Group Body Psychotherapy (Part 2)
Example 4
Tim and Rita developed an intense love-hate relationship throughout the course of a group. Tim was a tall, skinny, languid, shy man in his late 20s with a history of medium-term relationships with older women who basically mothered him. This would develop into a downward spiral, with both partners increasingly resenting his dependency. Rita, a woman in her late 30s who had joined the group after her divorce from a man she felt bullied by, was the perfect match for Tim's pattern. She found his reluctant helplessness quite cute, and certainly unthreatening, and he appreciated her steady attention and nurturing attitude. Bion (1961) observed that such pairing is a common reaction, often serving a defensive function and helping both people avoid engagement with the group. This 'coupling' can shut out the rest of the group, setting up rivalries and envy of the 'special' intimacy. In this case, Tim and Rita could be seen to fit what character theory describes as oral and masochistic (holding) styles, respectively.
Rather than directly interpreting the defensive aspects of Tim's and Rita's pairing, the facilitator used their body language when sitting next to each other to draw attention to how they were shutting the group out. They were ever so slightly turned towards each other, their backs rounded and shielding the space between them. This developed into a scenario where the two of them were given special attention by the therapist, whilst the group crowded around at a distance. In both allowing and embodying the dynamic, interpretation became unnecessary: through attending to a shared sense of diffuse bodily tension, Tim and Rita discovered how much they were already protecting themselves in anticipation of envious attacks. The therapist encouraged them to deliberately and actively protect themselves; after explicitly confronting and jointly shouting at the rest of the group, it became obvious to both of them how in their different ways they were projecting a hostile family environment onto the rest of the group: Tim felt ignored and neglected, whereas Rita expected shaming and humiliating responses, denying her right to intimacy. The short-term effect was that Tim and Rita began to see each other more realistically, including each other's defensiveness, rather than being simply united against a shared common 'enemy'.
Regression and transference processes
The number of conscious and unconscious, verbal and non-verbal messages communicated in a group increases exponentially the more members it has. When compared with one-to-one contact, this makes any attempt at control - by either group members or leader - a hopeless undertaking. Beyond a group size of ten, we are confronted with such a multitude of dynamics that it approximates a 'mini-society' - a sense that some people find containing and others utterly threatening.
The uncontrollable diversity and complexity of collective process overwhelms the individual ego and explains the regressive potential of groups. Another source of regression is a culturally neglected, but intense longing for community - what Paul Goodman, one of the co-creators of Gestalt, called the communitas aspect of therapy (Goodman 1947).
Regression has long been recognised as a powerful and valuable therapeutic tool, though a double-edged one. If anything, body psychotherapy intensifies and enhances regressive tendencies: 'Touch is our earliest language, and capable of taking us back instantaneously to our most primitive universe' (Conger 1994, 13). We commonly find that if an individual resists awareness, then any movement towards embodiment will be regressive (or at least experienced as such). Although regression does entail dangers of retraumatisation, the tradition of Body Psychotherapy has accumulated decades of evidence that 'an unfreezing of an environmental failure situation' (Winnicott 1954, 287) and transformation of deep structural psychic wounds cannot occur entirely without it.
In a group context, regression and associated transferences can take on a particularly trauma-laden, primal quality. In particular, there can be a transference onto the group as body, including as the body of the mother: since the group is so much 'bigger' than the individual, the transference is frequently infantile, with qualities of needy dependence, destructive envy or helpless terror. Leaders can, of course, have similar countertransference experiences of the group.
We can usefully distinguish between more primitive and potentially more overwhelming and unconscious transferences to the group, and more differentiated and particularised transferences to people in the groupincluding the facilitator. Both levels, of course, co-exist, in the group and in each individual, but a detailed exploration of transference-countertransference as bodymind processes is beyond the scope of this chapter (but see Soth 2005, 2006).
A socio-bio-neuro-psychological paradigm?
Since the inception of our discipline, notably through Reich, a bridging between the intra-psychic and interpersonal-social domains, as well as between the biological-neurological and psychological-mental has been intuited as a possibility. But the beginning of the 21st century may now herald our capacity to actually achieve such an integration in ourselves, in our therapeutic theory and practice on a wider scale.
I have suggested elsewhere (Soth 2006) that psychotherapy as a profession has a 'birth trauma', going back to its origins in the zeitgeist of the late 19th century. By transcending both the doctor-patient dualism implicit in the 'medical model' as well as mind-over-body dualism, we come closer to embracing the inevitable and necessary paradoxes at the heart of our work.
Meta-models, such as Wilber's integral theory (AQAL), drawing on holographic systems theory (Johanson, G. chapter in handbook), as well as neuropsychoanalysis (Schore 1994), based on detailed scientific investigation of the biochemical and anatomical systems of the brain, indicate the degree to which more comprehensive and integrative models are being pursued and now considered feasible and necessary. One of the main obstructions to such integration, the popular reduction of psychology to genetics, is no longer tenable and its entrenched and polarised position has been challenged and superseded by the notion of 'nature via nurture' (Ridley 2003).
An important aspect of all integral models is the recognition that a) our identity is structured by larger-than-individual forces, and that b) psychology cannot be reduced to only internal processes. The social construction of subjectivity, through early conditioning and socialisation, through implicit relations of power in every sphere of life, through a myriad of frameworks and influences (Chomsky 2003, Foucault), is acknowledged across the human sciences. It is equally understood that a large proportion of pervasive modern distress is rooted in the dislocation and alienation of the individual within social and community life. Rather than mis-representing this distress as an individual problem, and in the extreme as a genetic or biochemical condition, we now have theories which interweave biological, emotional, psychological and social domains, as anticipated in Reich's functionalism and his analysis of psycho-social processes. Wilber's 'four quadrants' explicitly distinguish individual and collective processes (in both the subjective-interior and objective exterior domains) and the complex dialectic between them.
In therapeutic practice, however, such grand integrating models have as yet remained fairly abstract and inconsequential in their influence. Undoubtedly, there are many reasons for this, but the traditional absence of the body within the field of psychotherapy needs to be seen as a crucial factor: without a holistic bodymind paradigm the integration of the various domains remains theoretical, and does not work through to an experiential-embodied level.
Postmodern and feminist discourse has long recognised the social construction of the body: the bodymind processes organising our social identity are largely taken for granted as they are pre-conscious and pre-reflective. But it is precisely because they are embodied, and communicated as such, that the inclusion of the body in a collective therapeutic context is required if we want to bring into awareness the otherwise implicit sociocultural forces. These are strong indicators that a body-oriented and holistic-integral theory and practice of group therapy is needed and could make a powerful contribution to the provision of therapeutic services. However, before concluding this chapter, some cautions and provisos need to be addressed.
Whose body is it, anyway ? And whose feelings does it carry and express ?
In the same way that Body Psychotherapy's reaction to the body-mind split has been situated within the cultural objectification of the body, we can ask: are there socially embedded assumptions which condition our understanding of the body in relation to collective processes? Or, to what degree is our thinking about the body restricted by individualism ? Whose body are we talking about ?
Group Body Psychotherapy is liable to be torn apart from the outset by inherent contradictions unless we challenge individualistic notions of the body.
Apart from the phenomena of projective identification, somatic countertransference and parallel process (Soth 2005), there are two therapeutic approaches which both place great importance on subtle body messages and consider the body as a carrier of forces beyond the individual: Process-Oriented Psychology and Family Constellations are both relevant to group work and share an underlying assumption that the body does not 'belong' to the individual only.
Transgenerational Processes and the Field
Hellinger's approach to family constellations recognises all kinds of transgenerational family dynamics and collective-cultural processes which deeply shape the body and its largely unconscious functioning and communicating. But he also sees the body of the representative - the group member who stands in for and represents a figure who is entirely unknown to them personally - as participating in the 'knowing field'.
Process-Oriented Psychology's approach to groups also starts out from the concept of the 'field' (although the term is defined differently here):
"We think we manage or organize our lives and groups, but actually fields create and organize us as much as we organize them. Fields organize people into groups, if we understand a group to be any number of people who use the word we in the same way." (Mindell 1992, 24-5)
According to Mindell, fields also position the group members to take on specific roles and feelings which the group field requires to be filled (Durkin 1981). One image which he offers for this process is of the group as a single embodied being:
"Imagine a group of which you are part. Can you think of it as a field, as a huge humanlike or divine figure? What role do you play in the humanlike figure? Are you the eyes, head, feet or stomach? ... The work you do is done in part for the figure. The field may be using your eyes to see with! How does that last sentence change your relationship to this group?" (Mindell 1992, 29)
Mindell here emphasises the physical and sensory aspects of identifying with this figure. Body psychotherapists are at home with this kind of awareness, but are not used to seeing it in a group context.
Continuing in Mindell's vein, we might say: "whichever body system is currently activated in you, at the moment you are carrying that capacity for the group as well as for yourself. Hence, to welcome, engage with and process that activation is to accomplish something for the group as well as for yourself."
This is a holographic way of understanding groups: because they are made up of embodied individuals, who influence and resonate with each other, activation at the individual level also reflects activation at the group level and vice versa.
Example 5:
In a group facilitated by two therapists, one was working with a conflict between Lou and Dave which had been brewing up for most of the morning. She supported them in fully expressing the anger they felt towards each other, culminating in some lively (still predominantly controlled) pushing and shoving, together with a lot of shouting and swearing. The group's attention was riveted by this dramatic scene; luckily, though, the other therapist noticed that Grant, on the far side of the group, was pale and tearful. She sat with him and supported him while the scene played out, then asked whether he could share what had been happening for him throughout the process. His bystander reaction of helpless shock was picked up by several other participants, and turned out to be a crucial turning point in the group process, bringing out the fearfulness that had been hidden within Lou's and Dave's interaction, and in the group generally.
Resonance, embodied attunement and the 'shared intersubjective manifold'
In recent years, neuroscience research into infant development has both confirmed and further stimulated body psychotherapy thinking through its emphasis on the crucial role of relationship: specifically embodied attunement between baby and carer. Stern (1985), Trevarthen (1993, 2001), Schore (2001), Porges (2005) and others have explored how, in Stern's words: "All learning and all creative acts begin in the domain of emergent relatedness." (1985, 67).
Such attunement occurs pre-reflexively, right-brain to right-brain and relies on a myriad of subtle messages, the bulk of which are both communicated and received unconsciously. However, it is possible for therapists to develop and sharpen awareness of such non-verbal communication, and - as NLP has shown - to 'clear up our perceptive channels'. Body psychotherapy has a long-standing tradition of subtle and energetic perception, and helps us translate and apply neuroscientific insights to the group context.
Stern and Trevarthen both emphasise the rhythmic, mirroring quality of infant-carer interaction, and the importance of cross-channel reflection, which Stern terms 'affect attunement' (1985, 138-61): frequently-repeated interactions in which the baby acts in one expressive channel, and the adult responds in a different channel but with the same rhythm or activation profile. This sort of interaction occurs spontaneously in all human relationships, and sets up a resonance between individuals which generates a continuous reinforcement of social bonding - or conversely, if affect attunement does not happen, social disturbance and anxiety.
The therapeutic effect of harmonious group interaction can be understood further through Stephen Porges' theories, one of many neuroscientists to implicitly validate body psychotherapy, in this case by his work on the vagus nerve as a hardwired 'Social Engagement System. He points out that social bonding depends on interrupting the fight-flight-freeze reflex triggered in mammals by close proximity, and substituting instead a capacity for relaxed presence, enabling us to experience interpersonal contact as soothing and nourishing, through a complex interactive effect on the ears, eyes, breathing, heart and digestive system (Porges 2005, Kepner 2005).
Our understanding of the subtle messages constituting embodied affect attunement can be further enhanced through the function of 'mirror neurons' (Gallese 2003). Recent research strongly indicates that when we observe or even hear about someone else performing physical actions, dedicated neurons in our brain fire in response, creating a vicarious sense of embodied action in ourselves and allowing us to empathically recognise the other's internal state and bodymind condition.
On the one hand this lends support to the notions of 'energetic perception' and 'embodied countertransference' which body psychotherapists increasingly rely on. On the other hand it complicates the question as to whose experience it is that is activated in the body. Body Psychotherapy, consistent with humanistic principles, has assumed that sensations and feelings experienced in 'my body' are 'mine', and that it is healthy to own, inhabit and express them - as mine. Likewise, if I resist feelings, I am assumed to be defending against 'my own experience'. There are strong indications, however, that not everything occurring within my skin is my individuality. On the contrary: the evidence from somatic countertransference, Process-Oriented Psychology and Family Constellations as well as neuroscience suggests that our bodies carry and express the sensations and feelings of others.
So if we extend the functioning of mirror neurons to groups and social organisation, we can arrive at Gallese's 'Shared Manifold Hypothesis and the Neural Basis of Intersubjectivity' (2003): we are constantly mapping, representing and therefore experiencing subliminally each other's internal states - through bodies which we presume to be individual, but energetically and experientially are far from separate and neatly delineated. This lends some substance and embodied reality to the notion intersubjective oneness: we are indeed inside each other, swimming - so to speak - in a soup of shared experience. A complex embodied weave of intersubjectivity will be operating in the background of all group processes, defining the group 'feel', its affective tone.
Much of group life is the emergent product of multiple experiences of resonance and dissonance, attunement and non-attunement, merging and separation at each level from the dyad to the whole group. The subtle internalisation and externalisation processes are how the 'group organism' - referred to above - actually comes into being: wavering in and out of existence as the group resonance patterns shift between order and disorder, separate experience and collective entrainment. Such phenomena will ensure that shifts in the embodied process of one member affect the embodied process of the whole group.
We can perceive an inherent drive to wholeness in the group, which directs the group process towards the goal of entrainment. But this entrainment is not some sort of disembodied consciousness - an impossible concept in itself (Damasio 1996): all human relatedness is grounded in and expressed through embodiment, through biology and anatomy, through all the tissues and systems of the body, through the heart and the guts. It is the particular alertness of body psychotherapists to the energetic and embodied aspects of group process, across the whole bodymind spectrum from cellular and physiological to imaginal and cognitive processes, which is a unique contribution to the field.
Whilst our culture is largely unaware of these subtle processes, both in how they affect individuals' inner experience and how they shape interpersonal and group experience, there is nothing mysterious or mystical about them. We can usefully apply Reich's notion that many ideas associated with 'mysticism' are rooted in mis-perceived life energy to groups and how they organise, communicate and support individual aliveness and collective togetherness.
Even though much of this communication is pre-reflective, non-verbal and unconscious, group body psychotherapy can nevertheless rely on its presence, bring awareness to it and help with the containment of dynamics which the participants would otherwise be unaware of and disconnected from.
Conclusion
Groups raise energy: concentrated collective attention intensifies everything, all interactions and contributions. This heightened awareness can bring stark recognition of basic life scripts, character styles and interpersonal patterns, thus allowing for deep work. The group context also tends to lend more weight and significance to any resolutions and transformative moments which do occur, allowing for easier and more comprehensive translation of the therapeutic experience into 'real life'. If, therefore, it gets facilitated as a real-life setting (rather than an artificial and idealised therapeutic world - of healing, reparation and harmony), the group dynamic - if it works - can be transformative in and of itself.
Body psychotherapy is an ideal foundation from which to bridge and integrate diverse disciplines into a new and larger whole - into a comprehensive socio-bio-neuro-psychological paradigm and the potential for socially transformative practice. By bringing - amongst others - group dynamics, relational psychoanalysis, neuroscience and attachment theory to body psychotherapy's established holistic theory and practice and its inherent countercultural social commitment, we can forge a profoundly creative and undogmatic therapy which can address the pain of social and cultural splits, precisely because it has embraced and transcended those splits on both personal and professional levels.
Such an approach does not just apply the principles of individual work to group practice, but can re-define more fundamentally our vision of what therapy is about: an integral-relational practice of evolution/transformation which recognises the interweaving of individual and social identity and does justice both to the depth of the individual 'inner world' and the significance of inter-dependent intersubjective relating.
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