Leadership

The group analyst works as both group member and therapist, beginning with dynamic administration, assuming an active role in a new group and allowing a decrescendo of his or her own role as the group gains authority. He or she is responsible for the location of disturbance in the group's process and for providing a balance between analytic and integrative forces whilst manifest content is translated into language that describes the unconscious. Transference is prominent, but the work is undertaken in the dynamic present. Foulkes' account, in the following passage,(80) of the conductor at work in a group stands in dramatic contrast to Freud's account of the psychoanalyst at work behind the couch:

He treats the group as adults on an equal level to his own and exerts an important influence by his own example ... representing and promoting reality, reason, tolerance, understanding, insight, catharsis, independence, frankness, and an open mind for new experiences. This happens by way of a living, corrective emotional experience.

Adapting Foulkes' ideas to clinical practice, Lipgar, (8I) basing his account on that of Pines, describes leadership as the performance of functions which enable the group to adapt to the requirements of changing internal and external realities, which promote a sense of group cohesiveness and identity, which protect individuality while achieving group coherence and integrity, and which allow a range of achievements that can be shared.

This is particularly clear with the more disturbed narcissistic or borderline patients who bring to the group more primitive psychic structures and processes that put strain on the resources of other group members. Such patients can create turmoil, in which the leader's task is to maintain the responses of the group from a more mature level of psychic organization. By responding to part-object relationships and processes on the level of whole-object relations, more benign containing responses can be established. Progressively, these help to build up for the disturbed patient a more benign world of inner object relationships and processes. (82> More disturbed patients desperately seek attention in ways that are inappropriate and disruptive. This search for attention arises because the patient cannot establish a sense of connection between him- or herself and the processes of the group. Mirroring and resonance can steadily come to replace these isolated and fragmentary responses, allowing the patient to attain for the first time a coherent sense of self and a capacity to recognize the identity of others.

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