Abstract
Group Analysis can be considered the ultimate development in psychoanalysis after Freud. It is based on the relationship between the individual and the social unconscious, which interact and constantly and dynamically influence each other reciprocally. It represents a real Copernican revolution; the overturning of a view. While Psychoanalysis considers the social context marginal, Group Analysis proceeds in the opposite direction, placing the context in the centre rather than excluding it.
Thus the social context enters the therapy room. The analysis and working through of conflicts and unconscious individual problems goes hand in hand with the analysis and working through of everything that is shared at the level of the social unconscious.
Group Analysis is an analytic therapy practiced by the group as a whole under the direction of the analyst conducting it. The group engages in the analysis and translation of the latent unconscious meaning of communications. The translation work leads to the maturation of the group matrix, which in its turn generates individual change (Pisani R. A., 2000).
Science and Art
Concerning the conductor in Group Analysis, Foulkes asks himself (Foulkes S. H. Introduction to Group-Analytic Psychotherapy. London, Reprinted Karnak 1983, p.141–142):
“…how far can technical rules go? The conductor could not possibly think it all out, the more so as he is to act spontaneously himself if he wants his group to be spontaneous. Obviously he proceeds intuitively, by controlled instinct. He must act first but should think about it afterwards. Is, then, conducting a group an art, a gift or can it be taught and learned? Both surely.” In a chapter headed “Psychotherapy: Both Art and Science”, Nathan W. Ackerman says: “In my mind, it will always be both but it is our immediate interest to develop the scientific basis of psychotherapy. This is the only aspect that can be taught. The artistic side of psychotherapy is the product of the therapist’s creative use of his personal powers in the interests of the patient. He uses everything he humanly is as a medium for the application of psychotherapeutic knowledge. As such, the skilful use of his personality is of tremendous importance. But the therapist must use his personal powers in therapy with a constant and highly disciplined orientation to the meaning of the patient’s behaviour and the needs which are reflected in that behaviour. While art has a recognised place in psychotherapy a comprehensive understanding of psychopathology is indispensable to the therapist. No amount of art in psychotherapy can excuse an inadequate training in psychopathology. The art in psychotherapy must be made to serve the science and not vice versa”.
In these times in which there is so much emphasis on evidence in Psychiatry the contribution of J. Anthony is fundamental. Anthony had the merit of applying the scientific method in Group Analysis. Speaking about scientific method in 1957, Anthony defined it and wrote:
“The most significant features (of Group-analytic Psychotherapy) are:
1- seven or eight members meet for one and a half hours sitting in a circle together with the analyst
2- no programme or directions are given, so that all contribution arise spontaneously from the patients
3- all communications are treated as the equivalent of the free association of psychoanalysis, the ‘group association’.
4- the therapist maintains throughout an attitude which corresponds to that of the Psychoanalyst.
5- all communications and relationships are seen as part of a total field of interaction: the group matrix
6- all group members take an active part in the total therapeutic process.” (Foulkes S. H. – E. J. Anthony, 1957 p.28)
While the psychoanalytic situation is analysed in terms of a transference situation, the group-analytic situation is analysed in terms of “structure, process and content”(Ibidem p.30), inseparable from each other.
“Structure takes shape as configurations…the structural or configurational analysis is especially important in the localization of persistent disturbances in the group” (Ibidem p.31).
The group-analytic situation discourages the development of a regressive transference neurosis. It privileges the here and now phenomena, but, at the same time, vertical analysis meets horizontal analysis.
The phenomenology of the group-analytic situation concerns specific factors like mirror phenomena, resonance, chain phenomena, condenser phenomena, socialisation etc. (Anthony E. J. in: Foulkes S. H. – Anthony E. J. 1984 p. 149,150,151,152).
In the words of E. J. Anthony “Every therapeutic episode can be regarded, somewhat loosely, as an experiment or essay in research” (Foulkes S. H. – Anthony E. J. 1984 p. 61).
“The problem has been to design a therapeutic situation to meet the two simultaneous requirements of therapy and research…the two arrangements dovetail most effectively into each other” (Ibidem p. 61-62).”Although the group therapist does not achieve, or wish to achieve, the pure requirements of the laboratory situation, his ‘field’ is simple enough in its essentials to allow for endless repetition by many workers. Employing a similar constructed situation, different analysts have reported the occurrence of similar phenomena and the emergence of similar predicted phenomena” (Ibidem p. 147). But, with wisdom, Anthony adds: “But here we are set between the proverbial horns. Too much science will kill therapy; too little science will reduce it to the status of faith-healing” (Ibidem p. 148).
Art, Conductor And Leader
As well as a scientific preparation the therapist must have a creative function, like an artist.
Foulkes’ choice of the term conduction was inspired by the music conductor. The reference to the conductor of an orchestra is not accidental. It serves to differentiate the function of the conductor from that of a leader or führer. The term leading has an authoritarian connotation. It also means that the patient shows his disorders and wants the leader to show him the solution and how to heal them. This corresponds to fundamental resistance.
The similarity to the orchestra has been expressed thus:
“I was not the composer who wrote the music but the conductor who interpreted it, the conductor who brought it to the light…I feel like a conductor, but I don’t know in the least what the music is which will be played” (Foulkes S. H. 1990, p. 292). “If we hear an orchestra playing a piece of music, all the individual noises are produced each on one particular individual instrument; yet what we hear is the orchestra playing music, the conductor’s interpretation, etc. We do not even, in terms of pure sound, hear a simple summary, a summation of all the individual waves which reach our ears; rather, these are significantly modified, being part and parcel of a total sound. In truth, what we hear is the orchestra. In the same way, mental processes going on in a group under observation reach us in the first place as a concerted whole” (Foulkes S. H. 1990, p.153–154).
In music, “concertante” signifies a dialogue between musicians, in which the soloists alternate with the orchestra. It corresponds to the Gestalt concept of the whole being greater than the sum of its parts. What we experience is the group as a whole. The parts can only be understood in the context of the whole.
Art Of The Orchestral Conductor
Classically, orchestral conductors can be divided into two types:
1) authoritarian: the orchestra is under his orders. He corresponds to the figure of the leader.
2) democratic: the conductor does not place himself above the orchestra, but makes music together with its members. The individual musicians, even the least important, have greater responsibility in the execution of a piece of music.
The conductor acts as guide to an orchestra, choir or group of musicians. He is the medium through which the orchestra executes the musical composition.
His function is to indicate the tempo, the entrances and the dynamics of the orchestra members, to make music together. He transmits to the musicians the content of the composition and his personal approach to its execution and interpretation.
He prepares and coordinates, through rehearsals, the performance of a work.
The orchestral conductor creates and maintains the rhythmic pulse of the whole orchestra, he shapes its sound, creates its spiritual unity – a kind of collective soul – and makes it implement his approach and express his way of feeling the music.
He gives the musicians the beat for playing together and inspires the orchestra. He is the centre through which the notes pass and are harmonised.
There is an ongoing exchange between conductor and musicians, a give and take.
The musicians read their particular part and their conscious attention is devoted to the written music symbols. But they also adapt to the conductor’s movements and gestures through their peripheral vision. They perceive, subconsciously or unconsciously, the director’s intentions which are reflected in his attitude, his body movements, his gestures and facial expression. They participate at the right tempo, following the score and listening to each other.
This is only possible if the maestro’s rhythmic action radiates from a centre that shifts only minimally and always remains within the field of the musicians’ peripheral vision. The centre of the rhythmic radiation is the conductor’s right wrist.
The left hand is used to convey timbre and phrasing, expressive indications par excellence.
Hence the main function of the right hand is the rhythmic direction of the whole. The baton is a physical extension and mental projection of the conductor. It is most important in expressive communication and in creating a director’s individual sound style.
A harmony between gesture and musical idea is essential for communicating with the orchestra. The conductor can permit himself great freedom, as long as he adheres to the principle of a base, a sole centre for the rhythm, determined by the right wrist, and to the rule of maximum economy of the orchestra’s conscious attention.
The other means employed: personal attitude, facial expression and gestures reflecting the conductor’s emotional state, determine the sound aspect of the execution and the implementation of the maestro’s interpretive plan.
The orchestral conductor is one of the musicians. He “plays” the baton, his hand, his gestures, his miming; he sings, he plays the notes, he leaps etc. He ensures order and rhythm; he keeps the beat. There is a give and take between him and the musicians, in order to create a harmonious, coherent whole. He gives each musician room to express himself individually, as if they were soloists whose music flows into a whole: the sound of the orchestra. Each musician adds his own touch as he plays.
Making music together means integrating. There is a constant flow of energy between conductor and orchestra. Everything is constantly connected in order to play together in synchrony, in synergy, in syntony.
Contextualisation is the crucial point, and here the director’s contribution is indispensable. If a section, for example the strings (violin, viola, cello, double bass), has a main part, that section must play in such a way as to be heard above the others. However, the relationship between its part and that of the others is fundamental for finding the unitary meaning of the piece of music. It enables an execution to pass from a juxtaposition to an integration of the parts. The different sections of the orchestra pass the word, as in a dialogue. The melody (theme) is passed from one to the other. This implies listening to the others and introducing one’s own sound in a way that does not interrupt the flow. Some musicians develop the melody, the rest of the orchestra provides a harmonious accompaniment.
Directing does not mean imposing but dialoguing – although a conductor must impose himself to some degree to conduct the dialogue. It requires logical mathematical rigour, study, daily application and commitment, discipline, but also participation and identification with the composer’s music. In short, it requires art, that is talent, fantasy, imagination, intuition, inventiveness and improvisation, at the service of creativity.
Creativity is the product of Eros. The sound comes from an intimacy, from the conductor’s and the musicians’ intimate adhesion to harmony and beauty. In order to direct, the conductor must feel and direct the music within. He must thoroughly understand the emotional aspect of the composition. He must have charisma if the members of the orchestra are to follow him, and he must act as the medium with his body, soul and intellect. Technique is not enough, it takes personality. Every conductor expresses his own personality and executes the composer’s work in a different way, while always remaining faithful to it. The music is that of the author of the composition, filtered through the conductor’s emotions and shared with those of the musicians.
The conductor is not passive. He feels the music, he participates and transmits his participation, he involves the orchestra and transforms it into a concerted, harmonious whole. He feels, amplifies and integrates the orchestra’s moods. It is said that when the Italian maestro Franco Ferrara stepped onto the podium it was as if a magnetic field had been created around him, a “magic” atmosphere that generated a powerful emotional communion.
For Bernstein the baton had to be a living thing, charged with a kind of electricity, which made it an instrument of meaning in its tiniest movement. A baton wielded by a great conductor is “magic”. The conductor is not merely a metronome. The baton polarises passions: joy, grief, enthusiasm, sadness, love, hate, anger, and so forth.
(Barenboim D. 2011, Bassi A. 2000, Battista T. 2012, Bernstein L. 2008 and 2010, Kàrolyi O. 2000, Lualdi A. 1940, Nicotra E. 2007, Quattrocchi A. 2006, Santi F. 2013).
Art Of The Conductor In Group Analysis
At a group-analytic session, unlike an orchestral performance, there is no score. The theme is always new and unrepeatable. Each session is a piece of “music” without a score.
The orchestral conductor is the composer’s interpreter, while the group-analytic conductor is the interpreter of the text (content of the communications) created by the group. He does not write the “music” but interprets it constantly, mainly in his head. He does not produce the “music” and he is very careful not to influence the group’s ideas and associations.
One could say that the group is the composer of the “musical text”, the content, and the conductor is the medium through which the content is created and expressed.
The orchestral conductor is the medium through which the orchestra executes the musical composition. The group-analytic conductor is the medium through which the group creates the content (“musical text”).
The conductor does not stand on the podium, but sits on a chair, like the other members of the group. The chairs are arranged in a circle; they are all identical and the same distance apart.
There are no spectators. The audience consists in the participants themselves, who create and listen to the “music” at the same time.
There are no rehearsals, like there are for a concert.
While the psychoanalytic situation is analysed in terms of the transference situation, the group-analytic situation is analysed not only in terms of transference but also of structure, process and content, each inseparable from the other. Technically speaking, the conductor organises the structure, directs the process and makes a contribution, at times crucial, to the creation of the content.
The conductor is responsible for the Structure of the group: selection of participants, location, arrangement of the chairs in a circle, times, vacations and type of group: open, closed, slow-open, trial group and so forth. Rather like the preparation of a performance in music.
The conductor has an aggregational function. He is the organiser, keeper, guarantor, animator and guardian of the process of free-floating communication.
He directs the Process mainly in silence in his head, with a kind of “mental baton” (Pisani R. A.), fostering interaction between the participating members. He is the centre through which the communications pass and are harmonised. He constantly integrates in his head the various levels of the communication process: reality, transference, projective, primordial. Solely through his presence, which is indeed vital, he gradually breaks down, in a non-explicit way, censoring and defence mechanisms in favour of free-floating communication and spontaneous, authentic, genuine dialogue between the participants. He creates the conditions for analytic culture. He triggers and sustains the free-floating dialogue; he triggers and sustains the analysis and translation of the unconscious meaning of the communications.
The conductor directs as someone on an equal footing with the other members of the group: he is the primus inter pares. He “plays” his instrument, the “mental baton”, in a non-directive way, setting the tempo, the sequence and the dynamics of the interventions in absolute silence, in synchrony, synergy, syntony and empathy with the participants, through subconscious or unconscious communication. He does not place himself above the others, he does not give orders; he functions as a guide, but with authority. Every gesture is reduced to the essential in a serene and relaxed mood; nothing should be superfluous. Like the orchestral conductor, he makes room for the content provided by individual participants who merge into a whole. He picks up moods; he integrates and amplifies them. Consequently, all the participants, like the members of an orchestra, are equally responsible for the creation of content, of the “musical composition”.
Through his expressive presence, his verbal interventions at the right moment, his miming and his gestures, he sustains the communication and the translation work, especially when the group or one of its members thwarts or stops the communication process. He creates and contributes to the concerted harmony of the whole.
A group-analytic session is an event that, at times, displays formal similarities to the execution of a piece of symphonic music, and in which an ongoing dialogue is created between the individuals and the group as a whole. The foreground figures create and develop the theme, the “melody”, and the background group participates in “harmony” with the others. As if it were a “concert for orchestra”.
The Content, the “music”, emerges through the interaction between structure and process. The conductor plays an active part in the analysis of the communications and the creation of content. He behaves like a kind of amplifier: he receives the meaning and the emotive content of the communications. He works them through and amplifies them in relation to his emotive participation (Klain E., 2009). His emotive participation is fundamental. It requires enthusiasm, fantasy, passion. The “music” passes through the conductor.
Creativity, as we have already said, is the highest expression of Eros. The connection between the parts generates the product of creation. In Group Analysis the product is the maturation of the group and of the individuals that compose it, referred to by P. de Maré as the Metastructure, which constantly evolves in time (de Maré P.,1991).
Also in this case, the technical rules require study and rigour: structure, process, and content. Transference, counter-transference, mirroring, counter-mirroring, abstinence, discipline and so forth, which must be mastered, above all, through didactic and propaedeutic analyses and clinical experience (see also Birchmore T., 2013). The art is expressed through the powers of the conductor’s personality and his “charisma”, within the scientific framework.
The art of the group-analytic conductor, like that of the orchestral conductor, is based on his personal talent, his intuitive capacity and his inventiveness, improvisation and animation; in a word, his creativity. He is a “poet” (Foulkes S.H., 1990) of conducting. Like the orchestral conductor, the conductor in Group Analysis must give and take, transmit and listen; he must pay attention to the communications of the individuals and of the group as a whole, integrating them harmoniously.
It is a complex combination of logos and pathos. One could say that the small group resembles a chamber ensemble and the larger groups a symphony orchestra.
Considering Gestalt group therapy, I divide the session into three parts, rather like a musical concert:
1 configuration of content. The foreground can be one individual or more, with the group as a whole in the background, or vice versa;
2 location on the foreground figure or figures, through which meaning will be made to emerge;
3 finale the whole group participates in working through the content.
Clinical Example
Meeting of the group of ex-patients on 27/01/2012 (Report by Dr Antonella Giordani)
Structure:
17 participants: 9 women and 8 men.
Process:
Mrs M, who has been trying to become pregnant for two years, opens the meeting. She dreamt of having her chest and breasts covered with pimples full of pus mixed with milk which is therefore poisoned. She admits she does not have a maternal instinct. Having a child may not be a priority since she is satisfied with her work (lawyer), and with her conjugal relations.
Also Mrs A. did not feel she had a maternal instinct. She remembers the effort it cost her to accept first her pregnancy and later the presence of a daughter to be nursed. She asks M. what she thinks is the origin of her lack of maternal instinct.
M. thinks of the inevitable involvement of her parents; it is impossible to establish a dialogue with them.
For A. it is necessary not to worry about the maternal instinct, but rather to separate from the maternal figure: detach from this in order to be oneself.
Mr. G. 2 sees himself in the discourse about parents. His father descends upon him and pressurises him to phone his mother, who instead is so cold and detached.
For Mr. Ga. the maternal instinct is present like other instincts: hunger, thirst, sleep. In M.’s case the unconscious desire to have a child with her father may carry weight.
The Conductor points out that, apart from this confusion related to having a child with her father, M. is afraid of being like her mother and having only poisoned milk to give to her children.
Mrs. C speaks about a dream she had after her daughter’s boy-friend told her he wanted them to go and live together. In her dream she sees two cows, one gives birth to a calf and the other sucks it up, swallowing it. C. interprets it as re-proposing herself to her daughter like those mothers who do not let you grow. They take over your life and want to make you what they say; they impose bans and punishments. Therefore she urges M. to have a child in order to free herself from her mother’s prohibitions, albeit not explicit ones.
G. 2 is furious with himself and with his own unconscious because he cannot behave in an adult manner. He thinks he is always waiting for a caress from his mother and a clap on the back from his father. He relates that he met one of his father’s political friends and was introduced to him as “the son of…”.
M. reflects that also in her conjugal relationship, she was afraid of re-proposing the parental bond.
Mr. Ga. recognises himself in the description of the parents that G. 2 gave. Today he no longer cares about his parents, but the fact remains that there is a little corner where the child Ga. Hides.
Mrs. Gn. is linked to M. by the fact that she experienced maternal inadequacy caused by Elena’s (her daughter’s) pediculosis. She, too, dreamt of her son with his head full of lice.
Also Mr. G. 1 recognises this need which he links to identity with and separation from his parents: “when the separation occurs I no longer know who I am”.
With regard to identity, Mr. E. says that having got to the age of 50 he no longer knows who he is. He is grieving for his mother’s death.
The Conductor ends the meeting asking everyone to assess what they have kept/modified/eliminated from the parental figure in the definition of their own identity.
Content:
Infertility and maternity anxiety associated with that of fusion-separation and identity.
The foreground is represented by Mrs. M, Mrs. C. and Mr. G.1, the background by the group.
I would like to conclude this paper by remembering my friend and colleague Salvatore Franco, who has sadly passed away. In a personal letter he wrote to me:
“The individual is composed of parts that seek harmony and concord … The individual Self is composed of multiple, heterogeneous parts … different parts that are like diverse musicians in a concert hall of our mind, where our Self, or rather our Me, attempts to read, interpret and direct this heterogeneous orchestra, seeking to harmonise all the other human instruments that are playing with it, exactly like the people in the great concert hall of the world …”
My thanks to the conductors Maestro Tonino Battista and Maestro Fabrizio Santi for allowing me to interview them on directing an orchestra.
Footnotes
Rocco Antonio Pisani
M.D. Psychiatrist, Neurologist, Group Analyst.
Former Head of the Neuropsychiatric and Psychosomatic Outpatients Department, from 1974 to 2004.
Former Professor of Psychiatry and Group Psychotherapy, Department of Neurological Sciences, University “La Sapienza”, Rome.
Full member of the Group Analytic Society (International).
He started, as conductor, small group analysis in 1981, and the median analytical group in 1991, at the University “La Sapienza” in Rome and in private.
The weekly sessions of the median group at the Department of Neurological Sciences, from 1991 to 2003, are collected in 19 volumes.
Postal address: via Latina, 166 – 00179 Roma, Italia
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