Biomedical subjects

Richard M Billow

Publications and source records attributed to Richard M Billow.

8 recordsLinked to original sources

PubMed2006

The three R's of group: resistance, rebellion, and refusal.

I describe three constellations of group life and group process: resistance, rebellion, and refusal. In resistance, an individual or group remains antagonistic to conscious but not unconscious thinking, the latter manifested in derivatives, including symbol and symptom formation, transference-countertransference, and enactment. Rebellion functions on the level of conscious thinking, manifested in challenge, defiance, and the possibility of sociopolitical action. The basic premises and values of the group and/or leader are at the center of the controversy, to be addressed on that level. Refusal establishes a mental boundary between what is considered appropriate and inappropriate. Unconscious as well as conscious processes of feeling, thinking, and meaning making are refused entry, left undeveloped, rejected, or obstructed. Working with refusal requires appreciating how and why the mind and its thinking operations are being suspended. The theoretical framework is applied to a case example.

Humans↗

PubMed2005

The two faces of the group therapist.

The group therapist wears two faces: spokesperson of the Establishment and spokesperson of significant truth. To run vital groups, these two roles of group leadership must stand in dialectic relationship to each other. The therapist introduces principles and practices that normalize group relations and provide a sense of cohesion, continuity, and regularity. However, to be constructive and promote significant truth, the group therapist must also be deconstructive, and encourage and support the group's questioning and challenging the very principles and practices that he or she asserts. A case example illustrates how the group leader is also two-faced in another sense of the term, since he or she may be false and insincere--or perceived as such--when being either the conservator or challenger of group process and culture.

Adult↗

PubMed2004

A falsifying adolescent.

The author describes an adolescent patient who, while often speaking factual truths, maintained an aura of falsity in her life, and in two interludes of psychoanalytic psychotherapy, that functioned as a barrier to psychological insight. To match her falsity, the analyst at times modified his functioning as a "real" therapist and took on her personification of neglectful and false adults. Eventually, the analyst became an object that the adolescent could trust and rely on. In discussing the case, the author introduces and applies Bion's ideas regarding truth and falsity, and three variations of container-contained relationships-symbiotic, commensal, and parasitic-in the context of the case's relational perspective.

Adolescent↗

PubMed2004

Truth and falsity in group.

The universal tension and juxtaposition between truth seeking and truth evasion are explored in a contemporary relational context, drawing on Bion 's later ideas on group. Bion's key idea of "psi," or psychic evasiveness, refocuses group theory, supplementing intra- and inter-psychic perspectives with sociopolitical analysis. To some extent the psychotherapy group exists as a political "Establishment" and thus corresponds to psi. Using three illustrative case examples, the nature and nurture of truth evasion is considered, along with the purposes it serves and the forms it may take. The therapist must maintain a disruptive-creative influence on group process, but like other group members, he or she instead may accept and promote falsity. Whereas the therapist ensures the integrity of the culture, the members, and not solely the therapist, break up old relational patterns and experiment with new ones. Dynamic, evolving groups aid the leader in life-affirming truth-seeking, eventually challenging establishment tendencies and exposing falsity.

Adult↗

PubMed2003

Bonding in group: the therapist's contribution.

Bonding is an ongoing aspect of intersubjective experience, a type of mental relationship to oneself and others. As a behavioral mode, bonding utilizes verbal and nonverbal communication primarily to establish a basic feeling of connection between individuals. Bonding is the floor, a cognitive-affective state that precedes and prepares the way for the complex processes underlying identification. The concept relates to Bion's early theory of basic assumptions, and takes on new and different meanings according to his later ideas regarding social communication. Bonding is also a therapeutic posture or technique, an element in the establishment of group cohesion, the positive transference, and therapeutic and group alliance. Case examples illustrate how the therapist and other group members bring a complex of bonding needs and anxieties that must be negotiated to establish and maintain bonding, which is a necessary condition for successful therapeutic work.

Adult↗

PubMed2003

Rebellion in group.

Rebellion is a strategy of social action: to overthrow the group's status quo or to adamantly oppose its revision. Rebellion occurs when other avenues of influence seem futile or unattractive-a judgment that depends on the group's genuine receptivity to discussion and change, and equally, on the state of mind of the rebel. There are different pathways of rebellion: defiance, secession/exile, anarchy, or revolution. Although rebellion represents an individual's mental attitude toward a group, it is useful to think of group process and rebellion as an attempt to move the group in a different direction. Similar to other group members, the therapist has rebellious feelings and thoughts, and may take on the multiple roles of defiant instigator, exiled outcast, anarchist, and revolutionary.

Cooperative Behavior↗

PubMed2003

Pursuing relational consciousness: thinking and antithinking in group.

Although human beings are interpersonal and innately curious, at the same time an aspect of the self defends against mental relationships with self and other, because such relationships threaten to cause psychic pain. Bion's ideas on thinking and antithinking are applied to this topic of relational consciousness: A "psychotic part of the personality"--which refers also to the "basic assumptions" level of the group-prefers antithinking: forestalling, evading, and assaulting thinking and thinkers. Clinical examples illustrate how the group therapist may address and treat the pervasive resistances to relational consciousness in the group setting. These involve understanding the dynamics and clinical manifestations of hatred of thinking, excessive projective identification, anticipatory anxiety regarding thinking, and bizarre and hallucinatory thought transformations.

Consciousness↗

PubMed2002

Passion in group: thinking about loving, hating, and knowing.

In his early work, Bion (1961) established the goal of learning about and getting beyond the basic assumptions to become a work group. Later, in his structural theory of affect, passion became a key concept. Passion describes the necessary and sufficient condition for a psychotherapy group to be a work group. Passion is an intersubjective process of bearing and utilizing one's most basic affects to reach self-conscious emotional awareness. Bion postulated three primary affects: loving, hating, and knowing (LHK). A clinical example illustrates how the therapist may represent, mentally organize, and mobilize the group's potential for passion by attending to the evolution of his or her own affects. Passion transcends transference-countertransference in that an optimal level of personal meaning from LHK is achieved and utilized in emotional participation.

Adult↗