Part III:

Some of the reasons for our pro-group bias arise from qualities common to all group therapy:

1. Groups break isolation, and we see isolation as a major source of people's problems. Because we believe that the source of our problems is alienation (see Chapter 2), it makes simple sense to create supportive group environments as an antidote. Our theory says that awareness, contact and action are needed to counter alienation, and groups provide the potential for all three.

2. Group members have an easier time identifying the sources of their oppression. The drama of recognition is frequent: " I know exactly what you mean. I always thought I was the only one who had that problem." People speak of loneliness, of frustration about work, of conflict with lovers or mates or parents or children, and seven others nod. It becomes harder and harder to believe that one’s problems are a result of one’s personal pathology. Common, and therefore social, sources of problems become clearer and clearer.

3. Group members benefit from the healing power of numbers. To reveal one’s secrets, to weep openly, to take a stand against one’s Internalized Oppression in the presence of eight others is a far more dramatic and healing experience than to do it with only one other person there.

4. Group members get more feedback from more people. Not only is the quantity of input helpful, but so also is its variety. Group members may have opinions which counter those of the leader; controversy can act as a check on the power of the therapist. Similarly, if a group member has a tendency to lock horns with the therapist, the intervention of other people can be a helpful check on competitiveness.

5. Groups help to demystify the power of the therapist. Both the diversity of opinions, and the healing power of numbers help to demonstrate that the therapist is only one among many. Healing that occurs in individual therapy is easily attributable to the magical powers of the therapist. When effective work occurs in the group, the specific role of the group leader is easier to delineate.

6. Groups mirror real life; they are a place where people can do what they ordinarily do, learn where their problems lie, and practice ways to improve. They are a stage for dramatizing problems, and a laboratory for practicing change.

7. Groups are cheaper than individual therapy. That they cost less is a fact of theoretical significance. We believe that people are fifty-percent responsible for their own healing. The group leader provides a place to do it, protection and certain skills. But the group member provides knowledge of what her problems are, and the will and energy to solve them. To charge reasonable rates for therapy is to codify the shared nature of the work. If you pay me enormous fees, you must believe you need me very badly. If you need me so badly, what I have must be very special, very hard to come by, very rare. We don't think so. We think you have something special, although not at all rare: the power to change for the better. We have something important, but it is readily accessible, and only one part of what you need.

8. Finally, groups counter the dyadic approach to life which dominates our culture. We are trained to expect our most meaningful connections to occur in twosomes. We relate more intimately to mother in childhood than to any other adult. We seek boyfriends and girlfriends as teenagers. We couple as young adults. We go to a shrink and reveal our innermost thoughts to him and to nobody else. To construct intimacy with seven other people at one time is to challenge a thick set of beliefs implicit in the " twosome" nature of so many of our relationships.

Other reasons why we do groups flow from the particular way in which we organize them. In general, problem-solving groups follow a cooperative model (see Chapter 4). Members make contracts to accomplish whatever goals they wish. Therapists do not diagnose: the person who comes to work on herself is the ultimate expert on what her true problems are. We encourage people to expect to solve real problems in measurable ways, so that results are clearly achieved. We assume that history is important in shaping both problems and an individual's responses to them. But understanding the past is only important insofar as it helps one to change the present. We'll return to all these characteristics of group work in more detail soon, but for now we want to point out the theoretical significance of the ways we work:

9. To organize groups around problem-solving implies the belief that the present matters more than the past. That position challenges the Freudian view that character is formed in early childhood (see Chapter 14). Individual therapy is often based on the idea that therapy consists of rectifying problems encountered in early childhood. Relationships are encouraged which mirror those between parents and children. The inequalities of power between a mostly silent therapist and a self-revealing client are precisely those sought to be replicated from the past. Cooperatively organized problem-solving groups, in contrast, encourage power relations of a very different sort (which I shall discuss more fully below), because what is important is not redoing the past but rather changing the present.

10. Because we are interested in making real changes in the moment, we seek not merely to reveal needs, but also to take care of them. Most people, for instance, need more "strokes" (see Chapter 8) in their lives. Group is an ideal place to get them. If most of modern life is lived in an economy of stroke scarcity, group provides an economy of plenty. We believe that the experience of enough strokes to go around is enormously progressive; most people will not again tolerate starvation after having once eaten their fill.

11. What goes along with the economy of plenty is the notion of group as a training school. Groups are in large measure a schoolroom: We are not in the business of healing illness; what we seek instead is to teach people how to solve problems. People ideally leave empowered with skills to handle what confronts them in the real world. To practice with others is a crucial part of learning those skills.

12. Group leaders in a cooperative problem-solving group say what they are thinking. They demystify their thinking, and they give advice. Group members learn to sort that advice, to take what is useful and reject the rest, and to assess realistically the power of the therapist.

13. On the other side of the coin, group members have an opportunity to practice helping others. Not only do they become more skillful at solving problems, their own and other’s, but they also get meaningful strokes in the process.

A problem-solving group meets once a week for two to two-and-a-half hours. It consists of seven or eight members, one or two group leaders, and sometimes a trainee (see Chapter 12). Groups are on-going; places in them become available when someone finishes her work and leaves. New members are often unknown to the group leaders; we do not routinely screen people for group, although sometimes we will have met with them individually while they've waited for a place to become available, or worked on immediate crises. In general, though, we have found that randomly collected groups work well, as opposed to groups organized around a theme or a certain type of problem. We do offer some groups for women only, and some for all lesbians or gay men. When women and men meet together in mixed groups, we keep the numbers even.

Group members are asked to abide by the cooperative contract (see Chapter 4): no secrets, no rescues, no power plays. When a new member joins, we give her a written list of the unstated agreements (reproduced in Appendix 2). We also suggest that new people try group out for a month or more before deciding whether or not it is right for them. On the one hand, we encourage critical consumerism; if group is not helping, then something is wrong with it. On the other hand, we believe that experience is the best guide to how helpful it is likely to be. We do not ask for a formal commitment, however, trusting people to use their own best judgment.

Because we see group as an experience in cooperation, we ask the members to divide up the time available in a way that is equitable. That does not necessarily mean an equal division; sometimes some members need and want more or less time than others. The system for deciding who gets how much time is left to the group; most use a blackboard, signing up for the amount of time they would like, and then negotiating if they need to, to be able to end (more or less) promptly.

Some groups set aside time at the beginning to take care of held feelings and resentments (see Chapter 8), although doing so is up to the particular group and many do not. We often encourage people to stay after the end of group to give each other strokes.

Contracts

The first task of a new group member is to make a "contract," our euphemism for a clear statement of goals. We use contracts for several reasons. First, we do not believe in diagnosis, trusting that each member is the best judge of what is wrong with her life and what she wants to change. That is not to say that group leaders and other members do not engage in active dialogue to settle on the contract. Sometimes, people need to talk through their problems and hopes before they can articulate a good contract.

A second reason for using contracts is that they give the group participant a measure by which to judge whether the work is actually helping. If change is not palpable, then something is amiss with the group and should be corrected.

The very business of making a contract is an important act of power, because it helps to identify and to prioritize the work, implying optimism about the future. On her first night in group, Susan signs up for twenty minutes at the bottom of the list. She asks a few questions, makes a comment or two, but is mostly silent, getting acquainted while others work. When her turn comes, she tells us that she is thirty-two years old, lives alone, and is having trouble in a relationship with a man she's been seeing for five years.

" I'm mean to him all the time. I don't know why, but there's nothing he says that doesn't make me mad. We don't sleep together anymore, because I'm not turned on. I think I have to work on my anger. It's too much."

" My contract should be to be less aggressive, selfish and mean."

A good contract has several characteristics:

It is a short, snappy sentence. To be helpful, the contract should appeal to the Child (in the sense that the word is used in Transactional Analysis to mean the feeling, intuitive, creative part of the psyche).

It is a positive statement. It tells you where you're headed, not where you've come from, so that you can tell when you've gotten there.

It suggests action to take that will help you to make changes.

Susan's proposed contract fails to meet a number of these standards. First of all, it contains a string of judgments about herself, reflecting not her Child's fondest desires, but rather her Pig's assessment of her faults. Second, it is negative, about what she should stop instead of what she wants to have happen. Third, it contains no helpful hints about what to do. Indeed, because it is cast in such accusatory terms, it suggests that Susan must " simply" become a better person if anything is to change.

So, while we respect Susan's take on what she's experiencing as a problem — the level of anger she feels at her boyfriend — we ask to look more deeply at what is actually going on.

Group leader: " Give us an example of when you're angry."

Susan: " Well, last Friday, we were out on a date, eating at a restaurant that Bob especially likes..."

Group member: " Do you like the restaurant?"

Susan: (Pauses) " It's fine (in a half-hearted tone)."

Group member: " You don't sound very enthusiastic."

Susan: (Speaking slowly) " It's OK with me, only we'd eaten there three weeks in a row and," (picking up speed), " I'm trying to diet and there's nothing there I can eat, but Bob's not very sympathetic about my dieting, although he hates it when I'm overweight."

We explore the transactions between Bob and Susan (as Susan experiences them) some more. A picture emerges of two dynamics: Susan Rescues Bob often (see Chapter 7), and they are competitive with each other about decisions and tastes (see Chapter 6). The group leader tells Susan what she's thinking, while other people in the group add their own perceptions and ideas. As the analysis emerges, a new statement of the contract can be articulated. Susan has a set of ideas that interfere with her ability to say what she wants. Moreover, she does not complain about minor grievances, waiting instead until she's built a massive case against Bob, and then she explodes. We suggest she needs to work, not on being less angry, but on being angry more quickly and saying it right away in a clear and direct fashion. The suggestion contains a number of values and opinions of ours: that honesty and openness are good, that Susan has sufficient power to be able to stick up for herself, and so on, and we state them openly.

Susan restates her contract:

" I want to talk honestly about what I feel and want."

The word " contract" is a less-than-accurate description of what Susan has just negotiated with the group, because it is not binding in the ways usually associated with a contract; nobody will enforce it. Susan comes to group each week and talks about whatever is going on in her life that seems most pressing. If it turns out that her relationship with Bob is not on her mind very often, then she may need to reformulate her contract to address what really troubles her. Contract-making is a matter of noting what is actually going on rather than limiting the terrain. Occasionally, people may not mention some problematic area of their lives because of shame or fear; a contract in those circumstances may be a helpful way of checking a tendency toward secrecy. But in general, the contract reflects a trust that people will work on what they need to work on.

Contracts are also used in another sense: to rule out behavior that is harmful. We use contracts against suicide, violence and substance abuse in particular. In these cases, the group member makes an actual promise to the group. " I will not kill myself." "I will not drink alcohol for a year."

No-suicide contracts are an important part of our work, and a good example of this second sense in which we use contracts. We have a very straight-forward and simple approach to suicide. We believe that it is a choice, and that people can decide for life instead of death. To work on anything else while someone is considering suicide is useless. We see suicide as the ultimate line of attack of the Pig: " You deserve to die" (see Chapter 5). The notion of suicide is a counterproductive escape-hatch; so long as it is an option, it is less likely that one will do the hard work of fighting for changes that make life worthwhile. The notion of suicide, therefore, is self-fulfilling: if you think, " I can always kill myself," you are far less likely to insist on happiness and do whatever is needed to achieve it, and therefore you are far more likely to wish to die.

On a more prosaic level, it is a waste of time to work with someone who is going to kill herself. Moreover, suicide is unfair to everyone touched by it. Group members and leaders alike would be marked by proximity to it for life. The group leader's conscience and reputation would be seriously damaged.

For all these reasons, we insist that people who are considering suicide rule it out. We ask for a contract that the person will not kill herself. We explore in detail the plan for suiciding, and ask the person to dispense of the means (to bring the pills or gun or whatever to group and leave them with the leader, or to flush the pills down the toilet or destroy the weapon).

In return for the decision to live, the group, and especially the group leader, pledge an extra measure of support. Often, we help to make the decision by saying why we want the person to live (including talking straight about the consequences to us if she doesn't). Once she has made the contract, we construct the details of help: when she can call people (anytime of the day or night, in the case of the leader, if she is feeling suicidal); what she can ask for that will help to fight the suicide Pig; what special measures she may need to take in order to protect herself from fresh infusions of Pig — space from parents, changes of work, altering drinking or drug habits, etc.). In other words, we take a no-suicide contract very, very seriously, appreciating how powerful, what hard work it is to make one, and matching that energy with our own.

Helping people who are suicidal depends very dramatically on the existence of the group. One leader cannot supply as much real support as people need. Moreover, the impact of a room full of people wishing life on someone is immeasurable. Finally, if the person will not make the contract, she is told she may not be in group. The no-suicide contract is one of the very few transactions which is non-negotiable in group. To continue to work with someone who is actively considering death is to collude with her Pig, and we clearly and firmly refuse to do so.

We use contracts to help people working on alcohol and other substance abuse. The first step is to figure out whether or not substances really are a problem. In the late ‘80s, alcoholism and drug addiction have come under intense social scrutiny. The media is full of material about them. Nancy Reagan urges youngsters to " Just Say No!" The work of Alcoholics Anonymous, especially their Twelve-Step Program, is applied to all sorts of problems, from addictions to relationships, from family dynamics to sex. Questions of power and justice (why young people are attracted to drugs, how we have come to tolerate the exclusion of so many people from any hope of lawful well-being, why people rising on the occupational ladder turn to stimulants as a means of handling job-pressures, and on and on) are translated into conceptions of addiction: people as addicts, organizations as addicts, indeed the society as a whole as an addict. Moral overtones attach to individual responsibilities: addiction, clearly, is wrong, a moral failing.

We have traditionally taken a more fine-grained approach, making a distinction between substance use and abuse. We first ask a series of questions to decide whether there is actually a problem:

Are you experiencing physical problems related to your use of substances? Are you hung over in the morning? Do you not remember what you did last night? Are you suffering from throat or sinus problems, or having chronic colds? The questions are many and detailed.

Does your use of substances interfere with your relationships with people? Do you fight with those close to you when you've been drinking? Are substances a bone of contention between you? Are you jeopardizing work against your best judgment?

Is your usage out of your control? In other words, do you use alcohol or drugs when you've decided not to?

Sometimes the answers are ambiguous, and we might ask people to moderate their usage as an experiment. They may try to drink only one drink a night for a week, for instance. It is much easier to eliminate a substance for a week, holding on tight and counting the minutes, than it is to use it regularly and moderately.

As it becomes clear that there are problems with the way a person uses substances, and precisely what those problems are, we ask that she make a contract of complete abstinence for a year. We examine in detail the problems generated by the contract. When is no-usage a hardship and what help do you need? Is it the lonely evenings, or socializing with co-workers, or hanging out at the neighborhood bar with friends? We help people make concrete strategies for dealing with the hard times. Included is the agreement to call people, fellow group members, friends, and especially the group leader, whenever help is needed. We counsel people about nutrition, exercise and health in general. We work on the Pig that is encountered as the contract proceeds. In other words, making a contract guarantees lots of support.

We choose a time period that is long enough to baffle simple willpower. To eliminate usage for so long means coming to terms with other problems that are associated with the abuse. Some of those problems may have been obscured by the substance abuse. If a couple is fighting all the time about drinking, for example, it may be very difficult to unearth the real differences between them so that they can be adequately assessed and attended to. If someone can only be angry when drunk, then it is only once alcohol is ruled out that he can truly work on reclaiming his power to feel, and with it his power to change that which makes him angry.

Marijuana, the mainstream hysteria against which we opposed all through the ‘60s and ‘70s, has proven itself in the ‘80s to be often a problem. It softens the edges of rational thinking, sometimes at the exact time that people are trying to work on taking power in the world. Samuel gets stoned every morning, and then tries to work on organizing his life, finding new and better work, making a plan for his old age, and so on. The dope and the agenda work against each other. Young people often find themselves trapped in a double-bind: they smoke dope to rebel against a joyless society, but in the process they remain stoned and silent in the face of the society which seeks to make them joyless. Act of political defiance that it once was, marijuana use has a way of undercutting its own statement and leaving its users voiceless and unprotected.

One of the most controversial of our stances about substances has been the contention that some people, having completed a year's contract and worked hard on themselves and their lives, can return to drinking or usage in a way that is not a problem. Over the years, as we've seen more and more people through this process, we have indeed watched many people do just that. Often, the process of learning how to use without abuse is far from automatic; people must experiment, with group and community support, over a long period of time in order to find their own way. Group members have invented methods of making contracts for limited usage: Susan contracts with her group to drink no more than twice a week, always when with other people, and no more than two drinks at a time. If it proves to be more work than she wants to do to stay on this contract, she may alter it, or go back to abstinence. But she has the choice and may sometimes choose to handle substances one way, sometimes another.

Some few people do seem to have strong and inalterable reactions to certain substances. Steven moves very quickly from one drink to drunkenness. Suzanne has a body-response to cocaine, craving it in large amounts once she's had a little; to control it is far more work than she chooses to do given the rewards of using it. For people with such responses, it makes perfect sense to declare themselves non-users for life.

For many years, we found ourselves in a contentious dialogue with Alcoholics Anonymous. Sorrowfully, the controversy has had a tendency to become caricatured, casting us as opponents and vice versa. AA offers a number of very rare and important resources to people. They build their program on an understanding of the value of community support. Meetings are available virtually any time of day and night. The self-help character of AA protects people from professionalism, and offers empowerment from peers. It is a cross-class, cross-gender, cross-race, cross-generation organization. For people who are struggling hard to change habits of substance abuse, AA meetings can often be an invaluable resource.

Many of us, however, continue to be critical of the way in which the spiritual is integrated into Twelve-Step work. We, too, have sought to address the "spiritual," in the sense that we have questioned the well-springs of our commitment to the social good, and have understood that it springs from our values and from a strong sense of oneness with others. But, to seek the sources of strength from a " higher power" seems to us to be problematic. Even if that higher power is seen to reside inside the individual, it is a conception with troubling political implications.

The topics of spirituality and politics, of acceptance and rebellion, of transcendence and engagement, deserve lengthy discussion. It is a dialogue we hope to pursue, not in a spirit of argument, but rather among friends with a shared goal: the improvement and empowerment of all of our lives.

Making the contract, then, is the first piece of group " work." From there on, people use group in a variety of ways. Problem-solving groups rely primarily on a form of " cognitive therapy." That means that we use ideas and words as major tools in the work. We do not, however, exclude other more emotive approaches from the room. Indeed, sometimes people need simply to cry in a nurturing presence, to rage, to mourn and so on. In general, we are open to the work taking us wherever it seems useful to go, within a few parameters.

We do not permit people to abuse each other. The group leader has two main functions: to provide protection and permission. Protection means assuring that each member is safe to talk about whatever she needs. Fear of being trashed by someone else in the room would clearly erode that safety. On the other hand, permission includes, among other things, encouragement to give honest feedback, to say what one is feeling and thinking about fellow group members and their work. It is for this reason that we have developed techniques for saying critical things in ways that are safe, especially held feelings and paranoias (see Chapter 8). Group members are urged to use these forms for their own protection and that of others.

One form of working is to deal with transactions in the room. Group, as I have said, is a laboratory for practicing new ways to handle problems that occur outside of group. For Susan, for example, to give held feelings in group, to negotiate for the time she needs for herself, to get feedback on the ways in which she Rescues during other people's time, are all invaluable opportunities for learning.

A second form of work is to problem-solve about events outside the room. Susan reports on a conversation with Bob, and gets help from the group to understand why she ended up mad. She may need to rage at Bob before she can move into the analytic mode needed to do that analysis. She may need to fight her Pig, which tells her the problem is all her fault, that she is crazy and mean. Eventually, she needs ideas about how to change her behavior. We do not hesitate to give people advice in group, trusting that they will sort good advice from bad. It is very consistent with our theory and values to tell people straight-forwardly what we think they should do. " Think" is an important word in that sentence; advice is always couched in terms of the therapist's opinion or beliefs, and the therapist is always open to discussion and to the very real possibility that she could be mistaken.

Some ways of working are:

Reporting

Dumping feelings

Getting strokes and nurturing

Analyzing problems

Making new strategies

Getting advice

Transactions with other group members

Fighting Pig (see Chapter 5)

In general, new people in group tend to work on the most pressing, external problems in their lives: work, relationships, substances, etc. Over time, as they take care of many of those problems, they learn more and more about themselves in relationship to the world: how their particular Pigs work, what are effective strategies in fighting them, where their lives structurally support their internal dramas, and so on. The work moves more and more inward, at the same time that it affects more and more profoundly the material conditions of life.

Susan, for instance, works as a clerk in a public utility office. She tells us that she's bored with her job, although, " It's okay; it pays well, and it's a whole lot better than a lot of other jobs I've had." Between work and her boyfriend, she has little time for other things. " I have some friends, but I don't see much of them, and besides, they're always busy with their own families or boyfriends." As she practices sticking up for herself with Bob, she realizes how much she depends on him, both to help her with real-life crises, and to provide the zing that she fails to get elsewhere. So long as she needs Bob so badly, she is hard-put to rattle his cage as much as she'd like.

Stage two of Susan's work, therefore, is to look for other sources of joy and well-being, to take the pressure off her relationship with Bob. She begins to ask more from her friends, wanting regular dates and talking more intimately about herself. Some friends are thrilled with these changes, others are not, and she soon realizes she needs new friends. Where can she meet people? The question leads to another: What would I like to be doing that might put me in contact with people I like? She confesses that she's always had a secret yen to paint, and she signs up for classes at the local community college. To do so, she must recognize and combat the profound Pig which sees her as boring, stupid, a drone with nothing to offer others but her sexuality.

As the quality of her life and of her " self-esteem" improves, she becomes more and more discontented with boredom at work. Newly engaged in the project of connecting more deeply with other people, she begins to talk to fellow-workers and discovers that many of them, too, are unhappy. They cook up ideas among them of ways to improve the quality of their jobs, including some innovative visions of organizational restructuring. Together, they begin to tackle the management.

One thing leads to another. Two fascinating facts emerge about working at the prompting of the client's wishes. First, while we never interject politics as an overt agenda, very often the project of personal improvement quickly leads to political action, in the broad sense of the word " political." That is to say, individuals can rarely change their personal psychologies without bumping up against real structures of power and injustice in the world that must be confronted and changed. To seek power to change the world is the essence of politics. In a very real sense, problem-solving demonstrates that the personal and the political are one and the same.

The second interesting quality of working contractually is how often the work ends up being very comprehensive. Radical Psychiatry is often accused of being "not deep," because we apparently concentrate on "superficialities." According to our theory, the distinction is a false one. In practice, that theory is supported over and over again. People take on the most intimate and profound parts of themselves in the course of working on the most mundane.

Because we engage in a contentious dialogue with Freudian views of the unconscious and of developmental theory (see Chapter 14), we sometimes are guilty of over-simplifying on paper our thinking about birth-families and the past. Biological families are important for two, interconnected reasons. First, the Pig is initially formed in the context of the family. The experience of small children is dominated by parents and siblings, although they are not exclusive influences. They themselves are operating in a larger social context. They transmit ideas that have wide cultural currency.

Moreover, the very structure of the family is a potent source of ideology. One mother (who usually does the greatest amount of childcare), one father, perhaps some sisters and brothers, grandparents often at a distance, some shadowy aunts and uncles and cousins who appear at the Thanksgiving table expecting affection: the shape of the nuclear family in and of itself teaches potent lessons. We learn that mother, with too little help and too many demands on her heart and hands, is " supposed" to supply everything we need and in fact does not. We learn to compete for what we need. We learn that women and men relate differently. Studies show that fathers relate to children in ways that are often more verbal, more about play, punishment and teaching. Mothers, on the other hand, spend the bulk of their time with children dressing them, feeding them, scolding them about safety or chores or behavior, coddling them, nursing them — in general, tending to the necessities of bodily existence and family living. We learn that men dwell in a world of ideas and learning, while women are bounded by the mundane. From the treatment accorded these roles in the outside world, we learn to respect the one and treat the other with contempt.

The family is indeed a schoolroom of life. It is not, however, the only one. From the beginning of infancy, the larger world is a presence. The clothing infants wear, their toys and food, conventions about sleeping arrangements (cribs versus family-beds) all are mediators of social norms and notions. Television flickers in the room; music is in the air. Baby carriers begin early-on to influence body postures. Think about the differences between small infants carried straddling a hip, in a firm structure on the back, or in a soft bag against the grown-up's belly.

Before long, children are actively watching television, reading books, playing with toys loaded with social significance (white-skinned, blue-eyed baby dolls; guns and sticks and sling-shots; Barbie dolls and G.I. Joes). Playground interactions take shapes particular to the culture. Children in India run in multi-aged packs, for example; in America age segregation is much more the rule. Village children find toys in trees and animals and ponds, while city playgrounds offer ready-made climbing structures, swings and slides. Every experience, in fact, from birth onward, carries a lesson about the particular world in which a child is growing.

Nonetheless, experiences with the family of birth do carry a special significance. Because children in our society are so thoroughly dependent on parents for care, the points of view of parents are especially weighty. How father or mother, sister or brother treats a child is of very great moment. The earliest, and sometimes some of the most potent, conceptions of the world are formed through these interactions, and they stay with us far into adulthood. Along the way, they are altered by other realities, reinforced by some, challenged by others, recombined in a myriad number of ways in a never-ending process. In other words, childhood consciousness is only the beginning of the story, not the end. But it is an important start.

To fight the Pig, therefore, it is often very useful at some point to understand where it came from. What was it in your own experience in your particular family that made you think you were crazy or bad? How did the family's treatment of you correspond to what you later figured out about yourself in school? Did your mother and three older sisters always do everything for you, convincing you that you were privileged on the one hand, and incompetent on the other? And did the fancy private school you went to confirm both those notions? To understand the historic roots of the Pig can be one very useful strategy. It is not always the most useful, however. Moreover, it often tells you some of what you need to know, but by itself does not necessarily tell you what to do about it.

The other way in which the family is important is contemporary. Those very family transactions that tended to form your Pig are likely to be continuing today. In more conventional therapies, people sometimes construct very exact pictures of dynamics which in early childhood undermined their power to be happy, and then do nothing to alter those dynamics in the present. We are alert to the current transactions between people and their families, and we regularly urge people to take their power in the moment, and to struggle against debilitating dynamics right now. A favorite technique is to notice the transactions that activate the Pig when one is in contact with parents, and then to write a letter giving criticism and asking for changes. Often, this work seems hopeless to people. "My parents are old, they know nothing of therapy; they'd never, ever change." Statements like these are a reflection of the familiar ways that power is distributed in families: parents have it all, and children must adapt, or fight in underhanded and rebellious ways. What we are urging is precisely an alteration in those arrangements of power. We are suggesting a vision of equality between parents and grown children, in which children have rights equal to the parents. It is often a startling idea to parents. Surprisingly often, after the initial shock and bewilderment about what to do differently, parents may be relieved, welcoming the effort of children to make relationships better and the leadership they provide in doing so.

Every group has its own dynamics and gestalt. After years of leading problem-solving groups, I am struck by how unique the character of each particular mix of people can be. At the same time, several patterns and problems do tend to be common to many groups.

Minorities: Our group members more or less show the same demographic characteristics as therapy consumers in general. The majority are white, heterosexual, female, in their twenties to forties, middle-class (in the broadest definition of that word), and able-bodied. However, many working class people come to us, as well as many lesbians, a smaller number of gay men, some people of color, occasionally a disabled person, a few teens and a few people sixty and over.

In women's groups, we try to keep a balance between heterosexuals and lesbians, although lesbians are frequently somewhat in a minority. In mixed groups of seven, we tend to give women the numerical advantage. It is undesirable for anybody to be a minority of one in a group, although sometimes it is unavoidable. Support from at least one other person who shares the particular aspect of identity that's in question (who is also gay, or black, or elderly, or disabled) is very helpful, both as a source of feedback from that particular vantage point, and also as a check on the judgments of the other group members. In the context of a cooperative agreement, and also because our general commitment is to the truth, to demystify the lies which characterize our society (see Chapter 2), we are obligated to be honest about our racism (see Chapter 21), homophobia, ageism and ableism (see Chapter 19), and to unlearn it. We presume that nobody immersed in a society in which " -isms" are so intrinsic can escape their influence. But we also think that such ideas are internalized oppression, or Pig, and, like all Pig, they can be uprooted.

It does occasionally happen that a group contains one person with a particular identity, at least for a period of time. The group leader tries hard to fill the next opening with someone else of the same community. Sometimes, when the task of identifying Pig is falling too much to the minority person, the rest of a group has met separately to take the initiative on unlearning their racism (or whatever). In general, the complaints and fears of the affected person must be taken very seriously and addressed (see Chapter 21). The tools of emotional literacy are enormously helpful.

Secrets: People keep secrets in groups for a variety of reasons.

They may Rescue other members by keeping silent about held feelings or complaints. They may give up their own time, or refrain from working on something they think will upset others.

Some people fear gossip. Ruth worries that Robert from her group will tell Janet, who works in the same office with Sam, the person about whom she wants to complain. Especially in the second decade of working in the same community, networks of acquaintanceship can grow quite Byzantine. Everybody knows somebody who knows somebody else.

Group members sometimes worry that others have heard their story too often before, that they will be bored, or worse yet, angry, wondering " why she hasn't gotten off that yet!"

People often are frightened to talk about sex, money, politics or religion. Sexual problems are embarrassing, money evokes envy or contempt, politics are too controversial or dangerous, religion is " taboo" in a " radical" therapy. Stuart is a member of a political party which has often been persecuted. Many of his most important connections with people are with party members. Yet he is wary of stating what his affiliation is to people he doesn't know well. In addition, his fellow party members are urging him not to give the show away.

In general, fears about working on something are useful. It is naive to believe that people will treat you well until you know it to be a fact. On the other hand, what's the point of paying good money for a group where you can't talk about what really matters? Hesitations are the raw material for making a group safe, an act of power which in and of itself is educational. To be able to say what you fear, check out the truth in it (and the group's task is to validate paranoias), and then construct the protection necessary are invaluable skills to have.

Stuart consults the group leader first privately. She urges him to tell the truth as soon as possible. They devise a strategy for checking out the preconceptions of group members about his politics, and for making an agreement of confidentiality that is convincing to Stuart. The group leader also urges Stuart to explain to his party-fellows why it is important to be able to talk openly in group, and to find out what guarantees they want of safety. Finally, she tells Stuart that there is some risk involved, although the risk can be minimized, and that he is the only one who can decide whether it's a risk worth taking for the benefit of being able to improve the things he wants to work on in his life.

Community and "Confidentiality" : Several of the problems noted above have to do with confidentiality. We have a rather unusual position about this matter. On the one hand, we promote a rule that people not discuss work outside of group lightly. The rule of thumb is that information not leave the room. The important exceptions are that the leader discusses people in collective (see below), and the trainees in their training sessions (see Chapter 12).

We are critical of a tendency in our culture to privatize personal business. Problems of isolation and mystification are central in our theory (see Chapter 2). What fuels the desire for " privacy" (more accurately, secrecy) is the assumption that others will judge one harshly. Often we make that assumption because we judge ourselves so cruelly. And it is true: most of us have learned to think in precisely those ways about ourselves and others, a facet of our internalized oppression (see Chapter 5). But in a community where there is clear agreement that nothing anybody does deserves judgment, to be open with one’s business is likely to be more beneficial than harmful. I do not wish to idealize the extended Radical Psychiatry community; to be sure, this is not utopia. But there is a common value on combating Pig, and that goal is protection against mean gossip.

Ruth tells Robert her fears, and Robert confirms that he and Janet do ordinarily talk freely about everything in their lives, that it would be unusual for him not to tell her about something that was relevant in his life. Ruth asks for a special agreement with Robert: " I want you to be very, very careful about what you say to Janet. If you learn something here that would be hard for you to keep from her, given the nature of your relationship, I want you to tell me that first so we can figure out together how to handle it." What the agreement implies is that Robert's relationship with Janet is important, too, and that there are likely to be ways that information can pass around this circle of people that are worthwhile for everyone.

Sex: We do not put lovers in the same group with each other. Occasionally, however, love affairs arise among people in a group. When that happens, a special set of problems arises. People are often strongly tempted to hold back information in the presence of their lover. They may need a separate space in which to think through troubles in the relationship, or to talk about being turned on to someone else. Lovers tend to make unspoken agreements not to talk about certain things, to Rescue each other around sensitive criticisms. They also have an understandable tendency to want to appear in a favorable light to a lover, particularly a new one or a would-be lover.

In general, we urge people to opt for friendship rather than love affairs with other group members. If, however, the attraction is strong and people choose to pursue it, we ask that they talk about it first. Starting a love affair involves a shift in the stroke economy of the group. Fellow group members have a right to know what the shift is about. Clearly, sex is a matter for autonomous decision-making; we do not wish to legislate it. But it is also a group matter, and the group deserves to be clued in. Most often, a love affair requires that one person switch to another group, to re-establish safety and equality for everyone concerned.

Power and Peers: Power is a central facet of our view of relationships (see Chapter 1). Part of what is "healing" about the group experience is being with equals in an atmosphere where cooperation is valued. But power is not an abstract concept, nor a unitary one. We must say what powers exactly we are talking about. Group members have equal rights to time, to strokes, to attention, to help. The shared commitment to equality guarantees a sincere attempt to avoid abusing powers which may derive from inequalities in the real world. Men, for example, learn in group to recognize ways in which they may assume a right to be taken more seriously, to talk more frequently, or to be afforded other special privileges, and the advantages to them as well as to women in being cooperative instead.

Nonetheless, some real inequalities do exist. In some groups, for instance, some people know each other outside of group, often having elaborate interconnections (living or working together, having friends in common, etc.). The power to elicit strokes inside group is affected by those connections outside group. Often, even when people are all strangers to each other, some group members are more drawn to each other than others. Strokes may not be exactly equal. It is our practice to be honest and forthcoming about these inequalities. For all intents and purposes, power is substantially equal among people in a group, and the exceptions can be addressed and either changed or accepted without ill-effect.

Between group members and leaders, on the other hand, there is a definite inequality of power. The group leader sets many of the terms of the group. She decides on which night it will meet, how many people will be in it, the ground-rules for participation (see Appendix 3) — the fundamental structure and philosophy of the group. Moreover, she does not work on her own life here. She knows a lot more about group members' "business" than they do about hers. We are generally willing to answer any questions about ourselves, and we are self-revealing whenever it is appropriate to be so, saying when we draw on our personal experiences, for example. But we also assume that people don't come to group to find out about us; they come to get help with their own problems, and so we try not to intrude our own problems into the process. This relative mystification of the group leader can lead to an inequality of strokes.

Our stance about the leader's power is controversial. Some people, especially feminists who have struggled hard and bravely against hierarchy in the world, wish all power inside groups to be leveled. We have resisted doing so for two reasons. First, we think it is an unlikely task, so long as a leader exists at all. We prefer to talk openly about inequalities that in fact exist, especially since we do not think those inequalities are necessarily bad.

Indeed, we believe that it is precisely for the sake of the therapist's power that people, in some significant part, come to group. The leader is not a better person existentially; she is not a superior being in any context that matters. But she does have specific powers. She knows some skills for working on problems. She has accumulated experience through the years of hearing people's stories and watching their work. She has access to the even greater pool of expertise and experience represented by the collective (which we'll return to below). Moreover, the very fact that her own person is relatively absent from the process of the group gives her a greater-than-ordinary power to help fight the Pig. This last power is one which people can freely assign to her, and when it is important to do so, withdraw. I have spoken of protection and permission. Group members are directly benefitted by giving to the leader the power to provide them. It is enormously empowering for individuals to be able to assign tasks like these to someone, with the promise that she will be very careful not to abuse those powers (not to inflict her own agenda, not to use them as sexual capital, not to treat lightly confidentialities, etc.), and with the knowledge that the assigned inequalities are temporal and situational. They apply only to the group process, and only so long as they are useful to the group member.

It does sometimes happen that the lines of power between therapist and group member are emotionally charged. A person may give over more power than feels comfortable, seeing the leader as magical or feeling that he cannot get along in the world without the therapist's help. More traditional therapists see this transaction as "transference" (see Chapter 14). It may be true that some elements of the exchange are common to other transactions with people in authority, maybe even parents. Rarely, however, is that quality the only important one, if it is important at all. What is more important is that the therapist be humble about the power given her, and that the group member be welcome to take it back when she wants.

Optimism is a very important part of the group leader's healing power. The simple anticipation that people can make the changes they seek — an anticipation implicit in the structure of the group, in contracts, in the straight-forward way of working — is an empowering transaction. Optimism springs from two sources. First, over the many years that we have collectively done this work, we have been moved and heartened over and over again by people's successes. We have literally been educated to optimism by results.

Second, our underlying political stance is itself optimistic. To locate problems in conditions which exist in the real world, and in their learned reflections inside people's heads, is to suggest a do-able set of actions that will lead to change. Conditions can be altered; Pig can be unlearned. The tasks are straight-forward and manageable.

Our therapeutic politic is closely linked to a world view. Let me say that Radical Psychiatrists do not share a political "line." One of the most compelling facts about our Collective is the variety of points of view it comprises. Some of us are Marxists of an old school. Others come out of the New Left. Still others evolved their social conscience in church environments. The Women's Movement was a definitive politicizing experience for others. There are atheists and witches among us, socialists and democrats, confirmed urbanists and "back-to-naturers." Debate is lively, occasionally heated, always educational, and generally productive. We are content to live with differences, and to learn from them, because we have a very compelling reason to be together: our shared work, and the unity we experience about the theory that underlies it.

What we do share is the conviction that people move toward well-being, and a view of history that sees behavior in a progressive light (see Chapter 3). We are very careful not to impose any particular political view on people in groups. Instead, our politics are contained in our psychological theory, and in the construction of our practice. We often speak about the wider context for personal problems, in order to demystify the experience of that problem and as a means of nurturing. When Sandra, a member of a prominent dance company, wept because she felt excruciating guilt about her envy of a fellow-dancer's skill, we spoke of the competitiveness of the art-world, and of how scarcity of money and an artistic ideology based on the notion of individual genius promote competitiveness. We both helped her to examine her own responses, to understand them in the larger context, and to find ways to address her legitimate needs for recognition and for continuing growth as a dancer. We did not lecture her about the evils of competitiveness, or the ideals of a cooperative art-world.

Leaderless Group: One time in a month, most groups meet without the leaders there. While the group follows exactly the same procedure as other nights, doing a full-fledged problem-solving regimen, this is a time to experience a wholly peer group, when different things can happen. People tend to talk more, to practice problem-solving skills, to take risks they might not with the leaders there, and so on. The therapists get a rest, and the group members learn things they might not otherwise. Hogie Wyckoff dubbed this night "leader-full" group as opposed to leaderless.

There comes a time, anywhere from six months to four years after starting group, when people are ready to leave. There is no value in Radical Psychiatry on "doing therapy" for its own sake. If people have problems and wish to work on them with the help of a group, then and only then should they be there. Sometimes a person knows she has a problem, and chooses not to work on it. Perhaps her career is more important than the lack of a relationship at the moment. Perhaps things are rocky with her teenaged child, but basically tolerable and not as pressing as the painting she is newly learning to make. It is crucial that the therapist not superimpose her own agenda.

For this reason, group leaders do not make leave-taking difficult. There is always a good reason why people talk about leaving, and most usually it is because they are ready to go. Occasionally, a group member may change his mind, having talked it through with the group, and realized that there is a new contract he wants to make. Sometimes, the discussion may lead to the conclusion that he has not completed his current contract and is feeling hopeless. Usually, that hopelessness is grounded in some helpful criticism for him, for the group or the leader. Very occasionally, a group member or leader may volunteer the opinion that the leave-taker is succumbing to her Pig, that she could in fact benefit from staying in group and working things through. This is an intervention which should be made by a therapist only with a great deal of care, and only after having truly understood the legitimate reasons why the client is considering going. Most of the time, when people talk about leaving, they have given the matter a good deal of thought and have rightfully come to the conclusion that it is the right thing to do.

Once the decision has been made, people are free to leave on their own time-schedule. Usually, both they and the group appreciate a week or more notice, to get used to the idea, to tie up loose ends, and to ritualize the parting. Sometimes, however, people want to leave more abruptly, and they may. The top priority in participating in a group is to be benefiting from it; leave-taking should follow that rule, which ordinarily guarantees that people will also take sufficiently good care of their fellow members. It is very hard on relationships, for instance, for people to leave without first discussing it in the group as a whole. A telephone call to the leader is not sufficient. But it almost never happens that people who have had a significant experience in a group would choose to leave without good-byes.

On the last night, we urge people to both give and get strokes. Sometimes, those strokes take the form of recounting the work accomplished over the time of participation. There are almost always stores of strokes to be given; this parting ritual both underscores the connections forged in group and sends the departing member into the world well-stroked.

As we've done groups for two decades, we've found that many people return for second or third rounds of problem-solving — a heartening procedure. If there is no such thing as "mental illness," then "therapy" cannot lead to cure. Instead, people are learning ways to solve problems as they arise. Sometimes, the help of a formal group is enormously useful, and that is the time to join one again. Often, because people have taken care of the most obvious problems, and because they have learned many skills in their first group experience, they come back primed to work deeply and effectively on the next level of their problems. Once again, we all know best what we need. Trusting people to be their own "diagnosticians" has paid off handsomely over the years we've led problem-solving groups.

The mid-1970s saw a blooming of alternative therapies along many paths. Among them was a new interest in techniques of bodywork, a method that derived, in the main, from the work of Wilhelm Reich.

Stated simply, bodywork is about reconnecting the mind and the body. Reich theorized that emotions were actually a body experience, that feelings operate as a flow of energy in the musculature. We are alienated from a wide range of physical sensation — almost everything, in fact, except pain and sexuality. At the same time we lose contact with our own deepest emotions.

Moreover, even when we are aware of what we feel, we are severely restricted in expression. It is hard to find a situation in which we can let go in safety and with full encouragement. Our society simply doesn't support that kind of behavior. Abandon can be found only in spectator sports, some churches, at wild parties which are usually stimulated by alcohol, or in one's car while driving on the freeway. It is hardly surprising that the ‘80s have seen a proliferation of sports-related riots, of freeway violence, of evangelical ecstatic churches. Heavy-drinking, heavy-drugging parties are a way of life for many Americans.

Reich, a disciple of Freud's, was trained in psychoanalysis. After a number of years, he grew critical of the practice, impatient with its length, restive because its results were so often imperceptible. He began to experiment with more dramatic and concrete techniques.

Reich fastened on Freud's theory of "libido," or sexual energy. To Reich, the notion that the human psyche is powerfully influenced by some form of energy was intriguing. A literalist, his dissatisfactions with psychoanalytic results prompted him to ask a set of concrete questions about the idea. Until that point, Freud's writings had a typically metaphorical quality: he postulated the existence of libido, but was unconcerned about examining its exact nature or consequences. Reich set to work to understand the ways in which body energy is akin to psychological energy, and the ways in which both become disrupted.

Connections between mind and body had become very obscured and alienated during the Victorian age, a process both abetted by Freud's emphasis on the intangible unconscious, and challenged by his revolutionary emphasis on sexuality. Reich's attempts to spell out the exact nature of that connection quickly took on a revolutionary character. The more he examined the ways in which mind and body are an organic whole, the more he was also forced to look at the ways in which individuals are a part of the social order. As he looked more and more inward, more and more concretely at the individual's psychology, he found himself looking more and more outward, or politically, at the way the individual was connected to society. Reich hypothesized that energy became blocked in the body, that circulation and electrical sequences were literally altered by patterns of tension in the muscles, and he asked how that blocking came about. What happens to people to block energy?

Oppression, Reich answered. As people are painstakingly formed into beings who fit the needs of society, their natural impulses and inclinations must be inhibited and altered, or oppressed. To do so, the physical manifestations of those impulses, the actual tendency of muscles to behave in particular ways, must be changed or blocked.

Children are taught many injunctions (see Chapter 5) that have concrete consequences for their bodies. "Don't cry!" little boys are told. Men, however small, are supposed to "be brave." To show what you feel is a disadvantage in a competitive world ("The other boys will think you're a sissy; you'll never get chosen for the team;" "If the boss knows how scared you are, how much you want the promotion, he'll think you're weak and pass you over." ). Men (and increasingly women in the business world) are supposed to be able to take what comes to them, do the job however adverse the circumstances, go-it-alone without fear or sadness. So "be a man, son," and dam that flood of tears.

But it takes a physical as well as a mental act to stanch a flow of tears. You must hold back your tears, gulp down your sobs. To do so, muscles must be contracted and held: the throat tightens, the chin trembles, the lips compress. The more often you repeat the process, the more adept you become. You can stifle your sobs more quickly, more thoroughly. Eventually, you develop a habit; like Pavlov's dogs, you learn to respond to the slightest impulse to cry with the clenching and tightening needed to resist. The body takes over; not-crying becomes as automatic as crying once was.

Meanwhile, you still feel sad. With no outlet for the feeling, it becomes an intensely painful sensation. So the mind turns away from consciousness of that about which it can do nothing. But it is difficult selectively to erase emotions. The brush wipes a clean slate, and along with sadness vanishes a wide range of other feelings. "Don't cry!" bleeds over into "Don't feel!" "Don't feel!" becomes justified by "Feelings are a weakness," which suggests, "The world is a cruel place; bear up and fight hard." An ideology is formed, that corresponds to the shape of the world. A competitive society is a cruel place, and it needs people who will compete hard in order to work.

What we have presented here is a very simplified sketch of how social injunctions are internalized, through the medium of the body, and become psychological systems. In the ‘70s, as many people turned to Reichian work and to Bioenergetics to address their physical-psychological selves, we, too, became increasingly aware of the body component of our work in groups. We developed our own version of bodywork.

What we sought in bodywork was a supplement to group work, which tends to be verbal, rational, linear, and goal-oriented. We began to offer monthly sessions, usually on a weekend morning, where group members could experience alternative ways of working on their problems. The first model for this work was developed by Claude Steiner, who did one session monthly for all the members of his groups. Before long, other practitioners began offering joint sessions, open to members of all Radical Psychiatry groups.

We rented a dance studio, in order to have enough space for ten to twenty people to move around and to lie down. Several group leaders would be there, assisted by as many trainees as possible. We scheduled three to four hours, and instructed people to come dressed in loose, comfortable clothing and to bring along foam mats, sleeping bags or blankets. In the early days, we offered these sessions as part of the "deal" when people paid for a month of group; in return, group leaders did not meet with their groups once a month (the origin of "leaderless group" ). After some time, bodywork practice became more specialized, because it interested some group leaders more than others. As that happened, we struggled with the economics of the matter, and began to charge a nominal additional amount for the bodywork sessions, to cover the cost of studio rental and to pay the "specialist." We will return to the questions of money and space, and the unresolved problems we struggle with in relation to them.

We apply to bodywork all the same principles that underlie our other work. We seek to share power, and to keep a cooperative contract.

As in group, we begin by making contracts, although these are for the session only. Everybody sits in a circle, and each person says what she or he is there to do. Sometimes, when bodywork is an unfamiliar way to work, people may start by saying their fantasy about coming to the session. Often, we help people to connect that fantasy to work they are doing in group. A woman, for instance, who has a problem with Rescuing, and has made an ongoing problem-solving contract to ask for what she wants, might contract in bodywork to express whatever she feels. She may be worried that she'll pay too much attention to other people's sounds, feel sorry for them, want to help, and lose touch with her own needs and feelings. She can ask permission from the group to ignore them, and decide firmly that her own work is her top priority for the day.

Other typical bodywork contracts are: "Getting angry," "Crying," "Feeling good," "Releasing tension," "Getting in touch with my feelings," "Relaxing," and so on.

Generally, the work begins with some warm-up exercises, anything to loosen muscles and get people in motion. They should be fun; we frequently do them to background music — a little rock'n'roll goes a long way to loosening people up!

Next, we might do an exercise that relates to a number of contracts. It's surprising how often common themes can be found. If several people are working on anger, for instance, we might have the group growl at each other, or fight for a towel, or walk around shouting "No!" at each other. Bioenergetics practitioners are a rich source of these thematic exercises. But this is also a chance to be creative and, again, to have a good time.

The core of Radical Psychiatry bodywork is generally the next phase of the session. We ask everyone to lie down comfortably. We suggest that they loosen their belts, remove rings and watches — generally unfetter themselves so that they can move in any ways they wish. Sometimes we'll talk people through a simple "getting-in-touch" exercise. Always, we interject a great deal of explanation of what we are doing.

Bodywork has a tendency to become mystified. Because we are habitually cut off from our bodies, when we begin to re-experience them, we are apt to be surprised. Many of the sensations and experiences of bodywork seem extraordinary to people. It is easy to attribute the fireworks to the magic of a leader, or to be scared about the secret capabilities one discovers in oneself. We seek to put the process back into the realm of the ordinary, to give people ways to possess their own work intellectually and well as physically — a direct outgrowth of our commitment to responsible uses of power.

We begin by explaining the process on which we're about to embark:

The purpose of bodywork is to provide an opportunity for people to speak from and with their bodies. Our culture causes us to disconnect our minds and bodies. As a result, we stop being conscious of what is happening in our bodies. This exercise is designed to help get reacquainted.

Close your eyes and breathe naturally. Let your arms relax at your sides. Focus in on whatever it is that you're conscious of right now, to whatever is occupying your consciousness. Consciousness is not limited by this room and this moment. Right now you might be in the past or in the future or in another galaxy. Pay attention to where you are right now and when you have a clear idea, speak out and say where you are so we all can hear. I'll give you some time to get in touch with that.

When you are ready, imagine that your consciousness is a light. You can use this light to survey your physical self and to notice what is going on. Start with your toes, imagining that the light reveals what is inside them.

Gradually, we talk people through a slow and gentle journey into their bodies. Most of us have a very limited range of possible discoveries. We may notice that some part hurts, or that another part is tight. We ask questions in order to stimulate an increase in available vocabulary:

Shine the light on your thighs. What do you find? Are they hot or cold? Soft or hard? Is one higher than the other, or shorter, or thinner? What color are they inside? Are they shiny or dull? Does the light reflect off them, or is it absorbed?

Each question is followed by a sufficient pause for people to introspect. Timing is very important in these exercises; the leader needs both to keep the process moving, and at the same time to be unobtrusive, to stimulate ideas without dominating them.

Eventually, we ask people to report on their experience. We encourage them to be wild and bizarre:

One of the ways we're separated from our bodies is that we're told many of the things we experience are crazy. It is not all right to tingle, or to feel your thighs are ropes or sponges or whatever. Here's your chance! Anything goes here.

Hesitantly at first, from one corner of the room and then another, people begin to speak:

"I found my stomach was like a cave. Its walls were pocked and shiny and black and red and cold. But there was a warm stream of golden liquid flowing through the cave, shining light everywhere and making me feel good."

We congratulate the person on her description, encouraging other imaginative ways of expressing our inner experience.

"I felt that my feet were much higher than my head, although I know I'm lying flat on the floor. When I shined my light inside my head, it seemed flat, like the inside of a book, while my feet were soft, and squirmy, like they were full of worms."

"I had a pain in my chest. When I looked at it, it was a knot of metallic strands. Only, while the light shined on it, it began to soften and unravel, and the pain went away."

Already, we begin to see body changes, happening gently and without effort, just because of a change in consciousness. After everyone (who wants to) has spoken, we continue with a new set of instructions. In what follows, we concentrate especially on creating a climate of safety, in which people can do and express exactly what they please:

What you've just done was to use your mind to gain a better understanding of your body. You might have noticed that the simple fact of concentrating attention on some part of your body changed the way your body felt. As your body sensation changes, so also will what is available to your mind. In this way, we can go back and forth between mind and body.

In this session it is OK to express what your body has to say. The kinds of things that people do when they express what we feel in our bodies would probably create difficulties in the outside world. We provide a situation here where there is total safety. It doesn't matter what you do with your body, what posture you assume, what movement you make, whether you cry or scream or yell; it's all OK, and you won't get criticized. You need feel no embarrassment or fear. The worst that could happen is that somebody else doing this work does not like whatever you are doing, and they may say so. But then you don't have to stop as long as you're not physically injuring anyone, and we will make sure that you don't accidentally hit or hurt someone or yourself.

These statements are designed to create a sense of trust and safety so the person can effectively deal with the strong messages which we all hear from our Pig (see Chapter 5) when we are about to express a strong feeling. Typically the Pig will say things like, "You are making a fool of yourself!" or, "This is childish and immature. Stop it!" or, "People will hate you for being so crude." The leader's reassuring statements come from her own Nurturing Parent, and provide the participants with ammunition against injunctions from the Pig. The permission and protection we provide in this way are essential to effective bodywork:

Some of the sensations you've been reporting — feelings of floating, hollowness, or heaviness, tingling or tight bands around some part of the body or energy fields, streaming sensations or what-have-you — can be alarming. People who feel them can get scared that they are losing their minds, which is in fact true. You are being encouraged to lose your mind, but remember that it is perfectly safe. You can get it back anytime you want. You are not really losing it — just setting it aside for a while.

If you get scared, however, say so, and if you want something ask for it. We will be here for anything you need. If you need a pillow to hit, or an extra blanket because you feel cold, or someone to hold your hand or hug or massage you, or if you need a tissue or something to spit or throw up into, just ask. We are here to take care of your needs while you explore your feelings.

Now that we've set the stage, making it safe, and encouraging people to ask for whatever they want so that it will continue to be safe, we begin to shift gears. We teach people how to alter their breathing in order to intensify their feelings:

How we breathe has a lot to do with how much we feel and also perhaps how we feel. Not breathing deeply has the effect of constricting your feelings, and breathing deeply has the effect of fanning your feelings like embers in a fire. If you blow into them, the embers will glow and sometimes flames will break out. It's the same with feelings: breathing will make them more vivid, and sometimes it will cut them loose into a roar.

I'm going to teach you a little bit about breathing deeply in order to facilitate your contact with your bodily feelings. Now you will use the power of your mind, of your consciousness, to alter your body. In turn, your body will make available to your consciousness more intensely experienced feelings.

At this point we give a brief exercise in thoracic and abdominal breathing, teaching the difference and then showing how to combine the two in order to maximize respiration. We instruct people first to breathe into their chests, expanding them as fully as possible on the exhalation. We suggest they notice which muscles limit their chest's expansion, and self-consciously increase their capacity. Sometimes it is helpful for people to lay a hand on their chests, and sometimes a helper will gently touch a tight spot.

We turn next to the abdomen, again instructing people to breathe more fully, to allow their bellies to balloon out with the inhalation and collapse with the exhalation.

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Finally, we suggest a three-part breath: inhale into the chest, then into the belly, then exhale fully. It sometimes takes a while, and some individual coaching from the assistants, for people to get the knack of breathing so fully. Also, people may begin to experience peculiar sensations, and to get frightened:

It is common for people to begin to feel some unusual tingling while breathing deeply. That's normal; don't be frightened. As muscles begin to relax, they may shake. It's good to let yourself shake. Also, some people's hands may contract and stiffen. This is a phenomenon called "tetany;" it is harmless, and you can stop it anytime you want by shaking your arms, breathing normally, or a variety of other ways.

You may want to raise your knees, plant your feet firmly on the floor, and let your legs hang in a comfortable position. This allows your hips to relax. Also, it is a good idea to breathe through your mouth. Most of us have tight jaws, a result of the many injunctions we have not to speak. Mouth-breathing helps you to relax your jaw.

Now we are ready to move to the next phase of the exercise: making noise. Again, the politics of this move coincide with the bioenergetic consequences. Our most heartfelt feelings are literally silenced by society; in order to release those feelings, we must relax the muscles which restrain expression. Making noise helps:

When you are ready, make a noise as you exhale. It can be any noise, anything that suggests how you are feeling. It might be a sigh, or a growl, or a song or a laugh.

One of the ways we are oppressed is that we are limited to a very small range of expression. We can speak words, if they are rational and "sensible." But if we go around growling, or sighing, or shouting, we are considered crazy and locked up in asylums.

Here's your chance to break the rules. Make whatever sounds you please. Nobody outside can hear us. Nobody inside will mind. Go for it!

Often, because we have no models for sound-making, it is helpful for the bodywork leader to make some noise herself. She may walk around the room, picking up the muted experiments of people, and mimicking them, making them louder, more strange, playing with variations on them. Be experimental, all in the service of giving people permission and ideas.

As the sounds begin to flow freely, people will start to experience waves of feeling. Someone may weep, someone else to shout and become angry. In another part of the room, a man laughs uproariously, while a woman screams. All these expressions are fine. The leaders and assistants move about the room taking care of people. Someone may want to pound with angry fists; pillows should be securely placed under her hands so she won't hurt herself. Someone else may want to curl up and be held while she cries. Tissues and sips of water are freely supplied. People often want necks or backs or hips massaged, to help in the relaxation of tense muscles. Some need to hear nurturing messages to help fight off restraining Pig messages. "You're doing just fine; let it all come out. What you're feeling is good and right."

It is very important that the helpers provide what is wanted, but also they should not jump the gun. We often have a strong impulse to Rescue, and it should be ardently resisted. When in doubt, it is better to ask people whether they want something, and what it is, than to plunge in unasked. It is helpful for the assistants to keep people's contracts in mind, and to remind people to be guided by them.

Throughout, the leader periodically reminds people to keep breathing. The release of emotions often comes in waves, with people taking heart from others in the room, or responding to their neighbors' work. So also are their occasional group lulls, when a little cheering on may be helpful.

There is a common "Bodywork Pig" that is biased in favor of big, noisy, explosive work. Emotional release of this sort can, indeed, be very relieving and illuminating. Often, though, very subtle changes happen that are just as important. To experience a tingle when one has felt nothing but big feelings for years is a revelation. Men, for instance, often need space to feel exactly what they feel, to be in touch with the softer and smaller sensations. It is very important that the leader not prejudice the work in one direction or the other.

The bodyworker develops an intuitive sense of when the group as a whole needs encouragement to do more, and when the work is finished. At some point, usually after an hour to an hour-and-a-half, she will say:

We're going to stop soon. Think about what you may need in order to finish. Ask for whatever you want.

When you are ready, slowly sit up. Let's form a circle and talk about what happened.

The closing circle is an important part of the process. Adequate time should be left to do it fully. People are urged to report on their experience, and to finish anything that is incomplete. Don't send people back out into the world without this kind of completion.

"I started out feeling really silly, and a little pissed off. I didn't want to breathe in such a peculiar way. Then you said to do whatever you want, and so I started to yell, 'No! No, I won't breathe deeply!' I realized quickly I wasn't kidding; I was really pissed off, and you brought me pillows so I could pound. I had an old-fashioned temper tantrum — it felt great! But as it ended, I remembered how I was punished as a small child for tantrums, and suddenly I got terribly sad. I cried and cried. It was terrific to have Sandy hold me. Now I feel all soft and glowy. What an experience!"

Another person looks uncomfortable and reports, "Nothing much happened for me. I breathed and breathed; I really worked very hard at it. After awhile, my hands stiffened and tingled. I didn't like it at all, and so I stopped breathing, but my hands stayed stiff, and I was getting really freaked out. Finally, Mark suggested I clap my hands together. That worked, and was fun, and I laughed a bit. But generally, I felt awkward and shy and I'm not sure why this was useful."

Someone asks what his contract was. "To feel whatever I feel," he answers. "Sounds like you did that," the bodywork leader comments. "Now that you know how to handle the tetany more effectively, maybe next time you'll be less distracted by it."

The group member replies, "I feel bad about doing so little when other people had such big responses. I need some strokes about what I did."

Strokes (see Chapter 8) are almost always easily forthcoming after a group experience as powerful as this one. Someone from the same problem-solving group says, "I know from our work together in group that just to come here was a big event for you. I also really am moved that you hung in there, and saw the thing through when you were scared. I think you did do big and important work."

After everyone has reported, the session ends with strokes. One of the side-benefits for us in doing bodywork in this fashion is that it helps to extend the Radical Psychiatry community. People from various groups meet each other, and have elaborate strokes to give at the end of working. People often need strokes by the end, because they have done work which runs so strongly counter to the Pig. Make sure that everyone gets what they need, and that people are not shy about asking for particular strokes, or strokes from particular people.

As we write this chapter, in the late ‘80s, we are in the midst of yet another re-evaluation of bodywork. We have no doubt of its value. But the fashion for this sort of work has passed in the culture. Fewer group members are excited about doing it, although they often become more interested after having experienced it once. Without pressure from our groups to offer bodywork, we have a tendency to overlook it. Arrangements are difficult to make. It is hard to find spaces large enough, and they tend to be expensive. Mounds of pillows and covers and tissues and so on have to be carted to the rented studio. Over the years, we who practice Radical Psychiatry have become busier. We do more groups, more Mediations, more individual sessions. To take time out for bodywork has become increasingly problematic.

Lately, we have begun experimenting with other ways to do more intensive work with group members. We are holding a series of one-day sessions, at about three-month intervals, in which we do more experiential work, although not necessarily bodywork. At one, for instance, we talked about the theory of the Pig, and then divided into small groups so that people could fight their Pigs using psycho-drama techniques. Interestingly, in the very early days of Radical Psychiatry, we used to offer something called Permission Workshops which were not dissimilar to these All-day Intensives.

Nonetheless, we are not happy with the difficulty we find in integrating bodywork into our practice. Here is a continuing frontier for more experimentation.

Racism will not be cured by Radical Psychiatry. Its roots lie in the structure of our society. Its face is reflected in a thousand ways in the course of daily life in America.

Radical Psychiatry can, however, make a contribution to the efforts of people of conscience to recognize our own racism and to do something about it. The ideas and methods we propose here are tools for working together to overcome the attitudes and habits which divide, and thereby weaken, us.

Racism is a structure of inequality which acts to deny certain groups of people their rights and access to opportunity. As a political institution, racism relies on the internalization of certain attitudes. In other words, people must believe that the members of the group which is discriminated against share certain characteristics, simply by virtue of their identity in that group. Black people are lazy, women are weak, Asians work unthinkingly and obediently, Latinos are shifty, Jews are greedy: all are generalizations, or stereotypes, based on little or no data. As a result of these stereotypes, individual members of the group become invisible; on first meeting, they are viewed through the prism of these internalized generalizations, rather than on their own merits.

Racist attitudes, then, are Pig (see Chapter 5), according to Radical Psychiatry's definition (Pig = Internalized Oppression). Let me quickly make the distinction between racist attitudes and racial oppression. The latter is a set of actions taken on the basis of racist attitudes to deny power to the discriminated-against group. Such actions often occur, despite the good, non-racist intentions of the person taking them.

Bob Blauner, for example, has detailed the ways in which people of color are disadvantaged at the University, despite the expressed (and sincere) intention of progressive faculty members to challenge racism. The underlying assumptions of the University (that scholarly work is constituted in a particular way, that academic standards must be maintained, that those standards rest on a particular culturally-determined set of beliefs, etc.) work against the success of people who hold different cultural values, and who have been traditionally excluded from the institutions which promote those of the University. This form of institutional racism (that which operates independently of the attitudes of the perpetrators, and so would have a strong tendency to continue even if prejudice were to disappear) is common among progressive groups.

In another example, a progressive theater company may wish to include more actors of color, but cannot find good scripts with parts for them and cannot bring themselves to consider radically unconventional casting (women in men's roles, people of color in roles which are clearly intended for white people, and so on.)

In Radical Psychiatry, we have long grappled with the contradictions of our position, because it tends to exclude many people with whom we would wish to be allied. For instance, we have resisted becoming credentialed, for theoretical and political reasons (credentialling standards select for a kind of therapy to which we are explicitly opposed). Yet to be uncredentialled means that we cannot work in agencies which pay (relatively) decent salaries. We are therefore dependent on private practices, and must charge fees. We try to keep those fees low and flexible, but nonetheless they exclude many people — many people of color, for example — who cannot afford them. Moreover, potential Radical Psychiatrists must be willing to take a very large risk, to work extra hard against substantial odds to support themselves during the slow years of building a practice. The success of that endeavor is even more problematic when practitioners seek to work with communities (such as working class people and people of color) who do not tend to seek out private therapy. Over the years, more and more Radical Psychiatrists have opted to get degrees and licenses, and to work inside mainstream institutions, bringing with them their radical predispositions. The effect has been productive, but has raised new problems. There are no perfect solutions to these contradictions. But if we decide that we are truly intent on working together in interracial groups, we must be willing to make institutional changes that may challenge us deeply.

We are still, however, left with the problem of our internalized oppression. Once we think of racist attitudes as the Pig, we can begin to say some things about how it works, and how to fight it. First of all, racist attitudes are always wrong. It may be true that the Pig attaches to some grain of truth. It may, for instance, be true that a given black teenager is less motivated to work for good grades in school than is his white, affluent classmate. The black youth may have figured out that his chances of getting a job are so small, even if he excels in school, that they are not worth taking. He may be resentful and rebellious as a result. None of this behavior, however, proves the racist Pig about him, that he is lazy and shiftless. That is a generalization. It stands outside of time and place (When and where is he lazy? Is he lazy when repairing his motorcycle? Is he shiftless when writing and performing popular music?)

The second characteristic of the Pig which is useful in the fight against racist attitudes is that the Pig can be changed. The Pig is an idea which has been learned. Consequently, it can be unlearned and replaced with ideas that are more accurate and truthful. Some ways of changing Pig ideas in a problem-solving setting are outlined in Chapter 5. I suggest below some strategies specific to a discussion of racism in other contexts.

Finally, to say that racist attitudes are Pig is to say that they come from a social milieu by which we all are influenced. Racist notions surround us: We see mostly white actors on television, unless we are watching a "Black piece." White is "normal," Black is "exceptional." Asian women models are very often dressed in lacy underwear or girlish dresses. Many citizens of big American cities never see a person of Chinese origins outside a laundry or a restaurant.

To recognize our own racist Pig, then, is not to confess original sin. It is very important to be able to be self-critical without self-blame. The majority of people in our society are immune neither from being stereotyped, nor from stereotyping others. I am a middle-aged woman. Sometimes, when I meet a person for the first time, I can read in his eyes his preconceptions about me: square, comfortable but not sexy, sweet but not interesting. On the other hand, I was recently part of a group that was challenged by a Japanese-American woman: Did we not assume she was shy and withdrawn? I found, to my consternation, that I did indeed. It was an assumption that proved entirely wrong, and that I have not since repeated.

Guilt and shame about racist ideas are not helpful. They lead to silence, and from there to an impregnable stronghold of secrecy. When unheard and unchallenged, the Pig festers. Only when it is out in the open can it be examined and undone.

Guilt and shame, however, are closely associated with pain and dismay about the racist state of our world. To combat the former is a step toward healing the latter. It is in the interest of all of us to do this work, for we all are affected in some way by a divided society, riven by racial (as well as other) injustices.

The fight against racist Pig can most sincerely be undertaken in the context of racially mixed groups. That does not mean that we cannot (or should not) work on our racism, or other -isms, at other times and places. But nothing motivates like necessity, and it becomes essential to fight stereotypes when working cooperatively with people affected by them.

People who have been oppressed by stereotypes, however, are frequently unwilling to struggle very hard with those who hold them. People of color, women, older people, gays, lesbians, and disabled people are often weary of warding off others' prejudices. Too often, particularly in groups of progressive people, criticism about racism is met with well-meaning discounts: "No, no, I didn't mean that; some of my best friends..." Or criticism is seen as accusation: "How can you think that about me? Others, maybe, but not me!" Not surprisingly, people who have been wounded by discount may eventually resort to attack. Criticism may turn ugly, for on its back are riding huge monsters of resentment and frustration.

Here, then, are four suggestions of ways to fight racist notions:

1. Listen very carefully to criticism from a discriminated-against person.

Even if it is badly delivered, it always contains some grain of truth. It may be mistaken in detail or in its speculation about intent, but the complaint is at its core useful and correct.

Think of criticism of this nature as paranoia, in the Radical Psychiatry sense (see Chapter 8). Like paranoia, such criticism always has a kernel of truth. Be sure you have understood that kernel before you act on any impulse to excuse or defend yourself. It will be much easier to take this unguarded posture in the face of criticisms if you remember that you are not a bad person for holding some mistaken belief. Such attitudes are inevitable, given the racism in our culture, and you are to be commended for working hard to discover them and to change.

People who have suffered racism, sexism, or any other -ism, are not under any theoretical obligation to struggle with such attitudes when confronted by them. However, when people have come together in a cooperative group for some shared purpose, the affected person stands to gain direct and personal advantages by giving criticism. It may be wise for her to do a minimum of work. If others in the group are not willing to work hard, harder than she does, to challenge stereotypes, then she should complain only about that. Criticism is gold, and the giver should be sure she is getting back equal coin.

But given a decision that the people on the receiving end are well-intentioned, open to dialogue and willing to work hard, the affected person will get better results if she gives her criticism skillfully. For example, to say that someone is racist (sexist, homophobic, etc.) is to invite discount. Generalizations are not sufficiently helpful, and they invite guilt and defensiveness. Look instead for the concrete: what did the person say or do that made you think she was racist? It is very different to say, "I became worried about racism when you kept interrupting to provide me with the next word while I was speaking just now. My paranoia is that you think I am not sufficiently articulate to say what I mean because I am Black."

In most settings where people share a progressive social agenda, racism may take forms that are subtle and hard to identify, making the task of both the giver and receiver of criticism hard. People will already have worked to overcome more overt forms, because they sincerely desire to be non-racist. But racism can be involved in more complex transactions. Rescue, for instance, can be a carrier of unhelpful attitudes (see Chapter 7), as the example above suggests. We once realized after the fact that we had urged a lesbian trainee to start leading groups too quickly, and too alone, making an exception to our usual practice in an effort to promote her career. It was a Rescue, and she suffered for it, because she was left out on a limb with insufficient back-up.

In our Collective, for instance, a long-time colleague who was a gay man insisted we meet without him to fight our homophobia. We protested that, after so many years of working together and sharing frank dialogue, we didn't need to. We knew from old experience, however, that our colleague deserved to be taken seriously, and that in fact we were very likely to benefit from doing so. We met, and for some time made little progress. Then someone asked how we would feel if our sons were gay. The question would probably not have been raised if our gay colleague had been present; it certainly would not have been answered so fully and, as it turned out, usefully. Here was a place we did indeed need to confront our homophobia, and did through heartfelt and honest discussion.

In the ideal, nobody would ever be a minority of one, or even a minority at all, in a group. But it does commonly happen that people of color, or gay people, or disabled people, or so on, find themselves in the position of being outnumbered by people from a category who are dominant in the culture. Conflicts are bound to arise, just as they might for any other member of the group. When they do, the minority person should have easy access to an advocate: someone to stand by her side, help to support and communicate her position to the group at large, give her encouragement and backing when she feels outnumbered, and so on. Sometimes, an ongoing member of the group can be asked to take the advocacy role by the person affected. He can rise out of his position as a "player" and look at the situation from the point of view of his comrade. Sometimes, however, there is nobody in the group sufficiently trusted by the person in a minority. In that case, she should be encouraged to bring an advocate from outside, a person she trusts and who, at the same time, will be careful to avoid further polarizing the conflict.

To have a method for working on racism can be an enormous relief. None of us wants to be thinking unfair and prejudicial thoughts about our comrades, nor to be acting unwittingly in ways which are oppressive. Most of us do not wish to benefit from racism, and we feel deep pain about the ways in which most of us do. That contradiction, that we do in fact gain from the deprivation of others, whether we be white, male, straight, upper class or able-bodied, while at the same time we deplore these inequalities, is one we must confront whenever possible. We cannot singlehandedly eliminate -isms, but we can expose and correct stereotypic attitudes wherever we find them among ourselves. And in the process we can treat each other with the respect and kindness that is deserved when people of good conscience undertake hard and pioneering work, both in the world and on our attitudes, together.