The Paradox in the History of Group Analysis in Greece: Challenging and Open-Ended
The history of Group Analysis (GA) “still remains to be written”, as Campos-Avillar (1981:177) points out and its writing will be helpful in the exploration of organizational conflicts, in dealing with the problem of theoretical diversity and addressing dilemmas that have troubled GA since its inception, affecting the field and the future of GA as a profession. Therefore, the Contexts initiative to collect the histories of the Institutes, is of the utmost significance.
Our present paper is undertaking an account of the events that contributed to our trajectory until the establishment of the Institute of Group Analysis ‘S.H. Foulkes’ (IOAF), viewing it as a product of historical development, unavoidably linked to the multiple splits that have defined the history of Greek GA, ascribing meaning to the past, as well as exploring expectations and fears for the future.
GA perceived its organization as an International Association, that would safeguard theoretical principles and the clinical practice of Group Analysts, with a conflictual spirit. In our view, the absence of such an international body is the first of the issues that determined GA’s evolution, even though it may have contributed to the avoidance of manifest splits. A further critical consideration in GA’s evolution was its relationship with psychoanalysis, which has been controversial from the outset.
Within the context of a wave of expanding networks of Group Analysis, the “Open Psychotherapeutic Centre” (OPC, 1980) and the first “Institute of Group Analysis, Athens” (ΙGΑΑ, 1982) were established by I.K. Tsegos. At that time, in Greece there was an academic deficit as regards psychotherapy training, and no particular interest in GA in Psychiatric Hospitals or Universities. Although “AKMA” (Systemic Psychotherapy of Groups and Family), was already established by the Vassileiou couple in 1963, during the years 1982-1984 a number of group psychotherapy training organizations were established: The “Laboratory for the Study of Human Relations” by C. Katakis (systemic approach), the “Hellenic Institute for Group Analytic & Family Therapy” by M. Josafat (based on GA and psychoanalytical psychotherapy), with the concurrent emergence of groups treating addiction in a therapeutic communities setting. Finally, the Hellenic Psychoanalytic Association was formed in 1984, as a constituent organization of the International Psychoanalytical Association.
Our account, as participant observers, in the events recounted below, is subjective and it is up to anyone to supplement it.
The IGAA, in which we trained, is a Group Analytic Institute, inalienably bound to the OPC, and deeply influenced by the principles and methodology of Therapeutic Communities (Tsegos, 1995), Social Psychiatry, and Anti-Psychiatry, and inhospitable to Psychoanalysis. Although its president had rightly mentioned that: “the basic thinking in most of the group-analytic training institutions is still debatable”, at the same time, unfortunately, he remained biased whether “this ‘basic thinking’ should be a group-analytic or a psychoanalytic” (Tsegos,1995: 321). By ignoring that psychoanalytic thought informs GA, the two are presented according to his ‘approach’ as foreign bodies. As a solution to this polarization, he proposed, that: “this…’approach’ of an institution can be completely different from the one promoted and included in the theoretical syllabus” (op). As if there can ever be a theory of human psychology disconnected from a continuous dialectical relationship with clinical practice or as if aspects of institutional life, organization and function can be unaffected by theory.
This separation of IGAA from psychoanalytic thinking and its ongoing evolution, but even more its solipsistic isolation from the more general theoretical concerns of the GA community and the plurality of ideas on how to incorporate and use psychoanalytic theory in GA, shaped the manner in which it was implemented. In our opinion, this is not only less congruent with Foulkes’ tradition, but has also led to a certain scientific sterility, ultimately impelling the training program to a certain version of a “technical school and a religious retreat” (Kernberg, 1986). This coupled with the implicit obligation of participating in the OPC (Tsegos, 1995: 316-317) in order to graduate, pervaded trainees’ institutional life. Although we are grateful for the experience, we were offered through our extensive participation in the socio-therapeutic groups of the OPC, concurrently we cannot help but wonder about: “How large should the experiential portion be, in relationship to the cognitive aspects of training?” Since, “any imbalance… is likely to produce therapists with serious deficits, either in their theoretical comprehension or in their ability… to understand the impact of group dynamics (Salvendy, 1985:133-134).
Furthermore, the trainees’ psychotherapy was of a reporting type, a type criticized for lack of privacy, with contamination and dependency issues, “characterized by the public bond of loyalty to the Institution, which endorses and sustains it” (Meyer 2003:1247), and resulting in indoctrination rather than identification (Thomä, 1993:37). Additionally, the minimum appropriate abstinence of the Training Group Analysts was compromised due to lengthy daily coexistence with their patients-trainees within the therapeutic community (TC) – “a regular horizontal relationship” as Tsegos puts it – resulting in a psychotherapy with a reduced capacity to contain the tensions generated in the institutional life. As Campos (1981) states in his ‘Writings on Teaching and Training’, transference with teachers and conductors can be “very dangerous because GA that way may easily be converted into group brain-washing and … the group be exploited at the service of its leader or of an ideology” (p.180).
Both the OPC and ΙGΑΑ’s group analytic trainees were in a plethora of sensitivity groups (medium or large), which functioned as amplifiers for “externalization of internal conflicts” (Hinshelwood, 2010:204). Having limited capacity for elaboration, they ended up becoming mostly mediums for conformity, voyeurism and intimidation of their student members, and ultimately for institutionalization. Besides, abstinence was seen as a “sanitary distance” “(or ‘who is afraid of students and patients?’)”, as Tsegos puts it, rather scornfully. (Tsegos, 1995:320).
In tandem, from the start, at this Institute, there was a tendency for frequent penalties in the form of pecuniary fines – ‘Epitimia’ (Επιτίμια)[1] – that were imposed on both trainees and members, mainly for mistakes or insubordination. Repeating academic years during the training, was likewise imposed, not so much for insufficient responsiveness to the prerequisites of the training, but chiefly for allegedly expressing meagre loyalty to the prevailing ideology.
From an institutional perspective it is also significant that the ΙGΑΑ’s president did not opt to turn the leadership over to other members, and the matter remained beyond the ambit of any process of elaboration. We think that such practices created for the trainees a basic assumption dependency group, where, as Eisold (2017) notes, “…members on occasion argue or dispute, but it does seem as if they have lost the capacity to clarify things for themselves” (p.23).
SCHISMS
The definition of a schism is a split of a group into different sections, as a result of differences in beliefs (Oxford Dictionary of Languages). The psychoanalytic movement, for instance, since its inception has been plagued by conflicts and has given rise not only to numerous splinter movements but also to adversarial sub-groups and internal divisions within its larger institutions. As GA has yet to produce a record of its global history, its schisms have not been recorded either: perhaps the absence of an institutional umbrella keeps them hidden.
In Greece, the IGAA, through splits, engendered at least 4 other Institutes, still in operation. Six years after its establishment, 8 people in their majority near graduation, departed from IGAA successively, over a short period. The reasons for these exits were varied, for instance, comments, instructions, or critique advanced by the Training Committee on personal issues, lying outside the boundaries of their group analytic treatment.
This initial split gave rise to intense conflicts made public knowledge in the daily press of the time (PROTI Newspaper 14/3/1989, and reply 20/3/1989), as well as extensive correspondence with GAS (from 2/1989 to 5/1989) as the IGAA president asked that they be expunged. The unanimous, final ruling of the GAS membership committee did not find “evidence to warrant the Committee’s withdrawal of (their) full membership from GAS” (Private correspondence with GAS membership committee, 10/5/89 handed to the authors by A. Tsoukali, 6/5/2022, and most definitely part of the GAS archives).
Soon after, those colleagues established a new Institute, the Hellenic Association of Group Analytic Psychotherapy (HAGAP), which eventually was also split in 1991, when 3 of the 6 founding members departed, citing abuse of authority, this time amongst themselves (A. Tsoukali 2022, personal communication, 10/5/22). As known among colleagues, matters regarding their split were taken to court. Several years later the initial form of this Association split again, forming yet another new Institute in Athens, HOPEinGA (2005).
During that initial IGAA split most of us, current IOAF members, were at the start of our training. It was obvious that rather than theoretical, the causes for it were differences in beliefs about governance, effectively power struggles instigated by an already ensconced authoritarian management. Such struggles over power and authority never came under the scrutiny of institutional processing but resulted instead in the scapegoating of departing colleagues. Due to the lack of transparency prevalent at the IGAA, we remained unaware of the impact of this split on IGAA’s founding members. Ultimately the lack of common professional interests, necessary for an organization to evolve and prosper, perhaps rendered the venture susceptible to schisms, in the form of insurrections.
Overall, as will be seen in due course, the absence of elaboration and processing of this first split led to the creation of a constellation of un-metabolized affects. What emerged as defence, among us young trainees, from the opprobrium levelled at those who had split away, was identification with the aggressor i.e., the institutional authority.
Thus, the ensuing trainee generations of IGAA (1989-1999) remained, in our opinion, locked in an effort to be ‘model students’, to blend into the surrounding institutional environment, into “the very thing that threatens” (Frankel, 2002: 101). In their need for belonging, they invested an extensive portion of their personal life, contributing on the one hand to the creative development of the Institute, while on the other striving to complete their training expeditiously, without being singled out for impetuosity or misbehavior.
Then, ten years later (1999) our own (the authors’ and another 12 colleagues’) split occurred. In retrospect, considering the prevailing circumstances of that decade, our sense of being victims fleeing an authoritarian power seeking to subjugate us seems inevitable. Instead of a single, major trauma, our departure from IGAA, was the result of cumulative traumatizing experiences. Since the process of deepening investigation, which always necessarily questions what is sanctioned and established by an organisation, was compromised, we had to deal with several partial traumas forming a group of aggravating causes, arising from the organizational structure we had to deal with, in order to qualify as Group Analysts. In agreement with Eisold (2018: 34), “that each schism is a response to a particular conflict at a particular moment in history; a vital interest is always at stake”. Our schism marked the end of the legitimation we had abundantly offered to the organization’s authority until then, culminating in a full-blown legitimation crisis and leading to the departure of the majority of the training community (12 seniors and graduates). Eventually, once again court procedures were involved between the Institute and some departing colleagues.
The ELINODE project
We formed a new Institute two years after leaving, impelled by our desire to belong to a professional group, to counterbalance our loss and rage, and find new ways of thinking and coexisting. It was soon apparent that this move could be based neither on new theoretical elaborations, nor on any evolved manner of institutional coexistence: it was a form of acting out, which was quickly terminated by consensus, before there was any time or space to address unconscious processes within the group.
Our endeavor ‘to metabolize’ the aforementioned, to counteract the shortcomings in our theoretical adequacy and process our abundant clinical work lasted more than 15 years. During that time, we tried to record the serious differences with the initial Institute (political on governance and others) expressed subliminally through the splits. Individual and group supervisions, individual analyses and psychotherapies and the undertaking of new trainings, mostly psychoanalytic, were required. In the course of this trajectory, we were able to attend to our history, despite the perennial realization that history is always encountered from a specific standpoint and for a specific reason. In any case, when a history becomes intelligible, and the object of a narrative, there is also the creation and preservation of some scope for internal and external dialogue, which mobilizes creativity and reinstates cooperation and communication.
Establishment of the Institute of Group Analysis “S.H.Foulkes” (IOAF)
Two new attempts to broaden our network of collaborations followed in 2015-16, both failed because we were confronted by various antinomian issues such as treatment in a trainees-only analytical group, psychoanalysis in the group, depreciation of psychoanalytic thought in training or, conversely, individual psychoanalysis as prerequisite for membership in a Group Psychotherapy Training Institute. Such group analytic therapy and training models, existing in Greece until now, made us realize that Foulkes’s thinking was not satisfactorily represented in Greece. Thus, having a vision for GA and for our role therein, we resolved to establish IOAF.
We seek to achieve a comprehensive and integrated outlook for GA, as we understand it, addressing the “riddle” that, according to Pines, had already been solved: “Foulkes was being seen as someone who had solved the Riddle, faced the problem of putting things together creatively: Foulkes had integrated groups with psychoanalysis. But, with his death and with the emergence of all sorts of other questions to be answered and integrated, we were again faced with the Riddle” (Jacobs, 1977: 139).
Having authored an article on IOAF’s precepts already in 2018, (with our first trainees having completed their training, and already conducting their own analytic groups, in tandem with our endeavour to effectively integrate them into the Institute), this note gives us an opportunity to evaluate what’s been done, with an awareness of the strength and the fragility of our creation. Considering institutional life as being of the utmost importance and given the enduring influence of the Institute where we trained and of the Societies, we are members of, we sought to avoid reprising many aspects of our aforementioned training experience, and to address its deficiencies that caused difficulties in our professional life. We also sought to avoid the kind of narcissistic investment, which, per Schwartz (1990), “instead of strengthening the organization can lead to its decay. Since… “the public face that meets the world, often hides considerable pathology at the core of the organization…” (as cited in Nitsun,1998:256-257).
Through confrontations among our members, we struggled, rather unconsciously, to avoid “rigidified, ritualized forms of speech and blocked communication” (Nitzgen,1999:235) on all matters critical to IOAF’s operation, and particularly the Rules of Procedure regarding training. The 4-year professional consultancy of our organization, with a Training Group Analyst of IGA London, helped us in this effort. In contrast to submission, acknowledging and accepting an unavoidable contentiousness betokens a relative healthiness both for individuals and groups: “a sort of polyphonic chorus”, as Zagerman (2017: xix) notes, “with remarkable differences and, sometimes, contrasts”.
Our effort was to evolve “to embrace the depressive position and leave paranoid-schizoid thinking behind”, comprehending, as Jurist (2017: 89) does, the depressive position concept as “strong pluralism” meaning “…to remain engaged with others”, “…to listen and to re-evaluate… beyond passive acceptance of diversity, even though resolution is not assured”. Without forgetting, nonetheless, what Eisold notes about Psychoanalysis: “pluralism as an expedient solution to internal conflicts contains the danger that it perpetuates an image … as inconsistent and irresolute” (Eisold, 2018:187-188).
What then does a work group signify (2)? How is coexistence achieved, whereby mutual dependency but also the limits of diverse approaches, within the same organization are acknowledged? To begin with, by discerning the substantial impact of the unconscious at work in our group and institutional relations. Then we also need to consider the ideological construct. Each intellectual discipline is shaped by an organizational structure, in which “ideas emerge and grow that may be accepted or dismissed” (Greenberg, 2018: ix). Organizations must be able to build and exert the authority required for their work. Therefore, IOAF is established as an Association, the most democratic form of organization in Greece.
The IOAF is governed by a five-member Board of Directors, elected every 3 years. Training is coordinated by a Training Committee, elected also every 3 years. It organizes the training process, per the tripartite model (Eitingon’s), always in accordance with the training community’s needs, and EGATIN’s specifications. The Rules of Procedure, as unanimously accepted, determine training and its structure. The alternation of our members in both the Board of Directors and the Training Committee makes it possible for all to assume positions of authority should they wish to do so, and to devise the manner they will exert it, in the context of the IOAF’s Articles of Association.
Trainees’ group-analytic therapy (twice weekly, in a slow-open ordinary patient therapeutic group, for the duration of the training, at least) is non-reporting. We try for attainable abstinence in the training process. Though we do not forget that albeit it is the explicit goal of analysis, individual and/or group, to resolve the transference, at the same time we understand what Nitzgen notes, that: “all analytic training institutions are inevitably bound to maintain it as the libidinal motor force of the training process” (1999: 236-237).
CONCLUSION
We wish to continue evolving GA as a comprehensive theory of human development and human relationships, seeking to strike at IOAF a balance between subjective aims and expectations, objective development needs and the restrictions necessary for any organization to thrive. In parallel we strive for a continuous re-evaluation, aspiring to a renewal of theoretical and clinical doctrine.
We believe that an institutional umbrella, Bacha also calls it a Group Analytic Federation (2015: 377), could help group analytic Identity to evolve, despite any conflicts or contradictions. Heretofore, regrettably, neither EGATIN nor GASI have helped in this direction, leading to questions such as “How Many Group Analyses are there…”
All divisions of the Group Analytic community in Greece, initiated from the first split in IGAA, have separated colleagues, and led to the loss of the means for dialogue, restricting its presence only in a typical monthly meeting via delegates at EGATIN.
It would be important for the history and the evolution of GA in Greece if other participant observers of the aforementioned events, and their aftermath, would complement this narrative. Furthermore, as we first proposed in our article in 2018, a meeting of all group analytic and group psychotherapy Institutes would be vital for illuminating all our trajectories until today.
Bibliography
Bacha, C. (2015). Commentary on Group Analytic Training in the Social Context: Who is influencing Who? Group Analysis; Vol. 48(4): pp.568-572
Campos-Avillar, J. and Campos, H. (1981). Milestones in the History of Group Analysis: The European Group Analytic Movement and the Question of Internationality of Group Analysis. GA XIV/1
Campos-Avillar, J. (1981). From the Politics of Teaching to the Pragmatics of Learning: Group Analysis’ Greatest Hope in Training, in Campos, J.C. Milestones in the History of Group Analysis: The European Group Analytic Movement and the Question of Internationality of Group Analysis, Appendix III GA XIV/1 pp. 172-190
EGATIN Constitution, https://www.egatin.net/about/about-egatin
Eisold, K. (2018). The Organizational Life of Psychoanalysis. Conflicts, Dilemmas, and the Future of the Profession. London and New York: Routledge
Frankel, J. (2002). Exploring Ferenczi’s Concept of Identification with the Aggressor. Psychoanal. Dial., 12(1):101-139
Greenberg, J. (2018). Forward in Eisold, K. 2018. The Organizational Life of Psychoanalysis. Routledge
Hinshelwood R.D. (2010). Organizational schism: Looking After a Psychiatric Service. Psychoanalytic Psychotherapy; Vol. 24, No. 3, September 2010, 202–212
Jacobs, I. S. (1977). Potentials for Learning and Change, Fourth London Workshop in Group Analysis: 3rd – 7th January 1977. Group Analysis; Vol 10(2), pp.136–150
Jurist, E. (2017). Psychoanalysis Unbound Dans Research in Psychoanalysis 2017/2 (N° 24), pp. 85-97
Kernberg, O. (2014). The Twilight of Training Analysis System. Psychoanalytic Review: 101(2),
Meyer, L. (2003). Subservient Analysis. International Journal of Psychoanalysis 84:1241-1262
Mylona, D. Lamnidis, N. and Moraitou, S.M. (2018). On the genealogy of group analysis: Our version of the Greek context. Group Analysis; Vol. 52(1): 51–64
Nitsun, M. (1998). The Organizational Mirror: A Group Analytic Approach to Organizational Consultancy, Part 1-Theory. Group Analysis; 31 pp. 245-267
Nitzgen, D. (1999). From Demand to Desire: What do we offer when we offer Group Analytic Training? Group Analysis; Vol 32pp.236-237
Oxford Dictionary of Languages: https://www.google.com/search?q=schism+meaning&rlz=1C1EKKP_enGR781GR781&oq=schism+&aqs=chrome.3.69i57j0i512j46i512j0i512l2j69i60l3.10860j0j7&sourceid=chrome&ie=UTF-8
Salvendy, J.T. (1985). Training, Leadership and Group Composition: A Review of the Crucial Variables. Group Analysis; XVIII/2: pp. 132-141
Staats, H. (2018). One Group Analysis and Many. Response to Farhad Dalal’s ‘One group analysis or many?’ Group Analysis; Vol.51(3) pp.334-342
Tsegos, I. (1995). Further Thoughts on Group-analytic Training. Group Analysis; 28(3): 313-26.
Tsegos, I.K. (1996a). Fifty Years of an Amateur Enthusiasm. On the Avoidance of Training and of Professional Identity in Therapeutic Communities. International Journal of Therapeutic Communities; Vol. 17(3) pp.159-165
Zagerman, P. ed. (2017). The Future of Psychoanalysis. The Debate about the Training Analyst System. London: Karnac
(1) Inspired by the ‘Epitimio’ (Επιτίμιο) in the Orthodox Church. Meaning the act to be performed by the confessing believer, as a healing exercise againstsinful desire and as proof of his true A therapeutic and pedagogical expedient, which helps in the spiritual recovery of the believer.
(2) The Work Group defines its task, acknowledges its purpose, and promotes its members’ cooperation; it is oriented toward external reality
Dominique Mylona, psychiatrist, group analyst-GASI, psychoanalyst-Hellenic Psychoanalytical Society, IPA. Founder member of the Institute of Group Analysis ‘S.H. Foulkes’, member of the Training Committee.
Sophia-Maria Moraitou, MSc, sociologist, group analyst-GASI, associate member of the Institute of Group Analysis, London. Founder member of the Institute of Group Analysis ‘S.H. Foulkes’, Chair of the Training Committee, and delegate to EGATIN.