The historical development of group analysis in Italy

The interest in the use of the group device for therapeutic purposes in Italy began around the 1950s, a period in which ever greater attention to the clinical, psychodynamic and social aspects of psychology began to circulate in the scientific and professional community. An example of this movement can be traced to the hope that emerged during the 1946 Conference for the studies of social workers, in which Adriano Ossicini, Paolo Perrotti, Cesare Musatti and Mario Ponzo are the spokespersons of a change in the theoretical and applicative direction of psychology on a clinical and psychodynamic side.

Having recovered a space of thought that the Fascist period had suffocated and repressed, the Italian Psychoanalytic Society was refounded after World War II and, in 1955, the publication of the magazine was resumed, edited, among others, by Franco Fornari and Francesco Corrao. The latter, together with other important figures, such as Giancarlo Trentini, Enzo Spaltro, Leonardo Ancona, Pierfrancesco Galli, to name but a few, promote studies and works based on small groups on the basis of Lewin’s theory of field, action research, of the T-group and studies on group dynamics. In fact, the first Italian experiments with the group device are developed in the context of corporate training.

The Italian contributions to the development and consolidation of group therapy are inscribed in the broader international trend that promotes and enhances the relational paradigm (Ferenczi, Fairbarin, Winnicott, etc.) as an evolution of the drive one.

Fundamental is the pioneering work of Fabrizio Napolitani who, borrowing the model of the English antipsychiatric therapeutic communities of Maxwell Jones and Tom Main, founded the first therapeutic community in Rome in 1963 where “the Group” is used as the main tool for work and intervention. In 1968, in Milan, Diego Napolitani also gave life to another therapeutic community experience inspired by the British model.

Thus began to circulate around the 70s the theories derived from Foulkes’ thought, the concept of matrix, that of network, the dynamic interaction between intra-inter-transpersonal, together with the contribution of Bion, particularly suggestive with respect to the themes of the proto-mental and basic assumptions (Bion, 1977)

In this fervent climate of research and study in the Italian panorama, the three commonly known approaches “to the therapeutic use of the group” converge, definition by which we mean that “doing group psychotherapy is basically using the dialectical or conflictual encounter between individual and group with therapeutic purposes“(Ondarza, 1999, p.3).

Psychoanalysis in Group, a psychoanalytically oriented therapy of the individual in a group setting, belongs to the first American psychoanalysts who used group psychotherapy, among which Slavson, Wolf and Schwartz should be mentioned. In this type of setting “the emphasis is placed on the individual and not on the group, the analyst is the main therapeutic agent, the goal is to highlight the intrapsychic dynamics in a group context” (Pisani, 2000, p. 19 ).

Psychoanalysis of Group, according to which the therapist’s attitude remains strictly psychoanalytic and the group as a whole is treated as if it were a single patient, refers to Bion, Ezriel and the Tavistock Clinic school in London: “interpretations are given to the group as such, almost never at the level of interpersonal relationships and much less at the intrapsychic level of the individual patient“(Napolitani F., 1980, p.75)

Psychoanalysis through the Group, the Group Analysis, frames itself, from a theoretical, methodological and technical point of view, proposing the group itself as the center of the analytic process (Ondarza, 1999; Pisani 2000), in a bifocal vision that constantly oscillates between figure and background, individual and group. The fundamental assumption is that “(after a certain time) the group is able to mobilize its own therapeutic resources, including, of course, its capacity for insight” (Napolitani F., 1980, p.76). The conductor, while deeply and emotionally involved in the group process, has the function of facilitating the dynamic matrix through communication between the members, promoting interaction between the intrapsychic, interpersonal and transpersonal levels.

Although at present, the above schematic description of psychotherapy and psychoanalysis in-of-through the group has been outdated, it is still useful “to remember “historically” the passage that has been made by the group as a structure, context or place where one can do or not “psychoanalysis” to the “psychoanalytic” interest in the peculiar structure and process of the group” (Ondarza, 1999, p. 20) which has also characterized the Italian context, fueling a debate, at times very heated, among those who have joined to the conception that group analysis was in a relationship of filiation and dependence on psychoanalysis and who, on the other hand, progressively supported an epistemological autonomy of group analysis.

If it is true that “psychoanalysis has invented an alphabet, realizing such a formidable event as the discovery of writing in relation to hieroglyphs, and with it has created a new language; (e) the group-analysis uses the same alphabet to speak a language other than the psychoanalytic one; a foreign language towards psychoanalysis, and reciprocally. This fact leaves both parties the possibility of learning and mutual enrichment” (Ancona, 1996, p. 10).

In the decade between the 1960s and 1970s, the first Italian associations interested in research and application of the group analytic device began to be founded: in 1968 the Institute of Group Analysis of Rome (IGAR) was set up, overseen by Fabrizio Napolitani; in 1974 on the push of Diego Napolitani the Milanese Association of Group Analysts (AMAG) was born, which became the Italian Group Analytical Society (SGAI) in 1982.

Between the 60s and 80s, Fabrizio Napolitani, Diego Napolitani, Leonardo Ancona, Francesco Corrao, Ferdinando Vanni, Jaime Ondarza Linares, Franco Di Maria, to name just a few, contributed to deepen, conceptualize and elaborate the stimuli coming from the international context , promoting intense theoretical debates and fruitful clinical exchanges. They founded the first Italian associations interested in the research and application of the group’s device, both from the point of view of the Group Analysis, Psychoanalysis of Group, Analytical Psychodrama, PsychoSocial-Analysis and Institutional Analysis:

Group Analysis

• 1968, Rome, the Group Analysis Institute of Rome (IGAR) by Fabrizio Napolitani;
• 1974, Milan, Diego Napolitani, the Milan Association of Analysts of Group (AMAG) with Diego Napolitani, which became the Italian Society of Group Analysis (SGAI) in 1982;
• 1974, Rome, the Italian Society of Psychoanalysis of Group (SIPG) with Paolo Perrotti;
• 1979, Rome, the Therapeutic Group Analysis Center (CATG), with Jaime Ondarza Linares;
• 1980, Rome, the Italian Society of Group Analytic Psychotherapy (SIPAG) with Leonardo Ancona;
• 1982, Rome, the Italian Center of Group Analysis (CIGA) with Alice Ricciardi Von Platen;
• 1983, Padua, the Venetian Association for Research and Training in Group Analytical Psychotherapy and Institutional Analysis (ASVEGRA), with Giovanni Gozzetti, Sergio Fava, Eliodoro Novello and Franco Fasolo who refer to the thought of Solomon Resnik;
• 1985, Turin, the Association for Research and Training in Individual, Group Psychotherapy and Institutional Analysis (APRAGI- Group Analysis) with Anna Maria Traveni;
• 1989, Rome, the Interpersonal Psychoanalysis Society and Group Analysis (SPIGA), with Vincent Alfred Morrone;
• 1996, Rome, from the merger of CIGA and SIPAG, with Ancona and von Platen Ricciardi, IL CERCHIO – Italian Association of Group Analysis;
• 1996, Palermo, part of the Palermo members who had trained at SIPAG founded the Group Analysis Laboratory (LdG), with Franco Di Maria and Girolamo Lo Verso;

Group Psychoanalysis

• 1978, thanks to Francesco Corrao who deepens and develops Bion’s group psychoanalytic theories, the Group Research Centers (CRG) were born, in Rome with Claudio Neri and Antonello Correale and in Palermo with Lucio Sarno. They will subsequently change their name to the Italian Institute of Individual and Group Psychoanalysis (IIPG);
• 1979, Milan, the Group Psychotherapy Association (APG) with Ferdinando Vanni;
• 1995, Genoa, ACANTO – Association for the study of group dynamics, with Claudio Neri, Gabriele Pasquali, Laura Tognoli as honorary members.

Analytical Psychodrama

• 1981, Rome, the Italian Society of Analytical Psychodrama (SIPsA) with Luisa Mele and Elena Croce;
• 2000 in Turin, APRAGIP- Psychodrama Association for Research and Training in Individual, Group, Institutional Ppsychotherapy and Aanalytical Psychodrama, with Giulio Gasca, Maurizio Gasseu and Wilma Scategni.

PsychoSocial-Analysis and Institutional Analysis

• 1983, Milan, ARIELE – Italian Association of PsychoSocial-Analysis, with Luigi Pagliarani;
• 2007, Turin, Il Nodo Group, founded by psychoanalysts and professionals of the human sciences who trained with the Tavistock Model and the Group Relations Conferences.

Some of them will converge in a Confederation of Italian Organizations for Analytical Research on Groups (COIRAG)[5], which will subsequently take part in the International Association of Group Psychotherapy (IAGP).

“In 1981 the Fifth European Congress on Group Analysis was held at the Midas Hotel in Rome, with the support of the Istituto di Gruppo-analisi di Roma (IGAR), the association of group analysts promoted by Fabrizio Napolitani and chaired by him and Malcolm Pines. The Congress was open to all organizations involved in group analysis. In a break with custom and in order to gain the most from the workshops, they were given priority over the theoretical parts of the symposium. Present at this Congress were Romano Fiumara, Jaime Ondarza Linares and several other well-known psychoanalysts, such as Paolo Perrotti and Francesco Corrao (1981), who sought to apply psychoanalysis to groups. On this occasion the idea of a confederation was put forward and 1982 saw the foundation of the Confederazione Organizzazioni Italiane di Ricerca Analitica sui Gruppi (COIRAG), comprising seven centres for group analysis. In the formative phase its president was Fabrizio Napolitani (1985-6), while the present author became its first institutional president.

COIRAG’ s scientific and cultural aim was to define the theoret¬ical and practical field of group analysis, which was considered to be a new sector derived from psychoanalysis but independent from it. Other federations subsequently asked to join. At present COIRAG includes nine associations whose names appear below in alphabetical order, together with the cities where they operate and the name of the director who either set up the association or is its most representative member: APG (Associazione Psicoterapia di Gruppi, Milan, F. Vanni); APRAGI (Associazione Piemontese Ricerca Analisi Individuale Gruppale e Istituzionale, Turin, A.M. Traveni); ARIELE (Associazione Italiana di Psicoanalisi, Milan, L. Pagliarini); ASVEGRA (Associazione Veneta Gruppoanalisi, Padua, G. Gozzetti, F. Fasolo); CATG (Centro Analisi Terapeutica di Gruppo, Rome, J. Ondarza Linares); SGAI (Societa Gruppo Analitica Italiana, Milan, D. Napolitani; Rome, F. Napolitani); SIPAG (Societa Italiana Psicoterapia Analitica Gruppi, Rome, L. Ancona, C. Pontalti, R. Menarini); SIPG (Societa Italiana Psicoanalisi Gruppale, Rome, P. Perrotti, P. Cruciani) and SIPA (Societa Italiana Psicodramma Analitico, Rome, E.B. Croce). CIGA (Centro Italiano Gruppo Analisi, Rome, A. Ricciardi von Platen) later applied to join COIRAG” (Ancona, 1996, pp.421-422).

From this overview it emerges that in the Italian scenario the growing awareness has been affirmed that “the individual cannot be conceived in isolation but in continuous relationship with his social group” and, consequently, “individual psychopathology can only be in close relationship with group psychopathology” (Pisani, 2000, p. 13), to the point of conceptualizing the relational and multipersonal foundation of the mind.

The group device has been progressively inserted within the practices in the Mental Health Services, feeding reflections and observations related to institutional dynamics, and continues to be applied to work with seriously ill patients, thanks above all to the intense theoretical and clinical work of Antonello Correale , Eugenio Gaburri, Franco Fasolo.

In recent years, research and intervention lines have been developing which also have as their object new structures such as the homogeneous group, family group analysis, but also social contexts and research on the evaluation and effectiveness of group psychotherapy.

It seems appropriate to emphasize, among many others worthy of note, the theoretical contributions of some Italian authors who have made it possible to disseminate and investigate issues related to the study and application of group analysis.

We will focus on the theoretical and clinical contributions of Diego Napolitani, Leonardo Ancona and of the Sicilian group-analytic school, albeit in a synthetic way and without pretense of completeness.

The contribution of Diego Napolitani, which promotes the recognition of a specificity of analytic work with groups that cannot be reduced to the intertwining of drives and defense mechanisms of individuals, can be defined as fundamental. He highlights the value and originality of the thought of Foulkes and Bion, as both, while following different paths, have come to very similar conclusions, namely that “the human mind is, first of all, a part of a collective relational structure, that structure that Bion defines as a protomental system, and which Foulkes defines as a transpersonal system” (Napolitani D., 1980, p. 23).

In his best-known text “Individualità e Gruppalità” (1987), we trace the effort to substantiate the relational foundation of the mind, overcoming the dichotomy between biological and psychic and integrating in his thinking approaches deriving from anthropology, social psychology and philosophy phenomenological. Napolitani D. states that the external and internal world are closely intertwined, they cannot be isolated from each other. Through identification, the child appropriates the characteristics of the environment in which he is born and this implies that the culture is permanently established in the internal world of the individual.

The concept of “gruppalità interna” (internal groupality ) refers precisely to the internalized relationships that populate each individual, for which the foundation of each one’s existence is characterized by being in relationship with.

But subjective existence cannot be resolved in a mere repetition of what has been learned from others and handed down, on the contrary, if this happens, one falls back into the register of pathology. Instead, the reflective action of thought must allow the transformation of events, the attribution of authentic meanings through the identification of new links.

“The foundation of <health> then lies in a delicate but fruitful balance between “the idem”, understood as an identifying identity, and “autòs”, as a potentially conceivable and generative attitude” (Lo Verso, Formica, p.87)

Equally fundamental is the theoretical and clinical contribution of Leonardo Ancona, author of many texts, articles and essays that have supported the specificity of the group-analytic approach with respect to psychoanalysis. Here we want to focus on the interest shown by Ancona in his writings towards that level of primordial functioning of the group that Foulkes intuited and Usandivaraas (1986) explored. It is defined as “a suprapersonal space, that of culture, taboos, myths, the space pertinent to the most archaic, pre-verbal that characterizes the subject, due to the fact that he comes into the world expressed by a group he belongs to, from a specific civilization” (Ancona, 1996, p.14).

The possibility of the group-analytic process to recreate those archaic experiences in which the subject was a group even before being an individual, gives the group device the ability to access an experience of restructuring of the nuclear Self.

Ancona has anchored this interest to the practice of the Analytic Large Group, an experiential workshop of seven ninety-minute sessions of Large Group, four on the first day (two in the morning and two in the afternoon) and three in the morning of the second day, historically structured in Italy at by Alice Ricciardi von Platen.

The well-known psychiatrist from Nuremberg, a direct student of Foulkes, had collaborated in Germany with Joseph Shaked and Michel Hayne in the 1970s, designing a so-called “block” training model, based on short periods of intense training work, repeated in the time, for a few years. It is possible to hypothesize that the Italian experience of proposing seven sessions in two consecutive days is attributable to an evolution of condensation of the experience of the large groups first at the London Institute (seven sessions in seven weeks), then of the block formations in the German training (seven sessions in one week) (D’Auria, Negro, 2016, p. 54).

The Analytic Large Group device thus conceived aims to analyze and detect the psychosocial dynamics that can be observed in the development of the group process, considering them a mirror of what happens in society. It offers itself as a valuable tool for experiential training, but also for updating and retraining for any professional who finds himself working with groups of more than 30 people. The Analytical Large Group gives the possibility to experience very intense emotional states and to develop a mental space where to elaborate those tensions between antagonistic interpersonal and social forces, inevitably present in every place shared between several people. While in the small group, thought is used as a defense against the fear of emotions, in the larger group, on the other hand, one learns to think and manage excessive emotionality (Von Platen 1995).

“Analytic Large Groups make the individual anonymous and confused, robbed of his ordinary system of defenses … in them, participants are given the opportunity to explore their own destructive conscious and unconscious emotions, but also their ability to exercise mature control over their interactions with others“ (Von Platen, 2003, p. 269).

Considering that “the work of the large group is much more widely declined on a more primitive unconscious, of cultural anthropological derivation, the dynamic has lost the relevant connection to the personal dynamics of the components, typical of psychoanalysis and also lacks the meaningfulness of the shared one that is specific to the small group” (Ancona, 2002, p.249), even the emerging narratives refer to the world of myths and taboos, understood as the cultural reservoir of humanity and this allows us to trace a renewed collective intimacy through a cohesive function of recognition .

The Sicilian group-analytic school has dedicated itself, among other topics, to deepening studies and reflections on the transpersonal matrix.

Lo Verso defines the transpersonal as “the constitutive datum, on the anthropopsychic side, of the psychic birth and therefore of the human personality” (1989, p.100), which is transmitted from one generation to another in the context of relationships, but is also subject to continuous interpretations by the individual, family, ethnicity, etc.The psychic, biological, anthropological dimension converge in the concept of transpersonal and together determine the foundation of the mind and its functioning. The transpersonal datum can be defined through five qualities: it is unconscious, internalizable by the human being, super-individual, intentional, as it directs and signifies emotions, but it is transformable. Six levels have also been distinguished in which the transpersonal matrix unfolds, which describe different areas of relationship between the human being and the environment and which must be considered interdependent, not clearly separable, if not for educational purposes.The biological-genetic, ethnic-anthropological, transgenerational, institutional, socio-communicative and political-environmental levels cross and permeate the human mind, highlighting how much it is a transpersonal event, which is independent of single individuals. On the level of the theoretical-technical framework that structures, regulates and guarantees the therapeutic treatment, it is worth noting the effort of conceptual definition of the terms of set and setting, where the first (set) outlines the structural organization, the organizational context (the disposition of the therapy room, the day, the duration of the session, the frequency, the payment), while the second (setting) refers to the theoretical-technical-personal system of the therapist, to the mental / emotional structure of the same, to the intention and the way of conceiving the group. Hence the proposal of a new conceptual definition of “set (ting)”, understood as a “specific experiential field, (the) place of the concrete therapeutic experience, which is defined in relation to an inseparable interweaving between organizational-procedural factors (set ) and the therapist’s “thought” variable (setting)” (Lo Verso, 2011, p. 49).

The set (ting) is configured as a psychic organizer of a transpersonal character, connected to the concept of the co-transference field, a term that underlines the specific process of the analytic group, capable of activating a complex of transference dynamics that intertwine the there and then with the here and now, also allowing the visualization of the unconscious dynamics that each patient activates in other relational areas (there and now).

“(…) within the group setting the interactions between the members of the group open (to an attentive analyst) the transference dimension in all its planes: through the re-proposition of the ancient – but still alive – identifying bonds, of the real relationships between family members, transgenerational family myths, fields of signification established (and sometimes frankly imposed) by the culture to which they belong, bonds and social norms, etc.” (Lo Verso G., Profita G, 2011, p.166).

The enhancement of the exploratory dimension with respect to the archaeological dimension of classical psychoanalysis clearly emerges, with the tension towards a work of discovering new parts, not yet born, of which the patient has not yet experienced.

The Sicilian group-analytic school highlights the need to confront the new frontiers of clinical and psychosocial work through the use of psychodynamic group devices, which need to be conceived and conducted with methodological coherence, taking into account the multiple reference parameters involved (typology of users, institutional context, objectives, purpose, duration, therapist training, etc.)…..to be continued…..

References

AA.VV. (1980), “Il Gruppo e la Psicoanalisi”, Quadrangolo, n. 12/14.

Ancona L. (1996), “The Group Analysis Scenario in Italy: Forty Years of Growth and Development”, Group Analysis, Vol 29, Issue 4, pp. 419-425.

Ancona L. (1996), “Psicoanalisi e Gruppoanalisi a confronto”, Gli Argonauti, XVIII, 68, 29-47.

Ancona L. (2002). “Pragmatica clinica del gruppo mediano e grande”, in Di Maria F., Lo Verso G. (a cura di), Gruppi. Metodi e Strumenti, Raffaello Cortina, Milano (pp. 235-251).

Bion W. R. (1977) The Italian Seminars, Routledge, London.

D’Auria A., Negro S. (2016), “Dal Large Group al Gruppo Allargato Analitico”, Gruppi, Vol.2, pp. 42-66.

Di Maria F., Lo Verso G. (2002) (A cura di), Gruppi. Metodi e strumenti. Raffaello Cortina, Firenze.

Di Maria F., Formica I. (2009), Fondamenti di Gruppoanalisi, Il Mulino, Bologna.

Lo Verso G. (1989) Clinica della gruppoanalisi e psicologia. Bollati Boringhieri, Torino.

Lo Verso G., Di Blasi M. (2011) Gruppoanalisi Soggettuale, Raffaello Cortina, Milano.

Napolitani D. (1980), “Al di là dell’individuo. Il rapporto tra soggetto e gruppo nella prospettiva gruppo-analitica”, in AA.VV. (1980), “Il Gruppo e la Psicoanalisi”, Quadrangolo, n. 12/14, pp.74-86.

Napolitani D. (1987), Individualità e gruppalità, Bollati Boringhieri, Torino.

Napolitani F. (1980) “Training in Gruppo Analisi. Un metodo propedeutico: «Equipe clinico-didattica» e «Teoresi gruppo-gestita», in AA.VV. (1980), “Il Gruppo e la Psicoanalisi”, Quadrangolo, n. 12/14, pp.74-86.

Ondarza L. J. (1999), “Le Psicoterapie di gruppo”, in Trattato Italiano di Psichiatria. Cap. 111, 2° ed., Masson, Milano.

Pisani R. A. (2000), Elementi di Gruppoanalisi. Il piccolo gruppo ed intermedio, Edizioni Universitarie Romane, Roma.

Von Platen Ricciardi A. (1996), “The setting of the Large Analytic Group”, Group Analysis. Vol. 29, pp. 485-489.

Von Platen Ricciardi A. (2003), Gruppoanalisi e gruppo analitico allargato nel lavoro e nelle istituzioni, in Ancona L., Giordano M., Guerra, Patella A., Von Platen, Antipigmalione. Gruppoanalisi e rivoluzione nei processi formativi, Franco Angeli, Milano.

Usandivaraas R. J. (1986), “Foulkes’ Primordial Level in Clinical Practice”, Group Analysis, Vol. 19, pp. 113-24.

NOTES

[1] Psychologist, Psychotherapist, Group Analyst, Convener of Large Group, Full Member and Scientific Referent of IL CERCHIO – Italian Association of Group Analysis, Full Member GASI (Group Analytic Society International), Professor of training in Rome and Member of COIRAG (Confederation of Italian Organizations for Analytical Research on Groups).

[2] Psychologist, Psychoanalytic Psychotherapist, Group Analyst. Convener of Large Group and Balint Group. Member Management Committee  of IL CERCHIO and COIRAG, Full Member GASI.

[3] Psychologist, Psychoanalytic Psychotherapist with a group analytic training.

[4] Psychologist, Individual and Group Psychoanalytic Psychotherapist, Candidate Member of COIRAG.

[5] The COIRAG, to date, is made up of the following associations: ACANTO, APG, APRAGI-Group Analysis, APRAGIP- Psychodrama, ARIELE, ASVEGRA, IL CIRCHIO, LdG, SIPSA

Simona Negro
dr.ssanegro@gmail.com

Simone Schirinzi
sim.sch@virgilio.it

Marlene Giulia Antonazzo
marleneantonazzo@gmail.com

Alfonso D’Auria
alfonsodauria@gmail.com