This week on the podcast I offer up a THEORY episode about a psychiatric nurse and a patient I worked with on a hospital unit many years ago. It’s a sweet story about life and work and how the hard journey of getting to know ourselves is always worth it. I briefly mention a co-therapist style of group facilitation and I wanted to share here in the newsletter a little background on the significance of group work and the specific reasons why this co-facilitator style is so effective.
Before we dive in, I want to encourage you to welcome yourself to this conversation. A lot of discussions like this are had by professionals trying to foster change, yet the knowledge gets trapped and is disseminated to a select few with the expectation that it will impact all. And sure, it does, eventually. But how about more invitations? For all of us. This happens often in psychology and is my biggest gripe about the profession. Psychology professionals love to hear ourselves talk to other psychology professionals in language and references that encourage us to flex our expertise muscles in front of each other at the expense of the information being widely shared. It creates a closed system. And the conversation needs to be bigger than just us to create meaningful change. The information should get to everyone in a useful way. Psychology is the one thing we all have in common. This information belongs to all of us. So if you are a leader, teacher, teammate, therapist, student, mentor, apprentice, worker, professional, novice, parent, child, or partner, this information is for you. You are invited.
Follow me down the group rabbit hole. All of you.
Groups are incredibly complex. And also unbelievably exciting. The most brilliant supervisors and mentors I had during my psychotherapy training were all experts in group theory. Groups are what seasoned experts study when they want to be challenged. There is a lot going on in groups and just when you think you have a handle on it, the scope gets bigger and the bottom falls out. It’s thrilling, really.
What is a group? A group is a collection of two or more members who share a common goal. The word group is used interchangeably with system, organization, continuum, cohort, and family depending upon under what lens the group is being understood. Groups can be centered around families, communities, clubs, work, neighborhoods, counties, states, religion and general interests. Chances are you are part of many groups, some of which cross pollinate and some of which do not.
The magical and perplexing thing about groups is that when we enter a group we bring all of our individual experience plus our behavior when we interact with others. This goes for everyone in the group. This mix of experience is incredibly impactful in ways that both facilitate new ideas and progress and rail very deeply against it. As Homer Simpson says of beer, groups are the cause of and solution to all of life's problems.
There are many ways to conceptualize groups. Psychoanalytically speaking, the all-star theorists are generally Bion, Hinshelwood, and Enrique Pichon Riviere. There are others and of course other big thinkers in different modalities of psychotherapy and psychology.
And then there is design systems thinking. Systems thinking is the design perspective of group work that uses the word system instead of group and stakeholder instead of member or participant. Systems thinking all-stars include Donella H. Meadows and Russell Ackoff among many others. Design systems thinking gets close to the origin of all the rich and complex psychological material that groups provide, but still sits more on the surface than systems thought would like to admit.
Systems design analyses systems and relationships in systems from the outside in order to solve complex problems. Psychoanalysts work from the inside, becoming part of the group and the system in order to understand the members and analyze the behavior in real time. It’s messier stepping in and out of the group and takes an otherworldly amount of skill and experience. But it is also extremely illuminating and offers perspective no other method can. This is one of the reasons couples therapy, group therapy and family therapy can be so effective.
When I was in training at the adolescent psychiatric hospital I mention in this week’s JOY episode, I was part of a Bion style supervision group. A supervision group is a required meeting of clinicians in training and a licensed supervisor. Supervision groups typically meet twice a week to discuss cases, theory, and interventions. A Bionian supervision group consists of a supervisor and a small group of clinicians in training. In a Bionian supervision group, the supervisor does not start the meeting, but remains quiet to witness and analyze the anxiety of not having a clear leader and a clear agenda. The supervisor sits back and witnesses how group members respond, then points out the group dynamics happening in real time in the supervision group and measures this against the group dynamics at play within the larger system. In this case, the hospital.
Bionian supervision groups can be painful, hard to acclimate to and make you anxious enough to practically levitate. But it is a really great way to get to know yourself and how you respond to anxiety, authority and leadership. For example, there’s always the group member who needs to get things started. And will take control despite even knowing that the silence from leadership is designed to discover exactly who will do this. As I mentioned above, the behaviors that arise in the supervision group also serve as a mirror as to what can be happening in the larger organization, system or group. Response and reaction to the supervisor and between group members can inform the larger picture. Group dynamics are just that powerful.
I should mention that the role we take on in a particular group/system/organization is not always congruent with the role we take in another group/system/organization. And this role can differ greatly from our actual personality and character outside of any group/system/organization. I hope that sunk in, because it is a BIG deal and something that typical organizational psychology solutions and interventions do not consider. Group dynamics are so powerful that the intricate makeup of the individuals combined in a group will encourage different responses and actions depending upon the makeup or the group. It’s wild. And this is because as psychoanalysts view it, specifically Ogden and Pichon Riviere, in all interactions between two people or more exists an intersubjective third (Ogden) or a link (Pichon Riviere). This third is a combination of the experiences of the members of the group combined to create another entity. The analyst's job is to recognize this third, honor it and use it to inform treatment, intervention and understanding. It’s a very cool way of working and something I adhered to strongly when working with patients.
Let’s pause to review real quick. So far we have a third, link or combined entity, the members of the group themselves, and leadership. I am using these terms interchangeably but know when I refer to group it is also system and and organization. Leader is also a supervisor, management, facilitator, therapist, parent, mentor, etc. Systems and groups are everywhere. Schools, hospitals, neighborhoods, cities, communities, clubs and as I mentioned, of course families - our very first system. When we enter into a system we bring information we have processed from the group before. For school this is family and for work, this is school. And school, as I have discussed on JOY is much bigger than we give it credit for.
Typically what happens in groups is that there is a reenactment of behavior from one of these previous groups, but as I mentioned, it is not always congruent. I’ll use myself as an example. In nearly all my training placements for my licensure I had the desire to go against the grain. I would often challenge my supervisor and take on the role of the teen with an attitude. The adolescent striving for independence in a system that didn’t allow for growth, even if it did. I was there to push on the boundaries. Think Judd Nelson in The Breakfast Club. This is not who I am. I actually honor boundaries, like rules, and adhere to them most of the time, but this was my response to the anxiety that being in a group caused. This was my role in the group. This role had varying degrees depending upon individual group dynamics, but mostly I was sliding through the hallway past lockers with a raised fist. Don’t you forget about me, etc. This rail against authority is common in groups as we assume what we already know to be true from other groups whether we play the same role or not. Think archetypes.
In the podcast I mention a nighttime reading group I co-facilitated with a colleague three nights a week on the adolescent psych unit. All groups on the unit were co-facilitated and for good reason. Acute mental health crises are disorienting. Simply being with someone who is experiencing psychosis can make it hard to think. Sometimes we can experience physical symptoms and become nauseous or dizzy. It is disorienting and an important energetic reminder of just how distressed the person experiencing the psychosis must be. A message to be tender. And remember they are human having a very human experience.
Logistically it is important to have two facilitators just to ride out the odds. Chances are if one person is confused or unable to extricate themselves from the group to offer analysis, the other facilitator is able to stay agile. Both facilitators come together to offer up different perspectives and/or support findings. Additionally, a second facilitator has an energetic purpose. Another warm body to provide some grounding. There are two of us here to keep you safe, to listen, to provide care. And this grounding provides an unconscious sense of safety that we humans love to assess for. In fact we never stop assessing for it. Having an additional warm body helps ground the anxiety of the group. It really does help. These are just a few of the many reasons co-facilitation is incredibly effective and to be honest, I would not want to facilitate a group without a partner. Groups are that complex.
Reflecting on the effectiveness of this co-facilitator approach got me thinking about other systems, specifically work and school. Two separate systems and the first ones we really experience outside of our family system. If you have listened to my Why School is a BFG episode, you know that school is such a dramatic and dynamic group that it doesn't have much to do with education. Learning and school are actually two different things. If they happen simultaneously, hooray, but this is rare. And in my opinion rare due to the fact that the group members (students) far outnumber the facilitators (teachers and staff). And this equation is often true for work as well.
So what is a sound ratio of leader to member in a group? This depends upon many factors, but lumped together it probably looks like a much lower ratio than what we typically allow for in any system. My daughter is in a rock climbing group. They meet once a week for a few hours. The group consists of 8 students and 2 facilitators. So a 4:1 ratio of student to leader/instructor. Additionally there are on average about 3 or 4 other staff members on hand at any time to assist with equipment or questions. And that seems to work pretty well. And yes, there is high risk for injury in this specific group. And the climbing facility honors this with a low student to instructor ratio. But one can argue that there is a high risk for injury at school and work, maybe not physical, but certainly emotional. And perhaps this risk is even more significant.
If healthy workplace and school (let’s add in any group or system here) function rely on psychological safety (“a shared belief held by members of a team that the team is safe for interpersonal risk taking.” - Amy Edmonson) and psychological safety is part of a looped system with feedback, then wouldn’t co-facilitation make sense in the workplace and school? And not just co-facilitation, but let’s also honor the ratio. A classroom of 28 students with two teachers is better but still not great.
Can schools do this? Probably not. Should they? Hells yes. Will they? Nope. But I’d like to see it. Can organizations do this? Absolutely. Should they? Hells yes. Will they? Maybe. Will the results transform the system?
Definitely.
And for the better.
Groups are complex, beautiful little buggers. They are mischievous and exciting but more importantly effective. Groups and systems, when healthy, allow for an open exchange of ideas. We push each other in groups to innovate. We bring diversity of thought and experience to groups which leads to a combination of ideas and perspectives that move us forward. If we are doing it right. The way we think when we are together leads us to the solutions of the future. And if we are honoring the true complexity of groups and systems, this outcome is not only a lot more likely, it can also be pleasurable and fun. Co-facilitation is just one of the many ways we can increase the useful outcome of group problem solving.
Have you tried anything like this at work or with your family? Do you have co-facilitation in place in the workplace or school? Are you part of a co-facilitator team? Tell me all the things.
I hope you felt included as you were reading this and feel comfortable asking questions. My goal is to make psychology more friendly, and that goal takes all of us. It means asking questions when something is unclear, reaching out with ideas, and bringing your own thoughts and experience to the discussion.
To find out more about Bion, Hinshelwood, Enrique Pichon Riviere, Donella Meadows and Russell Ackoff, click away.
Curious to learn more about groups/systems and how honoring their complexity can improve your system and leadership? This is my jam. Let's talk.
xxx
- LAS
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