The Power of Group Attachment John Bowlby Revisited from a Group-Analytic Perspective

Endorsements

About the authors

Dedication

Acknowledgments

Preface by Sir Paul Preston

Foreword by Dr Earl Hopper

 

Introduction: A radical group attachment viewpoint

Arturo Ezquerro and María Cañete                                                                                                                                       

0.1  The interface between interpersonal and group attachment

0.2 Synopses of the book chapters

0.3 Some learning points and concluding thoughts

 

Chapter 1: Group attachment created humankind

Arturo Ezquerro and María Cañete

1.1  Introduction

1.1(i) Contents and aims of the chapter

1.2  Section I: An exploration through human evolution

1.2(i): The birth of humankind

1.2(ii) The growth of the human group

1.2(iii) Migratory processes: survival and exploration

1.2(iv) The need for group attachment

1.2(v) Does stranger mean danger?

1.2(vi) Alloparenting and group attachment

1.2(vii) The cultural acquisition device

1.2(viii) Monotropic versus multiple caregiving

1.2(ix) Further thoughts on group attachment

1.2(x) Group selection and natural selection

1.3 Section II: Group attachment as an evolving concept

1.3(i) An implicit sense of group attachment

1.3(ii) Systematic research on group attachment

1.3(iii) Attachment and group analysis

1.3(iv) Attachment and wider group psychotherapy

1.3(v) Organisations as a group-attachment space

1.3(vi) Conceptualising group attachment

1.4 Conclusion

 

Chapter 2: Bipolar disorder: ups and downs affecting interpersonal and group life

Arturo Ezquerro and María Cañete

2.1 Introduction: The worst disaster that can befall a group?

2.1(i) Contents and aims of the chapter

2.2 Historical context: From the Old Testament through the Classics to the Mystics

2.2(i) Melancholia and mania in the Early Modern period and Industrial Age

2.3 Contemporary psychiatric perspectives

2.3(i) The impact of lithium on the management of manic-depressive psychosis

2.3(ii) Early 21^st century: Bipolar times

2.4 Psychoanalytic and attachment contributions

2.5 Review of the literature on group psychotherapy with bipolar patients

2.6 A clinical case study by Arturo Ezquerro

2.6(i) The referral and assessment process

2.6(ii) A newcomer in an ongoing psychotherapy group

2.6(iii) Protecting personal and group boundaries

2.6(iv) Group cohesion versus group coherency

2.7 Discussion

2.8 Conclusion

 

Chapter 3: Fostering a group attachment culture in a day-unit for psychotic patients

Arturo Ezquerro and María Cañete.

3.1 Introduction

3.1(i) Contents and aims of the chapter

3.2 Traditional psychoanalytic perspectives on psychosis

3.3 Bowlby’s attachment response to Freudian formulations

3.4 Other psychoanalytic contributions

3.5 Contemporary attachment standpoints on psychosis

3.6 An outline of the literature on group psychotherapy for psychosis

3.7 A case study by María Cañete: Group-analytic therapy with psychotic patients

3.7(i) The small therapy group: early stages

3.7(ii) Laughter: defence or enriching reinforcement?

3.7(iii) Developing a therapeutic culture within the group matrix

3.7(iv) Endings and new beginnings

3.8 Discussion

3.9 Conclusion

 

Chapter 4: Suicide risk: when group attachment is not enough, or is it?

Arturo Ezquerro

4.1 Introduction: Individual or group psychotherapy for suicidal patients?

4.1(i) Contents and aims of the chapter

4.2 Combining individual and group psychotherapy for highly vulnerable patients

4.3 Suicide from an attachment perspective

4.4 Further thoughts on suicidality

4.4(i) An evolutionary perspective

4.4(ii) Approaching suicide risk we an ethos of “we are all in the same boat”

4.4(iii) Some recent developments on suicide prevention

4.5 The clinical picture

4.6 The therapy group

4.7 Individual and group psychotherapy combined

4.8 Discussion

4.9 Conclusion

 

Chapter 5: Group cohesion versus group coherency through an attachment lens 

Arturo Ezquerro

5.1 Introduction: The politics of uncertainty

5.1(i) Contents and aims of the chapter

5.2 Complexity, cohesion and coherency in group psychotherapy

5.3 An attachment perspective on group cohesion and group coherency

5.4 A clinical case study

5.4(i) Interpersonal and group ruptures

5.4(ii) Reparative group work: from cohesion to coherency

5.5 Discussion

5.6 Conclusion

 

Chapter 6: A case of perverse group attachment

Arturo Ezquerro

6.1 Introduction

6.1(i) Contents and aims of the chapter

6.2 Filicide: an overview

6.3 Captain Aguilera: the man

6.3(i) Going back to an insecure base

6.3(ii) A military coup leading to a civil war

6.3(iii) The aftermath of a devastating war

6.3(iv) The captain’s late years resulting in tragedy

6.4 A group culture of unresolved trauma, scapegoating and violence

6.4(i) Vicious repression, racism and genocide

6.4(ii) The terror guns and voices of a perverse group

6.5 An attachment-based psychodynamic and group-analytic formulation

6.5(i) Some dynamics of perverse group attachment

6.6 Conclusion

 

Afterword by Dr Cheri Marmarosh

Index

Biography

Dr Arturo Ezquerro: London-based consultant psychiatrist, psychoanalytic-psychotherapist, and group analyst; senior assessor and trainer, Institute of Group Analysis; honorary member International Attachment Network, and World Association of International Studies; former Head NHS Medical Psychotherapy Services for Brent; over a hundred publications in six languages, including Encounters with John Bowlby (Routledge).

Dr María Cañete: consultant psychotherapist, psychiatrist, and group analyst; trained at the Tavistock Clinic; senior trainer, Institute of Group Analysis; former director NHS group psychotherapy programmes, University College, St Charles, and Mile End Hospitals, London; published widely in English, German and Spanish, including Group Analysis throughout the Life Cycle (Routledge).

1. An innovative volume that clearly shows how the attachment theory paradigm can be applied to the clinical realities and theoretical basis of group analysis. The group attachment formulation is so convincing that, indeed, I found myself wondering why no one had done it before! The distinction between group cohesion and group coherency and how this reflects the state and stage of the attachment dynamic is particularly illuminating. This academically sound yet readable book is strongly recommended for all mental health professionals and at all levels of experience and training. (89 words).

Prof Jeremy Holmes MD FRCPsych: Consultant Psychiatrist in Psychotherapy. Honorary Professor of Psychoanalysis, University of Exeter, UK.

 

2. Once again, Arturo Ezquerro and María Cañete have gifted us a truly original work, expanding and integrating such vital components of mental health as group analysis, attachment theory, and many others besides. Drawing upon the work of the late Dr John Bowlby, whom I had the privilege of meeting many times, and who would, I know, have adored this book, the authors have demonstrated effective ways in which the enhancement of attachment structures can not only enrich group life and interpersonal relationships but also help us to prevent suicide. I recommend this text most warmly. (94 words).

Prof Brett Kahr, Senior Fellow Tavistock Institute of Medical Psychology. Honorary Director of Research, Freud Museum, London.

 

3. The deepest and widest exploration into the complexities of evolutionary group attachment processes I have come across. It gives a more than welcome new dimension to both attachment theory and group analysis. Drawing on a broad range of disciplines, the authors clearly demonstrate how groups, in clinical settings and in society, can bring out the best and the worst in us. The reader will find moving stories of therapeutic group connections that promote well-being and maximise survival and, also, poignant examples of perverse group attachment, which is at the basis of fanaticism, dehumanizing others, violence and, in extreme cases, genocide. (100 words).

Dr Mauricio Cortina MD, Psychoanalyst. Director of Attachment, Development and Human Evolution, Washington School of Psychiatry.

 

4. In this engaging book the authors apply attachment theory to highlight the interconnectivity between individual and group dynamics. The result is a timely reminder of the creative and destructive potential that can emanate from the links between the two. This book is a clarion call to therapists of all persuasions to recognise the indivisibility of person and context, and to reflect on the significance of their interventions both inside and outside the consulting room. (74 words).

Dr Christopher Clulow PhD, Consultant Couple Psychoanalytic Psychotherapist. Senior Fellow Tavistock Institute of Human Relations.

 

5. A remarkable state-of-the-art study on healthy and therapeutic group attachment, as well as perverse group dynamics, which illuminates the paths back to sanity. It integrates contributions from different clinical disciplines and schools of thought in a very welcoming manner and, in consequence, serves as a good role model for badly-needed theoretical inclusivity. No doubt, Arturo Ezquerro and María Cañete have given birth to a genuine classic that will continue to attract readers for many generations to come. (77 words).

Dr Estela Welldon FRCPsych, Consultant Forensic Psychiatrist. Founder and Honorary President, International Association for Forensic Psychotherapy.

 

6. Drawing on attachment theory, anthropology, sociology, psychoanalysis, developmental psychology, group analysis, neuroscience, literature and poetry, this book is a catalyst that injects a contagious passion for life and makes knowledge on mental health, attachment and complex group dynamics palatable and accessible. I recommend it to primary care professionals, their managers and their patients. (53 words).

Dame Clare Gerada DBE, FRCPsych, President Royal College of General Practitioners.

 

7. Emanating from a rare amalgam of cross-cultural, socio-political, anthropological and qualitative clinical-process research, this volume brings attachment theory and group analysis up to date. It goes beyond conventional studies to explore novel aspects of group affiliation and group attachment, and convincingly demonstrates the relevance of attachment dynamics in challenging situations within organisational life and service provision. As a critical developmental psychologist, I found this text enormously helpful and inspirational. It should be core reading for professionals and service managers alike. (80 words).

Prof Erica Burman, Developmental Psychologist, Group Analyst, Professor of Education, University of Manchester. Former Chair, Psychology of Women and Equalities, British Psychological Society. Marcia Worrell Mentoring Award (2023).

 

8. A unique cross-fertilisation of John Bowlby's attachment theory and SH Foulkes's group analysis, which brings together innovative theoretical formulations and meaningful clinical interventions. The reader will embark on a fascinating journey from the birth of humankind, through increasingly sophisticated group configurations and organisational dynamics, to current evidence-based group-analytic psychotherapy. Beautifully written, this book is an awe-inspiring contribution to meet the challenges posed by contemporary mental health practice. (67 words).

Dr Carla Penna PhD, Psychoanalyst and Group Analyst. Former President Brazilian Association of Group Psychotherapy and Visiting Professor of Medical Psychology, Federal University, Rio de Janeiro.

 

9. Elegantly written, methodically researched and highly instructive, this book has succeeded in making explicit and accessible what has always been implicit but not always acknowledged: the centrality of attachment in group analysis. It distinctly shows how the group matrix can come to be a foundational secure base, from which multiple dynamics of interpersonal and group attachment relationships can be explored and understood. I was particularly struck by an original case study on perverse group attachment, a compelling narrative that includes a masterful and profound depiction of human frailty, socio-political complexity, and the tragic consequences of untreated personal and collective wounds. (100 words).

Reem Shelhi, Contemporary Psychoanalytic Psychotherapist, Group Analyst and Clinical Supervisor.

 

10. This a refreshing addition to group-analytic and attachment literature. It succeeds in making a strong, persuasive and much-needed case for the integration of attachment and groups, in therapeutic, organisational and socio-political contexts. It builds on a growing interest in the importance of group attachment, which is at the core of human evolution and survival. It should be essential reading for practitioners and students and, by application, offers an authentic theoretical basis to all those involved in group work in a wide variety of settings. (84 words).

Revd Dr Anne Holmes PhD, Group Analyst. Former Tutor IGA Foundation Course, Oxford. 

 

11. An attractive and generous read about how humans have lived, developed and related to each other that goes back to our very beginnings, to our earliest and most powerful drives, motivations and contributions, within which attachment processes have been essential in both interpersonal and group contexts. In addition, the book provides a 21^st century perspective on psychotherapy and organisational life, as well as on the influence that healthy (or otherwise) attachment experiences have on the different ways that teams employ to explore and work together. (85 words).

Prof Erik de Haan, Director Ashridge Centre for Coaching, UK. Professor Organisational Development, School of Business and Economics, Amsterdam University.

 

12. According to the World Health Organisation, about one in four people worldwide have suffered or will suffer from a diagnosable mental health problem at one point in their life. In this fascinating and original book, Arturo Ezquerro and María Cañete provide us with a broad perspective that meaningfully explains how culture and socio-political circumstances influence and modulate mental illness, and how societal pathologies impact on individual vulnerability. (67 words).

Rosa Montero, Journalist and Novelist (translated into 27 languages). National Prize for Spanish Literature (2017).

 

13. Wearing two hats, as a group-analytic psychotherapist with a background in education, I found this book provides a unique learning experience, as it delivers scholar and clinical knowledge in ways that are decidedly readable, personal and very engaging. I can strongly recommend it to professionals in both mental health and education, as well as to any interested member of the public. (61 words).

Jacqueline Fogden, Group Analyst, Psychotherapist, Former Headteacher.

 

14. I have very much enjoyed reading this book – a tour de force! Moreover, I am in awe of the authors’ erudition and their capacity to translate sophisticated concepts, as well as complex internal, interpersonal and group processes into plain English, which makes the text accessible, instructive and telling. I have found that this work has been written not only for the profit of mental health professionals, but also for the benefit of all enquiring minds. (75 words).

David Chalom BDS, LDS RCS, Former Dental Casualty Officer in Maxillofacial Surgery, London.

 

15. As a journalist, exposed to both British and Spanish culture, I have to communicate complex affairs to large audiences simply. Looking after my language is an essential part of my job. I am impressed by The Power of Group Attachment. The book is eloquent and jargon-free, rooted in British empiricism whilst displaying Spanish creativity; it contains wisdom and, at the same time, touches your heart. Above all, it is an antidote against despair, a model of inclusivity and an injection of hope. Read it for joy, for instruction, to be a better person, a better professional and a better citizen. (100 words).

Juan Cruz, Journalist and Writer. Author of 42 books.

 

16. Building on Bowlby’s attachment theory, this pioneering project brings together updated findings from anthropology and cross-cultural attachment studies, and proposes a radical hypothesis that group attachment created humankind. The volume helps expand the reader’s democratic consciousness in the context of real-life events and the life-long need for interpersonal and group attachment. Unlike other books written on group dynamics, this progressive text affords a fresh approach and develops a plausible narrative about the evolution of human group attachment as the maker of humankind. (82 words).

Orit Badouk Epstein, Attachment-based Psychoanalytic Psychotherapist, Supervisor, Trainer and Writer. Former Editor Attachment: New Directions in Psychotherapy and Relational Psychoanalysis.

 

17. This is a very welcome integration of group analysis and attachment theory, which puts group attachment firmly at the core of the evolution and survival of humankind.  The theory is robust, illustrated and brought to life with extensive historical, group-analytic and anthropological context, alongside contemporary attachment and wider mental health research, as well as the authors’ outstanding clinical work. (59 words).

Debra Nash, Psychotherapist, Group Analyst, Former Director of Training Group Analysis North, UK.

 

18. The Power of Group Attachment is a rewarding read that explores widely and deeply themes that are highly relevant to both the attachment and group-analytic schools of thought and clinical practice; it enhances and brings up to date attachment theory and group analysis. Anyone who fears that complacency is the enemy of creativity in any therapeutic endeavour can be sure to find, in this book, a satisfying antidote. (68 words).

Desmond King, Consultant Clinical Psychologist, Group Analyst, Honorary Member International Attachment Network.

 

19. Arturo Ezquerro and María Cañete’s book fills a gap in the attachment and group-analytic literature. Since therapy groups provide a relatively secure environment, it is only natural to use them to change people's attachment patterns. However, not enough had been written about attachment and group analysis, which are key mental health components. So, this is an important theoretical and clinical contribution to the mental health field, and highly recommended to students, experts and anyone who is interested in the field. (80 words). 

Dr Haim Weinberg PhD, Consultant Clinical Psychologist, Author of ten books, Group Analyst, Israel and USA.  

 

20. This sequel and companion volume to the successful Group Analysis throughout the Life Cycle – which was Foulkes revisited through an attachment lens, is a vade mecum for Group Analysts, Psychotherapists and all those interested in Groups and Mental Health, revisiting Bowlby through a Group-Analytic lens. It does what Manfred Kets de Vries did for business leaders and Psychoanalysis; it provides, in straightforward language, a comprehensive framework to understand what is going on with the inner worlds of those who perform or seek to perform in the external world, resulting in a compelling, accessible and integrated approach. Indeed, in their readability and accessibility to the non-technical reader, these twin volumes do a great service both to Group Analysis and to Attachment Theory. (121 words).

Prof Barry Curnow, National Director of Training, Institute of Group Analysis, UK.

 

21. The scope of this timely book is impressive, skilfully demonstrating the continued significance of the applications of attachment theory as a valuable means to thinking about group dynamics and analysis. It is a fascinating and engaging evidence-based read. Ezquerro and Cañete draw you in and present a meaningful and critical discussion of mainstream thinking, through which they invite the reader to make deep connections and enjoy the role attachment ubiquitously plays in our live. This is enticingly illustrated with captivating case studies. An essential reading for anyone wishing to understand the individual self together with the group self. (98 words).

Dr Deborah Bailey-Rodríguez PhD, Senior Lecturer in Psychology, Middlesex University, London.

 

22. Attachment theory provides a powerful tool to decipher a world descending ever deeper into pathology and violence. As exploited by nefarious leaders, the evolutionary and universal need for group belonging and group attachment explains how the collective can act in ways unthinkable to individuals. Arturo Ezquerro and María Cañete give us a timely and necessary perspective. (56 words).

Dr John Eipper PhD, President of World Association of International Studies, USA.

 

23. An important contribution to the specialist literature on the psychology of attachment and human development, and on the understanding of our complex social group nature. It includes a fascinating case study, exploring how attachment experiences as well as other psychosocial, cultural and political factors impacted on a press officer during the Spanish Civil War, who later murderer his two sons. A key learning point is made that confronting ghosts from the past can help heal deep wounds properly. (78 words).

Jimmy Burns-Marañón OBE, Author and Journalist, Chairman British-Spanish Society.

 

24. In this powerful and original book which will resonate in many branches of psychotherapy, psychology and broader mental health, Arturo Ezquerro and María Cañete work to fill a gap in the specialist literature, creatively exploring and developing the dialectical space between group analysis and attachment theory. At a time when group attachments appear to be intensifying and hardening, this book arrives as a timely exploration of a concept that carries great potential to help us make sense of the different ways (healthy, perverse or otherwise) in which we attach to our groups. (92 words).

Peter Zelaskowski, Psychotherapist, Group Analyst, Former Editor Group-Analytic Contexts.

 

25. In this original work, both scholarly and personal, Ezquerro and Cañete start from the premise that group attachment created humankind. Indeed, during the Pleistocene, collective child rearing enriched our capacity to think imaginatively about each other. The authors substantiate their argument with a deep exploration of the evolutionary processes of group selection (the group equivalent to Darwinian natural selection), key to the creation and survival of collaborative human organisations. Compelling narratives from group-analytic psychotherapy show effective change from idealising one’s own group to accepting and integrating real differences between members, the hallmark of both therapy and healthy social life. (99 words).

Dr Sebastian Kraemer FRCPsych, FRCPCH, Family Therapist and Honorary Consultant Child and Adolescent Psychiatrist, Tavistock and Portman NHS Foundation Trust, London.

 

26. I am delighted that Dr Ezquerro and Dr Cañete, have gifted us again the warmth and humanity of their approach in their work with people suffering from major psychiatric conditions such as psychosis, bipolar affective disorder, schizoaffective disorder and suicide risk, which indicates the complexity and value of their work. As always, their challenging and thought-provoking theoretical constructs are vividly brought to life and made clear by the jargon-free and receptive narrative of the clinical encounter. (76 words).  

Dr Paul Mallett FRCPsych, Consultant Adult Psychiatrist, Former Medical Director Central and North West London NHS Mental Health Trust.

 

27. Arturo Ezquerro and María Cañete apply great theoretical and clinical mastery whilst deeply connecting attachment theory with group-analytic thinking, bringing together key group concepts, such us cohesion and coherency, with reparative attachment-based work on group ruptures. Their clinical-process research is a source of inspiration. And they go beyond the consulting room to also study historical figures, which brings a new dimension to the group-analytic and attachment literature. It is especially rewarding to follow their narratives and learn how multi-personal attachment becomes interpersonal and even transpersonal, as there are elements located in-between people rather than only having personal characteristics. I was touched by their statement:

“There is no such thing as individual or interpersonal attachment without group attachment”. (121 words).

Dr Robi Friedman PhD, Consultant Clinical Psychologist. Co-Founder, Israel Institute of Group Analysis. Former President, Group Analytic Society International.