The Small Group Born Experience: On Group Processes and Some Countertransference Feelings of the Group Analyst

The paper was presented at the SPP GA Section (Moscow)

Group analysis is a psychotherapeutic method where several individual participants form a group and each member of the group is simultaneously included in the analytical process, including the group analyst, because when conducting a group, the group analyst inevitably faces his or her own countertransference feelings. Sigmund Foulkes described the position of the group analyst in the group as that of the first among equals.

I would like to present my paper on a small group of borderline patients with the focus on the process of countertransference at the initial stage of running the group, and try to analyse the process of transference and countertransference in the group from the object relations perspective of the British school. Paula Heimann (1950) labelled all the feelings that the analyst has in working with patients as countertransference. In other words, it is the capability to determine what figure the analyst represents to the patient at any given moment in transference without losing the knowledge of what we are to ourselves. Wilfred Bion (1961) described this in group work: “The analyst feels he is being manipulated so as to be playing a part, no matter how difficult to recognise, in somebody else’s phantasy – or he would do if it were not for what I can only call a temporary loss of insight, a sense of experiencing strong feelings and at the same time a belief that their existence is quire adequately justified by the objective situation <…>” Along with that, the subtle ability to sense what patients feel and to separate one’s own feelings from those of the patient in the process of projective identification can also be attributed to the analyst’s experience of countertransference feelings. The mechanism of projective identification was seen by Melanie Klein as an unconscious phantasy whereby the patient expels a normally disturbing content into another object. She also suggested that projective identification, as a method of evacuation, may fulfil a number of other unconscious functions for patients, for instance, to allow them to believe that they possess or control the object from within. Such a projective process alternates with an introjective one. Michael Feldman noted that conscious or unconscious pressure on the analyst may interfere with the analyst’s work, but it can also serve as an invaluable source of information about the patient’s unconscious mental life, in particular, his or her internal object relationships.

Also, I would concern the Kleinian concept of reparation – it involves a variety of processes by which the Ego feels that it destroys the harm done in the phantasy and thus restores, protects and revitalises objects. The significance of this tendency closely related to guilt is also determined by its valuable contribution to sublimation processes and thus to mental health.

The reparation process is also inevitably necessary for every patient in the group analytic process of developing and working on oneself, of restoring one’s inner links and damaged inner objects.

As for me, being a conductor of a new group, I needed to re-establish my identity as a group analyst after a year break due to an individual training project.

Joan Riviere (1937) wrote that the value ascribed to unconscious phantasy of reparation is perhaps the most significant aspect of Melanie Klein’s work.

At the initial stage of the group, each participant had to overcome his or her own resistance, resulting in an inevitable conflict: patients felt the need for therapy, but also experienced fears and resistance, triggering many aggressive transference feelings, addressed initially to their primary objects – parental figures – which found their psychic representations and were placed in the group.

Processing complex transference feelings is always a challenge when working with a group. The group space is inherently object-based, involving several subjects, patients, and group conductors at the same time, and this increases the possibility for more active work on some of the stagnant processes that cause developmental inhibition in borderline patients.

When in norm, the mental life of each person holds a triangular model of relationships. Britton wrote in this regard:

“If the link between the parents perceived in love and hate can be tolerated in the child’s mind, it provides him with a prototype for an object relationship of a third kind in which he is a witness and not a participant. A third position then comes into existence from which object relationships can be observed. Given this, we can also envisage being observed. This provides us with a capacity for seeing ourselves in interaction with others and for entertaining another point of view whilst retaining our own, for reflecting on ourselves whilst being ourselves. This is a capacity we hope to find in ourselves and in our patients in analysis.”

In borderline patients, the capacity of the third position lacks for a long time. However, the group space allows us to effectively expand the space of communication and interaction with others, this capacity to see oneself through reflection, through the eyes of another participant, thus developing the position of an observer, receiving feedback, at the same time also developing the ability to identify oneself with another, to experience feelings together and separately, in a state of shelter or isolation, in breaks after group sessions. There was a strong resonance at the initial stage of merger with the group, and I felt that the mirror transference that emerged served to preserve and unite the participants and at the same time separate us – the group conductors – and them – the patients – into two different parts of the group. I experienced tension, pressure and something terrible in countertransference which I wanted to alleviate with phantasies of an idealised group forming naturally. I realised that I could find support in my colleague co-therapist as well as in my personal experience of group analytic training. I think that these complex, largely hateful feelings which I unconsciously denied in order to withdraw into my own psychic shelter, but which I was nevertheless able to trace in myself, emerged in countertransference as a kind of phenomenon that allowed me to feel the patients’ condition, and it was probably what they experienced at the initial stage of group formation, which was not spoken about, remained hidden and repressed in order to avoid guilt and the emerging unconscious phantasy of further persecution.

Some thoughts arose on what is to be done about this and how the damage should be repaired?

I have tried to systematise the answer to this question a little. When the concepts of incorporated object, introjected object, and finally internal object – as well as good and bad objects, both internal and external – are gradually formed, order emerges out of chaos. These are concrete external objects of external reality, phantasy external and phantasy internal objects. All these objects are the subject’s constructions.

In the small group, phantasies about the helplessness of being around a bad, frightening maternal or paternal object were replaced by other participants’ phantasies of their own grandiosity, which helped to overcome the horror of being. To achieve wholeness and integrity in the group, I tried to provide explanatory interpretations that made the emerging split, which was a major defence mechanism, understandable. Bion called the transformation of the raw perception of beta elements into a mental object the alpha function. Using the example of an infant who calms down when his mouth finds his mother’s nipple during feeding (perception of my interpretations), he noted that the link takes a special form. One actually gets inside the other; Bion considered this to be an extremely important characteristic. One object entering another can also be found in the oedipal complex (the penis entering the vagina). Besides, this process of feeling together has similarities with the mechanism of projective identification and the formation of a container link (K-link) based on an understanding of emotions and relationships, necessary for the creation of a group analytic process based on the psychoanalysis of object relations. L-links and H-links (based on feelings of love and hate) are also considered here. Thus, the ‘link’ brings together a wide range of psychoanalytic ideas. In group analysis, we can consider this also as a process of containment of beta elements not only by the group analysts but also by other group members, which, through processing and reparation contributed to the formation of K-link between them, as well as free association, group unconsciousness and the capacity for reverie (Bion, 1962) in the group. Indeed, a unique group process formed where the group as a whole turned into a psychic container – a healing factor for each individual participant/patient.

One part of the patients accepted and processed my interventions, which gave rise to many free associations, while the other part of the group remained silent. In this way, each individual participant had his or her own individual process of processing L- and H-links, and the group as a whole gradually formed K-links between us. Patient L, woman of 43 years old, somatised at the initial stage (‘bubbles were bursting in my head’, ‘my hair was falling out’, she said), but continued the therapy from the first session to the last one. To the group sessions, she often brought dreams related to processing the oedipal level, relationship with her mother, unfreezing feelings and pleasure. I remember one of her first dreams she shared with the group: ‘I went outside. I see an ice chute. I tried to slide down. Uhhhh! And then I saw another one. Again I slide down. And there were several more. It was such a strange dream. I haven’t had a dream like that in a long while.’ The dream reveals fear of contact, frozen feelings, loneliness. L. was divorced, bringing her daughter up on her own; the time she joined the group, she was experiencing total loneliness, had fear of death. As a result, after such a difficult period of adaptation to the group, she nevertheless developed positive dynamics: anxiety lessened, a good internal object appeared, externally this manifested in getting a better job, relationships with a boy-friend (fella), a better connection with her aging mother, who previously annoyed her with everything, as well as a better understanding of herself, her daughter’s feelings, recognition of her own value. I think this patient’s psychosomatics at the beginning of the group was a symptomatic manifestation of the group’s experience of a strong fear of change and new contacts. It well may be that the focus on the body was a symptomatic manifestation of a defence mechanism of displacement of intolerable anxiety and the experience of the horror of annihilation of an individual and the group as a whole. In countertransference I realised that I was concerned not only with what was happening to her, but also to the group as a whole, and I was also anxious about my own condition. At times I found myself wanting to lean on the wall and retreat into slumber, into myself, i.e. into a dream bordering on a state of isolation.

Henry Rey wrote that thought remains spatially centred in the paranoid-schizoid organisation, and this method of functioning sheds light on schizophrenic and schizoid mental processes and on psychosis in general; the tails of such thinking persist also in neurosis and in normal individuals to various extents.

I did make an effort to tolerate physically the initial paranoid-schizoid stage, the period of adaptation and group formation. Perhaps it was challenging for me because I was trying to deal not only with the group as a whole, but also with the healthy part of psyche of each individual patient (being under the active influence of my individual training project), which was practically very difficult and affected my mental extra effort.

Nevertheless, there was another reason which I also found important to explore with the reader and which triggered my severe countertransference state and happened to be connected with the group in some unconscious way through a parallel process.

It was the third month of the group’s work. One of the participants (I., a lawyer by training, 40 years old) lost both her parents within one month. Her mother had been bedridden and cared for over the years by her father, who for this reason did not work. Her brother, a Philosophy department graduate who did not work either and lived with them, and I., who was separated, used to visit parents’ family regularly and did not work for this reason, had been involved in caring for her mother. She did not miss a single session and brought all her feelings to the group: her bitterness, anger and hatred, horror, fear, tears, guilt, shame, which over time have been elaborated through in therapy and transformed into remorse, love and gratitude to her parents. The whole group got involved in the theme of caring for the elderly. Patient A., a young woman of 23 years old (a literary critic with incomplete higher education, who dropped out from the University a few years ago and is not currently employed, living at her brother’s and mother’s expense) found resources and time for taking her grandmother to medical treatment. This topic proved to be quite difficult for me because a close maternal figure from my milieu died during the same period. The experiences of loss, bitterness, hatred, remorse, gratitude, love and shame became relevant for me as I also experienced a painful state like some of the other participants.

The origin of the group is described by Sigmund Freud in Totem and Taboo (1913). According to Freud, the group has its origin in murder. The group (gang) of brothers, the primary horde, is a proto-group that becomes a group through the act of murdering their father. This act forming and defining the group results in guilt. In Beyond the Pleasure Principle, Freud writes about the centrality of death to human psychology. Thanatotherapy, the shared experience of grief, made the patients more open, thus developing intimacy. The need for grief in the older participants found place as something naturally necessary for the development of maturity, which resonated with each person in the group. At the same time, it was noticeable how difficult it was for patient A. to experience depressed feelings; unconsciously she was bringing the saving Eros of life into the group. Soon she found a love object (a young man) and this fact influenced her appearance which stroke as unusual: her clothes became conspicuous by their absence at times; she seemed to shift attention from the psyche to her body (she attended the group sessions dressed up like a fashion model in unusual smart outfits and had dreadlocks done). She became more reserved in communication during group sessions, took an active observing position, and six months after she left the group due to a new job and busy work schedule – she got a job as a cook in a vegetarian restaurant.

In Grief and Melancholy (1917), Freud speaks of the melancholic person’s Ego state of identification with the damaged object. What is important is the realisation that “the shadow of the object fell on the Ego”, and when the melancholic indulges in constant self-criticism, he continues his attacks on the object with which the Ego is now identified. In the same work, Freud attempts to relate mania to melancholia. The liberated libido, which strengthens the subject’s narcissism, leading to an Ego equal or superior to the Super-Ego, somehow realises itself. The subject tries to feel safe through the mechanism of being able to feel his superiority over the formidable and punishing object. He is already capable of making changes that he did not dare to make before. At the group sessions Inna shared the story of her family, her ancestors, concentration camps in her grandparents’ past, totalitarian structures in her father’s work. The situation with her bedridden mother seemed to me to be an unconscious attempt to subjugate the family group members in such an exaggerated way as the withdrawal into illness and the impossibility to exist without painful co-dependent relationships. The theme of confinement was worked through in the group therapy. Somewhat later Inna found a job (she had not worked for more than seven years), though not along the lines of her professional training (she had taken antidepressants for several years before joining the group).

Our group got united in the collective experience of unconscious guilt for the symbolic murder of the primary object and became a true group. It could be that such a strong experience of feelings became quite a heavy burden, and I found in challenging as a conductor to contain the group’s depression, since I myself was actually immersed in it; our resistance as conductors to this process took place in the form of a salutary displacement of aggression: we increased the fee from March and thus lost one participant (T., 50 years old, whose parents died long ago), however unconsciously preventing the others from going into a strong regression. Although we had planned for a higher fee and the patients were notified of this from the very beginning (we started working at a discounted price), it did not come without lots of feelings, including guilt and loss.

This period of group development makes me think about the distinction between the lost and damaged object. Since the breast is the initial primary object of a newborn which partly replaces the enveloping mother’s womb after birth, the lost or damaged object in the paranoid-schizoid and depressive positions can be regarded as the breast, and the infant may either return inside the mother or replace the breast with another object to avoid the unbearable loss of the good breast. In depression, for example, the subject is in a relationship with the damaged and/or lost breast, not properly mourned and projected into new situations while maturing. Such new situations of professional growth began to emerge in the other three female participants of the group. The released libidinous energy of life in the group sought creative self-expression and found sublimation in the social realisation, since the theme of professional dissatisfaction and stagnation was a leading one. L., having found a new job, invited T. (an accountant by trade), the drop out participant, to take an interview and write an article on accounting for the magazine in whose editorial office she had found a job for herself. Our group turned out to be a damaged breast for the patients that now needed to be repaired. An object of dependence was necessary for the group to be able to feel secure and avoid loneliness. Good feelings began to be projected onto us; the bad ones were probably split off. Very soon two unmarried participants in the group found a love object (L. resumed relationship with the man she had once been very much in love with). I have already mentioned A.’s relationship above. I would like to note that something similar happened in my personal life as well, which is an interesting fact referring us to the issue of parallel processes, when being in a single group matrix makes it possible to feel something akin to another person’s experience.

I shall conclude with Hannah Segal’s thought that we should not misuse countertransference, using this constructively and recognising that countertransference could be a good servant but a bad master.

REFERENCES

1. Foulkes, S.N. (1946) “On Group Analysis”, International Journal of Psychoanalysis
2. Heimann P. (1950) “On Counter-Transference”, International Journal of Psychoanalysis
3. Bion W.R. (1961) “Experience in Groups”. London: Tavistock
4. Klein M. (1946) “Notes on Some Schizoid Mechanisms”, International Journal of Psychoanalysis
5. Feldman M. (2013) “The Value of Uncertainty”, The Psychoanalytic Quarterly
6. Hinshelwood R.D. (1999) “Countertransference”, International Journal of Psychoanalysis
7. Britton R. (1989) “The Missing Link: Parental Sexuality in Oedipus Complex”, Psychoanalytic Electronic Publishing
8. Rey H. (1977) “Schizoid Phenomena in the Borderline”
9. Freud S. (1913) “Totem and Taboo”
10. Freud S. (1917) “Mourning and Melancholia”
11. Segal H. (1993) “Countertransference” in “Countertransference: Theory, Technic, Teaching”, Karnac
12. Bell D. (1997) “Reason and passion: A celebration of the work of Hanna Segal”, (Tavistock Clinic Series), Karnac.

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