Group analysis’ meta-matrix as a healing social factor

Abstract

The article reflects on three key milestones of group analysis as a valuable social factor in mental and social health in Spain that has redefined the group-analytic relational matrix as a healing and liberating agent over time.

We define the notion of meta-matrix as a supra-unitary significance that represents a global series of collective phenomena. A complex supra-ordered matrix that frames a series of regularities and produces knowledge.

The influence of the group-analytic meta-matrix prompted, through Foulkes, a first milestone of the opening of the individual to the group space. It opened a fruitful period that allowed more than a generation of therapists to evolve into spheres of freedom and analysis.

A second milestone came with the Spanish democracy of the 1970s and promoted a network of health and progress. The group-analytic meta-matrix was reconstructed in the relational and social grid as a way of facilitating processes of opening up the group to the community. Group analysis was present in the social, mental and community care of citizens in its therapeutic, or didactic, projection of the group.

Finally, at the turn of the century, the establishment of virtual reality and the global health crisis have constituted a relational group-analytic meta-matrix that extends the healing network from the in-person group to the virtual group. Foulkes’ idea of the individual as a constituent point of the total whole develops and prevails in online group settings without detriment to the face-to-face.

Key words

Group analysis; relational matrix; milestone; Spain; meta-matrix

Introduction

The social framework has always been important when observing groups. The group-analytic imprint in Spain and its therapeutic and didactic projection in the country, contemplates the conscious and unconscious processes in the field of psychotherapy, although it also extends to organisational, educational and social areas (Martínez-Taboada, Amutio, Elgorriaga, & Arnoso, 2015). It is evident that the concept of group matrix involves an interactive interweaving of the group members and has emergents in the subsequent transmission of its members. Sunyer (2011) defines it as an intangible inter-relational element between the people. It constitutes and sustains the process of relating both with others and with themselves.

The group always maintains a balance between adaptation to suffering and the intrinsic capacity to develop as a healthy group (Pines, 1983). Therefore, the narrative reconstruction of the groups and their relational matrix in different settings is of particular importance, especially in uncertain circumstances.

In the work of Scholz (2003, cited by Sunyer, 2011) we see how for Foulkes, the understanding of the individual and society can be examined as units that are under permanent construction through communication (2003, p. 551). We might add, as Pines (1991) points out, that the concept emerges because social, political and cultural circumstances make it possible.

We understand the concept of meta-matrix as a specific reading of the macro part of influence on the relational and related nodes that constitutes and by which it is constituted. It is formed in the shared meanings between individuals and groups, which transmit and give meaning to the interaction in a supraunitary contextual framework that represents a series of collective processes. We can consider that the meta-matrix gives a global estimation (Cooper, Hedges, & Valentine, 2009), in this case of Groupanalysis that adapts creatively to reality (Campos, 1979).

1. The meta-matrix of Group Analysis as a healing social framework: opening up the individual to the group space

The group-analytic trace begins in the 1950s. At that time, society was under an autocratic dictatorship that persecuted groups as a threat to the forced social stability. Groupanalysis came to Spain at a time of dictatorship when groups were a threat to the system.

Making groups became, in a way, a light of resistance to the dictatorial situation for mental health professionals at that time. The group matrix as a concept became a space for sharing and questioning internal and external structures. Group resonances helped to heal common discomfort and the concept of “group as a whole”, with its own dynamics, was almost unacceptable. It transcended far beyond the individual and became a great challenge for professionals in the social situation at that time.

The origin of group psychotherapy in Spain is associated with the rise of group therapy in the United States and Europe at the end of the first half of the 20th century. The individual was opening up to the group space and was unstoppable. Reflections on the protective impact of groups on soldiers with post-traumatic stress symptoms after fighting in the Second World War gave rise to the use of the group as a therapeutic agent in figures such as Bion, Foulkes, Slavson or Moreno who changed the course of methodology and psychological care. This meant a different way of working, whose central focus was the group as a social undivided that can be analysed and studied as a complete, global and organic system by turning the components into its emergents.

Foulkes’ group analysis analysed simultaneously the individual and the group. From there, he was able to describe the creation of a relational matrix that complemented concepts and meanings about groups based on his theory. He highlighted the fact that each individual member chooses from the group pool what is relevant to himself (Foulkes, 1977). It gave rise to the term resonance as an unconscious reaction in response to individual disposition determined by group stimuli which can be reciprocal (Pines, 2009). From this perspective, the group establishes a series of unconscious relationships between people, which are spontaneous and continuous. He called this phenomenon group matrix. This interactive network that is established between individuals in a group is the shared operational basis that determines the meaning and significance of what happens in the group. From this approach it was possible to analyse the person and the group as a whole on both conscious and unconscious levels.

The IV International Congress of Psychotherapy held in Barcelona in 1958 with the central theme “Psychotherapy and existential analysis” was a milestone for group analysis and for group psychotherapy in Spain. It brought together Foulkes, Slavson and Patrick De Maré, as well as Moreno – all of them unique pioneers of psychotherapy – on the group, in the group, and with the group – using words and dialogue and, in the case of Moreno, action. They are recognised as the fathers of psychotherapy in small groups, and in the case of Pat De Maré, with medium to large groups.

As Foulkes walked through the garden door of the foyer of the University of Barcelona holding Slavson and Moreno’s arm, according to Campos (quoted in Markez, 2007), – a pity not to have taken a photograph then – the first connection of the Group Analytic Society (GAS) of London with Spain was formalised in September 1958. Foulkes headed the Special Section on Group Psychotherapy and organised – with the help of members of the Maudsley Hospital and the GAS – a Symposium in which he explained the training course for psychotherapists given in the outpatient unit of the hospital. At that time a relevant person for Group Analysis in Spain was the psychiatrist Juan Campos Avillar, later trained by Foulkes at the Maudsley Hospital in London.

Dr. Campos, a psychiatrist, was a member of the Group Analytic Society (London), also of the International Association of Group Psychotherapy and Group Processes (IAGP) and had a great involvement with the Spanish Society of Psychotherapy and Group Techniques (SEPTG). All of this, along with his writings, vitality, commitment, and intellect, exerted a special influence on the strengthening of group analysis in this first period of openness in the group-analytic meta-matrix in Spain.

Events such as the influence of the May 1968 movement in France, now considered a cultural, social and ethical turning point in the transformation of the modern era, the Education new Law and the growth of many psychology departments at the universities, brought about the change and the establishment of group analysis.  In the early 1970s the foundation of the Spanish Society of Psychotherapy and Group Techniques – SEPTG, was a significant event in the history of Spanish group therapies. A few years later, Dr. José Guimón, recently arrived from the United States, the Retama Peña Institute in Madrid and the London Group Analysis Institute, launched the first workshops on group psychotherapy in 1974.

In 1976, when the transition to democracy was beginning in Spain, military repression in Argentina drove many psychoanalysts and group therapists, who had participated in the democratic psychiatry and psychology movement in that country, into exile. Dictatorships are allergic to analysis and groups (Campos Avillar & Campos, 2007). So the Argentinean group of therapists were a factor that added to the interactive network of group development in the first half of the 1970s.

The beginning of the relational healing meta-matrix of group analysis, among mental health professionals in Spain, was a genuine and experiential space. A liberating display of opening the individual sphere to the group.

2 – The meta-matrix of Group Analysis as a healing social network in different settings: from group space to community and institutional settings

The applicability of Group Analysis in a wide range of settings, including general and psychiatric hospitals, outpatient clinics, rehabilitation programmes and institutions such as universities, made possible a new milestone in the renewal of the group-analytic meta-matrix in Spain.

The Mental Health Research Foundation OMIE was created by a team of professionals, supported by the London Institute of Group Analysis GAS and its president Dr. Malcolm Pines. This foundation was, and still is, deeply rooted in group-analytic training. However, the fact that the training programmes tended to be under the exclusive direction and responsibility of the British led to the separation of this initial arrangement. The relational matrix could not cope with so many tensions and they irretrievably separated their networks of connection. In any case, it is a fruitful period of great formative impact that has allowed several generations of therapists to continue developing and strengthening Group analysis in Spain.

Dialogues and group discussions were promoted following the example of the Department of Psychiatry of the Faculty of Medicine at the University of Geneva (Guimón, 2000).

The group programs fostered a greater integration of health professionals in different teams that provided a meeting place and a common theoretical framework of reference. The concept of group matrix of Foulkes was taken up again in a meaning of great utility for all (Guimón, Ayerra, Trojaola, González de Mendivil, & De la Sierra, 2004).

In the experience related to Geneva, the doctors and the students agreed on the importance of the doctor-patient relational matrix in the institutions. The identification and application in the management of the main psychiatric disorders and psychosocial problems became evident.

It was shown that, after group analytical training, there was an increase in the number of strategies used by professionals, with a more dynamic general orientation focused on the causes and the real state of the subjects, instead of only on solutions and consequences (Vucetic, Maercker, Ge-Fabry, Scherer, & Guimón, 2004).

The psychiatric care reform project entailed new forms of psychiatric education and understanding of interpersonal dynamics, to substantially improve the outcomes of psychotherapeutic care in general. Group analysis became a valuable tool as well as a way of understanding institutional dynamics and how they affect the development of relational processes.

On the other hand, the model of community mental health centres came to meet the demands of citizens. The systems and techniques of group therapies were taken into consideration, and specifically those of group analysis. As a result, the demand for group therapists with experience in outpatient, inpatient and preventive care increased (Guimón, 2003), both in hospitals and mental health centres. The development in Bilbao, Barcelona and Geneva of various group-analytical therapeutic programs for patients with severe psychiatric disorders in short and long-term inpatient and outpatient clinics, had very positive results both from a clinical and organizational point of view, in addition to the perception of a special environment that is not perceived in other units managed with different approaches (Guimón, 2016).

The orientation towards community therapy, in short-term and long-term units became alternatives for patients. Group analysis, with its particular emphasis on the “here and now” and cohesion among members, proved to be a stabilising tool (Guimón, 2006).

Psychoanalytically oriented group psychotherapy has thus become a basic therapeutic tool in short and long-term inpatient units for psychiatric patients. Staff thinking and training remains an essential tool in institutions, both for the maintenance of a therapeutic environment and for the understanding and improvement of the work of therapeutic teams.

Therapeutic factors that act independently of the diagnoses, the theoretical framework and the classification of the intrinsic components of group therapy have been evaluated. The infusion of hope being the most important principle for patients with serious mental disorders (García-Cabeza, Ducajú, Chapela, & González de Chávez, 2011).

Healing factors inherent in group dynamics and professional interaction represent primary components of meta-matrix change. In this way, the development of the processes of integration and differentiation of biopsychosocial elements (Sunyer, 2008), and the emergence of community groups and programs that humanize psychiatric care redefine the analytic group relational meta-matrix at this time.

We know that group analysis observes groups through conscious and unconscious processes, especially in the field of psychotherapy. However, it is important to highlight its extension in educational, organisational and social areas. Training in group therapy has been available in several Spanish universities, specifically in Barcelona, Bilbao and Madrid. In all cases, training aimed at professionals and students related to mental health, sociology, pedagogy and human relations defines a deep interest in helping and understanding people and communities.

The Master’s degrees and specific training in groups are a tool aimed at professional experts who work in the field of health, social or business organizations. Group analysis thus becomes a transversal element of interactive processing nested in the institutions.

It is worth highlighting the implementation of various training programmes at the University of the Basque Country (UPV/EHU), with a multilevel and Group analytic perspective, as a tool in the training of professionals, thanks to the contribution of Professor Sabino Ayestarán and collaborators (Martínez-Taboada, Arnoso, Aritzeta, & Amutio, 2018). Among others, the Master’s Degree in Human Resources Management at the University of the Basque Country in the 1980s, in which experiential groups received special attention as a shared successful practice in the formative exploration of group and personal processes.

In the same framework and many years later, although it has now celebrated its tenth anniversary, the Master’s Degree in Organisational Psychology and Psychosocial Intervention of the University of the Basque Country maintains the imprint of the different forms of group work, therapy, improvement, innovation teams, face-to-face and virtual, which determines the participation of students in experiential groups, growth groups of short duration, coordinated by expert group-analysts. Also, the supervision and follow-up group sessions incorporate group analysis with the whole student body with the aim of improving dialogue (De Maré, 2010) uncovering existing difficulties and creating a barometer of the group’s emotional climate. In this way, confused projective identifications are contained. A “making room” space begins to open up where the capacity for co-reflection (Barwick, 2006) and healthy adaptive functions can emerge.

3 – The healing meta-matrix of Group Analysis in its virtual projection: the opening of group and community space to virtual space

Group analysis is considered a key tool and a way of reorganising important aspects of people’s psychological lives. However, the psychotherapeutic landscape has changed in recent years. Not only with the trend towards shorter therapies that force us to look at what can be achieved in less time, but also with the incorporation of virtual work. The use of the internet in everyday life has inspired new group forms and possibilities (Winther, 2016).

Whether therapy groups, training groups, or demonstration groups, online groups maintain the same conditions as face-to-face groups for fostering healthy relational matrices. The setting must always be maintained and the usual issues such as boundaries, confidentiality and privacy must be clarified.

The meta-matrix of group analysis in Spain has always been linked to the SEPTG, the consequence of which, together with GASI (Group Analytic Society International), was the 1st International Online Symposium in 2020. We can remember that the RedIris GrupoAnálisis list was opened in 1995 by Juan Campos, a tireless seeker of communication tools (Campos Avillar & Campos, 2007), always far ahead of his time. Subsequently, and as a precedent in the online progression, we can point out the presentation of a book in a virtual version at the IAGP Congress in Jerusalem, The spirit of groups 2000: From Conflict to Generative Dialogue. He was referred to as a “network weaver” because of the great effort to establish connections and emotions with the incipient use of the Internet.

At the III Mediterranean Conference A Bridge Called Mediterranean, jointly organised by the SEPTG and the IAGP, Juan participated for the last time, but not before opening an online dialogue list that continued to function satisfactorily beyond the end of the Conference. Self-managed groups of peers in covision that could dispense with the therapist, once the experience was over, was one of Juan Campos’ goals, a prelude to the Intervision groups that today spread among professionals all over the world under the umbrella of the IAGP.  An internet forum that can be qualified as an extended matrix (Davidson, 1998), and may even question S.H. Foulkes’ (1975) scepticism as to the possibility of ever realising a healthy and functioning large group.

In recent years the Internet has expanded exponentially. The Big Group in cyberspace (Weinberg, 2003) is an issue that has taken on an extraordinary dimension today with the multiplication of virtual media of mass reach.

Covid 19 has given another twist to virtual projection. The world’s population has been driven into seclusion with thousands of people eager to connect and establish relationships of mutual listening and resonance. Anxiety and fear were incorporated into the physical isolation and the apprehension of the impact of the disease. The therapy group contained a demand, both individually and collectively, to establish support networks. Online therapy has brought together and co-created a healing relational matrix.

The virtual group, if it provides a safe environment, allows for a review of emotions and a strong sense of group bonding. The evidence, once again, of the need for interaction has taken over cyberspace as a great platform that is part of our community and professional life.

The group matrix is redefined while maintaining the same framing conditions. The number of sessions is negotiated. Respect for the times of the same time and day, once a week. Limits in the forms, no eating, no smoking, a confidentiality contract, and being present with the camera on during the sessions.  A final evaluation of the processes is included among the people who share their psychological elaboration online. The groups resonate in their sadness and in the construction of hope, in affection and in the internal reparation of psychological suffering. Transference, countertransference, defence mechanisms and therapeutic alliance happen equally online when the subjects involved genuinely participate. The achievement of affective support and compassion increases the need to promote pending farewell rituals to facilitate the coping of separation and decrease psychic suffering. Relational matrices prevail, no matter human or Internet provider (Billow, 2019). The particular characteristics of the electronic environment allow for the encounter to occur in each session and reflect the reality of human existence.

Foulkes’ idea of the individual as a nodal point in a network included in a total whole is more relevant than ever in the various meanings that have emerged in our environment. Group psychotherapists develop knowledge about online and intercultural competences in order to improve emotional well-being and health, while reducing symptoms of shared social stress.

The group analytic meta-matrix is renewed as a positive social factor. It integrates the influences of the social context and the new configurations that it determines and by which it is determined. Professionals working in hospitals, health centres, psychosocial and educational settings maintain the emphasis on group processes when working in a virtual space. Using the internet to foster dialogue, emotional communication and group interaction makes it possible to reduce the innumerable initial resistances to virtual communication (Campos Avillar & Campos, 2007).

Online group therapy stands as a substantial aid to society in its efforts to undo the current mental blocks that arise in constrictive situations of great stress and psychological grief. The ties of binding interdependence with which these people weave their relationships become a unique way of sustaining psychic suffering (Sunyer, 2008).

Finally, and in conclusion, as Foulkes (1948) said the individual and the society, the body and the mind, fantasy and reality, cannot be understood as opposites, since any separation would be an artificial isolation. Individuals co-create interactive networks that can never be considered alone since the essence of people and groups are social.

The evolution of the group analytic meta-matrix arises both from the internal and external interaction within the world of people, as well as, from their historical moment, from the community  of  which  they  are  part  and  from  the  interconnected relational matrix.  An exclusive and transcendent meaning is established, regardless of whether the scenario is in  person  or  digital. In  this  sense,  the  evolution  of  the  relational meta-matrix of Grupoanálisis in Spain allows us not only to exemplify a global vision of the conceptual transition of recent years but also to see it as a superordinate relational emergent.

We have exposed three milestones on the group-analytic meta-matrix that can  be  considered  healthful social  factors: the  opening  of  the  relational  space  of the individual to the group, then the transition from the group to the community, and finally, the integration of the face-to-face dialogue to the virtual one without prejudice of its most genuine function.

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Dr. Cristina Martínez-Taboada Kutz (PhD)
Licensed psychologist, group analyst. Past full  professor for 30 years, current  honor Prof. at the University of Basque Country / EHU. Spain.  Past President of the Spanish Association of Group Psychotherapy and Techniques (SEPTG). Senior member of the Spanish Association of Group Analytic Psychotherapy (APAG).  IAGP Board Member for nine years, IAGP Transcultural Chair (2016-2018).  Present Co-chair of the IAGP International Education Committee  (2018-2022). Co-chair of the Scientific Committee XXI International Congress-first IAGP Hybrid Congress (2022).   On a clinical and research basis she has published extensively on groups  and Community intervention.
cristinamtk@gmail.com;

Dr. Ainara Arnoso Martínez (PhD)
Licensed psychologist and Group analyst.  Prof. Department Social Psychology at the University of Basque Country / EHU.  Board Member of the Spanish Association of Group Psychotherapy and Techniques (SEPTG). On a clinical and research basis, she has published extensively on groups  and Community intervention.
ainara.arnoso@ehu.eus