Unexpected Objects in the Group: The Foulksian Group-Analytic Boundary

David Vincent

This chapter considers a problem for group psychotherapists: where does the group begin and end? What is inside the group, and what is outside? What is it that separates inside and outside and keeps them apart, as you cannot see or touch the boundary? There are various ways of thinking about this: is it a membrane, as in a cell, or is it a skin, like a body? Is it a fence, a border or a boundary? Or is it simply a conscious understanding between the members of the group, as in a gang or a club? All humans have a natural tendency to join together in small groups and to immediately have a sense of the group as a whole and its difference and separation from, and possibly rivalry with, other groups. In other words, the group immediately knows its boundary. This applies to all human groups, and to all psychotherapy groups.

This chapter is about three ‘boundary incidents’, unexpected intrusions into the group by animals: a hornet, some baby budgies and a companion dog. In each case, the intrusion became both a kind of‘enactment’ and an experience of triangulation, a kind of thirdness, and resulted in emotional, relational progress in the group, a growth in understanding both for the individual patients and for the group as a whole. There are very few references to group psychotherapy in relational theory compared to the richness of individual relational theory, and yet what could be more relational than a group? The analyst or therapist in a group in fact has little choice. In front of them, relational dilemmas are continually enacted between and by the members of the group. I have argued elsewhere that triangulation (thirdness) is a building-block of the group, which continually develops from two-person to three-person relationships and back again (Vincent, 2016).

Group analysis

S. H. Foulkes, the founder of Group Analysis, was a psychiatrist and a psychoanalyst. He thought that the ‘free-floating conversation’ in the group was the exact equivalent of ‘free association’ in individual psychoanalysis. Freud’s ‘fundamental rule’ (Freud, 1912, p. 107) and the connected basis of technique, ‘evenly suspended at attention’ (Freud, 1912), therefore, for Foulkes, could also both apply in group analytic psychotherapy.

In psychodynamic, psychoanalytic or group-analytic group psychotherapy, the distinguishing feature of the work, compared to all other kinds of group therapy, is the emphasis on the unconscious. The aim and drive of the therapeutic work are to get to know and understand both individual and group unconscious wishes, thoughts and fantasies. As in individual psychoanalytic psychotherapy, the major part of this work lies in the consideration of childhood, sexuality, family relationships, dreams, fantasies and daydreams. These can then be brought into the present moment through the transference, both to the group psychotherapist and to the group. The work of the psychotherapist is to see and consider this in the light of their countertransference, their reverie and their analytic internal working model. In group psychotherapy, the psychotherapist is also pushed along by the continuous lively re-enactment in front of them, in the group, of family and other relationships. An individual patient talking about their jealousy, for example, of a sibling is painful to hear, but in group psychotherapy, this jealousy and the accompanying hatred and aggression are alive, at the moment, acted out in the room. Group psychotherapists will know that a new member of the group will always excite, for example, in the group the loving interest, envious curiosity and jealous hostility that meets a new baby in the family.

How does the psychotherapist enable this access to the unconscious life of the patient in the individual session or in the group? The first two factors are the psychotherapist’s curiosity and their internal working model and the third factor is the psychotherapist’s robustness. This is sorely tested in a group. It is difficult enough when an individual patient, for instance, strongly resists an interpretation, but if a whole group together, angrily or complacently, refuse to accept the view of the group psychotherapist, it can be hard to keep on track. Bion describes this feeling when he says that he felt that he had ‘committed blasphemy in a group of true believers’ and in the same paper, he advises the psychotherapist to ‘throw off the numbing feeling of reality’ (Bion, 1961, pp. 148-149). This is useful advice. It is precisely at those moments in the group when the group-as-a-whole confidently assert their view that they are right, that the psychotherapist must work hard to remember who and where they are. This is not a normal interaction, or ‘the real world’, and the group are fiercely resisting knowing something about themselves both as individuals and as a group, for fear of the anxiety that knowledge may provoke.

If the psychotherapist is curious, confident in their understanding of unconscious processes and robust enough, then what else is important? After these qualities of the psychotherapist, the next important matter is what is usually called the ‘setting’. In group psychotherapy, this includes the ‘boundary’. This, like the other necessary factors, facilitates, allows and encourages the expression and consideration of unconscious processes and the internal world of the patient. The most obvious factors of the setting are, as in all psychotherapy, neutrality, safety, quiet, confidentiality and regularity.

As far as possible, the setting is always the same. In group psychotherapy, this may be more difficult to achieve. Group members may be early or late, they may meet one another outside the group or on the way in and they may each, individually, have a reason for disrupting the group at some point, by being late, by rushing out in a rage, bringing in food or drink, picking a fight or arriving drunk or drugged. The group-as-a-whole can also disrupt the setting as part of a concerted campaign against the group psychotherapist by all arguing, for example, that it is perfectly normal to have biscuits and hot drinks in the group and offer to bring them in themselves next week. Part of their argument is often that this will help the work of the group, that it is normal, part of the ‘real world’, and that the group psychotherapist should therefore agree, and be grateful for their advice. At any point in the group, of course, if this argument seems to be convincing to the psychotherapist, then they must immediately call Bion to mind, and ‘throw off the numbing feeling of reality’ (1961).

The setting includes the physical arrangements in the group room. This can very concretely embody the boundary, frame and body of the group, as the couch over time, in individual psychotherapy, comes to represent the mother’s and analyst’s body. As in an individual consulting room, the walls of the group room provide protection from the outside world, both real and imagined. They embody confidentiality and safety over time, and the separateness and uniqueness of this group, compared to all the others. The door of the group room therefore becomes invested with unusual importance as the portal to the other or ‘real’ world outside the group.

An established group learns to mutually protect the whole group setting by arriving on time and not leaving until the end. Group members often describe their apprehension in approaching the group room door when late, dreading the way the group would all turn to look as they entered. For group members who are often late, this may be what they are unconsciously creating for themselves through their lateness. One patient, who was always late for the group, described how frightening this was when all the heads turned towards him as he came in, but it was at the same time a confirmation of his very depressed conviction that no one ever thought about him unless he was not there.

The group room also contains a circle of chairs, a small table in the middle and perhaps some pictures on the wall. Hopefully, there is a window or a skylight to remind the group that there is also a world outside. But, if over time, the room begins to become increasingly useful to the group as a vehicle for both individual and group-as-a-whole projections, then sometimes the outside world, even if only briefly glimpsed through a window, can be changed to suit the emotional life of the group or the individual at that moment.

One group took place in a room overlooking a small courtyard in a hospital. A member of the group noticed that two people were in the courtyard, talking to one another and apparently examining the plants in the flowerbed.

The group stopped talking and all turned to look out of the window at the unexpected visitors. The two visitors were oblivious to this interest and after a few moments walked away around the corner of the building. I assumed that they were two long-stay patients from the main hospital and I looked back at the group to find that their mood had changed. They began to talk to one another, in a thoughtful, reflective, musing way, on what had just happened and what they had seen. It gradually emerged that they had all seen different things: two men, two women, a couple, old and young people, patients, nurses and visitors. No one ever came to the courtyard again in the life of this group, but this odd exchange deepened the reflective capacity of this group so that they could better understand that what they saw was always partly what they wanted or needed to see, and that this could also apply to the group here in the room, as well as the world outside.

The exoskeleton

This is an example of what started as a rather ordinary intrusion into the on-going life of the group but which went on to have an important effect on one patient and the group’s relationship with him. This group session took place in a large room in the old hospital building during the summer. The room had large glass doors, which looked out on a wild garden, full of wildlife. Foxes would often run by the doors, and the garden was full of birds.

One morning a very large hornet appeared in the group. It flew noisily around the room as we talked. Each time that someone spoke, the hornet seemed to fly towards their face, as though attracted by the sound. Gradually the group gave up and sat in silence staring at the hornet. They were amused to watch it fly at my face each time when 1 tried to make a comment. 1 thought, rather anxiously that I should do something about the hornet’s intrusion, as it fell under what the group analysts call ‘dynamic administration’ (Foulkes, 1990, p. 173). 1 should not let the hornet spoil the group. The door of the room opened onto a busy corridor, and if I opened the door to shoo it out I would be compromising the boundary of the group, inviting the people in the corridor to look in and intrude. The windows were rusted and therefore kept shut. I decided that my only choice was to swat the hornet and take the consequences. I stood up and took up a newspaper that was lying on a chair. The group were silent and staring intently at me as 1 waited for the hornet to come in range, and then I swatted at it with the newspaper. Each time that I missed, the group stared at me more intently. Finally, I managed to knock the hornet down at the side of the room, where there was wooden flooring and no carpet. I saw that the hornet was still alive, struggling on the floor. 1 thought for a moment and then decided to step on it. Because of its size and the hollow wooden floor, there was a very loud crunching sound. An appalled silence followed, and no one moved. After a moment a patient said, very loudly: Aahh! The crunch of an exoskeleton!’

After a thoughtful pause, the group began to talk, rather to my surprise, as I was expecting the group to freeze and to cast me in the role of a cruel, murderous assassin, extinguishing individual life in pursuit of the perfection of the group, and I said this, only for it to be ignored. The group, as is often the case, were interested in their own work, and not in me. To them, 1 had just done my job as the group therapist and let them get on with it. The patient, Simon, who had made the remark about the exoskeleton was particularly lively and relaxed. He was an intelligent and complex man, in middle age, then about halfway through his four years in the group. He had a difficult early life. He was born just after the war, during which his parents had lost their first two young children, a baby and a toddler, when their house was bombed, and a wall fell over onto the children’s bedroom, killing them. As he grew up he was continually compared unfavourably to the dead children, particularly to the toddler, whose photographs were everywhere in the family home. This never abated, and he recalled to the group that when he was bullied at school, as at home by his mother, he could never fight back and always gave in, protected only by a persistent fantasy that Superman would fly down and rescue him. He had a successful professional life as a technician but was not able to sustain personal relationships, mainly because of his persistent feeling that he could never be as good as his dead brother.

Shortly before the hornet incident, Simon had told the group about a vividly remembered incident from his childhood. He was about seven years old and in the course of building work at home, a large pile of sand had been left in the garden. He took his sea-side bucket and spade, and his teddy-bear, out into the garden and started to play with the sand, burying the teddy and digging him up again. His mother saw him from the kitchen window and ran out into the garden, shouted angrily at Simon, and seized the bucket, spade and teddy bear and threw them into the coal-fire. The group were moved by this story and began to relate to Simon more closely. They understood that Simon was unconsciously repeating and repairing the traumatic loss of the two babies, crushed under the bombed wall, by burying and digging up the teddy bear in the pile of sand, and that this was unbearable for his mother. A few weeks later Simon started to talk for the first time about his father, now dead, who was distant, but caring, also traumatised by the early loss of the children, but not inclined to continually upbraid Simon. He had managed to hold onto one connection with his father, a single button from his Merchant Navy uniform, and as he talked, he brought it out of his pocket to show us. Again, the group were touched by his trust in them, and he by their interest in him. The hornet incident occurred soon after this, and it is clear that what he was telling us then, was that his own exoskeletal character-formation, his ‘character armour’ (Reich, 1945), was starting to break down and give way in the group, where he was seen, perhaps for the first time, just for himself. On his last day in the group he told us that he had recently appeared in the audience on a television programme about psychotherapy. When the group asked him if he wasn’t afraid to be recognised, he explained that he had deliberately worn a very brightly coloured shirt. He thought that the shirt might distract viewers from actually looking at him. The group were not convinced by this, it seemed to be a regression to his split view of himself, and they asked him then if he felt better for being in the group for four years. “Oh, yes,” he said “Very much better. 1 have really changed, but not in any of the ways that I thought I would change”.

This was important for the group to hear. A major part of being open to change in psychotherapy is being open to the thought that the original idea of change has itself to be changed. It may be a basic relational idea that the aim of therapy is continually intersubjectively renegotiated. This patient was finally able to do this and to let go of some of the phantasies of being able to put right the family trauma by splitting himself and pretending to be a character that he was not. The extent of the trauma gave rise to the extent of the character rigidity that was itself deforming and counter-productive. His movement through this process was helped in the middle stages of his group therapy by the incident with the hornet, in which he was able to say out loud and thereby confirm that he was beginning to relinquish his own exoskeleton, and that it sounded good (the “crunch”). The hornet, in this sense, represented a kind of ‘thirdness’ in the group. This momentarily freed both Simon and the group, who could then hear it as a confirmation of their work together. The group also perhaps had its own exoskeleton, an unconsciously intersubjectively assumed kind of brittle relating, which they could relinquish. They could then forgive my cruelty to the hornet, or, in other words, the group.

Addiction to regret

This second example of a helpful breach of the boundary also concerns a difficult, complex patient in a long-term group. The patient was an eccentric clever woman in the middle age. She was the only child of elderly socially awkward parents, now both dead. The patient, Jennifer, lived on her own and had never had a relationship. She had been referred to with long-term depression and social inhibition and was very apprehensive about joining a group. At first, she was stiff and uncommunicative, and only occasionally whispered a few words. Fortunately, most of the other group members were, in various ways, as troubled as her, and they were pleasant to her, and encouraging when she did speak, but really they just got on with their group, to which they were, at this time, very attached. Too much fuss, at the start of the group, would have undoubtedly put Jennifer off, and so for several months she just watched and listened and occasionally mumbled a comment. Somehow this was just what she needed, and she clearly felt gradually drawn into the unique and complex life of the group. She had a range of health problems for which she consulted with doctors, but didn’t receive diagnoses or treatment. She then began to speak about this, finding her first real spoken

The Foulksian group-analytic boundary 103 involvement in the group in a vigorously shared series of complaints about the inadequacy of medical services. Almost all of the other group members had health problems, usually a mixture of diagnosable illness, psychosomatic complaints and depression. This allowed the group to show a lively interest in her, to engage her and to recruit her to their stringent views about the inadequacy of doctors, and, of course, psychotherapists.

She began to emerge, and in one group spoke at some length about her leg. She often looked uncomfortable and seemed to limp slightly. She explained that she had had a painful leg for a long time, after helping to push-start a car, which she could subsequently not fully bend for fear of pain, and for which she could get no help. Finally, a few years before joining the group, someone, perhaps a doctor, had advised her to have a very hot bath and to stretch out the leg in the bath. This had been a disastrous suggestion, and the leg had, by her account, painfully seized up for good. The group enjoyed this story and rallied around her. This had two consequences: the first was that she was finally able to ask us if she could put her leg up in the group on a stool, to which we agreed, and second, that it revealed an important part of her psychological life, with which the group identified, and which become a part of this group’s unique language, that we called ‘addiction to regret’. In this first account of her leg, she bitterly complained: ‘If only I had not straightened my leg...’ and this frequent repetition of‘if only I had not done this or that...’ became a theme for her and the group, a kind of repetitive magical defence against the demands of reality.

Asking for the stool on which to put her leg, so that it could become obviously present in every group, was very important, as it allowed her to make a claim for attention which she was as yet unable to do by talking. None of the stools in the clinic seemed adequate to the task, so the next week she brought a square plastic bucket from home, which, inverted in front of her chair, was perfect. This then gave rise to the next problem: where could she keep the bucket as it was too awkward for her to take it home every week on the bus? I suggested that she consult the clinic domestic, a kind and thoughtful woman, who subsequently found Jennifer an empty cupboard off the waiting room, which was perfect. The group were pleased, something important had happened, a complex anxiety had been concretely contained (the bucket in the cupboard), Jennifer felt she had a place in the clinic, and we could move on.

Gradually, the group began to sense that there was an undescribed difficulty in Jennifer’s early life, concerned with her father and that this connected with her leg, as it was her father’s car that she had tried to push. The group began to see how angry she was and how difficult it was for her to show it. A new patient then joined the group, a very loud, choleric man with a severe obsessional neurosis. By this time, we knew a little more about Jennifer, and she was, in turn, very involved in the lives of the other members of the group. Outside of the group animals were more available to her affectionate interest. She first told us about her love for foxes, and how she leftfood out for them in the neighbourhood and worried about their illnesses. She also revealed to us that she was extremely interested in budgerigars and had been for some years trying to breed a perfectly blue budgie. The group enjoyed this, it seemed hopeful, generative and reparative. Having talked for a couple of sessions about a new clutch, about which she was very optimistic, one day, very excited, she brought the baby budgies to the group in a little cage to show us. We admired them and she put the cage on a chair at the side of the room. The group started and very quickly our new member, the obsessional man, fell into a rage about something that he was telling us and started shouting loudly. The budgies woke up, alarmed, and squawked. Jennifer, enraged on behalf of her budgies, sat up, pointed at the obsessional man and, at the top of her voice, shouted: ‘Now look what you’ve done!’ Silence fell, the obsessional man looked abashed, and the group stared in admiration at Jennifer.

After this incident, in which Jennifer contacted her rage for the first time in the group, enabled by the thirdness of the budgies, our relationship with her changed. She began to seem generally more real and more reachable. We never really understood her leg and what it symbolised, but the group now allowed this to be explored a little. Previously, if 1 had attempted to look for the unconscious meaning of the stiff leg, for example by trying to link the leg with a fantasy about her father’s penis, then the group would vigorously interrupt: ‘there you go again...where did you get that idea from...you are spoiling the mood’. The group would together protect Jennifer, whom they saw as fragile, by keeping me in check. It is always interesting when this happens in a long-term group as the group may see something about a group member that the group analyst has missed. After this boundary incident, the group seemed to feel that it was no longer necessary to protect Jennifer so much after they had seen her in a rage, and they therefore were less inclined to obstruct me on her behalf. With further assistance from both Jennifer and the irritable obsessional man, the group moved on.

The helpful dog

In a different group was a woman patient, Mary, disabled by childhood polio. She came to the group in a motorised wheelchair with a companion dog. The dog was mature, serious and self-composed. His job was to be a useful companion, to open doors and pick up objects, and generally to keep an eye on his owner. This group contained troubled, vulnerable people, and they were, as a consequence, conservative in their group behaviour, sitting, for example, in the same chairs each week. One man, Len, always sat in the corner of the room. He was rather paranoid in character and employed both reticence and elaborate intellectual defences to keep the group at a distance. He in particular said very little about his immediate family. The group did know that a few months before this group his mother had been unwell.

At the start of each group, the dog would walk slowly around the room glancing at each group member in turn. He would then lie down next to Mary’s wheelchair for the duration of the group, only glancing up at her every now and again to check on her. If she became distressed then he would sit up and stare at her very intently until she recovered, and then he would lay down again. On this occasion when the group were assembled, he did his normal slow circular inspection. When he had gone around he turned back, and, instead of joining his owner, he went and lay down next to Len’s chair, and then did not move. The group fell silent and stared at the dog and at Len. After a few moments, the group began to talk and wondered what this meant. Len was anxious and disconcerted. The group pressed him to say what was happening, and after some pressure, finally, reluctantly and awkwardly, he told us that his mother had just died. He was not going to speak of it, he said, his feelings were too strong, but the dog lying down next to him had been a shock. The group became moved by Len’s plight, his inability to show feelings and his successful suppression of this sudden grief, which the group and I had missed completely. Only the dog knew that something was wrong and offered his close attention to Len. This was the only occasion, in two years of attendance, that the dog sat anywhere but next to his owner. The group were profoundly moved by the dog’s sensitivity to Len’s suffering. It showed them what can be hidden from and missed by the group. The group perhaps learned more from this than Len, who was still mostly hidden. He became a little more communicative, although rarely spontaneous. The group, however, began to be more sensitive both to the mood in the room and to the unspoken feelings.

The boundary of the group: conclusions

These three very ordinary incidents, when ‘unexpected objects’ appeared in long-term psychotherapy groups, show the importance of the group’s boundary. In these examples, the breach of the boundary was by an insect, some birds and a dog. These three creatures kept it simple. If it is true that ‘the group - and not the group therapist - is the agent of personal change’ (Ormont, 2001, p. 38), then the establishment and protection of the boundary and the understanding of the unexpected intrusions are of central importance. The world of a small group is overwhelmingly a relational world; it contains and displays at the same time the internal social worlds of each individual member of the group, the continuous life of the social world outside and around the group, and lived in the moment in the group, the recreated, re-experienced interpersonal life of the past.

The significance of the boundary for situations such as these is marked by the use of the term ‘boundary incident’ by group analysts to describe the breach of a boundary. In the three incidents described here, the fact of a very small and harmless breach, by an alive but non-human object, confirmed for both the group-as-a-whole and the individuals involved, including the psychotherapist, both the strength and the importance of the boundary, and had a marked effect on the subsequent feeling-life of the group.

References

Bion, W.R. (1961) Experiences in Groups. London: Tavistock.

Foulkes, E. (ed.) (1990) Selected Papers of S.H. Foulkes: Psychoanalysis and Group Analysis. London: Karnac.

Freud, S. (1912) in Complete Works. SE. Vol. 12. London: Vintage.

Ormont, L. (2001) The Technique of Group Treatment. Madison, WIS: Psychosocial Press.

Reich, W. (1945) Character Analysis. New York: Simon and Schuster.

Vincent, D. (2016) Couple and Family Dynamics and Triangular Space in Group Psychotherapy. In Novakovic, A. (ed.), Couple Dynamics. London: Karnac, pp. 125-143.

 
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