bookREVIEW: The Groups Book
Psychoanalytic group therapy – principles and practice
Caroline Garland (Ed)
The Tavistock Clinic Series, Karnac Books, 2010, pp133
Reviewer Lynda Woodroffe
With great clarity this book describes and explains what comprises a group, the history behind setting up groups and the advantages of group work over individual work, analysing group dynamics phenomenologically and in terms of behaviours, attitudes and ethos. What I found exciting is that it documents how this is done within the psychoanalytic context. To clarify this orientation further, the editor, Caroline Garland, who wrote eight of the thirteen chapters, highlights the essential need to know “what makes psychoanalytic group therapy therapeutic” (p38); at the same time she criticises the definitions of Yalom, Bloch and Crouch who, in her opinion, do not adequately and in such depth explore, in their texts, this question. This book is a study of groups in this psychoanalytic context.
Using examples from their own group work, all the authors illustrate succinctly, through the identities and rules that form within groups, how group members struggle through their difficulties to survive into a clearer understanding of themselves, and of others, and, thereafter, increase their chances of succeeding in their current and future relationships. The authors describe too, the conditions that make a group successful and what will lead to failure.
The book incorporates two volumes – The Groups Book and The Groups Manual. The first volume gives a definition of what a group is, which psychologists and psychotherapists first defined the benefits of group work, and the work that has been carried out at the Tavistock Centre, mainly through Bion and Foulkes. Moreover, authors make the distinction between the psychoanalytic group and other types of groups. These other groups include non-English speaking refugees, severely disturbed patients, work groups, institutional groups such as within a large institution like a hospital, and groups that form after disasters, such as destruction of the Twin Towers in New York City in 2001. References to the psychology of the masses are also made in a section titled Destructive Processes in Analytic Groups, with the examples of destructive mass behaviours in places such as Nazi Germany, Rwanda, Israel and Palestine.
The Groups Manual can be described as an aid for psychoanalytic group practice. It contains support and guidance for therapy group leaders in a condensed form, defining the life of each therapy group as unique, highly personal and revelatory. One chapter compares the advantages of group therapy to individual therapy, listing these as: the chance to disperse fears of dependence and envy of the authority (the therapist) by being with other people, as well as the therapist; the opportunity to identify oneself with and through others; becoming part of others’ treatments and healing; and experiencing a new flexibility through understanding others which can open up new interests and outlooks.
Another question emerges: what can group therapy bring that individual therapy doesn’t? The suggested answer is that the two are not counter-posed, that they have their own identities and assets, and can, and do, run simultaneously. But in groups, Garland states, the externalising and sharing of the patient’s inner world in the group context increases the patient’s chance to project visibly and openly enough to be observed by and commented on by other members of the group more often than can be done in individual therapy. The frequency of the interactions can therefore, she writes, help the passage from schizoid to depressive phase and reparation.
Furthermore, the editor stresses one obvious aspect of groups absent in individual therapy – that of disclosure. Disclosure is considered to be forbidden territory in most psychotherapeutic orientations and especially so for psychodynamic psychotherapy; this is still the case for the therapist in the psychoanalytic group therapy context. However, because the group members are free and encouraged to disclose, this, it is said, is one of the aspects that helps the psychological developments in patients; they are not alone, they can share their terrors, they can feel understood and this can occur not only through the therapist but also through the other members in the group.
Many years ago I passed two years in a psychoanalytic psychotherapy group. I found this book addressed many of my thoughts about my experiences while in that group. Reading over the vignettes and case studies, I was reminded of those times and I searched for my ‘family’ (other group members) and myself in them. I looked for us arguing, crying, soothing and giggling. That I didn’t find our group came as no surprise. Nevertheless, I could see us in other people’s stories. That in itself was reassuring.