Trideset Godina Instituta Za Grupnu Analizu (Iga) / Thirty Years of the Institute of Group Analysis (Iga)

TRIDESET GODINA INSTITUTA ZA GRUPNU ANALIZU (IGA)

/ THIRTY YEARS OF THE INSTITUTE OF GROUP ANALYSIS (IGA)

Ljiljana Moro

Kad kažemo da netko ima trideset go- When we say that someone is thirty dina, ne doživljavamo ni da ima malo years old, we do not perceive them as ei- niti da ima mnogo godina; nije više ther young or old. They are no longer a dijete, nego osoba koja kreće svojim child, but a person who is embarking on životnim stazama. Kao da je tek zapo- their own life’s journey. As if they have only just begun their own real way of liv- čela pravi, vlastiti način života. Tako ing. I think the same is true of our Insti- mislim da je i s našim Institutom. Tre- tute. It took a long time for it to be born, balo mu je dugo da se rodi, ali sada kao but it now seems it has begun to think da je počeo razmišljati kao odrasla od- like a responsible adult. govorna osoba. The tenth anniversary took us by sur- Za desetu godišnjicu nismo se još bili prise, and yet there it was. The Home- pravo snašli, a već se dogodila. Upravo land War had just finished, as had our su završili Domovinski rat i naš diplo- diploma course, which we had been run- ma course koji smo vodili s IGA-om ning together with the London IGA. For London. Za dvadesetu godišnjicu izdali the twentieth anniversary we published smo malu knjižicu radova. Kad listam a small book of papers. When I turn the tu knjižicu, ponosna sam na sve nas. pages of that booklet today, I am proud of us all. We wrote, spoke openly about Pisali smo, otvoreno govorili o svojem our work and discussed our professional radu, razgovarali o svojim stručnim dilemmas. We wrote about the difficulties dvojbama. Pisali smo o poteškoćama u of working with narcissistic patients. At radu s narcističnim pacijentima. Tada that time, we were still part of the Clinic smo još bili u sklopu Klinike za psiho- for Psychological Medicine, our parental lošku medicinu, u roditeljskoj kući. home.

Tridesetu godišnjicu proslavili smo We celebrated the thirtieth anniversary promocijom svojih novih supervizora/ with a promotion of our new supervisors/ 46 edukatora. Više nismo u sklopu Klinike educators. We are no longer part of the

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za psihološku medicinu, sad smo pod- Clinic for Psychological Medicine, we are stanari, razmišljamo kako se snaći u now tenants and are trying to find our novim trendovima. Psihoterapija kao way in the world of new trends. Psycho- struka dobila je status zanimanja, zva- therapy as a profession has gained the nja. Više nije „povlastica“ medicinara, status of an occupation, a vocation. It is psihologa i socijalnih radnika. Postala no longer a “benefit” of medical workers, psychologists and social workers. It has je zanimljiva za sve profile stručnjaka i become interesting to all profiles of pro- Institut se postupno privikava i pripre- fessionals, and the Institute is gradually ma za prihvaćanje novih ljudi u novom adjusting and preparing to receive new vremenu. people in a new period. Što nas danas muči u psihoterapijskom What are the problems we face today as radu? Čini mi se isto što i prije deset psychotherapists? It seems to me they godina. Narcistični pacijent i danas je are the same as they were ten years ago. naša preokupacija. Kako mu prići, po- The narcissistic patient has remained moći da se lakše snalazi u svakodnev- our preoccupation. How to approach nim situacijama. Kako mu pomoći da them, help them handle everyday sit- izađe iz svoje kapsule i uključi se u za- uations more easily. How to help them jednicu. U želji da se prisjetimo „dobrih leave their cocoon and join the commu- starih vremena“ kad smo o tome mno- nity. In our wish to remind ourselves of go razgovarali, odlučili smo u ovom the “good old days”, back when we used broju zamoliti kolege koji su prije de- to talk about this a lot, in this issue we set godina sudjelovali u radu okruglog have decided to ask the colleagues who stola XI. stručnog sastanka Instituta za ten years ago participated in the round table of the th grupnu analizu Zagreb pod ravnatelj- XI professional meeting of the Zagreb Institute for Group Analysis, skom palicom Eduarda Klaina da ponu- led by Eduard Klain, to provide their pres- de svoj osvrt na to kako danas gledaju ent views on the problem of narcissism na problem narcizma u istoj kliničkoj in the same clinical situation they spoke situaciji o kojoj su govorili, tj. pisali pri- or wrote about ten years ago. Eduard je deset godina. Eduard Klain izložit će Klain will discuss the historical devel- nam povijesni razvoj Instituta za gru- opment of the Institute for Group Anal- pnu analizu. Dragan Josić osvrnut će ysis. Dragan Josić will discuss working se na rad s narcističnim pacijentima with narcissistic patients in a group, as u grupi i pružiti nam savjete kako se well as provide “advice” on how to man- nositi s tim teretom u svakodnevnom age this burden in everyday work. His radu. Njegov originalni članak iz knji- original paper from the booklet will not žice nećemo tiskati jer je dio već izišao be published because a part of it has al- 47

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u našem časopisu (Narcizam u grupi, ready been printed in our journal (Narcis- Vol. 30 No. 2, 2016., str.188 – 211). Član- sism in a group, Vol. 30, No. 2, 2016, pp. ke Zdenke Brumen Budanko i Slavice 188-211). The papers by Zdenka Brumen Pavlović donosimo u cijelosti kako su Budanko and Slavica Pavlović are pre- tiskani prije deset godina i nakon toga sented in the form they were published njihov osvrt. Zdenka Brumen Budanko in ten years ago, followed by their dis- osvrnut će se na problem kontratran- cussions. Zdenka Brumen Budanko will discuss the problem of countertransfer- sfera koji može pobuditi narcistični ence, which may be initiated in a group pacijent u grupi. Slavica Pavlović piše by a narcissistic patient. Slavica Pav- kako je odigrala (enactment) pacijento- lović writes about enacting the role of a vu majku, a da u tom trenutku nije toga patient’s mother without being aware of bila posve svjesna. this at the moment. Vjerujem da će mnogi čitatelji od tog I trust that many of those who read this štiva imati koristi u radu s narcistič- will benefit from it in their work with nar- nim pacijentima, bilo u grupi ili indi- cissistic patients, whether in a group or vidualno. Dobit će sliku o tome koliko individually. They will gain insight into je kompleksan rad s narcističnim pa- the complexity of working with narcis- cijentom i što sve narcistični pacijenti sistic patients and the extent of what mogu izazvati u voditeljima/psihotera- narcissistic patients can induce in us as peutima, u grupi kao cjelini i u pojedi- leaders/psychotherapists, the group as a nom članu grupe. whole and in individual group members.

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TRIDESET GODINA INSTITUTA ZA GRUPNU ANALIZU (1988. – 2018.)

/ 30 YEARS OF THE INSTITUTE FOR GROUP ANALYSIS (1988-2018)

Eduard Klain

MALO POVIJESTI SOME HISTORY

Profesor Betlheim s grupom suradnika In Yugoslavia, in 1953 Prof Betlheim and osnovao je 1953. godine u Jugoslaviji a group of associates founded the first prvi psihoterapijski odjel u okviru Ne- psychotherapy ward within the Clinic urološko-psihijatrijske klinike Medi- for Neurology and Psychiatry of the Za- greb Medical School. Various techniques cinskog fakulteta u Zagrebu. Na odje- of individual psychiatry were employed lu su se primjenjivale razne tehnike on the ward. In the early 60’s, Prof Stjepan individualne psihoterapije. Profesor Betlheim visited London and his friend Stjepan Betlheim u ranim je šezdese- Dr H. S. Foulkes, who introduced him to tima posjetio London i svojeg prijate- the principles of group analysis. Upon his lja, doktora H. S. Foulkesa, koji ga je return to Zagreb, Prof Stjepan Betlheim upoznao s načelima grupne analize. began with group psychotherapy. His Tako je, vrativši se u Zagreb, profesor closest associate, Prof Duška Blažević, Stjepan Betlheim započeo grupnu psi- also visited London, and upon her re- hoterapiju. Njegova najbliža suradnica, turn started using group psychotherapy profesorica Duška Blažević, također of students. In the late 60’s, Prof Eugen- je nakon posjeta Londonu započela s ija Cividini, PhD and Prof Eduard Klain, PhD start co-therapy groups and lead grupnom psihoterapijom studenata. U them for many years. First attempts at kasnijim šezdesetim godinama prof. educational work on group analysis took dr. sc. Eugenija Cividini i prof. dr. sc. place in 1972, when Prof Leopold Bregant Eduard Klain započinju koterapijske from Ljubljana asked Prof Cividini and grupe i vode ih godinama. Prvi poku- Dr Klain to lead groups of his educatees šaji edukacijskog rada u grupnoj ana- during one semester. This was the begin- lizi pojavljuju se 1972. godine kad je ning of two groups, which lasted for the profesor Leopold Bregant iz Ljubljane duration of the summer semester of that 49

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zamolio profesoricu Cividini i doktora year. Unfortunately, the groups ended Klaina da vode grupe njegovih eduka- once the actual group process developed. nata tijekom jednog semestra. Tako su Encouraged by this initial success and počele dvije grupe koje su trajale ljetni convinced that our colleagues should be offered the opportunity to experience semestar te godine. Nažalost, grupe the therapy process, Prof Cividini and Dr su se prekinule kad se zapravo razvio Klain started educating our psychiatrists grupni proces. Ohrabreni tim počet- about group analysis, and two groups nim uspjehom i smatrajući da našim were formed and consisted of the em- kolegama treba pružiti mogućnost ployees at the Clinic for Psychological vlastita doživljaja terapijskog procesa, Medicine. The group met once a week for profesorica Cividini i doktor Klain za- three years. From the very beginning, we počeli su edukaciju naših psihijatara were aware of the difficulties we would iz grupne analize, odnosno osnovali face because we worked together. How- smo dvije grupe naših djelatnika iz ever, we decided that it was still useful Klinike za psihološku medicinu. Grupa to work with our colleagues in the group se sastajala jednom na tjedan tijekom despite all the problems such work en- tails. The London Group Analytic Society tri godine. Od početka smo bili svjesni offered us the opportunity to organize the teškoća koje će nastati jer smo zajed- sixth symposium and workshop on group no radili. Međutim, zaključili smo da je analysis. In 1984 we organized the work- ipak korisno da radimo sa svojim ko- shop in Zagreb. There were 100 partici- legama u grupi uza sve probleme koje pants from various European countries. takav rad donosi. Grupno-analitičko The success was significant. That was društvo London ponudilo nam je da the beginning of the discussion about organiziramo šesti simpozij i radioni- EGATIN, a European network of institutes cu iz grupne analize. Tu smo radionicu which offer education about group anal- 1984. godine organizirali u Zagrebu. Na ysis. Since we were recognized as good njoj se okupilo sto sudionika iz raznih organizers, the International Association zemalja u Europi. Uspjeh je bio znatan. for Group Psychotherapy entrusted us with the organization of the 9th interna- Tada se počelo razgovarati o EGATIN-u, tional congress on group psychotherapy, europskoj mreži instituta koji educira- which was held in Zagreb in 1986. There ju o grupnoj analizi. Budući da smo se were 1135 participants from different pokazali dobrim organizatorima, Me- countries from around the world. The đunarodno udruženje za grupnu psiho- president of the organizing committee terapiju povjerilo nam je organizaciju was Dr Eduard Klain, and the chief sec- 9. međunarodnog kongresa za grupnu retary was Dr Ljiljana Moro. EGATIN was 50 psihoterapiju, koji se održao u Zagrebu founded at that congress. The London

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1986. godine. Na njemu je bilo 1135 su- Institute for group analysis cooperated dionika iz raznih zemalja. Predsjednik with us on the organization of education Organizacijskog odbora bio je dr. Edu- for group analysis, which began in 1988 ard Klain, a glavna tajnica dr. Ljiljana and lasted until 1994. Due to the war, the education was suspended for two years. Moro. Na tom kongresu osnovan je The education began with 24 candidates EGATIN. Institut za grupnu analizu iz from Croatia and Slovenia, made up of Londona u suradnji s nama organizirao psychiatrists and psychologists. The ed- je edukaciju iz grupne analize koja je ucation was completed by 20 candidates. počela 1988. godine, a trajala je do 1994. The leaders were Dr Peter Lewis and Dr godine. Ta je dugotrajnost bila uzroko- Don Montgomery, both of whom were vana ratom, kad je edukacija prekinuta psychiatrists and educators on group na dvije godine. Tu izobrazbu započela analysis. Their associates were Dr Klain su 24 kandidata iz Hrvatske i Slovenije, and Dr Moro. i to psihijatri i psiholozi. Edukaciju je In the same year our Institute for group završilo dvadeset kandidata. Voditelji analysis was founded and met all the su bili dr. Peter Lewis i dr. Don Mont- conditions for becoming a full-fledged gomery, obojica psihijatri i edukatori iz training institute of EGATIN. grupne analize. Uz njih su bili dr. Klain i dr. Moro.

Iste godine osnovan je i naš Institut za THE CHILDHOOD OF THE grupnu analizu, koji je imao sve uvje- INSTITUTE FOR GROUP te da odmah postane punopravni tre- ANALYSIS ning-institut EGATIN-a. This has already been written about on the occasion of the twentieth anniversary of the Institute. DJETINJSTVO INSTITUTA ZA It is common knowledge that the pri- GRUPNU ANALIZU mary task of this type of institute is the education of group analysts, group psy- O tome je već pisano u povodu dvade- chotherapists and group therapists, as sete godišnjice Instituta. well as special training of educators for Kao što je poznato, osnovni je zadatak group analysis. The Institute also values professional and scientific work and pub- takva Instituta izobrazba grupnih ana- lication activities. litičara, grupnih psihoterapeuta i grupnih terapeuta te posebna izobrazba za Apart from experts from Zagreb, from edukatore iz grupne analize. U Institu- the very beginning our Institute also 51

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tu je važan i stručni i znanstveni rad te included experts from Rijeka, Split and publicistička djelatnost. Pula. Those centres were soon qualified to provide complete education on group Naš Institut od početka je osim struč- analysis. njaka iz Zagreba obuhvatio i stručnjake iz Rijeke, Splita i Pule. Vrlo brzo nave- The Institute paid special attention to the education of psychiatrists and psycholo- deni su centri osposobljeni za cjelovitu gists in psychiatric hospitals. In the psy- edukaciju iz grupne analize. chiatric hospitals in Jankomir, Vrapče, Posebnu pozornost Institut je posvetio Popovača and Rab physicians were edu- edukaciji psihijatara i psihologa u psi- cated through supervision of their groups hijatrijskim bolnicama. U četiri psihija- with psychotic patients. I believe that the education of medical nurses in group trijske bolnice, i to u Jankomiru, Vrap- psychotherapy in the aforementioned ču, Popovači i na Rabu, provodila se hospitals was of great importance. edukacija liječnika putem supervizija njihovih grupa sa psihotičnim pacijen- Apart from Croatia, the Institute also tima. Smatram vrlo važnom edukaciju carried out education in other countries, medicinskih sestara iz grupne psihote- such as Bosnia and Herzegovina. On two rapije u navedenim bolnicama. separate occasions our educators also worked in Sarajevo. Work began in Tu- Osim u Hrvatskoj Institut je educirao i zla during the Homeland War, and has u drugim državama, naprimjer u Bosni been carried out continuously ever since, i Hercegovini. U dva navrata naši su which has led to Tuzla having a great edukatori određeno vrijeme educirali number of highly trained group analysts. u Sarajevu. U Tuzli je početak bio već In Bosnia and Herzegovina, the education u vrijeme Domovinskog rata i od tada also encompassed experts from Mostar. se kontinuirano provodi, tako da u Tu- Members of the Institute have also edu- zli imamo velik broj visokoeduciranih cated and continue to do so in Slovenia grupnih analitičara. U Bosni i Hercego- and Italy. They have given lectures at in- vini edukacijom su obuhvaćeni i struč- ternational congresses and have been in- njaci u Mostaru. vited to lecture and lead groups in other European countries. Our group analysts Članovi Instituta educirali su i educi- have published a significant number of raju u Sloveniji i Italiji. Držali su preda- professional and scientific articles in vanja na međunarodnim kongresima, highly-regarded journals. They have also a bili su i pozvani predavači i voditelji published books on group psychotherapy, grupe u drugim europskim zemljama. as well as chapters in books in and out- 52 Naši grupni analitičari objavili su zna- side of Croatia.

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tan broj stručnih i znanstvenih člana- The most important gathering of the ka u uglednim časopisima. Objavili su members of the Institute takes place i knjige iz grupne psihoterapije te po- every year, during the so-called Study glavlja u knjigama u Hrvatskoj i izvan Days. Over two days, small and large Hrvatske. groups are held, which includes supervision groups and lectures with discus- Najvažnije okupljanje članova Instituta sions. These events are attended by a događa se svake godine tijekom tako- large number of educators in group anal- zvanih Studijskih dana. Tijekom dva ysis, members of the Institute and edu- dana održavaju se velike i male grupe, catees. Most of the lectures were held supervizijske grupe i predavanja s ra- by foreign experts, mainly experts from spravom. Tim događajima prisustvuje the London Institute for Group Analysis. velik broj edukatora iz grupne analize, Some lectures were given by our mem- članova Instituta i edukanata. Preda- bers. So far, 23 Study Days have been vanja velikim dijelom održavaju strani held. stručnjaci, posebno iz Instituta za grupnu analizu u Londonu. Neka predavanja održavaju i naši članovi. Dosad su THE MATURE PERIOD OF održana 23 Studijska dana. THE INSTITUTE FOR GROUP ANALYSIS

After a long childhood and adolescence, ZRELA DOB INSTITUTA ZA the Institute enter its mature period. The GRUPNU ANALIZU most significant years were 2013 and 2014. Nakon dugog djetinjstva i adolescenci- je Institut je ušao u zrelu dob. Najvažni- In the fall of 2013, the Institute left the je su godine 2013. i 2014. Clinic for Psychological Medicine and became independent and private. The Najesen 2013. Institut izlazi iz Klinike members of the Institute had conflicting za psihološku medicinu i postaje sa- feelings when the Institute left the Clin- mostalan i privatan. Članovi Instituta ic. On the one hand, the Institute was imali su suprotne osjećaje prilikom now independent, responsible for itself odlaska iz Klinike. Institut je sada sa- and has the liberty of making decisions mostalan, odgovoran sam za sebe i ima in every respect. On the other hand, the slobodu odlučivanja u svakom pogledu. long-standing work with colleagues and No dugotrajan rad s kolegama i život life in the Clinic inevitably left a trace. u Klinici nužno su ostavili traga. Zbog Due to all of this, there was also some toga je bilo i malo tuge i nelagode. Naj- sadness and discomfort. The saddest 53

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tužnije je što je Klinika za psihološku fact is that the Clinic for Psychological medicinu, koja je nastavak Psihotera- Medicine, which is the extension of the pijskog odjela koji je osnovao profesor Psychotherapeutic ward, founded by Stjepan Betlheim 1953. godine, promi- Prof Stjepan Betlheim in 1953, changed jenila orijentaciju i nije više glavna its orientation and is no longer the main ustanova za razne oblike psohoanali- institutions for various forms of psychoanalytic psychotherapy. tičke psihoterapije. In 2014, Prof Ljiljana Moro, PhD took Na čelo Instituta 2014. godine dolazi charge of the Institute. She is very profes- prof. dr. sc. Ljiljana Moro. Ona je vrlo sional and ambitious, with pronounced stručna i poduzetna, s izrazitim orga- organizational abilities. She succeeded nizacijskim sposobnostima. Uspjela in refreshing the Institute in every re- je osvježiti Institut u svakom pogledu. spect. The Institute’s program was mod- Program Instituta osuvremenjen je i ernized and turned into modules. When pretvoren u module. U vezi s razvojem it comes to the development of modern modernih tehnologija, Institut je dobio technologies, the Institute also received internetsku stranicu na hrvatskom i a web page in Croatian and English. In- engleskom jeziku. Pojačana je i među- ternational cooperation was intensified. narodna suradnja. Tako je naprimjer u For example, in October of 2016, a meet- listopadu 2016. godine održan sastanak ing of EGATIN was held in the Institute EGATIN-a u Institutu u Zagrebu, a 2017. in Zagreb, and in 2017 a European meet- europski sastanak EGATIN-a. Bilo je 154 ing of EGATIN took place. There were 154 sudionika iz sedamnaest zemalja. Iste participants from 17 countries. In 2017 smo godine učlanjeni u Europsku fede- we received membership in the Europe- raciju psihoanalitičkih psihoterapeuta. an Federation of Psychoanalytic Psycho- therapists. To return to the main tasks No vratimo se na osnovne zadatke In- of the Institute, since 2016 the Institute stituta. Od 2016. godine u Institutu se holds preparatory training in group anal- održava Pripremna izobrazba iz grupne ysis. It is important to mention that we analize. Važno je napomenuti da smo have succeeded in making preparatory uspjeli postići da je u okviru specijaliza- training in group analysis a mandatory cije psihijatrije obvezna Pripremna izo- part of the specialization for psychiatry, brazba iz grupne analize, koja na neki which, in a way, recruits candidates for način regrutira kandidate za edukaciju the education in group analysis. A Di- iz grupne analize. Od rujna 2017. godine ploma Course with 20 participants has održava se Diploma Course s dvadeset been held since September 2017, and a sudionika, a od veljače 2019. Diploma Diploma Course with 18 participants has 54 Course s osamnaest sudionika. Oba te- been held since February 2019. Both of

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čaja omogućuju sudjelovanje kolega iz the courses enable the participation of cijele Hrvatske jer se održavaju prema colleagues from across Croatia because blok-sustavu jedanput u dva mjeseca they are held in blocks once a month, to- zajedno s teorijskom izobrazbom. gether with theoretical education.

Naš Institut aktivno je uključen u po- Our Institute has been actively involved novno izlaženje časopisa „Psihoterapi- in the renewed publication of the journal “Psychotherapy” since 2016. It has been ja“ od 2016. godine. Od 2018. godine ča- published in Croatian and English since sopis izlazi dvojezično, na hrvatskom i 2018. Prof Ljiljana Moro, PhD is largely re- engleskom jeziku. Za to je najzaslužni- sponsible for this achievement. ja prof. dr. sc. Ljiljana Moro. The Institute has 98 members and 83 ed- Institut ima 98 članova i 83 edukanta u ucatees in various stages of education. 34 raznim fazama edukacije. U Institutu educators work at the Institute. rade 34 edukatora. I believe we can be very satisfied with Mislim da možemo biti zadovoljni ra- the work and development of the Insti- dom i razvojem Instituta za grupnu tute for Group Analysis. A great number analizu. Velik broj stručnjaka završio of experts has completed some of the ed- je neku od edukacija koje nudi Institut. ucation courses offered by the Institute. Uspješno širimo ideju grupne analize u We are successfully spreading the idea stručnim krugovima. of group analysis in professional circles.

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LIJEČENJE NARCISTIČNIH PACIJENATA U GRUPI

/ TREATING NARCISSISTIC PATIENTS IN A GROUP

Dragan Josić

SAŽETAK/SUMMARY Na početku članka autor govori o teorijskom konceptu liječenja grupnom analizom. Zatim se osvrće na voditelja grupe i spominje važne poželjne značajke njegove osobnosti koje trebaju biti u njemu integrirane.

U nastavku se opisuje proces odvajanja subjektova selfa od objekta čemu je posvećen najveći dio članka. O prelasku selfobjektnog odnosa u odnos u kojem subjekt može upotrebljavati objekt poziva se na Winnicotta, koji smatra da je to „možda najvažnija stvar u ljudskom razvoju“. Smatra se važnim što se u grupnoj analizi, kao ni u kojoj drugoj terapiji, pružaju mogućnosti da se proces diferencijacije selfa od objekta promatra kao u laboratorijskim uvje- tima, jer se u isto vrijeme vide subjekti na različitim stupnjevima napretka na putu odvajanja selfa od objekta.

Poznato je kako je agresija nužna da bi se taj proces zbivao. U grupnoj analizi ona može biti usmjerena na voditelja, na grupu kao cjelinu, ali i na pojedinog člana. Osim agresije prema drugim objektima, postoji i autoagresija subjekta. Ona može biti vrlo snažna i pogađa kontratransferne osjećaje objekta snagom kojom to čini i izravna agresija, tako da se zbog toga ta dva vida agresije mogu izjednačiti.

Da je agresijom ugrozio osjećaje voditelja i grupe, pacijent ne osjeća svjesno, ali nesvjesno to postiže, kao da intuitivno zna da je to jedini put ka zdravom novom odnosu. Kao i za izravno ispoljenu agresiju, i za autoagresiju uvjet je da je voditelj i grupa preživljavaju, jer će se jedino tako subjektov self moći odvojiti od objekta.

/ The authors begins by discussing the theoretical concept of treatment using group analysis. He then discusses the group leader and mentions the important qualities of their personality that they must have integrated within themselves.

He continues by describing the process of separating the subject’s self from the object, which is the main focus of the paper. On the transfer of the self-object relationship to a relationship in which the subject can use the object, the author refers to Winnicott, who believes that this “may be the most important thing in human development”. It is considered significant that group analysis, unlike any other form of therapy, offers the opportunities for the process of the differentiation of the self from the object to be observed as if in laboratory conditions because subjects which are in different stages of the separation of the self from the object 56 can be observed simultaneously.

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It is known that aggression is necessary for this process to occur. In group analysis, it can be directed at the leader, the group as a whole or an individual member. Apart from aggression towards other objects, there is also autoaggression of the subject. It can be very powerful, and it strikes the countertransferential emotions of the object with the power of direct aggression, so the two forms of aggression may be equated. The patient is not aware of the fact that they have affected the feelings of the leader and the group with their aggression, but this is achieved unconsciously, as if they intuitively know that this is the only path to a healthy new relationship. As with directly expressed aggression, the condition for autoaggression is for the leader and the group to survive it, because this is the only way for the subject’s self to separate from the object.

KLJUČNE RIJEČI / KEY WORDS

separacija selfa od objekta / separation of the self from the object, agresija / aggression, autoagresija / autoaggression

Dragan Josić, dr. med., psihijatar, edukator iz grupne analize, trening-psihoanalitičar. Član IGA-a i IPA-a, dragan.josic@ zg.t-com.hr Dragan Josić, MD, psychiatrist, group analysis educator, psychoanalysis trainer. Member of the IGA and IPA, dragan. [email protected]

Neutralizacija libidnog nagona omo- The neutralization of the libidinal drive gućuje izgradnju objektnih odnosa, enables the construction of object rela- a neutralizacija agresije (agresivnog tionships, and the neutralization of ag- nagona) omogućuje separaciju i indi- gression (the aggressive drive) enables separation and individualization. vidualizaciju. Blanck G&R (1) Blanck G&R. (1) .

INTRODUCTION UVOD The quality of treatment by group anal- Na kvalitetu liječenja grupnom anali- ysis is mostly affected by the leader’s zom najviše utječu voditeljeva emoci- emotional maturity, their experience onalna zrelost, iskustvo i poznavanje and knowledge of theory, and all of this teorije, a sve to treba biti integrirano u must be integrated within their person- njegovu osobnost. ality. 57

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U svojem bavljenju grupnom anali- In my experience of group analysis, I zom vrlo sam se čvrsto pridržavao have always used the concept based on koncepta po uzoru na osnivača gru- the founder of group analysis, the Brit- pne analize, britanskog analitičara ish analyst Sigmund Heinrich Folkes (2), which was accepted among us. I am very Sigmunda Heinricha Foulkesa (2), grateful to him because he helped me koji je bio prihvaćen u našoj sredini. understand the specificities of numerous Iznimno sam mu zahvalan jer mi je group phenomena and occurrences in a pomagao da razumijem specifičnosti group. Over time, I introduced psychoan- mnogih grupnih fenomena i zbiva- alytic elements of treating individuals nja u grupi. S vremenom sam u svoje into my group therapies. Just like mem- grupne terapije uvodio i psihoanali- bers of a group led according to Folkes’ tičke elemente liječenja pojedinaca u model quickly learn to understand sit- grupi. Kao što članovi grupe vođene uations from outside the group in light Foulkesovim modelom brzo nauče of events in the group, when dealing with an individual the group also quick- izvangrupne situacije razumijevati ly learns to understand relationships in u svjetlu zbivanja u grupi, tako gru- their childhood, past and present, with pa kad se bavi pojedincem brzo na- their intrapsychic object relationships, uči razumijevati odnose u njegovu as well as intersubjective relationships djetinjstvu, prošlosti i sadašnjosti s within the group and outside it. Every njegovim intrapsihičkim objektnim therapist who has been working for a odnosima, ali i intersubjektivnim long time encounters many therapeutic odnosima u grupi i izvan nje. Sva- theoretical concepts of certain great au- ki terapeut koji dugo radi upoznaje thors and uses parts of those concepts which their experience has shown to be mnoge terapijske teorijske koncepte valuable and which have been integrated pojedinih velikih autora i primjenju- within them. In group analysis, mixtures je dijelove tih koncepata za koje mu of various therapeutic concepts may be je iskustvo pokazalo da su vrijedni i used, and everyone develops their own koji su se u njemu integrirali. Tako se form and style of treatment. The basic u grupnoj analizi mogu primjenjivati question remains: do we understand how mješavine raznih terapijskih konce- we work, are we responsible for what we pata i svatko izgrađuje vlastiti način are doing to ourselves and the patients, i stil liječenja. Ostaje uvijek osnovno and does our work have good results? pitanje razumijemo li kako radimo, jesmo li odgovorni za to što radimo pred sobom i pred pacijentima i daje 58 li naš rad dobre rezultate.

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VODITELJ I NARCISTIČNI THE LEADER AND THE PACIJENT NARCISSISTIC PATIENT

Kad u grupi ima narcistične pacijente, When a group includes a narcissistic voditelj treba znati i treba imati isku- patient, the leader must know how to stva kako raditi s njihovim osjetljivim work with their sensitive narcissistic narcističnim transfernim osjećajima transferential emotions which develop koji se razvijaju tijekom terapija. To je during therapy. This knowledge is theo- znanje teorijsko, ali od njega neće biti retical, but it is of no use if the leader has not reached their own maturity, which nikakve koristi ako voditelj nije dosti- primarily means having developed em- gao svoju zrelost, a to znači prije svega pathy and having the ability to follow da ima razvijenu empatiju i da prati i and understand patients in order to con- razumije pacijente kako bi ih mogao tain them. They must feel the group, the kontejnirati. On treba osjećati grupu, events within it and within every individ- zbivanja u njoj i u svakom pojedincu, ual, which is closely tied to the words of što je blisko riječima Pavela Fonde (3): Pavel Fonda (3): “Only with the analyst’s „Samo uz analitičarevu empatiju pa- empathy can a patient feel that their ex- cijent može osjećati da je njegov izni- tremely painful part has been accepted, mno bolan dio prihvaćen, da se nalazi that they are in a beneficial holding and u blagotvornom holdingu i da može that they can be contained (Bion’s con- biti kontejniran (Bionov containment) tainment)” (4). In this sort of therapeutic (4).“ U takvoj terapijskoj klimi, u tako environment, in such a “group matrix”, stvorenom „matriksu grupe“, prema according to Foulkes, it is possible to ac- Foulkesu, moći će se aktivirati razvoj tivate development and growth which i rast koji su u prošlosti traumatično had been traumatically neglected in the past. Once positive multiple narcissistic zaustavljeni. Kad se razviju pozitivni transfers in the group develop, develop- višestruki narcistički transferi u grupi, ment and growth of the patient are ini- pokreće se razvoj i rast pacijenata, ali i tiated, but so is their great sensitivity. njihova velika osjetljivost. Tada samo During that time, only deep empathy of duboka empatija voditelja i grupe može the leader and the group can overcome prevladati sumnje i očekivanja pacije- doubts and expectations of such vulnera- nata koje je tako izrazito lako povrije- ble patients who, at the slightest non-em- diti, koji se na najmanji znak nedostat- pathic sign, temporarily either become ka empatije u trenu udalje i povuku ili distant and withdrawn or aggressive. The postanu agresivni. Voditelj treba biti leader must be open in order to receive otvoren kako bi mogao primiti pro- the projective identifications of patients, jektivne identifikacije pacijenata koje which they must then be able to process 59

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u sebi treba moći procesuirati i kon- and contain within themselves, and thus tejnirati i tako ih u njemu prerađene transformed and changed return to the i izmijenjene vratiti pacijentima da ih patient in order for them to re-introject reintrojiciraju. Ako terapeut odluči nu- them. If the therapist decides to provide diti interpretacije, one trebaju pacijen- interpretations, they should show the patient which of their projections have tu pokazati koje je njegove projekcije been received by the analyst and which analitičar primio i na koje se interpre- ones they are referring to through inter- tacijom osvrće. Da bi pojedini pacijenti pretation. For some patients to progress, napredovali, terapeut i grupa trebaju it is necessary for the therapist and the moći mnogo puta primiti projektivne group to be able to repeatedly receive pro- identifikacije koje su prenesene iz naj- jective identifications which have been ranijih faza pacijentova života i koje transferred from the earliest stages of prerađene u voditelju mogu utjecati the patient’s life and which, transformed na promjenu subjektovih unutarnjih in the leader, may affect the change in objekata i na izgradnju novih objektnih the subject’s inner objects, as well as the odnosa. Ako se terapijski odnosi dugo construction of new object relationships. pozitivno razvijaju, u pacijentima će If the therapeutic relationship is posi- se početi pojavljivati osjećaj ljubavi, za tively developed over a long period, pa- koju Fonda kaže da je jedini pravi na- tients will begin to feel love which Fonda čin na koji se ljudska bića mogu izvući claims is the only real way for human beings to extricate themselves from help- iz nemoćne osamljenosti. less loneliness.

NARCISTIČKI ODNOSI I NARCISSISTIC RELATIONSHIPS MOGUĆNOSTI RJEŠAVANJA AND THE POSSIBILITY OF Često čujemo kako je vrlo važno da se RESOLUTION subjektov self može odvojiti od objekta We often hear that it is important for the (odvajanje selfa od objekta) te se može subject’s self to be able to separate from steći dojam da je to kratkotrajan pro- the object (separation of self and object) ces. Naprotiv, to je dugotrajan proces and one can get the impression that this u kojem pacijenti postižu vrlo različite is a short-term process. However, this is stupnjeve odvojenosti, a to znači i ra- actually a lengthy process in which pa- zličite razine napretka prema zdrav- tients achieve various stages of separa- lju, jer je stupanj odvojenosti selfa od tion, which also means various levels of objekta izravno proporcionalan posti- progress towards health, since the stage 60 gnutom stupnju zdravlja. of separation of the self from the object

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Poznato je iz individualne analize kako is directly proportional to the achieved je agresija nužna da bi se taj proces level of health. događao. Analitičaru nije lako podno- Individual analysis has shown that ag- siti agresiju subjekta u vrijeme kad ga gression is necessary for this process to agresijom razara. Terapeut bi mogao take place. It is difficult for the analyst to imati potrebu da interpretacijama uka- bear the aggression of the subject when zuje na nerealnost subjektove agresije they are being hurt by aggression. The što bi izrazito oštetilo razvojni proces therapist may feel the need to use inter- „uporabe objekta“ (5) tijekom kojeg je pretations to show the patients the un- nužno agresivno razaranje objekta, ali reality of the subject’s aggression, which najbitnije je njegovo preživljavanje. would greatly damage the developmen- Kad bi se terapeut miješao u taj proces, tal process of “using the object” (5), dur- pacijent bi to mogao doživjeti kao za- ing which aggressive destruction of the object is necessary, but their survival is branu svoje destruktivne potrebe i zato of utmost importance. If the therapist je najbolje ne reagirati i pustiti vreme- interferes with this process, the patient nu da to riješi. U tom razdoblju terapeut may see this as a prohibition of their de- treba preživjeti napade agresije što je structive need, so it is best not to react u djetinjstvu zadaća dobre majke, a na and allow time to sort this out. During terapijama dobrog terapeuta i grupe. this period, the therapist must survive Odvajanje selfa od objekta kod djece se, the aggressive attacks, which is in child- ako je njihov razvoj bio dovoljno dobar, hood the task of a good mother, and in ostvaruje do napunjene treće godine therapies the task of a good therapist života, a do šeste se učvršćuje da bi u and a good group. The separation of the daljnjem životu moglo biti na dobrobit i self from the object is in children, if their zadovoljstvo subjekta u svim njegovim development has been good enough, odnosima. achieved by the third year, and by the sixth year it is strengthened so that in Donald W. Winnicott opisao je taj va- later life it may provide benefit and con- žan proces: Kad se proces odvajanja tentment to the subject in all their rela- selfa od objekta ostvari, postignuto je tionships. stanje ili sposobnost iskorištavanja ili Donald W. Winnicott described this im- uporabe objekta. Subjekt ulazi u za- portant process: when the process of the jedničku realnost u kojoj je i objekt, a separation of the self from the object is svi ostali vanjski objekti prestaju se fulfilled, the state or ability of using or doživljavati kao projekcija unutarnjih employing the object is achieved. The prvih objekata od kojih je sada self su- subject enters a mutual reality with the bjekta odvojen. Tek tada može razviti object, and all other external objects 61

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sposobnost za simbolizaciju i za krea- cease to be experienced as a projection of tivne igre. Ako se taj proces tijekom ra- internal first objects, from which the sub- nog razvoja djeteta nije ostvario, što je ject’s self is now separated. Only then can slučaj s našim pacijentima, onda se on it develop its ability for symbolization and creative games. If this process was treba ostvarivati u novom odnosu na not achieved in the child’s early develop- dobroj psihoterapiji, samo što će tada ment, which is the case with our patients, za to trebati mnogo godina. Ako se taj then it has to be achieved in a new rela- proces ni tijekom terapije ne ostvari, tionship in good psychotherapy, but this ta terapija nikad neće moći završiti, will take many years. If this process is not što se događa kod psihoza i graničnih achieved even in therapy, then this thera- pacijenata. py will never be completed, which occurs in psychoses and borderline patients. Kad su se razvili snažni narcistički transferi prema grupi i prema voditelju, Once strong narcissistic transfers to- tek u takvu terapijskom ozračju može wards the group and the leader have de- se pojavljivati spomenuta nužna agre- veloped, this type of therapeutic environ- sija koju transferni objekt analitičara ment can enable the development of the abovementioned necessary aggression, treba preživjeti da bi se mogao doga- which the transfer object of the analyst đati proces od posjedovanja, pripada- has to survive so that the process can nja objektu do „uporabe objekta“, kako go from possession and belonging to the je to opisivao Donald W. Winnicott, koji object to “using the object”, as Donald W. je rekao: „U početku je pripadanje, po- Winnicott described it. He said: “In the sjedovanje objekta, na kraju je uporaba beginning, there is belonging, possess- objekta, a između toga događa se mož- ing the object, and in the end there is da najvažnija stvar u ljudskom razvo- using the object, and in between hap- ju, koja se od svih prijašnjih razvojnih pens something that is perhaps the most situacija najteže ostvaruje, a koja će important thing in human development, kasnije dovesti do olakšanja (str. 712).“ which is of all early developmental situation the hardest to achieve, and which U procesu „uporabe objekta“ subjekt will later lead to relief” (p. 712). (pacijent) postavlja objekt (analitiča- In the process of “using the object”, the ra) u novu poziciju. Objekt nije više u subject (the patient) puts the object (the području subjektove omnipotentne analyst) in a new position. The object is kontrole i nalazi se izvan djelovanja no longer in the area of the subject’s om- stalnih subjektovih projekcija i projek- nipotent control and is located outside tivnih identifikacija, a to je novi manje the action of the subject’s constant pro- 62 ili više odvojeni odnos selfa od objek- jections and projective identifications,

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ta. Dotad je postojao samo stari odnos which is a new and more or less separat- koji je bio dirigiran iz subjektova need relationship of the self and the object. svjesnog, prema tipu odnosa s njego- Until then, there was only the old rela- vim prvim idealiziranim introjektima. tionship, which was directed from within the subject’s unconscious, according to I svi vanjski odnosi tada su samo bili the type of relationship with its first ideal- projekcija vladajućeg odnosa (simbi- ized introjects. All external relationships otičnih ili selfobjektnih) u subjektovu were then only the projection of the dom- nesvjesnom. To su neseparirani od- inant relationship (symbiotic or self-ob- nosi s arhajskim lošim i idealiziranim ject) in the subject’s unconscious. These introjektima koje zovemo narcistički are non-separated relationships with ar- odnosi. chaic, bad and idealized introjects which we refer to as narcissistic relationships. Kad subjekt uspije svoj self odvojiti od objekta, tek tada može doživljavati When the subject achieves in separating objekt s njegovim pravim značajkama. its self from the object, the subject can Da bi do toga došlo, bilo je nužno da finally perceive the object with its real u procesu svojeg rasta subjekt razara traits. For that to happen, it is necessary for the subject to destroy the object dur- objekt, da zapravo razara selfobjek- ing the subject’s growth, whereby it actu- tnu, tj. idealiziranu simbiotičnu vezu s ally destroys the self-object or idealized njim, a uvjet je da objekt mora preživje- symbiotic relationship with the object, ti to razaranje. Ako objekt ne može pre- with the precondition that the object živjeti spomenuto razaranje, subjekt must survive this destruction. If the ob- će stalno ostati u nezrelom odnosu ject did not survive the aforementioned (selfobjektnom). Ako je objekt preživio destruction, the subject would perpetu- razaranje, on u subjektovim osjećajima ally remain in an immature relationship dobiva vrijednost zato što je preživio (self-object). If the object survived the razaranje i time omogućio subjektu destruction, in the subject’s emotions it da izađe iz selfobjektnog odnosa. Dok gains in value because it survived the ga je razarao, subjekt je volio objekt jer destruction, thus enabling the subject to leave the self-object relationship. While ga je smio razarati, a objekt je to na te- being destroyed, it was loved by the sub- rapiji višekratno preživljavao. Tako je ject because the subject was allowed to objekt postao pouzdan te ga subjekt destroy it, and through therapy the object može upotrebljavati za daljnji rast. To survived this repeatedly. Thus, the object je početak individualizacije subjek- became reliable and the subject can use it ta, koji sada može početi živjeti život for further growth. This is the beginning odvojen od objekta (terapeuta) i biti s of the individualization of the subject, njim u istoj realnosti. Dobra majka, which can now begin living a life sepa- 63

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dobar analitičar, ali i dobra grupa omo- rated from the object (the therapist) and gućit će subjektu da ih razori u starom exist with it in the same reality. A good simbiotičnom ili selfobjektnom odnosu mother, a good analyst, and a good group i dopustit će njegovu selfu da se razvija will enable the subject to destroy them sa što manje nekadašnjih idealizacija in the old symbiotic or self-object relationship and will allow its self to devel- objekta. Ako se taj proces zbog nespo- op with as few as possible of the former sobnosti analitičara, voditelja grupe, idealizations of the object. If, due to the grupe kao cjeline ili zbog težine paci- incompetence of the analyst, the leader jentovih oštećenja (prevelikih deficita) of the group, the group as a whole or the ne može odigrati, takva analiza nikad severity of the patient’s injuries (deficits neće biti završena. that are too severe), this process cannot take place, then this type of analysis will never be completed. GRUPNA ANALIZA I PROCES DIFERENCIJACIJE GROUP ANALYSIS AND THE Grupna analiza vrlo je pogodna za pro- PROCESS OF DIFFERENTIATION matranje procesa odvajanja selfa od objekta. U grupi možemo istodobno Group analysis is very good for observ- promatrati pacijente koji su se različi- ing the process of the separation of the to razvili i koji su na različitoj dubini u self from the object. In a group, we can tom procesu. Neki pacijent nije ga ni simultaneously observe patients who započeo pa se čvrsto drži u selfobjek- have developed differently and who are tnom odnosu s voditeljem ili s nekim at different stages of this process. Some članom grupe koji mu figurira kao rodi- patients never even begin this process teljski selfobjekt. Drugi pacijenti raspo- and are firmly entrenched in the self-ob- ređeni su na ljestvici na vrlo različitim ject relationship with the leader or other group member who acts as the parent stupnjevima odnosa sa selfobjektima, self-object. Other patients are at various obično oscilirajući oko razine do koje stages of the relationship with self-ob- su se razvili u tom trenutku svoje te- jects, usually oscillating around the stage rapije. U grupi može biti i pacijent koji they had reached in their development je blizu izlaska ili je uspio izaći iz se- during therapy. The group may also con- lfobjektnog odnosa. Voditelj osjeća da tain a patient who is close to leaving or mu je takav pacijent vrlo blizak, da do- has already left the self-object relation- bro osjeća i razumije poziciju drugih u ship. The leader feels very close to such a grupi. Pacijent koji je to dostigao nalazi patient, one who has a good understand- 64 se u istoj, tj. zajedničkoj realnosti s vo- ing of the position of other members of

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diteljem. Oni se vrlo dobro osjete i ra- the group. The patient who has reached zumiju i tada grupni analitičar osjeća this level is in the same, i.e. mutual rekao da ima dobrog kolegu u grupi. Kad ality with the leader. They can feel and je grupa dugo i dobro radila, u približ- understand each other well, and then the group analyst feels they have a good no isto vrijeme mogu se pojaviti i dvije colleague in the group. If the group has osobe koje su kao pravi kolege grupnog worked well for a long time, at a similar analitičara što je za njega prava pomoć, point in time there may also develop two kontratransferno zadovoljstvo. people who resemble the analyst’s real colleagues, which is for the analyst very O procesu odvajanja selfa od objekta helpful, a countertransferential pleasure. govorili su mnogi autori različitim pri- stupima, ali suština razmatranja bila Numerous authors have commented je ista. Donald W. Winnicott opisao ga on this process of the separation of the je kao razvojni put do uporabe objek- self from the object, but the core of their ta, Margaret Mahler (6) kao odvajanje thinking has been the same. Donald W. i individualizaciju, a Heinz Kohut (7) Winnicott describes it as a developmen- smatrao ga je ključnim i nazvao ga je tal journey to using the object, while Mar- garet Mahler (6) defines it as separation „transmutacijskom internalizacijom“. and individuation and Heinz Kohut (7) Obratio je pozornost na zapažanja iz considers it key and calls it “transmuta- praktičnog rada i naglasio da posto- tional internalization”. He paid attention je dva razdoblja u kojima narcistični to the observations from practice and pacijenti postaju vrlo osjetljivi i mogu emphasized that there were two periods reagirati agresijom ili bolnim povla- in which narcissistic patients become čenjem: prvo je razdoblje kad se nar- very sensitive and may react aggressive- cistički transferi počnu pojavljivati, a ly and by painfully retreating: the first pe- agresija nastaje zato što je pacijente riod is when narcissistic transfers begin strah od pojavljivanja ponovne ovisno- to appear, and aggression occurs because sti kako se ne bi ponovila loša iskustva the patients fear the return of addiction s njihovim primarnim objektom. To se and the bad experiences with their primary object. This can also be observed at može vidjeti u početku rada grupe kad the beginning of group work, when most je većina subjekata vrlo zakočena u in- subjects are still very stiff in interaction. terakcijama. Možda se njihov bolesni Perhaps their diseased part fears the dio još više boji uspostavljanja novog i establishment of a new and unfamiliar nepoznatog bliskog transfernog odno- close transferential relationship, which sa, što nisu imali u svojim iskustvima. they have not experienced. During group Tijekom rada grupe to može biti olak- work, this can be made easier because in- šano jer se interakcije lakše uspostav- teractions are more easily initiated with 65

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ljaju s drugim članom grupe, koji može another group member, who may act as figurirati kao specifični grupni prijela- a specific temporary object until the re- zni objekt do odnosa s voditeljem. lationship with the leader.

Drugo je razdoblje još važnije i osjet- The second period is even more impor- ljivije, a dolazi kad je terapija iznimno tant and more sensitive, and it occurs napredovala i kad narcistički transferi when therapy has advanced significantly and narcissistic transfers become weak- postaju slabiji kao što postaje slabija er, just like the dominant narcissistic dominantna narcistička struktura pa- structure of the patient itself, while their cijenata, a njihov pravi self postaje sve true self becomes stronger. In this peri- jači. Pacijenti u tom razdoblju postaju od, patients become too sensitive, react preosjetljivi, reagiraju agresivno ili se aggressively or retreat as soon as they povlače čim osjete i najmanji nedosta- sense the slightest sign of a lack of em- tak empatije u voditelja. Takva preo- pathy in the leader. This oversensitivity sjetljivost i obrana agresijom proizlaze and aggressive defensiveness occurs due iz straha od nepoznatog i od rizika koji to the fear of the unknown and the risk su preuzeli jer se prvi put odvajaju i they have accepted because the subjects ostavljaju selfobjektni svijet. are separating for the first time, thus leaving behind the self-object world. Poduzimanje tog velikog koraka u na- pretku, kad se pacijenti usude raskinuti In order for the patients to take this im- simbiotičnu vezu s objektom, iznimno portant step in their development, their je dobro opisao Ronald Fairbairn (8) go- decision to dare break the ties of the voreći da pacijent u transfernoj situa- symbiotic relationship with the object ciji ima uz sebe posebno dobar objekt has been described well by Ronald Fair- analitičara (dodao bih i grupu) i time bairn (8), who claims that, in a transferential situation, the patient has available je stavljen u poziciju da može riskirati a particularly good object of the analyst oslobađanje svojih libidno investiranih (and of the group, I would add), which loših objekata iz nesvjesnog. places them in the position of risking the Ono što naziva „libidno investiranim liberation of their libidinally invested bad lošim objektom“ isto je što i Kohutov objects from the unconscious.

selfobjekt ili Winnicotov idealizirani What he refers to as “libidinally invested omnipotentni objekt ili simbiotični bad object” is the same as Kohut’s self-ob- objekt o kojem je govorila Margaret ject or Winnicott’s idealized omnipotent Mahler (6). Sve takve libidne investicije object or symbiotic object that Margaret s lošim objektima trebaju se raskidati Mahler spoke of (6). All such libidinal in- 66 (odvajati) i u analizi što više razriješiti. vestments with bad objects should be de-

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Može se reći da se agresivnim naleti- stroyed (separated) and resolved as much ma polako gradi proces odvajanja se- as possible during analysis. lfa od objekta. Terapijski uvjet za pra- We may say that aggressive outbursts ve promjene jest da grupni analitičar are used to slowly build the process of agresiju koja se upućuje njemu ne vra- the separation of the self from the ob- ća pacijentima, nego da je proživljava i ject. The therapeutic precondition for preživljava. To mu omogućuje njegova real changes is for the group analyst not sposobnost kontejniranja i razumijeva- to direct the aggression directed at him nje situacije u kojoj su pacijenti kao i back at the patients, but to experience njegovo teorijsko znanje. it and survive it. Their ability to contain and understand the situation in which the patients find themselves, as well as their theoretical knowledge, enable them ODVAJANJE SELFA OD OBJEKTA to do so. / REZULTAT DIFERENCIJACIJE

Kod nekih pacijenata u grupi, kad su blizu završetka terapije, često se po- SEPARATING THE SELF FROM javljuje iznenađujuće snažna agresija THE OBJECT/THE RESULT OF čiji je cilj konačno odvajanje selfa od DIFFERENTIATION objekta. In some patients in a group, when they Autoagresija projektivnom identifika- are nearing the end of therapy, there is cijom djeluje jednakom snagom kao the often-surprising onset of strong aggression which has as its goal the final agresija i ima snažan utjecaj na anali- separation of the self from the object. Au- tičara i grupu. toaggression through projective identifi- Autoagresija svojom agresijom daje cation acts as powerfully as aggression energiju za odvajanje selfa od objek- and has a strong influence on the analyst ta. Hoće li se agresija ili autoagresija and the group. pojavljivati kao pretežan način koji će Autoaggression provides the energy for voditi k rastakanju selfobjektne veze, the separation of the self from the object ovisi o tome dominira li u subjektovu through its aggression. Whether aggres- narcizmu grandiozni self (izrazitija sion or autoaggression will appear as the agresija) ili idealizirana roditeljska sli- dominant way that will lead to the de- ka (izrazitija autoagresija). struction of the self-object relationship depends on whether a grandiose self Autoagresija putem pogoršanja somat- (more pronounced aggression) or an ide- skog stanja prikazuje se kao psihoso- alized parental image (more pronounced 67

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matska reakcija vrlo velikog intenzi- autoaggression) dominates within the teta. subject’s narcissism.

Autoagresija koja se očituje velikim Autoaggression through the worsening of emocionalnim pogoršanjem u vidu je the somatic state appears as a psycho- somatic reaction of a very pronounced dramatičnih emocionalnih proživlja- intensity. vanja napetosti, zbunjenosti i iznad svega straha. Autoaggression manifested through a serious emotional worsening comes in the Oba oblika autoagresije putem projek- form of dramatic emotional experiences tivnih identifikacija agresijom poga- of tension, confusion and, above all, fear. đaju kontratransferne osjećaje analiti- čara i grupe, što oni trebaju preživjeti. Both forms of autoaggression impact Zahvaljujući tome što su preživjeli pa- countertransferential emotions of the cijentovu agresiju, postaju sve pouzda- analyst and the group through projective identification, which they have to survive. niji objekti i to daje energiju za slablje- By surviving the patient’s aggression, nje libidne selfobjektne veze s lošim they become more reliable objects, which objektom, sve do raskidanja. provides energy for the weakening of the Razlozi pojave obaju oblika autoagresi- libidinal self-object relationship with a bad object until its final destruction. je nastaju zbog lošeg objekta (arhajskog selfobjekta) koji subjektu nije pružio Causes for the appearance of both forms potrebno emocionalno razumijevanje of autoaggression can be found in the bad i sigurnost, a agresijom ga želi držati object (archaic self-object), which did not u strahu i pokornosti u starom odno- provide emotional understanding and su. Pacijent koji je počeo napredovati safety to the subject, and now uses ag- u terapiji to teško prihvaća i dolazi do gression to maintain its fear and obedi- njegove pobune, kad udara autoagresi- ence from the old relationship. A patient who has started progressing in therapy jom na svoje somatsko ili emocional- finds this difficult to accept, which leads no stanje. Pacijent još nema dovoljno to their rebellion, and they attack their zdravlja kako bi mirno, bez oštećenja somatic or emotional state using autoag- sebe, autoagresijom izlazio iz vlastita gression. The patient is not yet sufficient- starog selfobjektnog odnosa. ly healthy to calmly and without hurting themselves with autoaggression leave Razdoblje u kojem se više izražava their old self-object relationship. agresija ili autoagresija nastaje kad je pacijent napredovao u dugotrajnom The period during which aggressions or 68 procesu sve većeg odvajanja njegova autoaggression are more pronounced oc-

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selfa od objekta što je praćeno jakim curs when a patient has advanced dur- osjećajem straha, zbunjenosti, čak i ing the long-term process of separating izgubljenosti, jer se rastvara njegova its self from the object, which is followed narcistička organizacija osobnosti. Pa- by a strong feeling of fear, confusion and even bewilderment because their nar- cijent osjeća da doživljava nešto nepo- cissistic organization of personality is znato i novo, a burni doživljaji (simpto- being dissolved. The patient feels they mi koje stvara agresija ili autoagresija) are experiencing something unfamil- svaki put kad se pojave oslobađat će iar and new, and turbulent sensations motive i energiju za prekid veze njego- (symptoms created by aggression or au- va selfa s objektom. toaggression) provide motives and energy for the breakdown of the relationship U vrijeme liječenja analitičar i grupa between their self and the object. predstavljaju transferne projekcije arhajskog objekta, ali velika je razlika During treatment, the analyst and the od njega u tome što oni mogu izdrža- group represent transferential projections ti i preživjeti agresiju subjekta i time of the archaic object, but they differ from it by being able to withstand and survive je metabolizirati. Dokazom da mogu the aggression of the subject, thus me- preživjeti agresiju analitičar i grupa tabolizing it. By proving they can survive uspješno su prošli pacijentovo testi- the aggression, the analyst and the group ranje njihove pouzdanosti i zato im se successfully pass the patient’s test of pacijent okreće kao dobrim objektima their reliability, which leads to the patient kako bi se mogao sve više odvajati od turning to them as good objects in order lošeg odnosa sa svojim idealiziranim to increase their separation from the bad introjektom. U svim tim fazama agre- relationship with their idealized introject. sivnog transfera grupa i analitičar pre- The group and the analyst survive all these življavaju i kao nagrada za to razvijaju stages of aggressive transference, and the se pacijentovo povećano povjerenje u award for this is the patient’s increased njih i veća ljubav. confidence in them and greater love.

KAKO ANALITIČAR TREBA HOW SHOULD THE ANALYST RADITI DOK SE DOGAĐA TAJ FUNCTION WHILE THIS PROCESS PROCES U GRUPI? IS TAKING PLACE IN THE GROUP?

Postavljaju se i pitanja tehnike terapije There are also questions regarding the u opisanim situacijama: kako se posta- functioning of therapy in the outlined viti u terapiji kad dođe do izrazite agre- situations: which position should one 69

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sije? Pozvao bih se na Heinza Kohuta, assume during therapy when there is koji je o tome rekao da analitičar može strong aggression? I would like to refer reći kako vidi težinu njegova agresiv- to Heinz Kohut, who said something nog psihosomatskog ili emocionalnog about this: the analyst can say they see the severity of their aggressive psycho- stanja i da mu to nije nepoznato te da somatic or emotional state and that this zna zbog čega je sad pacijent u takvim is not unfamiliar to the analyst, which teškoćama. To pacijenta ohrabruje i is why they know why the patient is najčešće mu pruža olakšanje. Može experiencing such difficulties. This en- reći kako će o tome razgovarati na courages the patient and, in most situ- budućim seansama u grupi kad prođe ations, provides relief. We may say that pacijentova blokiranost simptomima. this will be discussed in future sessions U stanjima kad agresija preplavi paci- once they cease being blocked by symp- jenta ne treba interpretirati budući da toms. When aggression overwhelms the on interpretaciju ne može primiti jer patient, we should not interpret, since su mu svi osjećaji blokirani strahom. they cannot accept interpretation be- Pacijentu se ponekad mogu ponuditi cause all of their emotions are blocked by fear. The patient can sometimes be dodatne individualne seanse i ostaviti offered additional individual sessions mogućnost da ih prihvati ili odbije, a and let the accept or refuse this offer, najbolje bi bilo kad bi pacijent to sam and it would be best if the patient asked zatražio. Tom smo ponudom za razliku for them. By offering this, we show that, od iskustava s arhajskim selfobjektom unlike the experience with the archa- pokazali da smo uz pacijenta, da ima- ic self-object, we stand by the patient mo empatijsko razumijevanje za njega and have an empathic understanding posebno kad je teško, a i povjerenje u of them, especially when they are in a svoj rad te da smo uvijek tu za paci- difficult period, and we also show con- jentove potrebe. Ako pacijent prihvati fidence in our work and that we are al- ponudu za dodatnim individualnim ways there for the patient when they seansama, može nastaviti agresiju, need us. If the patient accepts the offer of additional individual sessions, they može je smanjiti ili prekinuti. Ako pa- may continue showing aggression, re- cijent nastavi s agresijom, analitičar duce it or stop it. If the patient continues treba biti spreman da po tko zna koji being aggressive, the analyst has to be put preživi kako bi došlo do sve većeg ready to survive it for the countless time odvajanja selfa od arhajskih selfobje- so that increased separation of the self kata. To će dovesti do ulaska subjekta from the archaic self-objects can take u zajednički realitet s nekim članom place. This will lead to the subject enter- 70 grupe koji se već prije odvojio i s ana- ing the mutual reality with some of the

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litičarem. Subjekt sad može iskoristi- group members who have already sep- ti analitičara i druge objekte za svoju arated themselves, as well as with the analyst. The subject can then use the an- dobrobit. Prema mojem iskustvu gru- alyst and other objects for their benefit. pa dobro reagira na dopunske indivi- In my experience, the group reacts well dualne seanse jednog člana jer drugi to additional individual sessions for one pacijenti iz grupe osjećaju koliko je to member because other group members subjektu bilo potrebno. feel how necessary it is for the subject.

LITERATURA/REFERENCES

1. Blanck G, Blanck R. Ego psihologija. Zagreb, Naprijed. 1983.

2. Foulkes SH. Analyse de groupe. Londres, Paris, Payot. 1964.

3. Fonda P. Fuzionalnost separat. 2002.

4. Bion WR. Entretiens Psychanalytiques. Edition Gallimard, Paris. 1980.

5. Winnicott DW. The Use of an Object; International Journal of Psycho-Analysis. 1969: 50: 711-716.

6. Mahler MS. Psychose infantile. Bibliothequa Payo, Paris. 1982.

7. Kohut H. Analiza sebstva. Naprijed, Zagreb. 1998.

8. Fairbairn WR. Psihoanalitičke studije ličnosti. Naprijed, Zagreb. 1982.

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NIKA (NARCIZAM TERAPEUTA I NARCIZAM ČLANA GRUPE)

/ NIKA (THE NARCISSISM OF THE THERAPIST AND A GROUP MEMBER)

Zdenka Brumen-Budanko

SAŽETAK/SUMMARY U okviru studijskih dana Instituta za grupnu analizu Zagreb 2007. godine, glavna tema skupa bila je: Narcizam u grupi. U svome radu prikazala sam „kriznu situaciju“ unutar grupnoga procesa koji se prethodno razvijao već nekoliko godina. Podnaslov rada glasio je: Narcizam terapeuta i narcizam člana grupe. U grupu sam približno dvije godine prije tog izlaganja, uvela novu članicu, Niku, koja je s teškoćom prihvaćala „spori način rada“. Za mene se daljnji rad u toj grupi svodio na prvom mjestu na introspekciju kontratransfera, unutar koje su se ljuštili jedan po jedan dijelovi vlastitih narcističnih slojeva, aktiviranih identifikacijom s dijelovima Nikine osobnosti kojima je od samih početaka uspješno „napadala“ moje empatijske kapacitete. Poremećaj koji je zahvatio grupu bi se slikovito mogao prikazati u upadljivosti Nikinih visokih, bijelih cipela, „nezažniranih“(tj. na kraju visokoga žniranja nevezanih, sa slobodno padajućim jednako efektnim završetcima žniranaca). U osnovi mojega terapeutskoga „povla- čenja“ koje sam razabrala u intenzivnoj i u nekom smislu bolnoj introspekciji kontratransfera, bila je podudarnost ranih traumatskih zbivanja u Nikinu i mojem razvoju. Tri desetljeća me- đusobno razmaknuti, i u vrlo različitim općim životnim okolnostima, i kod jedne i kod druge doveli su do nužnosti formiranja narcističnih obrana, premda sadržajno različitih. U međuvre- menu, stvarnu ulogu terapeuta u grupi preuzela je, spontano i uspješno, sama grupa. Nika je s iznenađujućom zrelošću „pregovarala“ s grupom oko svojega preuranjeno planiranoga izlaska iz terapije, što je njezin izlazak i odmaknulo za još nekoliko produktivnih mjeseci. A ovaj je sažetak, sada, za mene nešto kao: „Nika, treći put.“ I, s dosta autoironije, pada mi na pamet reče- nica jedne moje mudre stanodavke, dok sam na svome profesionalnome početku neko kraće vrijeme radila u lijepome zapadnoslavonskome gradiću smještenom približno na polovici puta između Zagreba i mjesta mog rođenja. Rekla mi je komentirajući neku „susjedsku“ situaciju: „Znate, kod nas se kaže: ima ljudi koji s jednom pameti ne znaju zažnirati dvije cipele“. / At the ‘study days’ organized by the Institute for Group Analysis in 2007., the main subject was Narcissism in the Group. In my paper I reviewed a “crisis situation” within the group process, previously developed for several years. The subtitle of the paper was Narcissism of the Therapist and Narcissism of a Group Member. A new member, Nika, was introduced to the group approximately two years before this pres- 72 entation. She had difficulties accepting “a slow pace of the work”. For me, the further work

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in that group has been presumably about the introspection of countertransference, which exposed the layers of my own narcissism one after another, all of them activated through the identification with parts of Nika’s personality, parts she used from the beginning to successfully attack my capacities for empathy. A disorder that spread all over the group one can picturesquely describe with Nika’s striking white high shoes, with untied, “free-falling” ends of shoelaces. In the basis of my therapeutic “withdrawal”, which I discerned during the intense and some- what painful introspection of countertransference, was a coincidence of the early traumatic events in both Nika’s and my own development. These events, separated by three decades and by very different overall circumstances, led both of us to urgency of formation of narcissistic defenses, although different in content. Meanwhile, the role of real therapist in the group took over, spontaneously and successfully, the group itself. Nika herself, surprisingly maturely, “negotiated” with the rest of the group her prematurely planned exit from the therapy, which led to postponing this exit for several more productive months. This summary is for me something like “Nika, part three”. And it strikes my mind, quite auto ironically, something my wise landlady said, as I was still on my professional beginning, working in a nice small town in western Slavonia, halfway in between Zagreb and my birth place. She said, commenting on some situation in the neighbourhood: “There are people who can’t tie two shoes with one brain.”

KLJUČNE RIJEČI / KEY WORDS

grupna analiza / group analysis, narcizam / narcissism, kontratransfer / countertransference

Zdenka Brumen Budanko, psihijatrica, grupna analitičarka, psihoanalitička psihoterapeutkinja, članica IGA-a i HDPP-a / Zdenka Brumen Budanko, psychiatrist, group analyst, psychoanalytic psychotherapist, member of IGA and HDPP

Nika je ušla u već razvijenu grupu od Nika joined an already developed group tri muška i tri ženska člana. Moglo consisting of two male and three female bi se reći da se grupa u toj fazi doista members. One could say that, at this stage, the group was successfully work- uspješno bavila odnosima na razini ing on relationships on the level of mu- uzajamnosti. Prevladavali su trenutci u tuality. The sessions were dominated by grupnom procesu kad se misli i osjeća- those intervals in the group process in ji u grupi bez jačih potresa slažu jedni which thoughts and emotions join with- do drugih, a u pojedinim se seansama out great upheavals, and in certain ses- dostiže mirno, kreativno stanje vedri- sions a calm, creative state of light-heart- 73

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ne. U drugim seansama zrcaljenje i re- edness is achieved. In other sessions, zonancija povećavali bi grupnu tenzi- mirroring and resonance would increase ju, ali najčešće bi se uspijevao pronaći the group tension, but the members usu- izlaz u benignijim oblicima projektivne ally found a way out through more be- nign forms of projective identification (1). identifikacije (1). The most seriously ill patient in the Najbolesniji član grupe, L., umjetnik group, L., an artist with a vulnerable self ranjiva selfa i granične strukture, moj and a borderline structure, my patient of višegodišnji pacijent s magijskim po- many years with magical needs for uni- trebama za jedinstvom i cjelinom, prije ty and wholeness, had ended his short- nekoliko je mjeseci izišao iz svoje krat- term psychotic episode several months kotrajne psihotične epizode. Grupa je before. The group successfully contained dobro kontejnirala njegove arhajske his archaic contents and fears. Now he sadržaje i strahove. Sad je funkcioni- functioned with a sort of “instrument” he rao s nekom vrstom „instrumenta“ ko- used to measure warmth, humidity and jim kao da je mjerio toplinu, vlažnost i pressure in “the group air”. He would re- tlak „grupnog zraka“. Reagirao bi svaki act every time the affective qualities in the group approached or even surpassed put kad bi se afektivne kvalitete u grupi the borderline values of aggression. He približile ili čak i prešle granične vri- moved within risky borderlines of the jednosti agresije. Kretao se u rizičnim need for the preservation of the “group granicama potrebe za opstankom „gru- illusion” (2). However, the group itself no pne iluzije“ (2). Iluziju sad, međutim, longer needed the illusion and repeat- grupa nije više trebala i uspijevala bi edly succeeded in making him feel that mu svaki put iznova vratiti osjećaj da neither he nor the group would collapse se ni grupa niti on neće raspasti zbog because of a harsher confrontation. kakve oštrije konfrontacije. Nika arrived with a fantasy about the Nika je došla s fantazijom o tome da group being led by an experienced ther- grupu vodi iskusan terapeut i da je riječ apist, a group that is “modern” and does not make one “dull”, one in which she o „modernoj“ grupi koja „ne zatupljuje“ i will finally be accepted, along with her u kojoj će ona napokon biti prihvaćena significantly eccentric lifestyle and risky sa svojim prilično ekscentričnim život- life choices. I had second thoughts about nim stilom i u više smjerova rizičnim including her in the group – it was com- životnim potezima. Dvoumila sam se pletely obvious Nika was looking for the oko njezina uključivanja u grupu – “aha” effects and not an introspective bilo je potpuno očito da Nika želi „aha“ journey of patient and careful research. 74 učinke, a ne introspektivan put strpljiva She was an intelligent, attractive per-

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i pažljiva istraživanja. Bila je inteligen- son in her early middle age, with a very tna, atraktivna osoba mlađe srednje youthful appearance and a distinct and dobi, naglašeno mladenačkog izgleda i distanced but undeniably seductive be- samosvojnog, distanciranog, ali nesum- haviour. The people around her saw her njivo zavodničkog ponašanja. Okolina as talented and successful in numerous ju je vidjela kao nadarenu i uspješnu u areas, but not as “different” or even eccentric. mnogim područjima, ali i kao „drugači- ju“, pa i ekscentričnu osobu. She showed a lot of understanding for T. from the very beginning. She expressed Za T.-a je od početka pokazivala mno- her surprise in a reserved manner at first, go razumijevanja. Čudila se, najprije but then did so more openly and angrily, suzdržano, a zatim sve otvorenije i sve showing her disagreement with the way srditije, iskazivala je svoje neslaganje s the group dealt with two situations: his načinom na koji se grupa bavila dvjema own, showing him how he arrogantly tore situacijama: njegovom, pokazujući mu down barriers and then was strangled kako bezobzirno ruši prepreke, a zatim by panic, and her own, in which jealous se guši u panici, i njezinom, u kojoj su episodes involving much younger men prevladavale ljubavne drame sa znatno prevailed and were based on knots of mlađim muškarcima, u teško razmrsi- mutual admiration and torture that were vim čvorovima uzajamnog divljenja i difficult to disentangle. The group con- mučenja. Grupa je postojano ukazivala tinuously pointed out the connection be- na povezanost njezine potrebe za in- tween her need for intense experiences tenzivnim doživljajima – strastvenom – passionate dancing in clubs, attending plesanju po klubovima, prisustvovanju show premiers, meeting famous people, premijernim predstavama i susretima s etc. – and desperation, depression and the feeling of loneliness that would in- poznatim osobama i sl. – s očajem, po- evitably follow, therefore making her feel tištenosti i osjećajem usamljenosti koji angry. Nika believed they were directing bi ih redovito slijedili nakon čega bi po- her towards a boring life she not only did stajala gnjevnom. Nika je smatrala da not want, but also should not live. je upućuju na dosadan život kakav ne samo da ne želi nego i ne treba živjeti. When T.’s revived anxious need for success led to his reacting during sessions, Kad bi iznova pobuđena T.-ova uzne- he would talk in an upset way about mirena potraga za uspjesima dovela his unsuccessful romantic attempt, do njegova agiranja na seansi, na ko- one that was superficial and manipu- joj bi uzrujano iznosio priču o svojem lative, and the group would be unable neuspješnom ljubavnom pothvatu, to respond with resonance. Nika would površnom i manipulirajućem, a grupa sometimes address him in a calming 75

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ne bi mogla odgovoriti rezonancijom, voice, gently choosing her words. She Nika mu se znala obratiti umiruju- would emphasise how important it was ćim glasom, nježno, biranim riječima. for him to simply regain “confidence in Naglašavala bi koliko je važno da on himself” (and not in the vicious group or samo vrati „povjerenje u sebe“ (a ne u its leader), and it would seem to me that ovu zlobnu grupu i njezinu voditelji- she was actually telling him to “think positively”. She would comfort him in a cu), činilo bi mi se da ustvari govori da wide range of vocal intonations: at first „pozitivno misli“. Tješila bi ga raskoš- peace, reprieve, only for today, it will not nim glasovnim registrom: najprije mir, take long, she cooed. Then, just like me, predah, samo danas, neće trajati dugo, you can fly high, she enticed him (or so romorila je. Onda kao i ja možeš u zalet, it seemed to me). And he would calm mamila ga je (tako mi se činilo). I on bi down, as though “enchanted”. He was se smirivao, opčinjen. Ostale članove unable to hear the other members of the grupe nije bio u stanju čuti. Javljala su group. I was reminded of Heine’s “Lorelei”, mi se sjećanja na Heineovu „Lorelei“, which we spent a lot of time on in high kojom smo se dugo bavili u gimnaziji u school in the group of free activities. Oth- grupi slobodnih aktivnosti. Ili bih imala erwise, I would have the impression I had dojam da sam zalutala na lošu kazališ- wandered into a bad theatre production, nu predstavu, a da ionako ne znam što without knowing what was being shown. igra. U takvim okolnostima činilo mi In such situations, it seemed to me that se da Nika iz seanse u seansu napada Nika was attacking my empathetic capa- moje empatijske mogućnosti. bilities from one session to another.

U jednoj od takvih seansi, napregnut In one such session, strained beyond preko mjere, „podivljao“ je instrument the breaking point, L.’s instrument “went wild”. The vulnerable self started pour- L.-a, mojeg „favorita“. Ranjivi self prokr- ing out towards T. “You’re a dead man, vario je bujicom prema T.-u: „Ti si mrtav a wind-up tin toy, come on, liven up, let čovjek, navijena limena igračka, daj oži- us feel you, stop rattling after Nika. And vi, da te osjetimo, prestani klopotati za you, Nika, you don’t even see the rest of Nikom. A ti, nas druge, Nika, uopće ne us, you’re waiting for something to shine vidiš, čekaš da nešto zasvijetli nad tvo- over your head and for you to be exhil- jom glavom i da se uzneseš. Ti ne znaš arated. You don’t know what I’ve been što sam ja sve prošao da stvari vidim through in order to see things as they are. kakve jesu. Stalno napadaš doktoricu You keep attacking the doctor about not da nas ne zna tješiti, a nismo mi tu zato knowing how to comfort us, but we’re not da se samo umirujemo međusobno. Svi here just to comfort each other constant- 76 mi imamo svoju kriminalnu prošlost.“ ly. We all have our criminal past.”

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Znam da je govorio još nešto, ali sam I know he said something else, but I had bila prestala pratiti grupu, vjerojatno na stopped following the group, probably for nekoliko trenutaka. Gledala sam u Ni- a few moments. I was staring at Nika’s kine razvezane visoke bijele cipele. Te untied high white shoes. That season je sezone bila takva moda: visoke, bije- that was the fashion: high, white, untied. le, razvezane. Nadolazilo mi je sjećanje: I remembered something: I am around three and a half, I’m in Mirogoj with my imam oko tri i pol godine, na Mirogoju parents and older sister, who are carefully sam s roditeljima i starijom sestrom searching for something. (Later I realized koji malo podalje nešto pažljivo traže they had been searching for someone at (kasnije sam shvatila da su, u to vrije- that time.) I climbed on top of the smooth, me nakon rata, tražili nekoga). Popela shiny surface of a recently constructed sam se na glatku svjetlu površinu veli- tomb and entangled the laces of my high, ke, tek izgrađene grobnice i zapetljala ugly brown shoes, which I had inherited vezice svojih svojih visokih cipela, ruž- from my sister, who had grown too big for nih, smeđih, naslijeđenih od sestre koja them. I jumped and tumbled down. I was ih je prerasla. Koraknula sam poskočiv- not hurt. ši i skotrljala se. Nisam se ozlijedila. In the meantime, the group had become Grupa je, valjda u međuvremenu, za- silent. Without thinking about it, I said: šutjela. Bez prethodnog promišljanja “Nika, it seems you and I have some mu- rekla sam: „Nika, čini mi se da Vi i ja tual questions. L. feels impelled to defend imamo neka svoja međusobna pitanja. me. You represent T, and the others are L. se osjeća ponukanim da brani mene, silent. It may be useful for all of us to at- Vi zastupate T.-a, drugi šute. Možda bi tempt to understand what is happening.”

bilo korisno da svi zajedno pokušamo I think I wanted to say we had some “un- razumjeti što se događa.“ finished business”, but I did not say that. The group, Nika and I attempted to un- Mislim da sam htjela reći kako imamo derstand those “questions” for the follow- „neraščišćene račune“, ali nisam to re- ing two years, before Nika prematurely, kla. „Pitanja“ smo grupa, Nika i ja poku- but still according to our agreement, left šavali razumjeti sljedeće dvije godine, the group following a long and strenuous dok Nika nije, prerano, ali ipak prema “negotiation” (1). dogovoru, poslije duljeg napornog „pregovaranja“ (1) napustila grupu. I think Nika was unable to establish a connection with the basic emotional Mislim da Nika nije mogla uspostaviti states in the group as a whole, she could vezu s temeljnim osjećajnim stanjima “catch” only T.’s disturbances and, it u grupi kao cjelini; mogla je „hvatati“ seems, as a mirror reflection of her own. 77

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samo T.-ove uznemirenosti, i to, čini On one level, she treated him in the same se, kao zrcalni odraz vlastitih. Postupa- way she wanted to be treated. As later la je s njim kao što je, na nekoj razini, became obvious, she was simultaneous- željela da se postupa s njom. Istodob- ly testing certain techniques of pacifica- no je na njemu isprobavala – kako se tion which she had learned in alternative kasnije ispostavilo – određene tehnike therapies she attended – for a while in parallel with attending the group. She smirivanja koje je naučila na alterna- successfully blocked the rest of the in- tivnim terapijama koje je neko vrijeme teractions in the group, including my pohađala usporedo s grupom. Ostale potentially empathic response, simul- interakcije u grupi uspješno je blokira- taneously activating my old narcissistic la, uključujući moj mogući empatijski injuries (3). If she was not able to deal odgovor, aktivirajući istodobno moje with her chosen – in reality, devalued – stare narcističke ozljede (3). Ako se nije member in her own way, she became de- mogla baviti izabranim – ustvari deva- pressed, coldly isolated within the group, luiranim – članom na svoj način, pre- distancing herself from all communica- puštala se svojoj potištenosti, u hladnoj tion. This resembled the description of izolaciji unutar grupe, distancirajući se narcissistic patients: “To the criticism of od svake komunikacije. To je bilo na- indifference of others they respond with lik opisu narcističnih pacijenata: „Na cold indifference or a strong feeling of kritičnost ili indiferentnost drugih anger, inferiority, shame, degradation or odgovaraju hladnom indiferentnošću emptiness” (4). In such states, however, ili snažnim osjećajem bijesa, inferior- it was possible to recognize how much nošću, sramom, poniženjem ili ispra- Nika was afraid of becoming her cantan- žnjenošću (4).“ U takvim se stanjima kerous, depressed mother once she grew older. ipak moglo nekako dokučiti koliko se Nika grozi da će kad ostari postati nalik I wonder whether in Nika’s case there svojoj zajedljivoj depresivnoj majci. developed a situation that Stolorow (5) writes about, the one in which the Pitam se nije li se u Nikinu slučaju ra- self-object dimension is not satisfied, zvila situacija o kojoj govori Stolorow which leads to it becoming burdened (5), kad se u terapijskom odnosu ne za- with latent aggression. Instead of “em- dovolji selfobjektna dimenzija pa self pathy in the function of providing a postane latentno agresivno opterećen. structuring experience” (6), it is possible Umjesto „empatije u funkciji pružanja that there was a repetition of a situation strukturirajućeg iskustva“ (6) mogu- of countertransferential occurrence in će je da se stalno ponavljala situacija which the therapist is “stuck” in one of 78 kontratransfernog zbivanja u kojem the positions, whether projective or in-

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terapeut „zaglavi“ u nekoj od pozicija, trojective or, together with the group, in projektivnoj ili introjektivnoj, ili, zajed- poorly defended momentary anxiety (7). no s grupom, u slabo branjenoj trenu- However, I believe that the situation of tačnoj anksioznosti (7). the therapist being “stuck” was in due Vjerujem, međutim, da se u seansi time resolved by a return to the group and the narcissistically charged suc- prikazana situacija „zaglavljenosti“ cessive interactions of the selves (Nika’s terapeuta ipak riješila pravodobnim and the therapist’s and Nika’s and L.’s) vraćanjem u grupu te su se iznimno successfully returned to the level of nec- narcistički nabijene sukcesivne inte- essary homeostasis. rakcije selfova (Nikina i terapeutkinji- na te Nikina i L.-ova) uspjele vratiti do Retrospectively, it seems that for a long razine nužne homeostaze. time, perhaps ever since Nika joined the group, the group process involved a lack Retrospektivno, čini se da se u gru- of “empathic synchronization”, a disor- pnom procesu dulje, možda sve od der of “emphatic listening”, which Nika Nikina ulaska u grupu, osjećao nedo- had a chronic hunger for. One may say statak „empatijske sinkronizacije“, da that this was a situation known as “mir- je došlo do poremećaja „empatijskog rorhunger person” (8). In it, the leader’s slušanja“, kojeg je Nika kronično bila “countertransferential readiness” (9) was activated with a sufficiently rapid gladna. Moglo bi se reći da je posrijedi (pre-conscious?) introspection before bila pojava opisana kao „mirrorhun- empathic capacity. (However, we may ger person“ (8). I u navedenoj situaciji ask whether the leader’s own experience aktivirala se voditeljičina „kontratran- was instigated by a form of empathy or sferna spremnost“ (9) s dovoljno brzom narcissistic mirroring while being fo- (Predsvjesnom?) introspekcijom, prije cused on Nika’s shoes. Or the therapist’s nego empatijski kapacitet. (Ipak, mož- unconscious defensive actions may be da nam je dopušteno zapitati se nije li assumed, as though she had been in- voditeljičin doživljaj bio potaknut ne- volved, together with the patient, in the kom vrstom empatije ili narcističkog activity of a certain “stimulating fantasy”, zrcaljenja dok je bila usredotočena na which was soon followed by a deeper un- Nikine cipele? Ili bi se mogli pretposta- derstanding of her own feelings through viti nesvjesni obrambeni potezi tera- the introspection of her own subjective experience.) peutkinje, kao da je s pacijenticom bila uvučena u agiranje u nekoj „pobuđu- I believe this is an example of how work- jućoj fantaziji“, da bi ubrzo introspek- ing with the problems of narcissism (both cijom svojeg subjektivnog doživljaja that of a group member and that of the 79

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dublje zahvatila i razumjela vlastite therapist), whereby for various reasons osjećaje.). empathy is not used as an investigative method per se (6), introspection of coun- Vjerujem da je to primjer kako se i u tertransference may be used to success- radu s narcističkom problematikom fully fulfil the task of studying the group (i člana grupe i voditelja), kad se zbog situation, which is also true of individual različitih razloga ne primjenjuje empa- group sessions (10). tija kao istraživačka metoda per se (6), I believe Nika had deep vertical fissures introspekcijom kontatransfera može in her personality (6). uspješno obaviti zadatak istraživanja grupne situacije. Slično vrijedi i za in- In order to defend herself from suffering dividualnu psihoterapijsku seansu (10). – the furthest she went was an ill-tem- pered depression – she could not use the Mislim da je Nika imala duboke okomi- experiences from the group and engage te rascjepe u osobnosti (6). in constantly working with aggressive (impulsive) derivates, which would per- Kako bi se obranila od patnje – najviše haps have enabled her to get in touch u što se usudila upustiti bila je mrzo- with her nuclear self (11,12). I thought that voljna potištenost – nije mogla primi- this was no longer possible. jeniti iskustva iz grupe i upustiti se u stalan rad s agresivnim (nagonskim) My experience with therapy shows that derivatima što bi joj možda omogućilo I can handle “bleeding” narcissism more easily than the “grandiose” one. Vulner- da stupi u dodir sa svojim nuklearnim able narcissists are difficult and afraid selfom (11, 12). Pomišljala sam da to because they are often a threat to them- više i nije bilo moguće. selves, there is a constant threat of the Moje mi terapeutsko iskustvo pokazuje decomposition of their self, but it seems da se mogu lakše nositi s „krvarećim“ that, once they are offered whatever it is they need to stop bleeding, they are able narcizmima nego s „grandioznima“. to develop mutuality with “their” objects. Ranjivi „narcisi“ teški su, boje se jer This helped me handle more successful- često ugrožavaju sebe i prijetnja je ras- ly the difficult psychological states of L., pada njihova selfa stalna, ali čini se da, whose narcissistic defences were in the kad im se pruži ono što je potrebno da function of psychological survival; over prestanu krvariti, mogu razviti uza- numerous years, persistently and with jamnost sa „svojim“ objektima. Tako great suffering, he developed the capac- sam se uspješnije nosila s često teš- ity to gather “good” introjects in order kim psihičkim stanjima L.-a, kod kojeg to repeatedly gather the authentic frag- 80 su narcističke obrane bile u funkciji ments of his self, which crumbled easily.

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psihičkog opstanka; on je uporno i s In Nika’s case, however, there is the open mnogo boli godinama razvijao kapaci- question of how the lack of the therapist’s tet da skuplja „dobre“ introjekte kako bi empathy or, to be more precise, the thera- mogao uvijek iznova okupljati auten- pist’s continued feeling of being attacked tične djeliće svojeg selfa koji se lako in her empathic function, was connected with Nika’s highly organized manipula- fragmentirao. tive activities. This does not exclude the U Nikinu slučaju ostaje otvoreno pi- position according to which the needs or tanje koliko je zakazivanje terapeu- wishes for exhibitionist (grandiose) or tove empatije, preciznije, terapeutova competitive gratification may occur in kontinuiranog osjećaja napadnutosti the dynamic of the group “along the de- u njegovoj empatijskoj funkciji, bilo velopmental and defensive continuum of the normal need for mirroring”, while pa- povezano s Nikinim iznimno organizi- tients with a disorder of the self may “use ranim manipulativnim agiranjem. To grandiosity defensively in order to pre- ne isključuje stajalište prema kojem serve themselves in the face of height- se u dinamici grupe, „uzduž razvojnog ened feelings of jealousy and anger” (13). i defanzivnog kontinuuma normalne Moreover, there is an even greater danger potrebe za zrcaljenjem“, mogu pojaviti of which Spacal writes (10), saying that potrebe ili želje za egzibicionističkom in similar situations the therapist “may (grandioznom) ili kompetitivnom gra- lose empathy as an observation model tifikacijom, a pacijenti s poremećajem and uncritically engage in the introspec- selfa mogu „možda defanzivno primje- tion of countertransference”, with the njivati grandioznost da bi se očuvali difficulty of separating their own -feel od naglašenih osjećaja zavisti i bijesa“ ings from the ones projected by the pa- (13). Tim više postoji opasnost o kojoj tient. However, I think that there is still govori Spacal (10), tj. da u sličnim okol- the basic experience of Nika’s intrapsy- nostima terapeut „može izgubiti em- chic dynamic, also mirrored within the group, according to which there was no patiju kao model opažanja i nekritički threat of disintegration of a poorly co- se prepustiti introspekciji kontratran- hesive self in frustrating circumstances sfera“ s poteškoćom da odvoji vlasti- (this was an experience the group repeat- te osjećaje od osjećaja koje projicira edly went through and knew well from pacijent. Ipak mislim da, zrcaljen i u the case of L.), but more commonly the grupi, ostaje temeljni doživljaj Nikine manifestation of Nika’s “chronic narcis- intrapsihičke dinamike prema kojem sistic anger” (6), with the consequence nije bila posrijedi prijetnja dezintegra- of attacking and devaluing the therapist cijom jednog slabo kohezivnog selfa u and the group as a whole. While her gran- frustrirajućim okolnostima (to je isku- diose self mainly retained its coherence, 81

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stvo grupa stalno proživljavala i stoga on the level of the group coherence grew dobro poznavala u L.-ovu slučaju), nego (coherence which includes higher levels najčešće manifestacija Nikina „kronič- of cohesiveness), which in the long term nog narcističkog bijesa“ (6) čija je po- resulted in the lessening of the destruc- sljedica bio napad i devaluacija tera- tiveness of the couple that had formed peuta i grupe kao cjeline. Dok je njezin (Nika – T.). It is important to emphasize that it seems, despite it being the subject grandiozni self uglavnom zadržavao of countertransferential questioning, that svoju koherentnost, na razini grupe there were no signs of the “scapegoat” kao cjeline rasla je koherentnost (koja process being developed in the group, obuhvaća više razine kohezivnosti) što which would, along with a silent “secret je dugoročno rezultiralo ublaživanjem connection” with the therapist, exhaust destruktivnosti para koji se formirao the libidinal energy of the group and even (Nika – T.). Pritom je važno istaknuti da lead to leaving therapy (14,15). se čini, premda je to bilo predmet kontratransfernog preispitivanja, kako nije There is the question of how much this bilo znakova da se u grupi razvija pro- view of the psychodynamics of Nika ces „žrtvenog jarca“ koji bi, uz prešutnu and the group leads to a collision with Kohut’s view, according to which aggres- „tajnu vezu“ s terapeutom, iscrpljivao sion connected with narcissistic anger libidnu energiju grupe, pa i doveo do always indicates a specific pathology napuštanja terapije (14, 15). of the self in the sense of its integrative Pitanje je koliko nas takvo viđenje psi- weakness (11). On the other hand, this hodinamike Nike i grupe dovodi u su- takes us back to Kohut’s previous views, kob s Kohutovim gledištem prema ko- according to which narcissistic person- jem agresija povezana s narcističkim alities construct cohesive archaic objects and may preserve a cohesive self (6,16), bijesom uvijek ukazuje na specifičnu but also to other, post-Kohut authors (17), patologiju selfa u smislu njegove inte- according to whom the “assertive set of grativne slabosti (11). Ono nas također emotions” is independent of the disinte- vraća prethodnim Kohutovim stajali- grating states of the self, and aggression štima prema kojima narcistične osob- may actually encourage the constitutive nosti konstituiraju kohezivne arhaične processes in the self (18). This is in line objekte i mogu očuvati kohezivni self with Kernberg’s concept of narcissistic (6,16) te stajalištima nekih drugih, post- personality, according to which narcis- kohutovskih autora (17), prema kojima sistic structures have a stronger self than je „asertivni set osjećaja“ neovisan od borderline ones (19). The fulfilment of dezintegrativnih stanja selfa, a agresija self-object needs (empathic understand- 82 može i potaknuti konstitutivne procese ing without introspective elaboration) in

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u selfu (18). U skladu je i s Kernbergo- such circumstances may be better char- vom konceptualizacijom narcistične acterized as “gratification outside (the de- osobnosti prema kojoj narcistične velopmental) stage” than as therapeutic strukture imaju jači self nego granič- support for the purposes of the transfor- ne (19). Zadovoljavanje selfobjektnih mation of structure. potreba (empatijsko razumijevanje Finally, there is the question of whether a bez introspektivne elaboracije) u ta- patient like Nika may benefit more from kvim okolnostima možda bi se moglo combined therapy (group and individual više okarakterizirati kao „gratifikacija analytic psychotherapy with the same izvan (razvojne) faze“ nego kao tera- therapist), which the leader had applied pijska potpora u svrhu transformacije very successfully for numerous years strukture. with other narcissistic patients.

Naposljetku, postavlja se i pitanje ne bi li pacijent poput Nike možda mogao imati više koristi od kombinirane terapije (grupne i individualne analitičke psihoterapije kod istog terapeuta), koju je voditeljica vrlo uspješno godinama primjenjivala u radu s drugim narci- stičnim pacijentima.

LITERATURA/REFERENCES

1. Pines, M. Group-Analytic Psychotherapy of the Borderline Patient. Group Analysis. 1978: 11/2: 115-125.

2. Anzieu, D. Illusion Groupale. Gruppo. 1985: 1: 110-113.

3. Klain, E., Moro, Lj. Konfrontacija s kontratransferom. Psihoterapija. 1991: 21: 37-42.

4. Nicholas, Mary W. The narcissistic personality in group psychotherapy. Group. 1983: 7 (4): 27-32.

5. Stolorow, RD. Aggression in the Psychoanalytic Situation: An Intersubjective Wiewpoint. Contemp. Psychoanal. 1984: 20: 643-650.

6. Kohut, H. (1971.) Analiza sebstva. Naprijed, Zagreb. 1990.

7. Hinshelwood, RD. Countertransference. Int. J. Psycho-Anal. 1999: 8: 797-818.

8. Kohut, H. Introspection, Empathy, and the Semicircle of Mental Health. Int. J. Psycho-Anal. 1982: 63: 395-407.

9. Bollas, C. Expressive Uses of the Countertransference – Notes to the Patient from Oneself. Contemp. Psychoanal. 1983: 19: 1-33.

10. Spacal, S. Empatija i kontratransfer kao sastavni dijelovi razumijevanja analitičkog procesa. Psiho- terapija. 1991: 21: 49-63. 83

Psihoterapija 2019_1.indd 83 02.09.2019. 6:55:51 Članak

11. Kohut, H., Wolf, ES. The Disorders of the Self and their Treatment: An Outline. Int. J. Psycho-Anal. 1978: 59: 413-425.

12. Slavinska-Holy, N. Kernberg’s Theories: Some Clinical Applications. Group. 1984: 8 (2): 26-34.

13. Stone, WN. On Affects in Group Psychotherapy. In: The Difficult Patient in Group. Ed. BE. Roth, WN. Stone, HD. Kibel. American Group Psychotherapy Association. Int. Univ. Press. Madison. 1990.

14. Lyndon, P. The Leader and the Scapegoat: A Dependency Group Study, Group Analysis. 1994: 27: 95-104.

15. Vlastelica, M. Drop-out as a result of scapegoating in my therapy group. Soc., psihijat., vol. 33 (2005.), br. 3, str. 127-143.

16. Kohut, H. Thoughts on Narcissism and Narcissistic Rage. Psychoanal. Study Child. 1972: 27: 360-400.

17. Stechler, G. Clinical Applications of a Psychoanalytic Systems Model of Assertion and Aggression. Psychoanal. Inq. 1987: 7: 348-363.

18. Lachmann, F. (2004.) Aggression verstehen und veraendern. Stuttgart: Klett-Cotta, Cit. Po Krume- nacker, F.J. 2007.

19. Kernberg, O. Borderline Conditions and Pathological Narcissism. New York, Jason Aronson. 1975.

20. Krumenacker, F.J. Vielleicht bin ich nur geboren, um anderen zu schaden... Kinderanalyse. 2007: 15 (3): 171-205.

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NIKA: DESET GODINA POSLIJE

/ NIKA – TEN YEARS LATER

Zdenka Brumen-Budanko psihijatrica, grupna analitičarka, psihoanalitička psihoterapeutkinja, članica IGA-a i HDPP-a / psychiatrist, group analyst, psychoanalytic psychotherapist, member of IGA and HDPP

Ništa ne znam o pravoj Niki deset I do not know anything about the “real” godina poslije. Tema je ovog osvrta Nika “ten years later”. The topic of this pa- dakako ponovno čitanje „Nike“ deset per is, of course, “a new reading of ‘Nika’ godina poslije. Novo čitanje bilo kojeg ten years later”. A new reading of any text is not just another reading, but a new one. teksta uvijek je ne samo drugo nego i Firstly, the thing that incentivised me to drugačije čitanje. Prvo što me pota- think about everything again is the subti- knulo u novom promišljanju već je tle of the topic I talked about at the Round podnaslov teme koju sam iznijela na table: The narcissism of the therapist and Okruglom stolu: „Narcizam terapeuta the narcissism of the group. The subtitle i narcizam člana grupe“. Podnaslov je was assigned, the presentation adjusted, bio zadan, izlaganje prilagođeno, ali but there were true psychodynamically bilo je i psihodinamički opravdanih justified reasons for the adjustment to razloga da prilagodba podnaslovu ne the subtitle not to be “strained” because mora biti „nategnuta“ zbog zadatka. of the task. Even so, despite numerous Pa ipak, danas bih unatoč mnogim noticeable elements of narcissism, now- uočljivim elementima narcizma kao adays I would rather put the following podnaslov radije navela: Kontratran- as the subtitle: Countertransferentially instigated storm of the therapist’s own sferno potaknuta bujica terapeutovih “memories” and memories, at the time „sjećanja“ i sjećanja Nikinim ulaskom when Nika joined the group. (As a side u grupu. (Usputna napomena, riječ je o note, this was an open-door group ana- grupno-analitičkoj grupi odškrinutih lytic group which had at the time when vrata koja je svoj grupni život u vrije- Nika joined it existed for 17 years; the me Nikina dolaska neprekidno živje- continuity was maintained when new la već punih 17 godina; kontinuitet se members joined by two or three “old” održavao postojanom poveznicom pri members of the group, the “guardians” of ulasku novih članova, putem još uvijek tradition.) 85

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prisutna dva ili tri „stara“ člana grupe, Nika was a young, educated, intelligent „čuvara“ tradicije.) woman, her head full of numerous psychotherapeutic techniques, some of Nika je bila mlada, obrazovana, inteli- which she had already tried since they gentna žena, oduševljena procvatom were available on the “free market”. The velikog broja psihoterapijskih tehnika group leader, on her part, has a strong od kojih je neke već isprobala, s obzi- belief in the psychoanalytic theory as rom na mogućnosti njihova izbora „na the basis of clinical psychotherapeutic slobodnom tržištu“. Voditeljica grupe methods. Most commonly, through the radi s postojanim povjerenjem u psi- attention of the leader and the entire de- hoanalitičku teoriju kao temelj klinič- veloped group, the new member gradual- kih psihoterapijskih metoda. Najčešće ly grasps the basis of how the group func- se događa da pozornošću voditeljice, tions without “learning” about it, through pa i cijele razvijene grupe, novi član the power of the effect of the specifics postupno hvata osnovnu nit rada bez of communication in the analytic group with its method of “free floating discus- posebnog „učenja“ o tome, snagom sion”. From the very beginning, Nika učinka specifičnosti komunikacije u showed resistance to this form of work- analitičkoj grupi s njezinom metodom ing within a group. „slobodno lebdeće diskusije“. Nika je od početka pokazivala snažan otpor pre- I say this for the sake of facts, and ma takvoj vrsti rada u grupi. everything else that occurred in the aforementioned snippets of the group’s To navodim radi činjenica, a sve ostalo work is connected with the specificity of što se događalo u prikazanim isječcima the leader’s countertransference, which rada grupe povezano je i sa specifično- was suddenly and unusually strongly šću voditeljičina kontratransfera, koji developed with Nika’s entrance into the se nenadano i neobično snažno razvio group. High, white, untied boots worn by ulaskom Nike u grupu. Visoke bijele Nika were a trigger for the development nepotpuno zavezane Nikine čizme bile of this countertransferential burgeoning, su samo otponac za razvoj toga kontra- which was apparently but conscious- transfernog razbuktavanja, prividno, tj. ly and carefully supervised. Apart from svjesno, pažljivo nadgledavana. the outlined episode set in Mirogoj, with the tightly tied laces of her sister’s high U voditeljičinu se doživljaju osim pri- shoes of an ugly colour on her own feet, a kazane „mirogojske epizode“ s čvrsto deeper drama from the leader’s childhood međusobno zapetljanim vezicama vi- was taking place in her experience. This sokih sestrinih cipela ružne boje, na was connected with the facts from Nika’s 86 vlastitim nogama, događala i dublja childhood, which had been expressed in

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drama iz voditeljičina djetinjstva. To the group and which had, through merely je bilo povezano s činjenicama iz Ni- distant and superficial similarity, deeply kina djetinjstva iskazanim u grupi što shaken me, the leader, and paradoxically je, iako samo s dalekom i površnom truly diminished my empathic readiness sličnošću, mene, voditeljicu, duboko towards Nika, while increasing counter- potreslo i paradoksalno uistinu uma- transferential resistance to understanding Nika. Still, I believe that what I said njilo moju empatijsku spremnost za according to Spacal (1991) holds true Niku, a pojačalo kontratransferne ot- even today: that introspection of coun- pore prema njezinu razumijevanju. tertransference may successfully per- Vjerujem ipak da i danas stoji ono što form the task of studying the group sit- sam prema Spacalu (1991.) već navela uation (unless there is an uncritical form u prikazu: da se introspekcijom kon- of questioning countertransference). I tratransfera može uspješno provesti believe that I truly managed to overcome zadatak istraživanja grupne situaci- the short phase of countertransferential je (ako ne dođe do nekritičkog oblika resistance and return to controlled (suffi- ispitivanja kontratransfera). Vjerujem ciently critical; maybe today I would add da sam doista uspjela prevladati kraću a question mark?) introspection of my fazu kontratransfernog otpora i vratiti own emotions and experiences stirred se kontroliranoj (dovoljno kritičkoj; no by the resemblance of Nika’s and my možda bih ipak sada stavila i upitnik) own biographical narrative. I believe that introspekciji vlastitih osjećaja i doživ- mine are at the basis of my own narcis- ljavanja koje je pobudila sličnost Ni- sistic vulnerability. kinih i mojih biografskih narativa. Za The narrative similarities are, in short, svoje vjerujem da su u temeljima moje the following: neither Nika nor I were narcističke ranjivosti. born in the cities in which we have lived since the earliest months of our lives. Narativne sličnosti ukratko su sljede- The reasons for this are different but may će: Nika, kao ni ja, nije rođena u gra- in both cases be reduced to “external” cir- du u kojem živimo od svojih prvih cumstances, which caused our mothers mjeseci. Razlozi su za to različiti, ali u to return to the places where their own oba se slučaja mogu svesti na vanjske mothers lived, for a period of time before okolnosti koje su potaknule vraćanje they gave birth, so both Nika’s and my naših majki u mjesta života njihovih birth (with a thirty-year difference) oc- majki neko vrijeme prije porođaja pa curred in those places. Both Nika and I se i Nikino i moje rođenje (s tridesetak love our cities and would gladly include godina razlike) tamo i dogodilo. Nika i them in our birth certificates and our- ja volimo svaka svoj grad i rado bismo selves as the places where we were born. 87

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ih u matične knjige i u sebe upisale kao There are further similarities, but I think svoja mjesta rođenja. Daljnjih sličnosti they are less important. According to ima još, ali mislim da su manje važne. the belief of our profession in the time of Mislim da sam svoje kontratransferne Nika’s therapy, I think that I supervised my countertransferential memories osjećaje, kako je u vrijeme Nikine tera- well. Therefore, countertransference did pije još uvijek i vrijedio „nauk“ u našem not afford me a chance (nor did I create pozivu, „uredno“ nadgledala. Nije mi se one for myself) for establishing a more stoga iz kontratransfera stvorila prilika flexible contact with Nika’s pronounced (nisam si je omogućila) za uspostav- conflict relationship with her mother, ljanje fleksibilnijeg dodira s Nikinim which was, of course, transferred to her naglašenim konfliktnim odnosom s transferential relationship, but also to njezinom majkom što se, dakako, pre- several lateral transferences towards nosilo u njezin transferni odnos, ali i group members. u nekoliko lateralnih transfera spram Regarding my birth, despite numerous članova grupe. analytical attempts, I have not succeeded Što se mojeg rođenja tiče, unatoč mno- in discovering in myself the related mo- tivation for being angry with my mother, gim analitičkim pokušajima nisam of which there was little and was fairly uspjela otkriti u sebi s tim povezane rarely manifested. There was always motive ljutnje na svoju majku, koje je a certain quiet sadness about Zagreb, uostalom bilo malo i doista se rijetko which I love, which has always been and manifestirala. Preostajala je uvijek is not completely my city, and an equal- samo neka tiha žalost zbog Zagreba ly quiet jealousy towards my sister, with koji volim, koji zauvijek jest, ali nije po- whom I had a strong connection. As if I sve moj grad, i vrlo tiha zavist prema understood that after the war, it was dif- sestri za koju sam bila snažno emo- ficult to find a lot of things in Zagreb, -in tivno vezana. Kao da sam razumjela cluding shoes. Still usable because chil- da je u poratnom Zagrebu uistinu bilo dren would quickly outgrow them, shoes would usually be inherited by a younger teško pribaviti mnogo toga, pa i obuću. child. However, my sister was also born Još uščuvane jer bi ih djeca brzo „pre- in Zagreb. And, along with that, other rasla“, cipele bi bilo normalno ostaviti similar “titbits”. mlađem djetetu na uporabu. Ali sestra je usto još i rođena u Zagrebu. I tomu There is, however, a more significant slične dodatne „sitnice“. situation which affected the unfavoura- ble transferential/countertransferential Postoji međutim mnogo važniji trenu- constellation in Nika’s therapy, which I 88 tak koji je utjecao na nepovoljnu tran- said nothing about in my overview from

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sferno-kontratransfernu konstelaciju ten years ago. Due to her mother work- u Nikinoj terapiji o kojem u prikazu ing abroad, for the first year of her life otprije deset godina nisam napisala ni Nika lived with the other members of riječi. Nika je zbog „gastarbajterskih“ her family in her city, while her mother okolnosti njezine majke u prvoj godi- performed her job in one of the Europe- ni života ostala s ostalim članovima an countries. In my tenth month (which was around the final stage of breastfeed- obitelji u svojem gradu dok je njezina ing), my mother took my sister and me to majka obavljala svoj posao u jednoj “visit” our grandmother and her older sis- od europskih zemalja. Moja je majka u ter, who lived with our grandmother, for mojem približno desetom mjesecu ži- “a week or two”, according to our family vota (završavajući s mojim dojenjem) story, so that she and our father could re- sestru i mene „na tjedan-dva“ (tako ide solve certain problems with our home in obiteljska priča) odvela „u goste“ našoj Zagreb. She would have been unable to do baki i svojoj starijoj sestri s kojom je this while worrying, like many of those baka živjela kako bi ona i otac u Zagre- living in Zagreb, about purchasing milk bu riješili neke stambene probleme. To and other necessities in the surrounding ne bi mogla obaviti brinući se, kao i ve- villages, often by walking to them if there lik broj stanovnika Zagreba, za nabavu was no transport to be found. This was mlijeka i ostalih potrepština u okolnim one of the hardest years of the Second selima, često i pješačeći do njih ako World War. In the large village of Nijem- se ne bi našao kakav prijevoz. Bila je ci in Srijem, where I was born, there was to jedna od najtežih godina Drugoga still milk and other food. svjetskog rata. U velikom srijemskom I remember how, very early in my child- selu Nijemcima u kojem sam rođena hood, I wondered how, in a time of fierce bilo je još uvijek mlijeka i druge hrane. battles and sudden night attacks with explosives that targeted railroads, my Sjećam se kako sam se već vrlo rano u mother had the courage to travel long djetinjstvu pitala kako se to moja maj- distances by railway with two little chil- ka u vrijeme žestokih ratnih događaja dren: among other things, she needed u koje su se ubrajali i nenadani noćni official passes to travel. What was the napadi eksplozivom upravo na želje- source of this desire to maintain contact zničke linije usudila s dvoje male dje- with her family in such difficult times? ce putovati željeznicom na toj zapravo The Allied bombings of Zagreb, which dugoj relaciji: među ostalim, za puto- started at the time of this second trip af- vanja su joj bile potrebne i službene ter my birth and arrival in Zagreb, when I propusnice. Odakle je potjecala snaga was less than two months old, and which te želje da u tako teškim okolnostima were (later, of course) used to explain to 89

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održava kontakt sa svojom rodbinom? me this second trip, were, it seems, a suf- Saveznička bombardiranja Zagreba ficiently strong argument for me to stop koja su započela u vrijeme tog dru- asking further questions out loud. gog putovanja poslije mojeg rođenja i “A week or two” turned into eight long mojeg dolaska u Zagreb s nepuna dva months without my mother. In the mean- mjeseca, oko pola godine kasnije, i ko- time, the so-called Srijem frontline was jima mi je to drugo putovanje (kasnije, opened, a large, protracted, bloody battle naravno) objašnjeno, bila su, izgleda, in a war that would end in less than a dovoljno snažan dodatni argument da year. Different armies came to Nijemci, dalje naglas ne postavljam pitanja. and the population, which was of various leanings, became refugees, depending „Tjedan-dva“ pretvorilo se u dugih on their individual situations; most com- osam mjeseci, bez majke. U međuvre- monly everyone would leave because it menu je otvoren takozvani Srijemski was difficult to predict which army would front, velika, dugotrajna i krvava bitka enter their houses in which night. It was rata koji će završiti za nepunu godinu possible to return, during quiet periods, dana. U Nijemcima su se počele smje- but they would run away again after that. njivati vojske, a stanovništvo, različitih The final period of our family living as opredjeljenja, odlazilo je u izbjeglištvo refugees lasted for months. My sister and ovisno o situaciji; najčešće su odlazi- I were constantly with our grandmother li svi jer je bilo teško predvidjeti koja because other children had their moth- će vojska koje noći ući u njihove kuće. ers (our two aunts, our mother’s sisters). Povremeno bi se mogli vratiti, za za- After the impermanence of coming and tišja, a nakon nekog vremena ponovo leaving, our grandmother decided to take bi morali pobjeći. Posljednje izbjegliš- us to the town where she was born, an old town in Srijem which still bears the same tvo naše obitelji trajalo je mjesecima. name from the time of ancient Rome, Moja sestra i ja bile smo neprestano uz and through which numerous Panno- baku jer su druga djeca uz sebe imala nian wars have swept through over the svoje majke (naše dvije tete, mamine millennia, and still it has survived. There sestre). Baka je nakon nestalnosti odla- were no more battles taking place in it by zaka i povrataka odlučila s nama otići then, so my grandmother’s mother (our u svoj rodni grad, stari srijemski grad great-grandmother) and my grandmoth- koji svoje ime i danas nosi prema ime- er’s brother took us in. Our mother, who nu iz starorimskog vremena, i kojim was in Zagreb (the railroad tracks were je tijekom tisućljeća prohujalo mnogo then truly cut off), did not know where we panonskih ratova, a ipak je opstajao. U were or if we were even alive up until the 90 njemu se tada više nisu vodile borbe i very end of the war. There is a story that

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bakina majka (naša prabaka) i bakin she went grey overnight. I really do not brat su nas prihvatili. Naša majka u remember her as having a black head of Zagrebu (pruge su tada doista bile pre- hair, which is what she had looked like sječene) gotovo do pred kraj rata nije according to photographs. At some point znala gdje smo ni jesmo li uopće živi. she received news about us and managed to travel to the village using the first re- Govorilo se da je „preko noći“ posijedi- paired railway, which the German army la. Doista je se ne sjećam kao izrazito was using for their retreat. I did not rec- crnokose kakva je bila, i prema fotogra- ognize her and refused to approach her. fijama. Nakon nekog je vremena, ipak She took out dolls from her bag which dobivši vijesti o nama, prvim poprav- she had sewn herself out of something ljenim kolosijekom pruge kojom se još filled with soft fabrics and for which she povlačila njemačka vojska, uspjela do- had used heads from torn dolls from putovati. Nisam je prepoznala, odbijala neighbourhood children and dressed sam joj prići. Izvadila je iz torbe lutke them in clothes. She offered me one and koje je sama sašila od tkanina ispu- I accepted it. (They say my older sister njenih nečim mekanim te im stavila immediately ran over to our mother.) „prave glave“ od potrganih lutaka dje- Holding the doll, I sat in my mother’s lap ce iz susjedstva i obukla im haljinice. (according to the story, I do not remem- Jednu mi je pružila i prihvatila sam ber this; I was not yet two years old) and je. (Starija sestra, govorili su, odmah je started telling her something. Our father came for us and soon we all returned dotrčala do nje.) S lutkom u ruci sjela to Zagreb. Several years ago, I needed a sam mami u krilo (tako ide priča, ja se new birth certificate for some legal work. toga ne sjećam; nisam još imala dvije One of my cousins was in charge of the godine) i počela joj nešto govoriti. Otac municipal office and the birth registry, je došao po nas i uskoro smo se svi vra- so acquiring copies while I was far away tili u Zagreb. from Zagreb was never a problem. Now, however, there had been a change in the Prije nekoliko godina trebala sam zbog municipal office, and I was told that the nekog pravnog posla novi rodni list. documents from 1943 had been burned in Jedna moja rođakinja vodila je općin- the previous war in Croatia because the ski ured, pa i matice rođenih, te mi pri- place had been occupied and they had no bavljanje izvadaka daleko od Zagreba record of me. My birth certificate issued nikad prije nije bilo teško. Sad mi je, by the police administration in Zagreb međutim, iz u međuvremenu promi- was made on the basis of the most basic jenjenog općinskog središta rečeno da data from the earlier copies. It no longer su dokumenti za 1943. godinu spaljeni contains the note I have saved in my u prošlom ratu u Hrvatskoj jer je mjesto original certificate of christening: “Born 91

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bilo okupirano i da „mene nemaju“. Moj in Nijemci, where her mother had been rodni list u Policijskoj upravi zagrebač- staying with her relatives.” Her parents’ koj sastavljen je od osnovnih podataka residency: Zagreb. starijih izvoda. U njemu više ne stoji This how a shortened story, which is zabilješka koju imam u sačuvanom ori- in reality filled with much more detail, ginalnom krsnom listu: „Rođena u Ni- about what significantly affected my jemcima gdje joj je majka boravila kod development and life, can be condensed rodbine. Prebivalište roditelja: Zagreb.“ in one transferential/countertransferential process of an individual or group Evo koliko skraćena, a u zbilji s još analytic psychotherapy. Also, it can mnogo važnih detalja ispunjena priča affect the extremely sensitive relation- o onome što je zacijelo nemalo utjeca- ship between countertransference and lo na moj razvoj i život, može biti zgu- empathy, beside the mutual narcissistic snuta u transferno/kontratransfernom aspects of the aforementioned thera- procesu jedne individualne ili grupne peutic relationship. Actually, if I think analitičke psihoterapije. I utjecati, about it again, the subtitle of the over- među ostalim, na krajnje osjetljiv od- view about Nika does not express the nos kontratransfera i empatije, i mimo core of that relationship very precisely. obostranih narcističkih aspekata tog I hope that Nika’s grandiose/crumbling terapijskog odnosa. Zapravo, razmis- structure (which I now believe was more lim li ponovo, podnaslov prikaza o Niki defensive than structural in the sense doista ne pogađa baš precizno bit tog of personality) found a balance by Ni- odnosa. Nadam se da je grandiozna/ ka’s further maturation. I am inspired to urušavajuća Nikina struktura (za koju hope for this by the surprising maturity ipak sad vjerujem da je više obrambe- of the “negotiation” about her leaving the group, which we paid a lot of atten- nog nego strukturnog karaktera u smi- tion to, along with a constructive and slu osobnosti) pronašla ravnotežu Ni- emotionally very engaged cooperation kinim daljnjim sazrijevanjem. Za to mi of the entire group. Thus, Nika’s depar- nadu daje čak i iznenađujuća zrelost ture, although premature, proved to be „pregovora“ oko njezina izlaska iz gru- very fruitful for both Nika and the group. pe, kojima smo posvetili mnogo pozor- And how about the group’s leader? For nosti, uz konstruktivno i emocionalno her, for some unexplained reasons, it left vrlo angažirano sudjelovanje cijele another layer of her own “story”, which grupe. Tako se Nikin izlazak, iako preu- had first stopped her from using coun- ranjen, zapravo provodio neočekivano tertransference for therapeutic purpos- plodonosno i za Niku i za grupu. A vo- es, significantly increasing her coun- 92 diteljici grupe? Njoj je, zbog ustvari još tertransferential caution, and then, “ten

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ne posve providnih razloga, ostavio još years later”, once again opened sources jedan sloj njezine vlastite „priče“ koja of intense excitement. joj je jednom zakočila slobodu primje- Under the influence of the latter, which ne kontratransfera u terapijske svrhe, perhaps makes it more difficult to fin- povećavajući do krajnjih granica kon- ish this overview, instead of measuring tratransferni oprez, a drugi put, deset blood pressure and taking another med- godina poslije, ponovo jednom otvorila icine, I wish to describe one of the unfor- izvore snažnog uzbuđenja. gettable scenes connected with Nijemci, where I have not been for decades (since Potaknuta time, što mi možda otežava my grandmother’s death: most of the završetak osvrta, umjesto da izmjerim rest of my family has gradually moved krvni tlak i uzmem dodatni lijek, imam to Zagreb). It happened like this: I am a želju prikazati jednu od nezaboravnih little over five years old, it is Christmas scena povezanih s Nijemcima, u koje the next day, it is still officially allowed već desetljećima ne odlazim (od baki- to celebrate it and have a day off work. ne smrti: ostatak rodbine postupno se My family travels by fast train to Nijemci. većim dijelom preselio u Zagreb). Bilo From the train station to the village there je to ovako. Imam nešto više od pet go- are six or seven kilometres. Snow has dina, Badnjak je, Božić je još i službeno covered the endless plain, it is white and dopušteno obilježavati i imati neradni sparkling in the dusk that is an unreal dan. Moja obitelj putuje brzim vlakom blue-green light-and-dark over the white- za Nijemce. Od stanice vlaka do mje- ness, one which, it seems to me, I have sta ima šest-sedam kilometara. Snijeg never seen since then. A large sleigh with je prekrio beskrajnu ravnicu, cjelovit je, two horses came to pick us up at the train bijel i sjajan u sumraku koji je nestva- station, and the horses had bells, which I know because horses stomp their legs, ran modrozelenkast „svjetlomrak“ nad impatiently waiting to leave, and the bells bjelinom i kakav, čini mi se, nikad više ring with the stomping of the horses’ nisam vidjela. Po nas su došle velike hooves. The sleigh is being ridden by my saonice s dva upregnuta konja s pra- mother’s childhood friend, they call him porcima – to znam jer konji topću no- Pavel. He is cheerful, smiling. We slide, gama, nestrpljivi da krenu, a praporci relaxed, followed by the sound of bells. zveče u skladu s topkanjem konjskih My parents start some serious conversa- nogu. Saonicama upravlja mamin tion with Pavel, and it seems to me that prijatelj iz djetinjstva, zovu ga Pavel. he is no longer smiling. Years later I real- Vedar je, nasmijan. Klizimo opušteno ise what they had been talking about. He uz zvon praporaca. Roditelji s Pave- is a descendant of “Danubian Germans”, lom započinju neki ozbiljan razgovor i perhaps the only one left in this region, 93

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meni se čini da on više nije nasmijan. while the others have been chased away Godinama kasnije shvaćam o čemu or they “chose” to leave. Those were my su razgovarali. On je potomak „podu- mother’s good pre-war friends. Through navskih Švaba“, možda jedini preostao one of them our mother finally received u tom kraju, ostali su protjerani ili su news about us while we were refugees. „izabrali“ odlazak. Bili su to dobri pre- Pavel wore high, laced boots. Even today, I am completely certain about this. dratni mamini prijatelji. Preko nekoga od njih mama je za našeg izbjeglištva Can an emotionally charged “story” like napokon dobila vijesti o nama. Pavel je this, which a therapist encounters within nosio visoke zavezane čizme. To još i themselves in some countertransferen- danas posve pouzdano znam. tially instigated moment, truly be “used” for a therapeutic intervention, whatever Može li se takva ili slična emocijama the category we place it under? Or is a nabijena priča, na koju terapeut u sebi “story” like that more appropriate for a naiđe u nekom kontratransferno po- quiet contemplation, perhaps after a ses- taknutom trenutku, doista „iskoristiti“ sion, for thinking about a patient during za ljekovitu intervenciju u kakvu je the entire therapy, for the estimation of god podvrstu od mogućih svrstali? Ili “which of this is just mine”. There are so je takva priča prikladnija za tihu kon- many ways to overcome separations that templaciju, možda poslije seanse, za happen too early, and perhaps this coun- razmišljanje o pacijentu tijekom cije- tertransferentially awakened “content” le terapije, za prosudbu „što je od toga does not have to be, despite the associ- ipak samo moje“? Toliko je načina da se ations that emerge with emotions, in- prebrode preuranjena odvajanja; i mož- corporated into the therapeutic process, da ne treba tu kontratransferom probu- merging elements that may come from entirely different psychodynamic layers đenu „građu“ unatoč asocijacijama koje of the patients and the therapist, despite se pojavljuju uz emocije ugrađivati u external similarity; in any case, one must terapijski proces, sjedinjavati elemente be careful, even at the cost of a “lack” of koji možda potječu iz sasvim različitih empathy and a surplus of countertrans- psihodinamičkih slojeva pacijenta i ference, in case this can be done without terapeuta, unatoč vanjskoj sličnosti; u countertransferential opening. Empathy svakom slučaju treba biti oprezan, pa is still, along with everything else, truly i uz cijenu „manjka“ empatije, a viška an “inner research method”, but this is kontratransfera, ako se s pacijentom something the introspection of counter- može ophoditi i bez kontratransfernog transference can also be. If there is truly otvaranja. Empatija je ipak, uz ostalo, no empathy, but there is a disturbing, un- 94 uistinu i „unutarnja istraživačka me- critical countertransference, it is neces-

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toda“, ali to može biti, znamo, i intros- sary to study the causes thoroughly and pekcija kontratransfera. Ako empatije openly towards oneself. Even “ten years doista nema, ali ima ometajućeg, ne- later”, I do not have the feeling that I did kritičkoga kontratransfera, treba te- not feel empathy for Nika. The most I can say is that my empathy was some- meljito i otvoreno spram sebe istražiti how “resting”. As if I was waiting to see uzroke. Ni deset godina poslije nemam what would happen next, with a feeling osjećaj da nisam spram Nike osjećala that I do not have to hurry anywhere, and empatiju. Najbliži mi je doživljaj da je to deal with my own problems in myself, moja empatija nekako „mirovala“. Kao while I follow and listen to Nika (!; per- da sam postojano čekala kako će biti haps the quote from the overview about dalje, uz osjećaj da nikamo ne trebam insufficient empathic listening was not žuriti, a da se svojim bavim u sebi, dok entirely appropriate in our case? But it Niku pratim, slušam (možda citat iz could not have been chosen by accident.) prikaza o nedostatnom empatijskom I think that there was no lack of connec- slušanju i nije bio posve primjeren u tion between the listening and her inter- našem slučaju; no ipak nije mogao biti actions in the group, with the direction of group communication, and Nika’s con- ni slučajno odabran). Mislim da nije tributions to this communication, my at- nedostajalo povezivanja tog slušanja tempts to understand her when, through s njezinim interakcijama u grupi, sa some “external” or group occurrence felt smjerom kojim su se kretali grupna the need to interrupt it or be dramatic. komunikacija i Nikini doprinosi toj Would countertransferential opening komunikaciji i pokušaja da razumijem have helped in this case? I think it would kad ju je ona nekim vanjskim, a kad have only made the group process more unutarnjim grupnim zbivanjem imala dramatic, it being already “shaken up” by potrebu prekinuti ili dramatizirati. Bi li T.’s need for shortcuts even before Nika pomoglo kontratransferno otvaranje? joined the group. On the one hand, with Mislim da bi ono samo pridonijelo dra- her choice of words and her pronun- matiziranju grupnog procesa, koji je ciation (she sounded like the patter of soft rain, that is what it seemed like to već bio „uzdrman“ T.-ovim potrebama me; this could be an effective sound in za prečacima i prije Nikina ulaska u a scene of some “art” movie, it occurs to grupu. Nika je odabirom riječi i nači- me now), she quieted T.’s noise of impa- nom na koji ih je izgovarala („romorila“ tience. On the other hand, by inviting the je kao tiha kiša, tako mi se činilo; mo- group in a more “intense” life, she herself gao bi to biti učinkovit zvuk uz scenu increased the drama of the sessions. The nekog art-filma, pada mi sad na pamet) need for a more “intense” life could surely izvanjski utišavala buku T.-ove drame be connected with the state of depriva- 95

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nestrpljivosti. No pozivajući grupu na tion of an infant who is left without its „intenzivniji“ život, sama je povećava- mother’s care, whatever the fortunate or la dramatiku seansi. Potreba za „inten- unfortunate replacement of the primary zivnijim“ životom zacijelo bi se mogla object it receives, with all the implica- tions this has for its later stages of de- povezati s uskraćenošću djeteta doje- velopment and life. Could we, in relation načke dobi koje je ostalo bez majčine to this, now return to the question from skrbi, kakvu god, više ili manje sret- the overview related to the “possible un- nu ili nesretnu zamjenu primarnoga conscious defensive actions of the leader, objekta dobilo, sa svim implikacijama who seemed to be drawn, along with the na njegove kasnije razvojne i životne patient, into action in a ‘stimulating fan- faze. Bismo li se s tim u vezi sad mogli tasy’, and soon, through the introspection vratiti na pitanje u prikazu povezano of her subjective experience, understood „s mogućim nesvjesnim obrambenim her own emotions more thoroughly.” Ni- potezima voditeljice, kao da je s paci- ka’s phases of grandiosity and sinking, jenticom bila uvučena u agiranje u jed- with the consequence of anger, could be noj ‘pobuđujućoj fantaziji’, da bi ubrzo understood precisely from the position of early deprivation, the withdrawal of introspekcijom svojeg subjektivnog something good and “great” which she doživljaja dublje zahvatila i razumjela had already experienced. The sinking vlastite osjećaje“? Nikine faze gran- stages had to follow because of her moth- dioznosti i potonuća s posljedičnim er’s departure, and later because of the gnjevom mogle su se razumjeti upravo experiences of various losses of narcis- s pozicija rane uskraćenosti, oduzima- sistic gratification, which would be suc- nja nečega dobroga i „velikoga“ što je ceeded by an outburst of anger, but Nika već bila iskusila. Stanja potonuća nuž- refused to deal within the group with her no su morala uslijediti majčinim odla- extreme and rapid mood swings. Only in skom, a kasnije doživljajima različitih the aforementioned stage of “negotiation” gubitaka narcističke gratifikacije -na about her decisively announced depar- kon kojih bi uslijedio napadaj gnjeva, ture, which she processed in the group for almost a year, could one recognize ali Nika je u grupi odbijala bilo kakvo that the group’s efforts had contributed to istinsko bavljenje svojim ekstremnim the creation and sedimentation of traces i brzim promjenama raspoloženja. of the internalizing process of a some- Tek u fazi „pregovaranja“ oko njezina what altered direction within Nika’s in- odlučno najavljenoga te zatim u gru- trapsychic reality. Unfortunately, her de- pi gotovo godinu dana prorađivanog parture from the group, caused by, among izlaska iz grupe moglo se prepoznati other reasons, her life circumstances at 96 da su se nastojanjem grupe u Nikinoj the time, could not be prevented. I can

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intrapsihičkoj stvarnosti počeli stva- only hope that the traces of internaliza- rati i taložiti tragovi internalizirajućeg tion of the “good thing” she received in procesa ponešto promijenjenog smje- the group were able to attract other good ra. Nažalost, njezin izlazak iz grupe, things from her surroundings in her fur- među ostalim i zbog složenog sklopa ther processes of internalization (is this not the potential life-long process?) and njezinih tadašnjih životnih okolnosti, strengthen her existing, primary ones nije se mogao spriječiti. Preostaje mi and ones already merged with traces nadati se da su tragovi internalizacije created within the group. „dobre tvari“ koju je dobivala u grupi mogli kod nje u njezinim daljnjim pro- To remind myself once again of the cesima internalizacije (Nije li to poten- thoughts mentioned in the overview, cijalni cjeloživotni proces?) privlačiti i when for numerous reasons empathy is nove, iz okruženja, i jačati njezine već not used as a research method per si (Ko- hut, 1971), the introspection of counter- postojeće, primarne i one stopljene s transference (but not an uncritical one!) tragovima nastalim u grupi. may be used to successfully complete Da se još jednom prisjetim misli već the task of studying the group situation rečenih u prikazu: (according to Spacal, 1991.).

„Kad se zbog različitih razloga ne primjenjuje empatija kao istraživačka metoda per se (Kohut, 1971.), introspekcijom kontatransfera (Ali ne nekri- tičkom!) može biti uspješno proveden zadatak istraživanja grupne situacije“ (prema Spacalu, 1991.).

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NARCISTIČKI BIJES ČLANA GRUPE

/ NARCISSISTIC RAGE IN A GROUP MEMBER

Slavica Pavlović

SAŽETAK/ABSTRACT U korijenu narcističke patologije su višestruka i kumulativna traumatska iskustva najčešće u ranom uzrastu, koja se mogu reaktivirati u analitičkoj grupi. Repeticija takvih iskustava u grupi nosi s jedne strane snažan potencijal za promjenu pojedinog člana, dok istovremeno može biti prijetnja za drugog člana, terapeuta, ali i opstanak grupe. Vjerojatno pojava narcističkog bijesa u analitičkoj grupi nije tako česta, ali je vrlo neugodna i krajnje delikatna pojava. Narcistički bijes može ugroziti i razoriti ‘kao da’ kvalitet grupnih interakcija i komunikacija. Voditelj je u posebnim iskušenjima. Njegova uloga je delikatna kada postoji rizik da bi aktivirani narcistički bijes mogao izmaći kontroli i biti usmjeren prema nekom članu grupe. Takav proboj narcističkog bijesa može zahtijevati od voditelja da izađe iz svoje analitičke uloge i direktno intervenira kako bi zaštitio pojedinog člana ili grupu. Pacijentu bi trebalo pomoći u otkrivanju izvora bijesa (‘tamo i nekada’) i proraditi vezane osjećaje i fantazije sa ‘ovdje i sada’. Grupi bi prije svega trebao pomoći da preživi tu destruktivnu fazu i iz nje izađe bez značajnijih oštećenja empatijskog kapaciteta. Opisani procesi su ilustrirani kliničkim materijalom. / Narcissistic pathology is routed in multiple and cumulative traumatic experiences usually taking place at an early age and which can reactivate in group analysis. The repetition of such experiences in the group has, on the one hand, great potential for effecting change in the individual member, while simultaneously being a potential threat for other group members, the therapist, and the survival as the group as whole. It is likely that the manifestation of narcissistic rage in group analysis is not very common, but it is a very uncomfortable and extremely delicate event. Narcissistic rage can threat- en and destroy the quality of verisimilitude in group interaction and communication. The therapist is especially tempted. Their role is at its most delicate when there is a risk that the activated narcissistic rage could spin out of control and become directed towards a member of the group. Such a surge of narcissistic anger may require the therapist to step out of their analytical role and directly intervene to protect an individual member or the group as a whole. The patient should be helped to identify the source and the rage (“then and there” and process these feelings and fantasies with the “here and now”. The group should above all 98

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be helped to survive this destructive phase without significant damage to its emotional capacity. These processes are illustrated through clinical materials herein.

KLJUČNE RIJEČI / KEY WORDS

Grupna analiza / Group analysis, narcistički bijes / narcissictic rage

Slavica Pavlović, psihologinja, grupna analitičarka / Slavica Pavlović, psychologist, group analyst

TERAPIJSKI PROSTOR GRUPE I THE THERAPEUTIC SPACE OF ZDRAVI NARCIZAM THE GROUP AND HEALTHY NARCISSISM Ashbach i Schermer uočavaju da se Kohut i Foulkes slažu u tome da je Ashbach and Schermer have noticed primarna funkcija grupe empatijsko that Kohut and Foulkes agree on the fact zrcaljenje selfa te da članovi grupe pu- that the primary function of a group is tem transfera imaju priliku obnoviti i empathic mirroring of the self and that ojačati koheziju selfa i osloboditi veći group members have the opportunity to prostor za razvoj autentičnoga na ra- restore and strengthen the cohesion of čun lažnoga selfa (1). Grupa članovima the self through transference, freeing up more space for the development of the postaje korektivni selfobjekt, koji pruža authentic self at the expense of the false ugodno iskustvo stapanja s idealizira- self (1). The group becomes the corrective nim objektom, koje „hrani“ autentični self-object, which offers the pleasant ex- self, održava i jača njegovu koheziju. perience of fusion with an idealised ob- Premda je ulazak u grupu narcistička ject, which “feeds” the authentic self and ozljeda, potraga za izgubljenom sve- maintains and strengthens its cohesion. moći i grandioznošću i za infantilnim Although joining a group is an injury of zrcaljenjem snažni su motivi zbog narcissism, the search for lost omnipo- kojih pacijenti ulaze u grupu. Korijeni tence and grandiosity, as well as the need potrebe za empatijskim zrcaljenjem u for infantile mirroring, strongly motivate simbiotskoj su fazi iz koje potječu fan- patients to join a group. The roots of the tazije i potrebe za stapanjem – jedin- need for empathic mirroring are in the stvom s objektom, kojima se pridružuju symbiotic stage, from which fantasies and grandiozno-omnipotentne fantazije. the need for a fusion with an object stem, 99

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Terapijska grupa pacijentima pruža and they are joined by fantasies of gran- ponovnu priliku da se infantilno, grandiosity and omnipotence. A therapeutic diozno, idealizirajuće i svemoćno pre- group offers patients another chance to cjenjuju i zrcale. Međutim, empatijska overestimate and mirror themselves in an komunikacija i neposredno korektivno infantile, grandiose, idealised and omnip- emocionalno iskustvo putem interak- otent way. On the other hand, empathic communication and direct corrective emo- cija i komunikacija u grupi omogućuju tional experience through interactions and zrelije zrcaljenje koje korigira i proši- communication in a group enable a more ruje autentični self (2). Cilj je terapijske mature mirroring which corrects and ex- grupe da se infantilno zrcaljenje gran- pands the authentic self (2). The goal of a dioznosti i omnipotencije postupno za- therapeutic group is to gradually replace mijeni realističnom procjenom selfa, tj. infantile mirroring of grandiosity and om- zrelijim zrcaljenjem. nipotence with a realistic assessment of the self, i.e. a more mature mirroring. Za razvoj odgovarajućeg doživljaja selfa u grupi najvažniji je odnos pacijent For the development of an appropriate – terapeut – grupa; on treba biti tako experience of the self in a group, the pa- usklađen da može pružiti dovoljno tient-therapist-group relationship is of (narcističkih) gratifikacija svim njezi- the utmost importance; it needs to be so nim članovima. To je blisko Kohuto- balanced that it can offer sufficient (nar- vu stajalištu da u radu s narcističnim cissistic) gratification to all its members. pacijentima treba dopustiti razvijanje This is similar to Kohut’s belief that when narcističkih transfera (zrcalnog, idea- working with narcissistic patients, one lizirajućeg, blizanačkog) i narcističke should allow the development of narcis- alijanse. Kad je ona dovoljno stabilna, sistic transference (mirrored, idealised, twin-like) and narcissistic alliance. When pacijent može internalizirati terapeu- this is sufficiently stable, the patient can ta i zatim se s njim identificirati. Tako internalise the therapist and begin to internalizirani terapeut, koji postaje identify with them. Thus, the internal- pacijentovo privatno, unutarnje dobro, ized therapist, who becomes the private, preuzima ulogu svojevrsne unutarnje internal good of the patient, takes over narcističke (samo)zaštite (3). the role of a sort of internal narcissistic (self-) preservation (3). Terapijska grupa svojim članovima pruža holding analogan onom koji do- A therapeutic group offers its members voljno dobra majka pruža djetetu. On a holding similar to the one a sufficient- obuhvaća prostor za ugodu u tjelesnim ly good mother offers to her child. It in- senzacijama; smanjivanje grandioznih, cludes a space for enjoying pleasant bod- 100 omnipotentnih fantazija i fantazija o ily sensations; the reduction of fantasies

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savršenosti; identifikaciju s idealizira- of grandiosity, omnipotence and perfec- nom slikom roditeljskih figura; odgova- tion; identification with an idealised rajući doživljaj ljubavi i prihvaćanja dje- image of parental figures; an adequate tetova tijela, igre i postignuća; kontrolu experience of love and acceptance of the child’s body, play and achievements; con- i toleranciju „zločestoća“; fazno odgova- trol and tolerance of “naughtiness”; ade- rajuće ohrabrivanje pri povećanju auto- quately encouraged increase in autono- nomije; osjećaj da ga se razumije (4). my; the feeling that it is understood (4). U takvoj grupi postaje moguće neutrali- In such a group, it becomes possible to zirati agresivne porive; potiče se težnja neutralise aggressive impulses; encour- prema autonomiji; dopušteno je osjetiti age autonomy; allow one to experience i iskazati „uobičajene“ porive (ljubomo- and express “common” impulses (jeal- ru, ljutnju, bijes, prkos, neposluh) bez ousy, anger, fury, defiance, disobedience) posebnih očekivanja; nema potrebe da without special expectations; there is no se bilo kome ugađa, može se razviti i need to please anyone, it is possible to de- pokazati ono što se pokrenulo tijekom velop and show whatever has been start- grupnog procesa; može se iskoristiti/ ed during the group process; it is possible to use or control the group, the leader or kontrolirati grupu/voditelja/članove the members because they are independ- jer su oni neovisni; moguće je uspješ- ent; it is possible to successfully separate no odvojiti self od objekt-reprezenta- the self from object-representations; show cija; pokazati ambivalentne osjećaje i ambivalent emotions and learn to observe naučiti promatrati sebe i objekt kao do- oneself and the object as good and bad, so bre i kao loše tako da nema potrebe za there is no need to divide the object into a cijepanjem objekta na dobar i loš dio; good and a bad part; object love becomes objektna ljubav postaje moguća jer je possible because each member is loved svaki član voljen – prihvaćen kao neo- and accepted as an independent person; visna osoba; uravnoteženošću frustra- through the balance of frustrations for the cija u funkciji rasta i razvoja mogu se purposes of growth and development, it is possible to integrate one’s own narcissis- integrirati vlastite narcističke potrebe tic needs without repression or division; bez potiskivanja ili rascjepa; transfor- the transformation of narcissistic needs macija narcističkih potreba tako po- thus becomes possible, as well as the de- staje moguća, kao i razvoj matriksa za velopment of the matrix for (self-) regula- (samo)regulaciju nagonskih poriva (5). tion of instinctive impulses (5).

Parafrazirajući Winnicotta i Miller, To paraphrase Winnicott and Miller, we može se reći: ako grupa ima dovoljno may say the following: if a group has a dobrog voditelja koji joj je na dispozi- sufficiently good leader, who is at the 101

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ciji i dopušta da se u njega narcistički group’s disposal and who allows the pa- investira i da ga se „upotrijebi“ u ci- tients to narcissistically invest and use lju rasta i razvoja zdravog narcizma, them for the purposes of the growth and članovi grupe moći će razviti zdravo development of healthy narcissism, the samopoštovanje. U osnovi, razvit će group members will be able to develop healthy self-respect. Basically, they will vlastitu slobodu i moći će ostvariti iz- develop their own freedom and be able ravan dodir s unutarnjim autentičnim to develop a direct contact with the in- sadržajima selfa. Miller podsjeća da taj ternal authentic contents of the self. This automatski, prirodni i spontani dodir reminds us that this automatic, natural s vlastitim emocijama i željama daje and spontaneous contact with one’s own snagu i samopoštovanje te jača sigur- emotions and wishes provides strength nost u sebe. Neovisno o tome hoće li and self-respect and strengthens self-as- zbog toga član biti voljen ili ne, moći surance. Whether or not this leads to a će u takvoj grupi slobodno pokazati member being liked, in such a group osjećaje bez straha da će time ugroziti they will be able to freely express their introjiciranu majku – grupu (5). feelings with no fear of threatening the introjected mother-group (5).

NARCISTIČKI BIJES NARCISSISTIC ANGER Mnogi autori (Symington, Kohut, Ker- nberg, Gabard) smatraju da je trauma Numerous authors (Symington, Kohut, izvor narcističke patologije. Često se u Kernberg, Gabard) believe that trauma anamnezi narcističnih pacijenata na- is the source of narcissistic pathology. laze višestruke, kumulativne traume In the medical history of narcissistic patients, there are often several cumula- uvjetovane karakterom i osobnošću tive traumas conditioned by the charac- roditelja. Što je dijete mlađe kad se ter and personality of their parents. The trauma pojavi, snažnije će biti gurano younger the child when trauma occurs, prema patološkom narcizmu (4). the stronger it will be pushed towards Traumatična iskustva dovode do fik- pathological narcissism (4).

sacija na lažni ili fragmentirani, ne- Traumatic experiences lead to fixations cjeloviti self koji sadržava roditeljske on a false or fragmented, incomplete narcističke projekcije i investicije. Da self which contains narcissistic parental bi sačuvali ljubav objekta i izbjegli ka- projections and investments. In order to znu, ti pacijenti selektivno razvijaju preserve the love of the object and avoid 102 samo oblike ponašanja za koje osjećaju punishment, such patients selectively

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da ih roditelji žele i trebaju. Neprihvat- develop only those forms of behaviour ljive osjećaje, koji su najčešće izravno which they feel their parents want and povezani s traumatičnim iskustvima, need. Unacceptable emotions, which are treba sakriti i od sredine i od sebe. most commonly connected with traumatic experiences, should be hidden Narcistički bijes primitivna je reakci- both from others and from oneself. ja na ugroženo samopoštovanje i in- Narcissistic anger is a primitive reac- tegritet selfa, reakcija na narcističku tion to endangered self-respect and the ozljedu ili neadekvatnost self-objekta. integrity of the self, a reaction to an in- On obuhvaća kontinuum iskustava, od jury of narcissism or an inadequacy prolazne ljutnje do rastrojenosti kao of the self-object. This encompasses a što su katatoni nemir i paranoidna continuum of experiences, from passing ideja (6). Zbog svojeg omnipotentnog i anger to derangement such as catatonic grandioznog selfa narcistični pacijenti distress and paranoid ideation (6). Due izrazito su osjetljivi i na stvarnu i na to their omnipotent and grandiose self, očekivanu narcističku ozljedu, na koju narcissistic patients are exceptionally reagiraju sramom i/ili narcističkim bi- sensitive to real or anticipatory injury of narcissism, to which they react with jesom. Budući da i svoje self-objekte shame and/or narcissistic anger. Since doživljavaju omnipotentnima i sve- they see their self-objects as omnipotent znajućima, izostanak očekivane zašti- and all-knowing, the lack of expected te i podrške uvijek se doživljava kata- protection and support is always expe- strofično i kao da je namjeran. Osjećaj rienced as catastrophic and intentional. ugrožene svemoći grandioznog selfa The feeling of endangered omnipotence budi snažnu i neodgodivu potrebu za of the grandiose self awakens a strong trenutačnom odmazdom kako bi se po- and immediate need for revenge in order ništila uvreda. to nullify the injury.

Najrazorniji oblici narcističkog bijesa The most destructive forms of narcissis- pojavljuju se u osoba kojima je osjećaj tic anger occur in people whose feeling of absolute control over their surround- potpune kontrole nad sredinom nuž- ings is necessary for the maintenance dan za održanje cjelovitosti selfa i sa- of a whole self and self-respect. They mopoštovanja. One ovise o bezuvjetnoj depend on an unconditional availability raspoloživosti odobravajućeg i ogleda- of a condoning and mirroring self-object. vajućeg self-objekta. Stoga takav bijes Thus, such anger emerges when absolute izbija kad je izgubljena potpuna kontro- control over the mirrored self-object is la nad zrcalnim self-objetom ili kad je lost or when the idealised self-object is svemoćni idealizirani self-objekt nedo- unavailable, i.e. when the people around 103

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stupan, tj. kad se sredina (neempatična them (a non-empathetic mother, ther- majka, terapeut, grupa) odbije podčiniti apist or group) refuse to respond to the i ne odgovara na djetetove želje. child’s wishes.

Pojava bijesa u svoj njegovoj razornoj The appearance of anger in all its de- snazi nosi opasnost od uništenja oso- structive power brings with it the danger of destroying the person from the outside be iz vanjskog svijeta (ako je doživljena world (if it is experienced as part of one’s kao dio vlastita selfa) ili, ako za to posto- own self) or, if there is some obstacle for ji neka prepreka, da se self fragmentira the fragmentation of the self, since it budući da sadržava introjicirani objekt carries within it the introjected object of bijesa. Projekcija je najvažniji kanal anger. Projection is the most significant odvođenja bijesa iz selfa i mehanizam form of channelling anger away from the koji self u osnovi čuva od fragmentaci- self and is a mechanism which the self je. Arogancija i okrutnost narcističnih essentially guards from fragmentation. osoba u odnosima s drugima mogu se The arrogance and cruelty of narcissis- objasniti pretpostavkom da je rano tra- tic people in relations with others may umatizirano dijete projicirano u drugu be explained with the assumption that osobu, a narcistični pacijent postaje tra- an early traumatised child is projected umatizirajući agens – roditelj (5). into another person, while the narcissistic patient becomes the traumatising agent-parent (5).

TERAPIJSKI RAD S NARCISTIČKIM BIJESOM THERAPEUTIC WORK WITH Kohut naglašava: kada se u terapiji nar- NARCISSISTIC ANGER cističkog poremećaja osobnosti obram- Kohut emphasises the following: when, beni zid prividnog unutarnjeg mira koji in the therapeutic treatment of the nar- je održavan socijalnom izolacijom, od- cissistic personality disorder, the defen- vojenošću i distanciranošću od drugih sive wall of an apparent internal peace te fantaziranom superiornošću počne maintained through social isolation, rušiti, pojavljuje se narcistički bijes, separation and distancing from others koji se može smatrati znakom oslo- begins to crumble through fantasised bađanja rigidne strukture osobnosti superiority, there is the phenomenon of (grandioznog selfa) i stoga on jest ana- narcissistic anger, which may be consid- litički i terapijski napredak (6). ered a sign of the liberation of the rigid structure of personality (grandiose self), On upozorava da takav razvoj terapeut which makes this an analytic and thera- 104 ne smije zaustavljati, nego ga mora na peutic progress (6).

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neko vrijeme prihvatiti s implicitnim He claims that such development must odobravanjem. Narcistički bijes poro- not be prevented by the therapist but ac- bljava i imobilizira ego, koji pod njim cepted for a period of time with implicit funkcionira samo kao njegova igrač- approval. Narcissistic anger enslaves and immobilises the ego, which then ka i racionalizator. Mobilizacija narci- functions only as its toy and rationalizer. stičkog bijesa stoga nije krajnja točka The mobilisation of narcissistic anger is analize, nego početak nove faze – faze therefore not the ultimate point of anal- prorade koja završava uspostavom do- ysis but the beginning of a new stage minacije ega u tom aspektu osobnosti. – the stage of working through, which Terapijski cilj – preobražaj narcističkog ends with the establishment of ego dom- bijesa ne postiže se izravno, npr. za- ination in this aspect of personality. The htjevima i porukama upućenim egu da therapeutic goal, the transformation of poveća kontrolu nad impulsima, nego narcissistic anger, is not achieved di- se izaziva posredno, sekundarno u od- rectly, e.g. through demands or messages nosu na postupni preobražaj segmenta directed at the ego to increase its control narcizma iz kojeg je bijes proizišao. over impulses, but is achieved indirect- ly, in a secondary way in relation to the Poput Kohuta, i Safán-Gerard smatra gradual transformation of that part of da pacijentov narcistički bijes ili para- narcissism from which the anger grew. noidna reakcija mogu biti dio razvoja Like Kohut, Safán-Gerard also believes terapijskog procesa i napretka. To je that narcissistic anger or paranoid reac- znak da je projicirani infantilni self do- tion of the patient may be part of the de- veden i vraćen natrag u self (7). Slom velopment of the therapeutic process and narcizma i pojava narcističkog bijesa progress in the patient, which is a sign mogu voditi paranoidnoj obmani koja that the projected infantile self has been se može prevladati interpretacijom brought back to the self (7). The break of koja pacijenta gura dalje prema pravoj narcissism and the appearance of nar- ovisnosti, u depresivnu poziciju i edi- cissistic anger may lead to paranoid de- fence, which may be overcome through povski sukob. interpretation, which pushes the patient Napominje da je cilj tretmana pomoći further towards real addiction and into a narcističnom pacijentu da pronađe i depressive position and Oedipal conflict. spasi ovisni, zdravi dio selfa, ali i po- Safán-Gerard points out that the goal of moći mu da postane svjestan rascije- treatment is, on the one hand, to help the pljenih, destruktivnih dijelova selfa. narcissistic patient find and rescue the Kad se pacijentu pomogne da prepozna addicted, healthy part of the self; and, on vlastitu infantilnu prirodu i self, njego- the other hand, to help it become aware 105

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va omnipotencija slabi; on počinje ra- of the divided, destructive parts of the zlikovati vlastitu ljutnju, ubojite osjeća- self. When the patient is aided in recog- je prema vanjskim objektima i prijetnje nising their own infantile nature and the od unutarnjih ubojitih napada. Osobito self, its omnipotence weakens, they begin to differentiate their anger and their je važno da pacijenti prepoznaju dra- murderous feelings toward external ob- mu koju iznose i koju proživljavaju jects and threats from the internal mur- „ovdje i sada“ i da je to ustvari njihova derous attacks. It is of special importance unutarnja drama. for patients to recognize the drama they are expressing and which they are living Psihoterapijska, a posebno grupno-ana- through “here and now”, and that this is litička situacija, može biti vrlo trauma- actually their internal drama. tična, i za pacijenta i za grupu, kada dođe do ponavljanja frustracije koju je The psychotherapeutic and especially dijete doživjelo od odraslih i kad se te the group-analytic situation can be very najranije traume oživljavaju u transferu traumatic for the patient and the group (7). Međutim, do izvorne se traume, tj. do when there is a repetition of the frustra- njezina ponavljanja u transferu, može tion which adults caused to the child and when the earliest traumas are revived doći samo nakon što se prorade masiv- in transference (7). However, the source ni obrambeni slojevi i oslabi grandiozni trauma, i.e. its repetition in transference, patološki self, za što su prema Kernber- may be accessed only after massive de- govu iskustvu, naprimjer, potrebne naj- fensive layers are worked through and the manje tri godine psihoanalize. grandiose pathological self weakened, for which at least three years of psychoanal- Pojavljivanje mržnje prvi je znak da se ysis are needed, according to Kernberg. zbiva promjena narcizma (7) jer ona in- dicira priznavanje i postojanje drugih i The appearance of hatred is the first sign kidanje iluzije da osim selfa ne postoje of a change taking place in narcissism (7) drugi. Ta mržnja prema drugima pri- because it is an indication of admitting družena je mržnji prema infantilnom that others apart from the self exist and a destruction of the illusion that no one selfu koji pokušava izroniti van. Pomak else apart from the self exists. This ha- prema drugima može promijeniti neu- tred towards others joins the hatred to- godno otporan i tvrdokoran narcizam. wards the infantile self, which is trying Kako bi terapeut omogućio terapijski to emerge. The shift towards others may change the uncomfortably resistant and rast i promjenu, mora imati dovoljno obstinate narcissism. tolerancije prema bijesu koji se pojavljuje u pacijentu kad njegove narcistič- In order for the therapist to enable ther- 106 ke potrebe nisu potpuno i trenutačno apeutic growth and change, they need to

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ispunjene. Terapeutov je osnovni za- have enough tolerance for the anger that datak u takvim okolnostima da svojim is manifesting in the patient when their intervencijama pomogne pacijentu u narcissistic needs are not sufficiently otkrivanju i lociranju izvora bijesa i u and momentarily fulfilled. The thera- identificiranju i prepoznavanju osjeća- pist’s basic task in such circumstances ja i fantazija koji su povezani s izvorom is to use their interventions to help the patient discover and locate the source of bijesa. Potrebno je krajnje pažljivo i anger, as well as identify and recognize uravnoteženo empatijsko razumijeva- those emotions and fantasies which nje puno potpore s čvrsto i jasno ute- are connected with the source of anger. meljenom interpretacijom. There is a need for a careful, balanced M. S. Foulkes je primijetio da člano- and supportive empathetic understand- vi grupe primjenjuju agresiju kako bi ing with a strong and well-founded interpretation. napali neurozu drugoga prije nego se napadne njih same. Međutim, to se ne M. S. Foulkes noticed that group mem- može reći za situacije kad je narcistič- bers use aggression to attack the neu- ka povreda takva da aktivira destruk- rosis of others instead of attacking their tivan narcistički bijes koji ozbiljno pri- own neurosis. However, this is not true of jeti da će izmaći kontroli i usmjeriti se situations in which narcissistic injury is prema nekom članu grupe. Tada grupa such that it activates destructive narcis- prolazi destruktivnu, kriznu fazu i pro- sistic anger which seriously threatens to cese o čijem ishodu može ovisiti i nje- get out of control and direct itself at one zin opstanak. of the group members. The group then goes through a destructive crisis stage Uloga je voditelja u tim destruktivnim and processes which its own survival fazama grupe posebno osjetljiva. Tre- can depend on. bao bi obaviti dva zadatka: ohrabriti In such destructive stages, the role of grupu da nastavi s radom na otkriva- the leader is very delicate. They should nju, ali i pomoći grupi da „preživi“ ono perform two tasks: on the one hand, en- što se dogodilo, tj. da očuva integritet courage the group to continue working (8). on discovery and, on the other hand, help Kad se u grupnoj komunikaciji izgubi the group to “survive” what has just happened, i.e. preserve its integrity (8). kvaliteta „kao da“, kad postoji velik rizik od destruktivnog acting outa, terapeut When group communication loses the “as će biti primoran izići iz analitičke ulo- if” quality, when the risk of destructive ge i izravno intervenirati kako bi zašti- acting out is strong, the therapist is forced tio grupu ili nekog njezina člana. Tada to abandon their analytic role and directly 107

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više ne vrijede Foulkesove riječi da je intervene in order to protect the group or grupna analiza „analiza grupe, u grupi one of its members. At that point, Foulkes’ i putem grupe, uključujući voditelja“, claim that group analysis is an “analysis podsjeća Roberts. Ono što se tada može of a group, in a group and through a group, vidjeti jest „destrukcija grupe, u grupi including the leader,” is no longer valid, according to Roberts. He continues: “We i putem grupe, uključujući voditelja“. are becoming more aware that both un- Nastavlja riječima: „Sve smo svjesniji pleasant and delicate situations can oc- toga da se mogu događati i neugodne i cur and […] we are ready, if necessary, to osjetljive situacije i (...) spremljeni smo, react in a way that will preserve an opti- ako je nužno, reagirati kako bismo odr- mally safe and creative group (8)”. Never- žali optimalno sigurnu i kreativnu gru- theless, the leader’s most difficult task is pu (8).“ Unatoč tome, najteži je posao facing the truth about the destructiveness voditelja u osnovi suočavanje s istinom in their group when it occurs. o destruktivnosti u njegovoj grupi kad se ona pojavi. Powerful and layered negative countertransferential replies represent a special Snažni i slojeviti negativni kontratran- difficulty. There is a great risk in situa- sferni odgovori posebna su poteško- tions which activate negative trans- ća. Velik rizik nose situacije u kojima ference and destructive transferential su aktivirani negativni transferi i de- reactions, which very directly attack struktivne transferne reakcije, koje vrlo the therapist’s basic and professional izravno napadaju terapeutov osnovni narcissism. The most common countertransferential responses to arrogance i profesionalni narcizam. Najčešći su and anger of a narcissistic patient are kontratransferni odgovori na aroganci- anger, fury and fear. There is danger for ju i bijes narcističkog pacijenta ljutnja, the group and the therapist when the bijes i strah. Opasnost za grupu i terape- therapist cannot distinguish their own uta postoji kad terapeut ne može razli- emotions from projected ones. kovati vlastite od projiciranih osjećaja.

CLINICAL MATERIAL KLINIČKI MATERIJAL Toni is a single man in his early forties, Toni je samac u ranim četrdesetim lives with his parents and is their only godinama, živi s roditeljima čije je je- child. He grew up continually terrorized dino dijete. Odrastao je u kontinuira- by a verbally and physically aggressive nom teroru verbalno i fizički agresiv- and rejecting mother, while his father 108 ne i odbacujuće majke i uz pasivnog, was passive and autistic. Initially a bril-

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autističnog oca. Na početku briljantan liant student, he dropped out of universi- student, poslije višegodišnjih pokušaja ty after many years of attempts despite prekinuo je studij do čijeg je završetka being only five exams away from grad- ostalo pet ispita. Nema stalan posao i uation. He has no regular job and has not had a stable relationship for several nekoliko godina nema stalnu vezu. years. Tijekom godina više je puta pokušavao Over the years, he attempted to establish uspostaviti terapijski odnos s više tera- a therapeutic relationship with several peuta, ali ga je stalno prekidao. Na tera- therapists many times but would always piju se javio prije više godina zbog de- end it. He applied for therapy many years presije i glavobolja koje su ga smetale ago because of depression and head- u učenju. Prije uključenja u grupu bio je aches, which distracted him from stud- na individualnoj terapiji oko tri godine ying. Before joining the group, he was u dvotjednom ritmu koji je sam odredio, in individual therapy twice a week for s čestim duljim pauzama. Imao je na- around three years, which was a rhythm glašenu potrebu za kontrolom svega u he determined, although he often had long breaks. He had a pronounced need terapiji, posebno materijala i „asocijaci- to control everything in therapy, espe- ja“, surađivao je tehnički korektno, sve cially materials and “association”, tech- vrijeme bio iznimno oprezan, distanci- nically cooperated well, was extremely ran i dozirano zavodljiv. O psihoanali- cautious, distanced and seductive at all tičkoj psihoterapiji prethodno se izvr- times. He had previously informed him- sno informirao iz kvalitetne stručne self excellently about psychoanalytic literature. Prijedlog za grupu prihvatio psychotherapy using quality professional je s ambivalentnim olakšanjem. literature. He accepted the invitation to the group with ambivalent relief. Jedini je muški član u homogenoj grupi regresivnih pacijenata od pet člano- He is the only male member in a homog- va. Grupi staroj pet godina priključio se enous group of regressive patients consisting of five members. He joined the godinu dana nakon njezina početka, five-year-old group one year after it start- prije četiri godine. Šesta članica grupe ed, four years ago. The sixth member of prije godinu dana napustila je grupu. the group had left it one year ago. A new Najavljena je nova članica čijem se female member was announced, whose dolasku diskretno protivio. arrival he directly opposed.

Seansa s novom članicom: Toni dolazi A session with the new member: Toni ar- potpuno promijenjen, „opasna“ izgle- rives completely changed, looking “dan- da; ukočena, mračna lica. Očito je da s gerous”, with a stiff, dark face. It is obvi- 109

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ogromnim naporom suzdržava svoj ra- ous it is taking him great effort to reign zorni, ubojiti bijes. Smrknuto i prijeteći in his destructive, murderous rage. He is šuti. Stare su članice poput mene zbu- quiet while being sullen and threatening. njene i uznemirene tom promjenom u The old members are, like me, confused and disturbed by this change in his be- njegovu ponašanju. Jedna od njih, ati- haviour. One of them, which is unusual pično svojem ponašanju, počinje agre- for her behaviour, begins to aggressively sivno „ispitivanje“ nove članice. “question” the new member. Nakon pola sata nova članica pažljivo After half an hour, the new member care- i s taktom poziva Tonija da se uključi fully invites Toni to join the group. He u grupu. Na to on potpuno promije- replies in a completely different, threat- njenim, prijetećim i opasnim glasom, ening and dangerous voice, barely con- jedva se suzdržavajući, govori kako se taining his anger, and says that he had cijeli tjedan osjećao užasno, nikada mu been feeling awful that entire week, and nije bilo gore. Bjesnio je, bacao i razbi- that he had never felt worse. He raged, jao sve po kući, noćima nije spavao, threw things around his house and broke ima strašne glavobolje, nikamo nije them, did not sleep for many nights, had terrible headaches, never left his house izlazio iz kuće, opsjedale su ga strašne and was preoccupied by murderous ubojite misli. Okrećući se meni kaže: thoughts. Turning to me, he says; “This „Vi ste za sve krivi! Jesam li vam rekao is all your fault! Didn’t I tell you not to da je ne dovodite, da ja ne želim novog bring her, that I didn’t want a new mem- člana! Krivi ste jer se moje zdravlje jako ber? You’re guilty because my health has pogoršalo, nikada mi nije bilo ovako, seriously worsened, I’ve never felt like liječite me pogrešno! Mislio sam Vas this, you’re treating me wrong! I want- tužiti Komori, Institutu! Vi ne znate što ed to complain about you to the Cham- radite, ne poštujete pravila grupe. Da ber, the Institute! You don’t know what mogu, promijenio bih grupu!“ Zatim se you’re doing, you don’t respect the rules okreće novoj članici riječima: „Ja, gos- of the group. If I could, I’d change groups!” He then turns to the new member and pođo, ne želim da vi budete ovdje, naj- says: “Lady, I don’t want you to be here, bolje je da odmah odete, ovdje nikome it would be best if you left immediately, ne trebate.“ Jedva suzdržavajući bijes, nobody wants you here.” Barely contain- nastavlja govoriti o ubojitim mislima ing his rage, he continues to talk about i fantazmima s kojima se borio cijeli murderous thoughts and phantasms he tjedan. struggled with for the entire week.

Grupa i ja smo zatečeni destruktivnom The group (and I) were stunned by the de- 110 agresijom i bijesom. Jedna članica structive aggression and rage. One mem-

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kaže da je znala da će tako biti, toga se ber said that she knew it would be like i bojala. Na pitanje kako je to znala i tko that and that she feared it. When asked tako reagira, odgovara: „Svi, moj muž, how she knew it would happen and who otac i brat! Kad god nije po njihovom, reacts like that, she says: “Everyone, provali iz njih takav bijes da se svi sle- my husband, father and brother! When- dimo; samo se ja tada naljutim i idem ever things don’t go the way they want them to, they let out such rage that we se svađati s njima, s kojim pravom nas all freeze up; I’m the only one who gets teroriziraju! To me strašno iscrpljuje, angry then and argues with them, what poslije budem sva slomljena.“ Druga right do they have to terrorize us? This članica dodaje da ona sluti, u biti zna drains me terribly, I am all exhausted af- da je i njezin muž u dubini takav te da terwards.” Another member adds that she se toga u njemu boji premda je fin i dis- felt or actually knew that her husband cipliniran i nikad dosad nije tako rea- was essentially like that too and that she girao.“ Članica koja se „solidarizirala“ s was afraid of that side of him, although Tonijem prepoznaje u njegovu ponaša- he is nice and has self-control and has nju sebe iz vremena razvoda, međutim, never reacted like that. One member, who grupa joj pokazuje da je i njezin drugi sympathised with Toni, recognizes her- muž takav. self in him from the time of her divorce, but the group shows her that her second Završavam seansu riječima da je Toni husband is also like that. imao vrlo težak tjedan, da je uspio doći u kontakt s vlastitim bijesom, osjetiti I end the session by saying that Toni ga, verbalizirati i podijeliti s grupom. had had a very difficult week, that he Strah da će izgubiti kontrolu nad so- had managed to get in touch with his bom bio je samo strah. Iako s velikim anger, feel it, verbalise it and share it with the group. The fear of losing con- naporom, uspio je kontrolirati svoj bi- trol over himself had only been a fear. jes, a i svi mi smo ga izdržali. To što ga Although with great difficulty, he had razara ipak su samo fantazije, svi smo managed to control his anger and all of preživjeli. Vrlo me uznemireno slušao, us had endured it. It was only a fantasy ljutnja je u njemu bivala sve jača i sve that it was destroying him, since we had češće mi je upadao u riječ. Odlučila all survived. He listened to me in a very sam ići dalje i dodala sam da smatram upset state, the anger inside him grew da je vrlo važno razmisliti i shvatiti even stronger and he kept interrupting odakle bijes potječe, kad se prije slično me more and more often. I decided to go osjećao. Vrlo ljut, kao da je jedva do- further and added that I thought it was čekao priliku svađati se sa mnom, što important to think and discover where sam (ljutito i uznemireno) prekinula. the rage was coming from and whether 111

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Odlučila sam se za vrlo izravnu inter- he had felt like that before. He was very pretaciju: vidim najmanje dvije situa- angry and seemed to be eager for an op- cije s kojima se mogu povezati takvi portunity to argue with me, which I (very njegovi osjećaji. Jedna proizlazi iz vre- angrily) stopped. I decided on a very direct interpretation: I see at least two mena kad je njegova majka dovodila things with which his emotions can be svoju nećakinju njegovih godina u go- connected. One stems from a situation in ste za praznike (često je govorio kako which his mother brought her niece, who tu rođakinju mrzi), a druga je ljutnja na was of his age, as a guest during holidays mene što sam mu srušila idealiziranu (he often said he hated that cousin) and sliku o sebi – grupi. the second one was anger he felt towards me for demolishing his idealised image Sljedeću seansu gotovo je cijelu prešu- of the self-group. tio, bio je nešto manje napet i prijeteći. Na poziv članica da se uključi nije od- He was silent for almost the entire dura- govarao, bijes je u njemu još bio prijete- tion of the next session and was some- ći i razoran, kao da bi izgubio kontrolu what less tense and threatening. He did nad njima ako bi počeo govoriti. Grupa not reply to the invitation of other members to join in, the anger inside him was ga je pustila da sam prorađuje svoje still threatening and destructive, as if osjećaje. he could lose control over it if he start- Dvije seanse poslije ulaska nove čla- ed speaking. The group let him work nice ponovno je imao potrebu napa- through his emotions alone. sti mene i novu članicu. Izravno i vrlo Two sessions after the new member agresivno obratio se najprije njoj i re- joined the group, he again felt the need to kao joj da u grupi nije poželjna. Ako joj attack me and the new member. Directly se već takve stvari ponavljaju u životu, and very aggressively, he first addressed da je dočekaju kao nepoželjnu (o čemu her and told her she was unwanted in the je govorila seansu prije), onda valjda group. If being unwanted was something vidi da uopće ne treba ni biti tu. Kako that was happening to her repeatedly (of which she had spoken in the preceding je bio vrlo neugodan i prijeteći, morala session), then she must understand that sam intervenirati i zaštiti novu člani- she should not be there. Since he was cu. Upozorila sam ga da mora poštovati very unpleasant and threatening, I had to druge i njihove osjećaje, da može poka- intervene and protect the new member. I zati svoje osjećaje i govoriti o njima, ali warned him that he had to respect others da mora voditi računa o tome kako to and their feelings, that he could show his čini. Moje suočavanje s narušavanjem emotions and talk about them but that 112 pravila grupe kao da je jedva dočekao he had to pay attention to how he did it.

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kako bi se mogao izravno obračunati He seemed to be eagerly awaiting my sa mnom. Kako je bio preplavljen bije- comment about breaking the rules of the som, to mu nisam dopustila. Procijeni- group so he could directly confront me. la sam da ga moram izravno zaustaviti Since he was overwhelmed with anger, I did not allow this. My assessment was i zaštiti novu članicu, grupu i sebe. Su- that I had to stop him directly and protect očila sam ga s tim da terorizira grupu, the new member, the group and myself. I da bih ga trebala podsjetiti da sam ja ta confronted him with the fact that he was koja je ovdje odredila pravila, koja vri- terrorizing the group and I reminded him jede i za njega, da poslije četiri godine that I had set the rules that he had to obey, grupe i tri godine individualne terapi- that after four years of the group and three je i truda koje smo grupa i ja uložili u years of individual therapy and effort that njega očekujem od njega barem da se the group and I had invested in him I ex- može kontrolirati i pristojno ponašati, pected him to at least control himself and poštovati grupu i njezine članove. Već i behave politely, respect the group and its members. Being very angry (and fright- sama vrlo ljuta (i uplašena), dodala sam ened) myself, I added that if he was un- da sam, ako to nije u stanju, vjerojatno able to do so, then I had probably made a ja pogriješila i precijenila njegove ka- mistake and overestimated his abilities. pacitete.

THE FOLLOWING SESSION SLIJEDILA JE SEANSA KOJA WAS NOT HELD DUE TO THE NIJE ODRŽANA ZBOG PRAZNIKA HOLIDAYS

Seansa nakon praznika bila je bez nove The session after the holidays did not članice, koja je najavila izostanak. Na include the new member, who had an- toj su seansi „stari“ članovi elaborira- nounced her absence in advance. In this li prethodna događanja. Toni je opet session, the “old” members described the bio onakav kakvog smo ga poznavali, events that had taken place. Toni was možda neznatno napetiji. Rekao je da once again back to his old self, perhaps only slightly more tense. He said he had je „došao k sebi“ , što smo svi dočekali come to his senses, which we all felt re- s olakšanjem. Tijekom ta dva tjedna lieved about. Over the two-week period, he intenzivno su mu se vraćale slike i intensively relived images and emotions osjećaji s početka osnovne škole kad from the beginning of primary school, je majka tijekom nekoliko godina do- when his mother brought her niece to vodila nećakinju k njima na praznike. spend time with them during the holi- Grupa i ja smo iz prijašnjih razgovora days. (From previous conversations, the 113

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o tim susretima imali dojam da je to group and I had thought that these events bilo u vrijeme srednje škole. Prema had taken place during high school.) The djevojčici je majka bila divna, nježna, mother was wonderful to the girl, gentle, pažljiva, davala joj sve za čime je on caring, gave her everything he yearned for. He had to observe all of this and felt čeznuo. Sve je to morao gledati, osje- a terrible anger and hatred toward both ćao je strašan bijes i mržnju prema of them but was not permitted to ex- objema, ali to se nije smjelo vidjeti jer press this because he would be cruelly bi bio okrutno kažnjen batinama. Maj- punished with beatings. His mother was ka je tada bila potpuno „luda“, tako da then completely “mad” and even wanted je rođakinju htjela i posvojiti. U to se to adopt the cousin. His otherwise very nesvjesno umiješao i nehotično ga za- passive father got involved at this point štitio inače vrlo pasivni otac komenta- and inadvertently protected him by say- rom da ne bi mogli izdržati te financij- ing that they would not be able to with- ske troškove. U to vrijeme idile majke i stand the financial expenses. At this time njezine nećakinje Tonija su često slali of his mother and her niece’s idyllic time, roditeljima nećakinje na selo. Tamo Toni was often sent to the niece’s parents’ place in the village. There he felt awful, se osjećao užasno, mrzio je sve u tom hated everyone in the village, could not selu, nije mogao podnijeti tu kuću, iz stand the house, kept running away from nje je stalno bježao. Godinama je imao it. For years, he used to have nightmares noćne more povezane s tim prostorom about that place and the village (dreams i selom (snovi tog tipa i sadržaja po- and content of this type repeated during navljali su se tijekom života, ali i tije- his life but also during the entire therapy). kom cijele terapije). U tih je dva tjedna Over the two weeks, he had become aware postao svjestan da je sav taj ogroman of the fact that this enormous anger which bijes, koji je tih godina morao skrivati he had had to suppress and hide deep in- i potisnuti duboko u sebi, sada izronio. side himself had now come bursting out. I sam je bio zatečen i vrlo uplašen nje- He himself was stunned and frightened govom ubojitom i razornom snagom. by its murderous and destructive power. For weeks he was torn by terrible destruc- Tjednima je bio mučen užasnim de- tive fantasies and thoughts and was very struktivnim fantazijama i mislima, afraid he was losing his mind. jako se bojao da gubi razum. Over those two weeks he realised how Tijekom ta dva tjedna postao je svje- pleasant it felt to be in the group, he en- stan i koliko mu je bilo lijepo i ugodno joyed it completely and savoured the u grupi, potpuno se uljuljao, „kokola- fact that he was important to us, that we vao“ i uživao u tome da nam je važan, were making an effort for him, that we 114 da se oko njega trudimo, da nam je sta- cared. He was not aware of how much

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lo. Nije bio svjestan koliko se u grupi he had relaxed in the group and how opustio i uživao. Takvo iskustvo nije much he was enjoying it. He had never imao nikad prije u životu. Napokon je had an experience like that. He finally imao svoje mjesto za ugodu. A onda had his place for pleasure. And then I interrupted that for him and ruined it, sam mu ja to prekinula i pokvarila, to which angered him. On the other hand, ga je razbjesnilo. No postaje mu jasno he realised he had been stagnating, that da je u osnovi stagnirao, da se ništa nothing was happening, that he was not nije događalo, da se nije mijenjao, kao changing, and neither was the group. He ni grupa. Polako shvaća da je vrijeme slowly realised that it was time for him da odraste. Spoznaje do kojih je došao to grow up. The realisations he reached mogao je prepoznati uz odnos s maj- were recognised through his relationship kom, uz bespoštedni rat koji je vodio with his mother, who he waged a vicious s njom i kojem je posvetio cijeli svoj war against and whom he had dedicat- ed his entire life to. Now he realised he život. Sad vidi da je tako kaznio sebe, had punished himself, and not her. He ne nju. Ostao je zarobljen njome, osi- remained imprisoned by her and lacked romašen, uskraćen za mnogo toga u many things in life. He wondered what životu. Pitao se što bi sve bilo da je tu would have happened if all the energy he energiju koju je trošio na borbu s njom had spent on fighting against her inside u sebi iskoristio za vlastiti razvoj, za himself had been used for his own devel- zadovoljstva u životu. opment and pleasures in life.

LITERATURA/REFERENCES

1. Ashbach, C., Schermer, V.. Object Relations, the Self and the Group. Routledge, London, New York. 1987.

2. Brown, D. Self Development Through Subjective Interaction, in Brown, D., Zinikin, L., eds. The Psyche and the Social World (Routledge, London. 1994. p. 80-99)

3. Moro, Lj. Prijenos i protuprijenos u terapiji narcističkih pacijenata, Psihoterapija. 1994: 24: 121-125.

4. Cooper, A. Narcissisism in: Essential Papers on Narcissism, eds. Andrew Morrison. New York Univ. Press. New York, London. 1986.

5. Miller, A. Depression and Grandiosity as Related Forms of Narcissistic Disturbance, Int. J. Psych. V.6. 1979 (61-76).

6. Kohut, H. Thoughts on Narcissim an Narcissistic Rage. Psychoanal. St. Chil. 1972: 27: 360-400.

7. Sáfan-Gerard, Desy., The Use of Countertransference in Response to Narcissistic Defenses of Group Members – Journal of Melanie Klein and Object Relations. 1997: 15 (2).

8. Roberts, J. Destructive Phases in Groups, p. 128-135. in: The Practice of Group Analysis, eds. Roberts, J., Pines, M. Tavistock/Routledge, London i New York. 1991. 115

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NARCISTIČKI BIJES ČLANA GRUPE

/ NARCISSISTIC RAGE IN A GROUP MEMBER

Slavica Pavlović

Poziv na promišljanje o materijalu o The invitation to write about the subject kojem sam pisala desetljeće prije iza- I wrote on one decade ago is a challenge zov je zbog osjetljive dinamike u pri- primarily due to the delicate dynamics in kazanoj grupi koja se zbivala kratko the group I discussed, which took place prije pisanja teksta. Što bih sve sad only a short while before the text was drugačije napisala (učinila)? Prije sve- written. What would I have written (done) ga, imam potrebu dovršiti i zaokružiti, differently? First of all, I feel the need to a ovo je izvrsna prilika za to. Prije deset finish everything, and this is the perfect opportunity. Ten years ago, for Toni and godina grupi, Toniju i meni, imperativ me the emphasis was on surviving a seri- je bio preživjeti tešku krizu, grupu na ous crisis, a group verging on an incident. rubu incidenta. Tada sam osjećala da At that time, I felt that would be more je to i više nego dovoljno, premda sam than enough, although I was thinking a intenzivno razmišljala o prikazanom lot about the reviewed clinical material kliničkom materijalu, pitala se koji su and wondered about my contributions i u čemu sve moji doprinosi/propusti. and failings. Attempts at understanding Pokušaji razumijevanja opisane dina- the described dynamic and the search for mike, traganje za teorijskim koncepti- the theoretical concepts that would help ma koji bi mi bili od pomoći trebali su me needed a distance of emotion and emocionalni i vremenski odmak. Ovih time. These ten years have been more deset godina više je nego dovoljno! than enough!

KOMENTAR COMMENT

O opisanim dramatičnim procesima u The described dramatic processes in grupi svakako se može promišljati na the group can, of course, be thought of mnogo načina i iz različitih perspek- in numerous ways and from numerous tiva. Smatram da praćenje transfera perspectives. I believe that following 116 i transferno-kontratransfernog ena- transference and transferential/counter-

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ctmenta (odigravanja) pruža potpuno transferential enactment offers the most razumijevanje. Dolazak nove članice u complete form of understanding. The grupu bio je okidač za ponavljanje tra- arrival of a new group member triggered umatičnog iskustva u transfernom po- the repetition of traumatic experience in lju grupe. Moje intervencije vodile su u the transferential field of the group. My enactment (odigravanje) traumatičnog interventions led to the enactment of a traumatic relationship between Toni and odnosa majka – Toni, iz „tamo i nekad“ his mother, from there and then to here u „ovdje i sad“. and now. Toni je tijekom četiri godine u grupi Over a period of four years, Toni enjoyed uživao sve blagodati stapanja s idea- all the benefits of joining the idealizing lizirajućim objektom – grupom koja object-group which, through its accept- je svojim prihvaćanjem, pažnjom i ance, attention and empathy, fed and empatijom hranila i zrcalila njegovu mirrored his grandiosity and omnip- grandioznost i omnipotenciju. Tomu otence. This was further aided by the je dodatno pogodovala činjenica da je fact that for a long time he was the sole dugo bio i jedini muški član. U grupi je male member. In the group, he showed pokazivao sve veće kapacitete da tole- increasing capacity for tolerating ten- rira napetosti i intenzivne osjećaje čla- sions and intense feelings of the female nica. Trudio se biti im od pomoći, ak- members. He tried to be helpful and was tivnije se i konstruktivnije uključivao. more active and constructive. In reality, U realnosti je ostvario bliskiji odnos s he achieved a closer relationship with his ocem, a s majkom je i dalje bio na veli- father, while continuing to be distanced koj distanci. Aktivno se uključio u rad from his mother. He actively engaged svoje braniteljske udruge. Pripremao se with the work of his veterans’ association. He was preparing to finish universi- da završi studij i bio nezadovoljan zbog ty and was dissatisfied because of prob- poteškoća s koncentracijom. Stvarao se lems with concentration. My impression dojam da postiže sve veću autonomiju. was that he was achieving greater auton- Grupa je znala da će nakon odlaska omy. jednoga doći novi član u grupu. Nije The group knew that after one member želio dolazak novog člana jer bi to us- left it, a new one would arrive. He did not porilo njihov rad. Kako su ostale člani- want a new member to arrive because ce imale drugačije osjećaje, povukao this would slow down their progress. se. Dvije seanse prije dolaska nove Since the other members felt different- članice govorio je da mu je važno da ta ly, he relented. Two sessions before the osoba barem ima određeno terapijsko arrival of the new member he said it was iskustvo. Kako se približavala seansa important for him that the person have 117

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u novom sastavu, postajao je šutljivi- some experience with therapy. As the jim. Kasnije je postalo jasno da je na- session with the new member drew near- java novog člana pokrenula strah od er, he became quieter. Later it became ob- fragmentacije selfa i gubitka omnipo- vious that the announcement of the new tentne kontrole nad grupom i terapeu- member’s arrival incited the fear of the tom. Agresivne osjećaje tada je mogao fragmentation of the self and of the loss of the omnipotent control over the group držati pod kontrolom. and the therapist. Prior to this, he was Seansa s novom članicom cijeloj je able to control his aggressive feelings. grupi bila iznimno teška. U njemu se The session with the new member was vodila duboka borba s razarajućim bi- extremely difficult for the entire group. jesom i strahom od gubitka kontrole Inside him, a difficult struggle between koji je šuteći projicirao na grupu. Jed- destructive anger the fear of loss of con- na je članica preuzela dio te agresije na trol was taking place inside him and he sebe i počela agresivno ispitivati novu was silently projecting it onto the group. članicu, koja je uspijevala ostati smire- One of the members took over a part of na i izvan zamke ulaska u projektivne that aggression and started aggressively identifikacije. Osjećala sam zabrinu- questioning the new member, who man- tost za nju, za grupu, za Tonija. Kad se aged to stay calm and not fall into the uvjerio da nova članica i grupa mogu trap of entering projective identification. kontejnirati njegov bijes, usmjerio ga je I felt worried for her, the group, and Toni. prema meni, ali mogao ga je verbalizi- Once he was convinced the new member rati što je otvorilo prostor za simbolič- and the group could contain his anger, he nu, verbalnu komunikaciju. directed it towards me, but he was able to verbalize it, which opened the room for Uključenje novog člana za njega je bila symbolic, verbal communication. duboka narcistička ozljeda zbog gubit- The introduction of the new member was ka kontrole nad zrcalnim self-objek- for him a deep narcissistic injury due to tom – grupom, ali i omnipotentnim i the loss of control over the mirror self-ob- sveznajućim voditeljem. Kako bi spri- ject group, but also over the omnipotent ječio fragmentaciju vlastita selfa zbog and all-knowing leader. In order to pre- razarajuće mržnje prema introjicira- vent the fragmentation of his own self nom objektu, morao ju je projicirati na by a destructive anger towards an intro- novu članicu i mene. Postajalo je jasni- jected object, he had to project it onto the je da je grupna situacija bila okidač za new member and me. It became clearer neke transferne osjećaje koji potječu iz that the group situation was a trigger for prošlih sličnih iskustava. O okidačima certain transferential emotions stem- 118 za transfer u grupi govori König. Kako ming from similar past experiences.

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bi neki član grupe, grupa kao cjelina, König writes on triggers for transference voditelj ili grupna situacija postali „oki- in a group. In order for a group member, dačima za transfer“, moraju imati neke the group as a whole, the leader or the iste/slične osobine kao osoba iz proš- group situation to become a ‘trigger for losti. Osoba u regresiji ponovno doživ- transference’, it has to have certain iden- ljava aktualni, transferni objekt onako tical/similar characteristics as the person from the past. The regressive person kako je osoba doživljena u prošlosti, ali relives the current, transferential object također će oživjeti u sebi ono što je bila in the way the person was perceived in kad je tu osobu doživljavala. Regresija the past, but they also revive in them- u biti djeluje kao svojevrstan vremen- selves whatever they were when they ski stroj (K. König, 1987.). perceived that person. Regression actu- Poznavajući Tonijevu osobnu povijest, ally functions as a form of time machine (K. König 1987). prepoznala sam da prikazani procesi jesu ponavljanje vrlo sličnog trauma- Knowing Toni’s personal history, I saw tičnog događaja iz prošlosti u aktualnoj that the processes were a repetition of transfernoj situaciji. To sam i interpre- a very similar traumatic event from the tirala, ali vrlo strogo i odlučno. Naknad- past in the current transferential situa- no sam shvatila da sam odigrala ulo- tion. I interpreted this, but in a very strict gu njegove majke, tj. da smo oboje bili and determined manner. Subsequently, uključeni u ponavljanje traumatičnog I realized that I had enacted the role of događaja, njegove unutarnje drame. his mother, i.e. that we had both been involved in the repetition of the traumatic Tijekom sljedećih nekoliko seansi po- event, his internal drama. javljivao se i prorađivao materijal koji Over the next several sessions, material nije simboliziran i mentaliziran, koji je which was not symbolized and mecha- bio vrlo konkretan – jezik aktualizira- nized appeared and was worked through, ne i eksternalizirane traume. Trauma- but it was very concrete – the language tizirani self (dječak Toni) projiciran je of actualized and externalized trauma. na drugu osobu (novu članicu), a on The traumatized self (Toni the boy) was sam postao je traumatizirajući objekt projected into another person (the new – majka. member), while he himself became the traumatizing mother-object. Dječak Toni također se pokušao obra- niti i obračunati s majkom – vodite- Also, Toni the boy attempted to de- ljem grupe i uspio, u „ovdje i sada“, ver- fend himself and confronted the moth- balizirati mržnju i bijes koje je osjećao er-group leader, successfully verbalizing „tamo i tada“, a nije ih smio ispoljiti. U in the here and now the hatred and an- 119

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literaturi se takav tip interakcija sma- ger he felt then and there, which he had tra enactmentom (odigravanjem), koji not been able to express. In the literature, je sličan, ali se razlikuje od acting-ou- this type of interaction is considered en- ta. Dok se acting-out (djelovati, činiti) actment, which is similar to but differs odnosi na postupanje jedne osobe, from acting-out. While acting-out refers najčešće pacijenta, enactment ima in- to the actions of one person, most commonly the patient, enactment has an teraktivni aspekt i uključuje najmanje interactive aspect and includes at least dvije osobe. Određuje se kao proces pri two people. It is defined as a process in kojem pacijentova nesvjesna fantazija which the patient’s unconscious fantasy u analitičaru pokreće kontratransfernu initiates countertransferential ‘action’ in „akciju“ na verbalnoj razini ili na razini the analyst on the verbal or behavioural ponašanja (Auchincloss, E. L., i Sam- level (Auchincloss, E. L. and Samberg). It berg). Predstavlja oblik simboličnih represents a form of symbolic as-if inter-

interakcija „kao-da“ koje pacijent ne- actions which are unconsciously initi- svjesno inicira izazivajući nesvjesnu ated by the patient and which cause an suglasnost kod analitičara i koje imaju unconscious compliance in the analyst nesvjesna značenja. and have unconscious meanings.

Enactment je složen proces od pet Enactment is a complex process with koraka ili faza (Bohleber, W. et al.). Po- five steps or phases (Bohleber, W. et al). činje nastojanjem da se očuva anali- It begins with the attempt to preserve tička funkcija neutralnosti, nastavlja the analytic function of neutrality, goes se emocionalnom uključenošću u through emotional involvement in the pacijentovu fantaziju, a slijede prepo- patient’s fantasy, the recognition of ‘en- znavanje „uhvaćenosti“ u odigravanje, trapment’ in enactment, the realization that the patient’s unconscious fantasy shvaćanje da je ostvarena pacijentova has been realized, and the interpretation nesvjesna fantazija te nakraju inter- of enactment. pretacija enactmenta. Generally, enactment represents the end Enactment općenito govori o prekidu of analytic dialogue because it involves analitičkog dijaloga jer je u njemu pri- action and not thinking. It represents the sutna akcija, a ne promišljanje. On je passage from the symbolic to the con- prijelaz sa simboličnog na konkretno crete and in that form seems to be the i jedini način da se težak traumatski only way for the difficult traumatic mate- materijal i sjećanja donesu u psihičko rial and memories to be brought into the polje i postanu dostupni verbalizaciji i psychological field and become available proradi. Kao da se neke unutarnje dra- for verbalization and working through. 120 me moraju ponovno dogoditi u psiho- As though certain internal dramas must

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loški povoljnijim okolnostima kako bi occur again in psychologically favourable mogle biti mentalizirane i metabilozi- conditions in order to be mentalized and rane. metabolized.

Numerous authors believe that enact- Mnogi autori smatraju da je enactment ment is an unavoidable communal event neizbježan zajednički događaj u radu in the work with traumatized and regres- s teško traumatiziranim i regresivnim sive patients which has great potential pacijentima koji imaju velik potencijal for recreating and working through one’s za rekreaciju i proradu vlastite prošlosti. past.

LITERATURA/REFERENCES

1. König, K. The 11th SH. Foulkes Lecture: Transference in Groups-Internal Phantasy and External Reality, Group Analysis. 1987: 20: 291–305.

2. Auchincloss, EL. and Samberg, E. Psychoanalytic Terms and Concepts. Psychoanalytic Electronic Publishing. 2012.

3. Chused, JF. The evocative power of enactments. Journal of the American Psychoanalytic Association. 1991: 39(3): 615–639.

4. Bohleber, W., Fonagy, P., Jimenez, JP., Scarfone, D., Varvin, S., Zysman, S. Towards a better use of psychoanalytic concepts: A model illustrated using the concept of enactment’. International Journal of Psychoanalysis. 2013: 94: 501–530.

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