||Community Group-Analysis: A Post-Crisis Synthesis
|Mark B. Borg, Jr. PhD
||Who Played Ball with Bin Laden? Commentary on 'Community Group-Analysis: A Post-Crisis Synthesis' by Mark Borg
||I Must Not Think Bad Thoughts: Latent Content in the American Dream Response to Commentary by Dick Blackwell
||Mark B. Borg, Jr. PhD
Community Group-Analysis: A Post-Crisis Synthesis
Mark B. Borg, Jr. PhD
Borg, Jr., M. B. (2003). "Community Group-Analysis:
A Post-Crisis Synthesis," Group-Analysis, 36: 228-241.
This article describes some ideas, both theoretical and clinical, related to group treatment of residents in a New York City homeless shelter for mentally ill persons immediately subsequent to the World Trade Center disaster. I provide details concerning this group as it dealt with community-level crises that were both acute, as they related to the World Trade Center disaster, and chronic, as they dealt with the ongoing condition of being mentally ill and homeless. I discuss my experience in the group and the ways that a synthesis of group, interpersonal psychoanalytic, and community psychology principles formed a framework for working through traumatic experiences in this community.
ON THURSDAYS, I MEET WITH A TEAM of community practitioners at a homeless shelter in lower Manhattan. We conduct a group where we facilitate a community empowerment program for residents deemed mentally ill and homeless. We were unable to attend the meeting the week of the World Trade Center (WTC) disaster. It was impossible to reach the location. After a missed week, we met at the usual time and location. The shelter itself, while about a half-mile away from "ground zero," provides a straight-shot view of the place where the twin towers had recently stood. From the window of the group room, we could still see the smoke infiltrating the sky.
On our way into the building the director of the program said, "No one around here has discussed 'you know' WHAT HAPPENED." In this paper, I examine that communication issue through conducting a series of interviews with group participants and by exploring some moments during a group session conducted subsequent to the WTC disaster. In this group we dealt with both acute trauma (the WTC disaster) and chronic trauma (mental illness/homelessness), and how they influenced each other. I pose that there are striking similarities between interpersonal psychoanalysis and community empowerment theory and that combining these models can, as we experienced in this work, greatly benefit group analysis, especially when dealing with trauma.
The Community Group
When we initiated group subsequent to the WTC disaster, there was an uncharacteristic silence. I mentioned this and my sense that the emotional tone of the community had shifted dramatically since the last time we had met. Group members expressed feelings like "burned out," "wasted," and "exhausted." I stated curiosity about these seemingly similar emotions being expressed in various group members. Regarding emotional linking in community contexts, Armstrong (1992) states that
- There is something in a culture, a context, which reproduces itself in different forms, different realizations from some common root. And along with this interest goes a deep awareness and concern with the making and finding of links: between one person and another, between individual and group" between physical and mental, conscious and unconscious (pp. 267-268).
On this Thursday, there was a depressive anxiety (Jaques, 1955) that appeared to form the common root or link between the emotional experience of the residents, the staff, and the practitioners. Underneath the depressive barrier was the threat of an emotional upheaval that related to the recent trauma. This sense of disruption crossed many complex internal and external borders and connected us all to the catastrophic loss that was lurking in our midst, in our recent experience, just outside the window.
After an uncomfortable stretch of silence, one of the residents, Lou, casually stated, "I used to play basketball with Osama Bin Laden." Then, as if either to counteract or stoke a mounting aggression in the group, he added, "and he was a pretty cool guy." Since his shelter residence began, Lou has had the label of Schizoaffective added to his sense of self-identity. As if to uphold his part of the diagnostic bargain, Lou has consistently made delusional claims, such as that his music was stolen by a famous 70s rock musician and that he contracted the HIV virus in a government experiment. Members of the group usually snicker and roll their eyes at these claims. However, when Lou told us about his relationship with and opinion of Bin Laden, the group exploded.
I met with participants of the group immediately afterward and asked them to tell me what happened. There are a number of versions of the group experience. I will give the reader the chance to choose between and among the synchronies and conflicts of the story lines.
At the beginning of this group, most of the residents were not present. However, by the end, most of the steady members had come into the room (15 members). This denied group members from experiencing the group discussion from a similar vantage point. One member, Joan, from the beginning, repeatedly stated that she was leaving. She had been sleeping in the middle of the meeting room prior to the group and started saying she was leaving before the group began. She stated that she was "sick" of the topic (ostensibly the WTC disaster), prior to the topic being mentioned, and was unaware that we knew the topic had not been discussed in the residence.
After some uncomfortable silence in the beginning of the group, Lou retreated into a fantasied relationship with the man suspected of orchestrating the disaster saying that they used to play basketball together. He then attempted to neutralize the anger that this comment engendered by recalling that the man was a "pretty cool guy." That only made it worse. Joan exploded at Lou and others soon joined in. Joan exploded and left the group accusing others of taking advantage of her.
When Joan left, Patty, who had observed the tragedy first-hand from a bus traveling down Fifth Avenue, said only that she felt "sad." Lou slumped on the couch, looking both stunned and relieved. Soon thereafter, Patty revealed that the passengers on the bus had "cried hysterically" in reaction to the sight. She, like the others in the group, did not initially identify the tragedy as a factor in how group members were feeling.
Joan returned with a cup of coffee that she shared with group members, and began to listen to the frightening experiences that were being shared. Finally she revealed her own terror of that day and how the trauma had increased her awareness of a more chronic sense of trauma that she had been living with for years. That being that she, and by extension, people in her situation, is/are "expendable." This was the similar feeling that residents had experienced in relation to thinking about the expendability of the people who were killed or missing in the disaster. It was an incident where a disaster, an acute crisis, was able to create a point of impact in the community that allowed them to begin the process of working through the more chronic and shared group experience.
Joan cried and asked the group, "Why did six million, or six thousand, people die?" Lou was the first to attempt an explanation, stating an intelligent conceptualization of political, religious, and financial reasons for the attack. Some residents offered very well formed rationalizations. Others joined Joan in tears and compassion when one practitioner asked, "What we can do when there are no adequate answers to our questions?" At the conclusion of the meeting, the practitioner summarized as follows:
- We may not have a recognizable template for what we are experiencing, yet the anger, anxiety, and depression in this group seems related to this communitys shared history of living with the consequences of previously unanswerable questions, and doing so all alone. We may be creating an option to that.
Residence Staff Member
When we started group, the residents noticed a similarity of feelings running throughout the community (e.g., jolted, tired, burned out, freaked out, sad) and were then silent. After some period of silence, Lou told a story of playing basketball Osama Bin Laden, who was a good guy but had a temper. He tried to condone the mans actions by relating that good people sometimes carry out bad things. The group became noticeably angry. There is usually much more tolerance for Lou when he tells one of his "stories." The reaction of the group was intense and Lou tried to counteract this by adding, "he is a pretty cool guy." It didn't work.
Joan became very angry and accused Lou of not caring about how anyone else in the house feels about his crazy story telling. Other group members screamed at Lou, calling him crazy, calling him a liar. Joan left the room screaming at Lou. The other residents took over and were becoming increasingly incomprehensible.
Soon after Joan left the room, things quieted down. "What just happened?" one of the psychologists asked. Patty stated that she felt sad. The psychologist pursued this, encouraging her to explore what this might be about and if it, in any way, related to what just happened. She cried as she told us that she had seen people jumping from the burning WTC.
Joan entered the room with a cup of coffee. She stopped in front of Patty and moved toward her. She glared at the psychologists as if to say, "who hurt her?" She shared her coffee with everyone. Joan, who is basically perceived as being tough and impenetrable, discussed her experience. She had been with her parole officer near the World Trade Center. Her only concern was what happened to the inmates in the building? Her parole officer told her, later, that they were left. She then discussed the idea of "expendable people." She added, "people like us."
She asked unanswerable questions about what had happened and why. Members of the group, especially Lou, worked very hard to answer her. When one of the psychologists asked what we could do to deal with such unanswerable questions, just about every member of the group, in turn, began to retell personal experiences about September eleventh.
When interviewed, Joan stated, "I take care of myself." This was both true and not quite the whole story as she did so by putting her needs aside in lieu of taking care of others. Her usual way of doing this was to take over the work (e.g., chores, cooking, etc.) of other residents. This had led to immense anger and resentment directed toward her neighbors. When the needs of others became overly intense in this group, she left. In fact, she left a number of times during this group.
I asked her why she left the group. She said that she had felt "disappointed."
- MB: Disappointed?
- J: It makes me so upset to see how they turn to you guys when they're feeling anxious.
- MB: What do you think they should do? (no answer). I've noticed that other residents often turn to you.
- J: No.
- MB: What was going on when you left?
- J: I was thirsty.
- MB: What was going on in the group?
- J: Lou's crazy.
- MB: I have not seen you react the way that you did today.
- J: I just couldn't take it anymore. None of us could take it anymore. This has been driving us crazy.
- MB: What has been driving you crazy?
- J: I don't even know I just don't feel so crazy anymore.
- MB: Do you have any ideas about that?
- J: I (crying) I am just so angry.
- MB: You feel angry?
- J: Not as much as I feel scared"and sad.
When I interviewed Lou and asked him what happened he said that he had "blown" his cover.
- MB: Your cover?
- L: Ya, I keep doing that in this group.
- MB: How did you blow your cover?
- L: I told them too much. When I expose myself like that, I wind up feeling crazy. They all yelled at me.
- MB: I wonder why you were willing to take that risk?
- L: It didn't feel like a risk. I just I don't know why I said what I did, it makes no sense now that I think about it. I just couldnt stand the silence any longer.
- MB: The silence?
- L: It's been so quiet here dead silence. It's so quiet. I want to scream. But I haven't been able to. I have been afraid of the silence, scared of wanting to scream. I have been stuck in this crazy kind of middle ground. It has felt lonely and scary. But even worse, it has felt like there is no escape from it.
- MB: Do you feel like that now?
- L: No.
- MB: Why do you think that is?
- L: I don't feel like screaming anymore.
The community psychologist Julian Rappaport (1981) stresses that "given the nature of social problems, there are no permanent solutions, no single this-is-the-only-answer-possible solutions" problems must have many solutions that change with the currents" (p. 149). This philosophy exemplifies both empowerment and interpersonal psychoanalytic theory. Both seek to expand options for dealing with problems in living and to support the agency of individuals in finding creative, health-promoting, collaborative, and sustainable approaches to dealing with the complexities and inevitable anxieties of everyday life (Mitchell, 1986; Rappaport & Hess, 1984; Sullivan, 1953, 1964). Both theoretical positions have also formed the foundation of the work that we have done thus far in the shelter. This is especially the case as the most prominent aspect of the "frame" has been the focus on collaboration, including a collaborative structuring of what it is that we, as staff, residents, and practitioners, are doing (building) together.
Empowerment theory describes the process whereby communities develop their own collaborative solutions that work for them (Seidman & Rappaport, 1986). The ultimate goal of the community practitioner is to promote empowerment as reflected in the increased agency and well-being of a community, generally measured by the functioning of collaborative processes (Rappaport & Seidman, 2000). Empowerment entails a process of working through historically entrenched feelings of hopelessness, depression, and powerlessness resulting in the enhancement of possibilities for people to control their own lives (Borg, 2002). This process suggests that functioning, in general, is a collaborative project between people as well as between and within the systems within which they operate (Zimmerman, 2000). As such, an assessment of functioning must address itself to an evaluative process that accounts for relationships, social structures, and resources that make it possible for existing competencies to operate. Empowerment implies that in those cases where competencies need to be learned, they are best learned in the context of daily living.
Contemporary interpersonal ideas about the cultural implications of transference-countertransference dimensions of psychoanalytic treatment address enactment as an ever-present dimension of the process, whether in analysis or in day-to-day living. Levenson (1983) states that "the transference becomes a highly intensified replay of the material under discussion" (p. 11). As such, what is explored in the development of empowerment interventions are the repetitive patterns of behavior/interaction in the community. Levenson (1981) states that "psychoanalysis begins when what is talked about between"persons is also experienced between them" (p. 495). This experiencing insinuates action, and an increasing awareness of such actions. Enactment becomes a means of deepening awareness of community interactions and patterns of thinking, feeling, and behaving that have been perpetuated and maintained, and highlights their defensive, protective, and communicative functions.
An extrapolation of the interpersonal psychoanalytic conceptual framework to community interventions accounts for the enactments between residents and practitioners, as well as among the community members themselves. Practitioners can assess and utilize the information gleaned from our involvement in the enactment to inform and mobilize the group-analytic endeavor. We utilize our awareness of and inevitable immersion in the ongoing enactments as a means of understanding the transference-countertransference dimensions implicit in the community members patterns of interaction. These patterns are indicative of areas of unconscious conflict within the community (Borg, Garrod & Dalla, 2001). Conflict from this perspective refers to the desire to be open to others and new experience on the one hand and to remain embedded in the familiar interactive patterns of the individual or group history on the other (Bromberg, 1998; Levenson, 1991; Stern, 1997).
Transference in Community Group Analysis
It is likely that a persons attitude toward his or her environment inevitably represents both transferential and realistic appraisals (Sullivan, 1953; 1964), and that familial as well as cultural/ environmental contexts contribute to processes of internalization and identification (Freud, 1921; Fromm, 1955) underlying these appraisals. Gustafson and Cooper (1992) suggest that groups, like individuals, form unconscious theories about what is going on inside them and continually test these theories through the interactive patterns that develop within them the most common form of testing is the "direct transference test" (p. 163). For example, Lous assertion highlighted a consistent concern in the shelter that group members were not to be trusted. Lou needed to know if he would be able to find a way to process the intense anxiety that characterized the residence subsequent to the disaster. This anxiety represented the underlying and shared experience of trauma, though defensive depression formed a protective emotional film to avert awareness of the anxiety as such (Bose, 1998). Regarding depressive issues in groups, Gosling (1985) states that "one is ones most dangerous saboteur [as] ones public stance on the side of learning turns out to be a determination to repeat what one already knows and to learn little that is new and possible" (p. 160).
In his own repetitive way, Lou tested the waters to see if his need for dependency would be taken advantage of or exploited. Lou offered a familiar, though confusing and potentially enraging, statement to see if others would be contemptuous, belittling, or cold. It was a direct transference test where others were tempted to repeat the traumatizing behavior predicted by the unconscious theory of the group. In this case, the past transfers directly into the present and confirms the need to maintain the silence (depression) that had preceded the group. Enactment, therefore, becomes the arena wherein the group tests its unconscious theories about the group itself and wherein group enactments/repetitions are inclusive of staff and practitioners as well as group members themselves.
According to Gustafson and Cooper (1992) the other common mode of testing unconscious theory in groups is "to give others, either members or consultants, the difficult state which one is afraid will be traumatic, hoping that they will demonstrate how to handle it" (p. 263). This could serve to define the concept of enactment. Since Lou, as a representative of this group, believed that open dependency was dangerous, the need to be taken care of was imputed to the practitioners. The others attacked him for his attempt at processing the tragedy, as well as for his implicit need for care and help. Since the actual data that would be needed to work through this moment of intense anxiety belonged to the group itself, the practitioners were in a position to turn to the group and demonstrate our dependence on the residents to do our job. This test could only be passed if the practitioners would be able to admit, against our own countertransferential resistance, our need for the groups contribution if we were to be of use.
We had an opportunity to work with the group to show that we were able to admit when we needed their help. Gustafson and Cooper (1992) conclude by stating that "a group deepens its participation when its tests are passed, wherein behavior designed to tempt trauma does not bring on the trauma, but clearly shows protection from it" (p. 264). Levenson (1991) considers this to be a process wherein the practitioner becomes embedded in the struggle and both patient and analyst have to help the other disembed from the transference-countertransference struggle.
Mentally Ill and Homeless
There is a broad consensus emerging from the field of psychiatric epidemiology that, of the homeless people residing in U. S. shelters, about one third have significant mental illnesses, with some discrepancy of opinion regarding whether these illnesses are a cause or a result of homelessness (Breakey & Thompson, 1995). Experience and research findings suggest a broad heterogeneity of homeless people (Cohen, 1993). It is possible that homelessness, as a category, provides a surface of fantasied homogeneity that can trigger stimulus-response transferential reactions, and ultimately serves as a receptacle for dissociated self-identities, in other words, a categorical scapegoat.
In one study regarding the "epidemic" of homeless mentally ill persons, the authors state that the "outrage" of the American public has little to do with concern for the people who are in this condition and more to do with "visible signs of failures of our social and health care policies" (Breakey & Thompson, 1997, p. ix). This system breakdown, evidently, is the cause of massive form of collective defense, characterizing U.S. citizens generally hopeless attitude about the epidemic proportions of homelessness. Homelessness may be the ultimate symbol for insecurity in the U.S. culture, and the WTC disaster certainly struck at the heart of a wide-scale sense of national and worldwide insecurity. Hence, creating society-level security operations against the anxiety that were I to fall into this status, I, like those who are there now, would be stuck there.
Thinking of the workings of such a societal security system conjures up the notion of Fromms (1947) social character. Invoking the specter of this character, Hegeman (1995) suggests that, within particular character formations, "successful adjustment to society could produce psychopathology" (p. 830). This being a society where some (e.g., the homeless/ mentally ill) suffer from an inability to adapt while others suffer from the compromises they have made in order to adapt (Fromm, 1955). Specific to homelessness and mental illness, perhaps as a screen for the displacement of other concerns about a system-wide failures, this adaptation allows non-homeless citizens to maintain a blind spot around the notion that were we to fall into that status, there would be nothing to catch us.
Thus far, in this work, therapeutic action was highlighted as group members became lost in unwitting enactments, playing out old repetitions, and eventually developing new interactional experience. The group enactment related to the WTC disaster wherein we joined the residents in their "falling" and experienced the hopelessness that resulted from that (uncaught) fall. Specifically, I believe that the reaction that we experienced in the residence setting was indicative of a deeper pain in the residence community. This pain emanated from a sense of being unseen and unheard in the context of a disaster, the recent disaster of the WTC, as well as the chronic disasters that many group members had perpetually suffered. This was, after all, a group of individuals who had had the very foundation of their security shattered. As such, they had been scared and traumatized. Paradoxically, they were isolated in the midst of their social environment. This, I hypothesize, resulted in a shared sense of defensive depression that was emotionally grafted into the already debilitated community character of the residents and shared with the staff and practitioners through the group enactment.
Pulling It Together/Apart
Throughout the intervention there has been an underlying expectation (assumption) playing out that by addressing the group problems/patterns, we could collaboratively develop solutions. By grounding the ongoing intervention in interpersonal/empowerment philosophy we consistently frame the work of the group on collaboration. This frame has been utilized to withstand the pull toward well-entrenched patterns of dependency and powerlessness expressed and manifested by the residents. As if he was the unwitting volunteer representative of the transitional space between collaboration and dependency, Lou was willing martyr himself to the potentially annihilating anger of the group. By his doing so, we were able to experience the deadness and depression that permeated this community in the aftermath of the WTC trauma. By setting himself up as a target for the groups rage, Lou allowed us to penetrate the groups seemingly intractable depression.
In the interview with Lou, we recognized his awareness of and ambivalence toward his historical imprisonment in his group identity ("crazy"). His own insight into this dynamic was revealed in his statement regarding the "blowing" of his cover. The work of the group (Bion, 1959) was to free the residents from their imprisonment in well-protected depressive symptoms/ identities that were enacted to represent increased isolation and affective distancing from one another resulting in an atmosphere of emotional deadness. The group task entailed processing a high degree of anxiety and anger in the object of mobilizing the intractable depression that had prevented this group from attaining insight into the affective-relational impact of the recent trauma. The group needed Lou to begin the process of mourning a, perhaps somewhat distorted, sense of security. This related both to the recent events as well as a shared history of recognizing themselves as a historically disenfranchised ("expendable") group. Lou was doing something, as the scapegoat, to mobilize the group.
The defensive stance in the group unconscious was one wherein flight (depression) was replaced by fight (rage/anger). Such assumptions can be seen as defenses that serve to protect the group from awareness of debilitating anxiety (Jaques, 1955; Menzies, 1960). The group enacted these assumptions to suspend the reality of their circumstances, hence indicating the need for security in an environment that could not contain their overwhelming fears. As such, the basic assumptions gave way to the realization of a task wherein fantasies of individual security were enacted and made conscious to set the stage for collaborative work on initiating and maintaining interpersonal security. Only when the group was able to address a realistic means of creating such safety, could the anxiety enter awareness, hence challenging its basic assumptions and serving to initiate the long-term process of working through the group-level trauma(s). This process was based on the interpersonal security that had been built into the group since its initiation. Although the question posed ("What Happened?") highlighted the unexplainable quality of the recent events and served both inter-connective and interpretive functions, much of the group "work" was non-verbal (e.g., Kuriloff, 1998). Grounded upon the collaboratively developed safety, a shift occurred in the collective/repetitive defensive pattern of the group that mobilized the unconsciously implemented depression of the group. This occurred only when the groups very life was threatened. After all, at the most basic level, the work of the group is survival (Turquet, 1985). A shared sense of the individual traumatization of group members led to an increased connection to and compassion for each other. This, in turn, formed a base of support for working through both the acute trauma and the history of chronic traumatic experiences that permeated the character structure of this community.
The psychoanalyst Irwin Hoffman (1998) suggests that "The universal bad object is nothing but the human condition. To combat it we band together in groups, in families, in communities "to make sense of our worth" (p. 240). In the aftermath of the WTC tragedy, our sense of meaning and security was shattered. Yet, if the "banding together" supporting our sense of worth is not shattered completely, we can sustain the hope necessary to rebuild. This rebuilding of interpersonal connection, whether in psychoanalysis, group work, or community intervention is empowering to the extent that it increases our understanding of symptoms and their enactment and creates a forum of collaboration for working through traumatic experience.
Walking home through the East Village that Thursday I noticed a message spray-painted upon a building wall "YOU ARE ALIVE!" The message, like the group that day, served as yet another reminder.
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Who Played Ball with Bin Laden? Commentary on 'Community Group-Analysis: A Post-Crisis Synthesis' by Mark Borg
Blackwell, D. (2003). Who played ball with Bin Laden? Commentary on 'Community group-analysis: A Post-crisis synthesis' by Mark Borg.
Group Analysis, 36 (2), 242-247.
FIRST OF ALL, I WANT TO WELCOME this paper and the work it represents. Psychoanalytic psychotherapy has for too long been much more available to the affluent and to the comfortably well-off than it has to the poor. So it is good to see an effort being made to take it to street level and to integrate it with theories of community empowerment. I therefore hope the following remarks will be understood in the context of my overall support and enthusiasm for this enterprise.
However, it may be that I approach the problem from a significantly different perspective from Dr. Borg. I do not regard societies as unitary structures in which all members share a common interest, and in which casualties such as the 'homeless mentally ill' occur as a result of individual misfortune or system wide failures. I regard societies as arenas of struggle between competing and often conflicting interests, so that certain groups become not only disadvantaged but exploited and oppressed. Thus in working with such groups, professionals are called on to address the political context in which their oppression takes place. Moreover, I think we are obliged not only to empower them to find their own voice, but also to empower ourselves to give voice to their predicament; to write not only about them but also FOR them.
I am therefore interested in the relationship between the client group and the event they are reacting to, not only at a psycho-social level but at a socio-political level, and I am interested in the place of professional staff in these contexts.
Many years ago a particular piece of graffiti was regularly to be seen. It said, 'If you're not part of the solution, you're part of the problem!' In 1971 I heard the London-based community activist from the US, Ed Berman, challenge this claim. He proposed replacing it with the assertion, 'If you're not part of the problem, you can't be part of the solution!'
Over the years I have thought a lot about these two claims and have come to the conclusion that the latter is an advance on the former. If you're not part of the solution, you are indeed part of the problem whether you know it or not. But in order to become part of the solution you have to recognize how you are part of the problem. I have further concluded that Ed Berman's version should be posted on the office wall of every psychiatrist and psychotherapist, and it should be axiomatic for all group analysts who believe in analysis of the group, including the conductor. Indeed one might hope that this understanding underpinned any training analysis. Alas, all to often, a training analysis and the training itself is believed to mark the transition from being part of the problem to being part of the solution and, by definition, thereby no longer part of the problem. The patients become the problem, and we become the solution.
So, it becomes important to ask of any approach to community development, community mental health or community group analysis, 'To what extent does it enable the practitioners to perceive themselves as part of the problem?' I am therefore struck by the fact that we are not told in this paper what impact the attack on the World Trade Center has made on the author and his team, nor how they have sought to cope with it, nor again, and perhaps crucially in this context, how they have sought to explain it to themselves. Indeed it is not until the conclusion that the author explicitly locates himself as a member of the community which has been traumatised: 'OUR sense of meaning and security was shattered.'
In the aftermath of 9/11 it was not uncommon to find mental health professionals struggling to come to terms with what had happened. Most, if not all of us, were to some extent shaken. Yet there was a remarkable tendency to shift the focus onto our clients and how they were coping with it all. This tendency is to be found in much of the work done with the survivors of various sorts of trauma. (When, in 1990, a colleague and I conducted a workshop on countertransference at the 2nd European Symposium on Traumatic Stress, we were struck by how many of those attending said this was an issue to which very little attention was given in their workplaces.) Having successfully shifted the location of distress onto the client group the final stage of the professional defence system is then to develop a complex and abstract theory about what the clients are doing with it. This shifts the debate away from what the clients actually experience onto which theory of unconscious process most effectively explains their behaviour. That is now two steps away from the professionals' experience.
The next thing that interests me in Dr Borg's account is the claim by the director of the program that no-one had talked about the WTC attack. How did he know? Are the residents so closely monitored that they can have no secret conversations? Did they never go out on the street where they might have discussed the situation with other citizens? Was it in fact the residents who had not mentioned the event or was it the staff?
It is also interesting at this point to wonder how staff might perceive their part in the overall problem of the 'homeless mentally ill'. Dr Borg's reference to a 'categorical scapegoat' is an important observation but only a start to a more elaborate analysis of the psychodynamics of a socio- political context in which scapegoats and scapegoaters need to be located.
Then there is Lou. Our group-analytic colleague, the late Murray Cox, used to tell the story of the junior doctor on the psychiatric ward who always sat in the same seat at the ward group meeting. When asked about this, the young doctor replied that he always sat next to a particular schizophrenic patient and this patient always sat in the same seat. The reason for sitting next to him was that he muttered under his breath a commentary about the group from which the doctor was able to follow what was actually going on. The moral of this story is, 'look for the wisdom in what your so-called 'schizophrenic' patients say, not just the pathology.' People who get labelled 'schizophrenic' (or perhaps 'schizo-affective'), tend to be adept at two things: taking on and symptomatising the disowned madness of those around them, and saying what no-one wants to hear about that madness in such a cryptic and metaphorically encoded way that no-one hears it who can't bear to, and no-one can prove they've really said it who might try to prosecute them for saying it. So let's see what it MIGHT mean for Lou to say, 'I used to play basketball with Osama Bin Laden. And he was a pretty cool guy.'
Basketball is one of three quintessentially American sports, along with Grid-Iron and Baseball. But it is the only one to have been successfully exported all over the world. So Lou says he's played an essentially American game with the guy who is supposed to be responsible for the WCT attack and whom everyone is blaming. I cannot help noting that 'Uncle Sam' used to play ball with Bin Laden too. And in those days, when he was fighting the Russians in Afghanistan, Uncle Sam appears to have thought him a pretty cool guy too. But one then has to ask 'How welcome would such an observation have been in the context Dr Borg describes?'
There are several references to the attack as a 'disaster', along with a sense that it is somehow inexplicable and that various questions about it are unanswerable, all of which suggests to me a tendency to depoliticise the event. In a depoliticised context questions about it do indeed become unanswerable. Whereas in a political context answers become readily available though they might be contentious. Indeed, my reaction to first hearing the news was that it was shocking but not surprising. So I begin to wonder, 'Is this a context where there is a resistance to arriving at the sort of explanation for the attack that might be arrived at quite quickly by anyone who had taken serious note of US foreign policy over the preceding half century in general and its recent policies in the Middle East in particular?' Such an explanation requires, as Chomsky has consistently argued, that the US intellectual community takes some responsibility for challenging or failing to challenge these sorts of policies.
In October 2001 I joined an online symposium for the US psychoanalytic community and other interested parties to reflect and try to make sense of 9/11. To begin with there was a good deal of splitting and projection between the civilised, democratic 'us' and the barbaric, undemocratic 'them'; and of course a good few theories about how 'they' did the splitting and projecting in order to have this irrational hatred of 'us'. Then a Palestinian living in Canada introduced a significantly different view. Much of the discussion up to that point, he suggested had been ill-informed and bordering on racist. There were he said two views: The European North American White view, and the Rest of the World view. The latter, which he proceeded to elaborate, was radically different from the former Many of the contributors to the symposium turned on him, regarding his comments as extreme, outrageous or crazy, much as the group in Dr Borg's paper turned on Lou. It is an interesting parallel.
A further point of interest is the reference to people who are 'expendable' with whom the residents readily identify. This appears at first sight to be applied to the victims of the WTC attack. However a little reflection reveals that the victims of the attack mattered a great deal and were not generally viewed as being at all expendable. They were, as the journalist John Pilger put it, 'worthy victims', as distinct from the 'unworthy victims' who die in great numbers on a regular basis without anyone making too much of a fuss about it, such as victims of the civil war in the Sudan, or civilian casualties in the post 9/11 retaliatory attack on Afghanistan. The term 'collateral damage' was originally coined to cover this latter category of people. Those innocents who unfortunately (but inevitably) get killed as a result of some military action or political strategy. It's a nice anodyne term in the tradition of 'newspeak', which helps us avoid thinking of human casualties as real people. We are instead invited to transform real human suffering into some vague consequence on the debit side of the balance sheet, the regrettable cost of achieving some lofty political ideal.
The homeless mentally ill are part of the collateral damage of the 'American Dream', and particularly of its recent manifestation in Reagan-Thatcher neo-liberalist economics. They clearly perceive their status of expendability. Perhaps at some unconscious level they also recognise that 9/11 might represent mainstream America's first direct experience of being on the receiving end of 'collateral damage', and that while that might not be consciously recognised it was nevertheless a significant part of the trauma. (It is indeed noteworthy that the official US response to the tragic loss of life has been to embark on a military campaign that was guaranteed to cause the death or suffering of a whole lot more nameless, faceless third world people otherwise known as the civilian population of Afghanistan.) An interesting question here is, 'How far do the community group analysts view the client group's perception of themselves as expendable as, a) A symptom of their disempowerment and therefore of their need for empowerment? or, b) An accurate perception of their social context and of their ascribed status within it?
My last observation concerns the sources Dr Borg draws on for his conception of empowerment and community development. All these models seem to be at pains to avoid any meaningful confrontation, or conflict of interest, with 'power', or with the ruling elites in their societies and the political mainstream. Conversely, one can think for example of Paulo Frière's approach to the education of oppressed peoples which involved focusing their learning on the structure of their oppression. Or one might look at the approach of Saul Alinsky who specialised in enabling community groups to win battles for self-determination against the dominant political authorities. Or again one could turn to the community programmes and empowerment philosophy of the Black Panthers which highlighted the oppressive structures and racist attitudes through which black communities are disempowered. Dr Borg talks about the 'system wide failures' which his client group represents. I suspect that 'system wide failures' is a euphemism behind which lies the essentially oppressive structures and processes by which these people are made victims, and it further obfuscates the degree of choice exercised and responsibility disavowed by the wider society.
I wish Dr Borg well in his work and hope we shall hear more about it in this journal in due course, so that community group analysis might give New York's homeless a voice on these pages which is not dependent on the interest aroused by a tragedy affecting their fellow citizens but which recognises their own particular tragedy and the wider social context in which it is enacted.
I Must Not Think Bad Thoughts: Latent Content in the American Dream Response to Commentary by Dick Blackwell
Mark B. Borg, Jr. PhD
Borg, Jr., M. B. (2003). I Must Not Think Bad Thoughts:
Latent Content in the American Dream.
Group Analysis, 36 (2), 248-252.
I AM GRATEFUL TO DR. BLACKWELL for reflecting with me us, I should say on the ideas and experiences that I took up in my essay. His thoughts are enriching and provocative, and provide considerable food for further thought.
The hairs rose on the back of my neck when I read the title of Dr. Blackwell's commentary: "Who Played Ball with Bin Laden?" My original working title was: "Playing Basketball with Bin Laden." After some heated discussion with the intervention team members, and a fair degree of "editorial feedback" from colleagues, I had reluctantly changed the title. Yes, I thought, it's true, the title is a bit flippant, and yes, it does carry within it the potential to offend. So Dr. Blackwell's title was an uncanny convergence indeed, and my initial response was the strange and disorienting sense that I was dreaming. Oddly, the refrain of an old punk song by the band X, I Must Not Think Bad Thoughts, was playing repetitively in my head, and I wondered what this dream was trying to communicate from my own, or my culture's, unconscious. If this is a dream, I thought, then what part of my own repressed, dissociated unconscious process is speaking to me through it, that is, through the voice of my overseas colleague? Perhaps Dr. Blackwell's exploration of the latent content submerged beneath the manifest presentation of my article makes visible a specifically American style of collective unconscious defense, a national character structure that wards off our own "bad thoughts" about the degree to which we are part of the problem. If this is so, I asked myself, what part of my own experience, and that of my colleagues on the intervention team, my fellow New Yorkers, and the rest of us Americans, is Dr. Blackwell holding for us?
I discussed at length in a previous article the impact of the World Trade Center attack on the community mental health profession in New York City (Borg, 2002), and the ways practitioners in New York might have been attempting to deal with their own trauma by using professional roles as "helpers" as a defense against their own anxiety. I remember my own struggle with feelings of helplessness when the Red Cross, overwhelmed with mental health volunteers, rejected my professional help. Why, then, as Dr. Blackwell points out, did I make no mention of this in this paper? I wish I could say that this was a thoughtful and considered decision. But it wasn't. I never noticed the omission until I read Dr. Blackwell's response. I see this now as an indication of my own engagement in a collective unconscious defense to ward off bad thoughts about the degree to which we may be part of the problem, specific to the World Trade Center disaster.
Dr. Blackwell, following Ed Berman, has offered us the ironic view that if one cannot be part of the problem, one cannot be part of the solution. It is easy to look back into the superficial aspects of this dreamscape upon the strange sense of unity (manifested in American flags, NYPD/FDNY baseball caps, and so on) that existed among New Yorkers in the days, weeks, and months following September 11. This was the most idealistic of dreams, and its unity seemed to transcend, for a time, age, race, ethnicity, class, gender, and sexual orientation. Perhaps this unity was an instinctive joining of forces in the face of our overwhelming sense of panic. But it quickly and not very subtly became clear that there were experiences and interpretations of the event that would be sanctioned, and ones that would not that would in fact result in fanatical censure, ostracism, and exclusion (as in Dr. Blackwell's example of the attack upon a Palestinian contributor to an online symposium).
Why did I exclude so many characters from my original (manifest content) telling of the story? Right, I left out Paulo Friere, Saul Alinsky, and Noam Chomsky, not to mention the interpersonal psychoanalyst cum human rights activist, Erich Fromm. Here again, I ask: what happened? Now it is much more tolerable than it was then to see how much I (we) did not want to see at that time. These sources I omitted (and many others), who have not avoided confrontation of ruling, monopolizing, and oppressing power structures, were/are reminders. Theirs are voices that, though generally familiar, I could not then locate to help me find my own, not to mention the voice of the people with whom we worked, neither to speak with or FOR them. After all, for most of us, the particular dream that I am describing is a nightmare, as are the implications that continue to reverberate in ongoing international muscle-flexing and threats of war.
That song continued to provide a backdrop to my thoughts about Dr. Blackwell's commentary, revealing further how I was using the manifest content of the dream (the nightmare of 9/11) to overshadow the latent content that Dr. Blackwell tapped into. The lyrics hold us (at least in the U.S.) accountable for the ways in which our tax dollars are spent (e.g., as Dr. Blackwell mentioned, funding the rebels in Afghanistan against the Russians):
- I'm guilty of murder of innocent men,
Innocent women, innocent children thousands of them!
My planes, my guns, my money, my soldiers,
My blood on my hands
It's all my fault;
I must not think bad thoughts, what is this world coming to?
This song implicates U.S. society in our own perpetration of atrocities and terrorism, and points to the violence associated with the current way that things work. It is a dramatic explanation of why we might dissociate our part in the problem: I am guilty of murder (?!). This includes both acute problems (for instance, the destruction of the World Trade Center), and chronic ones (such as homelessness, among many others). Unable to accept responsibility and accountability, we are able to be a constructive part neither of the problem nor of the solution. Implication, and resignation, in the non-participative status quo is subdued by personally and culturally sanctioned defensive mantras such as I must not think bad thoughts.
I thank Dr. Blackwell and the publishers of Group Analysis for giving me the opportunity to re-engage with the experience of this intervention. As if waking from a dream, I realize now how the initial telling of this story reflected many of the problems that we were attempting to target and work through in the intervention. In the interpersonal psychoanalytic model, it is considered inevitable that the unconscious dynamics of both (or all) parties will be enacted in the analytic engagement (these include cultural as well as personal dynamics). The general idea is similar to Ed Berman's, "If you're not part of the problem, you can't be part of the solution!" That being that the working through requires the analyst to become "trapped, immersed and participating in the system and work his [or her] way out" (Levenson, 1974, p. 174).
I suppose, then, that it should not be so surprising that the wider cultural dissociation of our part of the problem (both general issues like homelessness, and the specifics of the World Trade Center attack) would be enacted and recreated in my initial re-telling of this story. The challenge of integrating the latent and manifest content of this particular dream, has been for me a continuing process of seeking to locate myself in an expanded version of the story. I do not imagine that the story is, or will ever be, complete, especially seeing how persistently our enacted unconscious difficulties repeat, while newer and hopefully more complex, less defended movements toward the reintegration of dissociated material are slow and incremental. To become part of these particular problems/solutions is to locate ourselves not only in the communities and cultural value systems of our daily life, but also among the non-members of that community, the "homeless" who are a major voice of the bad thoughts that we regularly ignore. Such an endeavor also requires locating ourselves in the wider national and international communities that are impacted and traumatized by the policies, actions, and inactions of our government.
Dr. Blackwell asked two very important questions: Do I and my team view our client group's perception of themselves as expendable as a symptom of their disempowerment and therefore of their need for empowerment, or as an accurate perception of their social context and of their ascribed status within it? To the extent that our government speaks for us, we must grant that homeless peoples' perception of themselves as expendable is an accurate perception of their social context and status. However, the community approach that we used with this homeless group also contends that homeless people are both capable of, and can benefit from, an approach that helps them develop a more complicated view of themselves, their circumstances, and their capacities, including, possibly, their capacity to advocate for themselves. I agree with Dr. Blackwell that the homeless, and other disenfranchised groups, often need advocates who will speak FOR them. Yet it was our sense that in finding a way to do so, the unique and individual people in our group needed to first find a voice with which to speak. Therefore, we began by facilitating a process wherein these people could speak to and hear each other perhaps this serving as a basis for building a psychological sense of community. I also believe that this is a good start: that the "voice" of this community has been heard and responded to in these pages.
I agree wholeheartedly with Dr. Blackwell in looking forward to the day when the homeless will find a permanent voice in these pages, and in the pages of other community/clinical journals not one dependent on interest aroused by a general tragedy or other seemingly more sensational event. To me the problem isn't that interest was aroused by a tragedy, but that so often it is only the tragedies of the "voiced" that count, and not the tragedies of the voiceless.
Borg, M.B. (2002). The psychoanalyst as community practitioner. Psychologist Psychoanalist, 22(2): 36-44.
Levenson, E. (1974). The fallacy of understanding. New York: Basic Books.
X (1983). I must not think bad thoughts. More fun in the new world. Los Angeles: Elektra.