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Group therapy: A group analytic approach by Nick Barwick and Martin Weegman.

Group therapy: A group analytic approach by Nick Barwick and Martin Weegman New York, NY: Routledge, 2018. ISBN-987-1-138-88971-2
If you want to go fast, go alone, if you want to go far, go together.
(African Proverb)

Group Therapy: A Group Analytic Approach (2018) is an introduction to contemporary group analytic theory and practice. Often deemed as the most complex of all the psychological therapies, the book provides a concise introduction to the field. It is a theoretically rich offering which includes clinically vivid accounts of the theory and concepts and how these concepts may look in action. The intended audience includes qualified group analysts, students of group analysis and others who may be interested in or who may wish to explore and understand the field of group analytic psychotherapy. The introductory aim of the book is achieved as concepts are presented in a lucid manner starting with foundational group analytic theory and ending with clinical excerpts. It includes examples which remain true to and attest to the cumbersome task of a group analytic conductor as well as the power and peril of interconnectedness in group psychotherapy.

Barwick begins by tracing back seminal works of the main contributors of group work as a form of psychological therapy. In the first chapter, they lays the foundation of the development of group psychotherapy and some of the pioneering work by psychoanalytically trained psychiatrists who ventured into group work. Included are Bion (1897-1978) and his 'basic assumptions' theory and Trignant Burrow's (1875-1950) argument that 'Western culture's progression towards greater individualism caused people to become alienated, forgetting the essential nature of their relatedness' (p. 7). Barwick and Weegman detail how Burrow's inglorious professional fate influenced Foulkes' pioneering notion that individual and group analysis are 'two sides of one coin' (p. 22). It is upon this foundation that the authors give a detailed elaboration of Foulkes' core concepts of group-analytic theory in the first part of the book. In tracing the history and development of this mode of psychological therapy, Barwick and Weegman provide detailed descriptions of exactly what goes on in a group, from the size of the group, to the selection criteria and the role that the conductor plays during the group analytic process. In the presentation of the core concepts of this modality and the appreciation of the mother-infant paradigm (Chapter Six), is the authors are careful to map out some of the core psychoanalytic processes at work in groups. They offer a simple yet adequately detailed picture of concepts such as containment and projective identification, holding and playing. This suffices to grip any psychoanalytically inclined reader throughout the book and makes a case for why group and individual analysis is, as Foulkes stated, 'two sides of one coin' (p. 22).

The inclusion of attachment group oriented literature in Chapter Six maps out the rich tapestry of the role of conductor as therapist. Barwick and Weegman allude to the fact that there is marked absence of attachment theory in group oriented literature and admittedly offers a scant exploration into what he maintains is an important aspect of group analysis (p. 91). Attachment is considered an important and useful concept as it relates to issues of endings and loss in group work. Thus, despite the thoughtfulness of the clinical discussion and dialogue around endings at the end of the book (Chapter Twelve), the inclusion of how the attachment patterns of group members influence how they experience endings in group analysis would have allowed for deeper engagement with the notion of attachment group oriented literature.

The inclusion of Bion's basic assumptions theory in Chapter Seven initiates a view into and discussion of the complex historical rivalry between Foulkes' and Bion's work. This chapter's utility lies in Barwick and Weegman's ability to draw from Bion's concepts around the basic assumptions to elaborate on the sometimes toxic and annihilatory anxieties that may embody group analysis and the group-as-a-whole. The parallels and contrasts that they skillfully draw between Foulkes and Bion all emphasise the endless challenges faced by a group conductor (particularly a novice conductor), to maintain his capacity to contain the groups' anxieties and to avoid the provocation of 'the devastating loss of confidence in both himself and the group' (p. 112).

The unique offering of this book is the dialogue between the authors in the second part of the book in which they discuss the clinical accounts and excerpts presented. The second part of the book is remarkably comparable to the collectivist African ethos, a belief that 'the individual cannot be described in isolation' (p. 131). Barwick and Weegman's sensitive treatment of material offers some ideas as to some of the complexities of group analysis and the group's ability to sit with and bear each other's pain and uncertainty. This part of the book, which is mainly about practice, tells the story of a fictional character and uses this character to flesh out some of the main theories discussed in the first part of the book, namely attachment theory, self-psychology and the Winnicottian tradition.

In Chapter Ten, Barwick generously shares a very personal story about his own struggles as a trainee group analyst. The brutally honest account of a group process he termed an 'initiation of fire' (p. 139) provides an enriching account of the inevitable difficulties of group analysis and allays novice group analysts' fears of starting out.

Considering the scarcity of writing that provides actual guidelines of how one goes about running a group analytic group therapy, Barwick and Weegman's excerpts and clinical account come close to being the gold standard. The examples used in the book highlight the importance of consideration in group member selection; the initiation of the therapeutic alliance between the conductor and individual members of the group, and how to manage ruptures and difficult beginnings and resistance.

Barwick and Weegman implore their readers to consider by what means we come to know and engage with the other. Their handling of the case excerpts and the possible internal and unconscious forces at play in individual members and the group as a whole makes a poignant point about how being a conductor in group analytic group work is a playful craft that requires considerable experience and the preparedness to suffer and humbly bear uncertainty. The authors' ability to demonstratively display the creativity and intuition required as a group conductor, is depicted vividly in this book, for example through the manner in which the two authors bounce ideas around and interchange with each other in a very informal and unconventional way.

The reflection of the meaning of ending offers an encouragement to bravely examine this difficult area, which although a reality of life, represents so many different things to different people. As Barwick notes:
From an analytic perspective, the meaning of ending arises from an
understanding that each end, signals a separation and a loss. This is
so, even if the separation has, for all intents and purposes, been
willingly entered into (p. 165).

The book ends on an existential note, reflecting theoretically and personally on the myriad losses we encounter in our everyday lives. Such losses, as the authors state, remind us that 'at the very end, we have no control over our lives for indeed we are only mortal' (p. 166).

Group Therapy: A Group Analytic Approach places group psychotherapy in a much needed, albeit cumbersome context. This book has demonstrated group analytics' ability and utility in providing a containing space for unbearable feelings that relate to interpersonal connection. For clinicians and other mental health practitioners working in a South African context, which is fraught with overwhelming pain of 'otherness' as a result of the past, this book is an important reminder that an understanding not only of the other but also of the self through one's understanding of the other, has curative and reparative factors that far exceed what can be achieved in individual psychotherapeutic practice.

Charity Mkone is a clinical psychologist, associate lecturer and PhD candidate at the University of Witwatersrand.

Charity Mkone

University of the Witwatersrand
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Author:Mkone, Charity
Publication:Psycho-analytic Psychotherapy in South Africa
Article Type:Book review
Date:Dec 22, 2018
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