Fall/Winter Newsletter, November 2024

‘WHAT COMES AFTER REPAIR?’


“…End almost never means the end. End only means we have reached the limit of our ability to track what is occurring. End is the word that introduces us to an intimacy with, an anticipation of, and even a readiness for, new beginnings.”
From David Whyte’s forthcoming Consolations II 


REFLECTING ON OUR COLLECTIVE RESPONSES:

The focus of our academic offerings this year is on repairing ruptures. Not surprisingly, our discussions have evolved to contemplate, What comes after repair? Our prolonged collective exposure to the current climate of divisive conflict, both globally and locally, has us reflecting about how we can repair the ruptures that fuel conflict and impact our wellbeing and mental health. How do we move from survival to transformation? And what does transformation look like?

Rupture and Repair in Group therapy:
The turmoil of our times often seeps into the groups that we lead, manifesting itself as hostility, tensions and conflicts that result in ruptures. Ruptures are described as “disruptions in cohesion or connection to the leader, member, or group as a whole” (Lo Coco et al. 2019 cited by Marmarosh 2021). The challenge for group leaders is to harness the destructive forces inherent in all groups and transform them into healing possibilities by identifying and working through ruptures in order to facilitate repair. 

In System-Centered Theory (Gantt 2021) ruptures are repaired in the here-and-now using functional subgrouping, in which differences are identified and integrated in order to shift from survival to development and transformation. The weakening of individual past survival roles, as they are re-experienced in the present, is an important part of repairing ruptures between the person, group members, leaders and group-as-a-whole.

Group mentalization ( Bateman et al, 2021) is another way to repair ruptures in groups. Mentalization is described as, “the ability to take another’s perspective, different from our own” (Marmarosh, 2021). Repair is facilitated by group members jointly examining ruptures caused by automatic assumptions and projections towards others in the group and understanding with compassion how past relational trauma and early attachment ruptures impact the capacity to trust in relationships.

The group leader’s capacity to bear the intense emotions that emerge during conflict impacts how ruptures are repaired. Yalom and Leszcz (2020), point out the importance of the leader’s ability to hold and manage the discomfort associated with trusting the group’s capacity to tolerate tension and work through conflict. In addition, the group leader’s capacity to take responsibility for the ruptures we cause, as a result of empathic failures and mistakes, is essential to repairing ruptures in group cohesion.

The opening Leadership Conversation to our academic year was with Dr. Ronnie Levine, titled, Exploring Love and Hate in Groups. (Link.)  She highlighted the importance of developing a 'sturdy in-tune self' necessary to maintain connection with each other during these extreme polarized times. In her 2023 AGPA keynote address, which was then published as an article in the International Journal of Group Psychotherapy, Finding Yourself in Group, she writes, “With a strong stable in-tune self, we can relate instead of just hate”. This is wisdom that we as group leaders can use to guide our ongoing development of self-knowledge, self-awareness, humility and self-compassion. Our capacity as group leaders to facilitate repair of ruptures requires us to acknowledge and own our human capacity to harm, and to consciously work to contain our retaliatory impulses in the service of activating the healing power of groups. We have referenced several of Dr. Levine’s articles on this topic in our Fall/Winter reading List. 
 
Responding to Ruptures:
Recently a friend shared that he was involved in a confrontation after tripping on a hose in a garden center. He got a bit scratched up from the fall. Had the store manager apologized for leaving the hose in a poorly lit aisle and offered to pay his laundry bill, there would have been nothing further. But it didn’t go that way. He was met with denial and a lack of accountability by the manager.

Translating this scenario to the world of group therapy is easy, as there are inevitably group relationship ruptures that need to be addressed and repaired, given the multiple transferences that exist in a therapy group. Group member responses to various ruptures can range from nonverbal withdrawal to aggressive attacks. Group leader responses may also include just not noticing. Muran, Eubanks and Samstag (2022) in their Introduction to Rupture and Repair in Psychotherapy, define these interpersonal behaviours as ‘withdrawal markers and confrontation markers’. “Withdrawal markers include movements away from another: movements toward isolation, like going silent or pivoting away with another topic or abstract talk. Withdrawals can also include movements away from some aspect of oneself in an effort to appease the other, perhaps to avoid conflict, or to preserve relatedness … often at the expense of self-definition (or sense of agency). As for confrontation markers, we define these as movements against the other: movements involving aggression or control, like criticisms or manipulations. We have also described confrontations as efforts to promote self-definition (agency), ignoring one’s impact on another, at the expense of relatedness (or communion). One can see these markers in either patient or therapist behavior.”   

Similar to Ronnie Levine’s recommendations in our recent Conversation with her, these authors note that personal self-awareness and accurate attunement to the group as well as the ability to engage in non-defensive communications are key to the process of engaging in repair. They suggest being aware of 3 pathways that are typically required for therapeutic repair: reattuning to feelings or intentions; renegotiating tasks and goals; and exploring ruptures.

Muran, Eubanks and Samstag further suggest that “our understanding of any interpersonal encounter is only partial at best, and it is through conversation with another that we can expand understanding … Repair affords such a possibility …” Therapeutic conversations inevitably involve a certain messiness. Given our limitations in ‘knowing’, they suggest a stance of humility rather than one of overconfidence and conviction … as we try to negotiate ambiguity.

The absence of humility is often the hallmark of the charismatic leader. As noted in Encounter Groups: First Facts (Lieberman, Yalom and Miles,1973), charismatic leadership can inadvertently create a dependency leading to a lack of critical thinking and resulting in an inability to challenge the leader. While this might lead to increased motivation and productivity among group members, there is the danger that such leaders are not open to feedback or aware of ruptures in relationship within the group context. 

When handled well, repair leads to a greater feeling of understanding and a greater sense of resilience within the group and an appreciation that conflict need not lead to loss. Perhaps we can take a lesson from nature: When a forest experiences a fire, it creates the conditions for new life. Certain seeds cracked open by the heat, germinate and grow in the ash-enriched soil, and as the sunlight shines onto the forest floor, certain other plants which have been dormant begin to grow. (Lieberman, Yalom and Miles)

Repairing the Garden:
In a poignant talk, ‘One Eye Forward, One Eye Back’, the opening address at the 2015 Casey House, Understanding Aboriginal Health and Well-Being Symposium, Dr. Evan Adams, Chief Medical Officer, First Nations Health Authority, West Vancouver B.C., traces the trajectory of how the lives and landscape of first nations people is ruptured and irreparably changed through seemingly incomprehensible state-sanctioned human rights violations. Dr. Adams underscores the power of recalling memories and tracing history to understand and become attuned to the impact of trauma and discrimination, all the while searching for ways through which repair may become accessible.

Approaching the conclusion of his talk he tells the story of a garden where the pink flowers are put in rich soil and the red flowers in poor soil, which naturally results in abundant and healthy pink flowers, while the red flowers suffer. As the gardener looks at the outcome, they forget that they chose differing soils for the flowers and favour the pink flowers for their abundance. He concludes that it is time "to make things right in the garden". The work of repair can be long and complicated, requiring empathy, determination and resources, and we are called to remember that in many cases that journey to rupture has been long and complicated, accompanied by unequal resources and a lack of empathy.

The work of making things right in the garden is the work of moving toward repair in so far as that is possible, in spite of difficulty and with awareness of the moral imperative. 

You can watch the full video here:
Dr. Evan Adams- One eye forward and one eye back (Link)
From Casey House's educational video archive, filmed presentation from HIV and mental health series October 2015 in collaboration with OHTN.

THE VALUE OF RELATIONSHIPS AND CONNECTION:

Healing through Narrative: 
Narrative can be healing. Gretchen L. Schmelzer, PhD., writes that so much of trauma and grief can feel wordless. Trauma can keep words from memory to protect us from the unspeakable. Attaching words and a story to our ‘there-and-then’ traumatic experiences allow us to take in and integrate our own history - and it allows us to share our story and have it witnessed. "Often seeing our thoughts and emotions solidified on a page can help make sense of experiences and may even surprise the writer with new insights and ways of considering people and events in their life." We socially construct our identity through the stories we tell ourselves and others. The sense of self is acknowledged as being more than just a “physically embodied encapsulated individual” and the bidirectional relationships and influences of other people in individuals’ lives are explored. (Journey Through Words Guidebook, 2023).

Group therapy offers a safe holding space in which to speak of our stories, to create a new ‘here-and-now’ narrative together, integrating past and present. In Systems Centered Therapy (SCT) for example, the practice is to develop a here-and-now experience first and then to find the words to go with the experience, rather than telling a story in which the words come first. The narrative created within group is a way of exploring deep emotional experiences that are common to all people. However, exploring experiences is often anxiety-provoking, and we must pay attention to the time and circumstances of the telling of stories to help our traumatized group members stay emotionally present and connected (Kamozawa 2021). It is only through maintaining secure emotional connections that we can heal and grow.   

i am the product of all the ancestors getting together
and deciding these stories need to be told
by Rupi Kaur

Healing through Discourse: 

In a recent edition of the University of Toronto’s, Magazine, UofT President Meric Gertler wrote an article, Toward a more civil discourse, in which he acknowledges the challenges many Universities have faced particularly over the past year of geopolitical divisions. He states, “Ultimately, we need to rebuild a culture of civil discourse, in which mutual understanding is possible and even the most contentious of issues can be discussed rationally and peacefully…

"This goes right to the heart of our academic mission – the advancement of knowledge and truth, and the education of responsible citizens. We must welcome free and open debate and encourage people both to challenge the status quo and be open to being challenged on their own views…The purpose of the university also depends upon an environment of tolerance and mutual respect. Every member should be able to work, live, teach and learn in a university free from discrimination and harassment.”

You can read the full article here:
https://magazine.utoronto.ca/campus/toward-more-civil-discourse/ (Link)

In an effort to foster civil discourse, the University of Toronto created a new position – Provostial Advisor on Civil Discourse – the first of its kind at a Canadian University, and appointed Randy Boyagoda, a Professor of English, and Vice-Dean Undergraduate Faculty of Arts and Science to the position. In UofT Magazine, (October 2024) Boyagoda notes that civil discourse is about seeking “understanding from a place of curiosity and empathy, and recognizing the inherent dignity of the other person and that we are in a community of people thinking out loud together.”

In an October Globe and Mail article, author Erin Anderssen explored adversarial collaboration, and suggested we all might want to try it at our family Thanksgiving tables. Adversarial collaboration, as the article goes on to explore, involves working together with others holding opposing viewpoints to come up with solutions. Anderssen reports on multiple examples from different fields of study, and concludes by referencing Dr. Clark, the co-founder of the Adversarial Collaboration Project at Pennsylvania University. According to Anderssen, Clark believes that successful collaborations “are more complex, and … closer to the truth. They rarely reveal that someone is all right, and another person is all wrong … Often the ‘adversaries’ realize that they don’t disagree as much as they thought.”

You can read the full article here: https://apple.news/AMtmkPgPzRKWCuw5ldYYhqg (Link)
 
Self Love Poetry for thinkers and feelers
by Melody Godfred

Left brain thinkers:
If you want
Something done right,
You have to do it (yourself.)
with the help of capable people who deserve your trust.

Right brain feelers:
Turning down help
is paying full price
for something that’s on sale.
 
Understanding freedom:
In a recent episode of CBC’s, The Current, host Matt Galloway had a conversation with historian, author and Yale University Professor, Timothy Snyder, exploring the meaning of freedom in his new book, On Freedom, and differentiating between freedom from and freedom for. “Snyder says thinking about freedom as ‘me against the system’ is actually a trap that stops people from being truly free.” (CBC Listen, October 28, 2024).
You can access the full interview here:
https://www.cbc.ca/listen/live-radio/1-63-the-current/clip/16104397-timothy-snyder-avoiding-trap-negative-freedom (Link)

Forgiveness:
For many years, The Canadian Group Psychotherapy Foundation (CGPF) hosted a Public Lecture the evening before the annual Canadian Group Psychotherapy Association’s annual conference. Many of us will remember a particular lecture in Toronto, given by James Loney, a Canadian peace activist, who had been taken hostage in 2005 in Iraq, along with 3 other peace activists, and had been held in captivity in Baghdad for 4 months.

Loney’s talk to us was about forgiveness, and it was incredibly powerful. He spoke about how much easier it is to forgive someone who acknowledges their mistakes/mistreatment/hurt to you. But, he noted, forgiveness is a separate act that is within our control. As long as we tie our forgiveness to the other’s apology, we are still within their control; apology and forgiveness, he noted, are 2 separate acts.

And, as our own group discussions continued, we wondered, … Are there things that are unforgiveable?
 
“I am not what happened to me. I am what I choose to become.”
Carl Jung
 
As we come to the close of this edition of our newsletter, we felt compelled to share that our collective search for guidance into the question of what comes after repair? has led us to the realization that we have more questions than answers, and that we are standing squarely at ‘the edge of the unknown’. Rather than striving for certainty we find ourselves challenged to engage with these questions and embrace the nuance and ‘messiness’ of our current contexts without succumbing to outrage or despair.

Perhaps we can find some solace in the words of renowned Austrian poet Rainer Maria Rilke, who said in his Letters to a Young Poet,
“Be patient toward all that is unsolved in your heart and try to love the questions themselves, like locked rooms and like books that are now written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.” 


OUR COMMUNITY:
The Group Foundation for Advancing Mental Health, AGPA, has recently announced the establishment of the Smith Giesbrecht Canadian Scholarship in memory of David Smith Giesbrecht. David is the son of our long-time friend and esteemed Invited Faculty member, Joan-Dianne Smith.

“The Group Foundation for Advancing Mental Health is announcing the establishment of a new scholarship, funded by long time AGPA Member Joan-Dianne Smith and her husband James Giesbrecht in memory of their son, David Smith Giesbrecht. The Smith Giesbrecht Canadian Scholarship will support a Canadian therapist (with preference to those involved with the Toronto Institute for Group Studies) who demonstrates a commitment to group therapy as a life-long career focus. It will include two sequential years of attendance at AGPA Connect, travel support, and a stipend for supervision and/or consultation during the interlude between the two conferences.”

“David Smith Giesbrecht died suddenly of a brain aneurysm in 2024 at age forty-two. Although David was not a group psychotherapist, he exemplified the motivation of a natural life-long learner. Living with learning disabilities, David was no stranger to hard work and perseverance. He learned for the enjoyment of discovery in areas that inspired him. He was also deeply committed to attachment and connection. Because of this, his parents have chosen to honor his memory with this scholarship that will be given to a group therapist whose career centers these attributes that were so very important to David during his life.”

The application is now available for AGPA Connect 2025 in San Francisco, CA and can be accessed through the AGPA website: www.agpa.org (Link)

In our own TIGS community, our discussions about transformation have also included concepts such as sustainability and succession planning. In addition to our growing list of esteemed Invited Faculty, we welcome Debbie Nacson to our Newsletter and Reading List contributors. Welcome Debbie!

We’d like to end this newsletter with a beautiful rendition of Have you ever seen the rain, sung by Willie Nelson and his daughter, Paula Nelson: https://www.youtube.com/watch?v=b7MUcj312a0 (Link) 

With beautiful wishes to you all for a peaceful holiday season and new year ahead!

Respectfully submitted,
Aida Cabecinha, Susan Farrow, Maureen Mahan, Debbie Nacson, Allan Sheps and Terry Simonik, November 2024.