A History of Groupanalysis to the present day by Dr. César Vieira Dinis
The Contribution of Professor Eduardo Luís Cortesão for Portuguese Groupanalysis.
In 1954, with the help of a grant from the British Council, Eduardo Luis Cortesão undertook his training at Maudsley Hospital. In September 1955, following selection, he was appointed as psychiatrist at the Royal Bethlehem and Maudsley Hospitals. In 1956 he was admitted as a Full Member of the Group-Analytic Society of London. In the same year he began the groupanalytic movement in Portugal. This movement led to the creation of the groupanalysis study group in 1958, and, in 1963, of the groupanalysis department of the Portuguese Society of Neurology and Psychiatry. Finally, the year 1981 saw the establishment of the Portuguese Groupanalytic Society. The decisive contribution of Eduardo Luis Cortesão to groupanalysis in Portugal resulted in its acquisition of a well-defined practical-technical singularity, enabling the broadening of the groupanalytic model beyond the original limits set for psychological treatment in a group situation, and reaching different areas of human activity which he enriched with this new focus through a widening of their operational capacity. “The groupanalytic process, as I have been led to define it,… includes in an all-embracing manner, the whole of psychoanalytic theory – and presupposes, in this way, both technical and clinical considerations from metapsychological formulations to the fine detail of object relations, within a specific group situation – different, albeit not contradictory, to the dual situation of psychoanalysis.” (Cortesão) never content with the chance reliance on a brilliant therapeutic intuition and rare clinical sense, Cortesão always went to great pains to endow groupanalysis with the scientific credibility of a coherent and sound theoretical basis, submitting the hypotheses gleaned from observations in the clinical laboratory offered by the group undergoing analysis, to the criteria of pragmatic validation conferred by the therapeutic results. In this way, he established concepts and defined fundamental technical procedures which constitute what is generally defined, in the field of groupanalysis, as the “Portuguese School”. Of special note from among these concepts are:
– The groupanalytic process
– The groupanalytic pattern: “the nature of specific attitudes which the groupanalyst transmits and sustains in the groupanalytic matrix, with an interpretative function which encourages and develops the groupanalytic process. The therapeutic elaboration which ensues favours the aim of inducing meaning and differentiation of the individual self” (Cortesão) He developed this concept at the workshop in London in 1967, namely, during setting out of his ideas on the matrix.
– Levels of Experience and Interpretation in Groupanalysis.
– Commutative Interpretation
– Fulfilment through the Negative and Creativity through the Negative.
– Aesthetic Equilibrium in Groupanalysis
– Differentiated Therapeutic Action
– Transference Neurosis in Groupanalysis. Ist European Symposium on Groupanalysis held in Estoril in 1970.
Transference Neurosis exists in Groupanalysis and its eventual resolution is sought. “The concept of Transference Neurosis in groupanalysis – albeit originating within a different framework – exists and is both significant and natural in this new situation. It is different both in form and in structure but differs little as regards content and function. It is different but not contradictory.“…the members of the group represent, each for one another as well as in the overall setting, a fundamental role as figures of transference…” “…the intensity, the constancy, preponderance and the compulsive repetition of forms of acting, thinking and feeling become even more relevant and significant in this transferencial situation…”(Cortesão) It should be pointed out that the internal group of each individual is conceived to be in its origin that of the family group (M. Rita M. Leal). Cortesão insisted on the importance of the frequency and duration of sessions in groupanalysis for the establishment of the transference neurosis. The transference neurosis appertains to each member in the group context, or rather, in the group matrix. There exists, therefore, as many transference neuroses as there are members of the group. As Cortesão said regarding the transference neurosis in groupanalysis: “…the group is a structure, a mould, a matrix, a forum… It is not a psychic entity nor a mental apparatus. …It is for this reason that I must once again insist that certain expressions in current use such as group transference, group resistance, etc. should be used only as pointers to the situation in which they are technically applied…». After 1956, the impact of group methods had its roots in the teaching which Eduardo Luís Cortesão undertook at the Hospital Miguel Bombarda and at the University Psychiatric Clinic of Santa Maria Hospital. The structure and functioning of hospitals and psychiatric services were substantially altered:
– Group discussion
– The setting up of Day Hospitals
– The multidisciplinary and multi-professional approach in the formulation of a diagnosis and recommended therapeutic treatment.
– Group methods in medical training before, following and continuing after graduation.
– Groupanalytic orientation during professional training and practice in the Social Services
– Group methods in the field of Occupational Therapy.
– Group methods are on the curricula of some schools of nursing.
– From 1956, Cortesão oversaw supervision in groupanalytic psychotherapy and groupanalysis in the out-patients department of Santa Maria Hospital. Also in 1956 he began groupanalytic psychotherapy for psychotic patients in Miguel Bombarda Hospital.
– The teaching of interview methods and family therapy of a groupanalytic nature was begun by Cortesão towards the end of the 1950s.
– The university department of Psychiatry and Mental Health of the Medical Sciences faculty at the Nova University of Lisbon, under Cortesão, became a model of teaching, investigation, and training in which the groupanalytic dimension occupied a privileged position.
– From 1985 onwards, in collaboration with the Southern Institute of General Practice, training programme for GPs was set up.
– In 1988 he succeeded in setting up a protocol of cooperation between the Lisbon Faculty of Medical Science and the Ministry of Justice of which he had overall responsibility. This protocol was the driving force which led to the creation of the Department of Medical Health of the Prison Services Board and of the Clinic of Psychiatry and Mental Health of the Regional Board of the Caxias prison service.