Sunday, May 23, 2021

Electives: Students Present: Somatization and Group Therapy, Part IIIB

What had happened in the group happened in parallel process to my personal life: I split my feelings of loneliness and shame from the group’s projective identification of me in an omnipotent position. Now we will see how we managed to reinterpret the enactment and how an intersubjective space for new experiences was created for the group as a whole.

Foteini’s Case Study:

What happens when something unbearable for the analyst interacts with something unbearable for the group members? It is a moment of encounter in which the group projects to the therapist a deficiency of coordination, a moment when the inner personal will be the womb that will engulf the intersubjective.

The cauterization (medical term: of the heart, to correct the unstable cardiac frequency) of the group arrhythmia seemed to be the therapeutic challenge where bad representations, of the analyst and of the members' selves, were in discourse without detachment and without fear of somatization and fragmentation. Examination of projective identifications, happening in
a parallel process, began. The first process concerned the feelings of agony, pain and
frustration which the mother has to keep in control and she also has the responsibility
of planning the intervention. These qualities my child projected on me, inviting me to occupy an omnipotent position and having to feel loneliness at the same time. On the other hand, the group members, my symbolic children, reflected elements representing a motherly figure devastated and disconnected, a motherly figure feeling ashamed and shrinking, fearing being attacked by her children because of her absence. 


It seemed that the group needed to communicate the aspect of the not good enough mother. The mother who can be absent without guilt thus integrates the split and facilitates the transition into a depressive position. The group members sought an object of identification and explored, at a symbolic level, who was being abandoned, whose needs where forgotten. Ehrenberg (1995) supports that the challenge is not to surpass our own annoying feelings, but to recognize that they are part of the analytic procedure. If we see ourselves being defensive, or reluctant, this is an important analytic fact, indicative of what happens interactively, aspects that intervene between the need of the patients to mourn for idealized objects and the need of the analyst to mourn the limits of his/her therapeutic omnipotence. 


Until that moment of the session in the group, in which I returned after the cauterization of my son’s arrhythmia, I was not fully aware of the degree of difficulties concerning the relationship with my child. I had been a false self of a mother who does not admit her exhaustion, whose body is tired and who may have been persecuted by her child's attacks and enactments. After the session, I discussed the session with my co-therapist, as we do after every session. We had the belief in common that we had cracked open and then closed a door; that is, we did not encourage the cauterization of the group’s arrhythmia, an arrhythmia we belatedly understood as members and therapists may be mutually traumatized, mutually vulnerable without the need to deny the toxicity of the one or the other in order to maintain the sense of psychic integrity. 


It was at the beginning of my acknowledgement of the extent of my frustration and anger towards my son that I became more able to feel a greater sense of authenticity and aliveness. This, in turn, enabled the group to shift from seeking approval to a search for recognition of a true self. In the session that followed, the members’ interactions allowed the unfolding of material that shed more light on the emotionally suppressive mother-child condition. The confession of a member that admitted to how disorganized she feels by the presence

of the baby in the group, (as reminder there was a baby present at the group  with the consent of the group members), created more space to talk about the possibility that a child may cause threatening feelings for its mother, might persecute her or even remind her of her inadequacy. 


My own personal story met the stories of the group members, causing a resonance
(Foulkes,1990) with the experience in the moment - my willingness to perceive the members' material, to be susceptible to their impacts - revealing what happens if we go deeply and fight analytically. With continuous supervision, my co-therapist and I realized that we had gotten into regressive states of shame and guilt which could not be articulated. We realized the need to open a safe enough space where the mother-child dyad would be able to  embrace all their aspects of vulnerability allowing for autonomously reclaimed ability to bear to be bad together without threatening persecution.


The personal story with my son incited me to connect more truthfully with the group members, discovering the boundaries of my resilience and realizing that something like this can happen without it being dangerous. The group projected the aspect of a mother who might be exhausted shattered and angry. My resonance with this psychic state, and my realizing, through the supervision, the usefulness of my weak point as a tool of analytic work, allowed the emergence of emotionally difficult experiences of the members concerning their own mother-child relationships. Their experiences of frustration and exhaustion and their denial of the omnipotent position led to exploration of more liberating ways of relationship for the group members, leading not to disorganization but able to include detached shameful aspects of self. It seemed the heart of the group is less threatened by arrhythmia and is steadily regulated allowing for the creation of new perspectives in the analytic work. On a personal level, my therapy, my supervision and the continuous education facilitate the relational coordination of my multiple roles. As Ehrenberg writes: each participant does own something not owned before. This is something we keep even after the experience is over and it becomes a kind of 'private property.' I am different both with my family and my group.


- Fotini Doumoura

Ehrenberg, D.B. (2005). Working at the “Intimate Edge” Intersubjective Considerations—Comments on “A Case Study of Power and the Eroticized Transference-Countertransference”. Psychoanal. Inq., 25(3):342-358.

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