My interest in psychodramatic work developed all through the 1960s and 1970s. At that time, both Moreno 's version of psychodrama and Kurt Lewin's group dynamics arrived quite independently of each other in France via the United States . Group experience was something quite new here, so that there was an immediate and keen interest in these phenomena, one that took psychotherapists and psychoanalysts by surprise, given the wide diversity of approaches and of their underlying theoretical foundations.

Some psychoanalysts immediately seized on these techniques and attempted to recast the theory of group dynamics in terms of unconscious phenomena. However, extending what could be understood in terms of intra-psychic conflict as Freud had theorized it to explain what goes on between individuals raised as many new questions as it provided answers. On the other hand, this did make for a great deal of freedom for thinking through the concepts used, since there were no obvious mentors available.

I was all the more sensitive to these various movements because I had just finished my psychoanalytic training, I was beginning to treat patients on an individual basis and, as a lecturer in the Paris-VII University , I was responsible for setting up involvement groups for training students.

As all of this came together, I decided to learn more about psychodrama both from Anne Schutzenberger, who had been trained by Moreno, and from participating in the psychodrama course organized by the Institute of Psychoanalysis where, since 1948, three psychoanalysts of the Paris Psychoanalytical Society [S.P.P.], Serge Lebovici, René Diatkine and Evelyne Kestemberg, had been endeavouring to apply their own version of psychodrama techniques to the treatment of child patients and of psychotics. As they themselves put it: "At that point, we had no more than hearsay knowledge of Moreno 's work, so that we had to improvise and try out various different approaches." [Lebovici, Diatkine & Kestemberg 1958] They did, however, work mainly from a psychoanalytic perspective, with their co-participants, themselves trainee psychoanalysts, directly embodying the latent level of the proposed theme by emphasizing in their play, for example, the underlying drive-related issues or the superego prohibitions that the patient had internalized.

Though I had no particular guidelines, I felt intuitively that psychoanalysts were not paying sufficient attention to group dynamics and that Anne Schutzenberger's approach did not take unconscious processes sufficiently into account. I was learning.

At the same time, Didier Anzieu was bringing together psychosociologists and psychoanalysts with the idea of doing research on the contribution of group dynamics and psychoanalysis to the experience of training groups.

That, therefore, was the cultural background of which I was part at the time. The British group therapists, Foulkes and Bion, were still more or less unknown. I first read of Bion's work in 1965, when his Experiences in Groups was translated into French. That book reinforced and re-opened my own inner debate, and it continues to inform my thinking and my on-going clinical and theoretical developments. In my view, a psychoanalytic conceptualization that integrates the group dimension is still far from complete, thereby leaving room for much more stimulating research to be undertaken in this domain.

The psychodrama setting

Before giving some indication of my own research, I shall describe the set-up I use so that the reader may have a clearer picture of my clinical work.

My own groups are therapeutic in outlook, and I see them in private practice. There are seven adult patients in each; in most cases, they have already had individual psychotherapy, sometimes over a number of years. To describe them briefly, they are what we would call "borderline" patients. I am the sole therapist. Each weekly session lasts for two hours. The initial contract is for one year, and can be renewed; the group is therefore a "slowly open" one. Generally speaking, about two patients leave every July and two others are recruited the following September. The average length of time patients spend in the group is three years. This set-up means that patients can experience the anxiety of integrating the group and of leaving it; for as long as they require, they can continue participating in and thinking about the shared events that occur and learn slowly to deal with these. Over the years, each two-hour weekly session has come to form a pattern of three successive phases: initial exchanges, the play itself, and group discussion.

1. Initial exchanges

This phase lasts between 30 and 45 minutes. Participants exchange information, they tell one another how they are coping, they talk about a previous session, a dream, a memory. This sets up a shared backdrop against which the present and past history of the participants is communicated, their different sensitivities brought together, and the obscure forces of the unconscious hinted at. I leave the patients free to structure these exchanges as they see fit, since they form the basis of our therapeutic work together. If the exchanges tend to become too fragmentary, I point out the affect that appears to underlie them or I ask "What are we trying to say here?" or "What's bothering us right now?". This is one way of reminding everybody that whatever happens in the group is significant for us all and brings us all together.

2. The psychodrama play

After these initial exchanges, I ask who wants to propose a scenario. I accompany the patient in the space left free for this proposal and help him or her to make the proposed theme more explicit. The patient then chooses the other participants.

Even when the theme is personal, as it is here, the actual construction of the scenario is a group activity that requires several participants; they have of course precise roles to play, and in addition they approach the task with what they know consciously and unconsciously about their fellow participants. The play distributes these different kinds of knowledge and intuition throughout the group. In addition, if the scenic dynamics are to succeed, not only must the representation and inner cohesion of the story be maintained, but also a potential collective act has to be brought to fruition, and this demands the instantaneous attunement of reciprocal stimulation. This scenic group structure gives a powerful and mobilizing impetus to the participants and the onlookers, both as regards content and with respect to the modalities of the links that are thereby generated.

I never participate in the actual play itself. Sometimes I stand in for the author so as to state briefly the underlying theme whenever it seems to be getting lost. In one play, for example, Beatrice endlessly repeats the criticisms she directs at her husband, whom she feels is selfish and indifferent. These criticisms are well-known to all of us, as is the association made to her father, a cold and stern person. Some disappointing event or other always overwhelms Beatrice completely. I stand in for her and say: "What I really want to know is whether or not you love me." This sudden shift of emphasis surprises and moves her. The group discussion thereafter has to do with the feelings that were really at stake and which had tended to be side-stepped behind the manifest behaviour.

Often I use the change-of-role technique in order to access the unconscious reactions that are being sustained by two participants. For example, when a patient goes on repeating situations of persecutory attacks, it can be interesting to ask the two protagonists to swap roles so that the attacker can get in touch with his or her own violence (which is more often than not denied).

3. The group discussion

Whatever the actual content of the scenario played, it is important to have all the members of the group participate in responding to and thinking about what they have just witnessed. Their respective contributions are often surprisingly acute.

In this context, there is not much difference in interpretations made at the group or at the individual level, or when highlighting personal or group feelings. Participants are more in touch simultaneously with their own feelings and with those of the other patients.

Initial thoughts on mental functioning in a group situation

The complex link between the intra-psychic and inter-psychic dimensions has come to be the main focus of my research. The experience of small therapeutic groups leads to the discovery that learning about unconscious content is always of major importance for understanding how human beings, with their background of infantile sexuality, function. Thanks to Freud's discoveries, we make use of free association to catch a glimpse of the inexhaustible echoes of the search for satisfaction, their repetitiveness, their indirect means of expression. In a group situation, the associative network shaped by the participants allows a dominant active fantasy to be heard. Didier Anzieu [1975] and, after him, René Kaës [1976,1993] based their work on the universality of primal fantasies in developing their model of how reciprocal linking takes place between individuals.

I follow their example in this respect in order to analyse certain sequences of manifest content that awaken a simultaneous echo in everyone, particularly as regards fantasies that have to do with infantile sexuality. The question remains open as to the modalities through which this instantaneous contact between minds takes place. From my very first experience with groups I was struck not only by the content but at least as much by the currents of tension that flowed between the individual participants; the emotional climate that is thereby generated is difficult to define, but it does involve unstable linking / unlinking shifts. I call these fluctuating tension / attention systems "effects of presence" so as to emphasize the fact that they are linked to the actual presence of several individuals and their instantaneous interlinking.

These effects of presence have an energizing quality such that they create instantaneous mental links; they are not the same thing as representations involving the absence of primary cathected objects and the desire-based impetus that keeps them internalized and sustains the search for them in the external world.

These two modalities of the mind are so closely intertwined that they become impossible to dissociate and difficult to observe on their own.

Before going on to develop the premises that I required in order to integrate these ideas within an extended metapsychology, I shall give a clinical illustration that shows the unceasing ebb and flow that puts us in contact both with our internal world and with the external one.

A clinical illustration

I have chosen an example from one of my on-going psychodrama groups. Though the group began two years ago, it was very difficult for the participants to "be" a group. There are seven members, all of whom have significant difficulties in establishing contact. Most are withdrawn, but one woman, Jacqueline, is extremely exuberant. For a long time, nothing that was said by any one member was picked up by any of the other participants and added to. It was obvious that they were avoiding one another. The dramatic scenarios quickly petered out, except for Jacqueline, who spoke a great deal without anybody really listening to her – it was as though her torrent of words formed a barrier, so that she felt obliged to go on and on. The atmosphere was oppressive.

I try to link things together and find something meaningful in all of this. They listen carefully to me, sometimes even gratefully – then they go back to their usual factual descriptions, completely split-off from one another.

When I bring out the dominant aspect of the session, one or other of the participants (thanks to their long experience of individual analysis, they know what it is all about) may add: "Yes, that has something to do with my mother (or my father).... I know that, but it doesn't change anything." Their fear of making contact with one another is almost palpable; it obviously involves their extreme sensitivity to the reactive presence of the other participants.

I shall now present a psychodrama sequence in which four of the patients participate:

Jacqueline, the exuberant woman

Julie is the principal actor; she is a quiet, depressed person

Jane, whose emotional life is a desert

Jean-Paul, very withdrawn; he has ideas of persecution that sometimes bring him close to being delusional

The general atmosphere is, as usual, oppressive, irregular, with no vitality.

At one point, Jean-Paul seems to be the spokesperson for this general state of affairs. He says how restful it is once he is back alone in his room each evening, reading a book and perhaps smoking a joint. He was once in a disastrous sentimental relationship, his boss persecutes him, his colleagues are uninteresting. He repeats "so as to have nobody on your back", "peace and quiet", "other people are far away".

I intervene: "It would seem that, here too, everybody is afraid of everybody else." Julie, a quiet woman who is remarkable for the fact that she seems always to have her eyes downcast, states from behind this drawn curtain: "Other people tend to take advantage of you as soon as they feel you're weak. I don't know how to defend myself. I'm too porous ."

"Porous?" someone asks.

"Yes, anything they say to me just hits me too violently, it stops me thinking. My ideas fizzle out. I just go empty."

She wants to invent the drama scenario. What has been said in the session makes her want to play but she does not know how to represent the state of anxiety and emptiness she has felt inside herself ever since she was a child. I help her to associate. Suddenly a repetitive scene comes into her mind – at breakfast, "I was the one who had to do everything. I had to think of everything...." This was when she was about ten years old.

Her mother, ill for many a long year, is in bed. She is depressed and hypochondriac, but at age 10 Julie thinks that she is in danger. She brings her mother breakfast in bed. Then she has to get her little brother ready and take him to school. As for her father, he is in the kitchen, "in a state of collapse".

Julie chooses Jacqueline, the exuberant woman, to play her mother's role. Jacqueline finds it easy to pester her daughter with questions and plague her with complaints. Jane, the extremely inhibited woman, plays the younger brother. Immobile, not reacting in any way, he is jostled about by his older sister. Jean-Paul, flopping down onto a chair, repeats in a very convincing manner the words Julie had mentioned at the beginning: "Take good care of your mother, she might die at any moment."

It is impressive to see the three chairs standing quite a bit apart from one another, with each of the three seated protagonists all hunched up while Julie rushes anxiously from one to the other, responding to each of their demands – father, mother, brother. She says in a low voice "We'll never make it, we'll never make it."

I interrupt the scene and repeat that last sentence: "We'll never make it".

Julie: "I had to think of everything, if I didn't, I felt that it would all just collapse." She weeps.

In the subsequent discussion, the members of the group are very serious. They all listen to what each of the others has to say. They are at last venturing into the risky business of mutually responding. Probably more than other people, these participants have had the experience of how supportive these basic levels of coming together can be – but also how easy it is to find oneself bogged down in them. Some patients talk of how they themselves dealt with issues of family atmosphere.

-- Jean-Paul, echoing Julie, speaks of the scenes of incomprehensible violence that he witnessed between his parents. One day it would be calm, the next all hell would break loose. He used to hole up in a corner until the storm was over: "it would liquefy me".

-- Jacqueline, more restrained than usual, tells of how she used to act the clown in order to relax the atmosphere at home with her silent, sad parents. "I was glad when it worked; I would lay it on thick" [which is what she does here in the group]. "If they paid no attention to me, I was at a loss, I didn't know what to do."

The only thing that Jane says is: "In my home, nothing ever happened... I was bored."

This kind of family atmosphere can be so repetitious and habitual that it is experienced as a norm. It is part of our make-up, we do not even have to think about it. Jean-Paul says: "I was surprised later when I discovered that it wasn't like that in my friends' families." Jean-Paul spent his childhood in a family that was very turned-in on itself, with little contact with the outside world.

As far as group work is concerned, it is important first of all to acknowledge the scope of that experience and to help patients put words on their unthinking participation in it. It is one way of rehabilitating, as it were, the existential basis of each individual, thereby making it possible to participate willingly in the inter-psychic links. The group will slowly come to realize that the emotional climate, no matter how crushing or harmful it may have been, had been built up by everybody including the patient him- or herself. Their own interlinking functions are modelled on these earlier patterns.

Once this understanding initiated and accepted, it becomes possible to clarify the repetitive and excessive functional defences that are derived from it. Thereafter, the potential libidinal benefits that can be drawn from having recourse to these functions and defences can be examined. Holding the group together or being its jinx may become the unconscious path towards becoming acknowledged and loved. Participating in the scenic links can then be analysed in its sexualized dimension.

As far as Julie was concerned, it was thanks to the awareness of her function as regards sacrificial responsibility -- seen from different angles: in the past, in the work-place, in the group -- that it at last became possible to explore in a meaningful way the advantages that she may have drawn from this modus operandi :

-- obtaining her father's gratitude;

-- repressing her aggressiveness with respect to her mother;

-- keeping her younger brother under her thumb in a significantly violent way.

Inter-individual echoes came more and more to the fore, the whole group became alive and began to move forward.

Throughout this slow work of analysis with a group of patients, the psychoanalyst has to maintain the binocular vision that Bion recommended:

-- attention given to the participant modalities that initiate and terminate contact with others;

-- attention paid also to the latent content that continuously expresses infantile wishes involving sexuality.

These two activities are closely linked, more emphasis being given to one or to the other depending on the circumstances. This implies that the kind of intervention to make and the emphasis to be laid on some particular aspect or other are the fruit of the psychoanalyst's experience, sensitivity as a participant in the group atmosphere, and conceptual thinking. That experience of course is in constant development.

To return to some theoretical points

Bion's book on small groups was a defining moment for me, because it gave sustenance to my initial intuitions.

His description of group mentality and basic assumption groups was my starting-point. For Bion, there is the instantaneous achievement of a collective state of mind that is primary, uniform, anonymous and emotional in nature. The conceptual foundation he laid down for these observations was later to be shaped in terms of the proto-mental system, a hypothesis I feel is close to that of the instinctual drives: “ I cannot represent my view adequately without proposing a concept that transcends experience. […] The proto-mental system I visualize as one in which physical and psychological or mental are undifferentiated.” [Bion 1961 (1968: 101-102)]

From this proto-mental matrix composed of all the members of a given group, there arises “discrete feelings only loosely associated with one another […] emotions proper to the basic assumption flow to reinforce, pervade and, on occasion, to dominate the mental life of the group.” [ibid.: 102]

Though a very short summary of Bion's approach, two aspects are significant for what I am suggesting in this paper:

1. The importance he gives to shared emotional experience, the basis for all mental growth

2. The fact -- which he was later to highlight -- that there is very strong resistance to making use of this emotional experience in order gradually to develop one's thinking.

In his description of the specific nature of group mentality, Bion uses indiscriminately words like emotion, affect, feelings, sensations, emotional disposition.... thereby illustrating just how difficult it is to define the subjective states that enable people to feel themselves linked together, with no hesitation and no particular responsibility. These subjective states are not always pleasant, they may even be boring or stressful, but they do support the shared and instantaneous primary link, hence the difficulty we experience in making it develop further. There is, writes Bion, a “hatred of a process of development. […] In the group it becomes very clear that this longed-for alternative to the group procedure is really something like arriving fully equipped as an adult fitted by instinct to know without training or development exactly how to live and move and have his being in a group.” [ibid.: .89] . His work on psychosis constantly emphasizes this powerful resistance to mental growth that results in a refusal to learn from experience.

An even more radical form of psychotic avoidance consists in attacking and destroying the primary emotional link itself whenever the attempt to think through it becomes too demanding, requiring much constraint and effort. In Learning from Experience , Bion writes [1962: 42]: “ Failure to use the emotional experience produces a comparable disaster in the development of the personality; I include among these disasters degrees of psychotic deterioration that could be described as death of the personality.”

Effects of presence and the interlinking drive

Though for some time I have had to confront Bion's theoretical corpus and on occasions taken a quite different point of view, it has always been and still is a major impetus as far as my own work is concerned.

I now think that group emotionality is not sufficiently defined by Bion's across-the-board combination of group mentality and basic assumptions. When such uniformity does appear, it is the expression of a collective defence triggered by the paralysis of the internal-external processes that constitute the interlinking function. This function ensures that the minds of the group members are linked together not in any uniform world of the imaginary, but as a result of the mobilization of those minds in a state of receptivity and stimulation.

My own hypotheses [Avron 1986] concerning this drive-related interlinking function – which can be accomplished only when several individuals are together – involve three major aspects which I shall simply state briefly.

1) Interlinking becomes functional thanks to the highly mobile energizing processes emanating from all the persons actually present. These energizing movements are not the result of any internal discharge of excitation. They are patterns of tension / attention that are internal / external, and their role is to link up together -- hence the dissymmetry of their polarities (stimulation / receptivity) that switch over under the influence of the active external polarity. Their basic structural asymmetry enables an immediate dynamic gap and potential switch-over to be set up; both of these are necessary for the creation, continuous operation, or interruption of an auto-organization that is in a permanent state of imbalance.

2) It is possible to follow the activity of the oscillating energizing currents of interlinking if we focus slightly less on the content of the exchanges that take place in order to fine-tune our participant perception of the global processes at work. This is not a sensory perception of the external world nor a subjective perception centred on our own feelings. The perceptual opening-up to the impact of that external activity is carried out via the response it induces in us. Immediately the external world stirs something up inside us, it is simultaneously and partly our own creation, since we participate in these chain reactions. Thus we find ourselves in the paradoxical situation of being stimulated by a mental environment which we are getting to know and of which, at the same time, we are the co-authors without our realizing the fact. At one and the same time, we are both inside and outside ourselves. A particular kind of knowledge arises from that paradox -- the experiential knowledge of the mental world that surrounds us, rhythmed by an external activity of which we are in part the creators and which, in turn, informs us of its existence and intensity.

3) I use the term scenic thinking to designate this proto-thinking that can create scenarios for reciprocal linking activity and to some extent anticipate them. This form of scenic thinking that experiments with interlinking and guides its steps becomes increasingly predictable the more situations it has to deal with. It can gradually be used to promote finalized group actions. Like any mental act, scenic thinking can be used to further the development of solidarity or implemented in order to increase control and domination. The moral value of the action is another far-reaching question. In any case, the experiential capacity to participate in the earliest forms of reciprocal linking and the development of scenic thinking gives access to a generalized awareness of mental inter-causality and, in an even wider sense, to the multi-causality processes that link together people, events and things.

In an attempt to locate this multifarious energizing process that links individuals to one another without their realizing it, I suggest that, from the metapsychological perspective of Freud's second (structural) theory, we could envisage the existence of an interlinking drive that would be part of the Id's many forces -- that "cauldron full of seething excitations", as Freud [1933a (1932): 73] called it, that gives impetus to the energizing processes behind all forms of mental binding and unbinding. I cannot go into any detail concerning this hypothesis of mine, but the idea of an interlinking drive would enable us to argue that the emergence of inter-drive dynamics which set up instantaneous links between individuals possesses its own specific features. The effects of the interlinking drive could then combine their action with the representation effects of the sex drive and thus give shape to primal fantasy scenarios with their universal appeal. The expression of pleasure and the need to remain sufficiently linked together to ensure our safety would thus, from the very beginning, have to find an unstable and always unsatisfactory balance between inner and outer, between the private links of sexuality and those of communal gathering together. All this requires to be developed much more fully; for the moment, I am simply offering a general description of this metapsychological dimension.

When interlinking becomes dysfunctional

When interlinking is significantly dysfunctional, psychotic-like disorders appear. The organization of permanent and reciprocal link-creation with people in the environment is disturbed, thus generating anxiety states of varying intensity that go to the very heart of the feeling that one exists as a person.

If we accept that in all of us there is both a neurotic part and a psychotic part, in the fairly well-adjusted patients who participate in the psychodrama groups that I have described there is, it seems, a neurotic layer that protects them from the worst of anxieties concerning their sense of self-identity. Contact with other people makes for a kind of repellent attraction, if I may put it thus; they are attracted to the outside world but afraid of it at the same time since it may be either supportive or destructive. The therapeutic group represents confrontation not only with their own intra-psychic problem complex concerning sexuality but also with the creation of direct links with the these "others", who are both essential and dangerous.

I now find it important to monitor closely not only the emotional climate of the group and its variations, but also the functional modalities of stimulation and receptivity that each member, without being aware of the fact, uses in order to participate (or not) in the changing backdrop that forms the group's emotionality.

When interlinking functions are put to use in small therapeutic groups, this calls into question the way in which they are organized, perhaps defensively, in the original environment of each member. This kind of monitoring makes use of direct observation as well as the more indirect method of free associations with respect to the emotional climate in the patient's family.

1) Depending on the point in time, the comments made, and the responses to them, direct observation means that the variability or the inflexibility of modes of contact and avoidance can be monitored as the situation develops: the manner in which each patient responds or fails to respond to individual solicitations and participates in the overall climate in order to modify it or to prevent any changes, the role that the patient plays in the group as such, the way in which he or she is invited to participate or seemingly forgotten.

2) The indirect method: my hypothesis is that the characteristic features of these interlinking functions as observed in the therapeutic group derive initially from the person's original environment. When they take on a repetitive and defensive quality, we may suppose that they were generated within an environment that was itself dysfunctional. Unstable emotional systems may thus have had a considerable impact on the child's participant and linking functions; this is expressed in the adult patient either as excessive stimulation or as systematic withdrawal. In other words, the innate functions of stimulation and receptivity have lost their original features of flexibility and elasticity; they have become overly and repetitively fixated on the responses of the immediate environment. As a result, the necessary opening-up to the variety of actions and reactions of the outside world and the feeling of being attracted to it have, at least in part, been lost. This aspect is reinforced by the fact that, generally speaking, such families tend to shut themselves into their own world. Psychotic experiences may occur in these patients in the form of recurrent, ill-defined complaints: they feel that they have no cohesion, no backbone, that they are transparent, or are being attacked from all sides or threatened with sudden collapse. In addition to these impressions, there is often the idea that other people are using the patient to their own ends or that the patient has no defence against such attacks. This generates states of mind in which themes of escape or persecutory fears are dominant.

In order to promote awareness of these family structures and to help patients modify their participant processes, I try to encourage them to recall not only familiar characters from their childhood but also the emotional atmosphere that represents for them safety (or lack of safety) in links. At that point, very early memories, the outline of which remains vague, emerge.

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