64 Chapters
Medium 9780946439003

THERAPISTS AND PATIENTS

Foulkes, S.H. Karnac Books ePub

It remains to describe the conditions tinder which Psychotherapy takes place under civilian circumstances. It should be mentioned that the first series of observations took place during the war, 1940/42, in a County town. Patients came from many outlying districts and had no social contacts with each other outside the Group meetings which took place regularly once a week. More recent observations are taking place in London since the end of the war.

The general conditions of “ Outpatient Clinic “ patients need not be described. It is perhaps noteworthy that at the present time in London—in my case at St. Bartholomew’s Hospital— there is a long waiting list. It is not unusual for patients to have been half to one year on the waiting list before they are called up for treatment. On being first sent by their Doctor they are given a long interview by the Director and a careful “ social history “ is taken by the Psychiatric Social Worker. A provisional diagnosis is made and they are selected for a particular form of treatment, like electro-narcosis, Hypno- or Narco-Analysis, analytical Psychotherapy, etc., and allocated to one of the treating specialists on whose waiting list they go. Meanwhile they are usually given some medicine, e.g., Bromide and Luminal. Out of those on the waiting list I formed my Group. There was no particular selection, except ruling out those obviously not, or less, suitable. In this case I decided to begin with a women’s Group. Outpatients’ Groups are more difficult to form and treat than inpatients, and women appear to be more difficult to integrate into a Group than men. Mixed Groups have their own problems, but there is also much to recommend them. My private Group at present is a mixed one.

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Medium 9780946439560

7. On a chapter of Helen Keller's The World I Live In (1941)

Foulkes, S.H. Karnac Books ePub

The following paper, given here in a much shortened and edited version, was read to the British Psycho-Analytical Society in 1937. It throws light on another side of Foulkes’ interests and also includes an early mention of ego psychology.

Since the psychology of the ego and its relation to actual reality has come into the range of psychoanalytic investigation, works like that of Helen Keller (1908) have acquired a definite interest for us, though they do not carry any evidence on more classical psychoanalytic topics. The interest in ego psychology has grown particularly on the Continent, due I think to the more acute course of social developments there. The constant interference of external circumstances has led to observations on how far deeply established formations, such as our ego and superego (but not the id), can be influenced and altered by the social situation. Instead of considering this unrestful time as an accidental disturbance of our work we gradually realized that it showed an underlying factor at work, one we have to reckon with in practice and in science as long as human beings will be living in a social way.

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Medium 9780946439096

9. Psychodynamic Processes in the Light of Psycho analysis and Group Analysis

Foulkes, S.H. Karnac Books ePub

PSYCHODYNAMIC PROCESSES IN THE
LIGHT OF PSYCHO-ANALYSIS AND
GROUP ANALYSIS

Group analysis is concerned with the total field of mental dynamics, whether these be better studied in an individual or group situation. In this chapter a selection will be made and particular attention paid to psycho-analytic equivalents.

Freud’s contribution to group psychology was based on the findings of individual psychology, although he occasionally showed surprising insight in favour of the reverse procedure. In his book on the subject, he studied groups of an entirely different nature from those investigated by the present writer. He used two large, highly organized groups—the army and the Catholic church—as models from which to illustrate such concepts as for instance the ego ideal and identification. He did not attempt to explain the dynamic processes taking place in these groups as germane to them, but rather to show how the internal forces characteristic of individual life sought their expression through the group medium.

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Medium 9780946439225

2 - The Life Group

Foulkes, S.H. Karnac Books ePub

CHAPTER 2

The Treatment of the Life Group

NETWORK, PLEXUS

We are here concerned with problems as they arise in an interconnected, existing network in life. By contrast with the previous chapter, these people are very closely and intimately connected and their interactional network concerns the central area of their lives.

The family itself is the prototype of such a group, but I have stressed from the beginning that in psychological terms such a network includes persons who are not in the ordinary sense of the term family members.

Originally I used the term network and also nexus. Both these terms have since been used widely and with different meanings, so that I propose to use a special name for this concept of the intimate dynamic network with which we are concerned, and to call it complexus or for short plexus. (What is meant by that is that a relatively small number of people, who include the family, group themselves dynamically as the process of treatment proceeds, group themselves round the central person — the patient — especially in connection with his conflicts which are significant for the disturbance for which he has come to consult us.)

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Medium 9780946439096

6. Group Psychotherapy in the Light of Psychoanalysis

Foulkes, S.H. Karnac Books ePub

GROUP PSYCHOTHERAPY IN THE LIGHT OF PSYCHO-ANALYSIS1

The present historical situation shows clearly that human problems cannot be solved in isolation but only through a concerted effort of the whole of humanity. The future of the human species may well be made or marred according to whether or not it is able to grasp this fact and act upon it while there is still time. Anything we can learn as to the relationships of persons towards each other, and of groups towards each other, is, therefore, of great therapeutic significance.

Human people live always in a social setting, from the cradle to the grave. A neurotic patient asks for help because he cannot live satisfactorily in his community, or because his community cannot carry on with him. Because the forces by which he is run are anachronistic, according to an infantile and primitive pattern, he cannot adjust to his social group, and because he is not aware of the source of these forces within himself, he cannot have insight.

The main aim of a true therapy is, therefore, to develop insight and adjustment, vital inner adjustment establishing harmony between the individual and his world—not conformity. There is a relationship between the two: insight promotes adjustment, adjustment facilitates insight. Insight without adjustment does not go very far; adjustment without insight is incomplete but it can work. Adjustment seems the more fundamental from a therapeutic, insight from a scientific, point of view. Both meet on the testing ground of control of behaviour, when one is confronted with things and persons. If conflict involves predominantly early and primitive levels, control over present behaviour is lacking, individual analysis is the method of choice. Solution must then be sought in revision of the past, buried alive in the unconscious mind, or adjustment remains superficial, insight impotent. The group situation is the best medium when sufficient inner mobility is left to make control over present behaviour possible. Insight and adjustment can now be achieved in the face of the present task and the present group.

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