The Psychoanalytic Psychotherapy Relationship as a System: Perspectives from Group Relations
Allan Shafer
Allan Shafer MA(Clin Psych), D Litt et Phil
ACPP Conference Sydney 17th August 2024.
“I am large, I contain multitudes.”
(Walt Whitman Song of Myself 1855)
In this paper I want to present what I think is a different approach to working in the psychoanalytic psychotherapy relationship. A group relations or systemic perspective attends to the dynamics of the therapeutic field. I propose that the therapeutic field of the dyad contains a multitude of representations.
Over the course of my career as a psychoanalytic psychotherapist I have continuously worked at integrating unconscious systems psychodynamics with a more conventional psychoanalytic approach. This has meant – in part – disengaging from an historical and traditional view of the patient as object, to a view of the therapeutic dyad as a system and as the object of attention in psychoanalytic psychotherapy (Shafer, 2009). As a system the therapeutic dyad contains a multitude of internal representations for both psychotherapist and patient. In other words, the therapeutic dyad is a micro social system and has many of the properties of other open social systems. This includes the unconscious and conscious assumptions that each member brings to co-create the systemic transactions. Hence: “I am large, I contain multitudes.”
The vehicle for making sense of this, is subjective observation. As my colleague Susan Long (1996) puts it:
… psychoanalysis, as part of its practise, (aims) to cultivate and employ … a state-of-mind peculiarly able to work with and study the subjective states of mind of others. Such a state of mind is not unchanging, nor does it work in isolation but couples with the state-of-mind of the other in order to arrive at analytic truth. (See also Shafer, 2013)
Group relations.
My evolving understanding of this perspective on the psychoanalytic psychotherapy relationship arises from my decades long intensive and extensive experience in the associated psychoanalytic field called by various names which reflect different emphases: group relations, socioanalysis or systems psychodynamics.
‘Group relations’ (I will use this term here) is an intensive, experiential method of learning and exploration that enables a deeper understanding of the unconscious systems of relatedness and communication that may produce either creative movement or defensive stagnation in organizational systems. A group relations perspective casts new light on the unconscious and conscious dynamics that occur whenever people work together or share a purpose as a group or unit.
Group relations derives from the work of the psychoanalyst Wilfred Bion and subsequently others such as AK Rice and Isabel Menzies-Lyth and has its foundation in the experiential ‘group relations conferences’ which were initiated by the Tavistock Institute, London over 75 years ago at Leicester University. It has become known internationally as the “Leicester Conference”. For those unfamiliar with this approach, I want to differentiate it from group therapy: it is a form of learning from experience about the dynamics of groups and systems that often also has therapeutic effects on the learner though that is not the primary purpose. These conferences, which nowadays are run on almost every continent and have evolved in organization, process and purpose over time, are carefully structured experiential learning events uniquely based on learning from experience in the here-and-now.
They create opportunities to learn about the psychodynamics of social systems as they evolve. And they provide learning opportunities about various dimensions of these systems such as the task or purpose of the system, boundaries, roles, authority and leadership. Importantly, the framework has also been applied to other socio-psychological issues like racism for example.
2. The therapeutic couple as a systemic dyad
The psychoanalytic relationship is also a system or organization of work, albeit overtly a dyadic one. I emphasize that this is an overtly dyadic definition because we know that many internal representations reside in the unconscious. It is a form of organization, like other organizational systems, with boundaries, authority, roles and tasks and purpose. Each participant brings to the endeavor a complex set of conscious and unconscious systems-in-the-mind, which influence the evolving engagement in, and process of the dyad.
Psychoanalysts might conventionally conceptualize these constructs as unconscious phantasies which manifest in transference and countertransference - I prefer the term mutual transferences- while group relations thinkers (for example David Armstrong) might refer to them as the ‘organization-in-the-mind’ (Armstrong, 2005), the relatedness of and relationships between internal object representations.
Armstrong (ibid, p52) adds that what we try to observe in the psychotherapy encounter, is emotional experience:
(which, he says, is)… a property of a human context or, if you prefer, a relational context which is both internal and external. In the psychoanalytic encounter the object of attention is not the emotional experience of either the patient or the analyst alone; it is, rather a property of the analytic couple.
Put differently, the psychotherapist is both at the centre and the margins of the relationship- both in the relationship and observing it.
Armstrong puts it well when he asserts that the object of inquiry and the medium of inquiry in psychoanalysis are symbiotic. There is a relationship between observer and that which is observed – especially insofar as emotional experience is concerned. They are inseparable. We observe the patient, ourselves and the emerging relationship between us through the vehicle of the emotional engagement that that relationship produces.
As psychoanalytic psychotherapists we are usually consciously and unconsciously primed to perceive the individuals (as ‘figure’) in the dyad with greater primacy than the dyad itself (the ‘ground’) with the systems-in-the-mind that each member of the dyad contributes relegated even further into the background.
Here I draw on four key systems constructs which derive from group relations: boundaries, authority, roles, and task (BART, for short) which I want to apply to the psychoanalytic system.
‘BART’
Among other conceptions, these four key constructs have emerged as quite central to understanding and engaging with the system psychodynamics of the organization of work. I will clarify these terms, and I will try to briefly illustrate their meaning and relevance for therapeutic practice, in this highly condensed presentation.
Boundaries.
Boundaries and boundary management are at the core of the group relations framework. Appreciating the systemic and other functions of boundaries is critical for utilizing the other BART notions of authority, role and task. How the boundaries of the dyadic system evolve and function, how they form, how they affect both participants in the dyadic system and how both participants use them and affect them is a significant source of information about the system. Thus, the degree of rigidity, flexibility, porousness, rigor or consistency of boundaries is systemically meaningful.
I usually consider boundaries in two broad categories: conventional boundaries, and more subtle and complex relationship–specific boundaries, or boundaries of the ‘psychic field’. The brevity of today’s presentation limits me somewhat from exploring these in depth.
Conventional boundaries can be regarded from a few points of view, but crucial to all viewpoints is my proposition that boundaries may not be the province of the psychotherapist alone, who is the conventional formal authority in the relationship. Conventional boundaries may primarily and initially be established by the psychotherapist. But boundaries might more usefully also be thought of as emerging from and requisite for the work or task of psychotherapy, often shaped by unconscious processes.
Boundaries:
contain the therapeutic relationship and the work,
they support the ethical framework of the work and
they also provide nodal points of dynamic engagement. These nodal points provide data or information about the unconscious dynamic processes at play. Breaches and violations of boundaries, or engagements at boundaries are data available for making meaning.
When an understanding of boundaries and boundary management is superficial and trite, boundaries become rules that constrict and contract rather than containers that can expand. In contrast, diluting, ignoring and denying boundaries has other kinds of serious implications for psychotherapy – especially ethical ones. Rigorous – but not rigid - adherence to boundaries should be predicated on their meaning and their relevance to the task of psychotherapy.
The relationship, the context and the dynamic system determine the more subtle and complex boundaries or as I call them boundaries of the psychic field. These boundaries often include the way roles are taken up or formed in the dyad as well as the kind of boundaries of the material that the patient may bring or not bring. Management of and attention to these boundaries requires a more sophisticated balance between rigidity and flexibility while maintaining rigorousness.
Authority, role and task.
The notion of primary task or purpose refers to the essential reason a system exists – the main and unique purpose for its survival. The primary organisational task, according to Chapman (2005) is ‘the one thing that the system needs to do in order to survive.’ The specific primary task of the ‘organisation’ of psychoanalytic psychotherapy may vary according to the theoretical framework and may have subsidiary tasks, but for each endeavour the primary task needs to be defined or clarified. This is necessary because variations of, or amendments to the task constitute dynamic boundary or systems information.
For example: if the primary task were to be ‘interpretation of the transference’ then the provision of ‘reassurance’ or ‘advice’ (for example) constitutes a discrepancy from the task boundary. However rather than view this in a rigidly dogmatic and judgemental way as a violation of the task boundary – except where ethical considerations apply - the therapist might profitably explore what unconscious pressures in the system have produced this task-variation and what meaning can be made of it?
One of the most important conventional boundary conditions is that of the role of the therapist.
Although roles may have formal names like ‘mother’, ‘manager’, and ‘psychotherapist’ I am interested in the roles which achieve unconscious representation and shape our relationships with others particularly including their impact on the dyadic system. These are role boundaries of the psychic field.
In work systems, a formal role is the position adopted in order to perform the task or through which work is performed (Newton, 2013). However projective pressures that impinge on formal roles are vital systemic information. For example, pressure on the ‘psychotherapist-in-role’ to be a sympathetic ear, or a critical judge (for example); or equally (and this is a vital component of the dyadic system), pressure by the psychotherapist on the patient-in-role to be (for example) compliant or deferential or dependent etc provides reciprocal systemic data. In conventional terms this is usually limited to the realm of transference.
Engagement with the role boundary is a crucial source of information about transference phenomena since changes to or pressures on the role are usually indicators of the operation of projective identification. Systemically this might be called ‘role suction’. I might add here that traditional views tend to focus on familial and formal roles in transference phenomena, such as mother, father, sibling. What I am proposing includes a much wider perspective on roles, especially informal ones – like saviour, adviser, persecutor, judge etc.
Projective identification is a key medium of systemic dynamics in the dyad, just as it is in groups. I have long been intrigued by the proportional disparity intrinsic to the conventional idea of transference. It is as though there is no projective identification from therapist to patient, only one way. Viewing the dyad systemically affords an opportunity to discover and explore a mutually created dynamic system. A formal role boundary which is too loose interferes with the ‘as if’ dimension of the therapeutic relationship or the informal role system. But the role rigidity of psychoanalytic orthodoxy can also produce a paranoiagenic system.
I will shortly describe the concept of unconscious representation which is central to recognising the ’multitudes’ that we contain.
A crucial boundary that needs to be rigorously attended to is perhaps one identified by Whelan (1992) when he says:
I am not going to treat you as any other “real” person would. I am not going to react and have my human needs realised through you. I am going to listen, attend, think and then speak (interpret).’(p.44)
This is the crucial, but intricate and often inscrutable boundary between person and role: a delicate balance. It is also the domain in which we each carry multitudes of representations. A role cannot take shape without being represented in a mind.
Authority
In my experience over forty five years as a supervisor and also as an international group relations consultant working across many cultures, I have been intrigued to discover that the notion of ‘authority’ is very poorly understood by many psychotherapists. It also varies considerably across cultures. Often it is confused with the term ‘authoritarian’.
Hirschhorn (1988) described ‘personal authority’ in principle as ‘the right to be oneself’ and organizational authority, as ‘the right to work’. I think this can be narrowed down to the right to work on a specified task. In psychotherapy, authority may also be derived from the role as well as from the patient and also from professional certification. This is the statutory context in which the psychotherapist is authorized to work on the agreed-upon task of ‘psychotherapy’ from the role of ‘psychotherapist.’ Hence variations or fluctuations in the role and task boundary affect not only the nature of authorization. Similarly, and perhaps more crucially, variations or violations of the authority boundary, affect role and task boundaries. The ethical dimension is always primary.
Other boundaries that play a vital role include the boundaries of time and territory. They are important for containment. Engagements at these boundaries or variations or violations of the time and territory boundaries are valuable sources of systemic data as well.
Time is a particularly interesting one since it can be measured to the second and can thus easily be used defensively too, by both parties. Related to this, in contemporary work, the territorial boundary has become even more challenging as some forms of engagement occur outside the consulting room in the realm of virtual reality (and often outside of consulting hours via email and text messaging). Indeed, consequent to the Covid pandemic, virtual work has become standard, with its own intriguing boundary considerations and dynamics. The territorial dynamics of electronic media – including consultations by Zoom, Skype or other video platforms - are particularly nuanced.
In summary, variations or violations of boundaries or engagement at the boundary, provide valuable emotional information for making therapeutic meaning in the dyad, in the service of the patient’s growth and development (and indeed the therapist’s!) However, in order to optimise the capacity of the therapist a position needs to be found that is both at the centre and on the margins of the system. This is facilitated by emotional engagement in the therapeutic relationship.
4. Emotional engagement.
We need to be just sufficiently emotionally connected to be able to have a view of that connection that keeps us outside of it enough not to contaminate it, yet in it enough to be able to read the emotional temperature. This is emotional engagement: from the margins to the centre.
I am distinguishing it from emotional involvement which usually implies action or reaction aimed at reducing the psychotherapist’s and the patient’s arousal. And speech too – at times - can be a form of action! Emotional involvement entails a personal investment on the part of the reactor, (think back to Whelan’s ideas- a breach of the person/role boundary) unlike Bion’s imperative to ‘eschew memory and desire’. It is particularly evident - and concerning -when a therapist is emotionally involved that one or some of the multitudes of potential representational roles has been activated and enacted.
Drawing from Armstrong’s (2005) proposition that psychoanalytic psychotherapy aims ‘to bring into view the emotional experience present and presented within such a space’, it is the property of the couple – a two-person context – that is the basis of engagement. Engagement is a property of two-ness: the deep dynamic system that characterises a relationship at any moment.
Reverie may be the medium to bring this into view. According to Symington (2005), reverie:
‘... is a state where the mind of one person is engaged with the mind of another in such a way that there is space for imaginative reconstruction ... in the observer.’(p10)
Imaginative reconstruction is the crucial element for making sense of the therapeutic endeavour through – among other things – the capacity to draw on the emotional information produced at the boundaries of the therapeutic relationship and manifest in the emotional engagement. Boundary management is critical to creating a stance for observation too: a state of mind of floating attention that moves between the ‘I’ and the ‘we’ dimensions.
It is through Bion’s notion of the ‘selected fact’ -
‘the entry point into the object of contemplation – … that which transforms disparate elements into a patterned whole’ (Symington, 2005, p.11)
that this data can be made sense of. A deep understanding of the function of boundaries comes from appreciating the dynamics of systems and particularly of roles, afforded by group relations learning.
Unconscious roles and representations.
In a previous paper I noted that:
It is important … to keep in mind… the role of representation. What do I represent to you and what do you represent to me and how do our mutual representations shape both our view of each other and how we engage with each other? What you represent evokes unconscious phantasies and conscious associations in me and shapes our mutual communication. (Shafer, 2023).
What is often not recognised is that each individual in the dyad carries these multiple identities (an internal group, we could say) in the form of potential or latent unconscious (and conscious) roles – a form of role intersectionality. In the mutual transferences, particular representational roles that reside in the unconscious system may be mobilized.
Here is a case example – anonymized - which illustrates these phenomena in a different dyad: a father-son dyad. A patient had been struggling with his feelings of rage towards his young son who had been diagnosed with autism. The boy’s behaviour was difficult to manage. Often - for example - he would refuse to go to sleep till late in the evening, remaining preoccupied with his iPad. My patient’s capacity to tolerate frustration had worn thin and he found it very difficult to suppress his anger with the boy. In therapy we learned that this partly emanated from his disappointment that this was not the son he had fantasized having. He named this as the boy preventing him from being the father he had imagined himself to be – especially because he didn’t want to be like his own father, who was emotionally limited, authoritarian and judgmental. He gradually came to see that he was in fact acting on the unconscious representation of his ‘father’ in his mind. The idealized role of a father (i.e. not-his-father) that he held in his mind was incompatible with his son’s limitations. This developed further and more fruitfully with him beginning to see the world through his son’s eyes as well as his own. He stated strongly, ‘I realize that I need to be the father he needs, not the father I imagined myself to be.’ The clash between his fantasized role of father (and the representation of his own father he held unconsciously) and the boy’s fantasized role of a father created great difficulties until this reconciliation became possible and he could recognize the system he had unconsciously perpetuated.
I might add that in the therapeutic dyad, this was partially reproduced. The patient himself struggled with a degree of neurodiversity that resulted in him often being late for sessions (a time boundary violation) or missed payments (violation of the therapeutic contract). This evoked feelings of frustration in me, and of wanting to remonstrate with him and ‘make’ him into a compliant patient. The realization of this freed us both.]
Conclusion.
I hope that I have illustrated in this short paper, the added value that a group relations or systemic understanding can contribute to our work as psychoanalytic psychotherapists. But also how we all hold in our unconscious minds a multitude of object representations derived from evolving experience. And, importantly, how these shape our relatedness – the unconscious assumptions of our connection with others – as well as our actual or real relationships with others.
References:
Armstrong, D. (2005) ‘Organisation in the mind’ in French , R (Editor) Organization in the Mind: Psychoanalysis, Group Relations and Organizational Consultancy (The Tavistock Clinic Series), Karnac Books, London.
Chapman, J. (2003) ‘Hatred and Corruption of Task’, Organisational & Social Dynamics 3(1): 40-60.
Hirschhorn, L. (1988) The Workplace Within: the Psychodynamics of Organizational Life. MIT Cambridge, Mass.
Long, S. (1996) ‘Psychoanalysis, Discourse and Strange Lists: These are a Few of My Favourite Things’. Paper presented to the Annual Symposium, ISPSO, New York.
Newton, J. (2013) ‘Organisational role analysis’. in Long S. (Ed) Socioanalytic Methods: Discovering the hidden in organisations and social systems. Karnac, London.
Shafer, A T (2009) ‘What is the “proper object” of contemporary object-relations psychotherapy? ‘ Paper presented to the Annual Conference of the Psychoanalytic Psychotherapy Association of Australasia.
Shafer , A T (2013) ‘Is there a psychoanalytic state of mind and how is it formed?’ Paper presented at the POPIG Conference, APS, Brisbane. October 18th 2013
Shafer AT (2023) “How can we explain the uncanny experience of ’Gedankenübertragung’ or ‘thought transference’? Paper for the Psychoanalytic Psychotherapy Association of Australasia Conference 2023: The Unexpected and the Uncanny.
Symington, N (2005) ‘Where is the medicine of healing in psychoanalysis?’ Australasian Journal of Psychotherapy pp6-22
Whelan, M (1992) “What counts in the counting game?” Australasian Journal of Psychotherapy 11 (2), pp.41-54