We would like to take advantage of this meeting on dreams and the group to propose reflections relating to a particular working context with which we have been dealing in the last few years. We are referring to the supervisions carried out as external consultants in the mental health structures with groups of operators of the services.

In fact "group supervision" has become a stable practice in many psychiatric services, starting off from the pilot experiments carried out by some of us in the early 1980s. Previous meetings of occasional consultation had occurred in certain groups, however in our opinion without taking their place in the working set-up and modalities of institutional supervision, as has been attempted and described precisely by certain of us (Tagliacozzo, 1989; Barnà, 1995; and Correale, 1995).

Besides permitting the discussion and further exploration of a case or of a management of the service, supervision offers a particular prospection for the observation of certain dynamics of functioning of the psychiatric services and structures from the basal profile (basic assumptions) or institutional profile (institutional dynamics). Furthermore it reveals a particularly interesting context of analysis, elaboration and resolution of many aspects which are missing or dysfunctional in the collaboration between the various professional figures involved in clinical work; besides being a precious opportunity for the explicit and formal expression of the "culture" of the service itself.

In fact the "supervision group" is a "specialised working group" which gathers together the prerogatives and functions of certain earlier clinical traditions, integrating them in a modality which has yielded original and fruitful results. It brings together the functions of what traditionally were "case discussion" and/or "team meeting", present with different configurations and proportions in many health and psychiatric services; in the same way it encompasses the functions of "clinical supervision" attempted above all in psychoanalytical training (Grinberg, 1986; Tagliacozzo, 1989) and the functions of the "small group having an analytical function" perfected by Corrao (1979) and by what became known as Pollaiolo's group (Neri, 1995; Correale, 1991), on the basis of the theorising of Bion (1961) on group work.

Certain of the formulations in this context of research and theorisation appear to us to be still important today in order to set up and read the group functioning and phenomenology to which we will be referring in our work.

According to Corrao (1979) the re-viewing and re-significance of clinical material must start off from the "thematic amplification of the clinical report" by means of a "search for the hidden mythologhema" and "the exploration of the thermal zones of the passions and the more or less altered qualities of the perceptions, so as to come closer to the somato-psychic phantasmatisations and the fantasies of primitive or eschatological scenes".

He states that "if the clinical group overcomes the anxiety relative to this moment, the sense of an event begins to be built up again, by means of the connecting threads produced ex novo, up to the finding of contents of thought which may be ordered, symbolised, communicated and thrashed out, in order to arrive at the formulation of mythographies, allegories, metaphors, hypotheses and theories acting as a back-up to the conclusive cognitive operation".

According to this working modality, "the clinical fact appears to be achievable and understandable only insofar as it is imported inside the group, which explores it while at the same time exploring itself, according to a set-up which makes it equational, symmetric and specular to the 'object group'" (Corrao, 1979).

According to Pichon Rivière and Korob (1965) anything that happens in an operative group is extrinsicated through the emergence of a spokesman for the implicit content of the group situation; once someone assumes the role of spokesman, the implicit becomes explicit. The spokesman becomes the group's "go-between" and by means of his revealing, draws us into the implicit occurrence or the latent content of the group's fantasy. By the term "expressive delegation" Pichon Rivière (1965) indicates the depositing of the phantasm, of the action, of the thought and emotion on the person evincing it, in accordance with one or other modality by means of which this content can be evinced. The person carrying this deposit, takes it over insofar as, on account of his own personal story, he encounters approximately this content; and he will report the group's latent fantasy through pre-verbal communication, or the spoken word.

This theme was taken up again recently by Bonfiglio (1999), who notes that the person whose turn it is to speak is, as a rule, the one most sensitive to the type of fantasies, anxieties and defences present at that time. Accordingly he notes that "from this point of view the group may be visualised as a sum-total of warning lights which come on whenever the voltage of the electric current changes" (Bonfiglio, 1999).

We have referred to the conceptualisations reported in order to describe, in the present paper, a type or a level of active functioning of the supervision group based on a psychoanalytical leadership, which we may call "dream of the institution".

By this term we refer to those situations and exchanges within the supervision group's work, that while apparently "incoherent" with its "own" discourse that the group is carrying on, propose iconic representations or metaphors which we may define as images that come to encompass different elements expressing institutional or emotional contents which could not otherwise be expressed or said in the "coherent" context of the discourse.

These productions may occasionally be provided by each one of the participants in the group; they often appear as affirmations "aside" as compared to the coherent discourse. Whereas on other occasions they appear, instead, as particularly useful conceptual and/or metaphoric contributions for the purpose of saturating a representative tension in which the group is engaged at that moment or has been engaged for a certain time already. They may even pass unobserved and not be used; or on occasion may even be received by the participants with slight embarrassment.

Another characteristic of these images or of these "impressions" is that they are more easily produced by particular participants who are peripheral compared to the explicit discourse of the group and the group leaders' interventions; the operators carrying these images often seem stimulated to intervene only in particular affective-cognitive contexts which may have been produced in the atmosphere of the group.

Certain participants are more specialised in providing "belly" images in emotionally hot situations, while others tend to provide precious more or less synthetic conceptual formulations having the characteristic of words and images "to express it". We might say that here we are dealing with agents or functions of the basal productive level of the group which are set off at different temperatures in the group's affective-cognitive climate, as a result of the contemporaneous setting in motion of an oneiric-iconic function of participants' minds.

We also assign to the oneiric capacity of thought set in motion in the supervision group the capacity of "dreaming" the institution in certain configurations of the same which are not otherwise understandable and not "visible" even by the operators; these are above all deep-down dynamic aspects capable of characterising the pre-eminent functioning of the group and above all the dysfunctional aspects which produce suffering in the operators (burn-out) and in the users (actings, drop-out).

Usually it is the leader who gathers up these productions and reproposes them to the group as images or sayings useful for representing dynamic situations, group and/or institutional functionings and/or aspects not recognised until that moment and which are not otherwise recognisable. This is possible on account of the particular position of listening in that the leader assumes within the group, the mental functioning set off in himself and the training he possesses for receiving the participants' associative and oneiric communications

The leader's experience should bring him to decide whether such a "production" should be reproposed to the group "in clear", as the explicit expression of a latent content which, in that form, is made explicit and is socialised in the group; or whether it should not include the image or expression emerging in an interpretative discourse less "in clear". Any premature reproposing of the "conception" of what is happening in the group, of a nuclear dynamic aspect has many probabilities of proving useless, or not being listened to, or not "understood" by the group and in many cases may well produce disconcertion, suspicion of the person and intention of the supervisor and resistances of various types to continuation of the group's associative work.

And now we will endeavour to specify further the functioning we are speaking of and to frame it within the further explorations carried out by various Authors on group functioning and on the oneiric functions of the mind and of the contexts in which these are present in the waking state as a "creative" complement to the formal logical functioning of waking thought.

The supervision group as a matrix of thoughts

Sociological. socioanalytical and psychoanalytical studies on collective phenomena, on the institution, the organisation and the small group, have progressively enriched our understanding of specific group phenomena and of the problematical but also precious aspects of its use as an operative and formative instrument (Barnà, 1989). Accordingly fundamental importance continues to be ascribed to the contributions of those authors who have highlighted the profound psychodynamic levels circulating within the working group, in separate and contradictory terms compared to the motivation and manifest task of the group (Pichon Rivière et al., 1969); levels influencing the productive evolution of the group itself (Bion, 1961).

Jacques (1966) considers the group as a container of profound anxieties, and it is to him that we owe the concept of institutions as containers of persecutory and depressive anxieties. According to Gaddini (1983), each of the participants perceives the group as the concrete, multidimensional representation of his/her own "basic mental organisation" however fragmentary, adimensional and unintegrated this may be, corresponding to the first phases of experience. So that we should expect each group to understand a variable component of degrees of integration within the various individuals constituting it, and to tend to maintain a fragmentary organisation in order to contain the anxiety of "non-integration" of each one of its participants.

Bleger (1967) puts individual and group together, under the aspect of a very archaic functioning that he defines as "syncretic". By means of this term he indicates those strata of the personality that remain in an undifferentiated state¸ strata present in the functioning of every group and which may be traced back to pre-verbal, subclinical communication, difficult to pinpoint and to characterise. In each group there exists a type of relationship/non-relationship which constitutes a basic structure and provides a sort of permanent transitivism by means of which a group of persons, which from a naturalistic point of view we may consider to be isolated, finds itself instead in a state of fusion and undifferentiation.

The study of groups of any kind and in any productive dimension has shown that the individual, group and organisations in all cases behave like interacting and interdependent systems, while the group constitutes the intermediate aggregation interacting at the same time as the other two. If the tendency to remain attached to syncretic sociality prevails, the organisational aspects become rigid and stereotyped, the objectives tend to be considered as secondary, while the perpetuation of organisation as such becomes of primary importance. If the individual dimension prevails, we witness the strengthening of internal conflictuality within the group, that paralyses the activities of reflection and common working out of the task.

Brignone (1997) considers the institutional group as the presence of a sum-total of operators within an organisational structure, continually oscillating between the fact of being merely a group of individuals that chance has led to work in the same place, and the achieving of a greater or lesser capacity of drawing closer and taking their place within the carrying out of the task (Brignone, 1997). For Bonfiglio (1999) the function of the group, which he considers as "an actual fact" of institutional work, "takes its place along a continuum, or axis joining two opposite poles". At one vertex there is a function of putting together, of connecting up data, of aggregation of efforts, of broadening of awareness, of sharing of the anxieties and responsibilities; while on the other, the opposite function of dispersion, of fragmentation of data, of delegation and of personal de-responsibilisation (Bonfiglio, 1999).

In psychiatric institutions, on account of the complexity of their mandate and task, and due to the emotional impact that mental illness produces on the operators, it is more likely that a sort of subversion and of passing from a therapeutical to a iatrogenic role occurs, making these services antitherapeutical. At this point supervision may constitute one of the initiatives to be undertaken in order to ensure the continued functioning of the thought activity of an institutional group, if the latter is not already too seriously impaired.

When a group of institutional operators finds itself with a supervisor, we may immediately note a series of phenomena which could be considered as expressions of fear in the face of a new situation. But it is not the new element that creates this fear, but rather the unknown enclosed within the known; the unknown that each person carries with him/her in the form of non-identity, of syncretic Ego or non-integrated Self. However the knowledge and understanding of the "basal" level of the group makes it possible to develop, side by side with the techniques of leadership which foster the rationalisation of productive aspects, a type of leadership fostering rather the elaboration, learning and profound transformation of the members (improvement of the levels of integration of the participating individuals) (Barnà, 1995).

The supervision group, in the institutional version, takes its place as a group working alternatively either towards the external level, that of the organisational context, or towards the internal level, or the internal productive elaboration of each individual, where he/she undertakes a profound re-elaboration of individual motivations and of emotional involvements with the therapeutical task (Barnà, 1997). As regards the problems of relationship with the service - the institutional aspects - the supervision group may permit access to the dimension of internal institutionality present in each individual; and in this sense may function as an operational group. As far as training, learning and elaboration are concerned, group supervision may produce a transformation which does not merely refer to an external object - therapeutical practice - but to the group itself, that through experience acquires something thanks to which it emerges enriched (Barnà, 1995).

The role of supervisor or leader is that of backing up the group in the recognition and elaboration of the organisational and institutional levels, of the rational operative zone and the affective zone; the last-named relative both to involvement with the patients, and to participation in the in-depth dynamics of the group itself (Barnà, 1997). The leader may be helped out by his own controtransfert in this exploration aimed at shedding light on the unconscious processes operating in supervision, up to the achieving of a better understanding of what happens within an institutional group (Fazio, 1997)

Oneiric waking thought and iconic images in the supervision group

In Bion's "Imaginary twin" (1955) he describes the importance of the visual faculty in the associations of the three patients considered by him; this faculty appears to him as the expression of the emergence of a new exploratory capacity. More generally speaking, sight is considered by Bion as the faculty most appropriate for re-activating all the emotions connected with the progress of psychological development.

The Symingtons (1996) consider line C in Bion's Grid (1962) as the one which fundamentally describes everything expressed in terms of sensorial, generally visual images, also including oneiric thoughts, dreams and myths.

Line C also includes a "narration" of events that produces a visual image; a myth too is the description of an event seen from the point of view of a person, while no event can be described without account being taken of personal elements, even if recorded with mechanical aids, since these cannot record many of the qualitative elements present in the field. Thus the description that a patient gives of an event or that given by a therapist or an operator regarding a patient, may be considered as a personal myth of what has happened, and should be classified under line C.

Dreams too belong to line C and insofar as they are generally experienced in a visual way, although they may be felt with modalities other than the visual one, including even by means of somatic extrinsication. For the Symingtons (1996) there is in any case a difference which cannot be eliminated between the Freudian view of dreams and that of Bion:

Freud (1899) considers dreams as hidden desires which, in order to be represented, use images deriving from memories and from continuous somatic and sensorial stimulation; accordingly oneiric working occurs through the condensation and shifting which make the desire accessible and tolerable to oneiric awareness. This view he has of dreams as the hallucinatory satisfaction of a desire is in line with his idea of the "motivation" governed by the need of the organism to reduce tension.

Whereas Bion (1965) maintains a different position, considering dreams as the process by means of which every form of frustration and tension are incorporated and transformed by thought. What interests Bion (1962) is to see in dreams the application of thought to the emotional experience, which is in any case set in motion by a relationship.

Thought has a constructive function insofar as it provides a pattern of meaning to the basic elements of experience; but the foundation of thought lies in the absence of the object, that is, in the experience of frustration, and the only way in which all of this can be emotionally recorded is by means of a painful and persecutory ideation, the pieces of which consist of beta elements, as basic elements of absence. Thus thought has its roots in the alpha function which is the function that transforms persecutory ideation

Riolo (1986) shows that in case of alteration of the alpha function or of its suppression, the beta elements remain unchanged, with the consequence that the emotions are felt in the form of sensitive objects that the patient cannot dream.

However having dreams or having conscious thoughts in any case implies the same activity, that of the alpha function, and insofar as the alpha function works on all of the emotions and on all the sensorial impressions, the sleeping or waking experience differ only in the quantitative sense. Accordingly oneiric thoughts form an integral part of thought in the waking state, constituting the bridge for conscious thought. In this way the opposition between daytime thought and night-time thought is dissolved to form in a continuum that includes oneiric thought in a state of awareness.

According to Ferro (1999), Bion (1962, 1992) describes the presence of a continuous formation of alpha elements in the waking state; and he highlights (Ferro, 1998) the presence of different gradients of 'literacy' ranging from hallucination to transformation into hallucinosis, up to the oneiric photogram and to the dream. Thus visual elements are continuously and sequentially formed, and cannot be directly known except by means of the "visual flash" and the "reverie" of the therapist; the phenomena of "reverie" occur for example in those situations in which as therapists we are capable of coming into contact and "visualising" the alpha element. Outside of these situations, we may know them all the same by means of the "narrative by-products" of the alpha elements.

"Visual flashes" occur whenever the alpha element, that is a photogram of film of oneiric thought of the waking state (Hautmann, 1996) breaks away from the apparatus which should contain it and is projected and seen outside. These phenomena described for the first time by Maltzer (1982 a, b and c) are much more frequent than we might be led to imagine.

Accordingly Ferro (1999) considers that interest in the oneiric dimension in the waking state deserves to be as great as that concerning night-time dreams; in fact dream is the re-elaborated sample of a process under way at all times both in sleep in wakefulness. However Thanopulos (1998) tends to emphasise one difference between dream and oneiric state of wakefulness: while the dream would be of an essentially reproductive character and would function as a feeder of the oneiric state of wakefulness, the latter constitutes a veritable area of transition which opposes the scission between the imaginary and the real, permitting the imagination not to detach itself too much from reality and reality not to detach itself too much from the imagination.

In De Toffoli's opinion (1998), a couple in analysis sets off (and takes part in) a field of growing awareness which is expressed by means of waking thoughts, oneiric representations and experiences; this can be drawn on by each single individual in the form of short sharp intuitions and fragments of insight, by means of partial realisations occurring in successive stages, connected to the personal capacity and background. The work of psychoanalysis, thanks thereafter to the bodily, affective and mental structure of the couple, has available to it an enlarged field of awareness, that is at least bipersonal, in which oneiric awareness and waking awareness are at one and the same time present in the field, as borne out and sustained in a complementary manner by one or the other of the members of the couple, who in turn assume the responsibility. This permits certain realisations of knowing and being specific to the psychoanalytical method.

In the context of analysis, awareness as an individual realisation or realisation of a couple or a group, consists not in any particular "subject", but in the way in which previously scattered elements are bound together and organised by means of extension into the field of sense, of the myth and of passion; the possibility of expansion of awareness depends on the nature of these bonds (De Toffoli, 1998).

Shifting our attention away from the field of two-person analysis to the small group, we find that Corrao (1981) describes group thought, from "an extensional point of view", as a "multiple, multifocal or polycentric and polynoic thought, having a high productive potential" and finds in the Group's discourse a tendency to the extemporaneous construction of symbolic neoformations. He observes the reduction of the "subjective functions of conscious vigilance, with inconstant expressions of oneiroid or hypnoid states and the more regular appearance of states of 'reverie'". And, after having described the "suspension or reversal of the alpha function", he postulates the heuristic hypothesis of the existence of a "gamma function", as "symmetrical analogue" in the alpha function group, which would make it possible to place "in a more pertinent meaningful context certain phenomena such as group dreams, group hallucinations, group memory, etc.", thereby providing the stimulus to resume examination of the concept of "group mind" connected to the idea of an "interpersonal field" (Corrao, 1981).

Analysis of the function of thought in institutional groups in situations of supervision has led us to highlight the "transpersonal" phenomenon initially described and represented by the appearance, in these contexts, of the production of iconic images. The word icon, from the Greek "eikwn", has many different meanings (image, figure, painting, statue, embroidery, simulacrum, ghost, likeness, similarity, archetype, model); it comes from "eikona", a pluperfect used as a present which means "I am similar", "I resemble, you look like, I seem". These different meanings derive from the use made of them over time by different authors, and the origin of the word from the verb, also bears in mind the double level of sense present in the word "icon", which on the one hand appears connected to the area of representation, while on the other it expresses a likeness or similarity which would seem to go beyond the depiction of an object. This origin may account for the use we will be making of the term as an image or an impression which is similar to but also contains the representation of something else.

In exploring these passages or these moments of group mental life, we furthermore considered that they could be treated as close to phenomena of "trance".

Now "trance" or "possession" has been defined as "a particular personal or collective condition which takes the form of an occupation of the spirit or of the individual vital presence by extraneous realities, represented as impersonal or personal powers (gods, demons, spirits of the dead, natural spirits, spirits of animals, etc.)" (Di Nola, 1972). This author (Di Nola, 1972) goes on to describe a possession by negative powers, generating evil, and by another positive one which achieves the contact of man with divine powers for good. This latter is intended for prophesy, for individual and group salvation, and for healing. In this type of possession the presence of the spirit may be announced in a dream or in the course of a religious rite, and in ceremonies of possession all those present play an active part in the rite.

More frequently positive possession assumes the aspect of a "brought about" possession and the "causal stimuli" are many in number tending to generate "concentration, meditation, enthusiasm, abandonment, loss of consciousness and vital presence" (Di Nola, 1970). In the majority of cults of possession, each possessing spirit is defined with specific characteristics which are likewise found in the behaviour of the person possessed; furthermore, whatever the sex of the spirits, they are embodied indifferently in men or in women who by means of clothes or their behaviour, indicate their willingness to undergo the change.

The experience of "trance" could be considered as similar to what happens in a supervision group when one of the participants becomes the carrier of an iconic image, born of the fact of allowing his/her own particular sensitivity to be possessed by the "spirit" of the group.

The "dream" of the withered tree

In an institutional supervision in which all the operators of a psychiatric service in Tuscany take part, the case of Maria, a schizophrenic patient who has been undergoing treatment by the service for thirteen years now, is considered.

Maria, aged 35, is the youngest of three sisters, between each of whom there is an age gap of three years. They live in an isolated mountain hamlet, in a house originally occupied by the peasant grandparents, the parents and their three daughters.

When she was born her parents had been hoping for a son, so that perhaps this fact in itself will already bear a certain weight in her subsequent story.

At thirteen years of age, her mother's death of a tumour of the stomach affects the whole family, which from this time onwards begins to break up, seemingly unable any longer to maintain its internal cohesion: the eldest sister leaves to study in the city, the father is seldom at home on account of his work, while the two younger sisters, once the grandparents are also dead, are left by themselves to organise their daily life between home and school. These conditions were not conducive to the elaboration of a mourning which may have taken the form of anger at the mother having left them; a feeling which it was difficult to shake off.

Following this event, Maria's mental life seems to undergo a blockage which is expressed in her school results, and in the next few years Maria gradually becomes more and more lost and confused, describing a descending parabola which is to bring her, step by step, also following two abortions, to a grave alteration of thought, strange behaviour, and finally to chronic mental illness and domestic institutionalisation.

In the example we are presenting the iconic image was proposed by the head physician of the service, who in the course of supervision, recalled a talk he had had a year earlier with the patient's father, on the occasion of a change in pharmacological therapy.

In the course of that talk the head physician had occasion to speak with Maria's father of his wife's death. He told the doctor that the summer his wife died, from their window a tree in flower was clearly visible; but from that year onwards the tree never flowered again. From that time onwards grief for his wife's death was always present in him, and he had never succeeded in shaking it off; if he could have eased this grief by taking flowers to his wife's grave, he would have carried her enormous bunches.

The image of the tree in flower and that of the big bunches of flowers that could have been carried to the grave to ease the pain spreads within the group and immediately sets in motion a whole series of interventions.

There is talk of a freezing of the father, of a family tree which has stopped flowering, because since that father had three daughters, none of them will be able to carry on his name to his descendants. The psychologist presenting this case remembers that he had spoken of the impossibility of marrying again because none of the women he had known could in any way compare with his wife.

To this is added the memory of the second sister as indicated on several occasions by the eldest, who refers to her scathingly as not being her father's daughter. In the group the idea takes shape of a possible family secret, which has to do with an episode of unfaithfulness on the part of the mother and with the birth of a daughter; someone remembers at this point that Maria's parents were not at all a happy couple, and that in fact there was a great deal of conflict and anger between them. So that this inconsolable grief begins to look more and more like a mourning blocked by an excess of angry feelings and of ambivalence.

Since now the father is ill and in hospital, wild reports are beginning to circulate according to which Maria has the task of avenging her mother, killed by family conflicts, by making her father in his turn die of a broken heart.

Practically speaking a complex family picture begins to emerge in which the mourning for the death of the wife/mother would seem to have undergone a sort of denial of mental grief, which has prevented everyone from coming in contact with it, perhaps out of fear of revealing some family secret relating to the conflictual relationship of the parent couple.

The fact that Maria was sent on holiday immediately after her mother's death now becomes the enacted expression of this "denial of mourning" applying to a whole family group which chose not to come to terms with grief at its loss. And ever greater importance is ascribed to the hypothesis that Maria's serious mental illness, of which the first signs became apparent only a few years after her mother's death, underwent a first incubation at the time of the active prevention of any mourning on her part imposed by her father; as if, since she was the youngest, she was destined to undergo the sacrifice of her mental and emotional functions with a stifling of her suffering, on behalf of or in order to save the rest of the family group.

Side by side with the listening in to this ideative production set in motion by the image of the flowering tree which thereafter withered and died, another level of more hidden meaning connected rather with the institutional dynamics, begins to develop in the leader's mind. This picture seems to him to carry with it the underlying idea that at the time where these facts occurred and in the years that followed the service has undergone a sort of freezing and blockage of its thought functions, and that a hidden collusion has come about between the ideological attitude and the negation of the mental illness present on the part of the patient's sisters and the equally ideological attitude of those who should have been dealing with her suffering, but who instead had merely accompanied her in the long descent towards the disorganisation of her thought patterns and the progressively chronic nature of her affection.

So that the iconic image could express a sort of thought on the institutional freezing of the service which only now, under the impulsion of leadership by the new head doctor and with the help of a supervisor was capable of leading to the reflowering of an activity of thought. In this case, the choice of the leaders was not to explicitly express this level of meaning, by assigning to supervision a function which is in part real and in part idealised.

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