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The authors describe their experiences as members of an international online study group, initiated before the COVID-19 pandemic to read aloud and discuss Bion's (1965) Transformations. The three separately authored essays and commentary included here reflect the multifaceted phenomena in which images and voices in Zoom rectangles are transformed into shared emotional experience, the O of the group in Bion's language. These observations show how group members translate online experience into a felt sense of being with others, and suggest that oscillations in the sense of being inside or outside the group demonstrate the dialectical and constantly changing nature of the analytic field in an online group.
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Processos Grupais , Humanos , COVID-19/psicologia , Realidade VirtualRESUMO
Patients with borderline personality disorders (BPD) have great difficulties with interpersonal relations. Their extreme difficulties with interpersonal relations are illustrated in psychic family interaction. Parents become the recipients of conflicts and patient's aggressive behaviour, while family stress increases due to suicidal tendency, self-injuries and substance abuse. The current report presents the introduction of group psychotherapy for parents of young adult patients with BPD, treated in a special unit of personality disorders at Eginition Hospital. The aim is, through the parallel group therapy of patients and their parents, to establish the conditions of continuing therapy for the patients as well as maintaining therapy outcomes and to construct a facilitating environment where the family's mental pain, anxieties, anger, shame, guilt and sadness can be contained. Clinical material from the first sessions of a 13-member parent group is presented to illustrate the resistances, the primitive defenses and the basic assumptions of dependency and fight-flight developing in therapeutic work with parents. Furthermore, the groups' split and hostile transference communications and the therapists' countertransference reactions are discussed. Τhe containing function of the group is described as a therapeutic process of transformation of the primitive anxieties and projective identifications, which is gradually established through the therapists' elaboration of their countertransference reactions and their tolerance to hostility and confusion. Containment facilitates the establishment of a group culture of empathic understanding for parents' unconscious resistances, denial of the illness and negative projections onto their child and the therapists, so that resistances gradually to be curbed and archaic projections to be transformed. Hence, the group is expected to function as a safe space to allow the manifestation and relief of destruction anxieties, and the expression of unuttered and intolerable emotions. Finally, the group as a mother-object is expected to be internalised as a model of positive parental care, enhancing the empathic and reflective ability of the parents so that they may repeat the parental role in a process of reparation.
Assuntos
Transtorno da Personalidade Borderline , Psicoterapia de Grupo , Criança , Humanos , Transtorno da Personalidade Borderline/terapia , Transtorno da Personalidade Borderline/psicologia , Psicoterapia , Emoções , PaisRESUMO
Coronavirus disease 2019 (COVID-19) is currently ravaging health systems across the world. Psychiatric trainees are at risk of exposure to patients with COVID-19 given their clinical roles in emergency and inpatient psychiatric settings. This article represents a case study of group dynamics in which we reflect on our own experience as psychiatric residents at a Boston-area hospital system in the era of COVID-19 and apply Wilfred Bion's concepts of the "work group" and the "basic assumption group" processes of group operation. We assess dynamics between trainees and administrative leadership both at baseline and in the current pandemic. Since navigation through crises is more effective if group leadership recognizes and responds to basic assumption behaviors, we propose suggestions to enable health system administration to successfully lead health care organizations through periods of societal turmoil. We posit that these principles apply across settings, specialties, and provider types. In addition, we use our observations to indicate future directions for expanding Bion's theories in the contemporary context.
Assuntos
Infecções por Coronavirus , Internato e Residência , Liderança , Pandemias , Pneumonia Viral , Psiquiatria/educação , Betacoronavirus , COVID-19 , Processos Grupais , Humanos , SARS-CoV-2RESUMO
In this article, the author reviews the basic theoretical assumptions that underpin Faimberg's method of "listening to listening." It is emphasized that these assumptions cannot be altered without radically altering the method itself. A new and complex definition of "basic assumptions" that the author proposes helps us to understand how the logic of the method can "capture" the logic of the unconscious. One of the aims of the method is to hold a clinical discussion in a group in the frame of an "as yet situation," a basic assumption of the author (originally designed for the clinical situation) that concerns psychic temporality. It concerns the situation that has not happened yet, up to the moment we begin to discover, with surprise, the presenter's basic assumptions when working with his patient. Special attention is given to the impact of each participant's basic assumptions on how he engages in the discussion. This constitutes the main goal of the method. The method was originally devised to overcome the tendency to listen to clinical presentations on the basis of a privileged and unique theoretical perspective (whether or not recognized as such). The "listening to listening" function on which the method is based has its origin in a clinical concept proposed by the author. On the basis of "listening to listening," a particular kind of misunderstanding can be detected. If, instead of being regarded as an obstacle, the misunderstanding is analysed through the method in question, recognizing the misunderstanding may offer the best possible way of gaining access to the different basic assumptions in play. The co-creation of a common language is another one of the aims of the method - a language whereby it becomes possible to recognize differences, so that the recurrent temptation can be more easily overcome of creating a single way of working in psychoanalysis. It recognizes differences instead of idealizing "sameness." Recognition of otherness is the basic theoretical assumption most valued by the originator of the method, who is also the author of this article.
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Donald Trump's improbable political rise and unexpected capture of the US presidency during the 2016 presidential election is framed within Wilfred Bion's (1961) theory of groups. Bion's concepts of basic assumption phenomena, the group as a part-object mother's body, the function of specialized work groups, and the roles of introjective and projective identification are explored and elaborated upon in the context of the relation between Trump and his supporters and detractors. Basic assumption phenomena were activated in both groups as each defended against psychotic anxieties tied to work group activity and other threatening aspects of group experience. Trump-as-leader emerged through a neglect of projective identification due to both supporters' and detractors' regressive and dissociative tendencies as they relate predominantly to pairing group activity.
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Many aspects of the institutional life and organizational functioning of psychoanalysis deal with and are affected by evaluation. This paper focuses on one manifestation of this difficulty, namely the evaluation of candidates in psychoanalytic training. Opinions vary regarding its place, necessity, and contribution. Although it is at least nominally practiced in many institutes, it is nonetheless fraught with difficulty. We explore some of the sources and nature of what hampers the function of evaluation of candidates, employing Bion's Basic Assumptions and their effect on institutional dynamics. Related issues include the ambiguity surrounding the role and authority of the supervisory role and the present theoretical diversity. The role and function of the supervisor is central to this evaluation and focal in our discussion. Our presentation draws on and makes use of the findings of the EPF End of Training Evaluation Project (ETEP).
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Este texto, sob a forma de verbete, feito sob gentil solicitação dos editores deste periódico, enfoca agrupamentos de pessoas observadas segundo o vértice psicanalítico, que pode ser visto como integração transdisciplinar entre, pelo menos, dois âmbitos de observação. Para finalidades de comunicação, esses âmbitos são definíveis por "níveis" ou "dimensões": macro e micro. Mais especificamente, trata-se do estudo das experiências emocionais que podem ocorrer no inter-relacionamento de pessoas que compõem um determinado grupo e também, conjuntamente, das características conscientes e inconscientes que podem agir. O estudo ressalta alguns antecedentes históricos e consequências em termos de comportamento; tanto o comportamento concreto, aparente, expresso (fenomenologicamente observável), como o comportamento implícito, imaterial, sempre atuante (denominado por Bion como "ultra" e "infra" sensorial, que não pode ser totalmente apreendido pelo aparato sensorial humano). Este estudo sobre grupos de pessoas identifica duas fantasias inconscientes, de natureza onisciente e onipotente, que compartilham da mesma aparência - a de postulados autoritários. Essas fantasias, compondo ideologias (ou Weltanschauungen), postulam duas tendências no pensar, segundo um vértice da história das ideias (ou, mais precisamente, duas tendências em que ocorre ausência do pensar). Para fins didáticos e operacionais, denominaram-se essas tendências de "quantitativa" e "qualitativa"; a partir daí, sempre sob o vértice psicanalítico, descreve-se o conceito de grupos de trabalho, e especificam-se métodos de estudo para grupos de pessoas; o estudo se finaliza com um breve elenco de experiências práticas em clínica que embasam este texto...
Organized under the form of an entry of a dictionary, this paper was written in response to the kind invitation from the editors of this journal. It focuses on groupings of people, observed under the psychoanalytic vertex. This vertex can be seen as a transdisciplinary integration between, at least, two fields of observation. Roughly speaking, just for communicative purposes, one may define those fields according to their "levels" and/or "dimensions": macro and micro (levels). Being more specific, this is a study of emotional experiences, which may happen in certain human group, and of conscious and unconscious features that may act on interrelationships among individuals who are parts of a group. The study emphasizes some historical antecedents as well as some effects, in terms of group behavior - both the concrete, evident, express behavior (phenomenally observable), and the implicit, immaterial and ever present behavior (which Bion named "ultrasensuous" and "infrasensuous", and cannot be fully apprehended by human sense apparatus). This study about groups of people identifies two omnipotent and omniscient phantasies that share the same appearance - the appearance of an authoritarian postulate. Composing ideologies (or Weltanshauungen), those phantasies propose two tendencies of thinking, according to a vertex of the history of ideas (or, more precisely, two tendencies in which mindlessness - or lack of real thinking - does prevail). For didactic, operational purposes, the author names these tendencies "quantitative" and "qualitative". From this point, always under the psychoanalytic vertex, he describes the concept of working group and specifies few methods for the study of groups. The author finishes this study with a brief list of experiences in clinical practice (cases) that support his theory...
Este texto en forma de nota fue elaborado para atender una gentil invitación de los editores del Jornal de Psicoanálisis y versa sobre agrupamientos de personas observados desde el vértice psicoanalítico. Puede ser visto como una integración transdisciplinaria entre, por lo menos, dos ambientes de observación definibles como "niveles" o "dimensiones": macro y micro. Más específicamente, se trata de un estudio de las experiencias emocionales que pueden suceder y de las características conscientes e inconscientes que pueden actuar en la interrelación de personas que componen un determinado grupo. El estudio resalta algunos antecedentes históricos y consecuencias comportamentales, tanto el comportamiento concreto, aparente, manifiesto (fenomenológicamente observable) cuanto el comportamiento implícito, inmaterial, siempre actuante (denominado por Bion "ultra" e "infra" sensorial, que no puede ser totalmente aprehendido por el aparato sensitivo humano). Este estudio sobre Grupos de Personas identifica dos fantasías inconscientes de naturaleza omnisciente y omnipotente, que comparten la misma apariencia de postulados autoritarios. Estas fantasías componiendo ideologías determinan dos tendencias en el pensar, según un vértice de la historia de las ideas o, más precisamente, dos tendencias cuando ocurre la ausencia del pensar, que se denominaron, didáctica y operacionalmente, "cuantitativa" y "cualitativa". Luego, se describe el concepto de Grupo de Trabajo y se especifican los métodos para estudiar Grupos de Personas. Finalmente, es citada una serie de experiencias clínicas que le dan embasamiento a este texto...
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Humanos , Psicoterapia de GrupoRESUMO
Se presentan los hallazgos conceptuales de un trabajo de investigación-intervención psicoanalítico elaborado a partir del acercamiento psicoterapéutico a mujeres maltratadas cuyo material en sesión fue categorizado y analizado bajo el esquema de "revisión meditativa" de Bion. Los autores encuentran un estrechamiento psíquico como resultado de experiencias continuadas de violencia y maltrato, entendida esta como la reducción de la profundidad psíquica, hacia adentro y hacia afuera, producto de la primacía del ello y los objetos sobre el yo, de la carencia de mundo interno que lleva a acciones-reacciones motrices sin pensamiento (unidimensionalidad), del predominio de lo perceptual sensorial en la relación con el mundo externo (bidimensionalidad) y del uso alternante y permanente de supuestos básicos, todo lo cual conduce a una vida deshumanizada. Se recurre a desarrollos conceptuales que siguen la línea de Freud, Klein, Bion Meltzer y Green.
The authors present the findings of a research on psychoanalytical therapeutic interventions with Battered women, using the "Meditative Review" proposed by Bion, categorizing and analyzing the clinical material. Continuing experiences of abuse and violence produce narrowing and annihilation of psychic, is described, by the authors, as a reduction of psychic depth, inside and outside, produced by the primacy of the id and the objects on ego instance, the absence of the internal world leading to motor action-reactions, without thought (one-dimensionality), with sensory perception predominance (two-dimensionality) and alternating permanent use of Basic Assumptions leading to dehumanized life. The analytical conceptual framework used follows the Freud, Klein, Bion, Meltzer and Green research lines.
Assuntos
Maus-Tratos Conjugais , Violência contra a MulherRESUMO
In his seminal works on group dynamics Bion defined a specific therapeutic setting allowing psychoanalytic observations on group phenomena. In describing the setting he proposed that the group was where his voice arrived. This physical limit was later made operative by assuming that the natural dimension of a therapeutic group is around 12 people. Bion introduced a theory of the group aspects of the mind in which proto-mental individual states spontaneously evolve into shared psychological states that are characterized by a series of features: (1) they emerge as a consequence of the natural tendency of (both conscious and unconscious) emotions to combine into structured group patterns; (2) they have a certain degree of stability in time; (3) they tend to alternate so that the dissolution of one is rapidly followed by the emergence of another; (4) they can be described in qualitative terms according to the nature of the emotional mix that dominates the state, in structural terms by a kind of typical "leadership" pattern, and in "cognitive" terms by a set of implicit expectations that are helpful in explaining the group behavior (i.e., the group behaves "as if" it was assuming that). Here we adopt a formal approach derived from Socio-physics in order to explore some of the structural and dynamic properties of this small group dynamics. We will described data from an analytic DS model simulating small group interactions of agents endowed with a very simplified emotional and cognitive dynamic in order to assess the following main points: (1) are metastable collective states allowed to emerge in the model and if so, under which conditions in the parameter space? (2) can these states be differentiated in structural terms? (3) to what extent are the emergent dynamic features of the systems dependent of the system size? We will finally discuss possible future applications of the quantitative descriptions of the interaction structure in the small group clinical setting.
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Este artigo visa explorar os processos psíquicos no interior dos grupos de trabalho. Partindo das pesquisas pioneiras do psicanalista inglês Bion e do psicanalista argentino Pichon-Rivière, o autor mostra que as ansiedades subjacentes à realização da tarefa, descritas por esses autores, não têm necessariamente um caráter geral, na medida em que elas foram observadas principalmente em grupos de formação e de terapia. Daí vem sua proposição de fenômenos inconscientes complementares, desde que a tarefa apresente uma dimensão operatória e que o grupo de trabalho esteja inserido em um contexto organizacional. Na última parte, são detalhadas as capacidades psicológicas individuais requeridas pelo trabalho em grupo e as perspectivas, em termos de formação e de intervenção, que sua abordagem implica...
Cet article vise à explorer les processus psychiques au sein des groupes de travail. En partant des recherches pionnières du psychanalyste anglais Bion et du psychanalyste argentin Pichon-Rivière, l'auteur montre que les anxiétés sous-jacentes à la réalisation de la tâche décrites par ces auteurs n'ont pas nécessairement un caractère général dans la mesure où elles ont été observées principalement dans des groupes de formation et de thérapie. D'où sa proposition de phénomènes inconscients complémentaires dès lors que la tâche présente une dimension opératoire et que le groupe de travail est inséré dans un contexte organisationnel. Dans une dernière partie, l'auteur détaille les capacités psychologiques individuelles sollicitées par le travail en groupe et les perspectives, en termes de formation et d'intervention, que son approche implique...
This article aims at exploring psychic processes within work groups. Starting from the pioneering research of the British psychoanalyst Bion and the Argentinean one Pichon-Rivière, the author shows that the anxieties which exists below the surface of the task realization described by these two authors can't be generalized as they have been mainly within training and therapy groups. Therefore his proposal of other and complementary unconscious phenomena when the task is an operational one and when the work group is part of an organization. In a last chapter, the author describes the individual psychological skills necessary to be able to contribute effectively to a group work and the possible consequences in terms of training and intervention...
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Humanos , Ansiedade , Cognição , Psicoterapia de Grupo , TrabalhoRESUMO
Las autoras describen una interrupción en la comunicación en los análisis de dos pacientes, que va conduciendo a una detención en el proceso analítico. Se plantean algunas hipótesis con el propósito de entender esta situación. Una de las explicaciones es la mutua identificación de superyoes primitivos en la pareja analítica, lo que genera un efecto moralizador, impidiendo la investigación y el descubrimiento. Se enfatiza la importancia del compromiso contratransferencial que provoca en parte este tipo particular de impasse. Se sugiere, así mismo, la idea de una actuación compartida, en la que la analista participa en forma complementaria con el paciente. La pareja analítica sostiene así un baluarte que ampara o protege el riesgo de quiebre de la omnipotencia del paciente y de la analista. Ambos comparten una fantasía inconsciente que alimenta una colusión vinculada a una culpa persecutoria inconsciente. También se describe el movimiento de salida de este impasse. El enclave entre analista y paciente es detectado y posteriormente elaborado a partir de la colaboración del paciente con material onírico y del trabajo de la analista con su contrantrasferencia
The authors describe an interruption in communication in the analyses of two patients, which gradually brings the analytic process to a halt ⁄ standstill. They propose several hypotheses for understanding this situation. One explanation is mutual identification of primitive superegos in the analytic couple which generates a moralizing effect thereby hindering investigation and discovery. They emphasize the importance of countertransference involvement which partly provokes this particular type of impasse. They also suggest the idea of shared acting out, with complementary participations of analyst and patient. In this way the analytic couple supports a bastion which protects against the risk of breaking the omnipotence of patient and analyst or contributes to this omnipotence. Their shared unconscious phantasy feeds collusion linked to unconscious persecutory guilt. The authors also describe movements to break free from this impasse. The enclave created by the analytic couple is detected and subsequently worked through by way of the patients contribution of dream material and the analysts work with her countertransference
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Comunicação , Sonhos , Relações Médico-Paciente , Psicanálise , Contratransferência , Identificação Psicológica , Pacientes , Transtornos Somatoformes , SuperegoRESUMO
El presente artículo analiza las angustias generadas durante el reciente terremoto y maremoto ocurrido en Chile, e intenta dar luces respecto a los numerosos saqueos posteriores a éste, utilizando conceptos de Bion. Se postulan angustias intensas y precoces, descritas en relación a la pérdida del pecho continente, y el posterior ataque a éste. Se describe la fantasía de una escena primaria particular que se asocia con la violencia posterior, intentando considerar los eventos de la realidad externa en relación con la fantasía inconsciente. Se abordan aspectos individuales, de la psicología de grupos y sociológicos para intentar dar cuenta de un fenómeno complejo que requiere de una integración de miradas (incluyendo la mirada literaria)
This article examines the anxieties generated during the recent earthquake and tsunami happened in Chile, and attempts to shed light on the widespread looting after it, using concepts of Bion. Profound anxieties are postulated described in relation to the loss of breast continent, and subsequent attack on this. It described the phantasy of a particular primal scene that is associated with subsequent violence, trying to consider the events of external reality in relation to unconscious phantasy. It deals with individual aspects, group psychology and sociology to try to account for a complex phenomenon that requires an integration of perspectives (including literary look)
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Humanos , Masculino , Feminino , Terremotos , Desastres Naturais , Psicanálise , Fantasia , Comportamento de Massa , Estresse Psicológico , Roubo , ViolênciaRESUMO
Com frequência, o material clínico é escutado a partir de um único pressuposto básico. Em nossos grupos, procuramos não apenas escutar o apresentador e reconhecer os pressupostos básicos com que escuta seu paciente, mas também reconhecer os nossos pressupostos básicos, aqueles com os quais escutamos tal apresentação. Usamos a função de "escuta da escuta", originalmente proposta (Faimberg, 1981) para a escuta da sessão. Exploramos o impacto produzido pelos pressupostos básicos de cada participante (incluindo os do apresentador), sobre a discussão em si. Escutamos o hiato entre o que o participante acreditava dizer e como foi efetivamente escutado. Faz-se, assim, possível explorar fontes de mal-entendido, bem como pressupostos básicos de cada um de nós. Cocriar uma linguagem em comum aponta para o entendimento mútuo na discussão, respeitando a alteridade de cada um. O projeto não consiste, portanto, em propor que, como analistas, trabalhemos de maneira similar.
Con frecuencia el material clínico es escuchado desde un único supuesto básico. En nuestros grupos procuramos no solamente escuchar al presentador y reconocer los supuestos básicos con los que escucha a su paciente, sino también reconocer nuestros propios supuestos básicos con los que escuchamos la presentación. Usamos la función de 'la escucha de la escucha' que originalmente había propuesto (H, Faimberg 1981) para la escucha en la sesión. Exploramos el impacto que producen los supuestos básicos de cada participante (incluyendo los del presentador) sobre esta misma discusión. Escuchamos el hiato entre lo que el participante creía decir y cómo fue efectivamente escuchado. Resulta así posible explorar las fuentes de malentendido y explorar los supuestos básicos de cada uno de nosotros. Co-crear un lenguaje en común significa entendernos en la discusión, respetando a nuestra alteridad. El proyecto no consiste, en consecuencia, en proponer que, como analistas, trabajemos en forma similar.
Quite often clinical material is heard from one chosen implicit basic assumption. It is part of our goals to train ourselves in listening not only to recognise the presenter's clinical assumptions with which he listens to his patient, but to recognise our assumptions as well. We use the function of "listening to listening", which H. Faimberg (1981) had initially limited to the psychoanalytical listening in the session. We explore the impact that the theoretical assumptions of each participant (including the presenter) have on the discussion itself. From the gap existing between what the participant thought he was saying and how he was heard we begin to co-create a common language to understand each other in our otherness (and not as a project of working as analysts in a similar way). The sources of misunderstanding may appear and by doing so we begin to recognise the basic assumptions of each participant.
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Humanos , Psicanálise , CompreensãoRESUMO
O autor tenta circunscrever a perspectiva singular do trabalho analítico que, como trabalho, é propenso a gerar ansiedades e inseguranças que a dupla tenta controlar engajando-se em uma atividade de pressuposto básico. A tarefa do trabalho da análise é lançar uma luz (torná-los conscientes) sobre as crenças operantes dos pressupostos básicos. Os impasses enfrentados nesta tarefa, seja do lado do paciente, seja do lado do analista são discutidos considerando os respectivos lugares do sintoma e das interpretações do analista. Os mitos de Édipo, Éden e Orestes são convocados para ilustrar a ameaça do superego arcaico, e seu moralismo sobre o alcance deste conhecimento e a implícita necessidade de tolerar a insegurança, a conexa inexatidão e a potencialidade destrutiva da interpretação. Assim, podese garantir uma proximidade à verdade e a criatividade como decorrência desta.
El autor trata de circunscribir la perspectiva singular de la labor analítica que, como trabajo, es propensa que generar ansiedades e inseguridades que un par intenta controlar participando en una actividad de premisas básicas. La tarea de la actividad de análisis es dar una idea (concientizarlos) sobre las creencias operantes de las premisas básicas.Los dilemas que enfrenta esta tarea, ya sea del lado del paciente, odel lado del analista se discuten considerando los respectivos lugares del síntoma y la interpretación del analista. Los mitos de Edipo, Edény y Orestes son utilizados para ilustrar la amenaza del superego arcaico, y el moralismo sobre el alcance de este conocimiento y la necesidad implícita de tolerar la inseguridad, imprecisión y la capacidad de relación destructiva de la interpretación. Por lo tanto, podemos garantizar una aproximación a la verdad y la creatividad como resultado de esta.
In this paper, the author focuses on the specificity of the analytic work that, as such, has a propensity to generate anxieties and insecurities. The dyad, thus, tries to control these by engaging in a basic assumption type activity. The analytic work's objective should be that of bringing, such operating beliefs of the basic assumption functioning, to consciousness. The impasses faced in going about with this task, be it from the point of view of the patient or the analyst, are here discussed, considering the respective positions of both the patient's symptoms and the analyst's interpretations. The myths of Oedipus, Eden and Orestes are used to illustrate the threat imposed by the archaic superego to consciousness, ultimately striving to achieve a greater proximity with truth, thus enabling the emergence of creativity.