“Fare gruppo nelle istituzioni”. A review

Fare Gruppo Nelle Istituzioni, Lavoro e psicoterapia di gruppo nelle istituzioni psichiatriche, edited by Claudio Neri, Roberta Patalano e Pietro Salemme, and published by FrancoAngeli, is a book whose conception is cheerful and successful in its intent stated of being a practical and nimble tool […] something resembling a joiner’s manual for those who wish to build projects and to carry forward group activities in the context of intervention on mental distress.
And if it’s true that writing a book, that can be useful in clinical practice, is anything but simple task, it’s also true that Fare Gruppo Nelle Istituzioni is a text that offers more than it promises: it widens reflections and thoughts about the “doing”.
Francesco Barale, in his mindful, accurate and comprehensive preface, doesn’t fail to point out that, among the aims enounced in the introduction by Claudio Neri, the main one is that this book can be lively and useful. Neither he fails to point out how, by his experience as a reader and as a trained person, both achievements are accomplished.
One could wonder what makes the reading of such a technical text, so pleasurable.
And when I say “pleasurable”, I mean something that is prompting as the sensation evoked by the word but, at the same time, has a complexity that the term doesn’t bear.
The book is capable of bringing the reader in the living experience of groups working in the institutions, and it does so accounting the difficulties that the operators can encounter while working in the institutional reality.
The fact that the institutional reality configures itself as a reality, which is external to the individual, characterized by pre-existing rules that have been established when the individual wasn’t there yet, can make the entrance and the stay in the institution an experience with critical issues. This critical issues concern mainly the need of articulating the institution, as an external reality, with the internal image that everyone can have, as well as with personal expectations.
This articulated joint is crucial in order to process the difficulties inherent to the work in the institutions.
The transition that allows the individual to feel to be the holder of his need of being acknowledged, by the institution, in his ambition of being thought by something that resembles an “institutional mind” (this function can be held by study groups, supervisors, guarantors) is of central importance in allowing everyone to feel as the author of his work himself, and not a purely mechanical instrument, a cog of a faceless gear.
One of the most fertile and lively element that this book presents and that brings hope, is to show the dialectic between the aspiration of being acknowledged by the institution, and the transformation of the internal image of the institution itself.
That’s what can be said, if we are attentive to the content.
However, the text doesn’t communicate only through the consistency of the content. It states a method, in a simple and immediate manner.
The introductive parts shed light on the way the book was thought and produced.
“Fare gruppo nelle istituzioni” seems to be a work that comes from afar, whose gestation has been developed through the experience of working in groups in the institutions.
It appears that the book is a condensation, a pith, of a long time life and working experience of thoughts bloomed in time and, maybe, sometimes faded, leaving traces (neither always nor necessarily conscious) in terms of great wealth, which then is able to convey.
The book is based on the strategic idea of allowing gathering and comparing operators working with groups, even when they possess dissimilar characteristics.
The purpose is achieved thanks to the framework, which is divided into thematic areas whose primary focus is always the employment of the group in the treatment of patients.
The resultant vision is quite broad. This occurs because the phenomenon is observed from various perspectives, which are always kept in the author’s mind in a lively and dynamic reciprocal relation.
It is also evident that, while writing the book, the writers have kept in mind the end-user. The authors’ will is to tell, in a clear way, who does what, and how it’s done.
The preparatory work of the text was flourished from an alliance between persons with different proficiency and different ages.
Far from being a book of collected articles, the volume came into being thanks to a team’s work, composed of the so-called senior (about twenty persons, psychoanalysts and not, who are operating in Italian institutions having a psychoanalytical inspiration), and of the so-called junior (students and former students, nowadays young professionals, who were previously studying at university).
It looks like the text has been permeated by the team work itself, which guides the reader’s experience to develop upon two levels: the first one, is to learn throughout someone else’s experience (drawn in the different papers); the second one, comes out from the reading experience that allows the reader to get in touch with the realization of the common project (represented by the text) of a working team. And this is actually a considerable achievement.
The working team enclosed a peculiar curator’s work to give the reader a sense that the chapters were “told” by the same narrating “voice”, while respecting the conceptual dissimilarities among the forty-five authors.
Different voices telling, describing, reflecting on specific experiences can be appreciated while reading; even though each author’s voice can be distinguished as their own, as their identity and specificity has not been lost, they do share an only breath, hence, the mind of the working group can be felt as a unitary matrix.
The choices that have been made for the structure of the texts by different authors contribute to give the reader such an impression.
The chapters are grouped into sections, preceded by a brief but useful introduction that provides an overview about the subject in the section.
Almost all of the chapters are conceived to be read in a short time (that is imagined by the authors as the amount of time that is usually available before going back to other activities), and are composed by a theoretical and by a clinical approach, which are kept in a fertile relation that can open the way to new thoughts.
The clinical accounts do not represent a mere explanation of the concepts that have been outlined in the theoretical part; made short by choice, they are able to convey emotions and to add a third dimension to the theory.
It seems important to emphasize the relation between the theoretical and the clinical part, because sometimes we blow out its sparkling vitality when we use a clinical account to demonstrate our theories; in those cases, if we read back the account, it suddenly sounds dull and muffled.
This is not the case. The clinical accounts carry out the function of making it necessary to use another way of reasoning (the clinical one), which requires a different expressive form: therefore, the reader will experience to be in presence of something that takes shape and assumes a three-dimensionality.
Through the choices made for the text’s structure, some aspects become prominent.
As mentioned above, the book can be used as joiner’s manual, since it constantly reflects on the “routine” of organizing the daily work, as well as about the levels of integration that can be reached, it lets the équipe come out as a multidisciplinary working group, in which operators bring different competences. The équipe is the essential and bearing element that provides the possibility to carry out the institutional mandate of assistance, rehabilitation and treatment.
This leads to the need of devices (such as supervisions, study groups) that can help in working out the problematic flows and discomfort burdening in the daily activity.
Even though the book reveals a pronounced practical vocation, it also displays some characteristics that promote reflection, thinking and awareness.
In this respect, it is a deliberate choice to postpone “Una riflessione dopo la lettura del libro” curated by Roberta Patalano, rather than placing it at the beginning.
The reader, who has gone through the composite panorama of the interventions that are possible while working as a group in the institutions, is presented in this section a theoretical model, both nimble and synthetic, that defines some crucial points and encourages an ex-post reflection, which is able to reorganize what the reader has encountered.
The institution in its twofold guise of bonds and opportunities, and the bidirectional connection between individual and institution, are focused.
There are roughly two reasons why those observations are of major interest: first, is the relationship that links the individual to the institution; second, are the issues relating to the processes of change within the institutions.
Proceeding from the inside of the operators’ experience in dealing with patients, relatives, and institutions, the book highlights the role that a non-dogmatic psychoanalysis can play in these contexts.
It is a vital role, which is addressed to the operators, the patients and their relatives. It involves in contributing in assigning a meaning to the human experience in suffering and to transform it through the group’s work.