Group-Analytic Contexts, Issue 81, September 2018

Newsletter – Autumn 2018 9
embraced this philosophy, resisting my natural tendency to use ten
words when one or two would suffice.
I encountered a further complication during my training as
a psychotherapist, when I was told that confusion was not only a
virtue but an absolute necessity if one was to make progress either as
a patient or as a therapist. One of my supervisors at the Maudsley
Hospital, a psychoanalyst by the name of Irving Kreeger, introduced
me to the notion that individuals who began their therapeutic journey
from a position of clarity had to be patiently guided into a mind-set of
uncertainty in which their formerly held assumptions could dissolve
to be reassembled later in a different constellation. In other words,
patients first had to be rendered confused before they could focus on
reality. Clarity, it seemed, was a tempting solution to life’s problems,
but it could also lead people horribly astray.
It slowly dawned on me that confusion could be creative as
well as destructive. Creative confusion allowed the mind to open up
for the entry of new thoughts. Bob Hobson, a Jungian psychoanalyst,
espoused this philosophy of therapy. Supervision with him
seldom advanced beyond reflections on the opening words of the
conversation between patient and therapist but was immensely
informative. Time faded into the background and it became
possible to dwell on the infinite meanings and inflections conveyed by
a single word or gesture.
At the opposite end of the spectrum were the diagnosticians
- people whose contribution lay in the collection and ordering of data
into compartments which then opened the way to an infinite number
of diagnostic possibilities. Prominent among these practitioners was
Sir Aubrey Lewis, a polymath and obsessional character who
intimidated registrars with his ferocious insistence on recording every
jot and tittle of the patient's life history and examination. I disliked the
rigour which this approach called for and much preferred to paint the
canvas with random strokes and see what picture emerged.
In a group, the scope for confusion is limitless. One is
dealing, not just with the muddle of one mind but several minds
thrumming together in various degrees of harmony and cacophony.
The art of making sense of all this proved too much for some
diagnosticians of my acquaintance, and many a good psychiatrist was
lost to the world of group psychotherapy for this reason.
I suppose it all depends on one’s ability to tolerate
uncertainty. According to the model of Sir Aubrey Lewis, which we
can think of as the disease model, the patient’s journey through illness
has a fairly neat trajectory with a beginning, middle and end. Study of