This is a draft of the Preface but is in continual revision
Janus
Group Guide
Philip K
Springer, MD
Shelby
Havens, ARNP DNP
Preface
5/24/15
Throughout
most of my adult life I have been in professions that were centered on helping
others. I have been a family physician with a practice based in Southern
Mississippi. And, for ten years I worked with Head Start children as part of my
regular medical practice. In retrospect, I recall how many politically
astute people bitterly fought the Head Start Program. And, concurrently, I
believe that programs such as Head Start helped prevent many of the
incarcerations of the inmates I treated in the Florida State Prison System.In..1960
I left my family practice and enrolled in the Residency Program in the
Department of Psychiatry at the University of Florida. Following
the completion of my residency requirements, I became an Assistant Professor in
the Department of Psychiatry. In this position, I was heavily
involved in the training of medical students, psychiatric residents, nurses and
a broad cross section of other mental health professionals as well.
During the last ten years of my professional life I served as a staff
psychiatrist in the State of Florida prison system.
I learned a
great amount of information and gained extensive and valuable experience from
service in each of these venues. That knowledge and experience served as the
primary objective in writing this paper (book). More specifically, I am
especially interested in describing the development of a treatment modality
which my colleagues and I designed for use in psychiatric and other
environments. It is known as The Supportive Person Group
Process (SPGP) and my interest in the Process can be traced back to my days at
the University of Florida.
While performing my training and
administrative duties in the Department of Psychiatry, I became very interested
in group dynamics and began to develop a program we identified as Supportive
Person Group Psychotherapy (SPGP) The
book you are reading was inspired by a desire to write about what is and has
been happening in my life from a personal and professional perspective.
I say desire because I am not a writer of experience. I am a
recovering alcoholic, a father, a widower, a retired psychiatrist, and former
country doctor. When I look for answers to important questions about life ’ s meaning, I am
looking for something from the heart. When I say to myself “ written from the heart ”
it is with humility and compassion and a strong sense of urgency inasmuch as I
am reaching an octogenarian mindset, but this does not imply any form of frenzy
but rather a firm sense of urgency about what I need to do to make it on this
planet for a few more years. As
for now, it is with considerable excitement that I bring to light SPGP as a
method of therapy that I had let lie fallow for many years.
However, we are now ready to bring this
group process forward. That is, I recognize that there are stimulating
new developments in understanding how the brain works. As psychiatry falls apart right under our eyes,
a broader and deeper effort to nurture our mental health therapies is finding
it ’ s
way through a bottom-up process in a multitude of self-help groups. With
this supportive person group process (SPGP) we hope to shed some light on how
people communicate with their feelings as well as with what they say.
It is acknowledged that many people today are feeling overwhelmed
and in search of new methods for dealing with mental health problems.
There are several books just out looking at dyadic relationships, or the
power of two, as a method for dealing with the problem of being overwhelmed.
Dyadic relationships are simply an attempt to work effectively as a pair rather
than as a single individual. These supporting personal group processes
are just that kind of effort. With one person supporting another in a
group session they find that they need to develop techniques for being
supportive rather than simply meddling in the partner's affairs. So what
began in the 1970s as an effort to deal with mental health workers and others
in a busy psychiatric service has become available to us to use as a learning
tool for becoming more effective in dyadic relationships.
There are many ways to explain bottom
up processing, but for the purpose of understanding how the process works in
group situations, the evidence is clear that emotions are activated more
strongly in bottom up processing than top down processing. Lofty and often
incomprehensible statements come from top down processing such as psychological
theories from single theorists, such as Freud. But bottom up processing come
from a deeper emotional level and is strongly felt rather than simply thought
about and easily discarded. Bottom up processing is more democratic than top
down processing.
At
present, science is expanding our knowledge about how the brain functions.
Through neuroimaging, we are also becoming more aware of simple
techniques in human interaction, which can improve our lives by being involved
in quiet conversation or in groups such as AA. We now have the
tools to watch the human brain in action through the miracle of functional
magnetic brain imaging (fMRI). Science and technology have made it possible for
us to follow emotions and thinking as they travel through the brain. However,
the real test is how we sense what is going on in each other through the magic
of just being close and intimate. We can get 20 hugs and know how it feels and,
at present, we can also find, through an fMRI, which the brain lights up in
response to these feelings of appreciation and affection. One of the most
startling recent findings is that the aging brain can set up new areas to store
memory in the right-brain even while the memory area in the left-brain has gone
into decay and disuse. There are many mysteries that lie ahead that can
be illustrated by the fMRI. However, this brief discussion is not focused on
technology, but rather, on human interaction at a very elemental level.
It is also important to note that the discussion presented in this
chapter is focused on group processes and not necessarily on group therapy
only. There is an intelligence in groups which is at first difficult to
see and which can never be seen unless you actually participate in a group.
Our thoughts are communicated not simply by words but we are
finding that through the medium of the fMRI that these thoughts can be
transmitted from person to person without so much as a word being uttered.
Thoughts can be read without words. It is possible that we humans can be
aware of someone silently standing behind us.
During my stint as an assistant
professor in the Department of Psychiatry at the University of Florida
(1976-83) I had to provide inpatient clinical experiences to the medical
students and residents. The question that kept nagging me and the
other members of the Staff was how can we educate and/or treat this menagerie
of groups we had on our Service. In addition to patients. on any given
day. our Unit often included faculty members, psychiatric residents,
nurses and medical students as well as a host of other mental health
professionals . This diverse collection was a
considerable challenge to the Staff. We had to find ways to communicate what we
knew about both personal and group therapies.
During my psychiatric residency one of
my colleagues kept urging me to attend the summer sessions of the National
Training Labs located in Bethel, Maine. I eventually went to the Lab meetings
and the result was a total conviction that group processes and group therapies
will be our ultimate pathway to mental and spiritual health. Many
of the ideas presented in this guide have evolved through my experience at the
National Labs.
In the 1960’s a
considerable amount of psychiatric and training was committed to educating future
psychiatrists so that they could become psychoanalysts in the tradition of
Freud. We are now in a different era, an era that is devoted to
promulgating new diagnoses and new medications to combat the assumed new
diagnoses. Since the 1960’s we have
moved abruptly from discovering and nurturing the patient’s individual positive
personality features to stamping out, in cookie cutter fashion, a diagnosis
based on a checklist and yielding a convenient (to the drug companies) a
medication treatment.
(Drawing of the double circle group)
Using a large single circle to begin
with I found that the medical students were prone to put the patients in an
awkward position of having to defend themselves. Part of this was the
awkwardness of the questioning employed by medical students, which I think must
have come out of their experience of watching Perry Mason on television. So
eventually I put all of the staff and students in an outer circle behind the
patients and the patients were placed in an inner circle with the group leader,
generally myself. With this simple beginning, SPGP was instituted in
1978. A great deal has changed since then so I will present the basis for the
changes as well as the rationale for SPGP.
The word supportive requires some clarification. Generally,
the failure in this process is seen as a one-person meddling in another persons
business. However, I found while working with the Staff of
the Florida School for the Deaf
and Blind that a staff member who knew the child well could be very supportive.
Being supportive is very delicate process and the teachers and counselors
at the School were amazingly adept at being supportive. But they
became supportive through an understanding of the sensitivity of the deaf child
and the understanding that the deaf child was willing to be supported if the
counselor knew them, as they understood their own self.
In this short book I will bring to
your attention both the mystery of the interaction between people at a very
elemental level and a method of exploring human interaction with a simple
technique within a particular style of group process. This done by use of the
group configuration by moving the circles inward and outward and also by moving
the individuals of the group inward and outward providing perspective to each
participant. The mystery is provided by the manner in which the flow of energy
among the participants creates a balance for the group and smoothes the jagged
egos of each individual. With this supportive person group process (SPGP) we
hope to shed some light on how people communicate with their feelings as well
as with what they say and perhaps become as astute as some of our dogs. Many
people today are feeling overwhelmed. It is obvious that many divorces stem
from expectations of each other in the marriage is simply are beyond our reach.
We are also seeing our young people back away from society because they feel
overwhelmed. Should we now look toward new methods for dealing with this
problem? There are several books just out looking at dyadic relationships, or
the power of two, as a method for dealing with the problem of being
Using a large single circle to begin
with I found that, particularly, the medical students were prone to put the
patients in an awkward position of having to defend themselves. Part of this was
the awkwardness of the questioning employed by medical students, which I think
must have come out of their experience of watching Perry Mason on television.
So eventually I put all of the staff and students outer circle behind the
patient's and the patients had the inner circle with the group leader,
generally myself. With this simple beginning Supportive Person Group
Psychotherapy (SPGP) happened in 1978. A great deal has changed since then so I
will present the basis for the changes as well as the rationale for SPGP.
The word supportive requires some clarification. Generally, the failure
in this process is seen as a one-person meddling in another persons business.
But I found while working in the Florida School for the Deaf and Blind with the
staff and the student in a conference setting that a staff member who knew the
child well could be very supportive but not interfere with what the youngster
wanted to say or do in the future. Being supportive is very delicate process
and these teachers and counselors at Florida School for the Deaf and Blind were
amazingly adept at being supportive. But they became supportive through an
understanding of the sensitivity of the deaf child and the understanding that
the deaf child was willing to be supported if the counselor knew them, as they
understood their own self.
In this short book I will bring to your
attention both the mystery of the interaction between people at a very
elemental level and a method of exploring human interaction with a simple
technique within a particular style of group process. This done by use of the
group configuration by moving the circles inward and outward and also by moving
the individuals of the group inward and outward providing perspective to each
participant. The mystery is provided by the manner in which the flow of energy
among the participants creates a balance for the group and smoothes the jagged
egos of each individual. With this
supportive person group process (SPGP) we hope to shed some light on how people
communicate with their feelings as well as with what they say and perhaps
become as astute as some of our dogs. Many people today are feeling
overwhelmed. It is obvious that many divorces stem from expectations of each
other in the marriage is simply are beyond our reach. We are also seeing our
young people back away from society because they feel overwhelmed. Should we
now look toward new methods for dealing with this problem? There are several
books just out looking at dyadic relationships, or the power of two, as a method
for dealing with the problem of being
to know about their job. But that is
the way of the World; is it not the one we often desire.
One of the paradoxes of serving others is that the serving person loses
energy and the person being served gains energy. In my opinion the better the
process of serving the more drain at the end of the day these serving person
experiences. I believe that this is why many people hold back on offering their
full attention and energy in the serving role. Intuitively they know what can
happen at the end of the day. They feel extraordinarily drained when they have
done a good job. We may have avoided serving I just went through the motions
idea of the day they might feel my brain did all. So this is a real problem for
each person who is trying to do their best and serving others. One way that one can counteract this problem is to provide
methods for energizing those serving. A frequent group process involving the
serving one's can be a remarkable rejuvenating force. There are many companies
and even institutions that practice this method of rejuvenation using a variety
of group methods. In 1947 the T group was developed for this very purpose. We
will be discussing in detail the Supportive Person Group Process (SPGP) in this
guide.
Before getting too deeply into the issue of supportive person group it
is very important that we at least try to grasp the difference between content
of the group and process of the group. Specifically content would be that it
contains 12 or 16 members, for instance, arranged in a circular fashion made up
of people about particular discipline etc. The process is more difficult to
understand what essentially is an unseen moving, often complex interaction
between members. For instance in baseball there is a very complex interaction
process that goes on between the area of second base and first base. The
content can be the first baseman, the second baseman, or the shortstop most
commonly but what they go through in order to complete the double play is a
process. Some of this can be so rapid that it is difficult to see how it
actually happened. When a mother is attempting to make contact with a new
infant she is participating in a process that cannot be readily seen. However
it is easy enough to see that there is a mother and a baby in the same place
doing something but we do not always know exactly what they are doing.
There is also urgency about how the flow of information is leaning
toward the top down rather than from the bottom up. Someone say that I am a hopeless
whom may prove politically out of sync but time will tell. My OPTMISM is based
on my I recall during my ten years of working with Head Start children in
Mississippi as a part of my regular practice. I also recall how bitterly many
politically astute people fought against the Head Start program. The Head Start
program was and still is an enormous benefit to the developing child. I argue
that more similar activity would have prevented many incarcerations of inmates
that I treated in Florida State prison and Union Correctional Institution.
Short-term thinking generally wins political battles.
We now live in a system, which is based on economics and extremely short
term thinking and planning. If we were to stop and think for a moment our world
system could be based on raising healthy human beings. We fail over and over
again to spend money on the very young and turn around and spend it on
fantastic war and dreadful prison costs. If one thinks of costs in four-year
segments it remains seemingly intelligent to stick with the economics but if
one thinks in terms of the lifespan of a human being then we are on the wrong
track.
Yet another story leads me to bring up
the matter of personality. My wife and I brought 7 children into the world with
such strikingly diverse personalities that I believe that current personality
theory must be reviewed in detail. I ask a very simple question concerning
personality but the answer requires a detailed explanation. The question is:
would it not be preferable that we approach mental illness treatment from a
strengthening of personality approach rather than from a diagnosis of pathology
approach? The personality is the humans ’
immune system and as time ravages on within chronic mental illness, the
personality is gradually eroded and misshapen. The patient ’ s pathology is not
the fulcrum. The discovery of balance and inner strength within the individual
demands our reverent attention. I say reverent because we as humans through
centuries of trial and error have gradually developed a soul. We find that this
soul development is somehow crucial to the survival of our planet, as we know
it. Perhaps the soul is the seat of what we are all about and once damaged we
can become tools of the state.
During my stint as an assistant
professor in the Department of Psychiatry at the University of Florida
(1976-83) I had to provide inpatient clinical experience to the medical
students and residents in psychiatry. However, this was
a considerable challenge to the Staff because there were so many students
and residents as well as the patient's who needed to learn as much as possible
about psychotherapy. The question that kept nagging the Staff was
how could we educate and\or treat the menagerie of groups we had on our Service.
In addition to patients on any given day our Unit often included faculty
members, psychiatric residents, nurses, medical students as well as a host of
other mental health professionals. Our high priorities included a desire
to provide an inpatient clinical experience to those who functioned on our
Unit. However, this was a considerable challenge because there were
so many different professional groups. The ideas presented in this guide have
evolved through my experience in National Training Labs and as such emphasize
the enhancement and enrichment of the personality in contrast to waging war on
mental illness.
Dyadic relationships are simply an attempt to work effectively as a pair
rather than as a single individual. These supporting personnel group process is
just that kind of effort. With the person supporting another in the group
session they find I need to develop techniques for being supportive rather than
simply meddling in the partner's affairs. So what began in the 1970s as an
effort to deal with medical students and a busy psychiatric service is now
become available to us to use as a learning tool for becoming more effective in
the dyadic relationship
