Group Analysis http://gaq.sagepub.

com/

Book Review: Compassion. Conceptualisations, Research and Use in Psychotherapy. Gilbert, Paul (ed.). London: Routledge, pp. 403. 19.95
Martin Bhurruth Group Analysis 2009 42: 89 DOI: 10.1177/05333164090420010702 The online version of this article can be found at: http://gaq.sagepub.com/content/42/1/89.citation

Published by:
http://www.sagepublications.com

On behalf of:

The Group-Analytic Society

Additional services and information for Group Analysis can be found at: Email Alerts: http://gaq.sagepub.com/cgi/alerts Subscriptions: http://gaq.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav

>> Version of Record - Feb 24, 2009

Downloaded from gaq.sagepub.com by Madalina Cotiga on October 29, 2012

What is This?

Book Reviews 89
not be able to mount mature defences against the anti-group in forensic institutions (Nitsuns important work, 1996. Another group analyst!) Running groups in forensic settings throw up some interesting technical questions. One particular question (that perhaps the editors will address in a second edition) is to what extent normal group processes are influenced by the context of the group setting, and especially the nature of the material that the group brings. To what extent does the forensic-ness of the material affect how the conductor facilitates the group? To what extent are modifications of technique appropriate to the group material, or represent a wobble of the therapeutic boundary? (These may not be alternatives of course). These are the debates that one tends to have when working with both forensic patient and staff groups. The last question that this stimulating book raises for me is an ethical one, about the identity of the psychotherapist working in forensic institutions. One can identify with the institution and its work task, and risk unconsciously colluding with either the staff, or the patients, or both. One can identify oneself as an outsider to the institution, and risk colluding with the contemptuous, and rejecting larger social group that excluded the patients, and does not want them to rejoin the community of nice people like us. Ideally, of course, one will want to maintain both perspectives. This may involve sitting on the fence: but as I often reflect, ruefully after a day in Broadmoor, sitting on the fence may be uncomfortable, but you do have a lovely view of both sides. Gwen Adshead

Reference
Nitsun (1996) The Anti Group: Destructive Forces in Groups. London: Taylor and Francis.

Compassion. Conceptualisations, Research and Use in Psychotherapy. Gilbert, Paul (ed.). London: Routledge, pp. 403. 19.95. The casual reader is often cautioned against judging a book by its cover. The cover to this book is beautiful: a pale, green colour background with a delicate image of a pink lotus flower in the fore. Along the spine the title Compassion is easily read in red typescript. This is a book that you wish for colleagues and patients to see on your bookshelves. It conveys a value that as an analyst you work compassionately. An ego ideal, perhaps. Within the covers the group analytic reader will find this to be a scholarly collection of papers edited by Professor in Psychology, Paul Gilbert. It contains 1056 references. Three main areas are introduced and elaborated upon. Evolutionary psychology is used to explain the development (and under-development) of compassion. Compassion is recognized as being pro-social, benefiting both the individual, and the group as a whole. Self-soothing and compassion to others are contextualised within social mentality theory. The inhibition of development of the soothing system is noted in individuals who have suffered trauma or failures in early life attachments. These individuals may then become prone to shame-related conditions such as depression, or anxiety in later life, and may be limited in their compassionate repertoire to others.

Downloaded from gaq.sagepub.com by Madalina Cotiga on October 29, 2012

90

Group Analysis 42(1)

Depression is recognized as a form of hunkering down in interpersonal relationships, playing it safe rather than sorry, and, as such has an evolutionary purpose of keeping the individual safe from attack. In safe rather than sorry functioning, the individual is in the grip of the threat-response system, being alert to danger, not wanting to draw any retaliatory responses nor wanting to lose any further good resources, internal as well as external, such as status. Whilst the threat-response system is activated, the individual may be considerably troubled by self-critical ruminatory thoughts. It is recognized that historically, cognitive therapy has not been able to bring about positive change to some entrenched negative thinking. An explanation is offered that cognitive therapy techniques have only been designed to attend to the explicit memory system, that which is conscious. New cognitive techniques, such as guided discovery through Socratic questioning, are developed to uncover the relational origins of shame. These are largely subconscious experiences and not subject to easy memory recall. Psychoanalysis, in contrast, would pay attention to implicit memory through analysis of the transference and counter-transference. It is recognized that clinical attention to both memory systems is required to bring about activation of the soothing system. There are some really exciting ideas about how principles from Buddhist meditation may usefully be applied in cases where there is negative rumination. Thoughts essentially are transitory, rather than fixed or ruminative. The Buddhist perspective both trains the individual to note the thought but also to allow it to pass on by, and also to develop an internal compassionate image and voice. This idea is taken further in an outstanding chapter, The Perfect Nurturer, which recognizes that individuals may not have had a good enough caregiver in the first instance, so to develop the soothing system, an internal perfect nurturer has to be created. This chapter touches on object relationships, and assumes that self-criticism is in fact an internal critical object speaking. Techniques are then developed to identify who might have spoken to them in that way, and then to check out how much the critical thought is endorsed by the individual. The person is then asked to question the validity of the criticizing persons point of view; why should their view be taken seriously? Then the Perfect Nurturer is included in the conversation; how might the Perfect Nurturer respond to the individual in any given situation that arouses self-criticism? The case-study demonstrates a lowering of endorsement to the critical voices, and a rise in endorsement of the Perfect Nurturer responses. The concept as exemplified in the case study is a fine synthesis of analytic and cognitive theory. Whilst this book excites me, I also have some concern. Largely the conceptualizations and evidence gained from experimental psychology are clinically unproven. Therefore the research enquiry remains incomplete until there is a greater body of clinical evidence to bring to bear. I would be very interested to read future efficacy studies on Compassionate Mind Training. My second concern is political. Gilbert writes about developing a science of mind, and moving away from therapeutic tribalism. It seems to me that already recognized ideas in psychoanalysis, such as object relationships, are being redefined in essentially cognitive therapy language. I support the idea of science of mind, but who are going to be the proprietors of it? This book does place the profession of Chartered Psychologists at the front of the queue. As such, I think this bold, confident book poses both a challenge, and an opportunity to group analysts by offering a good benchmark for how conceptual based therapies might be evidenced and published. Martin Bhurruth

Downloaded from gaq.sagepub.com by Madalina Cotiga on October 29, 2012