Thank you for the opportunity to say a few words as introduction to the workshop "Group Analysis: inspiration and practical tool for professionals." It is a very good title which brings up many things of a both personal and professional character. But first I would like to thank you for the invitation it is a great honour and it certainly is a pleasure to be in Prague again. Prague is my absolute favourite among European cities. The first time I was here was I think a year after the Iron Curtain fell. I was on holiday in Italy with my husband and on the way home we got the idea to get to Denmark by passing Prague. I had heard a lot about Prague many of my friends had been there. We came by car and the countryside and the suburbs were a rather drab experience it looked poor and worn down, but getting into the centre of Prague was like a revelation, Prague did not look like any other big city I had been to. The buildings, the architecture reminded me of the fairy tales of my childhood Sleeping Beauty and the like and then there was the atmosphere of old European Culture and spirit it was almost felt concretely in the air.
Since, I have been to Prague again and even to a workshop here at the time when Anne Lindhardt, Marie Ange Wagtmann and Thor Friis conducted the group Analytic Training Course, but my first impression is still very vivid.
What I also like about the workshop is that it is a joint venture between London, Copenhagen and Prague. I am here first as the President of the Group Analytic Society, London and not so much representing Denmark, Anne Lindhardt takes care of that part. This sort of networking is a very productive way of sharing ideas and experiences and are helping building up centres of knowledge and practices in Group Analysis, which are of great value especially in times like ours where the psychodynamic psychotherapies are under economic, political and ideological pressure.
What I would like to do is to give a view over some key concepts which have been of inspiration to me professionally especially Foulkes ideas and to some degree Bion´s and how the development has been during later years. And if I have time how can we apply these ideas in to-days world of managed care short term treatment and quick results Which is absolutely a very realistic challenge.
Foulkes himself carried a group of inspirators in his own head for the creation of Group Analysis . The two most important were Freud and the Sociologist Norbert Elias from where he got the notion of man as a first and foremost social being in contrast to Freud where it was the other way round first narcissistic then social, but also very important was the neurologist Kurt Goldstein and his idea of the nervous system functioning as a whole meaning if one part of the system was activated it influenced the whole system.
Absolutely central is his idea that man is a social and not an individual being and basically determined by the world he /she lives in and is part of. This is also what Foulkes calls the foundation Matrix. Our common Foundation Matrix you could say is that we are all human beings, but we are raised in different countries, speak different languages and have different stories both nationally and personally so the foundation Matrix is different depending on where we live and are raised. An interesting question is how the different foundation matrixes influences the way Group Analysis are understood taught and practiced in the different countries. Anne has something to say about it based on her experience in Prague. Another very central concept of Foulkes is the Dynamic Matrix of the group by which he understood the web of intrapsychic and interpsychic and transpersonal relations where the individual can be considered a nodal point, which only artificially can be seen in isolation and there is no contradiction between an individual and a group interpretation. I will not go into a deeper discussion about this concept only say that it is a typical Foulkes concept which is hard to put into a formula and difficult to do research on, but is extremely creative. The same applies to his concept of transpersonal processes, which he defines as mental processes, which like x-rays pass through the individual members of the group. The transpersonal processes are what underlie the Foundation Matrix and the Dynamic Matrix. Foulkes also liked the figure-ground picture. Sometimes the individual is in the foreground (figure) and the group is the background against which the individual is viewed. At other times it is the group that comes to the front of the mind.
I shall illustrate some these basic concepts of Foulkes with an example taken from one of my groups.
One of the group members a woman commented on my being dressed in black, she did not like it, it reminded her of her mother, wearing mourning many years after her father´s death in the war. That day my co-therapist was not there, which was the only time that happened. I found myself thinking about a film I had seen some time ago called "The Black Widow". An ordinary B-film. At first I felt a bit guilty of having my thoughts going elsewhere not staying with the group, until it struck me that the theme of the film was a woman who killed off her husbands just like the spider called the black widow. So what I said to the group member was that may be she as a child had had some fantasies that her mother had sent off her father to be killed in the war and that these thoughts had been tricked by my wearing black and the fact that the co-therapist was not there and she could be speaking for the whole group having the fantasy that I have killed off my co-therapist
.So this was the theme of the dynamic matrix with its web of intrapsychic and interpsychic and transpersonal processes in the here and now of the group and an example of the figure ground concept. First her story was the figure then it changed the group being the picture.
In later years there has been some critique of Foulkes. You can with some right accuse Foulkes of having a somewhat idealized picture of the group and it really was an eye opener when Morris Nitsun in 1992 put forward his concept of the anti group, describing the potential destructive forces in groups. It is not that Foulkes totally denied this, he is in fact one of the few, who took Freud´s concept of the death instinct seriously but he rarely elaborates on the theme of aggression. Anybody who has gone to school, only to mention an example, would deny that groups can be destructive.
Also Farhad Dalal in recent years has criticised Foulkes but from a different angle. He critisises him for not taking his own group concepts seriously, being too much embedded in psychoanalytical individualistic viewpoints. Farhad Dalal talks about orthodox Foulkes influence from Freud and radical Foulkes influence from Elias. In my view individual and group are so intertwined with each other and difficult to separate that there seems to be a continual tension between as Bion puts it narcissism and socialism, that it may be just as problematic to have a pure group theory. Our problem in the western world as I see it is that we are so individualistic and at the same time so imbedded in the groups we live in but so unaware or unconscious of how much they mean to us.
You cannot give a picture of Group Analysis without taking in Bion´s ideas about groups. His concept of the Work Group and the Basic Assumptions Groups, Basic Assumption Dependency, Fight/Flight and Pairing and the interplay of these. Those are very useful when looking at how groups function. I am not going into a description of these as they should be well known and I don´t have time. There have been some attempts of creating a fourth basic assumption notably by Pierre Turquet ,Gordon Lawrrence and Earl Hopper. I find Earl Hopper´s ideas of a 4th basic Assumption: Incohesion, aggregation/massification a very creative development of Bion´s ideas and a very interesting conceptualisation of what happens inside people and groups in traumatic situations and what failed dependency can do to you and groups and how it can be encapsulated and personified by individual members of the group.
In my own experience I find that Foulkes ideas are best applied in the clinical field and those of Bion in the organisational field including Hopper´s 4th basic assumption. But I cannot say that it is always so. Kernberg suggested that in institutions like large psychiatric hospitals the basic assumptions constitute the basis for group reactions that potentially always exists, but are particularly activated when task structure breaks down. I have myself been involved in a project where we examined the ward atmosphere of different kinds of wards in a psychiatric hospital using Bion´s conepts combined with Moos (1974) Ward atmosphere scale the socalled Biwas (Armelius og Fogelstam 1984) . Patiens as well as staff was asked about hundred questions and where there were correlation between the two parties. We used the results to go back to the staff and discussing the results with them, it was a very great learning experience.
I just touched upon research and Group Analysis. The concepts of Foulkes and Bion are very rich, but they are difficult to put into research of the sort called evidence based. But if we are going to survive in today´s world it is necessary to show that Group Analysis works it is not enough that we are convinced it does and it does not need to be the golden standard of double blind. There is much research on group therapy showing that is as effective as individual therapy and sometimes more, but very little on Group Analysis per se. In can mention Steinar Lorentzen work on long term group Analysis, which showed very good results and there is also a German study that Volker Tsuszke was responsible for. Just now the Group Analytic Institute, London in association with GAS is putting up a research project.
Last but not least I have some remarks on short tem group analysis. The political climate is such that we have to find alternatives to long term treatment and develop forms of short term group analysis. There is from the establishment a tendency to look down at short- term therapy. But why so, in my view it is a challenge we have to take up, necessity is the mother of invention and I am convinced it would do many people good. Christer Sanddahl in Sweden together with a colleague has developed a program for short term group psychotherapy for people with stress and on long-term sick leave, which the assurance companies are very interested in and support economically.
We could look at long term treatment as basic science and short term therapies as applied science just as I think Psychoanalysis has functioned viv a vis psychoanalytical or psychoanalytically informed treatment on the individual level. Psychoanalysis was the laboratory and classical long- term Group Analysis can have the same function.