The peer supervisory group for psychoanalytic therapists

The recent interest in peer supervisory groups for psychoanalytic therapists raises important questions regarding both psychoanalytic training and group process. The present paper explores these issues and suggests that there exists a continuum from case-centered peer supervisory groups to process-centered peer supervisory groups. Transference and countertransference and the recognition of parallel processes in psychotherapy supervision are examined in their relation to the supervisory group experience. The authors suggest that the model a therapist employs regarding the role of countertransference will most likely influence the kind of peer supervisory group that s/he will choose. Further, there are specific techniques, as well as experiences, which may foster alteration of the group's psychic organization. Illustrative case examples are provided throughout.     

The three R's of group: resistance, rebellion, and refusal

I describe three constellations of group life and group process: resistance, rebellion, and refusal. In resistance, an individual or group remains antagonistic to conscious but not unconscious thinking, the latter manifested in derivatives, including symbol and symptom formation, transference-countertransference, and enactment. Rebellion functions on the level of conscious thinking, manifested in challenge, defiance, and the possibility of sociopolitical action. The basic premises and values of the group and/or leader are at the center of the controversy, to be addressed on that level. Refusal establishes a mental boundary between what is considered appropriate and inappropriate. Unconscious as well as conscious processes of feeling, thinking, and meaning making are refused entry, left undeveloped, rejected, or obstructed. Working with refusal requires appreciating how and why the mind and its thinking operations are being suspended. The theoretical framework is applied to a case example.     

On hostage taking (a psychoanalytic object)

Abstract Hostage taking is a pervasive phenomenon in human relations, in groups, and in societies. It exists literally, figuratively, and psychologically, and hence is both a phenomenon in the mind and in the outside world. A case example illustrates how group members (including the leader) hold, or may seem to hold, others hostage by their words and actions. By conceptualizing and focusing on a series of interactions as a type of object relationship, that is, a complex idea worthy of attention, the group came to understand and experience hostage taking as a "psychoanalytic object."     

It's All About "Me" (Behold the Leader)

Abstract The group beholds its leader: a looming figure of fantasy, an emerging figure of reality. Psychic patterns that play out in group cohesion, culture, conflicts, and process are rooted in interaction with this combined object. I describe a two-day conference on relational group psychotherapy. An assemblage had beheld "me," a visitor with gifts of knowledge, initially welcomed with collective expectation. Rivalrous and acquisitive desire (Girard, 2004) set group process in motion, involving scapegoating and open conflict, but also, self discovery and mutual appreciation. Confronted with "me," the representative, messenger, even embodiment of truth, the group had to deal with feelings, fantasies, and thoughts that were "not nice." There were moments of fear for the safety and survival of our group, yet I did not comprehend the extent to which envy, in tooth and nail, with devouring hunger tore into every aspect of our mentalities. Under its catabolic force, I was captured and I could not articulate to myself the sense of what it was, until the group shifted and released me from envy's intersubjective captivity. In group, whatever is being talked about-whoever is reacting to whom or to what-the group's focal conflict, predominating basic assumption, developmental level or stage, its regressions and progressions, dyadic interactions, subgroupings, and so forth, I now assume that on one level, it is all about "me."     

The Bully Inside Us: The Gang in the Mind

Bullying is a pervasive phenomenon in human relations, in groups, and in societies. It literally, figuratively, and psychologically, is a phenomenon both in the outside world and mentality of the leader as well as group member. Bully/bullied motifs prevail in our clinical theorizing, thinking, and behavior—interwoven into the fabric of psychoanalytic culture and process. I present 5 key ideas: (1) Bullying/bullied dynamics originates and remains in the domain of the paranoid–schizoid position, involving shifting, bipolar perceptions of self and others as good or bad. (2) Bullying–bullied dynamics emerge immediately and unmediated by thought in situations of emotional intensity, i.e., frustration, anxiety, threat, challenge, and competition. (3) These dynamics represent an aspect of our inheritance as a herd animal, which play out in all societies and groups, families and dyads, psychoanalytic and otherwise. (4) Bullying is linked, metapsychologically, to the creation and sustenance of the superego (Freud, 1921). (5) Each individual is both the bully and bullied, and an aspect of “mutual recognition” resides in acknowledging the pleasure as well as the pain in our co-participation.     

Witnessing: The Axis of Group

We enter the group and, to some degree make choices in what we observe and focus on, and how we participate and make our presence known. Unavoidably, and with limited control, we are thrust into a public position of witness and witnessed. Witnessing deals with the impact of embracing experience beyond observing and participating–the uncertain consequence of coming to know and becoming known. It is specifically the axis of personal growth and transformation around which a dynamically oriented group process rotates with our leadership. Discussion and two case examples illustrate its key features and the role members and therapist play in fostering this process.     

Passion in group: thinking about loving,hating, and knowing

In his early work, Bion (1961) established the goal of learning about and getting beyond the basic assumptions to become a work group. Later, in his structural theory of affect, passion became a key concept. Passion describes the necessary and sufficient condition for a psychotherapy group to be a work group. Passion is an intersubjective process of bearing and utilizing one's most basic affects to reach self-conscious emotional awareness. Bion postulated three primary affects: loving, hating, and knowing (LHK). A clinical example illustrates how the therapist may represent, mentally organize, and mobilize the group's potential for passion by attending to the evolution of his or her own affects. Passion transcends transference-countertransference in that an optimal level of personal meaning from LHK is achieved and utilized in emotional participation.     

Pursuing relational consciousness: thinking and antithinking in group

Although human beings are interpersonal and innately curious, at the same time an aspect of the self defends against mental relationships with self and other, because such relationships threaten to cause psychic pain. Bion's ideas on thinking and antithinking are applied to this topic of relational consciousness: A "psychotic part of the personality"--which refers also to the "basic assumptions" level of the group-prefers antithinking: forestalling, evading, and assaulting thinking and thinkers. Clinical examples illustrate how the group therapist may address and treat the pervasive resistances to relational consciousness in the group setting. These involve understanding the dynamics and clinical manifestations of hatred of thinking, excessive projective identification, anticipatory anxiety regarding thinking, and bizarre and hallucinatory thought transformations.     

Truth and falsity in group

The universal tension and juxtaposition between truth seeking and truth evasion are explored in a contemporary relational context, drawing on Bion 's later ideas on group. Bion's key idea of "psi," or psychic evasiveness, refocuses group theory, supplementing intra- and inter-psychic perspectives with sociopolitical analysis. To some extent the psychotherapy group exists as a political "Establishment" and thus corresponds to psi. Using three illustrative case examples, the nature and nurture of truth evasion is considered, along with the purposes it serves and the forms it may take. The therapist must maintain a disruptive-creative influence on group process, but like other group members, he or she instead may accept and promote falsity. Whereas the therapist ensures the integrity of the culture, the members, and not solely the therapist, break up old relational patterns and experiment with new ones. Dynamic, evolving groups aid the leader in life-affirming truth-seeking, eventually challenging establishment tendencies and exposing falsity.     

The Therapist Dissociates: Psychic Nodules and Group Process

I introduce the term nodule to call attention to the effects of a particular type of irruption into the therapist’s psychology, leading to dissociation. A preoccupying state of mind emerges that muffles, mutes, or blots outs other internal and external channels of communications. The therapist’s associations do not integrate usefully, furthering self-reflection and contributing to productive leadership. Rather, a nodule crystallizes as the therapist becomes preoccupied with an amalgamation of affects and feelings, fantasies, reality statements and suppositions, bodily states, actions, and actions-tendencies. I focus on the influence of psychic nodules on me, as a commandeered subject, and their effects on the communicative matrices (nodes) of three groups I led.