On the genealogy of group analysis: Our version of the Greek context 1

Abstract

This article aims at pinpointing some aspects of group analysis, especially in relationship to psychoanalysis, as they have emerged and developed in the context of Greek group-analytic (and psychoanalytic) institutions. Group analysis in our country has been trapped and rigidified either as a ‘therapeutic-community-oriented’, anti-psychoanalytic polemic or as a ‘psychoanalytically-informed-group-work’ project, applied in institutional settings and attributing secondary importance to group matrix. This situation has been amplified by the prevailing psychoanalytic institutions’ tendency (in opposition to Freud’s legacy) to minimize the social origins of the unconscious processes.

In our current Greek context, the Institute of Group Analysis ‘S.H. Foulkes’, has as its core aim a healing return to the original, integrative Foulkesian vision: A search for integration of contemporary psychoanalytic developments and the legacy of group analysis.

Keywords

Greek context group analysis psychoanalysis integrative transference conductor social unconscious

1. Psychoanalysis and group analysis

Group analysis is a ‘psychoanalytic’ project. Group-analysis is the group counterpart of psycho-analysis: They are both ‘analyses’ of the unconscious.

According to Freud, the individual remains connected to his groups of belonging (Rouchy, 1995), whichever that may be; ‘. . . in the id, which is capable of being inherited, are harboured residues of the existences of countless egos; and, when the ego forms its super-ego out of the id, it may perhaps only be reviving shapes of former egos and be bringing them to resurrection . . .’ (Freud, 1923:38). We think that this idea contains the seeds of the conception of the Foulkesian group matrix.

Foulkes, a psychoanalyst who later became the first group analyst, succeeded in developing an approach so as to reframe the individualistic/collectivistic dichotomy (Elias, 1939; Freud, 1921; Le Bon, 1895). Foulkes’ (1948) radical innovation was that he created a new setting where a ‘psychoanalytic approach’ could be applied and could impregnate both psychoanalysis and group therapy with new perspectives.

Psychoanalysis and group analysis should remain closely connected, because the social base of the psyche should, unavoidably, be of primal importance for a psychoanalytic mind, but all the more so because group analysis can make use of a background referential frame of psychoanalysis for the understanding of the human psyche. As much as psychoanalysis needs to integrate the group representations of the individual, with greater reason, group analysis should not become an approach exclusively ‘social’ e.g. ‘communitarian’ (McIntyre, 2007), thus losing sight of the dynamics of the individual subjectivity. Sovereignty of the social and its regulatory structures of conformity and socialization, if unchallenged, run the risk of undervaluing the intrapsychic universe of the individual².

Group analysis and any form of dynamic group psychotherapy for that matter, should not become a mechanism for grinding social friction or conflict into a conformist socialization of the individual, ignoring the importance of unique individual experience and the possibility of a discourse which allows for the exploration of deeper inner primitive proto-social and pre-lingual experiences.

‘Politics’

Historically, the massive democratization and economic flourishing of the western world, coupled with the ‘baby-boomers’’ social ascendance and the expansion of their culture (Rock n’ Roll, anti-authoritarianism etc.) brought about a revolution of the psychological and psychoanalytic conceptualizations. The prevailing and mainstream psychoanalytic approaches were massively questioned, not only from outside psychoanalysis (e.g. Laing’s and Cooper’s anti-psychiatric movement, therapeutic communities, new CBT treatments, etc.), but also from the inside, primarily under the form of the so named ‘relational and intersubjective turn’ (Greenberg and Mitchell, 1983). The view of an internal world motivated mainly by drives and inhabited by fixed endopsychic structures was questioned.

We hypothesize that in the years that followed Foulkes’ era, group analytic community ‘felt’ so much empowered by its ‘expansion’ that an urge came about: to ‘emancipate’ from ‘mother’ psychoanalysis. This symbolic ‘matricide’ of its psychoanalytic origins took the form of a so called ‘radicalization turn’, which guided group-analytic theory into a false and disadvantageous conflict with its psychoanalytic roots (Dalal, 1998). This led to divisions among group analysts. For some, the psychoanalytic perspective was maintained, and broadened conceptualizations emerged, such as the anti-group (Nitsun, 1996) and the social unconscious (Hopper, 2002; Hopper and Weinberg, 2011). For many others, a certain ‘a-theoretical’, still ideologically ridden and ‘political’ attitude prevailed (Lamnidis and Hopper, 2016), to the dismay of the Foulkesian thoughtful equilibrium.

Nowadays, timelier than ever, in a kind of Nachträglichkeit, the Foulkesian ideas regain a still more classical position in our mind.

2. A version of the Greek context

To place the above issues in more reality terms it is unavoidable to examine the historical and socio-economic framework. Group analysis in Greece, like any institutional development, is the child of its contemporary Zeitgeist, denoting some aspects of the foundation matrix, or the social unconscious. Interestingly, group analysis—through the Institute of Group Analysis of Athens (founded in 1982) and the Hellenic Society of Group Analysis and Family Therapy (founded in 1983), and psychoanalysis—through the Hellenic Psychoanalytical Society (founded in 1984), were simultaneously ‘born’ in Athens, as a kind of inversed condenser phenomenon (Foulkes, 1964). This happened in a context where Greeks, for the first time since the 1930s, were re-enjoying full parliamentary democratic liberties. Furthermore, in a parallel institutional context, at that same period, the differentiation of psychiatry from neurology—as discrete and not unified medical specialties, as they used to be till then—was established.

Group analysis in Greece has, since its initiation, been represented by two different institutions, which mirrored the upcoming dissociation of the two disciplines. Since then several schisms and divisions followed. Today seven institutions represent group analysis in Greece.

Concerning the two initial institutions: The Institute A conceived itself as an alternative to the (still existing, at that time) mediaeval psychiatric asylums and to over-medication, and pointed towards deinstitutionalization and psychiatric reformation, within the aforementioned political climate, while, at the same time, consciously departing from psychoanalysis³.

This community-based model viewed the individual as a narrowly social outcome, lacking almost any intra-personal account of the human psyche⁴. The pendulum was too much towards the pole of ‘social-ism’, as Bion (1992) would put it and disregarded the pole of ‘narcissism’. Epistemic foundations were undermined, in the interest of an existential/adaptation-oriented approach, and an anti-psychoanalytic, anti-psychiatric, therapeutic-community-oriented stance prevailed. The individual (and the group) was absorbed in a communitarian spirit, with ideological admixtures⁵. The workings of the group were almost exclusively on dynamic administration and ‘common sense’.

The Institute B conceived itself as ‘psychoanalytically informed’, but while minimally using group-analytic theory, it was mostly based on: 1) Yalom’s model; 2) elements of psychoanalytic object-relations approaches; and 3) elements of systemic theory. Foulkes’ concepts had minimal presence and the group theory remained without its autonomy.

Each one of these two initial institutes remained in conflict, non-recognition or negation of each other. Although, they both claimed to be closer to the social aspect of individuals, they both remained, since their creation, isolated and in conflict with each other, capturing, in this way, the reactionary origins of their structure and obstructing the further development and evolution of group analysis in Greece.

Consequently, within the initial Greek group-analytic paradigm, intra and trans-institutional theoretical fermentation was prevented. This factor possibly accounts for the consecutive divisions, splits and continuous emergence of new institutions.

By disregarding pluralism, both these initial group-analytic institutions were unable to tolerate theoretical and clinical challenges that could have led to development. Furthermore, there was no adequately scientific and clinically relevant examination of basic theoretical and clinical questions like, e.g. what makes a group-analytic group work, which were rather out of interest.

Further to the above we should consider governance of these institutes. The matter of irregular distribution of power, much of the kind that Kernberg (1986, 2004) attributes to psychoanalytic institutions, has been lurking in the foundations of these first two institutional structures. In the past 35 years of their existence, presidency for these institutions has not changed. This kind of applying authority led to a malformation of structural arrangements, whose aim was to maintain this structure, to protect their interests from any kind of threat. Concomitantly, this led on the one hand to the development of arbitrary and untouchable dominance, and on the other to a kind of dependent subordination, passive aggressive and ultimately rebellious behaviour. This created a precedent to be followed in different kinds of degrees by some of the descendant institutional structures.

Some common characteristics that have been observed of these two initial institutions are the following:

- One leader is often the founder of everything. Leader-centred institutions continuously promise a kind of illusory, future ‘equalization of power’ that never comes about.

- The demonization of the opponents.

- The splitting and the projective maximization of ‘theoretical differences’ which are usually minor, or not sufficiently elaborated.

- Whenever a maturation of real differentiations and differences comes about the splitting mechanism is repeated in a multiplicity manner.

The question here is whether the resulting ‘plethora’ of group-analytic institutions in Greece constitutes a kind of development towards pluralization or a kind of institutional pathology. Is this pathology a manifestation of the development of group analysis in Greece, unique for our domestic social unconscious? Or could this possibly be an enactment of latent difficulties in the international group-analytic community? A similar study of patterns of the multiplication of group-analytic institutes in many European countries would be also useful.

All new institutions disseminated from schisms or divisions of previous ‘parental’ structures, which the ‘offspring’ would view as ‘pathological’. This fact, probably, counts for their inability to coexist under a single umbrella. Consequently, this is not only a matter of theoretical divergences—leading to different kinds of group analysis; this is also an index of ‘narcissism of small differences’.

A recent example: a couple of years ago yet another group training institution was founded, which for the first time officially acknowledges individual psychoanalysis as the principal therapy for trainees! This, on the one hand acknowledges psychoanalysis but on the other undermines the capacity of the group as an adequate therapeutic tool, perpetuating the division between psychoanalysis and group analysis.

3. Thinking about theory

Here we are sketching a general frame for comprehending psycho-analytic and group-analytic theorizations in a figure-ground perspective. The way this is applied in practice (group-analytic groups, training, supervision, institutional functioning etc.) will be the object of following articles.

Drives—intrapersonal structures—sociality

Group analysis has its roots in psychoanalysis and the individual is perceived as bearing his own psyche and body, as pertained via the intra-personal structure (Brown and Zinkin, 1994). Viewed from this Foulkesian perspective:

The superego could be thought of as representing both internal constraints and external restraints, within a specific societal framework, and could permeate the individual and contribute to the wholeness of the social within the individual’s internal world.

The id, which bears ‘residues of the existences of countless egos’ (Freud, 1923: 38), could be thought as the depository of cumulative amounts of human ‘knowledge’, in the shape of unconscious primary phantasies (e.g. primal scene).

The ego could represent an assembly of interpersonal and transpersonal structures, much like communicational nodal points that have been introjected, where a relatively stable and energetic equilibrium (much along the lines that ego psychology conceptualizes the ego) is established between foundation, dynamic and personal matrices.

Along the same lines, many other psychoanalytic conceptualizations could be considered from a group-analytic point of view and, in the spirit of Cortesão’s writings, this could integrate ‘ . . . the technical and clinical management of the metapsychological formulation and the minutiae of object relations, in a specific group situation, which is different, but not inconsistent with the dual situation of psychoanalysis . . .’ (Ferreira, 2015: 469).

For instance, introjection (and its counterpart, primary identification), reviewed by Foulkes (1937), based on Ferenczi’s legacy (1909), is a bringing about of a qualitative dimension of the sociality, complementing its conceptualization in solely drive terms.

Using the—not without dangerous traps—translation of psycho-analytic concepts into group-analytic ones (and vice versa), as a kind of bridging of the two, many other metapsychological concepts, could not only become enriching for both fields (Kaës, 2013), but also open new theoretical and clinical perspectives, revealing the limitations as well as the hidden possibilities of each concept.

Nitzgen (2013) presents such an example of how Foulkes viewed the individual as an agent of libidinal forces, manifesting in a ‘total situation’: situated among disruptive or destructive libidinal tendencies the ‘ . . . conductor aims to maintain a “tolerable imbalance” between such opposing tendencies in groups . . .’ (Foulkes and Anthony, 1957[1984]: 58).

Communication—symptoms—objects—transference—symbolization

Foulkes emphasized the importance of the communicational process, advocating that

. . . neurotic disturbances, symptoms, in themselves autistic and unsuitable for sharing, exert for this very reason an increasing pressure on the individual for expressing them. As long as he cannot express them in a better communicable way he finds no real relief . . . (1948: 169)

Accordingly, it is the ‘process of communication’ that ‘drives the therapeutic process forward’ (Foulkes and Anthony, 1957[1984]: 260). Communication can be thought of as the other side of transference, which in Foulkes’ mind and writings has changed over the years (Hopper, 2007, 2009). And although placing transference interpretations at the centre of the analytic process was not recommended, he nonetheless considered the group analytic situation ‘in essence a transference situation’ (Foulkes, 1964: 109).

Along the same lines, according to Leal, free floating (group) discussion and communication could be an equivalent of transference ‘ . . . not only (as) transposition of content, not only as a compulsion to repeat unconsciously former interactions or relations, but also [. . . in terms of] economic [libidinal] emphasis . . .’ (Leal, 1971: 54). So, the technical focus may be intrapersonal, if we concentrate on the individual; or the technical focus can be transactional or interpersonal, if we concentrate on dyads and subgroups (Billow, 2017: 12). In both cases concepts like ‘group-as-a-whole’ ‘transference’ and ‘resistance’ can function as interacting relational modes through which the group members and the therapist come to experience, communicate with, and symbolize each other (Billow, 2017: 9), given sufficient length of the treatment.

Besides communication, matrix is the central Foulkesian concept: Within the matrix, communicational/intersubjective processes, restructuring/mutative processes and representing/symbolizing processes become intertwined⁶.

Through communication and matrix, groups represent and process intersubjective experiences at various developmental levels of thought. Such intersubjective experiences are modeled as histories of dyadic, triadic, and social relationships. All these are partly introjected/internalized (subjectivated) and partly re-activated when met with a concomitant, mirroring environment (Pines, 2003).

According to Rippa et al,

. . . each group member unconsciously brings to the therapy group his/her entire collection of inner significant objects, which may be individual objects and . . . may also be group objects. These may then be unconsciously projected onto individual members; the conductor and/or the group-as-a-whole can affect their real behaviour in the group in positive and negative ways . . . (Rippa et al, 2013: 415)

As Anzieu remarks

. . . psychoanalytic work needs to be done where the unconscious shows itself, standing, sitting or lying, individually or in a group or in a family, wherever a subject can put words on his distress and his fantasies towards a person who is there to hear him and able to give him an interpretation . . . (Anzieu, 1975: 37)

The difficulty is therefore to open up individual analysis to another level of analysis, while at the same time to favour an approach to unconscious processes within a small group.

4. Thinking about conductor—administration—interpretation

Foulkes’ conceptualization of the group analyst implied (1) his specific position in the dynamics of the group; (2) his dynamic administration of the group, which aims at maintaining the setting. Later he acknowledged ‘ . . . the culture of the group. This is not brought about by a particular act, although this total atmosphere is the result of his actions . . .’ (Foulkes, 1975: 95); consequently (3) his ‘analytic attitude’ (op cit: 108); the group analyst remains an analyst who apprehends the unconscious processes in the group.

Consequently, we conceive the group conductor’s role and position as follows:

Since professionally led therapeutic groups differ considerably from self-help groups (Lambert, 2013), the group analyst does not have a negligible influence in the group and has a key role in the translating process, resorting to interpretations (an activity that he/she teaches by sharing with the other members of the group), thus ‘leading’ and ‘training’ the members of the group to become aware of certain processes that occur among, between and within them.

The conductor’s task is to help point out and clarify multiple communications as well as to help analyse transferences, projections and repetitions, the final aim being the facilitation of the group process and the promotion of change, at the level of individuals. As Lecourt notes the conductor’s task is ‘his/her attention and his/her particular way of listening to unnoticed/unconscious processes . . .’ (Lecourt, 2016: 7).

The conductor’s responsibility is to maintain the therapeutic functioning of the group and simultaneously he/she belongs to the inter-subjective field and the total situation of the group. Foulkes emphasized this intersubjective nature of the group process and its transpersonal character and as early as 1948 he formulated his conception of the inevitable embeddedness of the conductor in the group (Potthoff, 2017).

A conductor attempts to realize and respond to the divergent and evolving dynamics of groups, while striving to understand the ways that his/her own personality, life circumstance and therapeutic presence may have an impact on how they intervene or what they foster. Simultaneously the members’ individual and collective ideas about the leader influence everything that takes place in the group. ‘The group beholds its leader: a looming figure of fantasy, an emerging figure of reality’ (Billow, 2017: 12).

Thus, the conductor is of central importance in (the emergence of) the group’s dynamic matrix, and he/she has a special and essential role on (the creation of) the group-analytic process. For Cortesão

. . . the group-analytic matrix is the network of communication, relationship and working through, which, by incorporating the group analytic pattern, allows the evolution of the group analytic process within the adequate theoretical and technical dimensions by which it is characterized . . . (Ferreira, 2015)

Group analysis bears on the intra-psychic, the inter-personal and the social. The study of the individual and the group can only be attained within the framework of a total situation and cannot be understood in isolation. Foulkes (1948) taught us to consider mental disorder as a disturbance of the network of communications/relations of the person within the internal/external world.

It is however important, towards and within these group locations, to rely on a theory of the mind, which will allow for ‘ . . . taking interrelational individuals seriously’ (Lavie, 2005: 531), without sacrificing them to a kind of conformity hidden in any societal normalization. In other words, it is both the personal and the collective, conscious or unconscious that shape and mold the human psyche and we advocate that for the unconscious processes in a group, new concepts are required, as methodological tools and keys for understanding it.

5. A response to this historical and theoretical context: the IGA ‘S.H. Foulkes’

Considering the way group analysis institutionally developed in Greece, our chosen response is our newly founded Institute.

We aim for all our members to participate in as many activities of the Institute as possible, allowing for personal initiatives that will enrich pluralism and democratic functioning. Towards this direction we adopt all necessary constitutional paths for a democratic and regulated institutional functioning which, we are strongly convinced, will become apparent in the institutional dynamics. With the approval and support of all our members we are constantly under organizational consultation to ensure our optimal development.

Our training programme is structured according to the Eitingon (and EGATIN) tripartite model—therapy, theory, supervision—and there is a complete (non-reporting) differentiation between therapy and all other training activities. Therapy, for the trainees, is in a twice weekly analytic group with other patients in a proportion of 1/3. Trainees are treated in the same way as patients and it is possible that before entering the group a trainee-patient is in individual psychoanalytic psychotherapy for as long as the training group analyst (whom he/she has chosen from a list) considers necessary. For our trainees to get a minimal level of acquaintance with individual treatment we have a requirement of 100 hours of individual supervision during the whole training period.

In our theoretical seminars throughout the five-year training—the Introductory Course included—we give importance to both psycho-analytic and group-analytic theories. In parallel with the group-analytic line of teaching, our trainees get a sufficient level of knowledge of the principal psychoanalytic theories of functioning of the individual mind. This is coupled with their supervision and personal group-analytic experience, since the orientation of the great majority of our members is group-analytic and psycho-analytic, in tandem.

It is in our future plans to pursue, for this purpose, an—eventually difficult—dialogue with the other group-analytic institutions in Greece, aiming at identifying all eventual convergences and differences. It would be useful to organize a first conference focusing on different kinds of group analysis in Greece, with the—hopefully—maximum possible representation of all Greek group analytic institutions.

5. Epilogue

Group analysis is a conception of integrating a person’s individual psychological and biological qualities, with his social world and its unique internalization. Such a theoretical framework offers the exceptional opportunity to re-think the body/mind borders, the inside/outside, as well as the concept of drives as a boundary between the mental and the somatic.

In this perspective, a whole range of theories concerning human development, spreading from the social view, e.g. sociology, social psychology and systems theory, through to the inter-subjective and object relational aspects of the human psyche, all the way to Freudian views as well as recent neuroscience findings, are important for understanding and ultimately curing individual persons in groups.

We aim that our students maintain an enquiring mind, get well trained in group-analytic theories, become familiar with psycho-analytic theories and learn how to use both perspectives in a ‘figure-ground’ and mutually complementary way, as exemplified by Foulkes himself.

Footnotes

Notes

Dominique Mylona, MD, is a psychiatrist, a group analyst and a psychoanalyst in private practice, in Athens, Greece. She is a full member of GASI and a member of the Hellenic Psychoanalytical Society and the International Psychoanalytic Association. She is a founder member of the Institute of Group Analysis ‘S.H. Foulkes’ and serves as its Vice-president and as chair of its Training Committee.

Nikos Lamnidis, MD, is a psychiatrist, a group analyst and a psychoanalyst in private practice, in Athens, Greece. He is a member of GASI and a full member of the Hellenic Psychoanalytical Society and the International Psychoanalytic Association. He is a founder member of the Institute of Group Analysis ‘S.H. Foulkes’ and serves as its President and as a member of its Training Committee. He is the founder and editor of the Greek psychoanalytic journal Oedipus. He is also a fellow of the College of Psychoanalytic Researchers of IPA.

Sophia-Maria Moraitou, MSc, is a sociologist and a group analyst in private practice, in Athens, Greece. She is a full member of GASI and an associate member of the Institute of Group Analysis, London. She is a founder member of the Institute of Group Analysis ‘S.H. Foulkes’ and serves as treasurer and as a member of the Training Committee.

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