Slovenian Group Analysis
Slovenia is a small European country, a member of the European Community since 2004. Prior to that, it was one of the 6 republics of the Socialist Federal Republic of Yugoslavia and, according to its location, its westernmost republic. It has a population of just over 2 million and has 21 group analysts.
In the late 1960s the idea of a therapeutic community was brought to Slovenia by prof. Miloš Kobal, psychiatrist and lawyer. The therapeutic community was first introduced in the Psychiatric Clinic of Ljubljana and later gradually implemented in other psychiatric hospitals in Slovenia. The Center for Mental Health / CMZ Ljubljana together with the Outpatient Clinic, where group and individual psychotherapy of various orientations was practiced, represented the center of psychotherapeutic development. There were practiced also small staff groups and supervision groups.
Slovenian psychiatrists and psychologists were very interested in group psychotherapy, as evidenced by their participation in psychotherapy seminars in the former Yugoslavia as well as abroad.
Many Slovenian psychotherapists have worked with the Zagreb Center for Mental Health. There they attended analytical experiential groups and some continued their education with an introductory study and later also the graduate study of group analysis. Croatian psychoanalysts Evgenia Cividini and Eduard Klain, then already prominent members of GAS London, were staff members of our school of group analysis. Later Ljiljana Moro also participated in our education.
The beginning of the group analysis in Slovenia is represented by the first analytical small group, facilitated by prof. Leopold Bregant, clinical psychologist and psychoanalyst. In fact, he facilitated two small analytical groups whose members were psychiatrists and psychologists employed in a psychiatric clinic and Outpatient clinic. Small analytically oriented groups were held as part of the postgraduate study of psychotherapy. For many years, they were facilitated by (experienced) psychotherapists.
One of the members of the first small analytical group in Slovenia, Franc Peternel, a psychiatrist and group analyst, studied at the London Institute of Group Analysis in the 1980s. The then management of the Ljubljana Psychiatric Clinic supported and enabled his many years of systematic analytical education. His many years of cooperation with the London Institute of Group Analysis gave birth to the beginning of a systematic study of group analysis in Slovenia.
In the years 1989-1990, Peternel and his colleagues organized the first introductory one-year study at the Psychiatric Clinic in Ljubljana as part of postgraduate studies at the Faculty of Medicine. In 1991, George Renton (IGA London) and Franc Peternel organized a graduate study of group analysis in Ljubljana. This dates back to the time of the disintegration of Yugoslavia and the independence of Slovenia. The students were committed to studying GA, and implemented the acquired knowledge and experience in the work environment. Most students were given time off work and were financially supported by their employers.
At the end of the five-year study, the London Institute evaluated the dissertations or so called Clinical papers of fourteen students. Upon successful completion of studies they were issued a certificate of practical competence in the field of group analysis.
Strong engagement in the field of group analysis in Slovenia led to the establishment of the Group Analytic Society of Slovenia (SDSA) in 1998. Its first president was Franc Peternel.
The purpose of the established association was to develop and implement group analysis in Slovenia. It encouraged and guided the members and all those who ran groups of patients and clients to continuous professional development. In accordance with its mission, the association continued its one-year GA education (introductory study), but for various reasons postponed advanced and graduate studies for 6 years.
In 2011, an independent Institute of Group Analysis, Ljubljana (ISAL) was established. Since 2004 it has otherwise operated as part of the SDSA. This caused tensions in the Society and opposition from the former President of the Society. He had an unpleasant experience from the time of his education in the UK, when GAS and IGA separated. The realization of our project did not happen overnight. In the manner of group analysis, we opened a long-lasting dialogue regarding this project and discussed the matter within the special group set up for this purpose.
ISAL is a full member of Egatin. It organizes introductory, advanced and graduate studies of group analysis according to its standards. Certificates of completed studies are usually awarded at the biennial meetings of the association. One-year studies are carried out according to their own program, while advanced and graduate studies are held together due to the small number of students. There is also a joint seminar which contents are cyclically changed every 4 years. Undergraduate and graduate students are members of the same supervision group. English consultants and supervisors have been invited to assist with the education: Tom Hamrough and Ewa Wojciechowska in the past and Jo Joyce at present.
The professional meetings of the association and the median group are the central monthly professional events of the Slovenian group analytical community. Although the median group was originally established for study purposes, over time it has become important in creating dialogue among members of the entire community: members of the SDSA, which has 54 members, students and graduate students of SA, members of the Institute of Group Analysis and others. It is worth mentioning that interest for the median groups arose from the Patric de Mare’s visit to Ljubljana in 1984. He held 9 experiential median group sessions. The experience was so rewarding that we met once a month for another three years.
In 1995, we hosted EGATIN study days in Ljubljana with the topic: Median and Large Groups in Group Analytic Training. Students who have just completed the SA studies in Ljubljana also took part in this meeting.
The above mentioned EGATIN study days are considered to be a precursor to biennial workshops, which the Group Analytic Society of Slovenia has been further on organizing. They are based on the London model of workshops. So far, 10 of them have been organized and have been dedicated to various topics. The late Malcolm Pines visited us several times and gave several lectures at various psychotherapeutic events in Slovenia. He was appointed an honorary member of the SDSA for his contribution to the field of group analysis in Slovenia.
In 2005, the Group Analytic Society of Slovenia was offered the opportunity to organize the European Symposium of Group Analysis together with the London Group Analytic Society – GAS. We were unfortunately unable to seize the opportunity. Perhaps the organization of such a large meeting was too much of a feat for the then young Slovenian society. It seemed that the withdrawal from this project damaged the reputation of our Society and influenced the colleagues who were actively involved in the preparations for the symposium. Some even distanced themselves from the Society.
In 2018, we co-organized an international summer school together with GASI. A group of GA students and graduates at the time, called “Grupiči”, actively participated in the organization of the summer school, the theme of which was “Between generations.” Consequently a period of changing generations of group analysts in the management of the Society and the Institute started. Graduates of group analysis are now elected to the Board of the Association. Young group analysts take on educational tasks and carry out new forms of group work (support groups for people in need, a group based on Reflective citizens).
When the newly elected Slovenian government took office last year, it restricted public life due to the spread of the disease caused by SARS COV 2. The restrictions were implemented on the second Friday of the month when the Group Analytic Society of Slovenia was supposed to have one of the regular professional meetings it has been holding since its establishment in 1998. It was for the first time in Society’s history that both events had to be cancelled: the professional meeting followed by the median group and the continuing and graduate study meeting planned for the next day. After 21 days of quarantine, the Board of the Institute decided that the studies of GA will be carried out online as well as all accompanying activities. Remote work has caused a great deal of anxiety, especially among the older generation of group analysts, who have asked the Society to postpone this kind of psychotherapeutic work in order to gain more experience. GA students in favor of this form of work took the initiative to write instructions for working online that were accessible to all. Thus in April, the studies started online and continued throughout last year and this year, as well as small analytical groups, which the students conducted themselves.
Changes in society over the last 30 years have affected the health care system and consequently psychotherapy. The legal status of psychotherapists is not yet properly regulated. Psychotherapy in the public sector is not adequately financially valued, which is why psychotherapists leave the public sector and continue working in the private sector.
Unfortunately the basic education in psychotherapy (2 semesters), that could involve a variety of health professionals, no longer exists. This education offered the basics of psychotherapy as well as personal group experience, which was a great benefit and encouraged many to work with groups giving them at least a basic framework. This program has been a precondition for the study of group analysis. As it no longer exists, those interested in the study of group analysis have to find their own sources.
As a full member of Egatin, the Institute of Group Analysis educates psychotherapists according to European standards, which require many years of education as well as engagement and commitment to work with groups. Throughout its years of functioning, the Institute of Group Analysis, Ljubljana has primarily strived to train qualified group analysts for therapeutic work with patients.
I notice that in the last 10 years 4 group analysts have completed their educational process and are involved in the management of the Association. We hope that five more GA graduates will soon complete their studies with the writing of their mandatory Clinical Paper.
Almost every year we carry out an introductory study with at least 5 students. A few choose to continue their studies, most of whom psychiatrists and clinical psychologists. The reasons for such low interest are:
Education is an effortful process that requires a large investment of time, energy and money. Demanding daily clinical work is often an obstacle for young specialists in psychiatry, clinical psychologists or other health professionals to enrolling in study of group analysis. Young people are more likely to opt for more “established”, modern or widespread modalities, such as behavioral cognitive therapy.
The recognition of group psychotherapy in Slovenia outside the profession is insufficient. So far, the association has done too little in this direction (lectures, workshops, promotion of group work). Given the small group analytical environment, it would be necessary to consider including in the GA study also the ones who are interested in this study and work with groups but are not health professionals. In parallel a customized educational GA program could be offered.
The first generation of group analysts is slowly saying goodbye. Fewer and fewer are still running groups and can no longer offer group analytical experience to GA students and supervision.
There was an interesting experience last year when, due to the state of emergency in our country, we received the call for help from pedagogical staff. The available group analysts and graduates of the GA study responded and organized online support groups accompanied with regular peer supervision. After the project was completed, we presented it to the board of Slovenian school principals. The project ended with an awareness of the importance of working with teachers and certain recommendations were issued. During this time, a group involved in the community work was also established and is still active in Ljubljana.
I think our generation has been too focused on the therapeutic aspects of group analysis and its use in healthcare (the area we all come from), and have overlooked the fact that the applicability of group analytical knowledge extends to other areas, e.g. pedagogical work, group leadership, etc.
Last year’s experience indicated direction in which group psychotherapy could develop.
In Slovenia, there is a long tradition of group psychotherapy in the treatment of various mental health disorders for patients and their relatives. Over the years, many in-hospital and out- hospital groups for a wide range of mental health disorders have been held in clinics, especially in the University Psychiatric Clinic. Group psychotherapy approaches are also used in day hospitals.
Both SDSA and ISAL had the support of the University Psychiatric Clinic in the past, as all activities of the Association and education took place on their premises. The situation changed in 2015, when the management of the clinic finally denied us hospitality. Meetings at the clinic were financially favorable for us, but at the same time we were distant from the wider community, real life. The former president of the Society reprimanded us because we accepted the “expulsion” too easily and we failed to prove to the clinic that psychotherapy is much needed by psychiatric patients.
The desire for one’s own space has always been present in both organizations but more difficult to achieve. Acquiring one’s own space would mean introducing group analysis into a wider space in which it is otherwise less known than some other psychotherapeutic approaches. The idea is to find a space where we would carry out all social and educational activities and where GA students and others could run their own groups.
The situation has also changed in University Psychiatric Clinic, where group psychotherapy is not currently promoted as a treatment modality in terms of systemic staff education and supervision options, but financially support group psychotherapy students’ requests for partial reimbursement of their study fees. I believe that group psychotherapy as a modality of treatment will always exist in psychiatric institutions.
A bigger current and future challenge is planning the training of group psychotherapists.
Reflection on our school of group analysis and its further development in Slovenia is extremly topical.