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Chapter Seven – A Discussion – Page 221
for whom the writing of clinical accounts is an essential task (Task and Clinical Foci
highlighted and Group obscured). The integration of the capacity to contain and manage
this conflict is aided by the presence of the group matrix, and ideally becomes
integrated within each participant (Task). The presence of the Group focus (which
represents and stands for the sense of the therapist’s presence in their work as an
individual as well as a person socialized in their professional milieu) is important. Much
of this importance is because the challenge represented by the conflict that Judi and
Paula are carrying is a very personal one, yet the implications in terms of potential
clinical skill and capacity are very great. Far from being a problem, the raising of
anxiety in the group represents a potential opportunity to learn personally and hence
professionally from addressing that anxiety by confronting it.
EXAMPLE 7.2 (Taken from the description of events on Page 215
above), ‘Nancy feels empathy for colleagues in these situations (Group).
Paula shares her struggle with the issues, including her identification with
patients (Group/Clinical). Bill and Tom talk about the various difficulties of
making use of countertransference (Task, but also potentially Group).
Somehow the group gets into the issue of what patients know of what we
know about them (Clinical, but also Group), Judi suggesting that they know
that you know about them. Clinical concerns about patients reading notes as
well as task issues in how to deal with situations where this is an issue are
then discussed by the group (ostensibly Clinical and Task, but also
importantly Group)’.
In this example, it is striking to me that the Group focus is powerfully present
throughout this sequence of discussion and interaction, but usually not explicitly so. I
believe that a core issue is the difficulty in speaking directly in the here-and-now of the
session. Maybe this is particularly the case at this point because the atmosphere that has
prevailed (or at least, that the tutors have sought to foster) throughout the semester,
particularly the eschewal of supervisory or critical comment, and of a sense of a
‘correct’ way of doing things, has to give way to a return to the world outside, including