The Large Group

Dynamics and Therapy

Lionel Kreeger

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429921261
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This important, pioneering book collates our knowledge of large groups, both at a theoretical and practical level. Thirteen distinguished contributors offer experiences from a wide range of disciplines and settings. Roughly half the chapters are psychoanalytic in their orientation; other contributions derive from general psychiatry, sociology, anthropology and industrial psychology.The place of large-group therapy is still to be defined, but it is hoped that this book will contribute to the careful and detailed assessment that is necessary to fulfill its evaluation.

Part One
Theory

In this section, the first three chapters are psychoanalytic in their orientation: Dr Foulkes, a Freudian psychoanalyst, who founded the school of group-analytic psychotherapy, offers a perspective of the group-analytic approach to the problems of the large group. Dr Main is a Freudian psychoanalyst of the Independent group. In his chapter on psychodynamics, he deals mainly with the mental mechanism of projection and the further developed concept of projective identification. Dr Turquet belongs to the Kleinian group of the British Psychoanalytic Society. He is concerned with the individual's sense of identity and need for boundaries, and the threat to these in the large group.

Chapters 4 and 5 approach the large group from a more general psychosocial viewpoint: Dr de Mare, an eclectic psychotherapist trained in group-analytic psychotherapy, discusses large-group dynamics in the light of communication theory and information-flow, with an emphasis on psychosocial therapy. Earl Hopper is a sociologist, who has also trained as a psychotherapist. In collaboration with Anne Weyman, their chapter focuses on the application of sociological concepts to the large group.

For the sake of completion, perhaps it may be mentioned here that Dr Kreeger and Dr Pines are both Freudian Pschoanaiysts.

Problems of the large group from a group-analytic point of view

S. H. Foulkes

It is the inner working of the human mind as a social, multi-personal phenomenon — transpersonal processes inside a shared mental matrix — with which the method and theory of group analysis are concerned. No particular limits have ever been set regarding the size of the group under consideration, although we rely mostly on the observation of men and women in small groups, conducted over longish periods. The purpose of these groups is to help them dissolve and overcome difficulties in their relationships with other people which are, in the last resort, at the root of neurotic or psychotic disturbances, symptoms and character formations, of excesses and inhibitions affecting their existence and well-being and for which they consult us.

A paper I read to the British Psycho-Analytical Society¹ on 3rd April 1946 ended as follows:

'Group treatment can thus be looked upon in a number of different categories. The narrowest point of view will see in it merely a time-saver, perhaps, or a kind of substitute for other more individual forms of psychotherapy. Possibly it will concede that group psychotherapy might have special advantages, its own indications — say, for instance, for the treatment of social difficulties. A wider view will see in it a new method of therapy, investigation, information and education. The widest view will look upon group therapy as an expression of a new attitude towards the study and improvement of human inter-relations in our time. It may see in it an instrument, perhaps the first adequate one, for a practicable approach to the key problem of our time: the strained relationship between the individual and the community. In this way its range is as far and as wide as these relationships go: treatment of psychoneuroses, psychoses, crime, etc., rehabilitation problems, industrial management, education —in short, every aspect of life in communities large and small. Perhaps someone taking this broad view will see in it the answer in the spirit of a democratic community to the mass and group handling of totalitarian regimes.'

A year later, addressing the first post-war Congress of European Psycho-Analysts in Amsterdam,² I said:

'The present historical situation shows clearly that human problems cannot be solved in isolation but only through a concerted effort of the whole of humanity. The future of the human species may well be made or marred according to whether or not it is able to grasp this fact and act upon it while there is still time.

'Anything we can learn as to the relationships of persons towards each other, and of groups towards each other, is therefore of great therapeutic significance. . . .

' . . . Group analysis is the instrument of choice for the study of the dynamics of the group, a new science in which psychology and sociology meet. In view of the importance of good relations between groups of all kinds, including whole nations, the relevance of such studies need hardly be stressed at the present time. Once again it may be the privilege of psychopathology, through the analysis of disturbances in inter-personal relationships to throw decisive light on the social life of man in all its manifestations.'

In the same paper, in 1947, I also said:

'Group treatment is the resolve to take a larger part of the external world and of a person's associates into the field of direct observation than is the case in individual treatment. Or, if you have a group of patients only, you bring them together so that each can be observed and face himself in a group setting; moreover they can now face their problems as a group, including their reactions towards each other. One could say, too, that group treatment means applying "commonsense" — the sense of the community — to a problem by letting all those openly participate in its attempted solution who are in fact anyhow involved in it; instead of two people grappling with the problem, the one in the role of patient the other of therapist, you have now a number of people confronted with a problem as well as with the task of its solution. They will soon enough know what they can share in this, what prevents them as a whole group from solving it and where, on the other hand, they have to turn their attention to any one member's personal and individual difficulties,'

If I said no more than that now, in 1973, it would sum up the situation quite adequately. However, since that time worldwide progress has been made in this field. One such development is the approach to problems in a relatively much larger group, of say 50 to 100 people. This expansion is welcome. I am happy still to be able to participate in this, though no longer in the frontline of events. I do my best to take part in what is within my reach, to follow the experiences other authors describe and to think about them, perhaps more quietly than one is able to do while one is in the middle of these activities.

Social psychotherapy

The observation of people in groups usually arises when we are concerned with their problems — in a sense with social psychopathology. This is opening up and making accessible otherwise concealed areas. These conditions enable us to observe and to analyse behaviour and experience as they occur in action —serious, genuine action, not playing games or roles. Above all, we can observe changes in attitude and behaviour, changes which in a wide sense could be called therapeutic. An important ingredient in our procedure is that the group should be an active participant in these processes, should be aware of what is going on and thus eventually become the responsible agent of its own institutions. In this sense we are concerned with sociotherapy. Our special contribution to sociology and social psychology lies in the elucidation of these processes and in their effects on the individual member. Though we cannot, in my opinion, base the total comprehensive science of man on our work, cannot, as little as can psychoanalysis, produce a general comprehensive psychology or sociology, our contribution is an essential one for these disciplines and all disciplines which are concerned with the human being. Sociology studies the roots of human conduct and interaction in every respect and on the basis of social relationships, but it is quasi-statistical; it does not focus on the particular mental events which occur in the members of the group on each particular occasion. Let me illustrate this difference by comparing, let us say, the study of traffic accidents. The people who study traffic and its rules, who build roads, regulate speed, are concerned with notions such as the particular frequency of accidents at a certain place — say a roundabout or a crossroads. The observation that, for instance, at one place three times as many accidents occur than elsewhere is relevant. There need be no doubt that these accidents are linked with the individual drivers concerned, with their mental or physical condition, with their anxieties and worries, or even with unconscious needs to have an accident just at that time, day and hour, with accident proneness — but all this complicated network of motivations enters the picture equally everywhere, at other crossroads. The psychologist or psychopathologist, on the other hand, is interested in these very motivations, or even the special individual compelling reasons which brought about the accident, while appreciating that a particular turn of the road presented a special hazard. Some sociologists, for example, Norbert Elias, have gone beyond this point to a more living or more realistic type of sociology. Elias³ has long recognised that so-called 'precise studies' based on objective measurements alone are misleading and insufficient. He maintains that it is necessary for the sociologist to co-operate with the psychoanalyst and perhaps even quite particularly with the group analyst. Professor Elias sees social psychiatry as an interdisciplinary field, a borderland between psychiatry and sociology, which are two distinct disciplines. As he sees it, the understanding on two levels at the same time —namely the individual and the group level — is essential. Such a two-level approach he would see as of general theoretical significance. I have myself always felt that group analysis, rightly understood, furnishes an integrated approach to these problems which is adequate and new.

Human beings always live in groups. Groups In turn cannot be understood except in their relation to other groups and in the context of the conditions in which they exist. We cannot isolate biological, social, cultural and economic factors, except by special abstraction. Mental life is the expression of all these forces, both looked at horizontally, as it were, in the strictly present reality, and vertically, in relation to past inheritance. In the group-analytic view this inheritance is not seen entirely, or even predominantly, as a genetic and biological one, but more as a cultural inheritance, a transmission from generation to generation, from the earliest days onwards. Rather, the distinction between group and individual psychodynamics is meaningless, except again by abstraction. We sometimes talk of group and individual separately, as we focus more on one or other aspect of what is in fact one single and inseparable process.

Mental processes

Normally, groups are more or less institutionalised or organised, but the more we are interested in the inner mental processes, the more we prefer a minimum of structure. These inner mental processes are not conceived as intrapsychic as if they were encapsulated inside the individual's mind. As a result of unprejudiced observation, I assume these inner mental processes to be the shared property of the group or at least shareable.⁴ This becomes visible when we reduce the usual structure and organisation of the group as far as possible. The more we do this, the more translation, analysis, interpretation enter the picture. What is usually unconscious or concealed becomes sufficiently noticeable and we can slowly, resolving defences and resistances by steps and stages, make it a conscious notion of the therapeutic group. This applies not only to the repressed unconscious but also to what I have termed the social unconscious. What is meant here by 'translation', by 'analysing', by 'interpretation', by all sorts of interventions, is that in the fully fledged group-analytic approach we slowly (or sometimes even quite quickly) achieve a culture and tradition, so that the group itself can do this work with our expert guidance and help. As this analytical component increases, we are likely to want to concentrate more on the network of interacting processes as these enter into the nodal points which are represented by the individual members of the group. If we do wish to observe these processes and the way in which they become modified in passing through the individual, we need a situation which allows sufficient time and intimacy to devote to those processes in adequate detail. For this purpose, we must reduce the size of the group. If we mean this intensive form of psychotherapy, the observation that such groups will have to be reasonably small holds good.

The concept of mental processes per se being multi-personal seems hard to accept. I will try to illustrate it by way of analogy. Let us assume that we wish to drive from one place 'A', through the countryside, passing many villages and towns to point 'B'. We use a map for our orientation. Now the most useful map for the total journey is one on a small scale, one on which a town may be indicated only by a dot. Our journey goes towards and through this or that town, and out again at another point, and so on towards the next place. But on entering the town —which may be quite large for our purposes — we enter into a complicated network of streets, for which purpose we now need for our orientation a map on a much larger scale. In fact we need a town plan, in which all the individual streets are clearly indicated. We also rely on the instructions we find for our benefit at the different turnings. It is the traffic with which we are here concerned. It is the 'traffic' which corresponds to what in group analysis we call 'transpersonal processes'. The traffic of the town is not an isolated fact and closed system. The traffic of the town is the result of all the connections the town has, of all the roads reaching the town from various directions, which way they pass through it, etc. Moreover the concept of 'traffic' is also an abstraction for something which does exist and yet does not exist. There is no such thing as traffic, there are only moving cars, lorries, obstacles of all sorts, and people who wish to move from one point to another. Together they make up what can be looked upon as a dynamic existing total thing called 'traffic'. One can then talk of traffic flowing, traffic coming to a halt, traffic being diverted and so forth. In the same way we use concepts such as 'mental processes' or 'matrix'. It becomes clear that the town modifies the traffic in its own way, and according to its own characteristics, and sends it out again changed in direction and speed from the way it reached the town. Nevertheless, it is not in isolation. It is not as if there was traffic in the country, traffic in the town, traffic in the village, alongside the river, etc., but it is all one flow, one interconnected whole. To our way of thinking the town represents the individual, and is as such a nodal point. Perhaps this makes it clearer what is meant by transpersonal processes. The processes reach the individual, go through him, are influenced by him in turn, and leave the individual — but the largest unit of observation on which we can focus is the total situation, such as the therapeutic group.

In the standard group-analytic group of 8 people, it remains true to say that the individual is in the foreground, the group in the background — the meaning determined by the context of the whole situation. There is a danger that this favours too much emphasis on the individual analytical approach and this is happening in perhaps the majority of group analysts' practice, especially if they come from an individual psychoanalytical tradition. There is therefore a certain neglect of group dynamics. Remember again that we separate these two only artificially for the purpose of making certain observations. Putting this another way, there is a strong tendency in both patients and therapists to approximate the small group to the family. Like anything else, this tendency must of course be accepted as existing and be analysed. Ultimately it is a resistance. It means that the individuals concerned including the therapist wish to establish as far as possible the conditions which have shaped them, made them into what they are, so that they need not change. If we accept that as a basic framework and fall in with it, it is wrong, indeed it is a trap by which ultimately the neurosis successfully resists any attempt at its basic resolution. It is of course quite different when we see a real family, a couple with children, who are a natural group. In the same way and by contrast to the small group-analytic group, all problems affecting groups in a real situation should — indeed must — by the principles of a group-analytic approach put the whole large group in the centre. It is likely that the issues raised in that large group are dealt with more or less spontaneously in informal sub-groups and by each individual.

Community problems

This large-group approach has a wide range of application, under the varied conditions of everyday social life and of course in the fields of psychiatry and psychotherapy themselves, Such a group can either be part of an institution or may encompass the whole of a smaller institution. They may be less organised groups devoted to some movement or pursuit wishing to improve their efficiency, their spirit of common concern and co-operation, to reduce conflicts and friction and to liberate creativity. In a recent Dimbleby Lecture⁵ Sir Robert Mark, the Commissioner of the Metropolitan Police, spoke of the four stages in our system of criminal justice: 'Politicians make the laws, police enforce them, lawyers run the trials, and the prison or probation services deal with the convicted offenders. None of these groups is obliged to give much thought to the problems of the others, or to consider the working of the system as a whole. This is unfortunate because the different parts of the system are intimately connected.'

I do not know whether Sir Robert has ever heard of group analysis, but the tenets of his argument are very similar to those held by practitioners of group analysis. The media allow us to gain insight into many spheres and issues of ongoing life with which otherwise we would be quite unfamiliar. A psychiatrist can never know enough of all this for his own work, quite apart from his professional qualifications.

Here is an opening for the sociologist or the social psychologist. If he wants to — as he should — deal with problems and get involved with human beings, he needs to have experience and training in group analysis.

In a similar vein, under my Chairmanship of the Psychotherapy and Social Psychiatry Section of the Royal College of Psychiatrists, we showed that psychiatric problems are not essentially different from those encountered in other areas. These findings were published in a volume, edited by G. Stuart Prince and myself, entitled Psychiatry in a C...

Table of contents

• Cover
• Title
• Copyright
• Preface
• Acknowledgments
• List of contributors
• Contents
• Introduction
• PART ONE: THEORY
• PART TWO: APPLICATION
• PART THREE: CONCLUSION
• Notes and references
• Index