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Systems-Centered Practice: Selected Papers on Group Psychotherapy

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Systems-Centered Practice presents a series of papers that trace the development of the theory of living human systems between 1987 and 2002. As the theory develops, so do the methods and techniques that put it into practice. The book also describes in detail the connection between the hierarchy of defence modification and the specific phases of system development that determine readiness for change. The papers in this volume contribute to our knowledge of the permeability of the boundaries between clinical and social psychology through the investigation of living human systems, and of systems-centered group and individual therapy. The author's considerable body of work constitutes a blend of creativity and learning of the highest order.

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CHAPTER ONE. Group-as-a-Whole Theory applied to scapegoating

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In this chapter I present a way of looking at groups from two perspectives: the perspective of the individual and the perspective of the “group-as-a-whole” (“Theory of the Invisible Group”— Agazarian & Peters, 1981). This theoretical framework applies practically to making interventions in groups. Choosing which level to influence can have significant impact upon the potential outcome of important therapeutic group issues. For example, interpreting scapegoating from the individual perspective will have a different impact from interpreting it from the group-as-a-whole perspective and may significantly influence the developmental potential of a psychotherapy group.

* * *

The underlying dynamic common to maturation of all human systems, be they as small as a cell or as large as society, is the functional discrimination and integration of differences, from simple to complex. This is the process that makes order out of chaos, makes the unconscious conscious, and codes information and organizes it in relation to group goals.

 

CHAPTER TWO. Re viewing Yalom: an interpersonal tale retold from the perspective of the group-as-a-whole

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Let me start by relating a true story. One sunny summer day in 1983, I was lunching with my friend George Vassiliou in his garden in Athens. We were talking about applying General Systems Theory to group psychotherapy. To illustrate a point, George threw a piece of his hamburger into the goldfish pond. One little goldfish, faster than the others, reached the hamburger first. It was too large for him to swallow, so he swam off with it in his jaws, while the other goldfish darted around him nibbling away at his prize.

George pointed to the goldfish with the meat in his mouth: “That poor little fellow is having his dinner stolen from him by the other fish, and if he is not careful, he will have nothing left to eat but the last small bite”, he said. “On the other hand”, said George, pointing again, “here is the whole shoal of goldfish with a large meal falling into their midst—too big a serving for any single fish to swallow; one fish holds it, while the other fish nibble at it, breaking it up into bits, which they either swallow or which drop into the water for the others. Thus the meal is distributed among the whole population of the goldfish pond!”

 

CHAPTER THREE. The difficult patient, the difficult group

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This chapter is written about one session of a difficult psychotherapy group, seen on videotape at the fall conference of the Eastern Group Psychotherapy Society in 1985 and discussed by a panel composed of Miss Fitzgerald, Dr Parsons, Dr Ormont, Dr Taylor, Dr Tuttman, and myself.

The original group (whose names have been changed for purposes of protecting confidentiality) consisted of six women: Mary, Gwen, Cherry, Zara, Liza and Lizzie. Shortly after the group started, two men joined the group. One man dropped out and the second, Fred, was diagnosed as having a malignant, terminal carcinoma and died.

The panel comprised the two therapists and the supervisor of the group—Miss Fitzgerald, Dr Parsons, and Dr Taylor—and three professionals in the field with three different frames of reference—Dr Ormont, Dr Tuttman, and Dr Agazarian. My own approach was that of the group-as-a-whole. When I first listened to the tape, I was looking for live examples of the “Theory of the Invisible Group”, my own formulation of group-as-a-whole thinking. I also wanted to see whether listening to the voice of this videotaped group would yield insights into the dynamics of this group that would not have been apparent if I had confined my listening to the voices of the individual members. This, for me, is the test of theory. If theory can help us to see things or do things or understand things that we could not, without theory, then theory is useful and important.

 

CHAPTER FOUR. Group-as-a-Whole Systems Theory and practice

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Imagine yourself on a summer picnic, throwing a piece of your hamburger to the fish in a pond. Imagine one goldfish swimming off with the hamburger in his mouth, while the others dart around him, nibbling away at it.

On the one hand, you might think that the poor little fellow is having his dinner stolen from him by the other fish, and if he is not careful, he will have nothing left to eat but the last small bite.

On the other hand, taking a second look, you might think that here is a whole school of fish with a large meal falling into their midst. It’s too big a serving for any single fish, one fish holds it, while others nibble away at it and the rest dart after the bits that drift away into the water. Thus all the fish are fed.

When we observe a goldfish pond, it makes no difference to the fish whether we say “the individual fish has had all his dinner nibbled away except the last bite” or whether we say “the school has developed an efficient food distribution centre”.

But, anthropomorphizing, to say to a group that “this poor little fellow is having his lunch stolen from him by the rest of you” will have a very different impact from “you are solving the problem of how to feed your whole population from one otherwise indigestible lump of hamburger”. One could expect the reactions, subsequent events, and indeed the future course of the group to be significantly influenced by which of the two interpretations it receives.

 

CHAPTER FIVE. The invisible group: an integrational theory of group-as-a-whole

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Foulkes, in his Introduction to Group Analytic Therapy, says: While having an eye on each individual member and on the effects they and their utterances have on each other, the Conductor is always observing and treating the group as a whole. The “Group as a Whole” is not a phrase, it is a living organism, as distinct from the individuals composing it. It has moods and reactions, a spirit, an atmosphere, a climate… . One can judge the prevailing climate by asking oneself: “What sort of thing could or could not possibly happen in this group? What could be voiced?” The Conductor can gauge his own distance to the group by asking himself “What sort of thing could I say within this situation, and what could not be said?” In fact, it is the group as a whole with which the Conductor is primarily in touch and he experiences its individuals inside this setting. He should sense what this group needs at any given moment, be it encouragement, reassurance or stimulation, steadying or exaltation. [Foulkes, 1948, p. 7]

 

CHAPTER SIX. The phases of development and the systems-centered group

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Group development: a crucible, a relentless, uncompromising, inexorable pressure on the outer shell of defences—burning hot and cold—a ring of fire around the inner core of ash— transformation—and the many-splendoured phoenix.

Systems-centered theory approaches all living things, whether as small as a cell or as large or larger than society, by defining them as systems that are similar in structure, function, and dynamics. This then sets up a hierarchy of classes of living systems where each class, and every member in it, has a set of common factors that apply to all classes in the hierarchy; and each class, and every member of each class, is unique unto itself! The advantage of describing all living human systems isomorphically in this way is that what one learns about the dynamics of any one system says something about the dynamics of all the other systems in its hierarchy (Agazarian, 1997).

It is through the discrimination and integration of similarities and differences that systems develop from simple to complex (Agazarian, 1989a). The system of the group-as-a-whole develops from simple to complex by splitting into differentiating subgroups that have the potential to remain in communication with each other across their boundaries (Agazarian, 1989a). In a systems-centered group, the basic unit is not the individual member, but the subgroup (Agazarian, 1989d).

 

CHAPTER SEVEN. Reframing the group-as-a-whole

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It is my privilege, at this Ninth A. K. Rice Scientific Meeting, to have been asked to describe the “alternative model” that I have developed. In the organization of this chapter, Section 1 orients the reader to the differences that makes mine an “alternative model” to the more traditional approach. Section 2 begins the discussion of the differences in theory and practice, with examples. For those for whom theory is not a major hobby, Section 2 might be a more practical place to start. The Summary (Section 3) recapitulates the central ideas in this chapter.

1. ORIENTATION

The major difference between my “model” and the A. K. Rice Conference model is one of emphasis—a shift in emphasis in practice that reflects a shift in emphasis in theory.

The connection between group behaviour and group goals is made explicit to the working group, as are both the identification of the defensive behaviours and their consequence upon task performance. This is a shift in interpretive focus towards underlining the defensive nature and purposefulness of Basic Assumption behaviours.

 

CHAPTER EIGHT. Book review of Koinonia: From Hate, through Dialogue, to Culture in the Large Group

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It will be of great significance to every group therapist who has wondered how large a therapy group can be that the authors of Koinonia propose a “median” group (of 20 to 40) as the ideal “container” for hatred and paranoia. The “median group”, they argue, is the ideal arena for social resolution through “koinonic” dialogue, which requires the transcendence of individualized narcissism and the development of impersonal and interdependent friendship/citizenship. Thus “Koinonic dialogue” carries a potential highly relevant to all group work—and a potential particularly relevant to therapy Koinonia is a remarkable and milestone book.

Koinonia … communion, fellowship, intercourse … from the common carthorse of a language Koin … which united pre-classi-cal Greece … belonging to everybody because it belonged to nobody … Koinonia … implying not personal and individualistic but impersonal friendship … a “democracy” … a form of togetherness and amity that brings a serendipity of resources … “communion” as it is understood in the Greek Orthodox Church. [de Maré, Piper, & Thompson, 1992, pp. 1 & 2]

 

CHAPTER NINE. A systems approach to the group-as-a-whole

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In viewing the group as a system, I begin, not with Bion (1959) and Bertalanffy (1969), who are the true forethinkers of group-as-a-whole and systems theory, but with Korzybski (1948), who wrote passionately of the prison that Aristotelian logic has created for our Western minds. Whatever you say a thing is, it is NOT, says Korzybski, striking at the heart of our either/or splits. The map is not the territory, says Korzybski, forcing us to notice that our theoretical maps simultaneously both represent and misrepresent our reality as well as create it! All our observations are self-reflexive, says Korzybski—an important point for us as therapists who so often talk about the group as if we are not part of it. Finally, only when our use of language reflects both the structural and the dynamic aspects of reality, says Korzybski, will we understand that there is both space and time, as well as a relationship between space/time; individual and group, as well as the individual/ group relationship.

 

CHAPTER TEN. A systems-centered approach to individual and group psychotherapy

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Systems-centered therapy (SCT) is an innovative approach to individual and group psychotherapy. It is different from most approaches to therapy in that the theory about the dynamics of systems was developed first (a theory of living human systems, Agazarian, 1991b), and the practice of systems-centered therapy was developed from putting the theory into practice (Agazarian, 1997).

This systematic approach to therapy was introduced based on some important characteristics of system thinking. The most important implication for therapy is the idea that all living human systems exist in a hierarchy and function in the same way, develop in the same way, and have a common structure. This is called “system isomorphy”. Thinking about therapy isomophically is revolutionary. It means that once the structure (how a system is constructed) and function (how a system works) are defined for one system, they are defined for all systems. Therefore, although individual therapy, couples therapy, marriage therapy, and group therapy do not seem the same, whatever one learns about the dynamics of one will, because they can all be defined as living human systems, generalize to all the others.

 

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