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In order of social complexity, psychoanalysis and the therapeutic community stand at either end of the range of constructed therapy settings, with small-group therapy in the middle; the ends are distinguished by diversity of form and increasing unpredictability of culture which varies directly with the number of participants. Psychoanalysis provides therapists with insights into the hidden depths of individual minds, whence storms break to the surface in the form of symptoms and disturbed relationships. This individual, inner focus is both a strength and a weakness of the approach. Most group therapists look beyond the single mind and take as their perspective the individual in relationship to others; and, in an analogous way to individual therapy, analytically informed group therapists look to understand the unconscious processes that move the group as a whole. The therapeutic community provides the greatest scope for the free expression of the psychopathologies of its members, both patients and staff, and their confrontation.
The groups of the title ‘What Happens in Groups’ are not those of the small group but those of the therapeutic community. Hinshelwood's aim is to illuminate the processes of the therapeutic community. The examples given arose out of his experience of working at the Marlborough Day Hospital in the 1960s. His analytic perspective is Kleinian.
As the book progresses, layer upon layer of cognitive complexity is added. The six parts deal with the raw experience of group life, the community of the individual's inner world, the processes which lead to despair, idealization and high and low morale, ways in which the organization may be neurotic, how the community may act as a container and be therapeutic and, finally, a cross-fertilization of these ideas into small-group therapy.
At the outset, the reader is confronted with the acute discomfort commonly experienced by patients and staff in the therapeutic community. This discomfort may indicate actual f