal behaviour’ and other value judgements. This implies a thorough analysis of the way in which the group members’ beliefs and values – including the conductor’s – are being influenced, not only by their own personal upbringing, conflicts and experiences, but also by their insertion in the social, institutional, political and ideological context. We therefore try to compose a group which is as heterogeneous as possible, not only in the members’ clinical diagnosis and personality type, but also in their social environment, upbringing, profession, religion, marriage status or sexual preference, ideology and political affiliations or sympathies. The only limitation is derived form Foulkes and Anthony’s admonition: such heterogeneity increases the therapeutic potential only if the group can stand it. In this the group conductor’s experience and clinical wisdom are essential,

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in order to evaluate whether the group members, as individuals, and the group-as-a-whole are ready for the challenges that stem from facing differences. Heterogeneity not only helps to widen the group’s resources for facing, containing and understanding the members’ conflicts and problems, but it also opens the way for a relentless analysis of their underlying conceptions of the world. As perception is always based on contrast, such unconscious assumptions and beliefs can only be discerned when they meet their contraries, provided that there is also a shared reflection on such differences and their consequences. This is valid both for therapeutic groups and for learning groups, when the latter can be put together by the conductor. As William Blake once put it: ‘Without Contraries there is no Progression. Attraction and Repulsion, Reason and Energy, Love and Hate, are necessary to Human existence’ (Blake 1972, p.149). These considerations are, of course, only valid when dealing with ‘artificial’ groups – i.e. groups whose members are selected and joined by the conductor or the conducting team, and who have not had a previous relationship (the so-called ‘stranger groups’). When a conductor has to work with a ‘natural’ group – i.e. a pre-formed group such as a family, a society, a staff group, a football team or a community – such group is liable to be quite homogeneous inasmuch as the members are all included in the same ‘group culture’. These groups are usually resistant to any attempt to analyze their underlying assumptions, since all their interaction tends to reinforce their belief that these are not assumptions at all, but only ‘the way things are’. Here the contrast is created by the very presence of the conductor, who is naturally foreign to their culture, and this mobilizes opposition and feelings of hatred, which have to be dealt with by the coordinator, as we shall see in Chapter 6, which discusses various types of natural groups. However, when the attempt to analyze the group’s and the members’ Weltanschauungen is successful, the result is a much greater understanding of the ideas, precepts and habits of thought that rule their feelings, perceptions and actions within the group context. Such enhancement of differences can only become truly operative when it is contained by a newly formed set of agreements about existence, knowledge, and life in groups. This implies the acquisition of a new Weltanschauung which sustains the existence of differences in thinking, beliefs and ways of life. This is equivalent to Pichon-Rivière’s assertion that a group must develop, in order to be able to operate successfully, a common CROS, which provides the basis for the members’ cooperation and mutual understanding. In

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other words, the group members and the conductor have come from diverse contexts, and they therefore have to develop a common group context in order to be able to work together. And this brings us to the problem of context, which is discussed in the following section.

The problem of context The concept of ‘context’ has always been a part of the group-analytic lore, but not much has been written about it. One notable exception has been the writings of Earl Hopper (1982, 1985, 2002). In this section we shall expound our own understanding and use of this concept, which is quite compatible with Hopper’s ideas on the subject. A ‘context’ is a set of subsidiary information concerning a text, which permits the reader to determine the meaning or meanings that may be implied in the text. For example, those passages that precede and/or follow a certain section of a larger text may help the reader to find out what the author intended. The same is true in the case of peripheral information regarding the circumstances in which that text was written – e.g. biographical information about the author, his historical, geographical, or political environment, or the audience to which that particular communication was aimed. But the enlightening effect of context goes much further than establishing the author’s conscious intentions. It may also shed light on meanings that had never been conscious for him, but which may be convincingly inferred from the juxtaposition of the text and its context. Sometimes, the interpretation of an old text in the light of present circumstances may even drive to conclusions that would have been unthinkable at the time of its writing. This is the case when dealing with mystical texts which allegedly possess an enduring value, such as the Talmud or the I Ching. This is hermeneutics, the art of interpretation, but interpretation, unlike cryptography, is never restricted to the discovery of a pre-existent meaning. Quite on the contrary, it is a creative exercise that stems from the encounter of a text with its context, and of an interpreter with his own context. Together, these constitute the context of the interpretative act. This is why any valid interpretation must perforce include information about the interpreter, his context, assumptions, beliefs and interests, for a fuller understanding of his interpretative activity. All of this has been the subject of an on-going debate about meaning and interpretation, in which author-oriented thinkers stress the importance of the author’s original intention, while those who are reader-oriented emphasize

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the creative activity of the interpreter (Eco 1992). But, of course, not all interpretations of a text are equally viable: some of them are better than others, and there are quite a few which are completely inadequate. Umberto Eco has tried to solve this dilemma by suggesting that it is not just a question of choosing between the author’s intention and the reader’s intention; there is a third element in the semiotic act, and this is the text’s intention. And in this he purposely blurs ‘the distinction between literary texts and common texts, as well as the difference between texts as images of the world and the natural world as (according to a venerable tradition) a Large Text to be deciphered’ (Eco 1992, p.36, our translation). Therefore, meaning evolves from the confluence – and the conflict – of these three intentions. After all, the word ‘text’ originally meant not only ‘the style of a literary work’, but also ‘tissue’ (as in ‘texture’). And, just as the effect of a thread in a fabric must needs depend on its location within a larger whole, the effect of interwoven words always depends on the complex interrelation within the whole word-tissue in which they are embedded. But the effect of context goes even further: a piece of tapestry can only be appreciated in its relation with the wall on which it hangs, the room and the house where it is, and the culture and sensitivity of those who behold it, and a book also derives an additional meaning from the circumstances in which it is being read. A conversation is a tissue made of words, phrases, intentions, emotions and relationships, but it does not have a real boundary, since its edges are woven into a wider context, set up by language, culture, other groups, institutions, history, and society-at-large. Interpretation thus acquires a kaleidoscopic dimension, which never finds an end. There are, however, numerous concrete instances in everyday life in which it is essential to identify the context of a communication, in order to understand its meaning. Context helps us to recognize the code that must be used in order to avoid misunderstanding. Nonverbal communication also acts as a context that indicates what kind of communication a verbal expression really is (Ruesch and Bateson 1951; G. Bateson 1972). For example, in a very old Western movie one of the characters reacted to a rather offensive comment by another one by saying: ‘You better smile when you say that!’ What did he mean? It was as if he said: ‘You should smile when you say such a thing. Then I will know that you are saying it as a joke, and I shall accept it as such, because, if you were serious about it, it would be an offence and I would have to kill you for it.’

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What one deems to be an adequate behaviour depends on the context. A certain conduct that would be perfectly acceptable at a wedding would not be so at a wake or burial, and the expectations in both cases vary from one culture to another. During a psychoanalytic session, both parties are allowed – and even required – to say things that would be frankly shocking in an ordinary social environment. Clearly, psychoanalysis creates its own particular context, which starts to operate when the door of the analyst’s office closes, leaving two people alone in a room, engaged in the business of ‘analyzing’. Sometimes, the differences in the nonverbal expressions of people of different ethnic or national origins generate misunderstandings, even if they are speaking the same language. As an example, we recall a recent documentary we saw on television. It was about the Argentine actress Norma Aleandro. One of the people interviewed was the Italian actress Isabella Rosellini, who worked with her in the English language film Cousins. Rosellini remembered that they found that they were kindred spirits and became friends. On one occasion, while they were happily chatting, one of their fellow actors, Ted Danson, watched them with a worried expression. As soon as he managed to get Isabella alone, he asked: ‘What happened with Norma? Why were you arguing?’ She was surprised and answered: ‘We were not arguing, we were chatting.’ ‘But you were waving your hands!’ replied Danson, unbelievingly. This is, of course, another instance of overlapping of contexts: to a member of an English culture, waving your hands when you are speaking could only mean conflict; to a Latin, it could also mean enthusiasm. If two or more people are to understand each other adequately, they have to create a common context for their communication. This was clearly expressed by Gregory Bateson, a master in using anecdotes to clarify very abstract and complex matters, when he was interviewed by Daniel Goleman for Psychology Today (G. Bateson and Goleman 1978), in the following terms: Goleman:

What you say suggests that the behavioural sciences ought to be sciences of the context of behaviour.

Bateson:

That’s right. For example, nearly 30 years ago, I gave a lecture about context to the psychology graduate students at Berkeley. There was one young man who was getting quite impatient. When I concluded, he asked a few hostile questions, something like ‘How do you weigh a context?’ Afterward, half a dozen people gathered around me asking questions. I’m talking to someone and out of the corner of my eye I see this guy come

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up, and he obviously wants to do battle. I had stepped on what he thought was psychology. So, as I’m talking, I put my hand in my pocket, dig out a nickel, and as he comes up, I reach out and give it to him. He automatically takes it. He then gets very angry: ‘Why did you give me a nickel?’ My message has no context. Finally, after he controls himself, he reaches in his pocket and gives me a dime. By which, you see, he creates a context for both of us. (G. Bateson and Goleman 1978, p.51) A series of people turn into a group as soon as they start to develop a common context. This is what Pichon-Rivière called the building of a common CROS and what we have defined as the construction a new group Weltanschauung. But the group is always included in several wider contexts that contain and shape both the individual members and their interaction, and this brings us to new dimension: that of society and its institutions.

The social and institutional dimension It must be obvious, from all the previous discussion, that we strongly believe that the social and institutional context should be taken into account whenever we try to understand individual, interpersonal and group phenomena. Our position on this can be summarized by saying that every human event has an intrapersonal, an interpersonal, and a transpersonal dimension. It is therefore liable to be studied from various vantage points. One can focus on the individual, his actions, motivations, feelings, thoughts and other inner workings, while leaving all interpersonal and transpersonal phenomena in the background; this is what individual psychology and psychoanalysis do. Then, one can disregard the individuals and concentrate on what happens between them – their communications and interactions; this is what communications theorists and family therapists have done. Finally, one can take the complex symbolic organizations of society and culture as the subject of study, leaving aside the individuals and their interaction; this is the task of sociology and cultural anthropology. There are also some disciplines that try to bridge the gaps among these dimensions. For instance, the psychoanalytic object-relations theory and interpersonal psychoanalysis of Harry Stack Sullivan have tried to articulate the intrapersonal and the interpersonal dimensions. Social psychology has used the small group dimension in an attempt to inquire how society makes an

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impact on individuals. But only group analysis has really tried to integrate all these dimensions in a single, complex process of inquiry. Such an endeavour requires a multilevel approach, in which we must be constantly changing our focus and point of view, in order to access the hyper-complex reality of human life. It also demands that we relinquish the habit of thinking in terms of linear causality, and learn to think in terms of circular causality and the spiral process. Linear causality is only a way of punctuating a never-ending chain of events that is perpetually and recurrently traversing the same circular path in slightly varied ways (Bateson 1972; Watzlawick et al. 1967). The evolution of these variations as time goes by determines the direction and course of the whole process, which can either be progressive – when it develops new structures of greater complexity and stability – or regressive – when it dissolves the previously existing structures into their simpler components. Of course, progression in not necessarily ‘good’, nor is regression always ‘bad’. In this, everything depends on the context in which such processes take place. Classical psychoanalysis has traditionally opposed ‘inner’ and ‘outer’ phenomena, and has given full predominance to the former. The inner processes are supposed to be the true determinants of human experience and behaviour, while the impact of outer events is considered to be rather superficial and restricted to the conscious level. But there is evidence that personal relations with other human beings and the social and cultural processes are included in the intrapsychic dimension from the very first internalizations of relational experiences, thus shaping the very structure of the individual’s mind. If this were so, it could be inferred that the imprint of interpersonal and social phenomena, far from being a merely superficial addition to the outer strata of the mind, would be ingrained in the deepest layers of the unconscious. This seemed to be Bion’s belief, as expressed in an interview with Mexican psychoanalyst Marco Antonio Dupont on 22 March 1978, in the following terms: Dr Bion:

[In the case of] Brazilian culture, we see that it is possible to refer to its origins, but this implies a considerable knowledge of its language, its illustrious men, and its great poets.

Dr Dupont: It is important to know the history of the culture of the people that we are trying to understand, but do we not find common, universal fantasies in individuals from different cultures?

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Dr Bion:

In the case of Mexico, it seems to me that we would find a grandiose culture, with enormous historical antecedents. I do not have enough information about it, but I am, however, sure that it exists. I consider that we would need a person with a deep knowledge of Mexico and its inhabitants in order to discern its cultural roots. In the case of botany, the tree is not enough, one has to examine the roots that sustain that tree. I do not know how this could be done, but I do believe that it would be useful to try to investigate psychoanalytically some persons, to ensure a microscopic inspection, but it is also important to see it from the macroscopic point of view: the point of view that is attained when we observe a group of people in a room. If we see a group of Mexicans together, would we have a way of knowing that they come from Mexico? If we were in contact with a Mexican patient, why would we think that he is Mexican? It cannot just be on account of his name and address, that would be starting from the wrong end, it would be starting 4 from the diagnosis. (Dupont 1978, pp.51–52, our translation)

It is obvious that Bion believed that there was an inner dimension in the fact of being Brazilian, Mexican, or English, and that this could be investigated by means of the psychoanalytical method and some kind of group method of observation. It is also clear that he felt that these two methods were necessary and complementary. But society, its culture and its institutions should not be seen only through their impact on individuals, as this would be tantamount to the predicament of Plato’s cavemen, who could only know something of the world from the shadows projected on a wall. These are not only perceptions, but actual realities that may be studied from several vantage points. Sociologists study society and its institutions from the data contained in statistics and documents. Anthropologists go to live with their subjects and have extensive conversations with them. We, as group analysts, meet with groups in order to discuss and analyze their experiences and problems, and this opens the way for an inquiry into how society and culture are present in their whole life experience. This helps them to understand themselves and their society, and it also opens a path for us to understand some aspects of the social, cultural and institutional context in which such group discussion takes place. This will be further discussed in Chapter 6, ‘The Approach to Institutions and Society’.

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Communication, thinking, learning and change We have frequently used, in Chapter 2 on Pichon-Rivière’s concepts on operative groups, the terms ‘communication’, ‘thinking’, ‘learning’ and ‘change’ in statements such as ‘[The group’s] implicit task…tries to break, by means of elucidation, the stereotyped patterns that impede learning and communication, thus acting as an obstacle to any progress or change’ (Pichon-Rivière 1969, p.153). We also emphasized, following PichonRivière et al. (1960), the concept of a ‘dialectic spiral of communication and learning’, in trying to define the kind of group process that we intend to foster in our groups. But these concepts are extremely abstract, and this defies any attempt to draw a clear definition of them. It is quite difficult to determine their exact meaning and their mutual relationship. In this section we shall attempt to clarify, as much as we possibly can, the meaning or meanings they have within the context of the theory and practice of operative groups, at least from our point of view.

Thinking and change in operative groups We have already seen that every operative group needs a coordinator or co-thinker, whose function is ‘establishing, maintaining and fostering communication, which, though a progressive development, takes the form of a spiral, in which there is a confluence of teaching, learning, communication and operativity’ (Pichon-Rivière et al. 1960, p.112). This is accomplished by means of dynamic interpretations – both by the coordinator and the other members – of the operations that take place in the group. The result is an ever-widening, reflective thinking process that has been described as the ‘dialectic spiral’. The clinical experiences that we shall describe in the following chapters seemed to bear out the contention that we can foster in a group the kind of ever expanding process that is suggested by the image of a spiral. But the ‘dialectic spiral’ had not been ever precisely defined, and this concept is still a source of confusion for most of the readers of the literature on operative groups. We therefore set out to develop a theory of ‘spiral thinking’ and spiral change (Tubert-Oklander 1989–92). It was obvious to us, from the beginning, that any theory of change in human systems, both individual and collective, should be a theory of thinking. This would seem strange if we adhered to a conception of thought that links it to the functioning of an individual nervous system, but it makes

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sense if we adopt Gregory Bateson’s assertion that ‘a difference which makes a difference is an idea. It is a “bit”, a unit of information’ (Bateson 1969, p.272). This author used to differentiate between the explanatory world of substance, which cannot evoke any differences or ideas, but only ‘forces and impacts’, and the world of form and communication, which includes no things, forces, or impacts, but only differences and ideas. This implied a sharp contrast between natural science and the science of mind. But ‘mind’ comprised, for Gregory Bateson (1972, 1979, 1991), such apparently diverse phenomena as subjective experiences, individual thought, interpersonal communication, group processes, culture, animal learning, genetics, the evolution of species, and ecology – in other words, any behaviour or expression by living beings that could only be understood in terms of communication or information processing. Bateson’s thought is very complex and usually misunderstood, and we shall not attempt to expound it here. Any reader interested in knowing it better would do well to read his books, and others that comment on his life and work (Ruesch and Bateson 1951; Bateson 1972, 1979, 1991; Bateson and M.C. Bateson 1987; M.C. Bateson 1984; Lipset 1980–82). We want, however, to make it clear that his ideas have had a crucial impact on our own work, and in order to convey some of the flavour of his thinking, we reproduce here a brief quotation from his paper ‘Double bind, 1969’: Clearly there are in the mind no objects or events – no pigs, no coconut palms, and no mothers. The mind contains only transforms, percepts, images, etc., and the rules for making these transforms, percepts, etc. In what form these rules exist we do not know, but presumably they are embodied in the very machinery that creates the transforms. The rules are certainly not commonly explicit as conscious ‘thoughts.’ In any case, it is nonsense to say that a man was frightened by a lion, because a lion is not an idea. The man makes an idea of the lion. (G. Bateson 1969, p.271)

But ‘the very machinery that creates the transforms’ cannot be conceived only in terms of the workings of the nervous system. This computing of ideas does not only depend on the hardware, but also – and perhaps mainly – on the software – i.e. on such rule-generating phenomena as personal experience, group culture, language, tradition, religion, art, science, and society and its institutions. Foulkes tried to describe this in terms of the ‘network’, Pichon-Rivière in terms of the Conceptual Referential Operative Schema, and we have done it in terms of the Weltanschauung. But the implication is that there are ideas and rules for their combination and transformation, not only in

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the individual, but also in interpersonal relations, and in group, family, institutional and social dynamics. And real change in human systems always means a change in these rules. Whenever the change affects the content of the ideas, but not the rules for their construction, combination and transformation, we get that kind of apparent change that is described by the French proverb ‘Plus ça change, plus c’est la même chose (The more it changes, the more it remains the same)’. Therefore, if ideas are bits of information and thinking is any process of generation, combination, or transformation of these bits, then it makes sense to use the term ‘group thinking’ in order to refer to the communicative interactions that take place in a group; and it is likewise adequate to conceive any significant change in a group as a change in the group’s thinking processes. The dialectic spiral would then be an expanding process of communication and thought.

Communication and information We can define communication as the process that occurs when the behaviour of one organism somehow modifies the behaviour of another. Every communication implies a transference of information between one organism and the other, but not every transference of information is a communication. A tremor in the floor and walls of my house informs me that there is an earthquake going on, but it would not be adequate to say that ‘it is communicating’ this to me, since this would be treating a physical event as if it were a behaviour, and assigning it an inner meaning. The same thing happens when a physician observes a yellowish hue in the white of the patient’s eyes and infers that he is suffering of some sort of liver disturbance. These are signals – i.e. physical events that can be used by an organism as information about other events or situations – and not signs – an organism’s behaviour, or the by-products of such behaviour, that are somehow intended (either biologically or psychologically) to modify some other organism’s behaviour. Signals convey information, but they do not imply any communicative intent (Morris 1946). Information acts on any living being, not in terms of the intensity of the stimulus, but of its meaning for that being. We shall clarify this by means of a well-known example: a mother who is deeply asleep and tired for having watched all night over her sick child may not hear the ringing of the alarm clock, but she wakes up instantly at the child’s slightest moan. This means that it is not the loudness of the noise that wakes her up, but the information it conveys.

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Information is independent from matter and energy, even though it is often carried by energetic means (as, for example, the coloured light in a traffic light) or by a material substratum (such as this book). However, it can be conveyed without any such support: the absence of something is also information, as in the case of the letter that never arrived or the income tax return that was never filled (Bateson 1979). Communication is the interchange of information among living beings. It is always present in any interrelation among human beings, or among animals, or animals and human beings. It is impossible not to communicate, since even the most obstinate silence is communicating something, such as the silent party’s intention of not communicating with whomever is in front of him or her (Watzlawick et al. 1967). The same thing happens in groups: ‘not to speak’ does not equal ‘not to participate’, since a silent member of a group is very much present and active in the interaction (Thelen 1959). There is therefore always communication going on in human groups; the problem of the group’s operativity is not whether or not to have communication, but the quality of such communication, and its results, in terms of the group’s goals. Any act of communication among persons is carried out by means of signs. A sign is a mental structure made by the articulation of a ‘signifier’ and a ‘signified’. The signifier stands for the signified, and the latter is usually taken as the meaning of the sign. Signs are outwardly expressed by tokens. These are the physical entities or markers which manifest the signifier by standing for the signified as, for example, a spoken or written word, a photograph, a map, or a gesture. A sign only has a meaning because it is part of a code that articulates all the signifiers of a certain semiotic system – e.g. a language (Saussure 1916; Eco 1968–94, 1976). Now, for any act of communication to be effective – i.e. for the meanings perceived by the receiver to coincide with those intended by the emitter – it is essential that both of them share a common code that permits them to keep a consistent relation between the signifiers and the signifieds in their communicative interaction. Such code does not only include a lexicon (as in a dictionary) but also a set of rules for the mutual articulation and combination of signs (as in grammar). Whenever the codes of the emitter and the receiver do not fully agree, there is a misunderstanding (the receiver believes that he has understood the message, but what he ‘understood’ is different from what the emitter intended); and when the codes are utterly different, there is just a lack of understanding (as, for example, when two people speak different languages).

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Misunderstanding is, of course, a greater disturbance of communication than lack of understanding, since the one who has misunderstood really believes that he has understood, and therefore has no motivation for inquiring further into the communications he receives. One of the functions of the coordinator in an operative group is to point out the existence of misunderstandings, in order that the group members may embark on an exploration of their respective codes (referential schemas), in order to fashion a common code that permits effective communication among them. But this requires that the group members and the coordinator metacommunicate – i.e. that they communicate about their communication – so that they may modify their codes; and this brings us to thinking and learning. This was clearly stated by Pichon-Rivière et al. (1960) in the following terms: The individual and the group express themselves as much in the way in which they frame their problems, as in the very content of their discourse. We may say that communication is a context that includes a world of signals that all of those who intercommunicate know how to codify and decodify in the same manner… In the last analysis, communication in a group is made possible by the existence of a group conceptual, referential, and operative schema… We may thus say that learning follows the path of communication, and vice versa. (Pichon-Rivière et al. 1960, p.115–116, our italics)

Foulkes (1964b) also approached the problem of understanding and misunderstanding, from a quite similar perspective. To him both aspects of communication are of equal importance for study, that is to say, how communication is disturbed, as well as how it actually comes about. He noticed that while many problems of mutual understanding in a group arise from semantic differences, there is also a relational aspect, which he described in the following terms: Other distortions were called into being as communication raised simultaneous counter-communications which blocked the free reception and consideration of a communication. It was observed that the recipient of a communication while listening may already in his own mind be preparing his reply and in this way blunt or distort his ability to receive. For instance, a member mentioned that while he is listening to somebody else he has to re-translate automatically into his own terms for it to make sense. (S.H. Foulkes 1964b, p.276)

The process of communication, according to Foulkes, is a totally different and independent phenomenon from the two parties involved – transmitter and

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receiver – and transcends the mere transference of information. It is truly a group process and it is based on an emotional relation among the group members. He finally concludes that, in order to reach an adequate level of functioning, the group must develop a common ground and language, which he describes in very similar terms to Pichon-Rivière’s construction of a common CROS: We could not help observing that basic differences of personality make-up reflect individual differences in the approach to problems with a consequent disturbance of smooth communication. It creates a further problem for every group as to whether sufficient common ground or language can be found to render full cooperation possible, while making allowances for the individual personalities involved. This is closely linked up with the problem of taking personal motives into account and bringing intimate aspects under discussion… Complete understanding of a communication demands therefore a close appreciation of the nature of the situation leading to the communication, the personalities of the participants, the interpersonal relations and their standing within the group, together with the underlying motives, and finally the existing integration within the group. (S.H. Foulkes 1964b, p.278)

In other words, a true understanding of any act of communication requires that we take into account the context of that act, which is furnished by the total group situation.

Thinking and learning ‘Thinking’ may be defined from an inner or an outer vertex. If we study it from outside the individual, we may define it as ‘all the inner processes of information processing that lie between the stimulus and the response’. Such processes are undoubtedly related to the interpretation of information input, in the light of a particular code. If, however, we take the inner perspective of the thinking subject, thinking is ‘the flow of the experience that the individual has of himself, his fellow human beings, their mutual relation, their location in space and time, and the context in which they are inserted’. From any of these two vertexes, there is an obvious relation between thinking and communication, since both refer to meaningful processes of symbolic transformation that take place either inside human beings or in the relations among them. We may then say that communication is an externalized thinking process, while individual thought is only an intrapersonal communication. And this

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thin differentiation collapses when we define thinking – as Pichon-Rivière does – as a dialogue with a group of internal objects, and meaningful communication within a group as ‘group thought’. Therefore, thinking about thinking is also metacommunication, and this process is indispensable for learning from experience. Here there is a coincidence between thinking about thinking and communicating about communication. All this leads us to a discussion about learning. José Bleger (1961) defined it as follows, in the context of a paper on learning operative groups: [Learning is any…] more or less stable change in behavioural patterns, understanding behaviour as all changes in the human being, regardless of the area [mind, body, or external world] in which they appear; in this sense, there may be learning even if there is no intellectual formulation of it. But there may also be an intellectual apprehension, as a formula, and nothing more than that; in which case, there has been a dissociation in learning, a very common result of ordinary [teaching] procedures. (Bleger 1961, p.63, our translation)

We should emphasize in this definition the concept of ‘behavioural patterns’. If we come to a man who is quietly reading and slap him on the face, he might jump to his feet and give us a beating. This is a behavioural change, but if this is his usual reaction whenever he feels abused or insulted, then it is a behavioural pattern. If, after listening to an extensive sermon on Christian virtues, he reacts to the next insult or slap by turning the other cheek, and this new sort of reaction persists, it is a change of a behavioural pattern, not a mere behavioural change, and this implies learning. But there may be an even more complex and higher learning process, since this man, who is used to modify his behavioural patterns according to what people tell him – i.e. who is ‘influenceable’ – may learn to discriminate between new behavioural patterns that deserve to be learnt and those that do not. In that case, there has been a change in the pattern for learning behavioural patterns; in other words, the individual has learnt how to learn. This is what Gregory Bateson (1942) called ‘deutero-learning’ or ‘second degree learning’. But there is a still higher and more abstract learning level, and this is ‘learning how to learn how to learn’. This is rather difficult to explain and understand, unless we proceed to a discussion on the hierarchical organization of mind and behaviour.

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Hierarchical organization and change All the processes that we have been discussing in this section – communication, thinking, learning and change – are subject to hierarchical organization of logical types – i.e. levels of abstraction (Bateson 1972, 1979). Watzlawick et al. (1974) have tried to develop a theory of change in human problems. When nothing changes, this would be ‘Change 0’. When there is only a change in the content or in the order of ideas, or behavioural items, but no change in the rules that govern their construction, combination or transformation, this is what they call ‘Change 1’. This is the kind of change that can be induced by the supportive and behavioural therapies, and by those teaching techniques that focus on providing information. This we may call first degree change or ordinal change. A second kind of change, described by these authors as ‘Change 2’, is a change in the properties or rules of the system that is to be changed. If the system is made of ideas or pieces of behaviour, such rules are not really elements of the system, but they are unquestionably part of it. Of course, they are more abstract than the elements that they are ordering. In Whitehead and Russell’s (1910–13) terms, they correspond to a higher logical type. This kind of change, which we shall call second degree change or mutative change, corresponds to Bateson’s ‘deutero-learning’. It is the ‘Eureka’ moment of sudden discovery, when a new organizing idea strikes an individual and radically modifies his view of a certain problem or situation. This is the kind of change that can ensue in dynamic psychotherapies and therapeutic double binds, as well as in those educational approaches that foster an active discovery of new relations by the students. This is learning how to learn. But what about our third level of change, which has not been described by these authors, but can be found in Bateson’s 1964 paper on ‘The logical categories of learning and communication’? It is not easy to imagine what ‘learning how to learn how to learn’ might mean. Perhaps we might help with an illustrative model, a metaphor for the various levels of change. Let us consider a kaleidoscope. If we look through the eyepiece without moving it, we shall see an immutable image; this is Change 0. If we then rotate it, we shall behold a myriad images in an endless substitution, but all of them will have common elements and structure, since the coloured beads and the mirrors in it remain the same. In other words, there is a change in the disposition of the elements, but no change in its structure, and this is Change 1. If, being tired of always seeing the same kind of images, we open the apparatus and replace the glass bits and beads by others, we are changing the contents of the system, but

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not its structure and functioning. This is only an apparent change, as when a masochist turns into a sadist, without changing the sado-masochistic pattern of his relations (Plus ça change, plus c’est la même chose!). But if, after having changed the coloured pieces several times, we decide to further experiment with our kaleidoscope, open it and change the number and the disposition of its mirrors, we are changing our way of changing things, and we shall obtain a new and different universe of images. This is Change 2. But there is still a more radical change. We once had a kaleidoscope that had no beads at all, but only a lens that permitted its user to look at the whole world in front of him, and see multiple images of any object that he chose to focus on. This, of course, expanded infinitely the kinds of images that it might generate, as well as the ways in which the user could look at his world. This is Change 3, which utterly transforms the very structure of a system, thus altering our way of changing change. Bateson (1964–71) applies this model of a hierarchy of logical types to the study of learning processes. When a certain behaviour cannot be changed, as for example in the case of unconditioned reflexes, such as the patellar reflex, this is an instance of Learning 0. When there is a simple learning of contents, as in rote learning, this is Learning I. But the very repetition of single instances of rote learning helps the individual to become more proficient at this kind of learning with every new content. In other words, he has learnt how to learn; this is Learning II. But at the same time, he has learnt a set of premises about what learning actually is, and the ways in which it can be attained. These assumptions govern our later attempts at learning. When a teacher manages to convey to his students that there is some other way to acquire knowledge, aside from rote learning, and they start to experiment with this procedure, this is an instance of Learning II. The same happens when a therapist successfully suggests to a patient that talking about a conflict might be a better way of dealing with it than disregarding it altogether. But in both cases, the individual may still adhere to his lifelong assumption that all knowledge must perforce come from a knowledgeable source. This is the basis for that relational pattern that we call ‘dependence’. But whenever a teacher or therapist attempts to modify these assumptions about learning, he is aiming at Learning III – i.e. a change in the very categories that we use in order to think about change, learning, thinking, and communication. It is no longer a question of ‘communicating about communication’ or ‘thinking about thinking’, but of ‘communicating about metacommunication’ or ‘thinking about how we think about thinking’. This is the kind of goal that

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we set for ourselves in the case of psychoanalysis, group analysis, and operative groups. Gregory Bateson (1964–71) points out that the premises that have been acquired by Learning II are always self-validating. For example, if we have developed the habit of conceiving and perceiving the world in terms of causal relations, whenever we watch a certain phenomenon, we shall be looking for its cause and, since our very perception must needs be framed in terms of our set of mainly unconscious assumptions, we shall only be able to experience it as a cause–effect pattern. This, of course, will confirm our premise that ‘everything that happens has a cause’. But if in our discussion with other human beings – as, for example, in an operative group – we manage to identify and question this assumption, we might end up conceiving it as only one way of looking at things, among others. Such change in our Weltanschauung is an instance of Learning III. This has been described by Bateson in the following terms: What has been said…about the self-validating character of premises acquired by Learning II indicates that Learning III is likely to be difficult and rare even in human beings [and actually non-existent in other mammals, save dolphins (Bateson 1966, 1969)]. Expectably, it will also be difficult for scientists, who are only humans, to imagine or describe this process. But it is claimed that something of this sort does from time to time occur in psychotherapy, religious conversion, and in other sequences in which there is profound reorganization of character. …there might be replacement of premises at the level of Learning II without the achievement of Learning III […] That psychotherapists should be able to aid their patients even in a mere replacement of premises acquired by Learning II is already no mean feat when we consider the self-validating character of such premises and their more or less unconscious nature. The premises of what is commonly called ‘character’ – the definitions of the ‘self ’ – save the individual from having to examine the abstract, philosophical, aesthetic, and ethical aspects of many sequences of life. ‘I don’t know whether it’s good music; I only know whether I like it’. But Learning III will throw these unexamined premises open to question and change. (G. Bateson 1964–71, pp.301–303)

And how does this learning come about? We have already seen that, for Bateson, the rules for making percepts, transforms, thoughts and other mental contents are ‘presumably […] embodied in the very machinery that creates the transforms. The rules are certainly not commonly explicit as conscious “thoughts”’ (G. Bateson 1969, p.271). The fact that these rules are not

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ordinary ‘thoughts’ does not imply that they are not ‘thoughts’ or ‘ideas’ in the terms of our previous definition (‘a difference which makes a difference…a “bit”, a unit of information’ [G. Bateson 1969, p.272]). Therefore, ‘the very machinery that creates the transforms’ is also made of thoughts, but thoughts of a higher logical type. But if such rules were made conscious, by means of the creation of an even higher level of thoughts – i.e. by metacommunicating about them, as when a group starts to discuss the CROS of its members – this would generate a transcendental change in mental functioning, and this is Learning III. In our group practice, this is fostered by the interpretation of the unconscious aspects of their Weltanschauung and carried out through the ensuing discussion of the referential schema. These highly abstract matters seem to defy any attempt to depict them by means of language, so that many poets, philosophers, mystical thinkers, and some psychoanalysts and psychotherapists have had to resort to the use of metaphorical language and learning stories, in order to somehow convey their meaning. Others have abandoned all hope of ever speaking about such matters; Ludwig Witttgenstein (1921), for instance, ended his Tractatus Logico-Philosophicus with the admonition that ‘what we cannot speak about we must pass over in silence’ (p.74). This is related to two phenomena that we have often seen in operative groups. First, every now and then, one of the members of a group tells us that, when he told some friend about his group experience, the latter finally asked, ‘But what is it that you really do in that group?’ In none of the instances that we have heard of was the individual able to give a satisfactory answer to this query. Second, we have seen that it is usual for the group members to evaluate their group experience in positive terms, but to report to us that although they feel that they have been learning something, they are not able to determine what is it that they are actually learning. For example, during a course on the diagnostic interview for the staff in charge of selecting personnel in an large corporation, the group members declared that they did not know what they had been learning, but that they had observed a radical change in their way of conducting their interviews for applicants. They felt that this change had noticeably improved the value and the usefulness of these interviews. In this case, what the group conductor had been doing was to initiate and foster a discussion of the epistemological premises that underlay their practice.

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It seems that any attempt to verbally explain this sort of learning is doomed to failure, unless the person we are talking to has had a personal experience of it. Consequently, the teaching of these concepts should never be framed only in cognitive terms, but it must always also comprise an experiential element. And this is what operative groups attempt to do, as we shall see in Chapters 4 and 5.

Summing up We have reviewed in this chapter the major theoretical premises that underlie our conception and understanding of operative groups. This endeavour has carried us far beyond Pichon-Rivière’s concepts as they were expounded in Chapter 2. This involved referring to a motley assembly of unlikely writers – anthropologists, biographers, group analysts, neurologists, novelists, philosophers, poets, psychoanalysts, psychologists, semiologists and sociologists – who have had an influence on our thought. This is more akin to a collage or a dervish robe than to a systematic bibliography, and therefore quite alien to the academic tradition, but perhaps this variegated list of references is demanded by the protean quality of the group experience we are trying to think through. We hope that the following chapters on the clinical aspects of operative groups may assist the reader in understanding this highly complex practice.

CHAPTER 4

The Learning Operative Group

Introduction As we have already seen in the previous chapters, operative groups may be therapeutic on non-therapeutic, and they were first developed in a teaching–learning context. We shall therefore start the clinical part of this book by considering the learning operative group. In these groups the members develop a discussion on some prearranged subject, while the coordinator observes their discussion and intervenes every now and then in order to point out some obstacle that stands in the way of this endeavour, and tries to account for it in interpretative terms. He also strives to identify the premises that underlie the discussion and relates them to the members’ referential schemas, describes and analyzes them in his interpretations, and helps the group members to develop a common CROS that might help them to deal more effectively with the problem at hand, be it theoretical or practical. The coordinator’s function is therefore akin to that of both a group-analytic therapist, inasmuch he is trying to identify and interpret the group’s emotional conflicts in dealing with its present task, and an epistemologist, since he is attempting to induce the members to launch a critical analysis of their own theories and the assumptions that underlie them. This technique requires that all the members and the coordinator share, as a starting point, a common information that sets the discussion going. There are three ways in which this may be done. The first one is to give them an initial lecture on some agreed subject and then ask them to discuss it. This was the model used by Pichon-Rivière and his co-workers in 1958, in the ‘Rosario Experience’ (Pichon-Rivière et al. 1960), as we have seen in Chapter 1. In this kind of large groups the lecture is usually delivered by the teacher, 101

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and then the audience is divided into smaller discussion groups, each of them with a coordinator or coordinating team. The second model is usually used in smaller classes or study groups that meet regularly over an extended period. Here, there is some pre-assigned reading that has been available to all the members, and the group’s task is to discuss these readings, starting from the impact that they have had upon them. The coordinator does not answer their questions or clarify the difficulties they have found in their reading, as a teacher would, but he will rather help them in using their own resources for clarification and further discussion of the material and its implications. He also assumes that all the group members have read the material and, were he to find out that this was actually not the case, he would consider this situation as an obstacle, a resistance to the task, and would inquire into its motives and meanings, both conscious and unconscious. This kind of group is illustrated by the experiences portrayed in the following two sections of this chapter. The third model, which is frequently used in brief workshops in institutions or conferences, takes as a starting point a certain problem or question, which is usually stated in the workshop’s name. Here the coordinator starts by recalling the problem question that members are to tackle, asks them to state their points of view on the subject, and then suggests that they discuss their findings. In this case he refrains from stating his own position vis-à-vis the topic, in order to allow the members to expound their own views, and then help them to develop a critical analysis of the assumptions and beliefs that underlie them. It is only in the final part of such a group that the conductor may state his own position, not as a conclusive statement, but as just another example of the many vertexes that may be taken in order to view the initial question and its consequences. As this kind of group is also useful for the development of social research on the subject, we shall include an example of it in the section ‘The use of operative groups in social research’ in Chapter 6. So that readers may better understand the following protocols, we should explain a couple of points about the way in which we conduct our groups and how we record our experiences in writing. In our technical approach, every learning operative group should start with a contract and end with an evaluation. The evolution of the group is therefore framed between two discussions of the group process that are not, strictly speaking, a part of it. The first is a discussion of what the group is going to do and how is it going to do it, before starting the actual task. The second is an analysis and appraisal of what

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has been done, once that the task is finished. In other words, these are moments of metacommunication about the group’s task. This we always do, whether the group is meeting only once, as in workshops, or for an extended period, as in seminars or study groups. Of course, this metacommunication can also be seen as a part of a wider process that includes the contract, the development of the group, and the evaluation, but it cannot be evaluated in the group, but only in the later meetings of the coordination team. Gregory Bateson (1953) once wrote about this in his ‘Metalogue: Why do things have outlines?’ The ‘Metalogues’ were fictitious dialogues between a father and a daughter in which they discussed several interesting themes, and also discussed their discussion – i.e. metacommunication plus dialogue. The end of this particular text went as follows: D:

What did you mean by a conversation having an outline? Has this conversation had an outline?

F:

Oh, surely, yes. But we cannot see it because the conversation isn’t finished. You cannot ever see it while you are in the middle of it. Because if you could see it, you would be predictable – like the machine. And I would be predictable – and the two of us together would be predictable [but living beings, unlike machines, are always unpredictable]. (G. Bateson 1953, p.32)

Then, there is the question of the use of written records during the operation of the group. We usually write down the contract, after having discussed it at the initial meeting. We also ask the members of the group to act as observers, one at a time, of the group sessions. Therefore, one of them takes notes every session and afterwards synthesizes them into a brief report that is read at the beginning of the next meeting. These reports, which are not only a summary of what has been discussed, but also a description of what happened in the group, from the observer’s point of view, are copied and distributed to all the participants. These written materials are therefore available to the group members and the coordinator, as elements for the study of the group process. When the evaluation comes, we ask the members to bring a written appraisal of their personal experience of the group, and we also write down our comments. These written reports – the outline of the conversation that has already taken place – are read at the beginning of the evaluation session, and then discussed and analyzed. This procedure is, of course, only applicable in the case of seminars or study groups. In workshops and conferences we usually have a formal

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observer, who is a member of the coordination team. This observer takes notes and gives oral feedback to the group at the end of a session. This is a very difficult endeavour, since there is almost no time to think through and elaborate the report, so that it is not unusual for the observer to be more experienced than the coordinator, whose task is truly simpler (Dellarossa 1979). When there is no one to take the role of the observer, the coordinator has to play both roles, but this is much more difficult, and the results are not so satisfactory. All these written records, taken together with the coordinator’s notes, are used as the primary material for the elaboration of clinical reports of group experiences. Now, the final protocols may be written in two quite different ways. We may take one group session and study it in itself, without considering its position in the whole evolution of the group. Such disregard for the temporal perspective of the group process provides a transversal description of the group field. It is as if we had taken a snapshot of a single moment of the group process and then studied it as a simultaneous, timeless, meaningful structure. The whole process of a group may then be thought of as a series of such moments. On the other hand, we may study the group process as an evolutionary movement that flows from the contract to the evaluation. Such process is then conceived as a progressive change through time, which has an organization, a direction, and a rhythm. Such an evolution may well be described in terms of phases, but we should always remember that such phases are really a construction that we invent in order to be able to describe our intuitive perception of this flowing change. This is a longitudinal description of the group process. Of course, the difference between these two descriptions is also a matter of the way we construct an image of what we have perceived to be happening in the group, rather than of time units. A single session may be described in process terms, if we use a close-up lens, so to say. Everything depends on what Kurt Lewin (1943) called the ‘definition of the field at a given time’. Any given moment is not truly timeless, even though we decide to describe it as if all its elements were simultaneous. The time needed in order to be able to formulate the description of ‘the field at a given time’ depends on the size and complexity of the field we are trying to encompass; an individual’s visual field may take only a second, a historical period may take a century, a group configuration usually takes a session. But the transversal (synchronic) and the longitudinal (diachronic) descriptions imply contrasting and complementary 1 mental organizations; it is a kind of figure–ground relation.

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The following two sections present instances of these two types of description, taken from learning operative groups that met according to the seminar model. 2

The transversal description of sessions First illustrative material

This first material comes from a study group on group psychotherapy. This group had started in an institutional setting, in response to a psychiatric external consultation ward’s request to start a group psychotherapy programme in order to cope with the growing patient demand. One of us (JTO) was then called to start a summary training on group psychotherapy for those clinical psychologists and psychiatric residents working in the ward who wanted to participate. The consultant proposed a brief study group, which was to be coordinated with the operative group technique. The objective of this period of group work was to study group psychodynamics. These first ten weeks were successfully completed, and the group members wished to continue with the training. But by that time a conflictive situation had developed in the ward, since its head had a therapeutic ideology that was opposed to that of therapeutic groups. He had accepted this project because he needed to increase the number of patients treated in the ward in a short period, in order to solve certain conflicts with the director of the hospital. He had expected, however, that this training would help the ward’s clinicians to apply classical psychoanalysis in a group setting, and now he found that the consultant’s philosophy implied a group-analytic theory and technique, which he felt to be untenable. This attitude was shared by some other members of the ward who were not attending the seminar. The group members were mostly young and their participation in the ward was temporary. They felt that they still needed much more study before they were able to conduct a therapy group, and this made the seminar of very little use for the head of the ward. As there was no way to negotiate this situation with the authorities, the consultant decided to leave his post in the institution. The group members, however, asked him if he would be willing to continue working privately with them, in order to study group psychotherapy. The coordinator accepted, even though he was sure that this change of setting was bound to generate important difficulties. During the first few sessions of this new period, two of the members abandoned the group, but it was not possible to analyze the

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others’ emotional reaction to the loss of the hospital setting and of the two companions who had left, even though the coordinator had tried to suggest that the group study this situation, by means of several interpretations that had proved unsuccessful. The seventh session of this new period started with an incomplete group, since two of the remaining members were absent. The reading material consisted of two introductory papers on group psychotherapy that posed the differences among three models of group therapy: psychoanalysis in groups, psychoanalysis of a group, taken as a patient, and group analysis. The group had been trying to discuss this material during the last two sessions without any success. The session begins in a chaotic emotional climate, in which it is not possible to tackle the group task. The members criticize the material as mere information; they suggest that it is high time to abandon it; they declare that some of the models described in the papers are impossible to understand. The general climate of the meeting is uncomfortable, confusing, and defiant. The whole discussion shows an extremely low intellectual level, as it basically consists of disjointed phrases. As the coordinator notices that all the group members are almost hidden behind their books and papers, he suggests that perhaps the obstacle lies in the difficulty of moving from a dyadic relation (the reader and the book) to a group situation. As this interpretation proves to be unsuccessful, he tries another line of thought, and says that the difficulty might come from the denial of the fact that this is a new group, and that in its constitution it has left behind an institution, two of its members, and its previous setting and goals. This new interpretation seems to induce a dramatic change in the emotional situation of the group. The members suddenly show an interest in this proposal and develop a lively discussion in terms of an apparently insoluble opposition. Some of them maintain that, after these successive changes, this is truly a new group, while others assert that it is still the same group, which has undergone changes. The coordinator suggests that the two polar positions may not be incompatible, but rather correspond to two perceptions of a same reality from diverse vertexes: one of them would be the perception of change, while the other would be the recognition of continuity. This brings about a new shift in the group’s climate, that now becomes reflective. One of the members says that he now realizes that in the first position one would be thinking in terms of the group field, while the second implies thinking in terms of the group process. The conductor observes and

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points out that this is the first time that some of the concepts that had been acquired during the first period of group work (i.e. in the ward) have reappeared and are being used in order to understand the present situation. It would seem that the group members are recovering their memory and their capacity for thought. He remarks that the group process can be described as follows: a transition from a split-up situation – a splitting among the group members and between each member and his personal experience, capacities, and previous knowledge – to a more integrated one – an integration of the group as a whole and of the members’ mental faculties, with the consequent recovery of their previously split-off experiences, capacities, and previous knowledge. It seems that, for this reorganization to occur, the group members must first become aware of change, and only then recover the group’s continuity. This process implies a mourning situation. The group enters a new reflective moment, and its mood turns into sadness. The members talk about the passage from childhood to adolescence and other life shifts. After a brief silence, one of them suggests that it is high time to go back to the discussion of the material, and this is worked through by all of them in a cooperative and productive fashion, during the last fifteen minutes of the session. The climate is now serene, and the feeling is that they can now work without anxiety. Comment: At the time of this session, the group conductor was working with the Kleinian concepts of the schizoid-paranoid and depressive positions, used in a phenomenological-descriptive sense to refer to two alternate mental states, characterized by the following traits: 1. Schizoid-paranoid position: a) a splitting of cognitive processes, which determines various disturbances of thinking, memory, attention, and perception – i.e. the set of ego functions described by Freud (1911) in ‘Considerations regarding the two principles of mental functioning’; and b) an emotional climate of fear, hate, persecution, violence, distrust, boredom and despair, which is expressed through attitudes and behaviours of attack, flight, and rejection. 2. Depressive-integrative position: a) a re-integration of those cognitive processes that had been previously split up, which brings about a recovery of the affected mental faculties; and b) an emotional climate of sadness without despair, which is expressed by reflective and responsible attitudes and behaviours that tend to reparation of previous damage and are accompanied by hope.

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It should be remarked that the operational use of these Kleinian concepts in order to refer to alternate moments of the process of living and relating (Segal 1964) does not necessarily imply an acceptance of Melanie Klein’s (1952) conceptions of early development nor of her controversial use of the concept of a ‘death instinct’. We therefore feel free to use these descriptive concepts without having to take a stance in an ongoing controversy. We have also extended the scope of these terms, originally intended to describe the inner dynamics of the individual, in order to apply them to the group situation. We believe that in the latter, these two mental states may be observed both in the individuals and in the group-as-a-whole. This is a consequence of the confluence of the individual matrices and the social matrix to generate the group matrix, as discussed in Chapter 3. It is quite obvious that the first part of the session that we have just described corresponds to our definition of a schizoid-paranoid moment (loss of mental faculties and a defiant, destructive and distrustful attitude). We may also notice that the splitting mechanisms not only affect the integrity of the isolated members’ mental processes, but that they also imply a fracture of the bonds among them and the development of opposition and conflicts, as well as the formation of subgroups. The most split-off aspect of the group situation is the task itself, and this corresponds to Pichon-Rivière’s concept of the pre-task moment (Pichon-Rivière and Bauleo 1964), as we have seen in Chapter 2. After the coordinator’s first successful interpretation the task is reassumed, but there is a dissociation within it (the insoluble polarization). We are now in the dilemma stage, and there is still a need for further interpretations before the group can move to the problem stage (Gear and Liendo 1974). The latter implies that this group must go through a period of mourning for its own changes and losses, before the external task may be reassumed (the discussion of the reading material). Mourning has two quite different aspects: mourning for unavoidable losses and mourning for the damage that has been done (Mello Filho 1973). The former is solved through the acceptance of reality and pain, while the latter requires assuming one’s responsibility and performing acts of reparation, either material or symbolic. But in this session we only worked through the mourning for unavoidable losses (the effects of change and the passage of time), while leaving out the guilt for the real or fantasized damage to the object (the conflict with the institution and the head of the ward). It was to be expected that this unanalyzed aspect would later surface as manifest conflicts

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or acting-out situations among the group members. This is what actually happened in the next session, when a struggle broke out between those group members who had attended the previous session and those who had been absent. This appeared as a reaction to the observer’s report of that session, and unleashed a dilemmatic discussion on the concept of ‘mourning’, which was denied by the members who had been absent and upheld by those who had been there.

Second illustrative material This clinical material depicts the working through of the mourning for the damage done. It comes from a group of psychologists, psychiatrists and psychoanalysts who attended the coordinator’s private office to study operative groups. There were five members and a permanent observer, who worked with the coordinator. The weekly reports of the sessions were written and read, at the beginning of the next session, by one of the group members, following an alphabetical sequence. We shall now reproduce one of these reports, with no other alteration than the omission of the real names of the members. ‘M’, one of the five members, was absent. He was a psychiatrist who played a special role in the group, as we shall describe later. We have reproduced this report exactly as it was written and read, keeping the grammatical and syntactic mistakes, and adding only a few clarifying comments in square brackets, in order to keep the material just as it was handed over to us at that time by one group member. On analyzing this session, we can observe that the passage from the initial schizoid moment to the later integrative moment coincides with the awareness of the implicit loss and mourning that underlies the passage from the individual organization of the personality to a group system (de-individuation). Paranoid anxieties (fear of the impending group situation) and depressive anxieties (fear of losing the previous state of individuation) are apparent. But this working through is accomplished only when the group faces the object that has been damaged by its earlier incapacity for integration (the time that has been wasted and lost).

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REPORT OF THE 14TH GROUP SESSION MEMBERS: D, K, H AND S. COORDINATOR: JTO OBSERVER: G

We start the session after a 15 minute delay. As there was no report on the previous session [which should have been brought and read by M, who was absent], we endeavoured to reconstruct it during the first few minutes. There were yet a few minutes, while we finished settling down, until someone suggested that we should start, and then began a tense silence, which was broken by the question of why is the moment of introjection of the object for its working through called ‘depressive.’ Again, there was Silence. There were some attempts to deal with the question, but they were swallowed by the Great Silence. The coordinator suggested that we diagnose the moment of the group; after a long silence, we tried several diagnoses that we could not define, so the coordinator pointed out that, if we looked at it in terms of the thinking process, we were facing an inhibition of group thinking, since no proposal had been followed. There was a suggestion that we go back to the last theme of the previous session, about viscosity and those anchors that impede the group, and it was said that that was what we were doing, only that by acting, instead of conceptualizing. This reminded us of a climate such as that described by Dellarossa [1959, a paper that was to be discussed during this session, which dealt with paranoid anxiety during first sessions in operative groups and therapy groups]. We asked, why is this happening to us? There is a discussion on absences, on H as the ‘absent member’ [H had been absent during the last three sessions, and there had even been a doubt about whether he would continue in the group], and we realize that this theme was being used to screen the fact that this happened even when we were all present. It seems that we are trying to avoid something and today’s absences (M, the time of the beginning of the session, the report, Dellarossa, etc.), and this something is the task. There was an insistence in saying that our silence was depressive, but this was questioned, and we found out that it was rather schizoid that our ‘symptom’ of an inhibition of group thinking

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would bring us to a fear that we were not thinking as an operative group [what had been actually said during the session was ‘not thinking as a group’], and that we have a resistance toward substituting our thinking models, our individual referential schemas, by a group schema. There is some talk on the separation-individuation process. There is a deluge of comments. The difficulty seems to have started when we began to be an operative group [when reading this text, the reporter corrects a ‘typo’: he had written the Spanish word ‘ser’ (to be) instead of ‘ver’ (to see or to study), as he intended], that is to say, we are including a ‘reading’ of what is happening in the group. There was now an avalanche of witty comments: the fear of losing our security is the fear of losing our ‘thought’, of going mad. We are afraid of ‘letting loose the family madwoman’, which is fantasy. There is a comment that we were loosening up, and this is connected to the idea that we might be falling into a therapeutic group, with the fear that there might not be any therapist. Laughs and relaxation. It is said that we were talking-playing with the bogeyman, so that we might overcome the fear of it and be able to approach it. There is talk of madness, and that one goes mad as a result of defending against madness. We finally fall into a silence that the Coordinator defines as depressive-integrative, and we shared his assertion, remarking that after a disparaging beginning we finally had a worthwhile session. This is associated with time and intensive group work (sessions lasting several hours) and there was a fantasy that if we were to continue the meeting we would be able to produce much more. The Coordinator said that we have time parameters and that this was the end of the meeting, and interpreted this fantasy as an attempt to recover the time that had been wasted. We agree to review the two papers by Pichon-Rivière that had already been assigned, as a basis for further reflection, and other papers were added, which this reporter did not register because he was taken up by the fascination of continuing the session [here the reporter crossed out the following phrase: ‘which would not be inferred from the length of this report’]. Signed: S

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It is interesting to note that in the next session there was, just as in the other above-mentioned group, a conflict with the member who had been absent in this one, who became the depository of all the group’s anxieties and resistances to change. This group member, M, was, as we have said before, a psychiatrist without any dynamic training. He had never been in therapy, even though he had intended to, and had even booked interviews with several therapists, but never showed up. He transferred to the operative group this ambivalent attitude towards his potential personal treatment, and this turned him into the manifest leader of the fear and unconscious wish – ever-present in learning operative groups – that the group become therapeutic. He had had several violent confrontations with K – who had been in psychoanalysis and had a dynamic training – in which M said that we had never agreed to study the dynamics of our own group, and K retorted, with increasing irritation, that this had been explicitly stated in our contract. During the fifteenth session, this happened for the third time, thus generating a very tense situation, until the coordinator reminded the group (and informed M) that during the last session, when M had been absent, K had been the spokesman for that fear, by saying, ‘And if this is a therapeutic group, where is the therapist?’ When the group members acknowledged that M was only the spokesman for a shared fear, while K represented a reaction formation against this fear, the tension subsided, and we could work productively for the rest of the session. However, M’s personal conflicts, which had led him to act systematically as the spokesman for this particular anxiety, were too strong for him to continue in the group, which he finally abandoned without notice. The working through of this desertion by the remaining group members was a clear example of mourning for an unavoidable loss. The splitting of a group into two subgroups (the ‘radicals’, who demand ever more ‘therapy’, even if the group’s original goal had been learning, and the ‘conservatives’, who shun becoming more personally involved) has been described by S.H. Foulkes (1964b). He also reported a similar phenomenon in a therapeutic group, in which the radical faction continuously criticized the other half for their cautious and restrained commitment to the group experience. It is interesting to note that, after the end of the group, the ‘radicals’ wanted to go on working with their therapist for one further year, and that then, being deprived of their projective screens, they were compelled to analyze the very same split in their own selves. Foulkes also had occasion to talk with some of the former members of Balint’s seminars for general practitioners at the Tavistock Clinic, and they reflected the same emotional

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situation, wanting to enrol his support for their idea that Dr Balint did not 3 give them enough ‘analysis’.

Discussion Both clinical illustrations show that we conceive the passage from a schizoid-paranoid moment to a depressive-integrative one as a mourning process. These processes may either be the ‘micro-mournings’ that occur in every session, when the members enter and leave the group situation (the individuation–deindividuation–reindividuation process), or the ‘macro-mournings’ that signal the passage from one stage of the group to the next. In this sense, the first clinical example is a case of macro-mourning, while the second is one of micro-mourning. Nevertheless, these are neither pure nor clearly differentiated situations, since in the second illustration, for example, there is a confluence of the micro-mourning of the de-individuation of the members at the beginning of the session, with the macro-mourning of their growing awareness that the group is really a group (‘when we began to see/be an operative group’). These two clinical examples show how an isolated session may be used to describe a moment of the group process, taken as a timeless mental structure – in this case, the passage from a schizoid-paranoid organization of the group field to a depressive-integrative one, with the corresponding experience of mourning. In this type of description, the information about the history of the group is used as a context for determining the meaning of what happens in the session, but there is no attempt to depict the evolution of the group process. The two protocols also illustrate how we use interpretations of the psychodynamics of the group in a learning operative group. Such interpretations are always framed in collective terms, avoiding any exploration of the psychodynamics of individual members, and they endeavour to foster the learning process. Unlike therapeutic groups, where the coordinator tries to help the group to proceed from intellectualization to a full emotional experience, in learning operative groups our job is to help them to progress from emotional situations to a conceptualization of what is actually happening (Dellarossa 1979). In this undertaking, reading the report of the previous session at the beginning of the next one helps the members to attain a certain detachment from their own participation in the group, which paves the way for a rational analysis of their shared experience.

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The longitudinal description of the group process The goals

In the previous section we presented a transversal description of two learning operative groups, in which we studied the microprocess of individual sessions and endeavoured to frame our description as the timeless organization of ‘the field at a given time’ (Lewin 1943). In this section we shall describe and analyze the macroprocess of the whole evolution of a learning operative group, from its initial contract to its final evaluation. We shall use for this the experience that one of us (JTO) had with a group of students of the Training Institute of the Mexican Association of Group Analytic Psychotherapy (AMPAG is the acronym for its Spanish name: ‘Asociación Mexicana de Psicoterapia Analítica de Grupo’), during a course on ‘Research Methodology in Psychoanalysis’. This study has three different but interrelated goals: 1. To present a longitudinal view of the total evolution of a learning operative group. 2. To evaluate the results of this group, in terms of the previous learning goals set by the institution, the coordinator, and the group members. 3. To evaluate whether the results justify the use of this approach for coordinating learning groups. This evaluation intends to answer the recurrent question, which appears both in these groups and in academic discussions with colleagues, about whether the use of an interpretative approach to the coordination of learning groups does not imply ‘a confusion between learning groups and therapeutic groups’, which might result in a deterioration of the cognitive level of the group task. As we have also frequently asked ourselves whether the inevitable digressions that occur in these groups are not a waste of time and a distortion of our initial goal, this discussion is also a self-critique of our conception of operative groups.

Background information and the institutional context The Training Institute of AMPAG is an autonomous subsystem within this institution, in everything that relates to its training function, which is defined as follows: to train ANALYTIC GROUP THERAPISTS who, having the reference of the Theoretical and Technical System of Psychoanalysis, and the various

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theoretical approaches to groups, are able to apply this knowledge to the understanding and research of individual and group dynamics and therapy. (Instituto de Enseñanza 1977a, p.1, our translation)

This educational programme has been shaped according to the classical Berlin model of the psychoanalytic institutes (training analysis, theoretical seminars and supervised clinical practice), with the exception that, in this case, the training analysis takes place in a therapy group, and the supervisions are done either in a supervisory group or in a co-therapeutic experience with an expert. In 1977 the Institute introduced a change in its selection procedures. Instead of carrying out thorough interviews of those applicants who had already had two years of group training analysis, it decided to accept every one of them who fulfilled the academic requirements and had a minimum of one year of analysis, for a one-year ‘pre-course’. This ‘prerequisite’ for admission had the following goal: to unify, as much as possible, the previous knowledge of future candidates, to fine-tune basic knowledge, and to remedy deficiencies in their previous knowledge; ideally, to learn to use a common code. [However] fulfilling this prerequisite does not imply any obligation by the Institute to accept the applicant for the next course. (Instituto de Enseñanza 1977b, p.1, our translation)

Therefore, in order to become a candidate in the Institute’s training course, it was not enough for the applicant to pass the pre-course, but he would also have to go through the usual admission interviews. This created a new status in the Institute, quite different from that of candidate, which was that of an aspirant, placed at the border between the ‘inside’ and the ‘outside’ of the institution. This situation was bound to generate conflicts and anxieties, as we shall presently see. The members of the group, both psychiatrists and clinical psychologists, were to take various courses, some of them together and others separated according to their professions. The clinical psychologists would study ‘Clinical psychiatry’, while the psychiatrists would attend two courses on ‘Developmental psychology’ and ‘Introduction to psychoanalytic psychology’. Both groups would join in order to take ‘Sociology of mental disease’ and ‘introduction to the methodology of research in psychoanalysis’. The goal of the latter was to foster an interest in psychoanalytic research. The seminar on sociology was also being coordinated as an operative group, although with a quite different technique.

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The setting and the contract When the coordinator (JTO) started to plan this course, he immediately had to face two basic questions: what to teach and how to do it. Should he offer a systematic and consistent programme, or should he, perhaps, attempt to convey an image of the bitter disagreements among epistemologists? Would it be worthwhile to avoid, by means of the sequence of reading material or by the teacher’s interventions, the anxiety that the group members would inevitably feel about the scientific status of psychoanalysis, or would it be better to let them face this anxiety and find their own answer? And, finally, should he apply the operative group technique that he usually employs when teaching the theory and technique of group conducting (see preceding section in this chapter), or perhaps resort, in response to the demands of the subject he was to teach, to a more directive technique that might offer better cognitive results? He finally decided to stick to his own conception of, and values on the subjects of learning and working in groups, and to give the group members full freedom to approach this new field of knowledge and to develop their own relation with it, aiding them by means of interpretations, according to the operative group technique. As to the selection of readings, he chose a selection of contradictory papers, both on the nature and methods of epistemology, and on the scientific or non-scientific character of psychoanalysis and its method. He thus sought, not only to give them a clear idea of the contradictions and the incompleteness of epistemology and methodology, but also to avoid, as much as possible, that his own epistemological bent should impose preconceived answers to the questions posed by the texts. The selection and the sequence of the readings, however, already implied his position, as they went from the more general to the more particular questions, and ended by stating a belief in the potential scientific character of psychoanalysis. The coordinator’s state of mind at the time was much more uncertain than these comments perhaps suggest. He was especially worried about whether a dynamic approach, such as that of operative groups, would be adequate for the study of a chiefly logical discipline, such as epistemology. However, once he had taken his decision, he was ready to keep it to the end. He therefore wrote a programme for the course, which would serve as a written contract for the group, in which he declared his intentions, set up the rules for working together, and provided a sequence of readings. In presentating it, he wrote the following lines:

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The main difficulty of this course is that it tries to teach something that does not yet exist: the methodology of research in psychoanalysis. When I say that it does not exist, I am trying to describe the present situation, in which, after a prolonged indifference towards research by psychoanalysts, who were mainly interested in clinical practice, there are various proposals about what such research should be. In other words, what we are trying to study is not an organized body of knowledge, but the recognition of certain problems, and the various solutions – which are frequently conflictive and incompatible – that have been proposed for them. This situation is made even worse by the fact that there are, within the more systematical field of epistemology or philosophy of science, several schools of thought that differ in their conceptions about what science actually is and what they believe to be its method. Consequently, and since it is materially impossible to develop a full course of epistemology before approaching the concrete case of psychoanalytic research, I have chosen to follow a programme that gives a panoramic view of the field, including its inconsistencies, confusions, contradictions, and conflicts. The papers in the bibliography have been chosen for their illustrative value in showing the various positions on the subject, rather than by the amplitude of their exposition. The aim of the course is that it may lay open a number of questions, that the students should strive to answer for themselves in their later studies and during their whole professional and scientific life, rather than giving preconceived answers to them.

The programme also stated the way in which the group was to function, in the following terms: We shall use the method of free group discussions about the assigned readings, which the students should have studied individually. The group task will be to analyze the questions that arise during the discussion. In order to record for later analysis the vicissitudes of this process, one of the group members will write a synthesis of each session, following an alphabetical order, which will be given to all the other participants and read at the beginning of the following session.

The whole course was to take twenty one-and-a-half hour sessions. The coordinator had planned that the first one would be dedicated to discussing the contract, in terms of the proposal he had framed in his programme. As the writing of the reports of the sessions had not yet been agreed, he himself wrote the synthesis of the first session. This was the first time that the psychiatrists and the clinical psychologists were to work together. The report was as follows:

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REPORT OF THE FIRST GROUP MEETING – SUBJECT: THE CONTRACT The coordinator suggests that the group members introduce themselves, and express their expectations for this course. When trying to classify the latter, we identify five possible motives for studying this subject: 1) the possibility of strengthening psychoanalytic theory vis-à-vis the criticisms it receives; 2) to learn how to carry out a research; 3) to respond to an evolutionary need of psychoanalysis and psychotherapy (to adapt to the changing social needs); 4) to serve as a basis for the study of later subjects, and 5) to learn to systematize one’s own thoughts. The coordinator also introduces himself. He reads the programme for this course and opens its discussion, which starts by considering how we are going to work. There is a very confusing moment, in which the members confound the coordinator’s proposal of writing syntheses of the sessions, with another one, suggested by one of them, of starting the meetings with a summary of the subject to be discussed. It is suggested that this confusion may derive from two motives: a) the persecutory character of the synthesis, both as a personal expression of the reporter and as a mirror of the group, and b) the impact of the new situation that is being experienced (new subject, new teacher, new group). We turn again to the discussion of the best way of operating in the group. It seems that the proposal of a more lax way of functioning, in which a greater emphasis is laid on the questions that emerge from the discussion than on a thorough analysis of the reading material, generates fear of a possible chaos. It would seem that, in this apparent opposition between freedom and order, we are looking for a transaction that imparts order without rigidity, and flexibility without chaos. It is obvious that, rather than discussing about ways of functioning, the real problem is the need to constitute the group. The meeting ends with some formal arrangements about the reading material.

The development of the course We shall use, in order to describe and analyze the evolution of the group, a document that the coordinator wrote for the first evaluation session (the penultimate session of this course). It is, of course, an interpretation of what happened in the group from the coordinator’s vantage point, but it was read to

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and discussed with all the members of the group, and they felt that it was a fair account of their own experience. Their own evaluation of the group will be included in the subsection ‘The evaluation’.

EVALUATION BY THE COORDINATOR 1. Evaluation of the group process: I have divided the evolution of the group, for this evaluation, into five stages or periods as follows: 1.1 First stage (sessions 1–3): The group starts with interest, but the first material already gives rise to confusional anxiety and paranoid 5 defences. Confusional anxiety as a response to an overload of information and to the emergence of a new model for thinking. Paranoid defences, as the group feels that the new knowledge may become a danger for the already established knowledge. There is much criticism of the reading material, as it is felt that it threatens the scientific status of psychoanalysis, and there is also a criticism of the setting and the conducting of the group, which are felt as an invitation to change schemes for thought, thus breeding confusion. There is a predominance of defensive individuation, which is expressed through an extremely competitive attitude. 1.2 Second stage (sessions 4–8): Confusion subsides and there is a fluctuation between depressive anxieties (fear of loss of what is familiar) and paranoid anxieties (fear of the new). We manage to begin, not without difficulties, the critical analysis of the group’s here-and-now, thus progressing from phobic moments (‘hiding behind the material’) to reflective moments. The group advances and retreats. Resistances emerge against the group task, expressed by insufficient study and the reappearance of objections that seemed to have already been solved. The group works better during the paranoid moments: at least there is something or someone to fight with. 1.3 Third stage (sessions 9–11): Starting from the concept of an 6 ‘epistemologic break’ , the theme of change in the group comes to the fore. There is a new aperture for thinking, though a rather timid one. The discussion widens to include ideological, philosophical, political and even religious problems. 1.4 Fourth stage (sessions 12–15): Psychoanalysis appears in the reading material for the first time, in Freud’s voice, and the conflict between freedom of thought and submission to authority becomes central. The group is torn by ambivalence towards the idealized object Freud–psychoanalysis–AMPAG, and this is reinforced by various institutional events

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(AMPAG’s General Assembly, meeting with the director of the Institute). The group is now centred on the coordinator, who is the depository of (and countertranferentially assumes) the role of the defender of the external task (the reading material) and the only one who questions established knowledge. This would seem to be a group of fearful children with an audacious adult leader. The subject of the members’ professional identity comes to the fore. 1.5 Fifth stage (sessions 16–18): The dependent relation with the coordinator is finally analyzed, after an very explicit expression of the group’s interest in him as a person, and there is a reorganization of the group, which becomes group-centred. Now the coordinator’s lengthier interventions are felt as a nuisance, while before they were anxiously expected. He understands this and lets the group work alone. We discover and overcome the dissociative mechanism of placing emotional experiences in one of the two courses that the whole group is taking, and the intellectual aspects in the other. There is the suggestion of a new synthesis that leaves aside both experiencing the methodology of science as a norm or a threat, and the manic denial of the awareness that there actually are methodological problems in psychoanalysis. There is an acceptance of the fact that there is much work to do, and that we are at the beginning of a path whose end we can neither glimpse nor imagine. There is a reappearance of the terms and concepts that had been acquired at the beginning of the course. It seems that there has been a de-idealization of psychoanalysis, as well as of the institution and the coordinator, and this allows the members to finally express gratitude towards the latter. The subject of the members’ identity appears to have lost its urgency. The paranoid anxiety about the evaluation has apparently lessened, and the members accept the re-individuation of a personal evaluation.

As this text was read during the nineteenth session, it is unavoidably incomplete, since there is no mention of the sixth stage (sessions 19–20), that of evaluation. In Gregory Bateson’s (1953) terms, the conversation was not over yet, so that we could not see its full outline. We shall include the summary of these two sessions in subsection on evaluation below, but now we shall continue with the rest of the present document.

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2. Evaluation of the external task: There was less work than what had been expected. It seems that there was an excess of reading material, that did not take into account the time needed for the working through of the group process. Perhaps in a future course the bibliography should be shorter. Nevertheless, the programme was respected and all the papers were read, even though their discussion in the group was not always as deep as we would have wished. 3. Evaluation of the group’s relation to the task: This observed the following dialectic process: 3.1 Thesis: Fear of the new (epistemology), which is felt as a threat for what is already known (psychoanalysis). 3.2 Antithesis: Relief at re-encountering psychoanalysis as a science, together with a denigration of epistemology. The scientific status of psychoanalysis is conceived as something that has been acquired once and for ever, and that does not require any further work. 3.3 Synthesis: Discovery of the potentially scientific status of psychoanalysis. There is much work to do in front of us, and it is necessary for us to at least acquire information about the contributions of many other disciplines. 4. Evaluation of the group’s relation with the coordinator: This relation had three moments, which shall be presently described in chronological order: 4.1 Distrust: He is a representative of the Institution. He is here to indoctrinate. His lack of responsibility generates chaos. 4.2 Dependence and ambivalent idealization: He is the defender of the task. He is the only one who is allowed to question established knowledge but, at the same time, he is criticized as being responsible for whatever the group does not accomplish. 4.3 Recognition and integration in the group as a human being: The group no longer works against the coordinator, nor does it follow him, but it works with him, including him. There is an affective recognition of his work. 5. Evaluation of the group’s relation with the institution: This was pervaded by a basic paranoid situation, as a result of the ambiguity of the students’ insertion in the institution. They were neither inside nor outside, and they felt that they had to be mindful of their behaviour, and even hide their true thoughts, in order not to be excluded and expelled. This was reinforced by several institutional situations in which they felt excluded from the

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relevant information (a general assembly that enforced a suspension of classes, of which they knew nothing and which they could not attend; being called to meetings with the Director of the Institute, without any previous knowledge of the reason for them). Sometimes, the imminence of these events seriously disturbed the group’s task, but most of the time, however, it was possible to continue working, while recognizing the existence of such disturbing factors.

As can easily be inferred from the previous considerations, our interpretation of the group process is that it followed an evolution from the initial, confusional situations to schizoid-paranoid moments, and then to depressive-integrative ones. This is related to the subject of the macro-mournings in the development of the group. Such mourning was, of course, obvious at the group’s closure – i.e. the two evaluation sessions that were not included in the previous report. Since we believe that the final evaluation is particularly important for a good termination of a group, we shall describe it in the following subsection.

The evaluation Whenever one teaches a course in an academic or training institution, the evaluation is a formal obligation. We believe, however that it is also an indispensable stage in the closure of any operative group, so that we use it equally in our private groups. Nevertheless, there is a difference, as we usually do not include an individual evaluation when there is no institutional requirement, but only a group evaluation. It was only during this experience that the coordinator felt that perhaps there was no contradiction between an individual evaluation and the group-centred conducting of an operative group. A) THE GROUP EVALUATION

The evaluation was defined in the programme as follows: ‘[…] this is the conjoint discussion and appraisal, by the coordinator and the group members, of how the group functioned, to what extent did it fulfil its task, and what has each of the participants contributed to it.’ At the end of the eighteenth session, the coordinator told the group members that each of them should bring his evaluation in writing, to be read at the beginning of the next meeting. This procedure is meant to ensure that

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the members bring to the group what they thought about the experience while alone. When the evaluation is only oral, each member’s contribution is inevitably influenced by what others have said before. The coordinator was also bound to bring a written evaluation (included in the previous section), and this was read after the students had read theirs. At the beginning of the nineteenth session, there was some discussion about whether there should be a report of that session, or not. Finally, the coordinator offered to do it, so that the members could have greater freedom to participate in the evaluation. After the closure of the group, he also wrote a brief summary of the evaluation stage, which was included in the copy of the evaluation documents that were later given to every one of the students. This summary went as follows:

1.6 Sixth stage (sessions 19–20): This stage corresponds to the evaluation sessions. In these, the general climate is calm, with the feeling that everyone is taking quite seriously the arduous duty of appraising what has been done. In the first of these two sessions, each of the members of the group reads his evaluation of the course, the group, the coordinator, and himself. (A summary of these evaluations, made by the coordinator, is included below.) Then, the coordinator reads his evaluation of the group, which is approved. In the last session, the coordinator explains the criteria he has used for the individual evaluation of the members, and then reads it. The members agree with and validate this evaluation. In the last few minutes, several of the members express their satisfaction about this shared evaluation, which does not lessen in any way, from their point of view, the degree of commitment that has been kept during the whole course.

This brief summary does not really convey the emotional climate of these meetings. It was a mixture of earnest dedication and a quiet sadness. The coordinator’s feelings were quite similar, and he experienced the intellectual and emotional effort of carrying out this evaluation as an essential part of the mourning process for the termination of the group. The effort was even harder when dealing with the individual evaluation, but before reporting this last part of the work, we shall include the summary that he wrote of the members’ evaluations, which were read in the penultimate session.

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SUMMARY OF THE EVALUATION MADE BY THE STUDENTS This is a summary, written by the coordinator and approved by the group, of the evaluations that were individually presented by all the group members. In these, there were seven themes, to be described as follows: 1. The contents and the setting of the course: The goals had been well determined from the beginning, and they were accomplished. The reading list was comprehensive and its sequence was systematically planned. The content of the readings stimulated both anxiety and cognitive interests. The course was focused more on epistemology than on methodology. Some of the members feel that there was a over-evaluation of their previous knowledge, and that this course could be understood better if it were preceded by a introductory course on philosophy. The material seemed hard and cold at the beginning, but afterwards it gradually turned more comprehensible. 2. The coordination technique (operative group): The method was useful and systematically applied, but it induced a great deal of anxiety. The members’ opinions are divided between those who feel that this level of anxiety was both unavoidable and productive, and those who feel that a somewhat lower anxiety level would have been more profitable from a cognitive point of view. There is a general agreement that, in this method, maturation prevailed upon concept formation. One of the members feels that the method was confusing, on account of the admixture of teaching with analysis. At some times, the members felt an emotional overload, as they were having, in the same day of the week, two groups that were being coordinated with the operative group technique. One possible liability was that there was no attempt to induce the silent members to participate. 3. The coordinator: His actions were consistent with the goals that had been stated in the programme. At the beginning, he kept an aloofness and mystery which were quite similar to the analytic attitude, and this was felt, and sometimes suffered, by the group. Afterwards, his participation increased, and he was felt to be integrated with the group, although one of its members feels that his excessively detached attitude unduly restricted his contribution to the very end. 4. The group: In the beginning, it was a very competitive group, where everyone cared only for himself. Then it began to gradually integrate, until it became a strong and cooperative group, which was pleasant to work

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with. There is a feeling that some of the problems that had to be faced were generated by ambiguous communications that were received from the institution. At the present time, the members feel that they belong more to the group than to the institution, and this is explained by the ambiguity of their present situation (neither inside nor outside), and by their personal uncertainty about whether they will be accepted for training, or not. 5. Personal participation: Every member of the group has felt a deep commitment with the course, both in the affective and the cognitive areas. They all agree that they have experienced intense anxiety during the process, and most feel that their relation with psychoanalysis entered a crisis. This crisis was solved, however, by reaching a new relation of de-idealized respect for psychoanalysis, and a realization that there is still much to do in order to consolidate the scientific status of this discipline. At the beginning, they felt a compulsion to exhibit their knowledge, in order to ensure that they would be accepted for training, but this subsided as they became integrated in the group. 6. The results: The experience of this course was useful to stimulate their wish to do research on the bi-personal analytic situation, both in and out of the sessions. It fostered self-critique and the systematization of one’s own thinking; it emphasized the need for studying and keeping an open mind towards all contributions, especially those that are new or come from other disciplines, and also the need to be aware of ideological distortions. Basically, it left many questions open for future clarification. 7. Recommendations: 7.1 To keep the course. 7.2 To move it to the first year of training. 7.3 To have a previous introductory course on philosophy. 7.4 To divide it in two semesters: the first for the study of epistemology and the second for methodology. 7.5 To introduce a methodological course in every one of the semesters of training. After the initial course, this would be used as a space for working though the theoretical material that had been studied in other subjects, finally turning into a self-teaching workshop for the development of their theses, as a practical research work.

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B) THE INDIVIDUAL EVALUATION

Having completed the group evaluation, the coordinator had yet to face the individual evaluation. As we have already noted, he was rather reluctant to do it, and did not quite know how to tackle this task. He felt that doing this kind of traditional academic evaluation was somewhat opposed to the whole concept of operative groups. He therefore told the group, at the end of the first evaluation session, that he had some difficulty in doing the individual evaluation, and asked the students to help him with this duty. But afterwards he understood that his resistance was not due to an intellectual difficulty or to an ideological conflict, but that it had a powerful emotional charge. This insight helped him to take the decision of fully assuming his responsibility as a teacher to evaluate the individual members of the group. The Institute was asking him to evaluate the following items: attendance, punctuality, interest, participation, responsibility, clinical capacity, knowledge and learning. Therefore, his first task was to find an operational definition of these terms. ‘Attendance’, ‘punctuality’, ‘interest’ and ‘participation’ were easy to define. He then defined ‘responsibility’ as ‘perceived dedication, both in and out of the sessions’; ‘clinical capacity’ was characterized as ‘degree of insight in the group dynamic situation’, as there was no other way to measure this; ‘knowledge’ became ‘information shown in the discussion, other than that offered by the readings’, since the measurement of study was included in ‘responsibility’, and finally ‘learning’ was defined as ‘quantitative and qualitative changes in participation, from the beginning to the end of the course’. The next step was to evaluate the group according to this scheme, since the coordinator felt that an individual evaluation would be meaningless if it were not related to the group in which the individual accomplishments took place. For instance, it is not the same for an individual to show poor punctuality in a punctual group, as it would be if he were in a non-punctual group. The quantitative key provided by the Institute included the following grades: ‘very good’, ‘good’, ‘average’ and ‘bad’. The group evaluation, therefore, went as shown in Table 4.1.

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Table 4.1 Evaluation of the group Attendance

92% VG

Responsibility

G

Punctuality

G

Clinical capacity

G

Interest

VG

Knowledge

G

Participation

G

Learning

VG

Before he started to evaluate each member of the group, the coordinator studied all the items, in order to decide which of them should be taken as group scores, and he decided that ‘interest’ and ‘learning’, both graded as ‘very good’, were really evaluating the behaviour of the group-as-a-whole, and therefore assigned this grade to every student. The rest of the scores were decided in terms of whether an individual had functioned at the same level as the group, below that level, or above it. He then added a few qualitative comments about the type of contribution and the role played by each one. We include in Table 4.2, as an illustration of the procedure, the comparison between two of the students, called ‘A’ and ‘B’.

Table 4.2 Individual evaluation Group

‘A’

‘B’

Attendance

92% VG

100% VG

95% VG

Punctuality

G

G

G

Interest

VG

VG

VG

Participation

G

G

G

Responsibility

G

G

VG

Clinical capacity

G

VG

G

Knowledge

G

G

G

Learning

VG

VG

VG

Comments: Student ‘A’

Participation is average, but pertinent. Reflective role.

Student ‘B’

Good participation at the beginning; he then played the role of the silent member.

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We have described the procedure in detail, partly in order to show how the coordinator solved the problem of having to evaluate the group and the individuals at the same time, and partly to convey the difficulties involved in this task. When the coordinator had to read these personal evaluations to the group members, he felt a clear emotional resistance, which he could only master by accepting a certain amount of emotional suffering. This observation, together with his impression that this individuated evaluation had helped in the working through of the final mourning for the end of the group, made him think that these difficulties were really a counter-resistance (Racker 1958). In other words, he was at the time, as a result of the institutionally assigned role that he was playing, the spokesman for the whole group’s resistance to experiencing the mourning that corresponded to a re-individuation process leading to the final separation (Ferschtut 1969). This experience made him change his previous opinion about individual evaluations in operative groups, starting to consider the possibility of using these evaluations as an aid to the re-individuation process.

Discussion We shall now deal with our initial question about whether the results justify the use of the operative group approach for the conducting of learning groups. In this case, we believe that the Institute’s goal of fostering the students’ interest in the study of the methodology of research in psychoanalysis was fully accomplished. The students’ personal goals had been partly achieved, since they learnt, at the same time, more and less than what they had anticipated, having to change some of their expectations on the way. As to the coordinator’s expectations, he felt that they had been fulfilled, in spite of the limitations of the purely intellectual work that he noted in his evaluation. All the members of the group agreed that his objectives had been met, although some of them questioned whether they were fully desirable. But, which were these objectives? It must be quite clear by now that the coordinator’s main aim was not to impart information, but to induce what Balint (1957) called a ‘limited but deep change’ in the personality of the members that may open the way for thinking in new terms. Susanne Langer (1942) has suggested that what characterizes every age in the history of philosophy (and every discipline of human knowledge, we would add) are their ‘preoccupations’ – i.e. whatever problems people consider to be speakable and to have a meaning. These find their expression in the technique used for posing questions. This is what

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Germans call the Zeitgeist, the spirit of the time, and it is clearly related to the Weltanschauung, as Langer clearly states: The ‘technique’, or treatment of a problem begins with its first expression as a question. The way a question is asked limits and disposes the ways in which any answer to it – right or wrong – may be given… These are natural ways of thinking. Such implicit ‘ways’ are not avowed by the average man, but simply followed. He is not conscious of assuming any basic principles. They are what a German would call his ‘Weltanschauung’, his attitude of mind, rather than specific articles of faith. They constitute his outlook; they are deeper than facts he may note or propositions he may moot. But, though they are not stated, they find expression in the forms of his questions. A question is really an ambiguous proposition; the answer is its determination. There can be only a certain number of alternatives that will complete its sense… A philosophy is characterized more by the formulation of its problems than by its solution of them. Its answers establish an edifice of facts; but its questions make the frame in which its picture of facts is plotted. They make more than the frame; they give the angle of perspective, the palette, the style in which the picture is drawn – everything except the subject. In our questions lie our principles of analysis, and our answers may express whatever those principles are able to yield. (Langer 1942, pp.1–2)

But not only a philosophy, but also any discipline of thought has its own principles of analysis, which should be acquired and mastered, if one is to become a part of this discipline. This is equivalent to ‘learning the music, rather than the words’. Such problems have been studied by Thomas S. Kuhn (1962, 1977), who suggested that every scientific discipline is based on an agreement, among the members of its community, about what sort of questions may be asked, how they should be formulated, what kind of procedures are acceptable in order to find an answer, and, above all, what sort of questions should never be asked. This set of agreed assumptions he calls a ‘paradigm’, and he proposes that the advancement of science lies in periodic paradigm shifts, what he calls a ‘scientific revolution’. Therefore, learning a new discipline of thought can never be only a question of acquiring information. Just as it is not enough to learn a vocabulary in order to be able to speak a new language, getting information about a discipline is not enough in order to really incorporate it. Even learning logic and mathematics is more than acquiring techniques for problem-solving. What has to be done is to learn to think in the language of the new discipline, and this is a question of understanding its problems, rather than learning its answers to them. In the case of the group process we have just

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described, it was a question of the students starting to think in epistemological terms, rather than learning about the various schools of thought about scientific knowledge. Operative groups are an opportunity for their members to ‘learn the music’ of the discipline they are studying, as they demand a permanent revision of their own assumptions and ‘principles of analysis’, as well as of those that underlie the reading materials. It is an attempt to help them to ‘learn how to think’ and ‘learn how to learn’. As we have already shown in Chapter 2, operative groups are not a kind of groups, in terms of their goals, but a perspective, a way of thinking about groups and acting in them, and a set of values about what constitutes a better way of living and working in human groups. Therefore, the question about the convenience of approaching learning groups with the operative group technique is not empirical, but ideological; it is a question of what kind of learning process one considers to be desirable, and this depends on the conception of the world and the values of whoever is making the choice. This is why, even though all the students agreed that the group had been adequately conducted in terms of the goals set by the coordinator, their opinions were divided on the question of whether these goals were or not desirable. There is still one last episode in the story of this group. A few months after the course was finished, in October 1978, the coordinator read, in a scientific meeting of the Mexican Analytic Group Psychotherapy Association, the paper on which this section is based. Most of the members of this group were in the audience, as well as other teachers, students, and members of the institution. Consequently, the discussion of the paper also represented a final working through and closure of this experience for those who had participated in it, as the former members of the group communicated and reflected on several of their personal experiences during the course. We believe that, just as the author’s reflections and comments must have been an effective feedback for the group members on their perceptions of the coordinator during the evolution of the group, their comments also were a feedback for the latter on what he had perceived in them during the course. It was truly drawing the outline of a conversation after it has finished. Besides, we believe that it is an ethical imperative for any group analyst who is carrying out a research on a group that he is working with, to give back to the group anything that he has learnt from them, so that they may either use it or discard

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it, but mainly in order that they may discuss it further with the analyst and help him revise his understanding of what he has shared with them.

On workshops and laboratories As we have already mentioned in the introduction to this chapter, this kind of group is also useful for social research. We shall therefore include an example of it in the section ‘The use of operative groups in social research’, in Chapter 6. Nevertheless, in this section we would like to discuss a few aspects of the technique used for the conducting of such groups.

The workshop as an operative group A workshop is a single learning group experience, lasting several hours, that usually takes place in an institution or in the context of some congress or conference. The subject and nature of this group is made public, and people register for it, or simply drop in at the time. There is therefore no attempt to select the members of the workshop: the coordinator or coordinating team must make do with whoever happens to come. The term ‘workshop’ is chosen to imply that attendants are expected to actively participate in a discussion or practical work of some kind, instead of passively listening to a learned conference. When a workshop is conducted as an operative group, the coordinator usually starts by stating the problem or question that the participants are to tackle as a group. He also explains the sort of group work that he is proposing. The next step is to ask the members to express their views on the subject. Usually he only receives an apathetic silence as a response, so he has to do something to get the discussion going. He may question them again and try to instil some enthusiasm in them, as in traditional teaching. On the other hand, if he has been trained in operative groups or group analysis, he may make some group interpretation of this initial resistance. In many of our workshops we use some exercises to break the ice and set the discussion going. For example, if the subject is rather intimate or anxiety-provoking, we may ask all the members to write their thoughts on a nameless paper and drop it in a bag. Afterwards, we randomly take a few of these papers from the bag and read them as anonymous group expressions on the subject. This is usually enough to start an interaction. Some workshops take only two or three hours; others may last a whole morning or afternoon, a whole day, or even a day and a half. The shorter workshops tend to be cognitively oriented, while the longer ones usually

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include some kind of emotional experience. When we are dealing with some delicate and conflictive matter, such as ‘Gender identity’ or ‘The crisis in the couple’, we prefer to have a two-stage design. An ideal timetable for this kind of work is to have a five- or six-hour afternoon meeting and a briefer two- or three-hour one the next morning. This allows us to use a more experiential technique in the first part, and lead a more cognitively-oriented work in the second one. This aids the closure of the group, thus ensuring that the members do not go home in a troubled emotional state. The inclusion of a night’s sleep in between the two parts of the workshop helps in the working through of any traumatic aspect of the experience. When this is not possible, on account of limitations of time and space, or of the organization of the conference in which the workshop is included, we sometimes manage with a single-day, two-stage design: a four- or five-hour period during the morning, a two-hour break for rest and a meal, and a second two- or three-hour closing session in the afternoon. When we are forced to do a single-stage three- or four-hour workshop, we just change the subject in order to allow a more cognitive approach. These precautions are intended to ensure that no one is harmed by the experience, since, as there has been no previous selection, we sometimes find some very sick people in a workshop. In such cases, it is easy to get some rather impressive regressive phenomena. This makes a good show, and has been exploited by some non-analytic therapists in public demonstrations of their techniques, but it may be dangerous for the people involved, and we consequently feel that it is unethical to induce psychopathological phenomena that one cannot possibly contain in such a brief intervention. Therefore, whenever we use an active technique for mobilizing emotions, we only do it after evaluating the group and its members by means of a less exacting task. We also select exercises that aim at mobilizing the group, but not its individual members, and we interrupt them, shorten them, or change their course whenever we detect that some of the participants are being unduly disturbed. We also believe that every nonverbal exercise must be followed by an extensive analytic discussion, in order to help the group proceed from the experiential stage to the conceptual-reflective stage. To give a brief example of our way of working in these groups, we shall recall a workshop on ‘The crisis in the couple’, which took place during a National Psychoanalytic Congress of the Mexican Psychoanalytic Association. This conference met in a city in the interior of the country, and was attended by colleagues, students, and general public from several areas. We

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had some thirty-five people for the workshop, and we were working in a large room. So we started by asking them to move aimlessly around for a few minutes. Then we told them to choose a partner for an exercise. There was a transitory confusion, but soon they had settled in pairs. There was, however, one young man who had been left out, since there was an odd number of participants. We asked him to choose one of the couples to make a threesome, and so he did. Then we asked them to spread all over the room and have a conversation with their partners, in which each of them would tell the other about him- or herself. We gave them fifteen minutes for this. When the time was up, we asked that each pair or threesome should report on their conversation in a particular way: each of them would introduce the other, according to what she or he had heard. The person who had been so introduced would have the opportunity to clarify or add some important point once the first one had finished. As the pairs gave their reports, all of us began to notice some striking similarities between the two members of each one of them. Some of them were almost eerie, as in the case of two young women: both were twenty years old; they had the same name; they both studied psychology at the same school, even though they had never met, since one of them had her classes in the morning and the other one in the afternoon; they were both single children, and they both had a dog, which happened to be of the same breed! Another case was that of an epileptic youngster who had paired with a young woman who had felt guilty all her life because she had an epileptic younger brother and her mother had always blamed her for that, since she believed that the disease was the result of her having dropped the baby when she was five. But the most impressive example was the threesome. When we asked them to do the introduction, the two women introduced each other, and the young man was left out again! We pointed this out and asked that the women introduce their male partner. We then found that he was an illegitimate child, and that his father had never wanted to see him. This experience, a modification of the ‘family systems exercise’ used in the training of family therapists (Skynner and Cleese 1983, pp.17–20), shocked the group, and opened the way for a prolonged discussion on why and how do couples come together in the first place. This discussion was coordinated as an operative group – by pointing out to the participants their underlying assumptions, highlighting the frequently unnoticed ideas that emerged from the discussion, and interpreting the emotional obstacles that hindered their thinking. During such theoretical discussions, one of us usually takes notes and tries to draw an organizing scheme of the ideas that are being put forward by the

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various group members, emphasizing those that have been stated on several occasions and by different people. When the ardour of the debate subsides, he submits his scheme to the group, in an attempt to ‘draw the outline of the conversation’ up to that point. When there is a blackboard available – which was not the case in this workshop – he draws the scheme on it and leaves it there, as a reminder and reference for the next stage of the discussion, which usually takes the form of a reflective analysis of the first stage – i.e. a metacommunication about the group’s thinking processes. This technique of summarizing in a structural scheme the evolution of the group’s discussion constitutes an attempt to neutralize and compensate for the lack of memory that is usually found in groups. Alejo Dellarossa (1979), one of the group coordinators who worked with Pichon-Rivière in the Rosario Experience and who was a teacher to one of us, analyzes this peculiar phenomenon and his use of the backboard technique in his book Reflection Groups, in the following terms: I have been thinking for some time that groups function with a peculiar lack of memory. This I have observed in therapeutic groups and in various training groups: study groups, reflection groups, groups that meet in institutions for developing ideas or taking decisions, etc. Whoever takes part in a group is submerged in the group’s dynamics to such an extent that he loses the panoramic view of what is happening, and therefore also the notion of the sequence and the articulation of events. The group therapist or coordinator, after observing what is happening, may include in his contributions not only his explanation of the moment of the group that has just happened, but also those successive contributions from the group that he took into account in order to construct his intervention. In these cases, he is handing back to the group, together with the clarification of a given situation, some information about his own way of de-codifying the messages that he received, and of constructing his conclusions. …a part of [the meeting], for instance, its final minutes, should be dedicated to reviewing the sequence of events. This behaviour in coordinating implies taking into account that the group does not have, or only has a very limited capacity for keeping a memory of the successive events, and therefore cannot make a conscious synthesis of them. The final totalizing feedback by the coordinator would be a way to compensate this incapacity; in other words, the group coordinator is the depository of these functions that the group cannot assume, and proceeds to give them back to it, with his final synthesis, in a plastic image of everything that has happened. (Dellarossa 1979, pp.130–131, our translation)

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This need to contain the regressive group process within the bounds of a more detached reflection about the group experience has prompted us always to initiate our workshops with a brief contract stage, in which we discuss what we are going to do together, before starting to do it, and end them with an evaluation, in which we discuss and reflect about what we have already done. Going back to our workshop, by the time we felt that the discussion about the results of the exercise had somehow closed, more than two and a half hours had gone by. We therefore suggested a fifteen-minute break, which turned out to be a bit longer, as usually happens. In the second part of the afternoon, we decided to start with the notes-in-a-bag exercise. We therefore gave each member a sheet of paper and asked them to write about the crisis in their own couple. We emphasized that this information would be strictly anonymous, and that all these papers would be deposited in a bag, and read in random order. It is interesting to note that, in this exercise, the bag is much more than a technique to warrant anonymity, thus helping them to express personal situations and feelings that they would not have exhibited otherwise. The bag is also a symbol for the group: a larger container in which the members may deposit their personal worries and concerns, a melting pot in which what was individual and private becomes collective and public, in order to be shared and worked through. The fact that the coordinators take the individual communications as parts of a pool, as anonymous contributions from the group, conveys the idea that they are taking them seriously as indicators of a social phenomenon, and not as a personal deficiency or an intimate suffering. In this workshop the results were truly impressive. It was obvious that the group members were taking advantage of the anonymity granted to them by this technique, in order to express their deepest concerns about their relationships. The discussion was intense, and we intervened by summarizing and conceptualizing the various themes that emerged, as well as interpreting the anxieties and fears stimulated by the subject. We were also able to relate these personal concerns with its social implications, at a time in which the divorce rate is steadily growing in our environment. Of course, we were unavoidably aware of some of the members’ personal conflicts, which would have been obvious to any experienced clinician, but we never focused on them, and we would not have accepted an undue exposure of any member’s intimate life, since that is not the aim of such a workshop. Any concrete conflict that was mentioned or alluded to was taken

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as an instance of a collective and social situation. This fostered a detachment that cooled down the group’s mood. After almost three hours of this discussion, we summarized our findings, and called for a break until the next morning. When we met again, we started by asking them what they had felt or thought about yesterday’s meeting. Starting from their answers and comments, we went through a new reflection about what had transpired the previous day. This discussion was much calmer and allowed a clearer formulation of the members’ thoughts. After closing this new period with another summary of the various ideas that had been put forward, we had a very brief break and then went directly to the evaluation stage. In the evaluation, we asked the participants to give us their impressions about the workshop, what they had learnt from it, and whether their experience had been up to their expectations or not. One by one, they commented on the experience, and finally we closed the evaluation by giving them our own feelings and reflections on the work that we had shared. Then we said farewell. This last morning meeting took about two and a half hours. This is, of course, a very brief account of a workshop that took over eight hours, since we have not elaborated on the many themes that emerged in it. We believe, however, that we have given a fair picture of the way in which we coordinate this kind of group and the theoretical and technical assumptions that underlie our behaviour in this task.

The operative group approach to human interaction laboratories Human interaction laboratories were introduced by Kurt Lewin and his co-workers (Bradford and French 1948; Bradford, Gibb and Benne 1964; Mailhiot 1967). Lewin, who had suggested this experience and participated as a researcher in the first laboratory, held in the summer of 1946, died unexpectedly in 1947, not long before the second one met for three weeks in Bethel, Maine. The idea was to introduce an new and revolutionary method for the training of community leaders. This was done by combining the cognitive transmission of the concepts and theories of social psychology with an actual life experience in group living, which would give an experiential meaning to those concepts and help the participants to develop those areas of their personalities that take part in social interaction. This was a triple approach to learning, which included the intellectual apprehension of new knowledge, the emotional experience of group interaction, and the development of social skills through active practice. It is therefore obvious that

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Pichon-Rivière’s Rosario Experience was inspired by this early stage of the laboratory movement. The social interaction laboratory was conceived as an intensive group experience, lasting several days. This implied a residential course which kept the participants living together in a transitory social system, even in their free time. The design included lectures, discussion groups and other interactive exercises, such as sociometry or role-playing. The whole experience was coordinated and observed by a team of social scientists, who had their own group meetings in order to discuss the evolution of the laboratory and to make decisions about the next actions to be taken. In this endeavour, they were developing an instructional course and a research project at the same time, thus acting as participant observers. Later in the evolution of the laboratory movement, these experiences increasingly incorporated elements taken from the field of psychotherapy. This upset the balance between cognition and emotional experience, with an emphasis on the latter, and a decreasing interest in research. After that, the laboratory design was used by the encounter group movement (Cappon 1978). Nowadays, there are various types of laboratory: social training laboratories, like the original Lewinian design or Pichon-Rivière’s Rosario Experience; personal experience laboratories, which try to sensitize the participants to emotional experience and interpersonal contact; encounter groups, focused on interpersonal relations and fostering an emotional climate of communality and fellowship; marathon groups, which are similar to encounter groups, but using an accelerated interaction (24 hours without a break) in which fatigue helps to break down characterological and ideological resistances; and psychotherapeutic laboratories, which may be similar to the previous three, but which have an avowed therapeutic aim (Glocer 1972–73). Our own group-analytic approach is incompatible with purely experiential laboratories. We strongly believe that this kind of work should keep the balance among emotional experience, development of interpersonal and social skills, and verbal reflection about the events and the experiences that take place in the group context, and that the more intense experiences require a lengthier, verbal working through. We therefore limit our work in this area to conducting social training laboratories or psychotherapeutic laboratories, and always coordinate them as operative groups. We also believe that laboratories should never be conducted by a single group analyst but by a coordinating team, which may be only two in smaller

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laboratories, or rather numerous in the larger ones. This implies that a group is being treated by another group, as such a setting offers much greater capabilities for containment and working through. In any case, the members of the team make use of the necessary breaks between the sessions in order to meet in private, discuss what has been happening, work through their own emotional experiences, try to understand them, and plan the next steps to be taken. This is essential: we feel that a laboratory should be planned beforehand, but that this planning should be flexible enough to allow changes in sequence or direction, according to what is actually going on in the group. These team meetings are a must in the case of large training laboratories, in which the large group is subdivided into smaller discussion or experiential groups, each with its own coordinator or coordinating team. The coordinators of the various groups meet, share what has been transpiring in their groups, and try to fathom the evolution of the laboratory-as-a-whole. The conclusions of these meetings serve as a basis for further planning, and they are partly given as feedback to the participants in a large-group meeting of all who take part in the laboratory. Psychotherapeutic laboratories, in our practice, are usually smaller, and they meet in a single group with a co-therapeutic team. In these, we usually require that all the participants be in personal therapy, in either an individual or a group setting, and that they have the sanction of their therapists. We also use this kind of laboratory as an episode in the evolution of a standard group-analytic therapy group, in order to stir up character structures and stereotyped models of interaction, and deepen the analytic work. The boundaries between workshops and laboratories are rather hazy. Both include elements of emotional experience, development of skills, and cognitive learning. The use of the term ‘workshop’ is sometimes restricted to the more cognitive-oriented groups, but there are also experiential workshops. Perhaps the main distinction is that a workshop is usually shorter than a laboratory – not more than one day – and that it is frequently included in the context of congresses or other conferences. According to this usage, our two-day workshop on the couple could also be called a ‘laboratory’. But perhaps this discrimination is mainly academic, and it would be better for us to concentrate on the process and outcome of these interventions, rather than trying to classify them in any definite terms.

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Conclusions We have shown how operative groups may be used for a teaching–learning process. This is quite obvious in the case of certain studies that require a change in the student’s personality, such as, for instance, getting in touch with his emotions. They are also useful, however, in teaching rather abstract subjects, such as epistemology. Learning operative groups may either be a regular enterprise, with periodic meetings over an extended period, or they can be single-shot endeavours, such as workshops and laboratories. In any case, our work with these groups is always group-analytic, based on an understanding of the group process and the dynamics of the group-as-a-whole. We shall see, in the following chapters, how these principles are used in the coordination of groups with other goals.

CHAPTER 5

Training of Psychotherapists, Psychoanalysts and Group Analysts

The transmission of the analytic experience Ever since the beginning of psychoanalysis, one of the greatest difficulties in conveying its theories came from the non-transmissibility of analytic experience. Every scientific theory talks about non-theoretical happenings that constitute its subject matter and its ultimate test. Such events, which are not rational but real, are directly accessible to our understanding, and must therefore be accepted as true, even if they happen to be inconsistent with our theory. Whenever there is a contradiction between our findings and whatever our theory had led us to expect, we should revise our theory. This is the gist of scientific research (Popper 1959). These primary data, whose truth is established by the mere fact that we have a direct access to them, without any further discussion, are called ‘givens’ (Schlik 1932–33); Popper calls them ‘basic statements’. But where do these unquestionable statements come from? In the logical positivistic interpretation of natural science, these are to be found in sensory perception, which is assumed to be accurate and common to all human beings. But perception is a highly subjective matter, as can be readily shown in the case of illusions and hallucinations, so that it becomes essential for various observers to compare notes in order to check if they are actually perceiving the same things. This is the requirement of intersubjectivity, which rules over the scientific endeavour. When such precautions are taken, we are no longer concerned about whether two people truly have the same subjective experience when the say that ‘the sky is blue’. It is only necessary to ensure that they both use the word 141

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‘blue’ when looking at the same sky. But what are the givens in the case of the psychoanalytic or the group-analytic experience? It is certain that in these inquiries we are dealing with concrete and immediate experiences that have no sensorial content. Bion has pointed out this peculiarity of the psychoanalytic method, in the following terms: Physician and psycho-analyst are alike in considering that the disease should be recognized by the physician; in psycho-analysis recognition must be made by the sufferer too… The point that demonstrates the divergence most clearly is that the physician is dependent on the realization of sensuous experience in contrast with the psycho-analyst whose dependence is on experience that is not sensuous. The physician can see and touch and smell. The realization with which a psycho-analyst deals cannot be seen or touched; anxiety has no shape or colour, smell or sound. For convenience I propose to use the term ‘intuit’ as a parallel in the psycho-analyst’s domain to the physician’s use of ‘see’, ‘touch’, ‘smell’, and ‘hear’. (W.R. Bion 1970, pp.6–7, our italics)

This certainly creates some problems, both for discussing the findings and theories of psychoanalysis with other scientists and epistemologists, and for the teaching of this discipline. It just does not work to tell people that our knowledge is based on ‘intuition’. There is, however, a parallel with what happens in the case of the ‘hard’ sciences. Mere perception is never enough as a basis for scientific observation. The latter always implies observation by trained observers. Those of us who have studied medicine know well how difficult it was to learn to identify a microscopic preparation, or a heart murmur. To see, hear or touch, yes, but by a trained eye, ear or hand. So, a psychoanalyst, a psychotherapist or a group analyst needs to be trained to adequately perceive – to ‘intuit’, in Bion’s terms – the sort of phenomena that take place in their own particular field. And how is this done? Exactly in the same way that medical students are trained to look through the microscope: someone has to explain to them what they are supposed to see, show them the correct image, and patiently stay with them until they manage to discover the perception that is being taught. The fact that not everyone is able to learn such skills has never hindered their teaching at medical schools. Of course, our field is even more complex, perhaps, since it is not the case of learning new perceptions through the use of the well-known sense organs, but of entering another realm of knowledge, that of emotional experience. Sándor Ferenczi was the first analyst to emphasize the role of experience in psychoanalytic knowledge. For him, the only sound basis for conviction

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about the discoveries of an analysis, for both the patient and the analyst, was to be found in what he called the ‘psychoanalytic experience’. This was first and foremost an emotional experience, which only afterwards was to be subject to painstaking analysis, in order to give it a meaning (Ferenczi and Rank 1922). His chosen field of observation therefore covered both parties of the analytic situation, as well as the whole of the patient’s environment. This he explains as follows, in his book on The Development of Psycho-Analysis, written with Otto Rank: The therapy itself, therefore, seems to rest on a kind of ‘knowledge’ which would thus itself be closely related to theoretic knowledge. But just psychoanalysis could for the first time clearly show that there were, so to speak, two kinds of knowledge, one intellectual, the other based on a deeper ‘conviction’; the clear cut distinction between these two, particularly in the sphere of psycho-analysis, must be considered among the first and strictest requirements. This appears to be one of the reasons why psycho-analysis lays claim to a peculiar position, for here ‘plausibility’ and ‘logical necessity’ do not suffice as criteria of truth, but rather a direct perception or the experience of the problems in question is necessary in order to be convincing. (Ferenczi and Rank 1922, p.45)

This need for the student to acquire a first-hand experience in the workings of his own unconscious led to the practice of the so-called ‘training analysis’. This offered him the opportunity to experience in himself those givens that would later fill the theoretical concepts of psychoanalysis with an emotional meaning. Bion, for example, ascribes his clear understanding of the Kleinian theory of projective identification to the fact of having been analyzed by Melanie Klein. During one of his New York Lectures of 1977 he answered a comment about his having clinically applied the concept of projective identification better than any other author, by saying: ‘It may be because of the advantage of being analyzed by Melanie Klein and having the experience of being told, “You are doing it”’ (F. Bion 1980, pp.50). Perhaps some of us might take exception at this overtly theoretical interpretation, but the example still shows that psychoanalytic concepts are only truly understood when they converge with an actual emotional experience. And this should be the main goal of the training of psychotherapists, psychoanalysts and group analysts. Michael Balint (1957), who had been analyzed by Ferenczi and worked afterwards with him, developed in the Tavistock Clinic, during the 1950s, a special method for teaching psychotherapy to medical practitioners. He was

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painfully aware of the uselessness of just giving information to the doctors – what Ferenczi called ‘mere knowledge’. To him, the basic mistake of the informative courses on psychotherapy was that they ignored the fact that the development of a psychotherapeutic capacity did not only consist in learning something new, but also unavoidably implied a certain limited, although at the same time considerable, transformation of the physician’s personality. In order to accomplish such a goal, he found an inspiration in the psychoanalytic training system, ‘the only systematic course for teaching psychotherapy’. He especially drew from the ‘Hungarian model’ for such training, which specified that the student’s first supervision should be conducted by his own analyst; this was intended to allow a full analysis of his countertransference. Therefore, in his training groups, the physicians told of their experiences in their relationships with their patients, and the conductor and the group analyzed the transference–countertransference process that evolved between them. There was no attempt to interpret either the therapist’s personal conflicts that determined his countertransference, nor the transference towards the group conductor. This training model certainly offered the students ample opportunities to articulate the theoretical and technical concepts with concrete experiences. The coordinating technique was somewhat primitive, from our point of view, since it eschewed the interpretation of the members’ relationship with the coordinator and with the task, which we consider essential in order to remove the resistances to learning and change, but it represented an enormous step forward in the teaching of a psychodynamic outlook. Unfortunately, this path has not been followed by most institutes in charge of psychoanalytic education, although it has become frequent in those that train group analysts. Foulkes, who had been simultaneously working with an alternative technique for conducting a supervisory seminar, which will be discussed in the next section of this chapter, was also critical of Balint’s approach. His own seminar at the Maudsley Hospital was intended for psychiatrists and psychotherapists who were interested in learning to conduct therapy groups, and his approach was group-analytic. On this he comments: My own impression is that with Balint the use of the group situation was more or less incidental, whereas with the group I am talking about here it was the other way round. It was a teaching situation very consciously and precisely derived from the particular characteristics of that group situation. (S.H. Foulkes 1975a, p.169)

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Pichon-Rivière’s conception and technique were very similar. The use of operative groups in teaching psychoanalysis, psychotherapy or group analysis opens the way for an integral form of learning that includes both the cognitive learning of theories and techniques, and the experiential learning from the group members’ reflection on their own emotional experiences while approaching the task of acquiring such theories and techniques. This coordinating technique uses interpretations that articulate the manifest discourse of a theoretical group discussion with the latent content of the recreation and enactment of the deeper meaning of these theoretical contents, on the plane of the group’s unconscious fantasy (Tubert-Oklander 1982). This kind of group work might even help the psychoanalytic community to overcome one of the greatest obstacles that lie in the way of mutual understanding among psychoanalysts. If we accept the proposition that psychoanalytic theories are a way of accounting for the particular experiences that the analyst and the analysand share during the sessions, it follows that any two or more psychoanalysts who have had different experiences in their own analyzes would find it very difficult to understand each other, since they would be assigning diverse emotional meanings to the very same concepts. This would seem to be a veritable blind alley: we cannot teach psychoanalytic concepts unless we manage to relate them to the analytic experience; the only way to acquire an analytic experience is the personal analysis, but personal analyzes are highly idiosyncratic, so that it seems inevitable that the analysts’ understanding of their own theory would also be so. Bion (1962) commented thus on the difficulty in conveying his analytic experience: I have an experience to record, but how to communicate this experience to others I am in doubt… For a time I thought of concentrating on analysis of trainees. I am confident that psycho-analysts are right in thinking that this is the only really effective method of passing on analytic experience that we have at present; but to limit one’s energies to this activity smacks of the esoteric cult… Nevertheless, I believe it may be possible to give some idea of the world that is revealed by the attempts to understand our understanding. (W.R. Bion 1962, p.vii)

Bion’s attempt to transmit his analytic experience was his writing of the book Learning from Experience. There are other ways, however, of sharing an experience, other than writing. In the analytic experience, both parties share a common emotional situation; they are therefore in a position to ‘compare notes’ of their respective renderings of their perceptions of one and the same situation. This would help them to develop a common dialect for referring to

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such experiences as ‘helplessness’, ‘fear of annihilation’, ‘envy’, ‘splitting’, ‘projection’, and so on (Tubert-Oklander 1982, 1999c). This agreement, however, is restricted to the analytic couple, and it would be difficult to share it with other people. Besides, the experience of an analysis with Bion must needs be very different from that of an analysis with Winnicott, Lacan, Hartmann or Kohut. What we need, therefore, is a method that aids us in reaching similar agreements among more people. The development of group analysis and operative groups has opened the way for sharing an analytic experience among more than two people and (when we use co-therapeutic techniques) also by two therapists or coordinators, or more. In such groups, all the participants share a common emotional situation, which is then interpreted by the coordinator and discussed by all of them. In the case of therapeutic groups, such discussion is used in order to intensify and deepen the emotional experience, while at the same time reflecting about it. In learning operative groups, the emotional experience is used in order to give meaning to the concepts and theories that are being studied, as in the case of the groups reported in the second section of Chapter 4. Perhaps, if this group approach were to be used in the training of analysts and therapists, as well as in the coordination of research and discussion groups which included analysts of different persuasions, this might help them to attain a better mutual understanding, in spite of their differences. 1

On group supervision

Supervision has been an essential part of the psychoanalytic training system since the founding of the Berlin Institute. The usual scheme for this system requires that the students follow a three-way path: 1) personal psychoanalysis, 2) theoretical seminars, and 3) clinical practice under supervision. In the Berlin model, the analyst and the supervisor must always be different. In the Budapest model, as we have already noted, the first supervision was always conducted by the training analyst. But the Hungarian model disappeared after World War II, and the Berlin model has become the standard. The reason for this is a moot question. Perhaps it is related to the western intellectual tradition that requires that learning and thinking should not be contaminated by emotion. This was the path followed by Descartes (1637). But another French philosopher, Blaise Pascal, wrote in his Pensées (1671), ‘Le coeur a ses raisons, que la raison ne connît point (The heart has its reasons, that Reason does not know)’, thereby implying that there is a logic of emotions, as strict and

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unbending as that of rational thought. Psychoanalysis would then be an attempt to articulate the reasons of the heart and the reasons of the mind. The supervision is perhaps the only part of the standard psychoanalytic training system that offers an opportunity for integrating theoretical concepts with actual experiences. The personal analysis is banned from such an exercise in concept formation and clarification, since it would promote intellectualization. The theoretical seminars do not, in their usual form, provide any direct experience that might give a concrete meaning to concepts. But supervision is, by definition, a space in which there is confluence of the student’s analytic experience with his patient, and the theoretical reflection that ensues between the supervisor and the analyst in training. Many supervisors also take heed of the complex transference–countertransference relationship that develops between teacher and student during the supervision, as it is well known that this relationship somehow mirrors the transference–countertransference that evolves in the treatment that is being supervised. This phenomenon has lately received the name of ‘parallel process’ (Caligor 1981; Doehrman 1976; Gediman and Wolkenfeld 1980). Nowadays the psychoanalytic training includes not only the classical individual supervisions, but also clinical seminars in which there is a continuous supervision of a case that is brought by one of the students. Such collective supervision might be regarded as a mere counterpart of the individual variety, with the exception that it includes other students who act as witnesses and learn from the suggestions that the teacher gives to their companion who is bringing the case. The supervisor may also invite the other members of the group to opine on the patient and the clinical material that has been provided, and this may be used in order to evaluate their clinical understanding and insight. Nevertheless, we believe that this way of looking at the supervisory group unduly restricts our understanding of the impact of the dynamics of the group on psychoanalytic (or psychotherapeutic) training. Even though the teaching of psychoanalysis makes systematic use of learning groups in its theoretical seminars, this has been applied as a merely circumstantial resort, without drawing the necessary theoretical conclusions about its dynamic implications for the teaching–learning process. In the case of collective supervision, the mere fact that it is being carried out in a group context has important consequences for 1) the learning process, 2) the students’ group, 3) their relationship with the teacher and 4) the evolution of the treatment that is being supervised. This demands the development of a specific theoretical approach for this kind of supervision (S.H. Foulkes 1964a,

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1975a; Moreno Corzo, Ramos de Moreno Corzo and Tubert- Oklander 1979; Tubert-Oklander 1990–92). This implies taking the fundamentally social nature of the human being as a starting point. As we have argued in Chapter 3, the isolated individual is only an abstraction, and we are always immersed in an extremely complex network of group, institutional and social interactions and affiliations, and a large part of our behaviour and subjective experience is derived from it. Therefore, any complete psychoanalytic inquiry should always include all these dimensions of human existence (Hernández Hernández 1994a; Hernández Hernández and Tubert-Oklander 1994; Hernández de Tubert 1995, 1997a; Tubert-Oklander 1995a; Tubert-Oklander and Hernández de Tubert 1996). In the beginning of psychoanalysis, Sigmund Freud certainly included in his clinical studies a painstaking study of the social and family contexts of his patients. This was particularly clear in the self-analysis of his dreams (Freud 1900), in which he highlighted the importance of his having been born a Jew in Austria, at a time in which the members of his religious and social group were at last able to aspire to high offices in social institutions. He also asserted, in Group Psychology and the Analysis of the Ego (Freud 1921) that only under exceptional circumstances may we study the individual without taking into account his relations with his fellow human beings. The later development of psychoanalytic theory focused, however, on the study of internal factors and mental processes, which were assumed to be a sufficient explanation of clinical phenomena. Nowadays, we know that the psychoanalytic situation is always bi-personal, so that it is not possible to fully comprehend it without taking into account the analyst’s total personality and its influence on the transference–countertransference field (Balint 1968; Tubert-Oklander 1997, 1999a, 2002a). But the standard version of psychoanalytic theory describes mental processes as if they were determined only by internal factors, disregarding the individual’s relation with his environment. In other words, it generalizes something that Freud qualified as very unusual when he wrote that ‘only rarely and under certain exceptional circumstances is individual psychology in a position to disregard the relations of this individual to others’ (Freud 1921, p.69). This omission has had very grave consequences for the practice and the teaching of psychoanalysis. Let us consider an example of this. There was, in a psychoanalytic training institute, a clinical seminar for all the students of the various generations that were in training at the time. This was conducted by two very experienced psychoanalysts, and the assigned task

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was to discuss the cases that were brought by the students. The first meeting of a term was uneventful. In the second one, two unannounced new students suddenly appeared in the class. They were two members of a previous generation, who had already completed their seminars. Such an unexpected change in the group’s setting was bound to disturb its functioning. Nevertheless, the two teachers started the class as if nothing new had happened. The result was much tension and apathy: the group members remained silent, without making any comment on the case that one of their companions was presenting. Finally, one of the students decided to make a comment about what was happening, and she suggested that it might be related to the presence of the two new students. Teacher A rapidly retorted that this had nothing to do with the class, and that what had to be done was to discuss the clinical material without further ado. Teacher B, instead, took heed of the suggestion and explained the reasons why they were there. Apparently the two students’ evaluation had not been fully satisfactory, so that the Teaching Commission had decided to require them to take one more term of the clinical seminar. This information relieved the tension in the group. There was, however, no attempt to explore the feelings of the two new students, nor of the rest of the group, about this difficult situation. Consequently, the two students remained silent during the whole term, and they never participated in the group work. How are we to understand such neglect of the dynamic processes that took place in the group? This is even more surprising, as these two seasoned analysts would never have acted thus in the context of a treatment. It seems that there is a striking split between the practice and the teaching of psychoanalysis. Any properly trained analyst will take into account the total situation of a session, and would never omit the exploration of the emotional consequences of an unexpected change in his office, the schedule, or any other aspect of the setting. Nevertheless, the very same analysts think and act in a rather naive way when they are playing the role of the teacher, and they expect that a radical change in the group, such as the unexpected appearance of two new students, should go unnoticed and not bring any consequences for the group’s task. It would seem that they are acting on the implicit assumption that emotional problems can only be dealt with in therapy, and that the teaching–learning situation should be ruled only by rational thought. Another underlying assumption is that it is possible to study a human

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phenomenon and carry on an interpersonal relational process, without regarding the context in which this takes place. There is no other way to understand the teachers’ attempt to go on with the class without paying attention to the many conflicts that were developing right in front of them. On the one hand, the two students who had failed the evaluation must have felt somewhat humiliated by having to repeat a course that they had already taken, and also angry at the powers-that-be for having imposed this obligation on them, as well as with the two teachers as their representatives. The regular students must have felt confused and suspicious at the inexplicable appearance of two former companions, who had already left the Institute. It is also possible that, after listening to the teacher’s clarification, they may have been alarmed by the possibility that something like that might happen to them, thus increasing the ever-present distrust of the authorities and the teachers. We do not know what the two teachers may have felt in such an anomalous situation, but their attempt at denial suggests that this also implied a conflict for them. Besides, this group was not operating in a vacuum, but was comprised in an institutional environment, governed by explicit and implicit rules, and the site of multiple personal, political and ideological conflicts. And all this happened in a cultural context – that of Mexico – in which there is an ancient tradition of not questioning acts of authority. There is no doubt, however, that this lack of concern for the dynamic group situation resulted in diminished attention paid to the case that was being presented. We do not know what the consequences were for the conduct of that treatment, but there certainly was a partial abandonment of the group’s intent. This is why it is so important to take into account all these factors, for a better development of the group task. This complex network is to be found in every human situation. It is surely impossible, and perhaps not even desirable, to verbalize all the factors that intermingle in this dynamic structure, but our training as psychoanalysts and group analysts should help us to discern this complexity, reflect on it, and use our understanding of the dynamics of each transient moment, to be able to act more reliably. Being an analyst is not something that can be restricted to our work setting; it is a whole way of perceiving and conceiving the human being, and this is revealed in every circumstance of our lives (Tubert-Oklander and Hernández Hernández 1993). If we accept these contentions, we shall no longer be content to teach psychoanalysis by means of the methods and relational models of traditional pedagogy. On the contrary, we shall have to develop a strictly psychoanalytic

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conception of the transmission of knowledge in our discipline. This would have to combine intellectual activity and the appropriation of concepts, the acquisition of those emotional experiences that give meaning to our concepts, and the development of that reflective capacity that allows an analyst to observe and understand himself while in the process of observing, understanding and relating to other human beings, who are at the same time observing, attempting to understand, and relating to him. The supervisory group contributes to this line of development of psychoanalytic education. When these seminars are conducted in terms of an understanding of the group context and process, they become a fertile exercise in that kind of reflective thinking that characterizes both psychoanalysis and group analysis. Foulkes developed an approach to this kind of work in his famous supervisory seminar on group psychotherapy at the Maudsley Hospital, which lasted fifteen years, from 1950 onwards (S.H. Foulkes 1964b, 1975a). Foulkes’s technique was introduced as an alternative to Balint’s seminars with general practitioners. Unlike Balint, he systematically used the group-specific factors in order to fuel the learning process. Although this was clearly not a therapy group, it certainly had a therapeutic influence on its members. As he conceived psychotherapy as a part of a ‘personal psychiatry’, which cannot be learnt or practised without involvement in a mutual process comprising therapist and patient alike, his supervisory group was also an emotional experience, as the active discussion disentangled the warp and woof of the transference–countertransference field. He deliberately confined the discussion to the interaction between the group therapist and his group of patients, sometimes also including the observer. The therapist’s disclosure of personal experiences in the group was not encouraged – even though it was accepted, if he was so inclined. Sometimes, however, such participation was discouraged, if it was not considered relevant for the group work. The same criterion was applied to the discussion of the member’s behaviour in the group: it was taken into account, but it was not unduly encouraged or allowed to become the group’s main preoccupation, as this is usually a resistance. This focusing on the group’s original purpose did not imply an intellectualized denial of affect. Quite on the contrary, the relations in the group were close and intense, as Foulkes clearly specifies in the following quotation: The tradition that evolved was that the reporting registrar was reporting to me as well as to his colleagues at the same time. His colleagues in turn participated freely and frankly, not only in the technical discussion but including

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very much the question of personal motivation, what in psychoanalysis is called transference and countertransference reactions. In this way the members of the group had a manifold and multifaceted opportunity to learn. This group became quite used to understanding very well and profoundly the deep connection of each colleague’s technique, approach, the atmosphere created by him, his reaction to special topics and to other people, and his own personal characteristics, with the purely technical activity with which he was manifestly concerned. (S.H. Foulkes 1975a, p.170)

In other words, there were no rigid norms about what was acceptable or not in the group; the litmus test was the answer to the question about whether any particular behaviour happened to be relevant for the work at hand. If it were so, it would be taken as a part of the process. Then, in Foulkes’ words, ‘everything fell into the right pattern and perspective as long as the conditions and functional purpose of the group was kept clearly in mind’ (ibid., p.171). In our own approach to the supervisory group, we pay special heed to the dynamic impact on the group’s emotional and defensive processes of the unconscious aspects of the material that is being presented. We are thus able to observe the impact that the therapist’s report of the case and the material from sessions have on every member of the group. Just as the emotional processes of the patient have a resonance on his analyst’s emotions, and vice versa, the complex unconscious interchanges that develop between them also have a resonance on all the members of the supervisory group, including the teacher or teachers. Sándor Ferenczi (1955, 1985) was the first psychoanalyst to identify and explore the complex emotional interchanges that took place between the analyst and his patient. To him, the minimum field of observation that allowed us a fuller understanding of what transpired in the analytic office comprised two people, not one. Thus he set out to record and inquire into his own intimate experiences vis-à-vis those of his patients, during the analytic sessions. This was the gist of his Clinical Diary of 1932. But the very same criterion can and should be applied to the supervisory relationship. In Mexico, Rubén Tamez-Garza (1963) described what he called ‘chain transference and countertransference reactions’. He showed, in a clinical vignette, that his reluctance to communicate to his patient an interpretation of his fear of madness was related to a corresponding fear in his own analysis. When the supervisor suggested that the fact that he had not turned his own associations about the patient’s dream into an explicit interpretation might be related to some conflict of his own, in the context of his training analysis,

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Tamez swiftly remembered that his analyst had interpreted the very same fear to him, a few days before. His denial and intellectualization of this interpretation led him to a complex defensive entanglement, in which his patient, his analyst and his supervisor all turned into persecuting objects. After gaining insight into this defensive manoeuvre and the underlying conflict, he was finally able to effectively interpret his patient’s fear of madness. It is a now a well known fact that the relationship between the supervisor and the supervisand tends to reproduce, as an echo, the unconscious aspects of the transference–countertransference relation that is evolving in the treatment. And a very important part of the supervisor’s task is to detect, analyze and understand these phenomena, and to share his understanding with the student. In the group situation, there is a remarkable expansion of the opportunities for the analysis and comprehension of these unconscious processes, since every one of the participants resonates with diverse aspects of the highly complex psychodynamic situation which is being studied, as a result of their different personal histories and particular sensibilities, experiences and knowledge. The end result is that the group can make use of multiple versions of, and outlooks on that fragment of the therapeutic relation that is being presented. If the group members are able to reach, with the coordinator’s help, an understanding of what emotional reactions this particular narrative induces in them, and if they find a way to synthesize this multifarious vision, they will have a much deeper and multidimensional comprehension, not only of the treatment that they are studying, but also of what psychoanalysis is and might become. This type of work frequently engenders a fear that the supervisory group might turn into a therapeutic group. If this were to happen, it would obviously be the result of bad management of the group, and it would imply an abandonment of the agreed goal. If the supervisory group were to be transformed into a therapeutic group, the students would no longer be using their emotional reactions as an aid for the understanding of the case at hand, but they would rather focus their attention on their own suffering and its historical roots. In any case, the group would no longer be fulfilling its task. It is worthwhile mentioning here that both denying the emotional group processes and taking pleasure in them bring out the same result, which is the abandonment and the deterioration of the agreed task (Gear and Liendo 1974). The question is that, if the common group work is to be both creative and rigorous, the group needs to keep a delicate balance between emotional and cognitive processes. And this is true for both therapy groups and learning

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groups. The difference between them is only a question of emphasis and of the direction of the process. In the therapeutic group, it is necessary to transcend the anecdote and the defensive theorization in order to reach a deep and intense emotional experience which opens the way for a structural change in the members’ personalities, and to a greater understanding of their personal lives. In the supervisory group, the emotional reactions induced by the narrative of the case are used to fuel reflection and the theoretical understanding of what is going on, both in the treatment that is being supervised and in the group. The final goal of the reflective process in a learning group is concept-building and the recovery of the previously read literature, which is now articulated with a set of new personal experiences (Dellarossa 1979; Tubert-Oklander 1990–92). We shall now present one clinical example of a brief period of a supervisory group, which was focused on the study of the so-called ‘parallel process’ – i.e. the reproduction in the supervisory field of the underlying dynamics of the treatment that is being supervised. 2

A clinical example from a supervisory group Two types of supervision

There are, nowadays, two basic ways of approaching the psychoanalytic supervision. One of them is essentially normative; it is conducted by an expert who distinguishes the diagnoses, the therapeutic indications and the planning of treatments, teaches the student to apply the ‘correct technique’ in the various stages of the process, and suggests the actions to be taken. The other one tends to create a space for reflection, in which the therapist’s conceptual, referential and operative schemas (CROS) may be reconstructed, analyzed, and questioned. The former is aimed at having the student internalize the referential schemas of the supervisor and of the training institution, whereas the latter strives to help him to develop his own referential schema, and to carry out a conjoint inquiry of the clinical phenomenon that is being considered. In order to clearly distinguish them, we shall call the first one ‘traditional supervision’ and the second, ‘operative supervision’. The traditional supervision is based on the assumption that there is a standard technique for practising psychotherapy, which must be taught by the supervisor and learnt by the student. This is the rationale for its normative character, since, from this perspective, it is essential that the student learns to accurately apply the method. Nevertheless, Michael Balint (1968) has

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challenged the belief in such standard technique ‘used by all of us’, at least in the case of psychoanalysis, since he deems that actual technique is a more creative enterprise, derived from the particular characteristics of the ‘analytic couple’. The operative supervision, on the contrary, emphasizes the creative aspect of clinical discussions, and the reconstruction and critical discussion of the underlying assumptions and theories. We might say that it is an epistemological critique of the clinical practice. This perspective is incompatible with the acceptance of a standard technique. Quite on the contrary, it is bound to conceive each treatment as a conjoint creation by the patient or patients, and the therapist or therapeutic team, which is designed according to the place, the moment, the people and the circumstances. Another difference between these two approaches is derived from the use of the concept of ‘objectivity’. The traditional supervision presupposes an objective attitude in both the therapist and the supervisor. The underlying assumption is that the therapist must be as objective as possible in his evaluation of the patients’ pathology, and that his technical interventions must be based on such objective knowledge. The supervisor is then to review the evaluation made by the student, and assess the adequacy and pertinence of his clinical interventions from the vantage point of his greater experience of the field and of the application of the method. The operative supervision, on the other hand, assumes that it is not possible to know a patient in isolation, but only in the context of a relationship with a particular therapist and in a particular situation. Similarly, the supervision would only be understood in terms of a relationship between the supervisor and the supervisand, in the context of the clinical situation that is being discussed, on the one hand, and the training institution, on the other. From this point of view, the understanding of the clinical phenomenon depends on a careful perusal of the total situation, which includes not only the patient and his circumstances, but also the therapist, the supervisor, the institution and the social context. Consequently, the supervision should not be thought of as a mere instruction, but as an analytic inquiry into the complex interaction that ensues between the clinical and the learning situations. Nevertheless, it would be unfair to identify the ‘traditional supervision’ with the psychoanalytic supervision, and the ‘operative supervision’ with the group-analytic supervisory seminar. Both approaches have coexisted from the beginning in the history of psychoanalysis, as we have seen in the opposition between the Berlin and the Budapest models. The Ferenczi model of doing

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the first supervision under the guidance of one’s own analyst was based on his understanding of the complex interweaving of transference and countertransference. But this technique generated its own problems, in terms of the transference, and it was the Berlin model that finally prevailed. This was also determined by an ideological factor, as a result of the greater prestige of the strictly intrapsychic conception of psychoanalysis, as opposed to Ferenczi’s intersubjective perspective. There are many psychoanalysts, however, who conceive and practise supervision according to an operative model. Anyway, it is easier to develop this kind of supervision in a group-analytic context, and this is what Foulkes did in his supervisory seminar at Maudsley Hospital (S.H. Foulkes 1964b, 1975a). In Latin America, the influence of Pichon-Rivière encouraged such an approach, conducting collective supervisions as an operative groups (Abiuso, Ahumada and Ferschtut 1973; Moreno Corzo, Ramos de Moreno Corzo and Tubert-Oklander 1979). One phenomenon that has been repeatedly observed in psychoanalytic supervisions, both in the traditional form and in the operative one, is the reproduction in the dynamics of the supervisor–supervisand relationship of the structure of the transference–countertransference field that underlies the material under study. Although this is readily discernible in bipersonal supervisions (Perrotta 1978a, 1978b), it is in the supervisory group that it can be more easily demonstrated and analyzed (Abiuso, Ahumada and Ferschtut 1973). This is so because the larger number of available ‘actors’ increases the potential for enacting the various elements of the unconscious scene. This is also an expression of a more general trend in group life. It is a frequent occurrence in operative groups that the theme or problem which is being tackled is dramatically reproduced in the dynamics of the same group. Thus, a group studying psychopathology tends to operate in terms of the pathology that it is examining. Also, as we shall see in Chapter 6, social institutions tend to reproduce in their workings precisely that social problem that they were designed to cope with.

Background information The material to be presented comes from a course on ‘Collective supervision of individual clinical practice’ which took place in an institute devoted to the training of group therapists. The teacher in charge was one of us (JTO). There was also an assistant teacher, a woman who was older and more experienced than the main teacher in the field of individual therapy, but who was not

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trained in group therapy at the time, nor was she a member of the association. They decided, however, that they would fully share the responsibility for the coordination of the group. The students were candidates in the third year of a four-year training. The coordinating team decided, and agreed with the students, that the course would be conducted as an operative group. This meant that the responsibility for discussing and analyzing the clinical material would fall to the group, and that the coordinators would help its members to think through this material. This they would do by means of comments about the discussion, but without taking part in it with direct opinions or suggestions about the case. Such interventions were thought to be an equivalent of what in psychoanalysis are ‘transference interpretations’. This implied keeping an analytic attitude during the supervision, in order to solve the paradox implied in trying to teach psychoanalysis by means of non-analytic – or even anti-analytic – methods (Perrotta 1978a). This experience gave the coordinators an opportunity to observe, both in the students and in themselves, certain intense psychopathological phenomena, which they had not perceived in other groups. These represented the recurrent appearance of some emotional and cognitive disturbances that Kernberg described as characteristic of the transference and countertransference in the treatment of borderline patients: ‘the presence of overwhelming chaos or emptiness, or conscious suppression or distortion’ (Kernberg 1975a, p.163). Such chaotic situations, which determined a pathological paralysis of the ‘didactic process’ (M. Baranger, W. Baranger and Mom 1978) were only solved by interpretations that reflected the juncture between a) the characteristics of the clinical material that was being discussed; b) the difficulties implied in the task that the group was attempting to tackle; c) the group’s own dynamics; d) the members’ relation with the coordinators and e) their relationship with the institution that contained the group. There were, of course, no interpretations about the elements corresponding to the members’ personality structure, although some of them were quite obvious in the sessions. From the coordinators’ point of view, this peculiar organization of the group field was due to the fact that all the materials that were brought for supervision related to the treatment of borderline patients. This determined a borderline organization of the dynamics of the group, at the unconscious level, and also a disturbance of individual and group thinking derived, as we shall later see, from the attempt to understand the material by means of a theory that was not germane to it.

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It is a common observation, however, that most of the cases that are brought for supervision today correspond to borderline patients. This may be due to an increase in the number of such patients that come for consultation; to our greater knowledge of severe character pathology, which helps us to identify such cases; and to the problems that they generate for inexperienced students. But this compels us to find an explanation of why this experience was different from others. When retrospectively reviewing the evolution of the group, the coordinators felt that a definite factor in this was the decision to work only with the material from sessions that included dreams. This was requested by the students, who were interested in learning more about the handling of dreams in the therapeutic situation. We shall now describe a few sessions of this group, in order to show how this phenomenon arose during its evolution, before passing on to an analysis of and an attempt to explain it in theoretical terms.

Clinical material The first session of this group is dedicated, as usual, to establishing a contract. The students feel somewhat uneasy at the presence of the assistant teacher. They have worked before with the main teacher alone and, although they have been informed beforehand and accepted this change in the setting, they clearly reject what they feel as an intrusion. Anyway, they apparently accept this situation and the proposal of working again as an operative group. The group task is defined as a group clinical discussion, rather than as a supervision. The idea is to do a microscopic study of sessions, and the students ask especially to review sessions with dreams. It is therefore decided that one of them will bring the narrative of a session, excluding his own interventions. This is an exercise aimed at helping the students to place themselves, at the beginning, as if each of them were the therapist in that session. After discussing their reactions towards the patient’s demeanour and expression, as described by the therapist, the latter informs the group about his actual interventions, in order to address the session as it happened. In the second session, the female teacher is not able to attend, on account of a car accident. The work begins, however, as agreed, by reading the protocol of a session. The student has brought it in writing, omitting only his interpretations. He distributes copies for every member of the group, and then proceeds to read it. The material, which is presented by a male therapist, relates to the third interview of a female patient. The first reaction of the group is a state of

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confusion: although the patient was talking about a dream, the students feel that it is impossible for them to differentiate the dream from the rest of the material. The therapist remarks that the same thing happened to him during the session, and that he had to interrupt the patient, in order to ask her what exactly was her dream. From that moment on, the students start a spontaneous brainstorming about the material and the patient, in which there are many references to an Oedipal conflict and an alleged phobic neurosis, but without ever developing a consistent line of thought. The coordinator finds himself, against his customary technique, making didactic interventions. These are mostly questions aimed at clarifying the confusion. The session closes with a final educational intervention by the conductor, when he suggests that the students study the material again at home, and write down their diagnostic hypotheses, based on the dream material, to be read at the beginning of the next session. When the third session starts, there is a very tense and anxious silence after the report on the previous one has been read. The assistant teacher, who was not present the week before, is compelled to intervene, and starts to expound, in a very didactic tone, her opinion about the material that has been presented. At this moment, one of the students interrupts her; she sounds very annoyed and confused, and she says that the teacher’s intervention implies a radical alteration of the group’s previous functioning. There follows a frankly paranoid moment. The students are angry and confused, their discourse is somewhat incoherent, and they are frankly hostile towards the female teacher. The coordinator interprets that she has become for the group, from the emotional point of view, a bad stepmother, who is interfering with their supposed idyllic relationship with the good coordinator. On hearing this, the group calms down and reassumes its task. The members read the various diagnoses that they have written. Most of them stick to the ideas that were put forward the week before (‘Oedipal conflict’, ‘phobic neurosis’), but one of them states that, in her opinion, this is a ‘pre-Oedipal narcissistic conflict, more severe than a neurosis’. They comment on the difficulty they had in analyzing the dream, as it seemed to have no symbols or images. Being essentially verbal, one wonders whether it is a thought or a dream. Starting from this observation, the group discusses the peculiar characteristics of this dream, and they reach the conclusion that it is quite different from the symbolically sophisticated dreams that Freud (1900) analyzed in The Interpretation of Dreams. This dream cannot be

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understood in terms of its semantic content, as it appears to be bereft of it, but only of its pragmatic impact on the therapist and the supervisory group. We have obviously been approaching the dream with the wrong theory. We were treating it as if it were a symbolic product with a semantic content, a product of the dreamwork described by Freud (1900), but it now seems that it was not really a symbol, but a ‘thing in itself ’ – what Bion (1962) called a ‘beta element’ – which could only be projectively identified, first in the therapist and then in the group, thus generating intense confusion and defensive attempts to contain it. The group then reconsiders the diagnosis, 4 and arrives at the conclusion that it is truly a case of a psychotic structure. The session closes in a climate of intense work. The fourth session starts again with a confusional moment: nobody seems to remember clearly the task that that the members were supposed to do and bring today and, in a bizarre enactment of the confusion, we suddenly find out that two of the students are simultaneously taking notes for the report of the session, without either one being aware of the other. The student who is presenting the material is absent. The group manages to come out of this confusion by means of a paranoid technique, as the members blame their absent companion for their present inability to tackle the task. But this student suddenly arrives, and the group falls again into confusion and a fragmented dialogue. The coordinator suggests that this clearly conflictive situation may be related to the other teacher’s situation vis-à-vis the group. Although she is an experienced individual therapist, with an important status in her own association, she has not been trained as a group therapist, and she is not a member of this institution. But the students have heard on the grapevine that she intends to apply for training in their institute. She is therefore simultaneously in the position of a yet unborn younger sister, and of a stepmother who pairs with a teacher they feel to be theirs, as a result of a previous period of work with him. Her ambiguous status in this group may be one of the sources of confusion. This interpretation is accepted by the members, who express many feelings and thoughts about the new teacher’s inclusion, which they had not manifested before. There is a shared feeling of relief; the group resumes the task, and analyzes the structure of the transference–countertransference field in the session under study, in the light of the concepts of projective identifica5 tion and counter-identification. The teachers point out the need to operate with a theory of partial object relations, since any attempt to analyze this material in terms of total object relations renders it incomprehensible, and

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prevents the therapist and the group from working through and understanding the pragmatic impact that the material has on them. In the fifth session the confusion appears already in the reading of the report of the previous one: one of the members has been omitted from the initial list of those who were present, but the reporter insists that he has not been omitted at all, since one of his interventions is included in the report, albeit anonymously. This is the final stage in the analysis of the first clinical material, when the therapist reintegrates the text of his interventions during the session, which has been hitherto unknown to the rest of the group. On analyzing the now complete material of the session, there is an emphasis on the importance of the confusion between the symbol and that which is being symbolized. The patient is not able to metacommunicate and, inasmuch as the therapist is counteridentified with certain split-off and projected parts of her, neither can he. At that moment the group discovers, with astonishment, a piece of information that had been there all the time, but that no one had taken into account: the material did not come from a therapeutic session, but from a diagnostic interview. Both the patient’s and the therapist’s behaviour, however, corresponded to the context of an analysis, and not of an interview. The conclusion is that this is due to the fact that neither the patient, on account of her pathology, nor the therapist, who is counteridentified with her, could distinguish between the ‘talking about a future analysis’ of an interview and the ‘analyzing’ of an analytic session. Once again, we are dealing with the inability to metacommunicate in order to discriminate the various contexts, which has prevented the group from distinguishing between the narrative of a dream and that of the session, or between the inclusion of a member’s name in a list and the inclusion of one of his comments in the report. At the end of the session, before agreeing to initiate the study of new material for next week, all the students ponder what happened with their initial diagnoses of this patient as a classical neurotic, since they now realize that they were really dealing with the psychotic part of the personality.

Analysis of the material It is obvious, when reviewing the material of these sessions, that its psychopathological dynamics is repeated within the field of the supervisory group. In the second session (the first in which this material was included) there is a prevalence of confusion, and the coordinator is unable to interpret it, as he is also immersed in it. His co-worker has deserted him, and he feels at a loss in

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facing an already troubled group. So, instead of interpreting the present chaotic situation, he attempts to deal with it by bringing order into the prevailing chaos, and to get out of the confusion by means of directive interventions, which resemble the question that the therapist had to put to the patient in order to differentiate a dream from what it was not. This reveals that the coordinator is also being counteridentified with the therapist, and with that part of the group that is suffering and wishing to come out of the confusion. In the third session, the assistant teacher reacts to the tension in the very same way that the male teacher did a week ago. The group manages to overcome the confusion by means of a schizoid-paranoid moment. When this is interpreted in terms of the group’s transference towards the coordinators as a couple, the members are able to recover their capacity for thought, and again tackle the task. The fourth session starts again with a confusional moment and an abortive attempt to find a paranoid escape from it. When this is again interpreted in terms of the transference to the coordinators, this time including a reference to the institutional context, the task is resumed. Finally, in the fifth session, the group is able to conceptualize the inability to metacommunicate and the identification of the symbol with the symbolized – i.e. what Segal (1957) calls a ‘symbolic equation’ – that underlie the confusion, both in the material and in the group. It is finally possible to clarify the lack of discrimination, which has been present all along, between ‘session’ and ‘interview’. We believe that, in the course of these five sessions, the group went through a true healing process of a disturbance of group thinking. This followed a course that started from a maximum pathology of the group (derived from a conjunction of a transference conflict with the coordinators and a counter-identification with the pathological processes conveyed by the material) and allowed it to heal, by means of the coordinator’s interpretations, until it fully recovered the capacity for shared thought. This opened the way for a greater operativity in the fulfilment of the task of thinking together about the material.

Discussion This kind of supervision only makes sense in terms of the presupposed theories. Just as in other scientific domains, observation is never naive: it always includes a certain – sometimes very complex – theory of observation.

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For instance, if we use a voltmeter for measuring an electrical current, we are accepting Ohm’s law, which is implicit in the very structure of our recording device. Consequently, Popper’s (1959) ‘basic statements’ are not ‘empirical’, in the sense of being derived from sensory data, although they are certainly derived from experience, but experience interpreted in the light of presupposed theories. In other words, the ‘empirical base’ is that set of observations that a scientist is ready to accept as valid, at his own risk. Consequently, any scientist’s observations will sink or swim according to the validity of his presupposed theories. It is therefore a sign of good scientific manners that one be willing to specify these theories. So, we shall list the theories that sustain our observations: 1. The theory of the unconscious fantasy (Isaacs 1952; Segal 1964; W. Baranger 1971). 2. The theory of projective identification and counter-identification (Klein 1946; Grinberg 1958, 1962). 3. The theory of the analytic situation as a dynamic field (W. Baranger and M. Baranger 1969). It can be easily inferred from this list that we consider the supervision to be an analytic inquiry in itself, although somewhat different from the one we carry out in a psychoanalytic treatment. In this we fully agree with Perrotta when he states that: The supervision is not a binocular vision [i.e. shared between supervisor and supervisand] of an alleged Real Patient, who exists out of and far away from the supervisor–supervisand relationship. It is rather a particular kind of analysis of a fantasized patient, who exists in the ‘here and now’ of the supervision, and is made up of the remains of the projective identifications of the Real Patient, which have determined countertransferences and projective counteridentifications in the analyst. (Perrotta 1978a, p.420, author’s italics) […It is] a complex act, by means of which the supervisor supervises an analyst who supervises a patient’s psychic process, who is supervising his unconscious system. (ibid., p.418)

And this is intended, we would add, to develop what Bion (1962) calls the ‘psychoanalytic function of the personality’ in everyone who participates in the process: the patient, the therapist, the supervisor and also, in the case of a

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supervisory group, the other members. That is to say that the main goal of the supervision is not to teach a standard technique, but to induce a ‘limited but deep change’ in the supervisand’s personality (Balint 1957). It is, in Mendizábal’s (1976) terms, the ‘awareness of knowledge’, an active process of discovery, construction and appropriation of knowledge. In psychoanalysis, ‘a piece of knowledge is the result of the overcoming of a situation, in this case, a derivative of the transference–countertransference situation’ (Mendizábal 1976, p.297, our translation). Although these comments refer mainly to the bipersonal supervision, the process is quite similar in the case of operative supervisory groups. In these, there is also the advantage that the group field allows a richer and more exact reconstruction of the unconscious fantasy underlying the session that is being discussed. This is because each of the members can enact one of the elements of a complex fantasy. It may be asked, in the case of the experience that we have presented, why we diagnosed the patient as a borderline case, if we had no background information on her. This is based on two theoretical assumptions that underlay that supervision: a) that any psychoanalytical diagnosis must be based on the analysis of the transference–countertransference field, rather than on anamnesis (Tubert-Oklander, Chevalili-Arroyo and Champion-Castro 1979); and b) the above-mentioned hypothesis that the organization and the dynamics of the supervisory field allow inferences to be drawn about the transference–countertransference field of the session under study. But how is it that this curious mirroring phenomenon takes place? This is an interesting question, since we have seen this reproduction of the dynamics of the session in the supervisory field happen, even when the therapist who sent the material is absent. It seems that the narrative of a session, both in its written and its verbal form, contains a ‘transformation’ (Bion 1965) of the structure of the unconscious fantasy of the original session, just as the latter is a transformation of the patient’s (and the therapist’s) unconscious fantasy. This structure is recreated as soon as the narrative is enacted in the field furnished by the juncture of two or more individual unconscious fantasies (the supervisor’s and the supervisands’). This is a process that can be compared to phonographic recordings, which contain a mechanical, magnetic or digital transformation, spread out in space, of the sound waves, which are reconstructed and once again spread out in time when it interacts with a suitable apparatus.

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This hypothesis may help to elucidate the importance of using sessions with dreams in this experience, since the dreams of borderline patients are a major instance of their peculiar communicational style. They are ‘evacuative dreams’, according to the classification suggested by Grinberg et al. (1967), which should not be interpreted symbolically, but only in terms of the projective counteridentifications that they evoke. This agrees with Margaret Little’s (1966) observation about the dreams of borderline patients: The dreams of a person who is dealing with material belonging nearer the psychotic end of the spectrum than the psychoneurotic are often not analyzable in the ordinary classical way. They may present the problems and conflicts quite directly – i.e. the dream thoughts are manifest, not latent, and there is no secondary elaboration – or the dreams may be wholly defensive, consisting only of elaboration, and no amount of analysis of such dream gets anywhere. The dream thoughts are split off in such a way as to be inaccessible until something else happens that brings them within reach. (Little 1966, p.478)

One last turn of the spiral The original paper in which this case material was presented was written by three authors. Two of them (Juan Tubert-Oklander and Vidalina Ramos de Moreno Corzo) had taken part in the experience; the third one (Luis Moreno Corzo) had not. When they began to work on this paper, the latter spontaneously took the role of an ‘ignorant questioner’, thus helping the other two to analyze and conceptualize their experience. Consequently, the elaboration of the paper became an operative supervision for the working through of the unanalyzed and uninterpreted residues of their projective counteridentifications with the supervisory group. Once the whole experience had been recovered by the two coordinators, the roles changed again, so that they might share with the third author their new understanding of it. Thus the three of them managed to overcome the last repetition of the borderline pathology that had characterized the evolution of the supervisory group, and turn it into a shared theorizing and the writing of a report. This final experience once more confirmed our conviction that analytic experiences can only be worked through by analytic means.

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An experience in the training of group-analytic family 6 therapists The underlying CROS The field of modern psychotherapy exhibits a wide gamut of techniques and conceptions of psychological treatment, all of them derived from psychoanalysis in one way or another. Their development has, however, been hindered by the enormous prestige enjoyed by their illustrious predecessor. Psychoanalysis truly inaugurated the age of scientific psychotherapy, so that it always had complete freedom to create its own concepts and to test them against its clinical experience. All the later schools of psychotherapy were born in a professional space dominated by the achievements of a great theoretical and technical discipline. They were, therefore, compelled to define their position vis-à-vis psychoanalysis, thus restricting their liberty to face clinical problems from a fresh perspective. For many psychotherapists educated in the psychoanalytic tradition, psychotherapies are only an application of the sound knowledge derived from psychoanalysis. Although this perspective has allowed the development of viable therapeutic techniques, it does not do justice to the unique characteristics of the various therapeutic contexts, techniques, practices and aims, and it unnecessarily restricts its potential by transferring unmodified concepts, techniques and norms from the psychoanalytic context to other quite different fields. But the new therapeutic schools have not only suffered from a passive submission to psychoanalysis; they have also been hindered by a compulsive need to oppose it. Many promising developments have been weakened by their insistence on opposing psychoanalysis. This type of fight is always sterile and impoverishing. These restrictions, which severely limited the development of new approaches to individual psychotherapy, also affected, although to a lesser degree, the progress of group and family therapy. A new paradigm emerged, however, in the field of family and marriage psychotherapy; this was provided by the complex theoretical field that includes the concepts of cybernetics, general systems theory, and the theory of communication. Although for many years the psychoanalytic and the communication-systems approach to family therapy followed two widely diverging and sometimes incompatible courses, in the last couple of decades we have witnessed the emergence of a new interest in an interchange between and an integration of these two modes of

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thinking and working (Hernández Hernández 1994b; Skynner 1987; Tubert-Oklander 1990a, 1990b, 1993b, 1994a, 1995a, 1996). The situation in the field of group psychotherapy is rather different. There, the psychoanalytic orientation has prevailed, with the creation of what has been called ‘analytic group psychotherapy’, or even ‘group psychoanalysis’. Nevertheless, as we have seen in Chapters 1 and 3, this did not impede the development of a particular approach which was centred in the group-specific phenomena. This new field, which is called ‘group analysis’ in Britain, and ‘operative groups’ in Latin America, was independently generated by the work of S. H. Foulkes (E.T. Foulkes 1984; S.H. Foulkes 1948, 1964a, 1975a, 1975b; Lear 1984; Pines 1983b) and Enrique Pichon-Rivière (Hernández Hernández 1994a; Hernández de Tubert 1995, 1997a; Pichon-Rivière 1971a; Tubert-Oklander 1990–92). But, unlike what happened in the field of family therapy, group analysis does not have a conflict with psychoanalysis. Quite on the contrary, it is truly compatible with both the various psychodynamic theories and communication-systems theory. It is therefore particularly suitable for building a bridge between these two great theories of psychotherapy (Tubert-Oklander 1995a, 1996). Our present position is that a general theory of psychotherapy should be based on the theoretic tripod provided by: 1. Psychoanalysis and the other analytical therapies. 2. The communication-systems theory. 3. Group analysis. This conceptual, referential and operative schema (CROS) has allowed us to harmoniously integrate all our theoretical sympathies and professional identities. Our first training, as group therapists, followed the path of group analysis. Our second training was strictly psychoanalytic. To these we should add more than twenty years of practising and teaching family and marriage therapy, from the binocular vantage point offered by the analytic and the communication-systems perspectives. We cannot now enter into the details of how we manage to make this complex integration, although the reader may find an instance of this in Chapter 3, in the section on ‘Communication, thinking, learning, and change’, where we articulate the ideas and thinking of Enrique Pichon-Rivière, S.H. Foulkes and Gregory Bateson. We would like, however, to emphasize that this integration leans on two more abstract and comprehensive contexts, which give it a meaning. One of them is an epistemological

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context – that of systems epistemology, which ought to be distinguished from systems theory. The other is an ideological an philosophical context, a true Weltanschauung, which we call, for lack of a better name, ‘existential phenomenology’. Systems epistemology is essential for the integration of these three theoretical perspectives, since it is the only theory of knowledge that allows the co-existence of widely divergent points of view without having them immediately come into conflict with each other. This is due to its contention that there is no such thing as an ‘objective truth’, since all knowledge is really constructed from an interaction between the knowing subject and the objects that it is attempting to know. This epistemological point of view, usually known as ‘constructivism’, does not assert that reality does not exist, nor that all knowledge is relative (G. Bateson 1972, 1979; Watzlawick, 1981). On the contrary, it holds that not all constructions are equivalent: some of them are better, others are not so good, and yet others are frankly inadequate, but their quality does not depend on an alleged correspondence between the description and ‘things in themselves’, but on the mutual fit between subject and object, and even, when the objects are also knowing subjects, on the agreements reached between them. Consequently, although this epistemology does not relinquish the attempt to discriminate between the better theories and the not-so-good theories, it does conceive the possibility of the existence of alternative and equally valid points of view for the understanding of the same set of facts (Tubert-Oklander 1993a, 1994c; Tubert-Oklander and Hernández Hernández 1995). Besides, inasmuch as the perceived ‘facts’ depend on the perspective taken by the investigator, several observers who are placed in diverse vertexes will have disparate experiences of a same situation, and this will induce them to develop divergent concepts. This view of the process of knowledge allows us to explain and accept the coexistence of three different theories in a same field of knowledge, as well as the enlightening dialogue that may develop among them, without relinquishing their individualities. The ideological and philosophical perspective of existential phenomenology corresponds to a conception of the human being and a set of values that is implied in it. The phenomenological perspective stems from the unavoidable reality of subjective experience as the essential link among all human processes. This compels us to develop a painstaking description of all the nuances of such experience, before attempting to give an account of it by 7 means of explicative theories. Experience may be explained, but it can never

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be reduced to the explanations. From this point of view, experience is a primary phenomenon, whose meaning becomes apparent from its description, which could well be called ‘existential analysis’ (Hernández Hernández 1994c; Tubert-Oklander 1994b, 1999c). The existential-analytic attitude implies an identification with the basic questions about human relations, the meaning of life, and the place of the human being in the world. This may be found in the thinking of such diverse psychotherapists and psychoanalysts as Ludwig Binswanger (1944, 1945, 1946), Viktor Frankl (1978), Ronald Laing (1959), Rollo May (1958a, 8 1958b) and Donald Winnicott (1971). Such identification refers to the questions posed by these authors, and not necessarily to their answers, so that this attitude does not imply an adherence to any school of thought. One characteristic trait of all existential approaches is to highlight that, on account of this experiential dimension, the human being is constituted as a completely different entity from all others in the realm of our experience. This does not allow us to consider him as an ‘object’ to be explained and controlled, in the scientific-technological western tradition. On the contrary, he or she is a fellow human being, who should be understood empathically – ‘placing oneself in his shoes’ – and with whom we may and should establish a significant dialogue. In Martin Buber’s (1923) terms, any relationship among human beings should be an ‘I–Thou’ relationship, and not an ‘I-it’ relationship. This dialogic dimension has always been an essential part of psychoanalysis, in spite of the fact that an important part of its theory, called ‘metapsychology’, makes an attempt to objectify the human being, in its struggle to be scientific. But another equally important part of psychoanalysis has endeavoured to overcome this rift between an existential practice and a natural-scientific theory, through the exploration of the strictly human dimension of the therapeutic relationship. This enterprise is obvious in the work of writers such as Michael Balint (1952, 1968), Erik Erikson (1950), Sándor Ferenczi (1955, 1985), Heinz Kohut (1984), Ronald Laing (1959), Rollo May (1950, 1969) and Donald Winnicott (1965, 1971).

The training model After many years of teaching various forms of psychotherapy, we have developed a training model based on this theoretical, technical, epistemological and philosophical basis. Our students study the fundamentals of the psychoanalytic theory – with a special emphasis on object relations

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theory – as well as the communication-systems and the group-analytic theory. All seminars are conducted as operative groups – i.e. as a non-therapeutic group analysis. This allows a better integration of the group, the solving of problems and conflicts that emerge during the teaching–learning process, and the incorporation, from personal experience, of a group-analytic working model. In order to develop such an undertaking we have created the Centre for Psychotherapy and Group Analysis, located in Mexico City. Our first projects have been in the field of distance learning, by developing training courses in psychotherapy in various cities of the country. This implies that classes are rather sparse – usually one weekend a month. The students work as a group, however, during the interval between classes. Even though these group discussions may be coordinated by the group members on a rotatory basis, we have found that things work out better when there is a local coordinator who takes charge of all the administrative aspects of the course, organizing the students’ clinical practice, and coordinating the group discussions on the literature for the next class. The students take turns at writing reports on all group meetings, which are read at the beginning of the next session. They also distribute copies of these reports to their companions and the teachers, and they send them to us, as the general coordinators in Mexico City. These reports fulfil the function of the group ‘memory’ (Dellarossa 1979) and allow us to take the pulse of the group process, in spite of the distance and the time intervals between our visits. We have even had to make distant interventions in some group critical situations, as we shall see in the next section. One limiting factor has been the availability of local trained therapists to be in charge of the students’ personal therapies, since metropolitan centralism had determined that most trained psychotherapists and psychoanalysts are to be found almost exclusively in one of the country’s three major cities – Mexico City, Guadalajara and Monterrey. We have found, however, some therapists who are capable and willing to cooperate with our courses in smaller cities. We have also complemented their personal therapy with group experiences, which are included in the syllabus. Consequently, the students have one experiential workshop every six months, called a ‘formative experience’. These are group-analytic workshops, coordinated as operative groups, in which there is a working through of the main anxieties and conflicts generated by the learning process and the institutional context. In the case of family therapy courses, we also include three specific workshops: one on the

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students’ original families, another on their conception and experience of the couple, and a third one on their present family. These formative experiences accomplish some of the functions that, in the classical psychoanalytic training, appertain to the candidates’ training analyzes. Furthermore, they complement and activate the students’ personal therapies. This is particularly necessary on account of these treatments’ limitations. Since this kind of therapeutic education is carried out in cities that do not have a well-established psychotherapeutic tradition, the students have to go for treatment with some of the few local therapists. This usually implies some form of individual analytic psychotherapy with therapists who do not have a relationship with the institution. We therefore use these formative experiences in order to explore and work through a series of conflicts related to the students’ choice of profession and the development of their psychotherapeutic identities. We also feel that this kind of group experience may be useful even for training courses that do not have this kind of limitation for finding adequate and sufficient therapists for their students. We have therefore designed a training model in which all group activities, each at its own level, are coordinated in terms of a group-analytic understanding of the individual, group, and institutional processes. We believe that this kind of work may help to avoid or adequately solve many of the crises and conflicts that disturb and hinder most of the training courses in psychotherapy. In the following section, we shall present one such experience.

A training course in family therapy At the end of 1994, we were asked by a colleague if we would be willing to plan and coordinate a formative course on family therapy for a group of psychologists and physicians who lived in, or near, the city of Hermosillo, in the Northern part of Mexico. This colleague, María del Carmen Alvarez, had trained as an individual psychotherapist in Guadalajara, and had also taken a two-year course on group-analytic psychotherapy with one of us (JTO), in one of our previous experiences in distance learning. She was then returning to Hermosillo, her native city, and was aware of a therapeutic need for family therapy in the population and an interest among mental health professionals in getting a proper training in that area. She had already contacted three of the institutes that offered training in either group or family therapy, but to no avail, since they never answered her letters. We therefore developed a project for this particular training. In this, we had to take into account the geographical location and the social and

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economic situation of the city in which we would give our course. The city of Hermosillo lies in a desert area, very near to the border with the United States, south of Arizona, a two-hour flight from Mexico City. It is extremely hot in summer – up to 50°C or 122°F – so that the classes would require air-conditioned facilities. All this implied additional efforts for the teachers who would be willing to travel there. The economic context was not very favourable either. Economic resources are usually much lower in the provinces, and this had been compounded by an extended drought which had affected the economy of this traditional cattle-raising country. Soon after we had started the planning of the course, things got even worse, when in December 1994 a massive devaluation of the peso precipitated a countrywide crisis. This new development forced us to change our three-year programme with twice-monthly classes, to a four-year one with monthly classes. It also implied more hours for each class. Finally, by April 1995, we were ready to carry out the selection of the prospective students. We both travelled to Hermosillo and had first a group session with twelve applicants, together with the local coordinator. We worked with them for four hours, trying to explore who they were and their motivations for taking the course. We also observed their character and their capability for group work. Afterwards, each of them had an individual interview with one of us. The next day, having completed the interviews, we had a new period of group work in which we informed them of our evaluation and discussed the project with them. Of the twelve applicants, ten were accepted, and we agreed to start working the following month. In the next two months we took another four students who had not participated in the original selection process, so that we ended with a group of fourteen. During the first two semesters there were some defections, and the group finally continued with eight members. Our programme was planned for eight semesters but, as each one of these terms included six ordinary classes and one formative experience, oddly enough, each semester lasted seven months. As we later included a one-month break each year, the whole course took over five years to complete. We started by studying the theoretical basis of family therapy, including psychoanalysis, communication-systems theory, group analysis and social sciences. We then went on to study psychopathology, from a group-oriented view, the techniques of family therapy, and clinical practice. The latter was supervised in smaller groups, and we also had an live interview with each class, which the group watched through closed-circuit television. Mary Carmen Álvarez, the

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local coordinator, had in the meantime turned her office into a small clinic, in which the students could interview and treat families. Each monthly class included ten hours of theoretical work and two two-hour supervisions with half of the group each. The group also met twice during the interval between classes. Each of these meetings, which were coordinated by the local teacher, lasted four hours. She also acted as an assistant teacher with each of the visiting masters. Both of us acted as general coordinators and took turns to travel to Hermosillo to teach a class; later we included visiting teachers. These were some well-known and respected family therapists, group therapists, and psychoanalysts. Their participation was, however, only episodic, and there was no way to develop a group with them. Consequently, the burden of keeping the continuity of the course fell on the three of us: the two general coordinators and the local coordinator. We therefore arranged that the first and the last class of a semester should be coordinated by one of the general coordinators, and that there would be two classes per term in charge of one of the visiting teachers. The students’ personal therapies were conducted by four colleagues who had trained as individual therapists in Mexico City, as the local coordinator had decided not to take any of them for therapy, in order to avoid any unnecessary contamination. These four therapists did not take any part in the course, and we did not have any dialogue with them. This was intended to preserve the students’ therapies, but perhaps it also generated some problems, since the therapists’ therapeutic identity leaned heavily towards classic psychoanalysis, and some of them mistrusted the group and family perspective. The first formative experience was coordinated by both of us, since its aim was to work through some conflicts with the coordinators and to help in the integration of the group. The second was dedicated to a workshop on the therapists’ families of origin, and it was conducted by an experienced family therapist who was not a group analyst. The next two were coordinated by two colleagues who were both psychoanalysts and group analysts, and one of them was also a family therapist. None of them gave any information about what transpired during the workshops, but we know, from the students, that the third experience was devoted to analyzing their conflict with the course authorities, and the fourth, to ventilating some obstacles in the path of developing their psychotherapeutic identity. While the coordinators of the formative experiences did not volunteer any information about them, the visiting teachers did, and we also had a pretty good idea of the evolution of the group from the written reports on the

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sessions – both the preparatory meetings and the classes – that they sent us by fax or courier, as they did not at the time have access to the Internet. We also kept in regular contact by phone with the local coordinator. We therefore knew immediately about a severe crisis that arose in the group, during the fourth term, midway between the third and the fourth formative experiences. One of the visiting teachers, a psychoanalyst and family therapist who was not, however, trained in group analysis, called us after returning from his class – the second in the term – and told us that there was serious unrest in the group. The members had expressed, during his visit, their dissent regarding the fees they were paying for the course. They felt that they were being abused and taken advantage of. This was not news to us, as it had been a source of conflict from the very beginning. We knew, of course, that the amount they were paying was high for the standards of the area. Besides, the group was composed mainly of women, some of them very young and beginning a career, others divorced and the sole providers for their families, while those who were married had had to carry the economic burden when their husbands’ businesses withered as a result of the nation-wide economic crisis and the local effects of the drought. So, they were clearly having a hard time of it. On the other hand, the tuition fees had to pay for the work of the three coordinators and the visiting teachers, as well travel expenses for those who came from the capital – or, in some cases, from some other city – the rent and expenses of the clinic, and the acquisition of equipment (the closed circuit television for the clinical interviews). If all these obligations were taken into account, one would have to reach the conclusion that we were certainly not becoming rich by exploiting them. But their feelings about this were particularly intense. There clearly was a typical regressive situation, and their relationship with the coordinators had become paranoid. But apparently this new situation had been rather violent. The visiting teacher who had to face the outburst apparently tried to deal with it in rational terms, by discussing the economic situation in itself. This was clearly not enough. We talked extensively with the local coordinator, and she told us that she had been having the same trouble with the group, and was at a loss about what to do. We discussed the alternatives. There was still one month to go before one of us was scheduled to fly to Hermosillo, and the group situation would not hold for that long. We therefore decided to write a letter to them. This text was painstakingly thought through and discussed to the smallest detail, since we conceived it as equivalent to an interpretation, but without all the subtle, nonverbal feedback that guides the formulation of such

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an intervention when one is face to face with the group. We finally finished writing it, and sent it. We shall now reproduce the text of our letter to the group, which was written five days after the class conducted by Dr A. It was a formal text, printed on official paper with the letterhead of the institution, and said:

TO THE STUDENTS OF THE COURSE OF FAMILY AND MARRIAGE THERAPY Dear Students: We have had notice, through Mary Carmen [the local coordinator] and Dr A [the visiting teacher] of your expression of discomfort about the Training Course of Family and Marriage Therapy that we are coordinating. We have been told, and we have also seen during the past two years, that you feel exploited, that you are paying too much and getting too little for your money. This view is so distant from the facts, as we know them, that we can only understand it in terms of a regressive phenomenon, which we have seen happen in other training groups, together with the emotional stir induced by the material that is being studied. We fully understand the effort – both economic and emotional – that you are making, and we have been willing to give ample time for these difficulties to be worked through in the group work, as well as in the course of your individual treatments. But your present demands widely exceed the limits that are both acceptable and compatible with the continuation of the course, as they imply a destructive attack on the minimal conditions which are indispensable for this task. Consequently, we cannot and must not accept them. It is up to you to reflect and decide if you are willing to continue with your training, while making the necessary effort for this. We know that regression in unavoidable, but we also expect a group of professional people in training to function on the terms of an adult agreement, which act as a container of the emotional processes and allow its working through. As regards your present lack of satisfaction, we do not share your point of view. Although the organization of a course in the provinces implies some unavoidable limitations, derived from the sparse contact with the teachers and the restriction of the options for a personal treatment, we consider that you have had an excellent syllabus and the best available teachers to be found in our country. You have also enjoyed the respect and consideration of both the coordinators and the teachers. We do not know of any other course of family therapy [in the country] that presents comparable characteristics.

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On the other hand, the tuition fee that you are paying for your education is significantly less than what you would be paying in other cities. This does not involve a denial of your economic difficulties, nor of the present crisis in our country, but you must also take into account that the fees that each of us is earning for this job are much lower than the real cost of our work, although they are still kept at a dignified level. To this we must add the personal sacrifice implied by coming to Hermosillo to teach classes, in terms of physical effort, hours of study, restriction of our family life, limitation of time for rest, stress, and even the risk involved in any air trip. The motivation for this is certainly not economic. There is, of course, a personal interest and satisfaction in the realization of projects that we deem valuable, as well as in the diffusion of a knowledge and a conception of the human being that may significantly improve the quality of life for many people. We have also taken pleasure from watching your growth and development, both as individuals and as a group, since we feel a part of it. As we have already said, we are still willing to work with you in order to attain the best possible understanding and working through of these vicissitudes of the learning process. What we do not in any way accept are the vicious and destructive attacks on what we have built together, nor on the group of coordinators and teachers. If we are to continue sharing this project, we demand that we be treated with the same respect and consideration that we have shown towards you. Regarding the tuition fees that you are paying for the course, there is some confusion about it. We are not administering money of yours, nor are we under an obligation to render any account of it. On the contrary, we are providing a service and charging a price for it. Consequently, the use that we make of this money does not concern you, as it is already ours. Nevertheless, and taking into account the intense disorganization originated by your fantasies in this respect, we are willing to discuss it personally a month from now, when Juan travels to Hermosillo. The only motive that leads us to consider this possibility is the desire to protect and preserve this project, which has cost so much to all of us. About your suggestion of finding other sources of financial support at a local level, especially in order to cover the travel expenses, we shall consider any concrete proposal that might reduce them, on the understanding that the final decision shall be only ours to take. With kind regards, Juan Tubert-Oklander and Reyna Hernández de Tubert

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The local coordinator read it during her next meeting with the group and, according to her verbal account and the regular written report sent by one of the members, this came as a shock to them. There was a radical change in the group’s mood, and they finally managed to conceive the other side’s point of view. By the time that one of us went there for the next class, the paranoid episode was already over, and it was possible to discuss it in more rational terms. The group working through that then took place brought an enlightening realization for the group: this new term was wholly devoted to the study of psychoses, from the psychoanalytic, group analytic and family dynamic points of view. This was clearly a case of a reproduction, in the group field, of the psychopathological dynamics of the theme that the group was studying, quite similar to what we have already seen in the case of the supervisory group. We have described this crisis in detail because it is no different from other crises we have witnessed in several training courses on psychoanalysis and psychotherapy. The only difference lay in our handling of it. The fact that the whole course was conducted from a group-analytic perspective created spaces for the open expression of feelings of discontent which are usually silenced and kept only as material for gossip and personal analyzes. The students were, therefore, able to freely expose their feelings, the teachers managed to react consistently, and the response was clear and firm. Besides, having taken the form of a written document, it could be repeatedly read by the group members, without the usual distortions of perception and memory that disturb oral communication. The fourth formative experience was carried out uneventfully and focused, as already noted, on the development of the students’ therapeutic identity. For the fifth experiential workshop, we decided that both of us should coordinate it, in order to deal with the conflicts with us as general coordinators that still remained. It was a tough but fruitful experience, and the group’s climate finally eased. This decision – that we should personally conduct the workshop – was also taken because we had detected that the students were feeling deserted by us, and demanding more contact with us both. The next two terms were less conflictive, and the formative experiences took a more technical character. They were both coordinated by one of us (JTO), who was the senior member of the coordinating team and was clearly perceived by the students as the leader. This may have been an unwise decision, since it fostered the group’s idealization of him. We were at a loss,

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however, to find other suitable coordinators for these experiences. On the one hand, there were not many group therapists with a group-analytic orientation, since the group therapy model that prevails in Mexico is more psychoanalytic than group-analytic. On the other, not many experienced therapists were willing to travel to Hermosillo for a weekend of heavy work. Besides, the personal and political conflicts that usually disrupt psychotherapeutic communities restricted the number of colleagues that we felt we could trust. We sorely felt, at the time, the lack of an integrated group of co-workers with a similar group-analytic perspective. On the unconscious level, we were perhaps responding to an emotional demand of the group. One of the main themes in the dynamics of the Mexican family is the absence of the father. Fathers are usually aloof, they keep themselves for work, and sometimes for a second family, and they are perceived as a mysterious stranger who is both feared and yearned for. This terrifying image usually hides the father’s weakness, which is defensively compensated by aggressive outbursts, womanizing and alcoholism. Mothers are conceived as nurturing, housebound martyrs, always willing to sacrifice themselves for their children, but also as all-powerful goddesses who own their children’s destiny, and the true power in the family (Paz 1950–59; Ramírez 1959–73). Were we, then, trying to prop up the image of the father? The group had clearly placed us as a parental couple, and this was compounded by the fact that we were a marriage in real life. Be it as it may, the fourth and fifth formative experiences were successful, in terms of their goals. The sixth one was a workshop on ‘The couple’. It was coordinated with a purely verbal, group-analytic technique, without including any of the exercises that we had used in some of the previous workshops. The group’s free-floating discussion expressed and explored the members’ inner archetype of ‘the couple’. The group’s mood was emotionally intense, but there was no attempt to explore the members’ personal experiences or their present love life, although they sometimes brought some episode from their lives, which was only taken as an example of the more abstract ideas that were being discussed. The seventh formative experience was planned, in response to a request from the group, as an exercise in Gestalt therapy techniques; they had been reading about Gestalt family therapy, and were intrigued by their actual use in clinical experience. This particular interest was fuelled by the fact that during the almost five years that the course had lasted, a Gestalt therapy group had emerged in Hermosillo.

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This was perhaps an indirect result of the very existence of the course. When we started this enterprise, in 1995, there was hardly any psychotherapeutic academic activity in Hermosillo. There had been a few weekend workshops on family and marriage therapy, and some of the psychoanalytic therapists who were to be in charge of the students’ personal treatments had been teaching psychology students at the local university, but there was no formal training scheme. When Mary Carmen Álvarez started to promote this course, there was a great interest in it, but many psychologists and physicians were discouraged by the exacting commitment that was demanded by the training scheme. They were intrigued and stimulated, however, by the continuous existence of the course, so that they strove to find a more accessible training scheme. Many teachers travelled to Hermosillo during the following years. Some of them were of a psychoanalytical bent, mainly of a Lacanian orientation, but their teaching was basically theoretical, so that it did not become a true training. Several groups of therapists appeared, but the most consistent among them was that of the Gestalt therapists, who started to teach their own approach. A few of our own students, who had been taking courses on mediation, were now working in the field, together with some Gestalt therapists, so that they were interested in attaining a better understanding of their approach. The workshop took the form of a series of Gestalt therapy exercises which showed how this psychotherapeutic school dealt with clinical situations. These basically included three techniques: the exploration of the awareness of the present; the ‘empty chair’ technique; and the Gestalt technique for the analysis of dreams (Naranjo 1989). Although these were all individual exercises, they were set in the context of a group-analytic workshop. Therefore, in sharp contrast with the Gestalt therapy tradition, there was much verbal discussion and analysis. In particular, after one of the students had worked individually in an exercise, there was a prolonged discussion, involving the whole group, in order to recover the unconscious fragments of experience that had been deposited in the bystanders, thus turning an individual experience into a group experience, and allowing a group working through. The workshop started, as usual in our practice, with an exploration of the members’ expectations and fears, and ended with a group evaluation of the experience. In the meantime, the dynamics of the group had changed. The students had grown professionally, and they started to take diverging paths. Some of them joined in renting a house and setting up their offices there, so that they

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no longer depended on the clinic in order to develop their own clinical practice. Another subgroup became interested in mediation, as we have already mentioned, and were very active in the mediation movement. By the time we started the eighth and final term, the main group conflicts were centred on their impending separation. We therefore planned the last formative experience, which was to be coordinated by us two, as a group-analytic working through of this final stage. On this occasion the local coordinator, who had not attended the previous formative experiences, was to take part in it, so that the group might work on the conflicts with us three. She had also become the focus of a new conflict, since she was in the process of constituting a new association for the diffusion, teaching, practice, and research on psychotherapy. Some of the students were identified with this project and wanted to participate in it, while others felt that this was her concern, and not theirs. This was clarified and worked through during the workshop. After the eighth semester was finished, we still had one further meeting, in order to make an evaluation of the whole course. The design had a somewhat symmetrical outlook: we had started with a meeting for the selection process, and we were closing the course with a similar meeting for the evaluation, and in both instances the three of us had been present. The fact that we had made an extensive use of written material was indeed an aid for the evaluation process. This material included: a) the original programme for the course, b) the schedule and reading list for each of the eight terms, c) the reports of every one of the meetings of the group, and d) the written evaluations of every term, including both the students’ evaluations of themselves, the teachers, the materials and the group work, and our evaluation of both the group and the individual members. This was an enormous amount of paper, so that the members agreed to review it by working in pairs, each of them focusing on a different aspect of the course. So they finally brought to the meeting several documents, evaluating the following themes: a) the literature reviewed, b) the evolution of the group, c) the formative experiences, d) the supervisions, and e) the students’ personal therapies. It was fascinating material, and it gave all of us much food for thought and discussion. We also made our own evaluation, in which we reviewed our own perception of the evolution of the group. From this starting point, we initiated a final working through process, which took over ten hours. The very same day that we finished this work, we had a social meeting, including the students’ families, in order to celebrate the end of such a long

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effort, and give them their certificates of completion of the course. Their individual therapists were also invited, and we formally thanked them for their cooperation. It was a very moving moment. This was in September 2000, five years and five months after our initial meeting for the selection process. But the story was not yet finished. The students had to write and present a paper on family or marriage therapy, in order to be graduated. They also started to organize, together with the local coordinator, a family therapy symposium, in which they would read their graduation papers. When the theme for this meeting was finally decided, it turned out to be, not surprisingly, ‘The Voice of the Father’. A few months before the meeting, the students asked for a new workshop on the writing of clinical papers, in order to help them in the organization of their graduation papers. The senior coordinator travelled again to Hermosillo and worked with them during a weekend. Although the academic work was very productive, he also found that there was a split in the group, since three of them seemed to be against presenting their papers in the symposium. The group finally agreed to go ahead with its plan, but soon before the meeting, the three dissenters decided that they would not take part in it. The rest decided to continue with the project, which had already been promoted, and also featured papers by several therapists from various cities. We were also invited and each read a keynote address in it (Hernández de Tubert 2001; Tubert-Oklander 2001a). The meeting, which took place in July 2001, was a success, and it was attended by many professionals who were working with families: physicians, psychiatrists, psychologists, social workers, teachers, lawyers, and even nuns. The group that finally graduated included five members: three psychologists, one psychiatrist, and one nurse. What had happened with the other three members of the group? It is, of course, difficult to know, since they withdrew from any further contact with the rest. We can partly understand their behaviour on account of their personal characteristics. One of them was increasingly interested in psychoanalysis, and shunned any further group or family clinical work. Another one had been systematically critical of the project, even though she was an intelligent person and certainly learnt during those years. The third one is a mystery to us, since we would not have expected her to act as she did, but perhaps her decision was related to her increasing distance from one of the members who remained, who had been her best friend in the group. From the point of view

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of the group dynamics, however, this split seems to have been the expression of an unresolved complication of the final mourning process. In retrospect, we feel that the lack of an integrated group of teachers was probably partly responsible for this dénouement. The course had become too much like a family, in its dependence on only three people, and this endogamous structure was reflected in the fact that we no longer invited outside coordinators to conduct the formative experiences after the fourth one. This family-like structure lacked the flexibility to accommodate those members who felt that they had to differentiate themselves from the group’s mainstream. We still feel, however, that the final result was satisfactory. We managed to conduct a whole training course in psychotherapy, according to group-analytic principles, and everyone involved, including the three coordinators and the students who went all the way with the group, as well as those who finally took their distance from it, learnt much from this experience. We feel that the eight members who completed the course have acquired the art and craft of psychotherapy, and that they are reliable professionals who are setting a new standard for clinical practice in their area. Some of them will go on working together in collective projects, others will not, but this is the final fate of any educational group. To conclude the narrative of this experience, we shall reproduce the final two paragraphs of our own written evaluation of the course, which we took to the final evaluation meeting: When evaluating the outcome of this experience, we arrived at several conclusions. The first is the reaffirmation of our previous conviction that the group interpretative-reflective work provides the optimal conditions for a true education of therapists, which does not fall into the ever-present dangers of rationalization and intellectualization. The second one was the satisfaction of verifying that it is indeed possible to conduct an adequate psychotherapeutic education in smaller cities which are far away from the great urban centres. We believe that there are still many paths to tread in the field of distance learning, taking advantage of the new technological resources, but without losing the experience of direct human contact. The final one was the confirmation that the theoretical approach that we have been developing, in which we intend to synthesize all our previous trainings and influences, may be of use for a group of therapists in training. All this leaves us with many tasks to develop in the future. The truth is that we have learnt a great deal during the past five years, and that we are not the same people that we were when we started. Now it is our turn, as well as yours, to reflect on this experience and work it through. For

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us, it necessarily implies writing and theorizing our personal experiences. May you feel the same need and be willing to share with us the fruit of your reflections.

CHAPTER 6

The Approach to Institutions and Society

The individual, the group and the community Our adult experience of reality is so commonplace and pervasive that it becomes for us utterly unquestionable, a mere reflection of ‘the way things are’. There is much evidence, however, to suggest that it is actually a construction whose foundations are laid during our early childhood years. And the uniformity with which members of the same community perceive their surroundings is due to the fact that this is a social construction, based on an agreement about what reality actually is. And this agreement is crystallized in the common social code of language (Whorf 1956). A baby does not perceive the world in the same way that an adult does, and it takes a long and complex process of maturation and learning before he starts to conceive and experience the world in terms akin to those of the adult (Spitz 1965). But those outer events that the baby is not able to represent or think about, since his human environment has not yet taught him the necessary code for this, do have an impact on his blossoming psychic structure, and inevitably leave their imprint there. Now, a stimulus from the outside world that the subject fails to conceive, represent or understand is what Freud (1920, 1926) called a ‘trauma’. Jean Laplanche (1997) has suggested that the baby and the young child are traumatized by their nonverbal awareness of the sexuality of the adult. The mother’s breast is not only an object, but a part of a subject with a sexual and emotional life that the child cannot understand. The fact that the breast is primarily a sexual organ for the mother, as an erogenous zone, turns each feed 185

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into a traumatic seduction, as the mother sends unconscious sexual messages to the baby. This, according to Laplanche, is the basis for the universality of seduction fantasies. But the very same thing occurs when the individual has to cope with the social system. Bion (1961) developed a complex and subtle investigation of the effects of transpersonal group phenomena on the behaviour and experience of individuals in groups. He also noticed that such dynamic processes – which Foulkes (1975a, 1975b) described as the ‘group matrix’ – not only exist, but are also perceived by the individual, who then establishes an object relation with them. If this were true, then the social matrix would be an essential part of the unconscious experience of the human being (Tubert-Oklander 1995b). The fact that social phenomena breed us, determine us, contain us, and are much larger than us, leads us to experience them as something akin to the baby’s relation with its mother. This is why ‘matrix’ refers us to the uterus and the mother, as we have seen in Chapter 3. Such hyper-complex entity is far beyond the individual’s capacity for symbolization, so that its continuing presence and influence becomes traumatic, thus leaving its traces at the unconscious level. Just like Laplanche, Bion suggested this traumatic imprint to be a universal occurrence, in his 1952 paper on ‘Group dynamics’, in which he wrote: I hope to show that in his contact with the complexities of life in a group the adult resorts, in what may be a massive regression, to mechanisms described by Melanie Klein (1930, 1946) as typical of the earliest phases of mental life. The adult must establish contact with the emotional life of the group in which he lives; this task would appear to be as formidable to the adult as the relationship with the breast appears to be to the infant, and the failure to meet the demands in this task is revealed in his regression. (W.R. Bion 1952, pp.141–142, our italics)

Now, is it true that both the mother’s breast and the social matrix are inherently traumatic? Winnicott (1965, 1971), who has also made good use of the comparison between the baby’s relation with its mother and the adult individual’s relation to society, highlighted the harmonious, nurturing and caring features of both relations. It is precisely because the baby cannot possibly cope with the adult’s circumstances that we actively build an artificially simplified environment for him, which in our culture is materialized in the baby’s room. We do whatever we can in order to ensure that the baby lives in an uncomplicated world, in which he does not have to deal with extreme stimuli of sound, light, people, uncouth physical contact, emotional disturbances, or bodily needs such as hunger, thirst, or lack of sleep. A good-enough

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mother is unobtrusive, so that the baby does not need to know that she is there at all. If she manages to achieve this disappearing act, the baby feels that he lives in a marvellous and protective world, that he himself has created with his desire – what Winnicott (1971) called the ‘subjective object’ – and he does not have to cope with a premature realization of his own defencelessness. This is the basis for an attitude of confidence in life – what Erikson (1950) designated the ‘basic trust’, and which we prefer to call ‘faith’, that is, the belief that life is good and that one can trust one’s environment. The same would be true for the case of the social system. One of the functions of the social network and its institutions is to protect and take care of individuals who would not be able to survive without them. But when the social matrix works as it should, it is as unobtrusive as the good-enough mother. We only notice it when it fails us, as, for example, when we open a water tap and nothing flows out of it. But the real question is whether human relations, starting from the breast, and social life are intrinsically traumatic or not. Freud (1930) adhered to a tragic conception of the human condition, in which there was a basic and unavoidable conflict between the individual and society. But this was a result of his definition of the individual as an instinct-driven creature. Object-relations theorists, such as Winnicott or Fairbairn, would rather highlight the friendly and loving aspects of relationships, and tend to think that such conflicts are the result of a tragic disturbance of otherwise harmonious relations. There may be a cultural element in this. Freud’s stance would seem to endorse Oscar Wilde’s (1898) gloomy creed, immortalized in his ‘Ballad of Reading Gaol’: Yet each man kills the thing he loves, By each let this be heard, Some do it with a bitter look, Some with a flattering word, The coward does it with a kiss, The brave man with a sword! The French psychoanalysts and the British Kleinians have taken up Freud’s fatalistic philosophy, but Winnicott’s optimistic outlook reflects an English Methodist’s view of life. Perhaps it is only an instance of the traditional difference between the optimist who sees the half-filled glass and the

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pessimist who perceives it as half-empty, but the fact is that both have their grain of truth. There is love, solidarity and mutual care among human beings, but hate, envy, self-centredness and heedlessness are also there. There is the germ of a traumatism in every human relationship, but this is, more often than not, compensated for by the effect of care and consideration, whenever love prevails. What the microscopic eye of the psychoanalyst is able to detect in ordinary people becomes readily seen when pathological conditions maximize it. Therefore, we should say that the group matrix is, just like the mother, both the incarnation of love, care and nurture, and the sinister and persecutory fiend of our nightmares. In every mother there is a conjunction of the Blessed Virgin and the Foul Witch, and in every group and social structure we shall find a Cradle and a Nurse, on the one hand, and an avenging and blood-thirsty Moloch, on the other. One of the tasks of group analysis is, therefore, to explore the imprints, traces, or even scars, drawn on our psychic structure by the social network of which we are a part. The group matrix is both within us and outside of us; it is a part of our very self, the framework of our mental processes, and an unseen object with which we have a most complex unconscious relationship. It is our Fairy Godmother and Godfather, and our Bad Witch and Ghoul. This essential ambiguity in our relationship to the group and the community is clearly reflected in our ever ambivalent relation to our leaders and rulers, which is always ready to turn them into good and protecting spirits, whenever we are in need of succour, and also to convert them into evil and menacing demons, when we are feeling threatened. Traditional psychoanalytic models of human life tend to focus on a very narrow field of observation. The orthodox point of view uses the isolated baby as a paradigm. Winnicott’s relationship-oriented perspective concentrates on the dyad. ‘There is no such thing as an infant’ meant that ‘whenever one finds an infant one finds maternal care, and without maternal care there would be no infant’ (Winnicott 1960, p.39). This is an instance of Lewin’s (1943) ‘definition of the field at a given time’. But the dyadic field is not enough for a full understanding of the situation. Just as the mother holds, protects and cares for the baby, someone else has to care for her, so that she may fulfil her function. So, ‘there is no such thing as a mother’ – i.e. mothers are never in isolation. There must be other people – father, grandparents, relatives, neighbours, social security, etc. – who sustain her, and, if there is no one present or willing to do so, things do not work out well. Therefore, the field is much wider than Winnicott thought.

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Whenever there is a disturbance of the relationship of individuals and groups with the larger community that contains them, this has substantial consequences for their lives. And when such disturbance is severe or malignant, these are bound to be pathological. This is one of the reasons why social violence is so harmful for people. It is not only that they cannot go out into the streets without fear, but that they feel forsaken by those who had the duty to succour them: the authorities and the social institutions. And things get even worse when those authorities and institutions become their executioners, as in the case of what have been labelled as ‘dirty wars’ fought by governments against dissenters among their own people. Elina Aguiar (1988a, 1988b), an Argentine group and marriage therapist, has written poignantly about the effects of political repression on couples who had been directly affected by it. This means that one of the couple, or both, have suffered one or several of the following situations: kidnapping, jail, torture, disappearance of a near relative, murder of a near relative, disappearance of friends, persecution, unlawful entry by the military or the police, internal or external exile. Some of those couples had sought therapeutic help, and had started to work through their unthinkable experiences. But when the new civilian government that came after the military dictatorship passed an amnesty law for those officers who had taken part in this state terrorism, their symptoms were aggravated. It was as if society, far from assisting and doing justice to their sufferings, had declared them to be nonexistent. Whenever a victim’s suffering is denied, and he or she is even blamed for what happened, as it frequently happens in the case of rape, it means adding insult to injury, and the trauma is compounded by injustice. Reyna Hernández de Tubert (1997b) has studied the pernicious effect of lies on individual mental functioning, when the liar is someone on whom the person depends for his welfare and subsistence, as in the case of the authorities. Conscious lies imply an attempt to omnipotently control the other, and a vicious attack on his or her perceptual functions. Whenever a human being is on the receiving end of a lie, he is necessarily harmed, unless he manages to understand the situation and know that he is being lied to. But if the person who is lying is someone on whom he depends for his welfare, his health, or his life, it is very difficult to recognize and accept that this is actually a lie, and there is a tendency to deny it. The discovery that someone whom one needs and trusts is being deceitful, generates a feeling of dire disillusionment and hopelessness from which it is very difficult to recover. This is so with parents, spouses, teachers, doctors, therapists, and the authorities.

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Those leaders that have been chosen by the community are fully responsible for their acts. Being bound to act in the name of those who cannot act, speak for those who cannot speak, a ruler must never use this circumstance for his own profit. The power that has been invested in him should only be used in the service of the whole community, particularly of the defenceless and the destitute. That is why corrupt, violent, abusive, ruthless or homicidal governments betray the hopes and the trust of the people, generating emptiness and despair. But one of the worst situations that ensue when the powers that be break their vows is that of the sovereign lying to the community. When people discover their leaders’ flagrant lies, they experience a breakdown of their Weltanschauung and of their trust in the social system. The same happens when a ruler is found to have broken those laws that he was supposed to defend, or to have used the power invested in him in the service of base interests, or the abuse, despoilment or destruction of a part of the community. These situations generate such an unbearable despair that people usually try to deny them, in order not to relinquish whatever hope they have left. This is probably the reason why ordinary people in Nazi Germany or in Argentina during the military government managed to actively ignore the genocidal activities of their governments. But when the evidence of the perversity and dishonesty of the higher authorities becomes undeniable, the community is suddenly plunged into depression, despair and apathy. This happened in the United States after Watergate, and in Mexico when the people were faced with the impunity of several major political assassinations, and when the criminal activities of a former president became public knowledge. But the reverse is also true. Whenever truth is upheld, crimes are finally named, justice follows its due course, and the victims’ sufferings are acknowledged, there is a revival of hope and a newborn trust in the survival of the community and, ultimately, of humankind. All these phenomena are a part of life in groups, and should be regularly explored in our daily group-analytic practice. We believe this inquiry to be a part of every group analysis, including therapeutic groups, but there are some special groups in which this social dimension comes to the fore: this is the case of institutional group analysis. Such groups offer a privileged vantage point for a new approach to social research. In the following sections, we shall review several examples of the analysis of the social and institutional dimension in groups, both large and small. We shall start the presentation of

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each with a brief theoretical introduction that sets the context for the group situations and problems that will be described and discussed. 1

Working with nurses in a public institution Nursing and gender

Nursing has traditionally been seen as a ‘female’ profession, since it deals with the care of human beings in need. Even today, the immense majority of nurses, at least in Mexico, are women. But this places them in an especially disadvantaged position, since they are prey to three forms of prejudice that prevail in our society. In the first place, the caring professions are assigned a much lower value than those which have to do with the production of property, goods, or riches. This affects several quite dissimilar professions, such as medicine, nursing, teaching, the police, and firemen. Second, those occupations that require manual labour and physical contact have a much lower prestige than those that focus on intellectual activity or on the use of complex technological devices. Third and last, ‘female’ professions have always been underprivileged vis-à-vis ‘male’ professions. When evaluated from any of these three different points of view (or prejudices), nursing has been diminished and relegated by comparison to other professions. It does not produce any riches, as it only works towards the preservation and care of the sick. Neither is it a mainly intellectual occupation, but a careful and attentive physical labour. Finally it is a mainly female profession, which has been contrasted with medicine, a traditionally masculine profession. We know that things have changed, in the case of the latter, since the number of women who study and practice medicine is growing every day. Nevertheless, the values of this professional group are still male values. In Mexico, for instance, most women doctors prefer to say that they are a médico (the generic masculine term for a physician), rather than a médica (the feminine form of the word). And every woman doctor knows that, in order to be accepted by and become a member of the group, she has to show, by her behaviour, that she is ‘one of the boys’. It is interesting to point out that, in terms of the first of the three prejudices that we have mentioned – being a caring profession – medicine would be as affected as nursing, even though it differs from it in other aspects. In the evolution of modern medicine, physicians have strived to acquire a greater distance from manual labour, personal care, and physical contact with patients, which are delegated to nurses, while otherwise emphasizing the

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intellectual, scientific and technological aspects of their practice. This would seem an effort to compensate for the handicap of being in a caring profession. As the medical profession also still perceives itself as ‘masculine’, in spite of the growing number of women doctors, this determines an uneven distribution of prestige, authority, and remuneration between the medical and the nursing professions, which nourishes a chronic conflict between them. All this has placed both male and female nurses in a disadvantaged position. Professional nursing implies hard, stressful and ill-paid work. This is compounded by the effect of the present worldwide crisis, which has impoverished most professions. Physicians, however, have other options for earning money, such as private practice, while nurses are chiefly limited to working in institutions, and their salaries have been greatly affected by the economic situation. There has been the need to work more than one shift, in a activity that is in itself tiresome and unhealthy. If we add the fact that most nurses are women, and many of them unwed or divorced mothers, the fulfilment of domestic and family duties means not just a double, but a triple working day. Consequently, they do not manage to fulfil their duties to their own satisfaction in any of these areas. This determines many situations of emotional suffering and great stress, which cannot fail to upset their relationships with their families, their companions at work, and their patients. This engenders, if we stick to what happens at work, major conflicts with doctors, with administrative personnel, with the patients and, above all, with fellow nurses. This discussion is not merely academic, as it is based on our experience of many years of hospital work, and mainly on a teaching and research project that one of us (RHT) developed, years ago, with groups of nurses.

The experience In the late 1980s, Reyna Hernández de Tubert received an invitation from the training department of one of Mexico’s countrywide health institutions to work with the nursing corps in order to review the problems of the nurse–patient relationship. Her proposal was to organize reflection groups. At the beginning, it was thought that this project should cover all the population of nurses in that institution. Nevertheless, as some of the medical and nursing authorities were worried about the possible consequences, it was decided to carry out first a pilot study with hierarchical personnel, including some of the nurses in senior posts. The directors were afraid that these groups might generate institutional conflicts, or that they might turn into a ‘holiday week’

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in an imaginary idealized group, which would yield no benefit either for them or for the institution. A reflection group is an operative group whose members work together or share an activity in a particular institutional setting, who meet with a coordinator in order to reflect together about their common experience at the workplace, their conflicts and problems, and their possible solutions (Dellarossa 1979). The function of the coordinators is to foster creative group discussion, to identify and help to overcome the obstacles that unavoidably emerge in every sort of group work, and to periodically recapitulate and summarize the ideas that the group members are working with. The institution appointed an administrative coordinator, who was also a psychologist, to take charge of liaison with the external staff of group coordinators, taking all the necessary measures in order that the nurses might attend and participate in the groups, and supplying the logistic support for this activity. Dr Hernández was responsible for the technical conducting of the whole project. She invited a colleague, who was also a group therapist, to share with her the coordination of the groups. Each of these had a coordinating team, including a group analyst as the coordinator; one of the institution’s psychologists who was studying psychotherapy in one group, and the institutional administrative coordinator in the other, who were to learn the coordination of such groups; and two other psychologists without any previous training, as observers and reporters. Each of the groups comprised fifty participants, all of them women, and lasted five days, during full working hours. There were twelve groups, so that the whole experience took six weeks. The coordinators used several active techniques for inducing experiences, such as relaxation exercises and role-playing. The analysis was not only focused on the nurse–patient relationship, but expanded in order to cover all the problems and conflicts that they faced in their everyday professional activity. At the beginning of the group work, it was obvious that the nurses shared the misgivings of the authorities. They especially feared that these groups might become an indoctrination, intended to deny all conflicts and problems, and to convince them of the many advantages of the institution and their profession. They also dreaded that the coordinators might not restrict their intervention to exploring the work area, but lead them to disclose their personal or family problems in the group. The truth was that they did not expect any good from the experience, but only, at best, that it would represent a week of rest from their customary work.

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As the groups managed to work through and solve the members’ initial feeling of distrust, their real preoccupations started to emerge. The conclusions derived from their discussion, which were shared by the nurses and the coordination team, were strikingly similar in all groups. One that clearly stood out from the rest was the idea that nursing is a high-risk profession, in terms of the physical and mental health of its practitioners. This is determined by many factors, starting from the fact that nursing has been one of the professions most chastised by the consequences of the global economic crisis, with the ensuing loss of prestige in medical institutions and in society at large. Other significant factors are gender-determined conflicts and the struggle for power with doctors, which expose traditional gender roles and relations vis-à-vis male leadership, on the one hand, and the rivalry with men and with physicians, on the other. All this was found to affect the relationships among nurses, which recreate the prevailing ideology of devaluing the work and the position of women in society, thus breeding a great antagonism and competition among them, particularly in obtaining recognition from doctors and principals. One common saying among nurses, which occurred again and again in the groups, was: ‘The worst possible enemy of a nurse is another nurse’. Other factors were the work overload, increasingly deteriorating work conditions, family problems, which are common to most working women, including a double or triple working day, difficulties in taking care of the children, and conflicts with their mate, or the lack of one. Starting from this discussion, they were able to recognize how all this affected their relationship with the patients, whose requests and demands often surpassed their capacity to respond. Institutional conflicts surfaced at various moments. The coordinators did not repress or deny them, and allowed free expression of them, but always pointing out that their discussion and, above all, their solution were far beyond the group’s goals and possibilities. None of the groups felt it as a manipulation or an attempt to have them submit to the institutional policies. For its part, the institution gave the coordinators full freedom and the necessary support to develop this work. At the end of each group, the coordinators and the participants carried out an evaluation of their joint task. After that, there was a second stage of the evaluation, when the authorities of the training centre joined them, in order to receive from each group and the coordinators a verbal report of its results, achievements and limitations. The members’ main conclusion was that they

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had had a space for reflecting about the conditions and the characteristics of their work. Although the dreaded exhibition of their private life never happened, they also emphasized that this work had been of use for them in order to identify and think through some problems in their personal lives, as well as their participation and responsibility in conflicts with male and female doctors, with patients, and with other nurses. They also declared that they had identified some alternatives for solving these problems, based on a greater solidarity with other nurses, as well as with doctors and patients. This redounded in a better understanding of their conflicts, which would help to ease them. They also recognized that they should actively participate in the solution of those aspects of the institution that they found unsatisfactory, instead of passively suffering them. In spite of these encouraging results, the project never came to the following stage, as a consequence of a change in institutional policies. Nevertheless, it left the coordinators with a valuable experience, and the conviction that it is truly possible to do something about such problems.

Discussion This experience had two types of results. On the one hand, it was a corrective intervention, aimed at fostering in the nurses a reflection about their professional identity, their situation and conflicts in the workplace, and the nurse–patient relation. In this, it was widely successful. On the other hand, it was a piece of social research about the position of women in general, and nurses in particular. This was a wholly unexpected result, since the original objective had only been the investigation of the nurse–patient relationship. This sort of qualitative research yields a deep understanding of the structure and dynamics of a social field, that can then be used as food for further thought. In this case, this research was the beginning of an ongoing inquiry into gender roles and relationships (see below, ‘The use of operative groups in social research’). It was also the basis of a series of lectures and workshops for nurses (Hernández de Tubert 1999a, 2000a, 2002). The additional experience derived from these workshops helped to further the investigation of the nursing profession. From the institutional point of view, however, something failed, since the project was not carried to the next step. What had happened? In retrospect, we think that the coordinators took a decision that was probably a mistake. It was agreed, as we have already mentioned, that two members of the institution would cooperate with the coordinators in conducting the groups, while two

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others would act as observers. This was decided in order to allay the initial paranoid anxieties in the institutional staff, and to help them identify with the project. It was also intended to give them some training in working with groups, so that they might assume some of these tasks in the future. Three of them were students in a course dictated by the senior coordinator and had a good working relationship with her. The fourth, who was the institutional liaison coordinator, later proved to have an ambivalent relationship to the project and its coordinator. When he participated in the group, as a member of the team, he tended to act the role of a charismatic male leader in a group of admiring women. When this was duly interpreted – not as a manifestation of his personality, but as an expression of a social relational pattern – this obstacle was promptly resolved, and the group went on working. But it is probable that this left some resentment in him. It appears that he also began to feel that he was fully qualified to conduct this kind of group on his own. This is an usual occurrence when non-trained professionals participate in group-analytic experience. The easy-going attitude of the coordinator and the fact that he does not employ any flamboyant techniques, but only fosters a conversation in the group and makes occasional comments on its content and evolution, creates the illusion that anyone can do it, without realizing the years of intense training and the deep transformations of the analyst’s personality that lie behind this ease. Be this as it may, there is no doubt that this man believed that he could do it. And the external coordinators’ fees were considerably higher than his own salary, so that he probably believed the whole set-up to be unfair. Consequently, he proposed to the higher authorities that he would coordinate some groups by himself. The general coordinator of the project was unaware of this, as she only knew that the institution was delaying the decision to start the next phase of the project, but she suspected that something was amiss. So she went one day unannounced and found this psychologist coordinating a group. She then decided to terminate her participation in this project. The institutional coordinator tried to go on with these groups but, as was to be expected, he did not go very far, since he lacked the indispensable training. Working with groups in an institutional setting is a delicate undertaking. It is always necessary to evaluate the political side of the workings of the institution. When one comes as an external advisor, it is always necessary to reach an agreement and keep a direct contact with the higher authorities who are entitled to take the final decisions about the project. In this case, the higher authority was satisfied with the results of the first stage, but there was no

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personal communication between the advisor and the higher officer, and the information was mediated by the liaison officer. This gave him the power to influence the final decision. In our present practice, we never accept this kind of work without making a careful evaluation of the power struggle in the institution, and we insist in having a personal dialogue with the highest authority in charge of taking decisions about the project. We are also very cautious about incorporating members of the institution in the coordinating team, since it is very frequently a source of rivalry and envy. And we never commit ourselves to coordinate a project unless we are conferred full authority in all the technical decisions, for the duration of the project. 2

A reflection group in a therapeutic community A brief theoretical introduction

A therapeutic community is an artificial social environment which has been specially designed in order to foster the healing process and the personal growth of the individuals who dwell in it. This concept stemmed from Harry Stack Sullivan’s (1931, 1947) pioneering work with schizophrenics, but it was fully developed in Britain during World War II. Part of this history was reviewed in Chapter 1, when dealing with the Northfield Experiment. However, the therapeutic nature of a community is not something that can be attained once and forever, nor can it be maintained without a constant effort. Quite on the contrary, it must be created and recreated every day. Whenever this work is omitted, the community ceases to be therapeutic, and becomes a pathogenic social milieu. What are the causes of this phenomenon? We can identify three determining factors, as follows. In the first place, it is a well-known fact that social institutions tend to reproduce, in their organization and inner functioning, the very same social problem that they were supposed to solve. Thus the police tends to become criminal and corrupt; schools, aimed at the transmission and development of knowledge, replace thought and reflection by mere habit and rote learning; recreational institutions substitute a lifeless routine for vivacious entertainment; and psychiatric institutions tend to reproduce, in their internal relations, the dynamics of the psychopathological disorder that is most frequent among their patients or inmates (Ulloa 1969). This is akin to the phenomenon of the reproduction in the supervisory group of the dynamics of the treatment being supervised, as we have seen in Chapter 5.

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In the second place, there is a general property of all living systems, derived from the second law of thermodynamics, that requires constant work in order to create, sustain, and develop their complex organization. If this work were to be interrupted, a degradation of the system would necessarily follow. We have already discussed, in Chapter 2, the need for such maintenance in the case of groups – the ‘internal task.’ The second law of thermodynamics states, in very general terms, that one fundamental feature of the Universe is that things spontaneously tend to become muddled and deteriorate, unless some work is done in order to reverse this tendency (Bateson 1948). This agrees with all of our everyday experience: motor cars deteriorate if they are nor serviced on a regular basis; papers become disarrayed and lost in archives, unless they are periodically rearranged, and people do not understand what we say, unless we make an effort in order to be clear. In the jargon of thermodynamics, the term ‘entropy’ is used for the measure of the degree of disorder of a system, and ‘anti-entropic’ qualifies any effort or work aimed at reducing entropy. The result is called ‘negative entropy’ or ‘negentropy’. We could, therefore, say that the wearing out of a house represents an increment in entropy, and that fixing and painting it is to act in an anti-entropic direction. Of course, the second law of thermodynamics refers only to isolated systems – i.e. closed systems. Living systems are, by definition, open systems. That is why they apparently are not subject to this law. The anomaly is readily solved once we expand the field of our observation to include both the organism and its environment. Every time the former incorporates matter and energy from the latter, it grows in an anti-entropic direction. But the entropy of the environment increases and, what is even more important, the entropy of the overall system that includes both also increases. The concepts of ‘entropy’ and ‘negative entropy’ have been found to be the bridge across the gap between the physical sciences and semiotic sciences. Ever since Norbert Wiener published, in 1948, his classic book, Cybernetics: Or Control and Communication in the Animal and the Machine, we have known that there is an identity between ‘negative entropy’ and information. Just as the amount of information in a system is a measure of its degree of organization, entropy is a measure of its degree of disorganization. In the case of informational systems, entropy is equivalent to the ‘noise’ in communication – i.e. meaningless stimuli that carry no information and disturb effective communication – while negentropy is equal to information (Angrist and Hepler 1967; Brillouin 1964; Wiener 1948–61, 1950).

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Therefore, in every productive system (and this applies both to material production and to the generation of thought), activity tends to degrade spontaneously to the lowest level of productivity, unless a constant effort is made to benefit from the external sources of matter, energy and information, in order to establish, develop and maintain the organization and function of the system. This work, which acts anti-entropically, is what we have called the ‘internal task’ (Tubert-Oklander et al. 1980). In the third place, the therapeutic community is subject to major pathogenic pressures, both external (the patients’ families and the social environment) and internal (the psychopathological mental processes that take place in and between patients and staff ). This tends to turn the community into a pathogenic environment, unless a conscious effort is made to avoid it. And what kind of effort can prevent this deterioration of the community? If entropy is equivalent to the disorder of a system, negentropy implies putting order into the system. So this anti-entropic effort must take the form of an organizing activity. This is achieved by means of certain administrative measures, on the one hand, and systematic reflection on the process of the community, on the other. This requires the creation of a variety of groups, in which the community members (patients and staff, including not only professionals, but also administrative personnel and help) may reflect together about the inevitable tensions and conflicts that characterize the community process, and also about the way in which decisions and actions are taken by the various sectors of the community. These groups will be conducted as operative reflection groups (Dellarossa 1979; Pichon-Rivière 1971a; Ulloa 1969, 1973), thus opening the way for a true socio-analysis or institutional group analysis. Now, we have already stated our conviction that, in social research, the investigation of a given social system must coincide with a modification in the system that is beneficial for its members, according to the principles of action research (Lewin 1951; Pichon-Rivière 1971a). Therefore, this practice will be at the same time socio-analysis – investigation of the dynamics of the social environment in a therapeutic community – and socio-therapy – the promotion of individual, group and institutional mental health within the community. In sum, we have stated that human beings can either become ill or heal in a group context. Therefore, the main risk for a therapeutic community is to become a ‘maddening community’. One way to avoid it is the application of institutional group analysis. We shall illustrate the practical use of these

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concepts by describing the experience that one of us (JTO) had with the therapeutic community called Mendao Institute, in Mexico City.

The background and the CROS Mendao Institute was a psychoanalytically oriented therapeutic community for the treatment of psychotic patients. It was founded in 1978 by Antonio Mendizábal, a Mexican psychoanalyst and group analyst with an extensive practice in the treatment of psychotic patients, and functioned for fifteen years before it finally had to close on account of various legal and economic difficulties. Strongly influenced by the work of Enrique Pichon-Rivière, the community worked earnestly in order to define their referential schema (CROS). They represented their institutional ideology as a quadrangular pyramid, whose vertexes corresponded to five basic elements. In the four-sided basis we find four theories: 1) the theory of the therapeutic community, 2) the psychoanalytic theory of psychosis, 3) the psychoanalytic theory of groups, and 4) the psychoanalytic theory of the family. The axis of this CROS was based on psychoanalytic theory, with a special emphasis on the contributions of Melanie Klein and Wilfred R. Bion. The apex of the pyramid corresponds to the therapeutic ideology of the institution, which was described in the following terms by its founder: the ideology comprises a series of non-demonstrable values, which are generally accepted by the team; these are the basic axioms of our thinking, and they articulate thinking and action. Of these, we may mention: humanism, knowledge, rationality, reflective and critical thought, active 3 adaptation to reality, respect for self and others, cooperation, creativity, responsibility, and effort towards personal and collective development. (Mendizábal 1982) Being convinced that every social environment is capable of generating either mental health or disease (Mendizábal and Kolteniuk 1980), we have considered socio-therapy as an element that may help us to decrease the alienation generated by our task of coexisting with and treating psychotic or other severe mental patients, as well as from our own lives. We also assign it the function of preventing iatrogenic disease, as a result of power abuse, projections, primitive anxieties, or ideological attitudes that may emerge in our dealings with the patient, or among ourselves, as in the case of the Stanton-Schwartz phenomenon (Rodrigué‚ 1965). If we view ourselves as a therapeutic community, if we acquire such a pledge, we have to accept the following working elements: dialogue, critical thinking and questioning.

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Confidence may emerge beyond the analysis of self and other, and the apparent circumstances and the avowed intentions. The word is a pledge for action in everyday life; in this we shall have to corroborate our commitment and our degree of consistency with what we say we believe. (Mendizábal 1984)

This CROS requires a permanent emphasis on teamwork and the use of group analysis as an instrument to foster reflective thinking in every member of the community, both patients and staff, thus creating a social and symbolic container for psychotic anxiety. Our own reconstruction of this ideology (Tubert-Oklander 1984), described the underlying values that sustain the functioning of this therapeutic community in terms of reflection, cooperation, active participation and relative horizontality among the members of the community. 1. Reflection means that there is an emphasis on the importance of reflective thinking, which is characteristic of every psychoanalytically oriented activity. ‘Reflective thinking’ is that kind of thinking process that turns upon itself – i.e. that not only tries to define, approach, clarify and solve a specific problem, but also intends to study itself in the process of facing the particular problem at hand. The result is that those who participate in this exercise not only learn something about the problem they are trying to solve, but also about their own thinking habits and problem-solving in general. This is ‘learning how to learn’ – what Gregory Bateson (1942) called ‘deuterolearning’, as we have seen in Chapter 3. Besides, this painstaking study of the way in which individuals think and study the problems and situations they have to face in their everyday life allows them to identify, understand, and, in the end, solve their thinking troubles and disorders. The significance of this sort of work for the treatment of psychotic patients is obvious, since these patients always present, by definition, a thinking disorder. 2. Cooperation, our second fundamental value, is partly derived from the previous one, since this reflective thinking activity must be shared. This is imperative because, in most cases, it is very difficult for any individual to detect the shortcomings and disturbance of his own thought, which are quite obvious, however, for other people. But the importance of cooperation in the treatment of these patients is also derived from other considerations. Since psychotic patients are egocentric, omnipotent and narcissistic, they become unable to learn

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from experience and from other people (W.R. Bion 1962). This is why cooperation with the other patients and with the staff may help them to overcome that wall of arrogance and contempt that defines the psychotic’s withdrawal, thus attaining a reopening of the patient’s creative interchange with his environment and of learning from experience. 3. Active participation by the patients in their therapy is the basis of all the previous considerations. This is not a treatment to which the patient may submit passively or against his will. On the contrary, his role as a co-author of his own and his companions’ healing requires his active and voluntary participation in the therapeutic process. This has some practical consequences for the handling of the community. In the first place, it is not possible to work with someone who has been committed against his will. It is true that many patients experience an intense ambivalence toward their internment, which leads them to display a violent resistance against it. Nevertheless, they manage to let us know, in indirect ways, that they actually want to be committed, but that they expect us to assume full responsibility for this decision. With patients of this kind, it is necessary to use various forms of persuasion for them to accept joining the community, but it is still true that, when a patient really does not want to be there, all our therapeutic efforts will be in vain. Second, these same considerations make it necessary to respect a patient’s wish to participate in any given activity, or not to do it. When a patient is apathetic, withdrawn, or hostile, he should be systematically invited to join the various activities, but without ever coercing him, since the wish to participate is the necessary basis for reflection and cooperation. This principle of active participation in community activities is of course also valid for the technical, administrative and service staff. 4. Relative horizontality of the members of the community means that, when actively participating in a cooperative work of conjoint reflection, all of them – both patients and staff – should be at the same level. This principle of horizontality does not imply a denial of the differences between patients and staff, or between the various sectors and specializations among the personnel. Nor does it ignore the necessary existence of hierarchical levels of authority, which are indispensable in order that an institution may function at all. On the contrary, all these differences are acknowledged, discussed and

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analyzed in the various groups intended for shared reflection. What this principle does affirm is that, in our conception of the therapeutic community, the weight laid on the words and thoughts of any of the members of the community should depend on his power of conviction, in terms of the reasons that sustain them, and not on hierarchy, profession, or being either patient or staff. This is an exacting ideal, since we have all deeply internalized the hierarchies and prejudices that prevail in our social mileu, but, if we make a conscious effort to attain it, we will be surprised to discover an unexpected lucidity in the opinions of some of the more severely disturbed patients, or of some of the less qualified members of staff, such as the concierge or the maidservants. This set of principles demanded the use of group techniques, since only these offer an opportunity to realize them; not just any group techniques, but those that were consistent with Mendao’s ideology. And these were found in operative groups, which were used in the conducting of the various group spaces in the community, such as therapeutic groups, family therapy, occupational therapy, art therapy, the daily assemblies with the patients, and the reflection operative groups for the personnel. The rest of this section will deal with the latter, since this was the coordinators’ research and clinical work area in the community.

The experience DEFINITION

What is, then, a reflection operative group or a group of institutional analysis? It is a group formed by the members of an institution, who meet in order to reflect in common about the institutional determinants of the problems that they find in their work and in their coexistence within the institution. Gear and Liendo (1974) point out, following Pichon-Rivière, that in every operative group, defined as ‘a collection of persons who meet in order to carry out a common task’, the behaviour of the individual members is the expression of five structural pressures, which are: 1. Personal factors – i.e. the members’ personal histories and the structure of their personalities. 2. The interrelationships among the members. 3. The relationship with the task.

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4. The relationship with the coordinator or coordinating team. 5. The social and institutional environment. In a reflection operative group we almost entirely omit any analysis of the personal factor, which would be central in a therapeutic operative group, and we highlight the social and institutional factors, without neglecting the other three. The Mendao Institute had had reflection operative groups since its inception in 1978. There had been up to three of them operating simultaneously – one for doctors, psychologists and therapists, another one for nurses, and a third for the administrative and service staff – but by the time of writing this report (April 1984) they had been reduced to two, since the nurses had joined the other professionals, to form the group of technical staff. The coordinator had been, at that time, working with this group for two and a half years, and his total participation in this group lasted five years – or six, if we take into account that he had previously worked one year with the same group, but with a quite different goal: coordinating their efforts to explicitly define the institution’s CROS. The group of therapists and doctors had been coordinated by other analysts before the coordinator who now took charge of it. THE SETTING AND THE CONTRACT

The reflection operative group of the technical staff, when the coordinator started to work with it, consisted of four nurses, four therapists, two psychologists, two physicians, two psychiatrists, an executive secretary, a psychoanalyst, a sports teacher and a teacher of plastic arts – a total of eleven women and seven men. The goals and norms for this group were registered by the coordinator in an detailed contract, after an extensive group discussion about them. The group would function in one-year contracts, from March to March of the next year. This particular date was chosen so that it would not coincide with the two regular vacation periods for most of the personnel (December and July–August), which usually determine crises in the community. The group would have a self-evaluation after six months of the work period (September), and another one at the end of it (March). This final evaluation would be the time for the coordinator or the other members of the group to suggest either a new coordinator for the next year, or continuation with the same coordinator for a new period. It was also the point at which to propose,

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discuss and approve any changes in the contract, which would then become unchangeable for the next one-year period. In other words, the setting of the group – coordinator and contract – was fixed for one year, and it was then reopened for a brief period of two or three sessions, during which it could be changed, before being closed again for another year. The only parameter of the group that could be modified during a work unit were its members, since this was, by definition, an open group. According to the contract, the participants were: all those members of the staff with technical and therapeutic functions (physicians, psychologists, nurses, and other therapists), whose commitment to the community, measured in terms of the amount of participation, degree of responsibility, and identification with the group project, determines that they be perceived by the others as members of the team.

Consequently, when a member of staff left the institution, they also left the group, and when someone new joined the institution, they also joined the reflection group, as long as they had the degree of commitment required by the contract. The contract defined the group’s goal and task as follows: The objective of the group is to create a permanent space for the analysis of the process of the therapeutic community, and the experience that the members have of it. This will be analyzed in all its dimensions: administrative, emotional, operative, economical, political and theoretical, with a special attention laid on the study of the decision-making process and the actions that are carried out during the team’s everyday work, within the community. There will be no prejudgement about the order of priorities among these various dimensions of analysis, since this will have to emanate from the group process. The only dimension that will be excluded from this space is the analysis of the personal determinants of the events that take place in it, since such an inquiry would correspond only to a therapeutic group.

As to the technique for the conducting of the group, it was defined as ‘a reflective analytic group that will function through free-floating verbal communication’. This emphasis on the technique that S.H. Foulkes (1964, 1975a) called ‘free-floating discussion’ did not exclude the possibility of using, on a permanent or transitory basis, other techniques, such as, for instance, dramatic techniques or the subdivision of the group for some specific tasks. Nevertheless, the fact that the coordinator’s training had been in the group-analytic tradition of strictly verbal communication, without pre-fixed plans,

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determined that he never suggested the use of dramatic techniques. At a later date, however, the group had to use the technique of subdividing into smaller task groups, in order to solve a problem that affected the whole team. Finally, the contract defined the coordinator’s task as follows: The coordinator should be, in principle, someone who is not in any way a member of the community, although it is convenient for him not to be extraneous to it, in the sense of being sufficiently close to its members and its work to understand and identify with them. It is essential that his therapeutic ideology be related to that of the institution. His function in the group will be to establish and preserve the setting, and to help the group to think, by means of his interventions, which may include psychodynamic interpretations, with the exception of those of an individual and personal nature. In no way shall the coordinator be responsible for any administrative, technical, economic, or political decisions that might be taken as a consequence of the working through done in the group. Such decisions should be taken out of the group, and in the appropriate spaces, in order to preserve the reflective and analytic nature of the group. THE COORDINATOR’S POSITION

The position of the coordinator of an operative group dedicated to institutional analysis is rather delicate. It is essential that he ‘be in the institution, but 4 not of the institution’ (Tubert-Oklander et al. 1980). This means that the coordinator must be outside the institution’s hierarchy, in the sense of neither giving nor receiving orders from any other of its members, and devoid of any power of decision, except in everything that appertains to the adequate functioning of the group, in which he is the highest authority. This particular position of the coordinator is indispensable to preserve his neutrality. We know that many colleagues with a left-wing ideology would take exception to this statement. We ourselves question the concept of neutrality, if it is meant to imply that a group analyst can ever be ‘objective’. Our own epistemological stance, which was spelled out in Chapter 3, precludes any attempt to define a specific view of a thing as ‘objective’. This is, precisely, our disagreement with Marxist critics, who assume an absolute historical causality and an objective path to knowledge. We also believe that critical thinking should be the landmark of operative groups, and that one should neither come to the group with a pre-ordained agenda, not collude with a denial of the actual problems and conflicts of the group, in the service of the preservation of the status quo ante. Nevertheless, we believe that a relative neutrality is possible, as long as our aim is to induce not a radical change, but

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only a partial reform which allows things to work better than before, and with the sole condition that the coordinators of this kind of group never work with an institution whose ideology is inimical to theirs and unacceptable for them. From this point of view, the coordinator’s neutrality would be defined as his capacity to identify with the various conflicting sectors of the institution, to ‘be in their shoes’ for a while, but without adhering to their views. This would allow him to understand their respective positions, and describe them to the members, thus aiding in the development of better communication among them. THE RESULTS

Finally, we would like to briefly mention some of the results that were attained during this experience: 1. It was possible to establish and preserve an adequate setting for the group’s functioning, which was formalized as a contract, which would be fixed during a work period, but which could be revised with every new contract. 2. It was possible to create, preserve, and recover, whenever it had been lost, a climate of critical discussion and rational analysis of the various problems faced by the group and its members during their everyday work. 3. The better understanding of the nature of these problems reduced the misunderstandings among the members of the group, thus avoiding many unnecessary conflict situations. 4. Those unavoidable conflicts – like, for instance, the conflict of interests between employers and employees – were taken to a rational negotiation, once the paranoid climate of mutual mistrust that usually 5 prevails in these cases had been reduced. 5. The better shared understanding of the administrative problems was increasingly turned into action, by means of decision making in the appropriate institutional spaces or, when such spaces did not exist, by creating them according to the needs. 6. It was possible to work through, in the group, the intense emotional reactions generated in staff by the patients’ pathologies, such as, for instance, the anxiety and depression that pervade the team when they have to deal simultaneously with several suicidal patients.

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7. Last, but not least, the group served as space for sharing and working through some very painful personal experiences and feelings on the part of some of its members. This happened, for example, when the boyfriend of one of the nurses was assassinated in the street. This last item is most important, from our point of view. Although it true that a reflection group is not a therapy, and that many of the anxieties that it stirs up cannot be worked through in it, but must be taken to the members’ personal therapies, this kind of group may, nevertheless, turn into a place for human fellowship and solidarity vis-à-vis the suffering of its members. And this humble function of the group is in itself important, since a therapeutic community that does not also take care of the mental and emotional health of its members would hardly be worthy of the name.

The case of the multifamily group The experience presented in this section was not coordinated by us, but by one of our teachers. We have, however, been able to witness his work and discuss it with him. We have included it in this book because we consider it to be a real breakthrough in the work with large groups and in the therapeutic community. It also offers a new and worthwhile approach to social research. Jorge García Badaracco, an Argentine physician who trained in psychiatry and psychoanalysis in France, developed, after returning to Buenos Aires in 1956, an original approach to the therapeutic community that he calls a ‘psychoanalytic therapeutic community with a multifamily structure’ (García Badaracco 1990). The heart and axis of such a community is the multifamily group – a large group, which may add up to one hundred people – that includes the patients, their relatives and friends, psychiatrists, therapists, nurses and other members of the staff, as well as the conductor or conducting team. The task of this group is psychoanalytic reflection about the life situations and experiences of the patients and their families, the events of everyday life in the therapeutic community, and anything that might happen during the sessions. This is, of course, an instance of group-analytic work, even though García Badaracco prefers to call it ‘multifamily psychoanalysis’. His rationale is that the use of the term ‘psychoanalysis’ should not be restricted to the classical two-person situation of individual treatment, but that it should include any form of psychoanalytic understanding of couples, families, groups, institutions and communities. He feels that he is acting as a psychoanalyst whenever

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he tries to understand, from the vantage point of the psychoanalytic conception of the human being, any human situation (García Badaracco 1998). On the other hand, his conception of psychoanalysis, firmly based on an object-relations tradition, lends itself to this expanded view of the field. The therapeutic process extends far beyond the limits of the sessions, and implies a mobilization of the whole network of human relations in which the individual patient is inserted. This point of view was clearly stated in his 1978 paper on ‘The family as the real context of all psychotherapeutic processes’, in which he says: The history of psychotherapy is somewhat linked to the idea of a technique. But clinical experience shows us that, apart from the various techniques at our disposition, we need to understand the psychotherapeutic process. By comparison with the process of normal growth and development within the family, we believe that any true psychotherapeutic process, whatever its technique may be, is a kind of new development in a family context, which may be either real or virtual… This conception, derived from our clinical experience with psychotic patients, may be applied, from our point of view, to every kind of patient. In this sense, apart from the consideration of family therapy as a technique for the treatment of individual and group mental pathology, we think that the family represents, in one way or another, the real context of every psychotherapeutic experience. It also plays, either directly or indirectly, a fundamental role in every psychotherapeutic process. …Psychotherapy has been generally studied in terms of the patient–therapist relationship, without paying enough attention to the set of conditions, factors and circumstances surrounding the patient (and the therapeutic relationship). These include mainly the family and the social environment, and constitute what we have called the real context of the psychotherapeutic experience… The [alleged] purity [of the psychoanalytical setting] is sometimes a fiction that is held by the analyst. The truth is that a patient in analysis is included in a network of situations and factors that act, directly or indirectly, upon the psychological field of the analytic relationship. [García 6 Badaracco 1978a, pp.9–10, our translation, our italics]

This statement can be compared with Foulkes’ (1961, 1964a, 1975a) conception of the ‘network theory of neurosis’, as can be readily seen in the following quotation:

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It is my belief that in the outbreak of the actual neurotic disturbance of the individual, which after all is the real object of our treatment, a whole circle of people are again actively involved, people who are very intimately connected with one another and, moreover, this is a regular occurrence [author’s italics]. It is true that they know very little of their interaction in this respect, and they do not wish to know about it either. I am inclined to ascribe to these observations a greater and more fundamental significance than does psychoanalysis, having as its object of study one- and two-personal dimensions. I have become more and more convinced that the patient whom we see is himself only one symptom of a disturbance which concerns a whole network of circumstances and persons. It is this network of interacting circumstances and persons which is the real operational field for effective and radical therapy. Perhaps it would be more correct to say this will be so in the future. This would be group therapy in a natural group with the persons primarily involved in the conflict themselves as members of the therapeutic group. Under present circumstances, it is very difficult to put such a multipersonal therapy into operation. It would be necessary for this work that it could be shared by a team of therapists who would have to be trained in both psychoanalysis and group analysis. So far my efforts here in London have not been more than occasional sketchy experiments; they have, nevertheless, given impressive testimony for the forceful and sometimes explosive strength of 7 such a method of approach. (S.H. Foulkes 1961, pp.171–172, our italics)

This multipersonal therapy that combines the characteristics of psychoanalysis, group analysis and family therapy – which Foulkes had left for the future – is what García Badaracco has done in his multifamily groups. His approach to the therapeutic community is presented in his book Psychoanalytical Therapeutic Community of a Multifamily Structure (1990). He has also edited a series of viedeo-cassettes and DVDs that show and analyze his work with the multifamily group, and published a book on the metapsychology of the multifamily group, called Multifamily Psychoanalysis: The Others in Ourselves and the Discovery of the Self (2000). Unfortunately, most of García Badaracco’s writing has not been translated 8 into English, so that it is not easily accessible to English-speaking colleagues. We shall therefore briefly summarize a part of the evolution of his work and ideas. García Badaracco returned to Buenos Aires in 1956, after studying psychiatry with Professor Julian de Ajuriaguerra and training as a psychoanalyst in the Paris Psychoanalytical Society. In 1957, he was appointed to direct a service in the Buenos Aires Neuro-Psychiatric Hospital – the same asylum in

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which Pichon-Rivière had worked – and started the first psychiatric residence. From the beginning, there was an attempt to work psychoanalytically with psychotic patients, but there were many difficulties in this kind of work. The main one was the impossibility of acting upon ‘the other twenty-three hours’ of the day, beyond the ‘specific’ therapeutic hour in individual treatments. Hospital patients had had a chronic evolution, and they were isolated. They needed much attention and developed ‘clinging’ symbiotic transferences that did not necessarily imply an improved therapeutic use of the sessions. The relationship between the psychotic patient and his therapist, paradoxically, tended to become impoverished, turning into ‘a bond of mutual imprisonment, a self-reproducing pathological interdependence that reduced the possibilities of treatment’ (García Badaracco 1990, p.50, our translation). When he took charge of a thirty-five-bed ward and started the first day hospital, García Badaracco built them into a ‘functional unit’. Psychiatric residents helped by taking the patients in individual treatment. Their enthusiasm and dedication compensated for their lack of knowledge of psychiatry and psychotherapy, and the patients improved at the beginning. But residents had to rotate to other services, and this cut off the improvement. Besides, even when the therapeutic relationship was preserved, the patient’s progress was interrupted after some time. All these difficulties led García Badaracco to attempt a wholly new approach: Partly as a consequence of my reflections about these difficulties, and partly on plain intuition, I started to work in a setting that was completely different from the usual one. I started to visit the ward every day at the same time, and seated in a corner of the patients’ sitting room, thus offering a ‘spontaneous’ setting, in which I was ‘available to everyone’, inasmuch as they wanted to come near and talk to me. Soon afterwards, I began to invite the male nurses. It is worth noting that this institutional mutation took place in 1964. (García 9 Badaracco 1990, p.52, our translation, author’s italics)

Soon García Badaracco noticed that, when the setting became more spontaneous, the patients’ difficulties in expressing themselves became more obvious. Paradoxically, they seemed to accept with greater ease the rigid individual interview, because it was more familiar and offered them a better prospect of controlling the situation, so that ‘nothing really happened’, from an emotional point of view. On the other hand, the group situation gave them an opportunity to keep silent, if they dared not talk, and yet participate by

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means of an identification with the other patients. Thus they managed ‘to carry out a learning process by proxy, in a setting in which their own parts are scattered into the other patients, and they can be joined, integrating them piecemeal in a gradual process of re-introjection’ (García Badaracco 1990, p.52). This was the beginning of a therapeutic community. The patients began to change and improve, but they usually hid these improvements as if they were a very intimate secret. Apparently, they had to test the reliability of these changes before they became ready to accept them. Quite on the contrary, they strongly denied the very existence of this progress. This seemed to be a test of the therapist’s capacity to endure unbearable anxiety. One peculiar phenomenon was that, whenever one of the patients voiced a very painful theme, the others readily introduced a manic mood into the session, blabbering or changing subjects, in order to relieve the anxiety of the moment. This seemed to be a group mechanism that protected the patients from the therapist’s interventions. When these anxieties and defences were interpreted and worked through, this opened the way for further growth and learning for everyone involved. Thus even episodes of sadistic, destructive conduct or violent aggression could be profitably used as a means for further growth and learning. All this determined a remarkable change in the climate of the ward, as can be seen in the following quotation: The group meetings not only had a therapeutic value in themselves, they also promoted an emotional activation in the patients and an active interpersonal communication among them, out of the sessions. In sharp contrast with the usual wards of a psychiatric hospital, characterized by the isolation and autism in which every one of the patients live, my ward became the noisiest in the hospital. Their interpersonal relationship during their living together, and the discovery and the adequate mobilization of such resources, were revealed as a ‘psychological climate’ or ‘psychological field’. This is the ‘container’ in which the more adequate elements for the development of the personality, in the direction of enrichment and maturity, come about. (García Badaracco 1990, p.54, our translation)

The resistance to these changes was also patent among the members of the staff. They were clearly not ready for them, so that they would also have to grow, together with the patients, in order to avoid a stalling of the therapeutic process. Thus ‘the therapeutic community became a confluence of patients and staff in which every opportunity should be used in order that all the

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members might have useful and enriching experiences for their maturation and growth’ (ibid., p.54). The next step was to be the inclusion of the families. This approach to the therapeutic community sets the stage for a peculiar kind of psychoanalytic treatment that overcomes the more common obstacles that hinder any attempt to treat psychotic patients by means of psychoanalysis. The community as a whole turns into a therapeutic environment that contains the psychotic anxieties, thus relieving the individual therapist from their sometimes unbearable emotional impact. The therapeutic process becomes independent from the individual sessions, overflowing into the whole living-together that takes place in the ward. Thus the patient can rely on an ample assortment of helpers, including both patients and staff, thereby reducing his absolute dependence on the therapist. This solves some additional problems such as the change of therapists, which is not unusual in the treatment of psychotic patients. This revolution within the hospital could not fail to generate intense resistances in the other sections of the institution. The very inclusion of the families in the work of the therapeutic community acted as a catalyst that set the rest of the hospital in motion, breaking the time-honoured routine. The result was a series of reactions against this change. The main criticisms were: a) that the ward was isolated from the rest of the hospital, acting as a cyst, an autistic group that had lost contact with everyone else; b) that the ward was badly managed, that it lacked discipline and created problems for the other groups and sections; and c) that this kind of work was not cost-efficient, since it did not produce a significant amount of discharges. Of course, these criticisms missed the point, since their aim was the maintenance of the status quo. The patients were much livelier and more difficult to handle – at least in the traditional ways of psychiatric hospitals – but this was precisely one of the goals of the therapeutic process. Since they had many interchanges with patients in other wards, the effect of this reactivation extended to those areas, thus creating problems for their staff, who were neither ready nor willing to respond to this new situation. And the aim of increasing the discharge statistics was quite alien to this attempt to foster a process of human development in patients and staff alike. After several years of conducting the therapeutic community in the public hospital, García Badaracco and his co-workers had the opportunity to start a private sanatorium. This was to become the prototype of the psychoanalytical therapeutic community of a multifamily structure.

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The new private institution was created in 1968, and was to last for almost thirty years. The vast experience amassed during this period is summarized in García Badaracco’s 1990 book. There he develops the theory of this kind of collective therapy and presents several case reports on the evolution of individual patients. He has also published an extensive account of the life, illness and healing of a schizophrenic woman who was treated in his therapeutic community (García Badaracco 1982b). In such groups, which are very large indeed, there is a mutual compensation among the pathologies of the various families. Each family is truly blind to its own kind of psychotic disturbance, but its members can be very sensitive towards another family’s pathology, and they frequently identify and interpret such phenomena with surprising accuracy and depth (Tubert-Oklander 2001b). This peculiarity of therapeutic groups had been stressed both by S. H. Foulkes, and by Enrique Pichon-Rivière, but it had not been previously described for the case of interfamily relations, until García Badaracco started to publish the results of his more that thirty years’ effort in developing this new approach. Foulkes had described what he called ‘a basic law of group dynamics’ in the following terms: ‘The deepest reason why these patients…can reinforce each other’s normal reactions and wear down and correct each other’s neurotic reactions, is that collectively they constitute the very Norm, from which, individually, they deviate’ (S.H. Foulkes 1948, p.29, author’s italics), and Pichon-Rivière had stated that ‘the greater heterogeneity in the members and the greater homogeneity in the task bring about a greater productivity’ (Pichon-Rivière 1969, p.151), and this task is ‘to cure the individual members of the group’. The same is true in the case of the multifamily large group. After closing his sanatorium, García Badaracco returned to the public hospital. He now works one morning a week in the Tomas Borda Neuro-Psychiatric Hospital for men, and one morning in the outpatient clinic of the Moyano Hospital for women, conducting his large multifamily groups. This is not only a therapeutic activity, but also serves as an opportunity for teaching his technique and overall therapeutic approach to a number of younger professionals, and also as a research tool, since the sessions are being filmed. One result of this effort is the production of the previously mentioned videos that depict and explain this unique experience. His influence has spread out to the psychoanalytic community. For many years he has been showing and discussing his films in numerous psychoanalytic associations. In 2001 he started a multifamily group in the clinic of the

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Argentine Psychoanalytic Association, which serves as a tool for teaching psychopathology to psychoanalytic candidates, as well as demonstrating his approach to this revolutionary kind of clinical work. In the same year, he presented these films in a workshop during the 40th International Congress of Psychoanalysis, held in Nice. In his 2000 book, Multifamily Psychoanalysis, he suggests that this approach to human problems may be applied in other areas besides psychopathology and psychotherapy, such as medicine, education and law. It is a generic approach to conflict analysis and resolution, as well as to a form of teaching that does not dissociate cognitive from affective development. This is, from our point of view, fully compatible with the operative group approach.

The use of operative groups in social research On axiological research Contemporary social research has increasingly depended on quantitative techniques for the evaluation of social phenomena. In recent years, however, there has been a new interest in qualitative techniques. We believe that operative groups and group analysis offer a particularly fertile approach for the investigation of the deeper meanings and nuances of the social experience. One area of research that seems to demand this sort of qualitative and dynamic approach is the study of values, which is essential if we are going to attempt to somehow change social attitudes, such as gender or racial prejudices. Before starting any campaign for such change, it is fundamental to identify the intense emotions that are stirred whenever one intends to act on such a basic aspect of individuals’ personalities and of the dynamics of social groups. It is therefore indispensable to apply suitable techniques to investigating both conscious and unconscious values. Values are rather difficult to research in the social sciences. This is due, in the first place, to the very nature of such entities. Values are not ‘things’ that may be observed, described, or quantified. Quite the contrary, they are abstract entities, which derive from our interaction with objects, and pervade all our behaviour and our experience of ourselves, others, the world, and life in general (Frondizi 1958–72). They determine a ‘style’ for all our cognitive and affective processes, and our concrete actions (Bateson 1967). Values are the nonrational premises that orient all our behaviour and experience; they are, therefore, an essential part of our Weltanschauung. They

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have diverse origins: religion, custom, identification, art, myths, and so on. They may be conscious, but they are mainly unknown to the subject. The value system of an individual, a group or a community likewise presents substantial contradictions and conflicts (Hernández de Tubert 2000c; Tubert-Oklander and Hernández Hernández 1993). Gregory Bateson approached the subject of values in his 1967 paper ‘Style, grace, and information in primitive art.’ He was then studying the plastic arts from a particular perspective, which disregarded the content of the work and focused on its form. This he stated in the following quotation: That aspect of the work of art which can most easily be reduced to words – the mythology connected with the subject matter – is not what I want to discuss… I am concerned with what important psychic information is in the art object quite apart from what it may ‘represent’. Le style est l’homme même (‘The style is the man himself ’) (Buffon). What is implicit in style, materials, composition, rhythm, skill, and so on? (G. Bateson 1967, p.130)

From these considerations, he goes on to study Balinese painting, showing how the main values of Balinese culture are immanent in the whole fabric of the work. But values are likewise inherent in every other cultural product or activity. One may find a great deal of information about them from the scrutiny of people’s manners and demeanour, their clothes, their houses, their artifacts and contrivances. This is the very stuff of cultural anthropology. Precisely on account of their ubiquity, values are intangible, both for the social scientist and for the very people who live and embody them. That which is everywhere necessarily becomes imperceptible, since we lack any element of comparison that would allow us to recognize it – it is said that a fish would be the last living being to discover water. This drawback becomes even more burdensome when the researcher comes from the same social environment as his research subjects, since his own thinking processes are ruled by the same values that organize the behaviour and experience of the individuals and groups that are being investigated. It is therefore easier to identify – although not necessarily to understand – the values of people who belong to social groups that are alien to us. This is why social anthropology was born from the study of other nations and races, but it also eases the study of marginal groups in our own society. The most difficult endeavour is, however, the inquiry into the values of our own culture, since this task imperiously requires that the investigator not limit his observation to his subjects of study, but he include himself in the exploration. In this sense, axiological research should always be reflective, since even in the case

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of recognizing and describing the values of other cultural groups, it requires the specification of those of the investigator, in order to preclude that his description and explanation of the observed phenomena become a mere rationalization of his prejudices. Another obstacle to the application of the classical techniques of social research to the study of values is derived from the unquestionable fact that a large part of them is unconscious. This means that most individuals are incapable of recognizing and verbally expressing some of the values that rule their behaviour and experience. Frequently, when someone else does put it into words, they react with anger and revulsion, because they cannot in any way accept this value as a part of themselves. For example, very few people are willing to perceive themselves as racists or prejudiced, even though they actually show it in their actions. This phenomenon is based on two factors. In the first place, values are incorporated imperceptibly, during the socialization process, as they are embedded in each of the concrete acts and skills acquired by the child. This learning process is very similar to that of language, in which the rules of grammar are internalized without ever having been formulated in words. A native talker knows which is the correct way to frame a phrase, and readily identifies those that are not, but he is at a loss when asked to explain why. He only knows that ‘it doesn’t sound right’. The same thing happens with ethical, aesthetic or social values: a properly socialized person intuitively knows what is ‘right’ and what is ‘wrong’ in a particular situation, but usually without being able to account for this judgement. But values do exist, just like the rules of grammar, and they rule the behaviour and experience of people, even if they are unconscious for them. Nevertheless, these imperceptible values may be known by the subject, by means of a conscious effort, or when someone else calls his attention to them. The second factor, which may be even more important, is that some values have been repressed. This means that individuals, groups, institutions, and society-as-a-whole may actively deny the existence of some values, which are nevertheless theirs and rule them. This is due to the fact that the axiological system is very complex, and often contradictory, so that one of our deep-rooted values may conflict with another, which is part of the ideal, conscious image of what we pretend to be. In this case, the usual reaction is to affirm the conscious value as if it were a fact, and deny the other one of which we are ashamed. Thus we declare ourselves to be ‘tolerant’, and deny our deepest prejudices.

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So there are two kinds of values that are unknown to the subject: imperceptible values and repressed values. The main difference between them resides in the intense emotions that are released in the case of the latter, whenever someone dares to name this denied value. This is why, in order to investigate unconscious values, it is essential that we resort to participant research, in which the researcher actively intervenes to stir them up. This is also why the traditional sociological surveys need to be complemented by other techniques that examine the complex axiological system that rules the behaviour and experience of individuals, groups and communities. A questionnaire or a guided interview may only reveal data about those values that are conscious for those who answer them. Such data are very valuable, since it is always necessary to know what people believe about themselves, but they are also incomplete, since they leave out those values that they do not know, and those that they actively deny. Sophisticated questionnaires include control questions that evidence the subject’s contradictions by showing, for instance, that an abstract value that has been affirmed by the interviewee, such as tolerance or equity, is not manifested in his everyday life. But this information does not elucidate the nature of the obstacles – emotional or otherwise – that hinder or impede the awareness of such contradiction. The technique of inquiry known as ‘focus groups’ allows a better expression of their members’ unperceived values. The conductor’s interventions – questions, paraphrases, or recapitulations – may lead the participants to discover and comment on some of those aspects which are characteristic of their conception of the world, but the goal of this technique is centred on the information attained by the investigators, rather than on the members’ learning. However, some aspects of their unconscious values may only be discovered when they become an active party in this inquiry, and this is particularly so in the case of repressed values, which are kept unconscious as a result of intense emotional barriers. And this kind of research can only be approached in operative groups and group analysis, in which there is a confluence of the research processes and those of the group members’ learning and maturation. Our methodological proposal for the participant research of values is to apply the technique of operative groups to the coordination of focus inquiry groups, centred on the study of some chosen aspect of a community’s axiological system, as manifested in the group field that we are able to

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observe. This is what we call ‘axiological research groups’. In the next subsection we shall present one such experience.

Exploring gender values In 1996 we were cooperating with a feminist organization that intended to produce an advertising campaign for the modification of gender prejudice. They felt, however, that they needed more information about the actual values that prevailed in Mexico, before developing a concrete project. This could be done by means of public opinion polls, a technique in which one of the members of our group was very proficient. We suggested that the use of operative groups might provide detailed qualitative information that could be used both as a guide for the campaign and for developing a more adequate and precise poll. We therefore agreed to do a few pilot tests of our technique, in order to fine-tune it. The first experience of an axiological research group on the values that underlie gender relations was carried out on a Saturday, in May 1996. It was coordinated by both of us, and there was also an observer, a university teacher who had invited a group of students who were willing to participate in it. Our basic goal was to test our research device and to define the details of our technique. The group met in one of the departments of the National University of Mexico, from 10:00 a.m. to 2:00 p.m., and from 3:30p.m. to 6:30 p.m. We had decided that these groups would meet on one occasion only. They would work for six hours, which would be divided in two periods of four and two hours, separated by an interval for rest, refreshment, and working through. We felt that the ideal distribution would be to have the first period in the afternoon, and the second on the following morning. This is the design that we favour when coordinating experiential workshops, as described in Chapter 4. We were willing, however, to do them both on the same day, with a break at lunchtime. The number of members would be from eight to twelve, although we could accommodate a larger number, if necessary. We recommended that the locale should be neutral for the participants, for example, an institutional setting. This needed to be spacious, comfortable, ventilated and quiet, and we would need cushions or rugs, so that we might work physically on the floor. We would also need some refreshments for the breaks. The group consisted of thirteen members, eleven women and two men. All of them, with the exception of one of the men, were psychology students who were taking a course with the observer. The other member of the group

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was one of the students’ boyfriend. They had been convoked by their teacher in order to participate in an experience that was part of a research on gender values. They were invited to bring their mates, if they so wished. This activity was not part of their course, and they were free to attend it or not, but they were offered an extra grade if they decided to participate. We started to work as a verbal discussion group, later we introduced some active techniques, in order to stir up the underlying emotions, and ended with a new period of reflection and evaluation of the experience. Our main observations refer to the members’ attitude towards questions of gender. It seemed, however, that they were not particularly interested in it, but that they were more preoccupied by sexuality. This was probably due to their life stage (late adolescence). At the beginning, we proposed an open discussion on the subject of gender differences, but we found them very inhibited. We then introduced an exercise in which they worked in pairs, telling each other what being a man or a woman meant to them. Afterwards, each of the members would tell the group what his companion had said. This gave us sufficient material on what they thought about both genders’ characteristic traits, even though they carefully avoided bringing up any personal experiences. Their description was framed in the traditional terms of our culture. In this version, women are more affective, repressed, and reflective; they hide themselves and they benefit from and enjoy their dependent role; they are not less capable than men, but they allow their emotions to get the better of them; their hormonal cycles may affect the clarity of their thinking, and they feel devalued when they exercise their sexuality. Men are stronger and more impulsive, they take faster decisions, they are freer, affects are forbidden for them, but sexuality is approved. The members conceived gender differences as basically physiological, although they paid lip service to the effect of education and of the expectations of the social group. The ideological dimension emerged in their belief that it is men who should grant women their equality, equity, and freedom, by which they are tacitly affirming their a priori superiority. But it is likewise important to note that they did not acknowledge this as a problem, but only as a fact which is intrinsic to the relations between both sexes. At a second stage, we asked each one to draw a masculine and a feminine figure. Afterwards, each of them presented their drawings to the group, and told a brief story about them. Strikingly, most of them introduced their two characters as a couple. On the other hand, their drawings were rather infantile,

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and totally unsexed. All the figures were dressed and the only attributes that allowed a gender distinction were the external symbols: long or short hair, and the clothes (skirts or trousers). In one of the drawings, it was not possible to distinguish the man from the woman. Another one totally omitted the human figure, and exhibited two objects that, according to him represented both genders: a pen and an old shoe. The difference was apparently based on linguistic considerations, since, as in Spanish there is a gender assigned to inanimate objects, the pen is feminine and the shoe is masculine. But, when he had to tell a story about them, both had masculine connotations. All the stories told by the group members were conspicuously idealized, as they conveyed the idea of a beautiful life, without any conflicts, and full of opportunities for development, understanding, respect, and equality. After a lunch break, we started with a relaxation exercise and an imaginary trip from which they would return with two images: the first one was the secret of the difference between men and women, and the second, their mother’s reaction, right after their birth, when she was told that they were a boy or a girl, respectively. We asked them to anonymously write down these two images and place the pages in a bag, subsequently to be read out. Strikingly enough, many of them did not follow our instructions, and showed each other their writings. This was especially noticeable in the case of the young couple. We interpreted this as an attempt to prevent the emergence of any fantasies or feelings that might suggest that they had any conflicts. Our impression was confirmed when we read these documents aloud, since they depicted an idealized version of their birth. All the mothers were enthralled by their baby’s gender. When we indicated that they were presenting a touched-up version of reality, their collective reaction was of great anger towards us. It is worth noting that all this experience was permeated by an underlying attitude of criticism, distrust, and devaluation of us as coordinators, of our knowledge, and of the effectiveness of our technique. We believe that this defensive disposition was partly due to the fact that we were working in a university setting, and this, taken together with the presence of their teacher, referred them to an educational model based on control. On the other hand, the students knew well their teacher’s preoccupation with the lack of equality and equity in gender relations. It seemed that they were trying to present her with an idealized version of their lives and feelings, concordant with the aspiration to a world without any gender conflicts. We also think that they were influenced by the belief that, as future psychologists, they should not

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exhibit any problems or personal conflicts, especially when facing two psychoanalysts, who were both idealized and denigrated as the image of magicians or conjurers who would be capable of exposing all their secrets. This attitude may have been compounded by the theoretical orientation of their school, which tends to value empirical research and the experimental method over the clinical method. All these problems in their relationship with the coordinating team were obvious during the whole process, and on several occasions we told them what we were perceiving about this, in order to resolve this active resistance to the task. Nevertheless, they kept denying that they had any conflict, and trying to discover what were our expectations of them, in order to provide us with a reasonable imitation. Finally, during the discussion that followed the reading of their ‘images’, there was a partial opening up, when one of the members shared with us a personal concern. This was the feeling of shame that she had always experienced – and still did – towards the development of her female body characteristics. This led the group to an active discussion, which was now connected with their personal emotions and experiences. The theme was a series of feelings of insecurity and shame, which were equally shared by the men and the women. They especially could not tolerate any other person observing them in such a way that his or her glance might make them aware of the sexual nature of their body and gender, unless it came from someone belonging to their own group or social class. This was the only part of the experience in which they had an active participation, filled with emotion. Some of them looked anguished, and they tried to discharge their tension through such activities as smoking, fiddling, or walking about, instead of verbalizing what they felt and thought. Besides, it was the only moment in which their self-images were not idealized, but rather included preoccupations, concerns, or insufficiencies. Finally, we closed the experience with an evaluation, in which every one of the participants, including us, commented on it. We could then confirm the mistrust that pervaded the whole process, since they tended to criticize our methods and knowledge. Over all, they felt that they had been used as a ‘representative experimental sample’. They reproached us for not giving them clear initial instructions, so that they might have known what we were trying to find, and then treat it in intellectual and rational terms, without the emergence of any spontaneous or unexpected happenings. They did not seem to salvage any valuable element from the experience, save, in some instances, that ‘they took home a few things to think about’.

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In our evaluation, we told them our understanding of the obstacles that hindered the task. In the first place, the group was pre-formed: they themselves had expressed how difficult it was ‘to disrobe in front of their companions’. Then, there was the presence of their teacher, whom they desired to please. Third, there was the university context, which tended to define the situation as academic and institutional. In the fourth place, there was a professional distortion, that led them to assume that they should be models of mental health, since they were studying psychology. Finally, there was a professional rivalry with us, and a generational gap that induced them to display their alleged superiority, as thriving youngsters who owned a more valuable and scientific knowledge vis-à-vis the coordinators, who were the representatives of another generation and a different theoretical orientation. One element that we did not include in our feedback to the group, but which we believe to be essential for the understanding of its dynamics, is the way in which it was mustered. The fact that they did not acknowledge in themselves any personal need that might have been fulfilled by this experience, determined an arrogant attitude of ‘doing us a favour’. We feel that this was intensified by having been offered a recompense for their attendance, in terms of higher grades, and even the provision of refreshments during the session. We are convinced that this took on the unconscious meaning of a bribe, which confirmed their hypothesis that the whole experience was geared to our needs, and not everybody’s needs. This compounded their anger and their active and persistent opposition – which was not only unconscious, as could have been expected, but also consciously intentional, since they felt that they were being used and exploited. All this was added to their understandable wish to avoid any potentially conflictive theme. On the other hand, their reproach that we were using them might perhaps have a realistic basis, inasmuch as our coordination tended to expose, in the first place, the problems of gender, thus postponing any other themes that might be of interest to the members. Furthermore, our denunciation of the idealization that underlay the non-conflictive world that they presented was experienced as a vicious attack on our part. Our main conclusions at the time referred to the details of the technique for coordinating these groups: 1. It is not advisable to work with pre-formed groups, nor to allow the participation of people who have important emotional bonds with each other, as in the case of a couple; that is, unless we decide to work with a group of couples or families.

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2. The participants should be offered no retribution for their attendance, other than the personal benefit that they might derive from it. 3. They should be free to attend or not, according to their interests. 4. The convocation should be framed in such terms that those who are interested may develop a personal demand for the experience. 5. It is not expedient to present the project as research, but rather to highlight that it is a service that is being provided. 6. Consequently, the participants should offer some kind of payment, even if only symbolic; for instance, they might be in charge of providing food and beverages, or any other necessary elements, such a paper, pencils, crayons, etc. 7. The coordinating team should not include anybody who has a work or personal relation with the group members. 8. There should be a longer interval between the two stages of the experience, and it would be advisable to consider the possibility of a longer period of work, according to the group’s characteristics and needs. 9. The results of this group should be compared with those acquired from another group of university students, free from the complications that hindered this experience. Soon afterwards, we had a similar session with a group of twenty-five adult women who worked together in community service, taking into account all the above considerations. This time we did not convoke them to a meeting, but responded to their request for a workshop on gender. They provided the place for it (a church), refreshments, and stationery. We both coordinated the group, without any observer. We were therefore free to work without any hindrance other than the ever-present resistance that stems from the avoidance of emotional pain. The results were strikingly similar to those of the first group. These women were likewise committed to the preservation of an ideal version of their lives, which included being free from any gender prejudice, since they belonged to a feminist organization. But the gender stereotypes that they disclosed were just the same as those of the young university students. This type of research allows a rapid identification and a detailed description of the value system of a group. But, since values are widespread in society,

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pervading every one of its structures, the findings of a few groups may be representative of the culture in which they are embedded. The results of such qualitative research may afterwards be checked against those of a traditional, quantitative study, based on the categories provided by the former. This example was meant to highlight some of the difficulties faced and the opportunities offered by the use of operative groups in social research. One consequential conclusion is that, in this case, as in that of psychoanalysis and therapeutic group analysis, research cannot be done for its own sake, but only as a by-product of a service rendered to a group in response to some of its needs.

CHAPTER 7

A Re-evaluation of Operative Groups and Group Analysis

We have by now trodden a long and winding road, from Northfield and the Hospicio de las Mercedes to a hellishly hot city in northern Mexico, following the spiral path of the group process. We have visited a wide and variegated assortment of writers, from Shakespeare and John Donne to Norbert Wiener and Kurt Lewin. But mainly we have established a dialogue with two great analysts: Siegmund Heinrich Foulkes and Enrique Pichon-Rivière. Now it is high time to look back and review our course. One question that arises over and over again is whether this sort of inquiry into human affairs is ‘psychoanalysis’ or not. Both Foulkes and Pichon-Rivière were very careful to differentiate their constructions from the palace that Freud built. They were especially concerned about the danger implied in the tendency to transfer unmodified psychoanalytic concepts to the group field, without taking into account the group and social specific factors. Consequently, Foulkes coined the term ‘group analysis’ by analogy with ‘psychoanalysis’. Where the latter studied (analyzed) an individual psyche, the former analyzed a group; hence, group analysis. Pichon-Rivière, on the other hand, preferred to speak of ‘social psychology’, in order to refer to his own view of the complex relationship between the individual and society. But his assertion that operative groups were not ‘psychoanalysis’ derived from the identification of this term with the theory of instinctual drives and the mechanistic models of the psychic apparatus – i.e. Freudian metapsychology. Whether this particular approach may or should be equated with the whole of psychoanalysis, is at least a moot question, since there are other approaches to 227

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psychoanalysis – such as interpersonal psychoanalysis or object relations theory – which are more amenable to an integration with group practice and concepts. It is certainly true that group analysis must develop its own concepts from the particular experience that is generated and studied when a few people meet in a temporarily closed space in order to learn and understand something from their being together. But this is precisely what Freud did when he started to build concepts and theories from the radically new experience that emerged when he locked himself in a room with another human being, in order to ‘do psychoanalysis’. It is true that group-analytic and psychoanalytic concepts are quite different, and so they should be, since they stem from disparate experiences, but their attempt to inquire into the hidden meanings of human behaviour and experience, as well as their particular way of listening, are pretty much the same. So, what are we to privilege, Freud’s manner of inquiry or his personal theoretical conclusions? If we define psychoanalysis in terms of its theory, we shall inevitably end up with a creed which varies from one school to another. This breeds dogmatism. But, on the other hand, if we emphasize its inquisitive approach, we shall encounter a galaxy of manifold theoretical points of view. This breeds uncertainty and confusion. Which is the greater of these two dangers? Our answer to this question is liable to depend on our own particular stance vis-à-vis the perennial problem of finding a point of equilibrium between Imagination and Rigour. Bion envisioned this problem when he wrote: Psycho-analysis cannot escape ideas of cure, treatment, illness, in psycho-analysts and patients alike. Eissler warns against a structure that is too rigid and too limited to permit development. At the opposite extreme the Sufis have no rigid institution yet have endured; their solution would open the way for an ‘expanding universe’ of psycho-analysis but it would not be long before members of the psycho-analytic movement could not understand each other. (Bion 1970, p.83)

Interestingly enough, the author made reference to the Sufis. These are a mystical sect of Islam that insists on finding direct experience of the invisible world, instead of having to rely on doctrine and texts as a guide for their beliefs. It is understandable that a group of people that claims to have witnessed True Reality should feel that they would be able to understand each other, in spite of expressing themselves in diverse languages. But can we rely on the various psychoanalysts having had comparable experiences of what psychoanalysis actually is? Apparently, we cannot, since the analytic

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experience is quite different for every analytic pair. Recently there have been several attempts to establish the dialogue among the various schools of psychoanalysis on the common ground of clinical experience, but there is still a long way to go in that direction (Wallerstein 1988, 1990). Group analysis and operative groups are in a much better position, since in this field it is possible to witness and participate in a group conducted by a colleague. This paves the way for the development of a common ground of group-analytic experience that might help us to make sense of the various theories. Our own position on this subject has varied over the years. For a long time, we were critical of the attempts to conceive the work with groups as ‘group psychoanalysis’. We felt it to be tantamount to imposing the limitations of a psychoanalytic theory born of a bi-personal situation and framed in uni-personal terms, on a hyper-complex group experience. But we have since modified our stance: if psychoanalysis is to be defined by its attitude and its approach, rather than by its theories, as García Badaracco (2000) does, then group analysis and operative groups should be conceived as a natural extension of that momentous inquiry into human life and experience that was initiated by Sigmund Freud (Tubert-Oklander 2000a). The issue is, of course, still open. But we do know that we find no contradiction between the way in which we conceive, practise and think psychoanalysis, and what we use in order to inquire, understand, participate in, and aid human groups. So that, perhaps, instead of being sometimes psychoanalysts and sometimes group analysts, we are just analysts, working with people in an attempt to understand them, as well as ourselves, and using whatever concepts we may find useful in this endeavour.

Notes Notes to Chapter 1 1

This section is based on a paper read at the 8th International Meeting of the International Association for the History of Psychoanalysis, ‘History of Psychoanalytical Clinical Work from Freud to Now. Retrospective and Prospective’, held in Versailles (Tubert-Oklander 2000a).

2

For a more detailed account of the story of the Northfield Experiment, see Harrison (1999) and Hinshelwood (1999).

3

This section is based on a paper read at the 9th International Meeting of the International Association for the History of Psychoanalysis ‘Psychoanalysts in Exile. Elements of a History’, held in Barcelona (Tubert-Oklander 2002b).

4

Since none of the writings of Pichon-Rivière has been translated into English, all the direct quotations from his work, as well as from the interviews he gave to Vicente Zito Lema (1976), will be in our own translation.

Notes to Chapter 2 1

Pichon-Rivière does not quote Bion, but he was never very much of an academic, so his papers usually carry no reference list and the acknowledgement of his sources is always rather oblique. There is no way, however, in which he might have missed reading Bion’s work on groups, which was obligatory reading for the founders of group psychotherapy in Buenos Aires in the fifties. So we shall assume this influence, on the basis of the similarity in their thoughts.

2

It can be argued that psychoanalysis does have a theory of the motives of action, as in the case of acting out, but it remains true that it has no theory of the planning of action, nor of its consequences.

3

See section on ‘The group process’ in this chapter for the definition of these terms.

4

See section on ‘The group process’ in this chapter.

5

The Spanish word ‘esquema’ can be translated as ‘scheme’ or ‘schema’. We have chosen the latter, for reasons that will become evident as we develop our argument.

6

Webster’s Encyclopedic Unabridged Dictionary of the English Language, 1989. New York: Portland House.

7

This quotation comes from a paper written by Fernando Taragano, one of Pichon-Rivière’s disciples, from his notes on the master’s classes and lectures on the body schema. It was published under the latter’s name, since it summarizes his ideas on this subject.

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8

See section on ‘The group process’ in this chapter for a definition of ‘verticality’ and ‘horizontality’.

9

See Chapter 3 for a further development of these ideas.

10

The neologism ‘emergent’, used as a noun, is derived from ‘emerge’, in the same way as ‘existent’ is derived from ‘exist’.

11

North-American readers should bear in mind that in Argentina ‘football’ always means soccer.

12

See Chapter 6 for further discussion and an example of a task-centred therapy of a pre-formed group (the staff of a therapeutic community).

13

Such a situation is depicted in a clinical example in Chapter 4, in terms of the Kleinian conception of the schizoid-paranoid position.

14

The philosopher Karl Richard Popper (1957), otherwise a severe critic of psychoanalysis, records his agreement with it about the dynamics of neuroses. To him, the constant repetition of an infantile pattern that defines psychopathology is identical with what he calls the dogmatic attitude, as opposed to the critical attitude. This contention supports Pichon-Rivière’s point of view in equating mental disorders with a blockage of learning. There is, however, no reference to Popper in Pichon-Rivière’s writings.

15

The original Spanish term enseñaje is a Carrollian portmanteau word (Carroll 1871) that condenses enseñanza (teaching) and aprendizaje (learning). We have translated it as an Orwellian Newspeak compound word, although keeping the gerund (Orwell 1949).

Notes to Chapter 3 1

Strachey’s translation of Freud (1921) made this confusion even worse, when he translated ‘Massenpsychologie’ as ‘group psychology’. Freud’s use of the term ‘mass’ was nearer to Le Bon’s ‘foule’ than Strachey’s ‘group’.

2

This emotional relation with the higher-order system is further analyzed in Chapter 6, ‘The Approach to Institutions and Society’.

3

See ‘A revision of the concept of CROS’ in this chapter for an ample discussion of the Weltanschauung.

4

We have retranslated this quotation from its Spanish published text, since we have not had access to the original transcript of the interview.

Notes to Chapter 4 1

Ferdinand de Saussure (1916), in his famous Course in General Linguistics, introduced the terms ‘synchronic’ and ‘diachronic’ in order to refer to the study of a language as a timeless structure or in terms of its evolution over time. These terms have since been used, with a similar connotation, in the social sciences.

2

This clinical material was originally part of a paper called ‘The schizoid-paranoid and depressive positions in the learning operative group’ (Tubert-Oklander and Baquedano 1978), later Chapter 2, ‘The transversal study of a learning operative

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group’, of the book The Learning Operative Group (Tubert-Oklander 1990–92). The present version has been revised and partially modified. 3

The case of Balint’s seminars will be dealt further in Chapter 5.

4

This clinical material was originally part of a paper called ‘A longitudinal description learning operative group’ (Tubert-Oklander 1979), later Chapter 3, ‘Longitudinal study of a learning operative group’, of the book The Learning Operative Group (Tubert-Oklander 1990–92). The present version has been revised and partially modified.

5

Kleinian analysts recognize two kinds of anxiety stemming from the earliest stages of development: paranoid anxiety and depressive anxiety (Klein 1952). Some Latin-American analysts, following Bleger (1967), describe a third type: ‘confusional anxiety’, meaning the sort of anxiety derived from being unable to discriminate between various stimuli. Such anxiety is distinctive of what he considers to be the first dynamic organization of the mind: the glishro-karyc position (’glishro-karion’ is a term derived from Greek meaning ‘agglutinated nucleus’). More recently Ogden (1989) has described an ‘autistic-contignous position’ which is rather similar to Bleger’s, even if framed in different terms.

6

This is a term introduced by Gaston Bachelard, who ‘argued that new scientific knowledge may lead to a fundamental reformulation of reality, just as the preexisting formulation of reality that the observer imposed on the natural world may have predisposed him to entertain some hypotheses but not others. Given the dialectic of reason and experience, reformulation of reality involves not the rejection but rather the recasting of previous formulations’ (see Columbia University Press 2001).

Notes to Chapter 5 1

This section is an enlarged and updated version of a paper called ‘Collective supervision in psychoanalytic education’ (Hernández de Tubert 1998).

2

This section is an enlarged and updated version of a paper called ‘The impact of borderline pathology on a psychoanalytic supervision’ (Moreno Corzo, Ramos de Moreno Corzo and Tubert-Oklander 1979), later included in Chapter 4, ‘A group psychoanalytic supervision’, of The Learning Operative Group (Tubert-Oklander 1989–92). The present version has been revised, updated, and partially modified.

3

This colleague was Vidalina Ramos de Moreno Corzo, who has since become a distinguished group therapist.

4

The term ‘psychotic structure’ was used somewhat loosely in this discussion. It is not unusual, in psychoanalytic circles, to qualify as ‘psychotic’ any psychopathological phenomenon that presents primitive anxieties and mechanisms. Present-day thinking about borderline states tends to clearly distinguish them from psychoses (Kernberg 1975a, 1975b). Nevertheless, these considerations were not part of the group discussion at that time, so that the ‘psychotic’ characteristics of the material and the patient should be understood as ‘regressive phenomena which are more severe and primitive than those of neuroses’.

5

‘Projective identification’ is defined as the patient’s unconscious fantasy that he can really free himself from the unwanted parts of himself, and project them into some other person or object (Klein 1946; Segal 1964). But this fantasy is always accom-

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panied by various communicational manoeuvres that tend to induce in the other person certain emotional states and behaviours that are consonant with what has been projected into them. In the treatment situation, the impact of this defence mechanism provokes in the therapist countertransference reactions, which are known as ‘projective counter-identifications’ (Grinberg 1958, 1962). These reactions may disturb the therapist’s judgement, but they can also be used as a source of information about the patient’s mental state and the organization of the transference–countertransference field. 6

The first two parts of this section are based on the paper ‘A model for the training of group and family therapists’ (Tubert-Oklander and Hernández de Tubert 1998). The third subsection, which presents the narrative of the experience, is new.

7

Melanie Klein’s theory of the unconscious fantasy (Isaacs 1948; Segal 1964) is a truly phenomenological theory – what Donald Meltzer (1978, 1981, 1984) calls a ‘descriptive theory’ – since it systematically and painstakingly describes the unconscious subjective experience, rather than explaining it away in abstract terms. Meltzer further asserted that ‘Mrs Klein…made a discovery that created a revolutionary addition to the model of the mind, namely that we do not live in one world, but in two – that we live in an internal world which is as real a place to live in as the outside world’ (Meltzer 1981, p.178, our italics). These are experiential ‘worlds’, one of them conscious and the other, unconscious.

8

The most comprehensive introduction to the existential approach in psychotherapy can be found in Existence, edited by Rollo May, Ernest Angel and Henri F. Ellenberger (1958).

Notes to Chapter 6 1

This section is based on excerpts from two papers called ‘Professional relations in the practice of nursing’ (Hernández de Tubert 2000a) and ‘Nursing: Women in conflict?’ (Hernández de Tubert 2002), with the addition of new material.

2

This section is based on a paper originally read at the 8th International Congress of Group Psychotherapy, held in Mexico City (Tubert-Oklander 1984).

3

Active adaptation to reality was one of the landmarks of mental health in Pichon-Rivière’s thought. By this he implied an alloplastic process of changing the world in order to attain a better fit between the individual and his environment. This is in sharp contrast with passive adaptation to reality, an autoplastic process by which the individual modifies, and even mutilates, his own personality, to allay a conflict with his surroundings (Pichon-Rivière 1967).

4

This is an extension of Gear and Liendo’s (1974) contention that the coordinator of an operative group must ‘be in the group, but not of the group’.

5

For example, a labour conflict between the owners of the institution and one sector of the personnel could be finally solved, that the underlying emotions and fantasies had been worked through in the group, by means of a rational negotiation which was done apart from the operative group. The final solution was found when both parts agreed to submit to a third neutral instance, in this case, the labour law.

6

For an English translation of this paper, see García Badaracco (1982a).

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7

See Chapter 3 for a discussion of the network theory and the relationship between the individual and the wider social environment.

8

A few exceptions are García Badaracco (1986, 1992). These two papers are intended for psychoanalytic audiences, but they pose some theoretical propositions that are relevant for the rationale for this sort of therapeutic intervention. García Badaracco (1982a) is an English translation of his 1978 paper in Spanish, ‘The family as the real context of all psychotherapeutic processes’, while (1978b) is a French version of the same ideas.

9

This strategy was quite similar to Harold Bridger’s approach in Northfield, where he ‘sat alone and waited for days in a large room with a new notice over the door announcing it as “The Club”, and when soldiers came in and asked him what club it was he asked them what club they hoped it was and then offered to work with them to make it so’ (Main 1983, p.208). Of course, Bridger was not working with psychotic patients – which was fortunate indeed, since he was not a therapist at the time – but these principles later proved to be applicable to all sorts of communities. S. H. Foulkes, who had the benefit of psychoanalytic training and group-analytic experience, likewise moved from the consulting room to the community space, and became an itinerant group therapist, who approached and intervened in every social gathering in the hospital (S.H. Foulkes 1948, 1964; Hinshelwood 1999).

References Abiuso, D., Ahumada, J. and Ferschtut, G. (1973) ‘Notas sobre la supervisión en grupos.’ [‘Notes on group supervision.’] Acta Psiquiátrica y Psicológica de América Latina 19, 5, 349–354. Aguiar, E. (1988a) ‘Efectos psicológicos del terrorismo de Estado en parejas afectadas directas por la represión política.’ [‘Psychological effects of state terrorism on couples that have been directly affected by political repression.’] Revista de Psicología y Psicoterapia de Grupo 12, 1–2. Aguiar, E. (1988b) ‘Efectos psicológicos de la impunidad de la represión política en parejas afectadas directas.’ [‘Psychological effects of the impunity of political repression on directly affected couples.’] Revista de Psicología y Psicoterapia de Grupo 12 3–4, 209–215. Ahumada, J., Dellarossa, A. and Koltan, H. (1971) ‘La tarea externa y la tarea interna del grupo.’ [‘The group’s inner task and outer task.’] Internal document of the Institute of Group Techniques. Buenos Aires: Group Psychology and Group Psychotherapy Association. Angrist, S.W. and Hepler, L.G. (1967) Order and Chaos: Laws of Energy and Entropy. New York: Basic Books. Arsham, H. (1994–2001) Applied Management Science: Making Good Strategic Decisions. Website of Professor Hossein Arsham: http://ubmail.ubalt.edu/~harsham/ opre640/opre640.htm December 2001. Avenburg, R. (1987) ‘Enrique Pichon-Rivière. Sus enseñanzas a través de mi vínculo con él.’ [‘Enrique Pichon-Rivière. His teachings through my relation with him.’] In Psicoanálisis: perspectivas teóricas y clínicas. [Psychonalysis: Theoretical and Clinical Perspectives.] Buenos Aires: Ediciones Publikar, 1998. Balint, M. (1952) Primary Love and Psycho-Analytic Technique. New York: Liveright, second revised and enlarged edition, 1965. Balint, M. (1957) The Doctor, His Patient and The Illness. London: Pitman. New York: International Universities Press, second revised and enlarged edition, 1964. Balint, M. (1968) The Basic Fault. Therapeutic Aspects of Regression. New York: Brunner/Mazel, 1979. Balint, M., Balint, E., Gosling, R. and Hildebrand, P. (1966) A Study of Doctors. London: Tavistock. Banton, M. (1965) Roles: An Introduction to the Study of Social Relations. London: Tavistock, 1968. Baranger, M., Baranger, W. and Mom, J. (1978) ‘Psicopatología del proceso didáctico.’ [‘Psychopathology of the didactic process.’] Revista de Psicoanálisis 35, 1, 181–190.

237

238

OPERATIVE GROUPS

Baranger, W. (1971) Posición y objeto en la obra de Melanie Klein. [Position and Object in the Work of Melanie Klein.] Buenos Aires: Kargieman, 1976. Baranger, W. and Baranger, M. (1969) Problemas del campo psicoanalítico. [Problems of the Psychoanalytic Field.] Buenos Aires: Kargieman. Barrera, U. (1975) ‘Desde el tablón.’ La Opinión Cultural, Buenos Aires, Sunday 22 June, 1975, p.11. Bartlett, F.C. (1932) Remembering: A Study in Experimental and Social Psychology. Cambridge: Cambridge University Press, 1967. Bateson, G. (1942) ‘Social planning and the concept of deutero-learning.’ In Bateson, G. (1972) 159–176. Bateson, G. (1948) ‘Metalogue: Why do things get in a muddle?’ In Bateson, G. (1972), 3–8. Bateson, G. (1953) ‘Metalogue: Why do things have outlines?’ In Bateson, G. (1972), 27–32. Bateson, G. (1964–71) ‘The logical categories of learning and communication.’ In Bateson, G. (1972), 279–308. Bateson, G. (1966) ‘Problems in cetacean and other mammalian communication.’ In Bateson, G. (1972), 364–378. Bateson, G. (1967) ‘Style, grace, and information in primitive art.’ In Bateson, G. (1972), 128–152. Bateson, G. (1969) ‘Double bind, 1969.’ In Bateson, G. (1972), 271–278. Bateson, G. (1972) Steps to an Ecology of Mind. New York: Ballantine Books. Bateson, G. (1979) Mind and Nature: A Necessary Unit. New York: Bantam Books. Bateson, G. (1991) A Sacred Unity: Further Steps to an Ecology of Mind (ed. Rodney E. Donaldson). San Francisco: Harper Collins. Bateson, G. and Bateson, M.C. (1987) Angels Fear: Towards an Epistemology of the Sacred. New York: Bantam Books, 1988. [British edition: Angels Fear: An Investigation Into the Nature and Meaning of the Sacred. London: Rider, 1988.] Bateson, G. and Goleman, D. (1978) ‘Breaking out of the double bind.’ Psychology Today 12, 3, 42–51. Bateson, M.C. (1984) With a Daughter’s Eye: A Memoir of Margaret Mead and Gregory Bateson. New York: Harper Collins, 1993. Benne, K.D. (1964) ‘History of the T-group in the laboratory setting.’ Chapter 4 of Bradford et al. (1964). Binswanger, L. (1944) ‘The case of Ellen West.’ In May et al. (1958), 237–364. Binswanger, L. (1945) ‘Insanity as life-historical phenomenon and as mental disease: The case of Ilse.’ In May et al. (1958), 214–236. Binswanger, L. (1946) ‘The existential analysis school of thought.’ In May et al. (1958), 191–213. Bion, F.R. (ed.) (1980) Bion in New York and Sao Paulo. Pertshire: Clunie Press. Bion, W.R. (1948–51) ‘Experiences in groups.’ In Bion (1961), 27–137. Bion, W.R. (1952) ‘Re-View: Group dynamics.’ In Bion (1961), 139–191. Bion, W.R. (1961) Experiences in Groups and Other Papers. London: Tavistock, 1968.

REFERENCES

239

Bion, W.R. (1962) Learning from Experience. London: Heinemann. Bion, W.R. (1965) Transformations: Change from Learning to Growth. London: Heinemann. Bion, W.R. (1970) Attention and Interpretation: A Scientific Approach to Insight in Psycho-Analysis and Groups. London: Tavistock. Bion, W.R. and Rickman, J. (1943) ‘Intra-group tensions in therapy; their study as a task of the group.’ In Bion (1961), 11–26. Blake, W. (1972, first published 1790–93) ‘The marriage of heaven and hell.’ In Complete Writings (ed. Geoffrey Keynes). Oxford: Oxford University Press. Bleger, J. (1961) ‘Grupos operativos en la enseñanza.’ [‘Operative groups in teaching.’] In Temas de psicología. (Entrevista y grupos.) [Psychological Themes. (Interview and Groups.)] Buenos Aires: Nueva Visión, 1972. Bleger, J. (1963–69) Psicología de la conducta. (second revised edition) [Psychology of Behaviour.] Buenos Aires: Centro Editor de América Latina, 1971. Bleger, J. (1967a) Simbiosis y ambigüedad. Estudio psicoanalítico. [Symbiosis and Ambiguity: Psychoanalytic Study.] Buenos Aires: Paidós, 4th edition, 1978. Bleger, J. (1967b) ‘Psychoanalysis of the psychoanalytic frame.’ The International Journal of Psycho-Analysis 48, 511–519. Bradford, L.P. and French, J.R.P. (eds) (1948) Dinámica del grupo de discusión. Buenos Aires: Ediciones 3, 1968. [Spanish translation of The Dynamics of the Discussion Group. Journal of Social Studies 4, 2, 1948.] Bradford, L.P., Gibb, J.L. and Benne, K.D. (1964) T-Group Theory and Laboratory Method. New York: John Wiley and Sons. Bridger, H. (1983) ‘Northfield revisited.’ In Pines (1985). Brillouin, L. (1964) Scientific Uncertainty and Information. New York: Academic Press. Buber, M. (1923) I and Thou (translated by Ronald Gregor Smith). New York: Charles Scribner’s Sons, 1958. Caligor, L. (1981) ‘Parallel and reciprocal process in psychoanalytic supervision.’ Contemporary Psychoanalysis 17, 1, 1–26. Cappon, J. (1978) El movimiento de encuentro en psicoterapia de grupo. Descripción y análisis crítico. [The Encounter Movement in Group Psychotherapy: Description and Critical Analysis.] Mexico: Trillas. Carroll. L. (1871) Through the Looking-Glass and What Alice Found There. In Gardner, M. (ed.) (1960) The Annotated Alice. Harmondsworth: Penguin, 1979. Clausewitz, C. von (1832–1968) On War (ed. Anatol Rapaport). London: Penguin, 1978. Columbia University Press (2001) ‘Bachelard, Gaston.’ In The Columbia Enciclopedia, sixth edition. Web page: http://www.bartleby.com/65/ba/Bachelar.html Defoe, D. (1719) Robinson Crusoe. Oxford: Oxford University Press, 1999. Dellarossa, A. (1959) ‘Planteos técnicos en una primera sesión.’ [‘Technical aspects in a first session.’] In Grinberg, L., Langer, M. and Rodrigué, E. (eds.) El grupo psicológico en la terapéutica, enseñanza e investigación. [The Psychological Group in Therapy, Teaching, and Research.] Buenos Aires: Nova.

240

OPERATIVE GROUPS

Dellarossa, A. (1979) Grupos de reflexión. Entrenamiento institucional de coordinadores y terapeutas de grupos. [Reflection Groups: Institutional Training of Group Co-ordinators and Group Therapists.] Buenos Aires: Paidós. Descartes, R. (1637) Discurso del método (translation, introduction and notes by Risieri Frondizi). Madrid: Alianza Editorial, 1981. Devereaux, G. (1967) From Anxiety to Method in the Behavioral Sciences. The Hague: Mouton. Dilthey, W. (1911) ‘Los tipos de visión del mundo y su desarrollo en los sistemas metafísicos.’ [‘Types of Weltanschauung and their development in metaphysical systems.’] In Teoría de las concepciones del mundo [Theory of the Conceptions of the World] (translated by and with an introduction and notes by Julián Marías). Madrid: Alianza Editorial, 1988. Doehrman, M.J.G. (1976) ‘Parallel process in supervision and psychotherapy.’ Bulletin of the Menninger Clinic 40, 1, 3–104. Donne, J. (1624) ‘Meditation XVII.’ In The Literature Network Web Page: http://www.online-literature.com/donne/409 Dupont M.A. (1978) ‘Algunas impresiones sobre Wilfred R. Bion.’ [‘Some impressions of Wilfred R. Bion.’] In La práctica del psicoanálisis. [The Practice of Psychoanalysis.] Mexico: Pax, 1988. Eco, U. (1968–94) La struttura assente: La ricerca semiotica e il metodo strutturale. Milan: Bompiani, 1998. Eco, U. (1976) A Theory of Semiotics. London: Macmillan, 1977. Eco, U. (1992) Interpretazione e sovrainterpretazione: Un dibattito con Richard Rorty, Jonathan Culler e Christine Brooke-Rose (ed. Stephan Collini). Milan: Bompiani, 1995. [English edition: Interpretation and Overinterpretation. Cambridge, MA: Harvard University Press.] Erikson, E.H. (1950) Childhood and Society. London: Paladin, 1987. Espiro, N. (1975) ‘La subversión de roles.’ [‘Role subversion.’] La Opinión Cultural, Buenos Aires, Sunday 22 June 1975, p.8. Fairbairn, W.R.D. (1946) ‘Object-Relations and Dynamic Structure.’ In Fairbairn (1952). Fairbairn, W.R.D. (1952) Psychoanalytic Studies of the Personality. London: Routledge, 1992. Ferenczi, S. (1955) Final Contributions to the Problems and Methods of Psycho-Analysis. New York: Brunner/Mazel, 1980. Ferenczi, S. (1985) The Clinical Diary of Sándor Ferenczi (ed. J. Dupont, trans. M. Balint and N. Jackson). Cambridge, MA: Harvard University Press, 1988. Ferenczi, S. and Rank, O. (1922) The Development of Psychoanalysis. Madison: International Universities Press, 1986. Ferrater Mora, J. (1994) Diccionario de filosofía [Philosophical Dictionary] (new edition in four volumes, ed. Josep-María Terricabras). Barcelona: Ariel. Ferschtut, G. (1969) ‘Notas acerca de la mentalidad y el acting out grupales y de su interpretación transferencial.’ [‘Notes on the group mind and group acting out, and

REFERENCES

241

their interpretation in terms of transference.’] Acta Psiquiátrica y Psicológica de América Latina 15, 324–333. Foulkes, E.T. (1984) ‘The origins and development of group analysis.’ In Lear, T. (ed.) (1984). Foulkes, S.H. (1948) Introduction to Group-Analytic Psychotherapy: Studies in the Social Interaction of Individuals and Groups. London: Maresfield, 1984. Foulkes, S.H. (1957) ‘Psychodynamic processes in the light of psycho-analysis and group analysis.’ In Foulkes, S.H. (1964a). Foulkes, S.H. (1961) ‘Group processes and the individual in the therapeutic group.’ In Foulkes (1964a). Foulkes, S.H. (1964a) Therapeutic Group Analysis. London: Maresfield, 1984. Foulkes, S.H. (1964b) ‘Teaching, study and research.’ In Foulkes (1964a). Foulkes, S.H. (1964c) ‘A brief guide to group-analytic theory and practice.’ In Foulkes (1964a). Foulkes, S.H. (1975a) Group-Analytic Psychotherapy. London: Gordon and Breach, 1978. Foulkes, S.H. (1975b) ‘A short outline of the therapeutic processes in group-analytic psychotherapy.’ In Lear (ed.) (1984). Foulkes, S.H. and Anthony, E.J. (1957–65) Group Psychotherapy. The Psychoanalytic Approach (second revised edition, 1965). London, Harmondsworth: Penguin, 1973. Foulkes, S.H. and Lewis, E. (1944) ‘Group analysis. Studies in the treatment of groups on psychoanalytical lines.’ In Foulkes (1964a). Frankl, V.E. (1978) The Unheard Cry for Meaning: Psychotherapy and Humanism. New York: Pocket Books, 1985. Freud, S. (1900) ‘The interpretation of dreams.’ Standard Edition 4–5. Freud, S. (1911) ‘Formulations on the two principles of mental functioning.’ Standard Edition 12. Freud, S. (1920) ‘Beyond the pleasure principle.’ Standard Edition 18. Freud, S. (1921) ‘Group psychology and the analysis of the ego.’ Standard Edition 18. Freud, S. (1926) ‘Inhibitions, symptoms and anxiety.’ Standard Edition 20. Freud, S. (1930) ‘Civilization and its discontents.’ Standard Edition 21. Freud, S. (1933) ‘The question of a Weltanschauung.’ Standard Edition 22. Frondizi, R. (1958–72) ¿Qué son los valores? [What are values?] (third revised and enlarged edition). Mexico: Fondo de Cultura Económica, 1981. García Badaracco, J. (1968) ‘Contribución al estudio de la noción de objeto interno.’ [‘A contribution to the study of the notion of the internal object.’] Paper read at the Argentine Psychoanalytic Association, Buenos Aires, 1968. García Badaracco, J. (1978a) ‘La familia como contexto real de todo proceso terapéutico.’ [‘The family as the real context of all psychotherapeutic processes.’] Terapia Familiar: Estructura, Patología y Terapéutica del Grupo Familiar 1, 1, 9–16. García Badaracco, J. (1978b) ‘Le processus psychothérapeutique et sa relation avec le contexte réel de l’ experience psichotherapéutique.’ [‘The family as the real context of all psychotherapeutic processes.’] Psychotherapy and Psychosomatics 29, 107–112.

242

OPERATIVE GROUPS

García Badaracco, J. (1982a) ‘The family as the real context of all psychotherapeutic processes.’ The International Book of Family Therapy 17, 293. García Badaracco, J. (1982b) Biografía de una esquizofrenia. [Biography of a Schizophrenic.] Buenos Aires: Fondo de Cultura Económica. García Badaracco, J. (1986) ‘Identification and its vicissitudes in the psychoses. The importance of the concept of the “maddening object”.’ The International Journal of Psycho-Analysis 67, 133–146. García Badaracco, J. (1990) Comunidad terapéutica psicoanalítica de estructura multifamiliar. [Psychoanalytical Therapeutic Community with a MultiFamily Structure.] Madrid: Julián Yébenes. García Badaracco, J. (1992) ‘Psychic change and its clinical evaluation.’ The International Journal of Psycho-Analysis 73, 209–219. García Badaracco, J. (1998) Workshop on ‘MultiFamily Psychoanalysis’ at the 33rd National Congress of Psychoanalysis. Mexican Psychoanalytic Association, Mexico City, November 1998. García Badaracco, J. (2000) Psicoanálisis multifamiliar. Los otros en nosotros y el descubrimiento del sí mismo. [Multifamily Psychoanalysis: The Others in Ourselves and the Discovery of the Self.] Buenos Aires: Paidós. Gear, M.C. and Liendo, E.C. (1974) Psicoterapia estructural de la pareja y del grupo familiar. [Structural Marriage and Family Psychotherapy.] Buenos Aires: Nueva Visión. Gediman, H. and Wolkenfeld, F. (1980) ‘The parallelism phenomenon in psychoanalysis and supervision: Its reconsideration as a triadic system.’ Psychoanalytic Quarterly 49, 234–255. Glocer, F. (1972–73) ‘Laboratorios de interacción humana. Ideologías en la búsqueda de nuevas técnicas psicológicas.’ [‘Human interaction laboratories: Ideologies in the search for new psychological techniques.’] Revista Argentina de Psicología 4, 13–14, 111–136. Goldstein, K. (1939) The Organism: A Holistic Approach to Biology. New York: American Book. Goldstein, K. (1940) Human Nature in the Light of Psychopathology. Cambridge: Harvard University Press. Goldstein, K. (1948) Language and Language Disturbances: Aphasic Symptom Complexes and their Significance for Medicine and Theory of Language. New York: Grune and Stratton. Grinberg, L. (1958) ‘Aspectos mágicos en la transferencia y en la contratransferencia. Sus implicaciones técnicas.’ [‘Magical aspects of transference and countertransference: Their technical implications.’] In Psicoanálisis. Aspectos teóricos y clínicos. [‘Psychoanalysis: Theoretical and Technical Aspects.’] Buenos Aires: Paidós, 1981. Grinberg, L. (1962) ‘On a specific aspect of countertransference due to the patient’s projective identification.’ The International Journal of Psycho-Analysis 43, 436–440. Grinberg, L., Apter, A., Bellagamba, H., Berenstein, I., Cereijido, F. de, Garfinkel, G., Faigon, D., Failla, I.S. de, Kalina, E., Lichtmann, A., Liendo, E.C. and Sapochnik, L. (1967) ‘Función del soñat, y clasificación clínica de los sueños en el proceso analítico. ‘Function of dreaming and a clinical classification of dreams in the analytic process.’ Revista de Psicoanálisis 24, 4, 749–769.

REFERENCES

243

Grosskurth, P. (1986) Melanie Klein: Her World and her Work. New York: Alfred A. Knopf. Harrison, T. (1999) Bion, Rickman, Foulkes and the Northfield Experiments: Advancing on a Different Front. London: Jessica Kingsley Publishers. Head, H. (1920) Studies in Neurology. Oxford: Oxford University Press. Hernández Hernández, R. (1994a) ‘El proceso terapéutico. Las perspectivas del psicoanálisis y del análisis grupal.’ [‘The therapeutic process: The perspectives of psychoanalysis and group analysis.’] Dissertation presented to the Mexican Analytic Group Psychotherapy Association. Mexico City, December 1994. Hernández Hernández, R. (1994b) ‘La identificación proyectiva en la terapia de pareja.’ [‘Projective identification in marriage therapy.’] Paper read at the 33rd National Congress of Psychoanalysis. Mexican Psychoanalytic Association, Querétaro, November 1994. Hernández Hernández, R. (1994c) ‘El mundo del psicoanalista.’ [‘The world of the psychoanalyst.’] Paper read at the 33rd National Congress of Psychoanalysis. Mexican Psychoanalytic Association, Querétaro, November 1994. Hernández Hernández, R. and Tubert-Oklander, J. (1994) ‘Del olvido a la violencia y de la violencia al mito. Reflexiones psicoanalíticas sobre el proceso político de nuestro país.’ [‘From forgetfulness to violence, and from violence to myth: Psychoanalytic reflections on Mexico’s political process.’] Paper read at the 16th ‘Anniversary of Sigmund Freud’ Annual Scientific Meeting. Ixtapan de la Sal, Mexican Psychoanalytic Association, May 1994. Published in Subjetividad y Cultura 4, 71–79. Hernández de Tubert, R. (1995) ‘El proceso terapéutico en el psicoanálisis y el análisis grupal.’ [‘The therapeutic process in psychoanalysis and group analysis.’] Subjetividad y Cultura 5, 73–82. Hernández de Tubert, R. (1997a) ‘La interpretación: del psicoanálisis al análisis grupal.’ [‘Interpretation: From psychoanalysis to group analysis.’] Paper read at the 7th National Congress of Group Psychotherapy. Mexican Analytic Group Psychotherapy Association, Morelia, May 1997. Hernández de Tubert, R. (1997b) ‘Mentira y poder: sociogénesis de la enfermedad mental.’ [‘Lies and power: The social genesis of mental illness.’] Cuadernos de Psicoanálisis 30, 1–2, 43–49. Hernández de Tubert, R. (1998) ‘La supervisión colectiva en la formación psicoanalítica.’ [‘Collective supervision in psychoanalytic education.’] Paper read at the First International Symposium on ‘Supervision in Psychotherapy.’ Universidad Iberoamericana, Puebla, September 1998. Hernández de Tubert, R. (1999a) ‘Enfermería y género.’ [‘Nursing and gender.’] Paper read at the 1st Meeting on Research in Nursing. Mexico, August 1999. Hernández de Tubert, R. (1999b) ‘For whom the bell tolls. Psychoanalysis and human rights.’ Contribution to the Workshop ‘Psychoanalysis, Politics and the New IPA UN Committee.’ 41st International Congress of Psychoanalysis, Santiago, Chile, July 1999. Hernández de Tubert, R. (2000a) ‘Las relaciones profesionales en la práctica de la enfermería. [‘Professional relations in the practice of nursing.’] Paper read at the 2nd Meeting on Research in Nursing. Mexico, May 2000.

244

OPERATIVE GROUPS

Hernández de Tubert, R. (2000b) ‘El principio de exclusión en el desarrollo del movimiento psicoanalítico.’ [‘The principle of exclusion in the development of the psychoanalytic movement.’] Paper read at the 8th International Meeting of the International Association for the History of Psychoanalysis. Versailles, France, July 2000. Hernández de Tubert, R. (2000c) ‘Inconsciente y concepción del mundo.’ [‘The unconscious and the Weltanschauung.’] Paper read at the 40th National Congress of Psychoanalysis. Mexican Psychoanalytical Association, Mexico City, November 2000. Hernández de Tubert, R. (2001); ‘La madre como portadora de la voz del Padre.’ [‘The mother as the bearer of the voice of the Father.’] Paper read at the 1st Symposium of Family and Marriage Psychotherapy ‘The Voice of the Father.’ Hermosillo, July 2001. Hernández de Tubert, R. (2002) ‘Enfermería: Mujeres en conflicto?’ [‘Nursing: Women in conflict?’] Paper read at the 4th Meeting on Research in Nursing. Mexico, May 2002. Hernández de Tubert, R. (2003) Psicoanálisis y concepción del mundo. [Psychoanalysis and the Weltanschauung.] Ph.D. Thesis in Psychotherapy (in preparation). Centre of Graduate Studies of the Mexican Psychoanalytical Association, Mexico City. Hinshelwood, R.D. (1999) ‘How Foulkesian was Bion?’ Group Analysis 32, 4, 469–488. Hopper, E. (1982) ‘Group analysis: the problem of context.’ Group Analysis 15, 2, 136–157. Hopper, E. (1985) ‘The problem of context in group-analytic psychotherapy: a clinical illustration and a brief theoretical discussion.’ In Pines (ed.) (1985). Hopper, E. (2002) The Social Unconscious: Selected Papers. London: Jessica Kingsley Publishers. Instituto de Enseñanza (1977a) ‘Esquema de funcionamiento.’ [‘Operational scheme.’] Mexico: Mexican Analytic Group Psychotherapy Association. Instituto de Enseñanza (1977b) ‘Esquema de funcionamiento del precurso.’ [‘Operational scheme for the pre-course.’] Mexico: Mexican Analytic Group Psychotherapy Association. Isaacs, S. (1948) ‘The nature and function of phantasy.’ The International Journal of Psycho-Analysis 29, 1, 73–97. Also in Klein, M., Heimann, P., Isaacs, S. and Rivière, J. (eds.) (1952) Developments in Psycho-Analysis. London: Hogarth. James, W. (1907) Pragmatism: A New Name for Some Old Ways of Thinking. New York: Longmans, Green. Kaplan, A. (1964) The Conduct of Inquiry. Methodology for Behavioral Science. New York: Chandler. Katz, D. (1943) Psicología de la forma (Gestaltpsychologie). [Psychology of Form (Gestaltpsychologie).] Madrid: Espasa-Calpe, 1967. Kernberg, O. (1975a) ‘Transference and countertransference in the treatment of borderline patients.’ In Object Relations Theory and Clinical Psychoanalysis. New York: Jason Aronson, 1995.

REFERENCES

245

Kernberg, O. (1975b) Borderline Conditions and Pathological Narcissism. New York: Jason Aronson. Khan, M. and Sutherland, J.D. (1968) ‘Introduction.’ In Rycroft (1968) Imagination and Reality. New York: International Universities Press. Klein, M. (1930) ‘The importance of symbol-formation in the development of the ego.’ In Love, Guilt and Reparation and Other Works 1921–1945. New York: Delta, 1977. Klein, M. (1946) ‘Notes on some schizoid mechanisms.’ In Envy and Gratitude and Other Works 1946–1963. New York: Delta, 1977. Klein, M. (1952) ‘Some theoretical conclusions regarding the emotional life of the infant.’ In Envy and Gratitude and Other Works 1946–1963. New York: Delta, 1977. Koffka, K. (1935) Principles of Gestalt Psychology. New York: Hartcourt, Brace and Co. Kohut, H. (1984) How Does Analysis Cure? (ed. Arnold Goldberg). Chicago and London: The University of Chicago Press. Korzybski, A. (1941–48) Science and Sanity: An Introduction to Non-Aristotelian Systems and General Semantics (third edition). Lakeville: International Non-Aristotelian Library, 1950. Kuhn, T.S. (1962) The Structure of Scientific Revolutions. Chicago: The University of Chicago Press, 1970. Kuhn, T.S. (1977) The Essential Tension: Selected Studies in Scientific Tradition and Change. Chicago: The University of Chicago Press. Laing, R.D. (1959) The Divided Self. Harmondsworth: Penguin, 1977. Langer, S.K. (1942) Philosophy in a New Key: A Study in the Symbolism of Reason, Rite and Art. New York: New American Library, 1954. Laplanche, J. (1997) ‘The theory of seduction and the problem of the other.’ The International Journal of Psycho-Analysis 78, 4, 653–666. Lear, T. (ed.) (1984) Spheres of Group Analysis. London: Group-Analytic Society, 1985. le Bon, G. (1895) Psychologie des foules. Paris: Alcan. [English translation: The Crowd: A Study of the Popular Mind. Dover Publications, 2002.] Lewin, K. (1943) ‘Defining the field at a given time.’ In Lewin (1951). Lewin, K. (1948) Resolving Social Conflicts. New York: Harper and Brothers. Lewin, K. (1951) Field Theory in Social Science: Selected Theoretical Papers. New York: Harper and Brothers. Little, M. (1966) ‘Transference in borderline states.’ The International Journal of Psycho-Analysis 47, 4, 476–485. Also in Transference Neurosis and Transference Psychosis: Towards Basic Unity. New York: Jason Aronson, 1981. Lipset, D. (1980–82) Gregory Bateson: The Legacy of a Scientist. Boston: Beacon Press, 1982. Mailhiot, B. (1967) Dinámica y génesis de grupos. [Group Dynamics and Genesis.] Madrid: Ediciones Marova, 1973. [Spanish translation of Dinamique et Genése de Groupes. Paris: Editions de L’Epi.] Main, T. (1983) ‘The concept of the therapeutic community: variations and vicissitudes.’ In Pines (ed.) (1983b). Matte-Blanco, I. (1988) Thinking, Feeling, and Being. London: Routledge.

246

OPERATIVE GROUPS

Maturana R.H. and Varela G.F. (1984) El árbol del conocimiento: Las bases biológicas del entendimiento humano. Santiago, Chile: Editorial Universitaria, 1992. [English edition: The Tree of Knowledge: A new look at the biological roots of human understanding. Boston: Shambhala/New Science Library, 1987.] May, R. (1950) The Meaning of Anxiety. New York: Pocket Books, 1979. May, R. (1958a) ‘The origins and significance of the existential movement in psychology.’ In May et al. (1958). May, R. (1958b) ‘Contributions of existential psychotherapy.’ In May et al. (1958). May, R. (1969) Love and Will. New York: Dell, 1980. May, R., Angel, E. and Ellenberger, H.F. (1958) Existence: A New Dimension in Psychiatry and Psychology. New York: Simon and Schuster, 1967. McDougall, W. (1920) The Group Mind. Cambridge: Cambridge University Press. [Also published by Ayer Publications, Salem, New Hampshire, 2nd edition, 1972.] Mead, G.H. (1934) Mind, Self and Society. Chicago: The University of Chicago Press. Mello Filho, J. de (1973) ‘Luto pelo self e angústia do tempo perdido.’ [‘Mourning for the self and anxiety about things past.’] Revista Brasileira de Psicanálise 7, 2, 197–218. Meltzer, D. (1978) The Kleinian Development. Pertshire: Clunie Press, 1985. Meltzer, D. (1981) ‘The Kleinian expansion of Freud’s metapsychology.’ The International Journal of Psycho-Analysis 62, 2, 177–185. Also in Meltzer (1984). Meltzer, D. (1984) Dream Life: A Re-examination of the Psycho-analytical Theory and Technique. Pertshire: Clunie Press, 1992. Mendizábal, A. (1976) ‘La toma de conocimiento en la situación analítica y la supervisión.’ [‘The awareness of knowledge in the analytic situation and in supervision.’] Actas del XI Congreso Latinoamericano de Psicoanálisis. [Minutes of the 9th Latin-American Congress of Psychoanalysis.] Buenos Aires: Asociación Psicoanalítica Argentina, 1976, 271–301. Mendizábal, A. (1982) ‘Trascendencia del psicoanálisis en la comunidad terapéutica Mendao.’ [‘The significance of psychoanalysis in the Mendao therapeutic community.’] Paper read at the 4th ‘Anniversary of Sigmund Freud’ Annual Scientific Meeting. Mexico City, Mexican Psychoanalytic Association, May 1982. Mendizábal, A. (1984) ‘La socioterapia en el Instituto Mendao, S. C. comunidad terapéutica.’ [‘Socio-therapy in the Mendao Institute therapeutic community.’] Paper read at the 8th International Congress of Group Psychotherapy. International Association of Group Psychotherapy, Mexico City, April 1984. Mendizábal, A. and Kolteniuk, M. (1980) ‘El ECRO de Mendao.’ [‘Mendao’s CROS.’] Unpublished document. Merleau-Ponty, M. (1942) Le Structure du Comportement. Paris: Presses Universitaires de France, 1953. [English edition: The Structure of Behavior. Pittsburgh: Duquesne University Press, 1989.] Moreno Corzo, L., Ramos de Moreno Corzo, V. and Tubert-Oklander, J. (1979) ‘Repercusión de la patología borderline en la supervisión psicoanalítica.’ [‘The impact of borderline pathology on a psychoanalytic supervision.’] Paper read at the 19th National Congress on Psychoanalysis. Mexican Psychoanalytical Association,

REFERENCES

247

Mexico City, November 1979. Included as Chapter 4 in Tubert-Oklander (1990–92). Morin, E. (1990) Introducción al pensamiento complejo. [An Introduction to Complex Thinking.] Barcelona: Gedisa, 1995. [Spanish translation of Introduction a la pensée complexe. Paris: ESF Editeur.] Morris, C. (1946) Signs, Language and Behavior. New York: Prentice Hall. Naranjo, C. (1989) Vieja y novísima gestalt. Actitud práctica. Santiago, Chile: Editorial Cuatro Vientos, 1990. [Spanish translation of The Attitude and Practice of Gestalt Therapy.] Ogden, T. (1989) ‘On the concept of an autistic-contiguous position.’ The International Journal of Psycho-Analysis 70, 127–140. Orwell, G. (1949) 1984. Chicago: New American Library, 1961. Pascal, B. (1671) Pensées. [Thoughts.] Web page: http://abu.cnam.fr/cgi-bin/go ?penseesXX1 See # 1378. Paz, O. (1950–59) El laberinto de la soledad (second revised and enlarged edition). [The Labyrinth of Solitude.] Mexico: Fondo de Cultura Económica, 1978. Perrotta, A.L.A. (1978a) ‘Cambios en la transferencia y en la contratransferencia en el psicoanálisis actual y sus consecuencias en la técnica de supervisión.’ [‘Changes in the transference and the countertransference in present-day psychoanalysis and their consequences for the technique of supervision.] Actas del XII Congreso Latinomericano de Psicoanálisis. [Minutes of the 12th Latin-American Congress of Psychoanalysis.] Mexico: Asociación Psicoanalítica Mexicana, 1978, 411–424. Perrotta, A.L.A. (1978b) ‘Psicoanálisis y supervisión. Intento de unificación teórica.’ [‘Psychoanalysis and supervision: An attempt at theoretical unification.’] Revista de Psicoanálisis 35, 5, 973–1023. Piaget, J. (1967) Biología y conocimiento: Ensayo sobre las relaciones entre las regulaciones orgánicas y los procesos cognoscitivos. México: Siglo Veintiuno, 1975. [English edition: Biology and Knowledge: An Essay on the Relations between Organic Regulations and Cognitive Processes. Chicago: University of Chicago Press, 1971.] Pichon-Rivière, E. (1951) ‘Aplicaciones de la psicoterapia de grupo.’ [‘Applications of group psychotherapy.’] In Pichon-Rivière (1971a). Pichon-Rivière, E. (1952) ‘Algunas observaciones sobre la transferencia en los pacientes psicóticos.’ [‘Some observations on the transference of psychotic patients.’] In Pichon-Rivière (1971b). [Originally published in French in the Revue Française de Psychanalyse 16, 1–2.] Pichon-Rivière, E. (1959) ‘Esquema corporal.’ [‘Body schema.’] In Pichon-Rivière (1971b). Pichon-Rivière, E. (1965) ‘Grupos operativos y enfermedad única.’ [‘Operative groups and the single disease.’] In Pichon-Rivière (1971a). Pichon-Rivière, E. (1967) ‘Una nueva problemática para la psiquiatría.’ [‘A new set of problems for psychiatry.’] In Pichon-Rivière (1971a). Pichon-Rivière, E. (1969) ‘Estructura de una escuela destinada a psicólogos sociales.’ [‘Structure of a school for social psychologists.’] In Pichon-Rivière (1971a).

248

OPERATIVE GROUPS

Pichon-Rivière, E. (1970a) ‘Neurosis y psicosis: una teoría de la enfermedad.’ [‘Neurosis and psychoses: a theory of disease.’] In Pichon-Rivière (1971b). Pichon-Rivière, E. (1970b) ‘Concepto de E.C.R.O.’ [‘The concept of CROS.’] Temas de Psicología Social 1, 1, 7–10. Pichon-Rivière, E. (1971a) El proceso grupal. Del psicoanálisis a la psicología social (1). [The Group Process: From Psychoanalysis to Social Psychology (I).] Buenos Aires: Nueva Visión. Pichon-Rivière, E. (1971b) La psiquiatría, una nueva problemática. Del psicoanálisis a la psicología social (II). [A New Set of Problems for Psychiatry: From Psychoanalysis to Social Psychology (II).] Buenos Aires: Nueva Visión. Pichon-Rivière, E. (1971c) El proceso creador. Del psicoanálisis a la psicología social (II1). [The Creative Process: From Psychoanalysis to Social Psychology (III).] Buenos Aires: Nueva Visión. Pichon-Rivière, E. (1979) Teoría del vínculo. [Theory of the Bond.]. Buenos Aires: Nueva Visión. Pichon-Rivière, E. and Bauleo, A. (1964) ‘La noción de tarea en psiquiatría.’ [‘The notion of ‘task’ in psychiatry.’] In Pichon-Rivière (1971a). Pichon-Rivière, E., Bleger, J., Liberman, D. and Rolla, E. (1960) ‘Técnica de los grupos operativos.’ [‘The technique of operative groups.’] In Pichon-Rivière (1971a). [Reproduced from Acta Neuropsiquiátrica Argentina 6, 1960.] Pichon-Rivière, E., Quiroga, A.P. de, Gandolfo, C. and Lazzarini, M. (1969) ‘Grupo operativo y modelo dramático.’ [‘Operative groups and the dramatic model.’] In Pichon-Rivière (1971a). Pichon-Rivière, E. and Quiroga, A.P. de (1970–85) Psicología de la vida cotidiana. [The Psychology of Everyday Life.] Buenos Aires: Nueva Visión, 1999. Pines, M. (1983a) ‘The contribution of S.H. Foulkes to group therapy.’ In Pines (ed.) (1983b). Pines, M. (ed.) (1983b) The Evolution of Group Analysis. London: Routledge and Kegan Paul. [Also published by Jessica Kingsley Publishers, London, 2000.] Pines, M. (ed.) (1985) Bion and Group Psychotherapy. London: Routledge and Kegan Paul. [Also published by Jessica Kingsley Publishers, London, 2000.] Plato (1956) ‘The Republic.’ In Rouse, W.H.D. (translator) Great Dialogues of Plato. New York: New American Library. Popper, K.R. (1959) The Logic of Scientific Discovery. New York: Harper and Row, 1968. Popper, K.R. (1957) ‘La ciencia: conjeturas y refutaciones.’ In Conjeturas y refutaciones. El desarrollo del conocimiento científico. Barcelona: Paidós, 1983. [Spanish translation of: ‘Science: conjectures and refutations.’ In Conjectures and Refutations: The Growth of Scientific Knowledge (4th edition). London: Routledge, 1972.] Popper, K.R. (1979) Objective Knowledge. An Evolutionary Approach (revised edition). Oxford: Oxford University Press. Powell, A. (1994) ‘Towards a unifying concept of the group matrix.’ In Brown, D. and Zinkin, L. (eds.) (1994) The Psyche and the Social World. Developments in Group-Analytic Theory. London: Routledge. Quiroga, A.P. de (1977) ‘El concepto de grupo y los principios organizadores de la estructura grupal en el pensamiento de E. Pichon-Rivière.’ [‘The concept of the group

REFERENCES

249

and the organizing principles of group structure in the thought of E. Pichon-Rivière.’] Temas de Psicología Social 1, 1, 11–21. Racker, H. (1958) ‘Counterresistance and interpretation.’ In Transference and Counter-Transference. New York: International Universities Press, 1982. Ramírez, S. (1959–73) El mexicano. Psicología de sus motivaciones. [The Mexican: Psychology of his Motivations.] (second enlarged edition). Mexico: Editorial Aleph, 1973. Remus, E. (2002) Personal communication. Remus, J. (2002) Personal communication. Rodridué, E. (1965) Biografía de una comunidad terapéutica. [Biography of a Therapeutic Community.] Buenos Aires: EUDEBA. Ruesch, J. and Bateson, G. (1951) Communication: The Social Matrix of Psychiatry. New York: Norton. Saussure, F. de (1916) Course in General Linguistics. La Salle, Ill.: Open Court, 1983. Schilder, P. (1935) The Image and Appearance of the Human Body. New York: International Universities Press. Schlick, M. (1932–33) ‘Positivismo y realismo.’ In Ayer, A. J. (ed.) (1959) El positivismo lógico. Mexico: Fondo de Cultura Económica, 1965. [Spanish translation of ‘Positivism and realism.’ In Ayer, A.J. (ed.) (1959) Logical Positivism. Glencoe: The Free Press, 1959.] Segal, H. (1957) ‘Notes on symbol formation.’ The International Journal of Psycho-Analysis 38, 391–397. Segal, H. (1964) Introduction to the Work of Melanie Klein. New York: Basic Books. Shakespeare, W. (1975) The Complete Works. New York: Avenel Books. Skynner, R. (1987) Explorations with Families. Group Analysis and Family Therapy. London: Tavistock/Routledge, 1990. Skynner, R. and Cleese, J. (1983) Families and How to Survive Them. London: Methuen, 1984. Spitz, R. (1965) The First Year of Life. New York: International Universities Press. Sullivan, H.S. (1931) ‘The modified psychoanalytic treatment of schizophrenia.’ In Schizophrenia as a Human Process (ed. Helen Swick Perry). New York: Norton, 1962. Sullivan, H.S. (1947) Conceptions of Modern Psychiatry. New York: Norton, 1966. Thelen, H.A. (1959) ‘Work-emotionality theory of the group as organism.’ In Koch, S. Psychology: A Study of a Science, Vol. III. New York: McGraw-Hill. Tamez Garza, R. (1963) ‘Relato de reacciones transferenciales y contratransferenciales en cadena.’ [‘A narrative of chain transference and countertransference reactions.’] In Palacios, A., Ramirez, S. and Valner, G. (eds.) Psicoanálisis. La técnica. [Psychoanalysis: The Technique.] Mexico: Editorial Pax and Asociación Psicoanalítica Mexicana. Trist, E. (1985) ‘Working with Bion in the 1940s: the group decade.’ In Pines (ed.) (1985). Tubert-Oklander, J. (1978) ‘Estudio longitudinal de un grupo operativo de aprendizaje.’ [‘Longitudinal study of a learning operative group.’] Paper read at the Mexican Analytic Group Psychotherapy Association, Mexico City. Published in Revista de

250

OPERATIVE GROUPS

Análisis Grupal 4, 2, 45–70, and included as Chapter 3 in Tubert-Oklander (1990–92). Tubert-Oklander, J. (1982) ‘Algunas reflexiones sobre la formación psicoanalítica.’ [‘Some thoughts about psychoanalytic education.’] Paper read at the 4th ‘Anniversary of Sigmund Freud’ Annual Scientific Meeting. Mexico City, Mexican Psychoanalytic Association, May 1982. Tubert-Oklander, J. (1984) ‘Institutional group analysis in a therapeutic community.’ Paper read at the 8th International Congress of Group Psychotherapy. International Association of Group Psychotherapy, Mexico City, April 1984. Published in Spanish under the name ‘El análisis grupal institucional en una comunidad terapéutica,’ as Chapter 5 in Tubert-Oklander (1990–92). Tubert-Oklander, J. (1990a) ‘El psicoanálisis: una base necesaria pero insuficiente para la práctica grupal.’ [‘Psychoanalysis: A necessary but insufficient basis for group practice.’] Paper read at the 2nd Meeting ‘Groups in Social Practice. Keys for transformation.’ Universidad Iberoamericana, Mexico City, September 1990. Tubert-Oklander, J. (1990b) ‘La integración de las teorías psicoanalítica y de la comunicación: una base para la terapia familiar.’ [‘The integration of the psychoanalytic and communication theories: A basis for family therapy.’] Paper read at the 3rd National Congress of Family Therapy. Mexican Association of Family Therapy, Mexico City, October 1990. Published in Psicoterapia y Familia 3, 2, 28–32. Tubert-Oklander, J. (1990–92) El grupo operativo de aprendizaje (third edition). [The Learning Operative Group.] Guadalajara: Universidad de Guadalajara and Asociación Psicoanalítica Jalisciense, 1992. Tubert-Oklander, J. (1993a) ‘Lenguaje, responsabilidad y “objetividad”’. [‘Language, responsibility, and “objectivity”.’] Paper read at the 15th ‘Anniversary of Sigmund Freud’ Annual Scientific Meeting. Mexico City, Mexican Psychoanalytic Association, May 1993. Tubert-Oklander, J. (1993b) ‘Fear is the best counsel: An approach to systems’ change.’ Paper read at the 5th World Congress of Family Therapy. International Family Therapy Association, Amsterdam, May 1993. Tubert-Oklander, J. (1994a) ‘Las teorías psicoanalítica y comunicacional-sistémica como base para la terapia de pareja.’ [‘The psychoanalytic and communication-systems theories as a basis for marriage therapy.’] Paper read at the 33rd National Congress of Psychoanalysis. Mexican Psychoanalytic Association, Querétaro, November 1994. Tubert-Oklander, J. (1994b) ‘Explorando mundos: el psicoanálisis como fenomenología.’ [‘Exploring worlds: Psychoanalysis as phenomenology.’] Paper read at the 33rd National Congress of Psychoanalysis. Mexican Psychoanalytic Association, Querétaro, November 1994. Tubert-Oklander, J. (1994c) ‘Las funciones de la interpretación.’ [‘The functions of interpretation.’] Revista de Psicoanálisis 51, 3, 515–544. Tubert-Oklander, J. (1995a) ‘Las bases teóricas y clínicas de la psicoterapia de grupo y de familia.’ [‘The theoretical and clinical bases of group and family therapy.] Keynote address given at the 1st Monterrey Congress of Group Psychotherapy. Monterrey Society of Group Analysis, Monterrey, N.L., May 1995.

REFERENCES

251

Tubert-Oklander, J. (1995b) ‘El psicoanálisis en la matriz social.’ [‘Psychoanalysis in the social matrix.’] Paper read at the 34th National Congress of Psychoanalysis. Mexican Psychoanalytical Association, Morelia, November 1995. Tubert-Oklander, J. (1996) ‘Contribución de los diversos enfoques teóricos a la práctica de la psicoterapia.’ [‘The contribution of the various theoretical approaches to the practice of psychotherapy.’] Paper read at the 4th Colloquium of the Centre of Graduate Studies. Mexican Psychoanalytic Association, Mexico City, June 1996. Tubert-Oklander, J. (1997) ‘El proceso psicoanalítico a la luz de la teoría de las relaciones objetales.’ [‘The psychoanalytic process in the light of object relations theory.’] Cuadernos de Psicoanálisis 30, 1–2. Tubert-Oklander, J. (1999a) ‘Sándor Ferenczi e la nascita della teoria delle relazioni oggettuali.’ [‘Sándor Ferenczi and the birth of object relations theory.] In Borgogno, F. (ed.) La partecipazione affettiva dell’ analista. Il contributo di Sándor Ferenczi al pensiero psicoanalitico contemporaneo. [The Analyst’s Affective Participation: The Contribution of Sándor Ferenczi to Contemporary Psychoanalytic Thought.] Milan: Franco Angeli. Tubert-Oklander, J. (1999b) ‘When neutrality is no longer: The impact of politics on the psychoanalytic situation.’ Contribution to the Workshop ‘Psychoanalysis, Politics and the New IPA UN Committee.’ 41st International Congress of Psychoanalysis, Santiago, Chile, July 1999. Tubert-Oklander, J. (1999c) ‘Experiencia emocional e interpretación.’ [‘Emotional experience and interpretation.’] Paper read at the 41st International Congress of Psychoanalysis, Santiago, Chile, July 1999. Tubert-Oklander, J. (2000a) ‘Group analysis as a natural extension of psychoanalysis.’ Paper read at the 8th International Meeting of the International Association for the History of Psychoanalysis. Versailles, July 2000. Tubert-Oklander, J. (2000b) ‘El psicoanálisis ante el nuevo milenio. Reflexiones sobre la epistemología del psicoanálisis.’ [‘Psychoanalysis facing the new Millennium. Reflections on the epistemology of psychoanalysis.’] Estudios sobre Psicosis y Retardo Mental 5, 275–295. Tubert-Oklander, J. (2001a); ‘La voz del Padre en la familia y en el desarrollo infantil.’ [‘The voice of the Father in the family and child development.’] Paper read at the 1st Symposium of Family and Marriage Psychotherapy ‘The Voice of the Father.’ Hermosillo, July 2001. Tubert-Oklander, J. (2001b) ‘Premises for a psychoanalytic approach to psychoses.’ Paper read at the 42nd International Psycho-Analytical Congress. Nice, July 2001. Tubert-Oklander, J. (2001c) ‘Psychoanalysis in the Third Millennium: On the epistemological crisis of psychoanalysis.’ Paper read at International Conference ‘At the End of the Battle.’ Lima, Peru, November 2001. Tubert-Oklander, J. (2002a) ‘The Clinical Diary of 1932 and the new psychoanalytic clinic.’ Paper read at the International Congress ‘Clinical Sándor Ferenczi.’ Turin, July 2002. Tubert-Oklander, J. (2002b) ‘Enrique Pichon-Rivière: Pioneer and outcast.’ Paper read at the 9th International Meeting of the International Association for the History of Psychoanalysis. Barcelona, July 2002. Published in the CD-ROM ‘Psychoanalysts in Exile: Elements of a History’. Paris: IAHP, 2003.

252

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Tubert-Oklander, J. (2003) Acerca del tipo de conocimiento que nos da el psicoanálisis. [About the Kind of Knowledge that We Gain From Psychoanalysis.] Ph.D. Thesis in Psychotherapy (in preparation). Centre of Graduate Studies of the Mexican Psychoanalytical Association, Mexico City. Tubert-Oklander, J. and Baquedano L.G. (1978) ‘Las posiciones esquizo-paranoide y depresiva en el grupo operativo de aprendizaje.’ [‘The schizoid-paranoid and depressive positions in the learning operative group.’] Paper read at the Mexican Analytic Group Psychotherapy Association, Mexico City. Published in Revista de Análisis Grupal 4, 2, 26–44, and included as Chapter 2 in Tubert-Oklander (1989–92). Tubert-Oklander, J., Chevaili-Arroyo, A. and Champion-Castro, G. (1979) ‘Organización del campo de la transferencia–contratransferencia en el tratamiento de pacientes fronterizos.’ [‘Organization of the transference–countertransference field in the treatment of borderline patients.’] Paper read at the 19th National Congress of Psychoanalysis. Mexican Psychoanalytic Association, Mexico City, November 1979. Tubert-Oklander, J., Chevaili-Arroyo, A., Champion-Castro, G.A. and Lonngi, R. (1980) ‘Las instituciones operativas: un esquema referencial.’ [‘Operative institutions: A referential scheme.’] Paper read at the Latin-American Congress ‘Psychoanalysis and Social Context.’ University of Querétaro, Querétaro. Tubert-Oklander, J. and Hernández Hernández, R. (1993) ‘Ideología y psicoanálisis.’ [‘Ideology and psychoanalysis.’] Paper read at the 32nd National Congress of Psychoanalysis. Mexican Psychoanalytic Association, León, Gto., November 1993. Tubert-Oklander, J. and Hernández Hernández, R. (1995) ‘Insight y curación.’ [‘Insight and healing.’] Paper read at the 39th International Congress of Psychoanalysis, San Francisco, July 1995. Tubert-Oklander, J. and Hernández de Tubert, R. (1996) ‘Psicoanálisis del poder y la violencia en el contexto social e institucional.’ [‘Psychoanalysis of power and violence in the social and institutional context.’] Revista de Psicoanálisis, Número Especial Internacional 1996, No 5, 231–251. Tubert-Oklander, J. and Hernández de Tubert, R. (1998) ‘Un modelo de formación en terapia de grupo y de familia.’ [‘A model for the training of group and family therapists.’] Paper read at the 12th Latin-American Congress of Analytic Group Psychotherapy. Latin-American Federation of Analytic Group Psychotherapy, Montevideo, November 1998. Ulloa, F. (1969) ‘Psicología de las instituciones.’ [‘Psychology of institutions.’] Revista de Psicoanálisis 26, 1, 5–37. Ulloa, F. (1973) ‘Grupo de reflexión y ámbito institucional en los programas de promoción y prevención de la salud.’ [‘Reflection group and an institutional space in programs of health promotion and prevention.’] In Grimson, W.R. (ed.) Nuevas perspectivas en salud mental. Instituciones y problemas. [New Perspectives in Mental Health: Institutions and Problems.] Buenos Aires: Nueva Visión. Varela, F.J. (1988) Conocer. Las ciencias cognitivas: tendencias y perspectivas. [Knowing. Cognitive Science: Tendencies and Perspectives.] Barcelona: Gedisa, 1990. [Spanish translation of Connaître: Les Sciences Cognitives, tendences et perspectives. Paris: Editions du Seuil.]

REFERENCES

253

Wallerstein, R.S. (1988) ‘One psychoanalysis or many?’ The International Journal of Psycho-Analysis 69, 5–21. Wallerstein, R.S. (1990) ‘Psychoanalysis: The common ground.’ The International Journal of Psycho-Analysis 71, 3–19. Watzlawick, P. (ed.) (1981) The Invented Reality: How do we Know what we Believe we Know? (Contributions to Constructivism.) New York: Norton, 1984. Watzlawick, P., Jackson, D.D. and Beavin, J.H. (1967) Pragmatics of Human Communication: A Study of Interactional Patterns, Pathologies and Paradoxes. New York: Norton. Watzlawick, P., Weakland, J.H. and Fisch, R. (1974) Change: Principles of Problem Formation and Problem Resolution. New York: Norton. Webster’s Encyclopedic Unabridged Dictionary of the English Language. (1989) Portland House: New York. Whitehead, A.N. and Russell, B. (1910–13) Principia Mathematica. Cambridge: Cambridge University Press. Whorf, B.J. (1956) Language, Thought and Reality: Selected Writings of Benjamin Lee Whorf (ed. John B. Carroll). Cambridge, Massachusetts: The M.I.T. Press, 1967. Wiener, N. (1948–61) Cybernetics: Or the Control and Communication in the Animal and the Machine. Cambridge: MIT Press, 1961. Wiener, N. (1950) The Human Use of Human Beings: Cybernetics and Society. New York: Avon Books, 1967. Wilde, O. (1898) ‘The Ballad of Reading Gaol.’ Emotional Literacy Education Web Site: http://emotionalliteracyeducation.com/classic_books_online/rgaol10.htm Winnicott, D.W. (1960) ‘The theory of the parent–infant relationship.’ In Winnicott (1965). Winnicott, D.W. (1965) The Maturational Processes and the Facilitating Environment. London: The Hogarth Press and the Institute of Psycho-Analysis, 1979. Winnicott, D.W. (1969) ‘The use of an object and relating through identifications.’ In Winnicott (1971). Winnicott, D.W. (1971) Playing and Reality. Harmondsworth: Penguin. Wittgenstein, L. (1921) Tractatus Logico-Philosophicus. London: Routledge and Kegan Paul, 1978. Zito Lema, V. (1975) ‘Todos los viajes de Enrique Pichon-Rivière.’ [‘All the voyages of Enrique Pichon-Rivière.’] La Opinión Cultural, 22 June 1975, 2–3. Zito Lema, V. (1976) Conversaciones con Enrique Pichon-Rivière. Sobre el arte y la locura. [Conversations with Enrique Pichon-Rivière: On Art and Madness.] Buenos Aires: Timerman Editores.

seminars, 112, 144 comparison with operative groups, 21 transference-countert action, 52, 54–5 see also ransference in, praxis 144 articulation with on the standard technique motivation, 45 in psychoanalysis, importance of, 20, 42 155 lack of theory of in Ballad of the Reading Gaol, psychoanalysis, 45n2 The (Oscar Wilde) 187 action research, 20, 43–5, basic statements (Popper), 199 141, 163 action schemes (Piaget), 76 Bateson, Gregory adaptation to reality on context, 84 active, 22, 31, 195, 200, on logical types and levels 200n3 of learning, 95–9 passive, 200n3 ‘Metalogues’, 103 agents for change, 44, 59 on mind, 89 analytic experience see ‘Style, grace, and experience information in anxiety see fear primitive art.’, 216 archetypes Berlin model see Father psychoanalytic training in Mexican family, system 178 beta element (Bion), 160 Mother, 188 Bion, Wilfred Ruprecht in Mexican family, analysis with Melanie 178 Klein, 64, 143 Society, 188 on the analytic areas of behaviour (mind, experience, 142, 145 body and external see also experience: world), 49, 50, 71 psychoanalytic Argentine Institute for Social contradictions, 63–5 Studies (IADES), 33, on culture, 86–7 43 denial of the existence of Argentine Psychoanalytic groups, 63 Association, 31, 34, on the ‘expanding 36, 215 universe’ of artificial groups, 81 psychoanalysis, 228 As You Like It (Shakespeare) Experiences in Groups, 64 73 influence on Pichon-Rivière, 39 Balint, Michael n1 analysis with Sándor Learning from Experience, Ferenczi, 143 145

Subject Index

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mental activity in groups, 39, 63 at Northfield see Northfield Military Hospital: First Northfield Experiment task in groups, 39 body schema, 49, 74–5 bond individual and group, 56 structure of interpersonal relationship, 56 borderline patients, 157–8, 164 dreams of, 165 Budapest model see psychoanalytic training system Buenos Aires Neuro-Psychiatric Hospital, 210, 214 see also Hospicio de las Mercedes case studies clinical seminar at a psychoanalytic institute, 148–51 course on research methodology in psychoanalysis, 114–31 reflection group in a therapeutic community, 197–208 reflection group with nurses in a public institution, 191–7 study group on group psychotherapy, 105–9 study group on operative groups, 109–13 supervisory group, 154–65

256

training course in group-analytic family therapy, 166–83 two groups of axiological research, 215–25 workshop on ‘The crisis in the couple’, 132–6 causality linear and circular, 67, 70, 86 Cave (Plato), 24, 66–7, 87 Centre for Psychotherapy and Group Analysis, 170 change of behaviour, 94 levels of (change 0, 1, 2 and 3), 95–6 ‘limited but deep’ in the students’ personalities (Balint), 128, 164 obstacles to, 88 of pattern of behaviour, 94 resistance to see resistance to change therapeutic, 57 codes, 91 common ground see experience: psychoanalytic; experience: group-analytic communication, 90–3 code, 91 context, 83 definition, 90 distortions, 92 as group process, 93 in groups, 91–2 and information, 90 and learning, 92 meaning, 90 non-verbal, 83 see also metacommunication signals, 90 signs, 90

OPERATIVE GROUPS

and thinking, 93 tokens, 91 communication-systems theory, 166, 167 see also systems complexity, 67, 69, 86 conception of the world, 130 see also conceptual referential operative schema (CROS); Weltanschauung cybernetic, 67 Newtonian, 65 pragmatic, 65 conceptual referential operative schema (CROS), 47–52 see also conception of the world; Weltanschauung authors’ revision of the concept, 74–82 body schema, relation to, 49 common to the group, 81, 85 definition, 48–52 ‘conceptual’, 49–51 ‘operative’, 52 ‘referential’, 51–2 ‘schema’, 48–9, 74–7 dynamic structure, 52 motivational basis of, 25, 50, 51 see also Pichon-Rivière: motivational basis of his CROS origin of the concept, 47 Pichon-Rivière, 47–52 psychological structure, 49–51, 77 reconstructed model, 49–51, 77 in supervision, 154 of training course in group-analytic family therapy, 166–9

and the Weltanschauung, 77–82 conductor see coordinator confusional moments in groups, 159–62 see also fear: of confusion (confusional anxiety) conspiracy, unconscious, 41, 45, 46 see also resistance: to change construction of reality social, 185 see also Weltanschauung constructivism, 168 context, 82–5 common to the group, 82, 85 of communication, 83–4 definition, 82 effect on the individual, 61 institutional, 114 disregard of, 16–17, 23 effect on the group, 105, 122 political in institutions, 196–7 of psychoanalysis, 84 of psychotherapy, family and social, 209 relational, 70 social and institutional, 85–7, 150, 204 in a reflection group, 197 of training courses, 172 contract, 102, 116–18, 158, 204–6, 207 contrast, as basis for perception, 81 the case of values, 216 conversation, outline of, 103 coordinator as co-thinker, 38, 88

SUBJECT INDEX

neutrality of, 207 as operational research analyst, 43 position, 206–7 relation with, 204 negative, 221–2 task, 48 crisis in a family therapy training course, 174–7 CROS see conceptual referential operative schema culture clash of, 17, 26, 84 as deepest layer of the unconscious, 86 group, 66, 81 decision making process, 42–3, 45 see also task, common in groups: evolution (moments and stages): decision stage definition of the field at a given time (Lewin), 104, 188 see also field theory deindividuation, 109 deposition, process of (deposited, depositor, depository), 56 depression, as basis of all psychopathology see single disease theory deuterolearning (Bateson), 94–5, 201 see also learning levels: Learning II diachronic (Saussure), 104 see also operative groups: longitudinal (diachronic) description dialectic spiral, 47, 52, 56, 88–90

dimensions of human phenomena (intra-, inter- and trans-personal), 85–6 discrimination between narrative of a dream and of a session, 159, 161 between the symbol and what is being symbolized, 161 see also symbolic equation distant education, 182 training model, 169–71 use of written reports in, 170 dreams without semantic content, 159–60 see also supervision: group: dreams in empathy, 169 empirical base see basic statements (Popper) encounter group movement, 137 entropy, 198 epistemologic break, 119 epistemology constructivistic, 168 systems, 168 without a knowing subject see Third World (Popper) evaluation, 47, 102 definition, 122 individual of students, 128 resistance to, 126, 128 of the group, 119–23 by students, 124–5 existential analysis, 169 existential phenomenology, 168–9

257

experience conscious and unconscious, 165 n7 emotional, 142–3 in operative groups, 146 formative see formative experiences: use in training of therapists group-analytic as basis for understanding among group analysts, 229 as primary phenomenon, 168–9 psychoanalytic as basis for understanding among psychoanalysts, 228–9 as basis for conviction, 142–3 non-sensuous character of, 142 non-transmissibility of, 141, 145 family, as the real context of all psychotherapeutic processes (García Badaracco), 209 family systems exercise, 133 fear of confusion (confusional anxiety), 41, 119 see also confusional moments in groups of damage (paranoid anxiety), 41, 56, 109, 119 see also paranoid moments in groups

258

OPERATIVE GROUPS

of loss (depressive participation in the anxiety), 41, 56, group: pertinence 109, 119 supervisory seminar at feedback to group members Maudsley Hospital, by the coordinator, 134 144, 151–2, 156 by a formal observer, 104 on theatre as model, 55 through a scientific paper, transference-countert 130 ransference in, Ferenczi, Sándor 151–2 Clinical Diary, 152 on understanding and The Development of misunderstanding, 92 Psycho-Analysis (with free-floating discussion, 205 Otto Rank), 143 Freud, Sigmund on emotional experience, Civilization and its 143 Discontents, 62 field theory, in Group Psychology and the psychoanalysis, 163–4, Analysis of the Ego, 15, 209 see also definition 66, 148 of the field at a given on groups, 62 time (Lewin) The Interpretation of Dreams, formative experiences, use in 159 the training of other, impact of the, 66–7 therapists, 170–1, on social psychology, 66 173, 177–8, 180 study of social and family Foulkes, Siegmund Heinrich environment by, 148 on Balint’s seminars, 144 on the Weltanschauung, 77 basic law of group García Badaracco, Jorge dynamics, 214 beginning of a therapeutic biographical sketch, 18 community, 211–12 comparison with Enrique biographical sketch, Pichon-Rivière, 20, 210–15 55, 73 comparison with S. H. comparison with Jorge Foulkes, 214 García Badaracco, on multifamily 214 psychoanalysis, criterion for selection of 208–15 group members, 73, Multifamily Psychoanalysis: 79–80 The Others in Ourselves network theory of and the Discovery of the neuroses, 209–10 Self, 210, 215 at Northfield private sanatorium, peripathetic group 213–14 therapist at, 17, Psychoanalytical Therapeutic 211 n9 Community of a seminar at, 19 Multifamily Structure, on pertinence, 151–2 see 210 also individual

videos, 210, 214 gender conflicts, in the nursing profession, 191–2, 194 values, investigation of, 225 generalized other, 54, 58 Gestalt theory, 65, 71 figure-ground relation, 69–70 therapy techniques, 179 workshop, 178–9 givens see basic statements group analysis, 86 apparent ease of, 196 comparison with operative groups, 19–21, 38 comparison with psychoanalysis, 24 definition of, 23, 38 inquiry of social and political phenomena in, 190 institutional, 190, 199, 203 name, 19, 227 as natural extension of psychoanalysis, 24, 229 need to build its own concepts, 228 as research tool, 24 in the selection of prospective students, 172 therapeutic and non-therapeutic, 19 in therapeutic community, 201 in the training of family therapists, 170–1, 177 group analyst see coordinator

SUBJECT INDEX

group culture, 66, 81 group dynamics borderline organization of, 157 of the Mexican family, 178 reproduction of the problem in, 156, 177, 197 group process, 56–9 evolution, 122 independent from individuals, 66 group thinking, 90, 94 group-analytic theory, in the training of family therapists, 167, 170 groups absent members, 109–10, 112 axiological research, 219 common language, 93 definition, 53 deindividuation in, 73 existence of, 61–6 lack of memory in, 134 splitting in subgroups, radical/conservative opposition, 112 therapeutic, task of, 214 Guaraní conception of the world, 27

heterogeneity, and analysis of the Weltaschauung, 80–1 hierarchical organization, 95–9 levels of authority, 202 homogeneity and heterogeneity in groups, 57, 79–80, 214 in the task, 58 Hospicio de las Mercedes, 21–2, 227 see also Buenos Aires Neuro-Psychiatric Hospital training groups for nurses at, 21, 30 training groups for patients at, 22, 30 Hungarian model see psychoanalytic training system: Budapest model

ideology, 78 see also Weltanschauung Imagination vs. Rigour, 228 individual behaviour in groups, structural pressures on, 203 individual participation in the group (affiliation, health, strategy for, 46 belongingness, hermeneutics, 82 see also cooperation and interpretation pertinence), 58 see also Hermosillo, 171–2, 178–9 Foulkes, Siegmund effect of training course Heinrich: on on the professional pertinence community, 179 individual psychology, Hernández de Tubert, Reyna relation to social biographical sketch, psychology, 15, 52–6, 11–12 66–74 study on Weltanschauung, information, 90–1 77–9 institutional group analysis, 190

259

institutions, reproduction of the problem in, 197 interdisciplinary teaching, 57 internal group, 53, 55 internalization of others, 54, 58 interpersonal phenomena see dimensions of human phenomena interpretation, 82 as creative act, 82 CROS of, 48 existent-interpretation-ne w emergent cycle, 52 of group dynamics, 38 in learning operative groups, 113 of group process, 88 of group resistances, 46, 131 in horizontal direction, 53 see also transversal description of the group field in operative groups, 145 in supervisory groups, 157, 162 of texts, author-oriented vs. reader-oriented, 82 in a therapeutic community, 212 of transference towards the coordinator(s), 160, 162 of unconscious Weltanschauung, 98 in vertical direction, 53 see also longitudinal description of the group process in writing (for distant education), 174–7 intersubjectivity (objectivity) in group analysis, 146 in psychoanalysis, 145–6

260

in science, 141 intrapersonal phenomena see dimensions of human phenomena intrapsychic different from intrapersonal, 24 exclusive focus on, 148, 156 intuit (Bion), 142 ‘I-Thou’ relationship (Buber), 169

OPERATIVE GROUPS

integration of cognition, emotion and action in, 20, 136 levels of Learning 0, 96 Learning I, 96 Learning II, 96–7 see also deuterolearning Learning III, 96–8 and thinking, 93–4 learning operative group, 101–5 Lewin, Kurt personality, 44 Pichon-Rivière, Enrique comparison with, 44 influence on, 43–4, 52, 137 lies, traumatic effect of, 189–90 logical types, 95 see also hierarchical organization longitudinal description of the group process, 104, 114 example of, 114–31

Meditation XVII (John Donne), 68 Mendao Institute, 200, 204 CROS, 200–4 metacommunication, 83, 92, 94, 98 see also context; communication about the group’s task, 103 inhibition of, 161 metapsychology, 169 Mexican Association of Group Analytic knowledge Psychotherapy awareness of, 164 (AMPAG), 114–5 multiple perspectives, 168 military theory (tactics and ordinary sources, 39 strategy), 45–7 see also operative planning laboratories, 136–8 misunderstanding, 48, 56, compared with 91–2, 207 workshops, 138 model coordination by a team, dramatic, 54 137–8 football as, 54 encounter groups, 137 scientific, 50 marathon groups, 137 moments of operation personal experience, 137 (strategy, tactics, psychotherapeutic, 137–8 technique, logistics and social training, 137 evaluation), 46–7 language mother common in groups, 93 ‘The Machine’ (River Plate good-enough (Winnicott), limitations of, 98 soccer team), 58–9 186–8 leaders, social and political Map-Territory relation, 78 holding the baby, 186–7 abuse and lies by, 190 Marxism, 206 holding by others, 188 ambivalence towards, 188 matrix, 69, 71–3, 188 mourning, 128 learning ambivalence towards, 188 for damage done, 108 and communication, 92 and CROS, 73 for loss of individuation, definition of, 94 definition, 71 109 experiential element of, dynamic, 73 for unavoidable losses, 99 foundation, 72 108, 112 how to learn, 57, 94–6, individual’s object relation in groups, 107, 112–13 130, 201 with, 186 macro-mourning, how to think, 57, 130 personal, 72 113, 122–3 identical with healing and traumatic effect of, 186 micro-mourning, 113 communicating, Mead, George Herbert, multifamily group (García 56–7 influence on Enrique Badaracco), 208–15 see Pichon-Rivière, 53 also García Badaracco, Jorge

SUBJECT INDEX

use in teaching and research, 214–15 multilevel phenomena, 67, 69, 86 National University of Mexico, 219 natural groups, 81 negentropy, identical with information, 198 network, 69, 150, 209–10 nodal points, 69 neutrality, 207 Northfield Military Hospital, 15–19, 197, 227 First Northfield Experiment, 16–17 Foulkes’ seminar at, 19 Second Northfield Experiment, 17–19 The Club, 211n9 nurses high-risk profession, 194 training groups for, 21, 30 nurturing baby by the mother, 186–7 individual by the social system, 187 objectivity see intersubjectivity in supervision see supervision: objectivity in object-relations theory, 85 observation analytic, 142 scientific, 142 operations research, 42–3 operative groups beginning of, 21, 30 comparison with Balint seminars, 21

comparison with group analysis, 19–21, 38 contract, 102 definition, 38 emotional experience in, 146 evaluation, 102 as a general conception of groups, 25, 37, 130 interpretation in, 145 see also interpretation learning, 101–5 comparison with therapeutic groups, 113 see also supervision: group: comparison with therapeutic groups objectives in, 128 name, 20, 43 observer, 104 use of protocols longitudinal (diachronic) description, 104 transversal (synchronic) description, 104, 113 see also transversal description of the group field reflection see reflection groups regression in, 174–5 reports of sessions, 103, 109, 117 example of, 110–11, 118 in selection of prospective students, 172 use in social research, 215–25 team work in, 38 therapeutic, 20, 37, 57

261

in therapeutic community, 203 in training of family therapists, 171, 177 operative planning, 46–7 see also military theory operativity, 52 see also action paradigm, 129 new paradigm of human existence, 34, 36 parallel process see supervision: parallel process paranoid moments in groups, 159–60, 162 see also fear: of damage (paranoid anxiety) Paris Psychoanalytical Society, 210 Pensées (Pascal) 146 passivity in groups, 62 patients, training groups for, 22, 30 Pichon-Rivière, Enrique adolescence, 29 analysis with Angel Garma, 31 Argentine Psychoanalytic Association, 31, 34, 36 atypical personality, 32 biography, 21–3, 25–36 brothels and nightlife, 29 childhood, 25–9 clash of cultures, 26 comparison with S. H. Foulkes, 20, 73 contributions to psychoanalysis and psychiatry, 31 death, 36 death, fascination with, 27–8 establishment, conflict with, 22, 35–6 family secret, 28

262

From Psychoanalysis to Social Psychology, 25, 31, 34, 45 Guaraní culture, 26–8, 35, 39 at the Hospicio de las Mercedes, 21–2, 28, 30, 33 see also Hospicio de las Mercedes as journalist, 30 Lewin, Kurt influence of, 43–4, 52, 137 comparison with, 44 medical studies, 29 money, attitude towards, 33, 35 motivational basis of his CROS, 35 see also conceptual referential operative schema (CROS): motivational basis of as pioneer, 23, 25 poetry, 26–8, 31, 35 sadness, 28, 31, 36 soccer, 29, 30, 54, 58–9, 64 social psychology, 34, 227 socialism, 29, 30, 32 sports, 22, 29 surrealism, 31 as teacher, 23, 25, 32 at the Torres Asylum for the mentally retarded, 30 positions application to the group-as-a-whole, 108, 113 depressive-integrative (Klein), 107 glishro-karyc (Bleger), 119 n5

OPERATIVE GROUPS

schizoid-paranoid (Klein), psychotic patients, 200–1, 107 209, 211, 213 pragmatism, 52 clinging transference of, praxis, 44, 47, 52 see also 211 action in a group setting, prejudice, 191–2, 203, 217 211–12 denial of, 217, 220–1, reflection groups 224 apparent ease of, 196 about professions, 191–2 comparison with primary process, 39, 68 therapeutic groups, principles of analysis, 129 204–5 projective identification and conflict with the counter-identification, institution, 195–7 160n5, 163, 165 coordinator psychoanalysis neutrality of, 206–7 conception of ‘inner’ and task and position, ‘outer’, 86 206–7 context of, 84 definition, 193 group, 229 evaluation in 194–5, 204 interpersonal (Sullivan), gender conflicts in, 194 85 institutional conflicts in, intrapsychic vs. 194 intersubjective, 156 interpretation in, 206 multifamily, 208, 210 mobilizing exercises in, split between practice and 193 see also teaching of, 149 workshops standard technique in, results of, 195 154–5 solidarity in, 195, 208 psychoanalytic function of in therapeutic community, the personality (Bion), 203 163 criterion for psychoanalytic theory membership, 205 disregard of interpersonal goal and task, 205 and transpersonal results of, 207–8 factors, 148 setting and contract, in training of family 204–6 therapists, 167, 169 working-though of psychoanalytic training labour conflicts, system, 144 207n5 Berlin model, 115, 156 therapeutic effect of, 195, Budapest model, 144, 207, 208 146, 156 as tool for social research, ‘psychotic’, use of term for 195 primitive phenomena, relations and patterns, as 160n4 primary observational psychotic part of the data, 66 personality (Bion), 161

SUBJECT INDEX

research axiological, 215–19 inclusion of the observer in the observational field, 216–17 representative results of, 224–5 technical recommendations , 223–4 methods, 87 anthropological, 87, 216 group-analytic, 87 sociological, 87, 218 participant, 218 see also action research in psychoanalysis, 115, 117 social, 102, 131, 208 use of group analysis for, 195 use of operative groups in, 215–25 resistance to change, 45, 56 in therapeutic community, 212–13 to evaluation, 126 to the task, 119 roles assignment and assumption, 56 and functions in groups, 73–4 Rosario Experience, 22, 33–4, 43, 101, 137 heterogeneous groups in, 33 homogeneous groups in, 22, 34 inspired in Lewin’s social laboratories, 44 large group in, 33

operative planning in, 46 rulers abuse and lies by, 190 ambivalence towards, 188 schemata, 48–9, 74–7 schism among British analytic group therapists, 19 School of Social Psychology, 36, 59 scientific method, 42 see also thinking: from ordinary or common to scientific secondary process, 39, 68 semiotics signals, 90 signifier and signified, 91 signs, 90 definition of, 91 tokens, 91 setting, 56, 116–18, 204–7, 211 change of, 105, 149, 158 single disease theory, 30, 31 soccer, 29, 30, 54, 58–9, 64 as model for the group, 54 social construction of reality, 185 social laboratories, 33, 44 social nature of the human being, 148 social psychologists, 59 see also School of Social Psychology social psychology, 85, 227 relation to individual psychology, 15, 52–6, 66–74 social system ambivalence towards, 188 nurturing the individual, 187

263

and thermodynamics, 198–9 traumatic effect of, 186 social violence, effect on the individual, 189 socio-analysis and socio-therapy, 199–200 see also reflection groups solidarity, 195, 208 spiral process, 86 see also dialectic spiral spiral thinking and spiral change, 88 spokesman, 53, 55, 112 state terrorism, 189 style, 215–16 Sufis, 228 supervision as an analytic inquiry, 155, 163 belief in standard technique in, 154 borderline patients in, 157 group, 146–54 as operative group, 156 comparison with individual supervision, 147, 164 comparison with therapeutic groups, 153–4 see also operative groups: learning: comparison with therapeutic groups dreams in, 158, 165 see also dreams: without semantic content dynamic impact of the material, 152–3, 156–7 see

264

also supervision: parallel process interpretations in, 157, 162 ‘objectivity’ in, 155. parallel process in, 147, 153, 161–2, 164, 197 psychoanalytic, 151 total situation in, 155 traditional and operative, 154–6 symbolic equation, 162 see also discrimination: between the symbol and what is being symbolized synchronic, 104 see also operative groups: protocols: transversal (synchronic) description systems epistemology, 168 theory, 166 see also communication-syste ms theory in the training of family therapists, 167, 170 task, common in groups, 37–42 explicit (external) task, 37, 40 implicit (internal) task, 37, 40, 88, 197–9 relation with, 203 in supervisory group, 158 in therapeutic groups, 20 task, evolution of (moments and stages) new project moment, 41–2 pre-task moment, 40–1, 108 task moment, 40–1

OPERATIVE GROUPS

decision stage, 41 dilemma stage, 40–1, 108 problem stage, 41, 108 ‘teachlearning’, 57 technique, as a creative enterprise, 155 text, definition, 83 theatre as model, 55, 73 theories, presupposed (Popper), 162 therapeutic community anti-entropic effort in, 199 conflict with the rest of the institution, 213 as container for the fragments of the patients’ personalitites, 212 contrast with traditional psychiatric wards, 212 CROS, 200–3 hierarchical levels of authority in, 202–3 internal task in, 197–9 interpretation in, 212 multifamily group in compensation of families’ pathologies in, 214 task of, 208 pathogenic pressures in, 199 psychoanalytic, with a multifamily structure, 208–15 psychoanalytic for psychotic patients, 200 reflection groups in, 199 see also reflection groups

resistance to change in, 212–13 risk to become a ‘maddening community’, 199–200 theory of, 197–200 therapeutic process in, 213 unavoidable conflicts in, 207 underlying values, 200, 201 thermodynamics in social systems, 198–9 thinking and communication, 93 definition, 93 dialogue with the internal group, 25, 53 disorder, 201 disturbance of, in individual and group, 157 by the group, 90, 94 disturbance of, 162 and learning, 93–4 ideas, definition of, 89 interpersonal dimension of, 89–90 machinery that makes the transforms, 89 as metacommunication, 94 from ordinary or common to scientific, 35, 38, 50 reflective, 201 Third World (Popper), 77 Tomás Borda Neuro-Psychiatric Hospital see Hospicio de las Mercedes training analysis, 143 training course in family therapy crisis in, 174–7

SUBJECT INDEX

CROS, 166–9 effect on the wider community, 179 family therapy symposium ‘The Voice of the Father’, 181 final evaluation of, 180, 182–3 final split in, 181–2 regressive phenomena in, 174–5 termination process, 179–83 training model, 169–71 use of written material in, 174–7, 180 transference and countertransference, 144, 151–2, 160n5 chain reactions, 152–3 interweaving of, 156 in supervision, 152–3 in the supervisory group, 157 in the supervisory relation, 147 transformations (Bion), 164 transpersonal phenomena see dimensions of human phenomena transversal description of the group field, 104 see also operative groups: protocols: transversal (synchronic) description example of, 105–13 trauma in belonging to a group, 62 definition, 185 effect of lies, 189–90 effect of mother’s sexuality on the baby (Laplanche), 185 effect of social system on the individual (Bion), 186

265

effect of social violence Wharncliffe Memorandum, and state terrorism, 16 189 Wiener, Norbert in human relations, 188 Cybernetics: Or Control and Tubert-Oklander, Juan, Communication in the biographical sketch, 11 Animal and the Machine, 198 unconscious fantasy, 163–4, Winnicott, Donald Woods 168n7 on holding, 186–8 understanding, 92 workshops, 102, 131–6 empathy, 169 compared with lack of, 91–2 laboratories, 138 definition, 131 values, 78, 130 see also ethics, 132 Weltanschauung evaluation, 136, 222–3 contradictory, 217 example of; see case research of see research: studies: workshop on axiological ‘The crisis in the scrutiny in groups, 80 couple’ in therapeutic community formative experiences in (active participation, see groups: formative cooperation, experiences: use in reflection and relative training of therapists horizontality), 200–3 mobilizing exercises in, unconscious 131, 220–1 see also (imperceptible and reflection groups repressed), 217–8 dangers of, 132 violence, effect on the family systems individual, 189 exercise, 132–3 notes-in-a-bag Weltanschauung, 65, 77–82, exercise, 135 129, 215 see also turning an individual conceptual referential exercise into a operative schema group experience, (CROS); conception of 179 the world two-stage design in, 132 as actual psychological use for research, 219 structure, 78 use of blackboard in, 134 analysis of, in groups, 80 use of Gestalt therapy breakdown of, 190 techniques in, 179 change in, 97 see also learning: levels: Zeitgeist (spirit of the time), Learning III 129 see also collective, 78–9 Weltanschauung as logical reconstruction, 77–8 new in the group, 81, 85 unconscious, 78

Balint, Michael (Hungarian-born British psychoanalyst) 21, 112, 113, 128, 143, 144, 148, 151, Abiuso, Dante (Argentine 155, 164, 169, 232 group therapist)156 Banton, Michael (British Aguiar, Elina (Argentine social anthropologist) group and marriage 74 therapist) 189 Baquedano, Gaspar Ahumada, Jorge (Argentine (Mexican psychiatrist) psychoanalyst and 232 analytic group Baranger, Madeleine therapist) 40, 156 (French-born Aleandro, Norma (Argentine Argentine actress) 84 psychoanalyst) 157, Álvarez, María del Carmen 163 (Mexican individual, Baranger, Willy group, marriage and (French-born family therapist) 13, Argentine 171–2, 179 psychoanalyst) 157, Angel, Ernest (American 163 existential Barrera, Ulises (Argentine psychoanalyst) 234 sports reporter and Angrist, Stanley W. commentator) 22, 54, (American engineer) 59 198 Bartlett, Sir Frederic C. Anthony, E. James (British experimental (British-trained psychologist) 75, 76 American Bateson, Gregory (British psychoanalyst and anthropologist, group analyst) 24, epistemologist, and 79–80 communication Aristotle 54–5 theorist) 13, 67, 69, Arlt, Roberto (Argentine 83–6, 89, 91, 94–8, novelist) 29, 35 103, 120, 167–8, Arsham, Hossein (Irani-born 198, 201, 215–16 American physicist, Bateson, Mary Catherine specialized in general (American operations research) 43 anthropologist) 89 Avenburg, Ricardo Bauleo, Armando (Argentine (Argentine psychoanalyst and psychoanalyst) 32 group analyst) 42, 108 Benne, Kenneth D. Bachelard, Gaston (French (American educational philosopher and philosopher, founder epistemologist) 233 of the National

Author Index

267

Training Laboratories) 45, 136 Binswanger, Ludwig (Swiss existential analyst and psychiatrist) 169 Bion, Francesca R. (wife of W. R. Bion and editor of all his later work) 143 Bion, Wilfred R. (Indian-Born British psychoanalyst, group analyst, and epistemologist) 16–19, 23, 39, 63–4, 67, 71, 86–7, 142–3, 145–6, 160, 163–4, 186, 200, 202, 228, 231 Blacket, Patrick Maynard Stuart (British physicist, Nobel prize 1948) 42 Blake, William (English poet) 81 Bleger, José (Argentine psychoanalyst and group analyst) 33, 38, 56–7, 71, 94, 233 Bochs, Gonzalo (Argentine psychiatrist) 21 Bradford, Leland P. (American education scientist, founder of the National Training Laboratories) 136 Breton, André (French surrealist poet) 31 Bridger, Harold (British psychoanalyst, founder of the Tavistock Institute of Human Relations) 17–19, 234, 235 Brillouin, Léon (French-born American physicist) 198

268

OPERATIVE GROUPS

Buber, Martin Defoe, Daniel (British (Austrian-born Israeli novelist) 70 existential philosopher) Dellarossa, Alejo (Argentine 169 psychoanalyst and Buffon (Georges-Louis group analyst) 13, 22, Leclerc Comte de 40, 42, 104, 110, Buffon, French 113, 134–5, 154, naturalist) 216 170, 193, 199 Descartes, René (French Caligor, Leopold (American philosopher) 63, 146 psychoanalyst) 147 Devereaux, George (French Canoi (janitor at the Goya psychoanalyst and brothel) 29 anthropologist) 79 Cappon, Jorge Dilthey, Wilhem (German (American-trained philosopher) 77 Mexican individual Doehrman, M.J.G. and group (American psychotherapist) 137 psychoanalyst) 147 Cárcamo, Celes Alberto Donne, John (English poet) (Argentine 67, 68, 227 psychoanalyst, founder Ducasse, Isidore see of the Argentine Lautréamont, Count of Psychoanalytic Dupont Muñoz, Marco Association) 31 Antonio (Mexican Carroll, Lewis (Charles psychoanalyst and Lutwidge Dogson, group analyst) 13, 86, British novelist and 87 mathematician) 232 Champion-Castro, Gloria A. Eco, Umberto (Italian (Mexican semioticist, essayist, psychotherapist) 164 and novelist) 83, 91 Chevaili-Arroyo, Arturo Ellenberger, Henri F. (Mexican (American existential psychoanalyst and psychiatrist) 234 group therapist) 164 Erikson, Erik Homburger Clausewitz, Carl von (Danish-born (German general and American strategist) 46 psychoanalyst) 169, Cleese, John (British actor, 187 writer and director) Espiro, Nicolás (Argentine 133 psychoanalyst and Corneille, Pierre (French group therapist) 22 dramatic poet) 26 Fairbairn, W. Ronald D. Danson, Ted (American (British psychoanalyst) actor) 84 76–7, 187

Ferenczi, Sándor (Hungarian psychoanalyst) 142–4, 152, 156, 169 Ferrater Mora, Josep (Spanish philosopher, novelist and poet) 77 Ferschtut, Guillermo (Argentine psychoanalyst and group analyst) 13, 128, 156 Foulkes, Elizabeth T. (British group analyst) 23 Foulkes, Siegmund Heinrich (originally spelled ‘Fuchs’, German-born British psychoanalyst and group analyst; creator of group analysis and founder of the Group-Analytic Society), 11–13, 17–21, 23–4, 34, 38, 55–6, 63, 69, 71–3, 79–80, 89, 92–3, 112, 144, 148, 151–2, 156, 167, 186, 205, 209–10, 214, 227, 235 Frankl, Viktor (Austrian existential analyst) 169 French, John R. P. (American social psychologist) 136 Freud, Sigmund 15, 23–4, 29, 31, 35, 39, 43, 62–3, 66–8, 77, 107, 119, 148, 159–60, 185, 187, 227–9, 231–2 Frondizi, Risieri (Argentine philosopher) 215 García Badaracco, Jorge (Argentine psychiatrist, psychoanalyst, and group and family

AUTHOR INDEX

therapist) 13, 76, 208–14, 229, 234 Garma, Ángel (Spanish-born Argentine psychoanalyst, founder of the Argentine Psychoanalytic Association) 31 Garma, Elizabeth Goode de (Argentine psychoanalyst and child analyst) 13 Gear, María Carmen (Argentine psychoanalyst, marriage and family therapist) 42, 108, 153, 203, 234 Gediman, Helen K. (American psychoanalyst) 147 Gibb, Jack L. (American psychologist) 136 Glocer, Florinda (Argentine psychologist) 137 Goldstein, Kurt (German neurologist and Gestalt theorist) 69, 70, 71 Goleman, Daniel (American psychologist) 84, 85 González Chagoyán, José Luis (Argentine-trained Mexican psychoanalyst and group analyst; founder of the Mexican Association of Analytic Group Psychotherapy) 13 Grinberg, León (Argentine psychoanalyst and analytic group therapist) 163, 165, 233 Grosskurth, Phillys (Melanie Klein biographer) 64

Harrison, Tom (British psychiatrist) 231 Hartmann, Heinz (German-born American psychoanalyst) 146 Head, Sir Henry (British neurologist) 74, 75, 76 Hepler, Loren G. (American chemist) 198 Hernández Hernández, Reyna (Mexican psychoanalyst, group analyst, and marriage and family therapist) 24, 34, 73, 148, 150, 167–9, 216 Hernández de Tubert, Reyna (née Hernández Hernández, Mexican psychoanalyst, group analyst, and marriage and family therapist) 11, 13, 24, 34, 65, 67–8, 73, 148, 167, 176, 181, 189, 192, 195, 216, 233–4 Hinshelwood, Robert D. (British psychoanalyst and group analyst) 13, 16, 17, 19, 231, 235 Hopper, Earl (American-born British sociologist, psychoanalyst and group analyst) 13, 24, 67, 70, 82 Isaacs, Susan (British psychoanalyst) 163, 234 James, William (American psychologist and philosopher) 52, 65 Jones, Maxwell (British psychiatrist and

269

theorist of the therapeutic community) 23 Kaplan, Abraham (American epistemologist) 51, 78 Katz, D. (Swedish Gestalt psychologist) 65 Kernberg, Otto F. (German-born American psychologist) 157, 233 Khan, M. Masud R. (Pakistani-born British psychoanalyst) 66 Khun, Thomas S. (American historian of science and epistemologist) 129 King Pyrrus, 46 Klein, Melanie (Austrian-born British psychoanalyst, child analyst and theorist) 31, 64, 108, 143, 163, 186, 200, 233–4 Koffka, Kurt (German Gestalt psychologist) 65 Kohut, Heinz (Austrian-born American psychoanalyst) 146, 169 Koltan, Horacio (Argentine psychoanalyst and group therapist) 40 Kolteniuk, Miguel (Mexican psychoanalyst and philosopher) 200 Lacan, Jaques (French psychoanalyst) 31, 146 Laing, Ronald (British existential analyst) 169 Langer, Susanne (American philosopher) 128, 129

270

Laplanche, Jean (French psychoanalyst) 185, 186 Lautréamont, Count of (pen name of Isidore Ducasse, Uruguayan-born French poet) 26–7, 31, 35 Le Bon, Gustave (French psychologist and sociologist) 62, 232 Lear, Terence (British group analyst) 167 Lewin, Kurt (German-born American social psychologist, creator of the field theory) 43–5, 49, 52, 63, 104, 114, 136, 188, 199, 227 Lewis, Eve (British psychologist and analytical psychotherapist) 18 Liberman, David (Argentine psychoanalyst and group analyst) 33 Liendo, Ernesto César (Argentine psychoanalyst, group, marriage and family therapist) 42, 108, 153, 203, 234 Lipset, David (American anthropologist and Gregory Bateson biographer) 89 Little, Margaret (British psychoanalyst) 165

OPERATIVE GROUPS

Main, Tom (British psychoanalyst) 16, 19, 23, 235 Matte-Blanco, Ignacio (Chilean British-trained psychoanalyst, logician and theorist) 68 Maturana, R. Humberto (Chilean biologist and systems theorist) 76 May, Rollo (American existential psychoanalyst) 169, 234 Mead, George Herbert (American social psychologist) 25, 52, 53, 54 Mello Filho, Julio de (Brazilian psychoanalyst) 108 Meltzer, Donald (American-born British psychoanalyst) 234 Mendizábal, Antonio (Mexican psychoanalyst and group analyst) 13, 164, 200, 201 Merleau-Ponty, Maurice (French psychologist and philosopher) 65 Mom, Jorge (Argentine psychoanalyst and group analyst) 157 Moreno Corzo, Luis (Mexican psychoanalyst) 13, 148, 156, 165, 233 McDougall, William Morin, Edgar (French (British-born American philosopher) 67 psychologist) 62 Morris, Charles (American Mailhiot, Bernard (French semioticist) 90 social psychologist) 43, 44, 136 Naranjo, Claudio (Chilean Gestalt therapist) 179

Orwell, George (pen name of Eric Arthur Blair, Indian-born British novelist) 232 Pascal, Blaise (French philosopher, mathematician and essayist) 146 Paz, Octavio (Mexican poet and essayist, Nobel Prize 1990) 178 Piaget, Jean (Swiss biologist, genetic psychologist, and epistemologist) 76–7 Pichon, Alfonse (father of Enrique Pichon-Rivière) 25–6, 29 Pichon-Rivière, Enrique (Swiss-born Argentine psychiatrist, psychoanalyst, group analyst, family therapist, and social psychologist; founder of the Argentine Psychoanalytic Association and the Argentine School of Social Psychology, and creator of operative groups) 11–13, 15, 20–35, 37–40, 42–60, 63–4, 71, 73, 77, 79, 81, 85, 88–9, 92–4, 99, 101, 108, 111, 134, 137, 145, 156, 167, 199, 200, 203, 211, 214, 227, 231–2, 234 Pines, Malcolm (British psychoanalyst and group analyst) 12, 23, 167 Plato 24, 66, 67, 87

AUTHOR INDEX

Popper, Sir Karl Richard (Austrian-born British philosopher and epistemologist) 77, 141, 163, 232 Powell, Andrew (British psychotherapist and group analyst) 72 Quiroga, Ana Pampliega de (Argentine social psychologist) 27, 53, 54, 59 Racine, Jean (French dramatic poet) 26 Racker, Heinrich (Polish-born Argentine psychoanalyst) 128 Ramírez, Santiago (Argentine-trained Mexican psychoanalyst, founder of the Mexican Psychoanalytic Association) 178 Ramos de Moreno Corzo, Vidalina (Mexican psychoanalyst and group therapist) 13, 156, 165, 233 Rank, Otto (Austrian psychoanalyst) 143 Raskovsky, Arnaldo (Argentine psychoanalyst, founder of the Argentine Psychoanalytic Association) 31 Remus, Estela (Mexican psychoanalyst and child analyst, founder of the Mexican Psychoanalytic Association) 33 Remus, José (Argentine-trained

Mexican psychoanalyst, founder of the Mexican Psychoanalytic Association) 33 Rickman, John (British psychoanalyst) 16, 18, 23 Rimbaud, Arthur (French poet) 27 Rivière, Josephine de la (mother of Enrique Pichon-Rivière) 26 Rolla, Edgardo (Argentine psychiatrist, psychoanalyst and group analyst) 33 Rosellini, Isabella (Italian actress) 84 Ruesch, Jurgen (American psychiatrist and communication theorist) 83, 89 Russell, Bertrand (British philosopher and epistemologist) 95

271

Spitz, René (Austrian-born American psychoanalyst and genetic psychologist) 185 Strachey, James (British psychoanalyst and Sigmund Freud translator) 232 Sullivan, Harry Stack (American psychiatrist and psychoanalyst) 23, 25, 85, 197 Sutherland, John D. (British psychoanalyst and analytic group therapist) 64, 66

Tamez-Garza, Rubén (Mexican psychoanalyst, founder of the Monterrey Psychoanalytic Association) 152 Taragano, Fernando (Argentine psychoanalyst and Saussure, Ferdinand de group analyst) 33, 231 (Swiss linguist) 25, 91, Thelen, Herbert A. 232 (American social Schilder, Paul (Austrian-born psychologist) 65, 91 American psychiatrist Trist, Eric (British social and psychoanalyst) 49, psychologist, founder 71 of the Tavistock Segal, Hanna (Polish-born Institute of Human British psychoanalyst) Relations) 23 108, 162, 163, 233, Tubert-Oklander, Juan 234 (Argentine-born Shakespeare, William, 73, Mexican 227 psychoanalyst, group Skynner, Robin (British analyst, and marriage group analyst and and family therapist) family therapist) 133, 11–13, 15, 20, 33, 167 42, 65, 67, 88, Socrates, 25 145–6, 148, 150, Sophocles, 55 154, 156, 164–5, 167–9, 176, 181,

272

OPERATIVE GROUPS

186, 199, 201, 206, 214, 216, 229, 231–4 Tzara, Tristan (Romanian-born French poet) 31

psychoanalyst and child analyst) 146, 169, 186, 187, 188 Wolkenfeld, F. (American psychoanalyst) 147

Ulloa, Fernando (Argentine psychoanalyst and group analyst) 197, 199

Zito Lema, Vicente (Argentine writer, interviewer of Pichon-Rivière) 21–2, 26–31, 34–5, 231

Varela, Francisco J. (Chilean biologist and communication theorist) 76 Vives Rocabert, Juan (Mexican psychoanalyst and group analyst) 13 Wallerstein, Robert S. (American psychoanalyst) 229 Watzlawick, Paul (Austrian-born American family therapist and communication theorist) 69, 76, 86, 91, 95, 168 Weil, Jorge N. (Argentine psychoanalyst and group therapist) 13 Whitehead, Alfred North (British philosopher and epistemologist) 95 Whorf, Benjamin Lee (American linguist) 185 Wiener, Norbert (American mathematician, creator of cybernetics) 198, 227 Wilde, Oscar (British poet and playwright) 187 Winnicott, Donald Woods (British paediatrician,