Abstract
This book is an encyclopaedia of group therapy with a special emphasis on group-analytic psychotherapy which is John’s expertise. But how can we review an encyclopaedia? It is too large and intense to be read as a novel, too rich to be digested in a hurry and has the authority of an extremely experienced and learned practitioner who is also a good teacher.
The book will provide a lot of knowledge for students and food for thought for those practising group therapy. The title already hints at the fundamental process many of us have gone through—following Foulkes—in understanding and accepting the exchange between individual patients’ responses in a group. This book documents the transition from the dyadic approach in psychoanalytic thinking to the multi-personal therapy of unconscious relations, ‘psychotherapy in the group, by the group, including its conductor’ (p34). This is the story of this book. John Schlapobersky believes firmly that this is a universal journey for group therapists and the book is full of stations in this traverse. I found his way with language and facility for the symbolic very enjoyable. The famous Foulkesian phrase here is quoted in the introduction that includes, amongst other things, a homage to Foulkes, his sources in Germany and his development in the UK (pp.11–19). The introduction’s detail is endorsed by James Anthony’s historical preview which was one of the last things he wrote before his death in 2014 (pp.xxcii–xxxiii).
The tripartite division of the book is already a declaration on the organization of learning and teaching therapy (p.19). Section I speaks of the foundations of therapy and especially group therapy. Section II provides a systematic account of the group-analytic model through Foulkes and Anthony’s original construction of a group’s structure, process and content and concluding with a chapter on the conductor. Section III on the dynamics of change begins with a revised framework for Foulkes’ account of a group’s four levels; it singles out the transference level in a following chapter, studies the group’s symbolic meaning in two further chapters and concludes with an account of location, translation and interpretation as basic therapeutic principles.
Section I provides a basic vocabulary, definitions for all sort of things and an organized list of useful concepts in the understanding and application of therapeutic measures. Section II provides an account of key group-analytic concepts with definitions for and discussion about resonance, mirroring, the matrix and a wide range of others. Section III explores, amongst other things, the group’s symbolic realm in the therapeutic use of metaphor with transference—for example—taken as one such construct.
My review concentrates now on the seven chapters in Section I with general observations about the book as a whole. Chapter four reproduces John’s already famous differentiation between modes of communication—monologue, dialogue and discourse (p.112). It is preceded in Chapter two with a new categorization describing the general process of change in psychotherapy in three dimensions that he calls ‘The Three Rs’: The Relational, the Reflective and the Reparative (p.59). The first starts with the connections between people; the second establishes a space in which awareness and consciousness arise in a group; and the third describes relationships that undergo change through resolutions affecting the unconscious. John’s ability to apply current and past therapeutic thinking to the enrichment and renewal of group analysis is found throughout the book and will be of good use to clinicians. Here the term ‘3 Rs’ is ‘borrowed’ from Billow’s Resistance, Refusal and Rebellion. In table 2.1 he supports his construction of these three ‘Rs’ by presenting Holmes’ (2010) tripartite division of psychoanalytic interactions, describing the Therapeutic Relationship, Meaning Making in Therapy and Therapeutic Action (p.62). Of the many other such examples, Chapter 10 in Section II brings current research on limbic resonance to bear on Foulkes’ original work on acoustic resonance (p.253). And Chapter 15 in Section III uses the constructs longing and belonging as registers to explore a group’s prevailing affect for which John finds a basis in Winnicott’s object and environment mother.
Chapter three studies a group’s phase development with a critique of earlier phasic models and gives John’s own account of group and personal development concentrating on the journey we make in group therapy (p.84). Here he selects nine sources in group analysis to provide an integrated account of engagement, authority, intimacy, change and termination in groups (pp.96–109). This is one of the many demonstrations of the critical aspects of John’s thinking which I also found in the concluding chapter of the book where he describes the uniqueness of the group’s contributions to human development and the individual’s therapy. This is endorsed by commentaries from his former patients in the concluding chapter’s ‘Last word’ (p.468). Chapter five explores speech and silence in the group, differentiating between silence of the unspoken and unspeakable. It is one of the first of the book’s topics to capture the attention of American reviewers and was the subject of a recent teleconference held by AGPA.
From the Couch to the Circle cites almost all the early and late English contributors to group analysis and beyond. From Foulkes to Nitsun, from Pines, Cox and Hopper to Adshead and Wotton, it provides for the essence of many group analysts’ contributions. Each chapter’s bibliography and the concluding Index will give readers direct access to these contributors. John’s sources give evidence of his own exchange with American group psychotherapy over many years. Chapter six traces many of the terms and definitions in current, world-wide use, to Foulkes’ early influence on North American practice through the early writing of Grotjahn, Scheidlinger and Ormont, followed by Yalom and Lesczc, Cohen, Kibel, Billow, Arlo, Rutan and Stone. Although Lorentzen’s recent work in Norway is given prominence, it is clear that the fountain of John’s knowledge is the English speaking professional world. I personally would like to see this group analytic encyclopaedia expand in a later edition to include a wider range of other professionals’ writing, especially from the German, Israeli, Nordic and other literatures, who will have caught John’s experienced attention.
Among the countless situations he describes, I found John’s approach to authority, extremely challenging. I would also think that in many places readers will profit more from a critical reading than a dogmatic and automatic acceptance. One of this book’s greatest values is the general direction it provides, with a coherent way of thinking and some clear do/do not do approaches. The undogmatic reader will find this direction especially useful as they encounter John’s group-analytic approach with a possibility to discuss and debate in the most enriching manner.
When a professional of John’s calibre provides us with so many sources of knowledge other than his own, his contribution deserves special appreciation. Many of the citations made me curious and invited me to explore them in further depth. I liked the book’s balanced mix between theory and practice. The many clinically sound vignettes are helpful in understanding the theoretical material. Most of them captured my interest and they often provide for exciting reading. Finally, the book is easy to read and the page structure is full of helpful features: case examples, space for commentary and many illustrated definitions. I am grateful for John’s huge investment in what seems to me an oeuvre that gives the group-analytic state of the art.