Chapter
Eight – Fraser House Big Meeting
BIG GROUP - USING COLLECTIVE SOCIAL FORCES
This Chapter outlines Big Meeting processes and Neville’s
leader roles. A summary of Big Meeting process written by patients (Appendix 8)
may serve as introductory reading.
Fraser House was a substantial endeavour. Once under way it
was having around 13,000 outpatient visits a year. While other therapeutic
communities in the
Each of the following terms were used to refer to the whole
community meeting – ‘Big Group’, ‘Big Meeting’, ‘Community Meeting’, ‘Large
Group Psychosocial Therapy’, ‘Collective Therapy’, and ‘Big Group Therapy’.
Morning Big Group was held from 9:30 AM to 10:30 AM. Evening Big Group was from 6:30 PM till 7:30
PM. Big Groups were followed by a 30-minute tea break; then everyone reconvened
and separated into small groups.
In Neville’s paper, ‘Collective Therapy – Audience and Crowd’ (1966; Yeomans, N. 1971c), Neville wrote, ‘the skilled use of collective forces is
one of the paramount functions of the socio-therapist and such skills are
defined by the team as ‘Collective Therapy’. In his paper, ‘Sociotherapeutic
Attitudes to Institutions’ Neville wrote, ‘Collective therapy, both audience
and crowd, utilizes social forces in the patients’ primary group (Yeomans, N. 1965a, Vol. 12, p. 46, 60-61).’ Neville engaged all involved in Fraser House in
recognizing, understanding and utilizing these social forces. The Fraser House
Handbook (excerpts in Appendices 7 and 8) also refers to audience and crowd
behaviour, especially contagion, being a central aspect of Big Group (Yeomans, N. 1965a, Vol. 4, p. 18-20, 50-54).
For a time, Big
Group involved around 100 people and then it grew to around 180 people.
According to Chilmaid (April 1999), it peaked at 300
on one occasion. All these people would be crammed shoulder-to-shoulder into a
rather small room – in Neville’s terms, ‘a mixture of the very mad and the very
bad patients’, along with their typically dysfunctional friends, workmates and
relatives as outpatients. All the staff on duty at the time would also
attend. Often there were visitors and invited guests also attending Big Group.
People who attended the Fraser House Psychiatric Research Study Group
(discussed later) also attended Big Group, along with people from religious,
business and government organisations interested in learning group skills.
Fraser House became a major centre for learning group skills, with people from
many government, academic and non-government organizations attending. Neville
said that much of the training was done by patients (August, 1998). Neville
would also invite people from the media, students, as well as people Neville
connected with through his extensive outreach talk schedule. Others who made
requests to attend would also be allowed in. Margaret Cockett
(who became Neville’s personal assistant) was in this category of visitor on
her first visit. Members of Alfred Clark’s External Study Team would also
attend. On one occasion a TV crew from the ABC came and filmed a section of Big
Group. (I was not able to track down this film in the ABC archives.)
Some patients had jobs that they would go to during the day. They would
attend evening Big Group. According to Chilmaid in an
email (Mar, 2003):
Evening Big Group was mandatory for all in-patients unless
excused by the Ward Committee (employed relatives living in, parental duties,
children, etc). Not all staff attended evening group.
In another email Phil Chilmaid (April, 2003)
wrote,
Children did attend Big Groups, but this wasn't de rigueur.
High school children usually did attend when not at school. Primary school
children had separate play time during evening group with the psychologist Porritt when he was there; a lot depended on the numbers
and ages of kids at any particular time.
Porritt and a senior
nurse spent time in observation and play therapy with the children at the same
time as Evening Big Group. Also, a couple of nurses remained on rounds (and
made tea for the report session) Chilmade 2003).
Evening groups catered for friends and relatives who found it difficult to come
during the day, and for inpatients that worked during the day. Very
occasionally the evening Big Group became a Special Group and mandatory for
all. Mostly evening Big Groups were well attended, probably 80% of morning Big
Group. In an email Bruen (Mar, 2003) wrote:
As I recall, the evening groups were compulsory for
inpatients but not for outpatients. However, family members of inpatients
were strongly encouraged to come in the evening, and there was a strong
emphasis on family dynamics for attendance by those families whose relatives
could only come in the evening.
Once Big Group started, the ground
rule was that no one left before it was finished. A toilet was available
within the room behind a screen. Two staff were
assigned to be recorders, one for content, and one for process. Big Group
process records were kept in a very large hard covered red book. This
assignment was rotated to improve staff’s process observing and attending
skills. This record was referred to during staff discussion in the tea break
following Big Group. I have been unable to trace this red book. It seems that
no records exist of any aspect of Fraser House in Government records. Neville
and Margaret Cockett both confirmed (Oct 1999) that
there were powerful forces very determined to see all trace of Fraser House
eliminated. I could find no health department archives relating to
Fraser House.
The Big Group meeting room was the
lower building behind the white car in the photo below.
Photo 1
A
photo I took in October 1998 of the room at Fraser
House where Big Group was held
One of the Fraser House Handbooks (Yeomans, N. 1965a, Vol. 4, p. 1-54) confirms that during the staff discussion in the tea break
following Big Group, the two official observers for the meeting used the Red
Book to give their report to staff, followed by comments by all staff members
present, including the Group Leader/Therapist.
The points assessed were: mood, theme, value and interaction,
therapist’s role and techniques employed. From these ‘post-mortems’ comes much
of the knowledge needed.
These four aspects - mood, theme,
value and interaction were the essence of what Neville was personally
constantly scanning for. These guided his interacting with the group. In having
these as the ‘discussion framers’ along with Neville’s role and process,
Neville was fast-tracking all staff into his way. Note that while these review
session were very involving, they were condensed by being limited to 30
minutes. They happened twice a day so the ‘unfinished’ may be taken up later if
deemed a potent theme.
The aim must be always to look at the community in the ‘BIG’ – as a
whole and this certainly is no easy matter (Yeomans, N. 1965a, Vol. 4, p. 51)
Neville also scanned the ‘BIG’ – the-whole-of-it - like his family did
on the farm. The handbook notes that this was ‘no easy matter’. Simultaneously
Neville was scanning for minute subtle nuances. Neville had ‘attending’ as a
highly developed resource state.
Some of the ways in which an emergent theme may be linked to sections of
the total community are indicated in the following quote from notes on how to
run Big Group (Appendix 8):
Usually the
therapist then allows the group to enter into spontaneous ‘free floating’
discussion until a general interconnecting theme is apparent. This may then be
pursued with promptings towards interaction between different generations or
social classes or psychiatric opposites – or perhaps to tie in together for
mutual support those with similar difficulties, personally or because of family
or life-crisis situation (Yeomans, N. 1965a, Vol. 4, 50-54).
On staff review of groups, an email Bruen
(Mar, 2003) stated:
The staff meetings to discuss the group were for staff
only. The summary was recorded but not made available to patients or
families. These summaries were used mainly as a training exercise in what
to look for in a group and to update staff at change of shifts - dynamics often
changed very quickly at Fraser House and staff needed to be up with the latest.
Also in an email Chilmaid (Mar, 1999) wrote:
While the feedback/report by the observers was given at a
half hour staff meeting (with a cup of tea and sandwiches) it was not unknown
to query the observers about content earlier in the Big Group during the
meeting.
Neville always led Big Group when
Fraser House was first set up. He was both evolving processes and modelling
these for staff. After a time, others began to get a feel for how to do it. Big
Group was then also taken by medical staff. Later on, some nurse leaders also
lead Big Group. As mentioned, three of the people I interviewed for this
research, Cockett, Bruen,
and Chilmaid all ran Big Group many times. After
Neville left Fraser House in 1968 some Big Groups were even run by skilled
patients. This was reported by Warwick Bruen (Interview
April, 1999).
Thursday morning Big Group was ‘administrative only’. Administrative
matters were discussed and patient committee elections were held under the
auspices of the Parliamentary Committee. Reports were also received from the
other committees.
During an interview/conversation with Neville (April, 1999) he stated
that any attempt to bring up an administrative matter in a therapy group was
deemed to be ‘flight’ and was interrupted with compassionate ruthlessness. Any
attempt to bring up a therapy matter during an administrative group was deemed
to be ‘obstruction’ and deferred.
The distinction in function between the Administrative Big Group and the
other Big Groups is detailed in the following quote from the Staff Handbook
(Appendix 8):
Morning community groups have two main therapeutic
functions; personality change is the aim of four meetings, while social control
is the focus of the Thursday morning administrative group (Yeomans, N. 1965a, Vol. 4, 50-54).
It was not ‘administration’ to sort out staff administration; rather, it
was ‘administration’ for furthering the mutual-help based social control of the
total community by the total community.
During
Big Group everyone - including staff, outpatients and guests - were ‘in
therapy’. Visiting Family, workmates and friends would ‘sign on’ as
outpatients. In an April 1999 conversation with Warrick
Bruen he said that while it was not ‘spelt out’ to
staff that they too were ‘in therapy’, a person could not be in Big Group and not
be ‘in therapy’; it was just so ‘dense’ that people had to have psychosocial
and emotional shifts occurring. This view was confirmed by Neville, Margaret Cockett and Phil Chilmaid (April,
1999). This is resonant with Maxwell Jones’ comment that anyone in Fraser House
had to change (Clark and Yeomans 1969, Preface).
Preventing Session
Creep
Neville told me (June, 1999) that
all therapy sessions at Fraser House were set strictly at a length of one hour.
Timing of the following tea break and the one-hour small group was also
strictly adhered to. When the Big and Small Group hour was up they stopped,
even if it was in mid sentence. Neville said (30 June 1999) this strict adherence
to time was specified by him after reading articles that therapy sessions get
progressively longer once over forty-five minutes. What tends to happen is that
people leave opening up and sharing to the last five minutes, and when they do
open up there is some pressure there to work through something, and the session
is extended. Next time nothing much happens till the last five minutes of the
longer period, and so the session extends even further. To stop this ‘session
creep’, Neville set sixty minutes as the non-negotiable length.
Big Group Layout
So that everyone could see everyone
at Big Group, moveable wooden tiers were set up along each of the long sides of
the Big Group room. Staff, patients and outpatients were all mixed together in
a self-organising process. A raised podium was set up at the far end for the
two recorders who kept a transcript of the proceedings.
The Big Group room was rather small
for the numbers that crammed into it - around 8 metres by 16 metres. Neville, Bruen and Chilmaid (April 1999)
confirmed that typically, the attendees sat in two rows along both of the long
sides. Attendees were all jammed in shoulder to shoulder. When the numbers
exceeded 180, there would be three rows along one or both of these long sides.
The Sixties were
a time when women were generally quiet in men’s presence and would be quiet if
men were talking. In other hospital environments this reticence to talk in the
presence of men tended to apply to both female staff and female patients. An
observation made by Phil Chilmaid (August 1999) was
that at Fraser House, females were often passionate contributors in groups and
would often catch the group’s focus and hold the floor.
Outside of Big and Small Groups, all
involved in Fraser House were dispersed throughout the quarter of a kilometre
long complex. In squeezing the total community and visitors into Big Group,
Neville was creating concentrated cultural locality. Everyone was part of the
shoulder-to-shoulder crowd; everyone was audience and spectator. And everyone
knew they could become the centre of the crowd’s focus and that this could
happen at any time. Being the focus of Big Group was a very potent
extraordinary socio-emotional experience. Neville was very adept at creating
the unexpected sudden shift in group focus. That anyone could become the focus
of group attention at any moment served to create and maintain tension in the
group.
A Mood That
Attunes
Mood was one of the four aspects of
Big Group that was discussed at the following thirty minute staff review. A key
part of the Big Group reality was maintaining a ‘healing environment’ that was
a ‘natural growth force’. The German word ‘stimmung’
is apropos. ‘Stimmung’ has, as one of its meanings,
‘a mood that attunes people together’ (Pelz 1974, p.89-90). Within Big Group, Neville set up processes whereby the
collective stimmung that was maintained for the time
together was tuned to healing (Pelz 1974, p. 89-90). However this did not necessarily mean gentle caring and
kindness. Healing often entailed what Neville called, ‘ruthless compassion’.
Healing was at times rugged and relentless. It was at times exhilarating and at
other times it was emotionally draining. In separate discussions with Neville,
Warwick Bruen and Phil Chilmaid
(April 1999), they all confirmed that Big Group was very tightly structured and
that no one liked it - staff and clients alike. At the same time it was widely
acknowledged among both patients and staff that Big Group was very important -
a crucial aspect of the Fraser House change-work.
Neville’s exploring of stimmung was resonant with the following remarks (about a
group of people attuned to each other) by Jaworski’s
(from his conversation with theoretical physicist Dr. David Bohm
mentioned in part in Chapter Four):
It’s activating a
single intelligence that works with people who are moving in relationship with
each other. Cues that pass from one to the other are soon picked up with the
same awareness just as we pick up cues in riding bicycles or skiing. Therefore
these people are really one. The separation between them is not blocking. They
are all pulling together. If you had a number of people who really pulled
together and worked together in his way it would be remarkable. They would
stand out so much that everyone would know they were different (1998).
People did recognise that Big Group
was very special. That’s why religious leaders, academics, bureaucrats,
businessmen, media people, people from all walks of life came to experience it
and co-learn.
Big Group was run
like a meeting (Yeomans, N. 1965a, Vol. 4, p. 18, 50-54). In writing about group process the handbook states (refer
Appendix 8):
‘The first essential in taking a group is to see it as a meeting and
like all meetings, there is a need for a chairman to conduct affairs and keep
issues to the point. ‘The function of the therapist is to see that the group
functions as a group. Be directive. The group could function well if the
chairman adopts a completely passive and wordless role (Yeomans, N. 1965a, Vol. 4, p. 17-20, 50-54).
Bruen commented (interview April, 1999) that Big Group was
‘exhausting for all present’ and that the leader had to be ‘really on the ball’
and ‘aware of everything’. Within Fraser House any destructive behaviour
was interrupted, and dysfunctional behaviour was regularly occurring because of
the nature of the patient/outpatient population. This dysfunctional behaviour
was often interrupted with what Neville described as ‘ruthless compassion’.
One of the Fraser House Handbooks
includes the following comment on Big Group process:
When both the
staff and patients are working well together in the Unit, a peak of enthusiasm
is reached at times when everyone sees almost any move at all as being gainful.
New enterprises are embarked upon with an eagerness that is almost inspired and
success is a certainty.
Again, when as a
whole the big group is swayed by frustration, contagious aggression and
excitement result - just as contagious as the feelings of fear and panic
experienced due to shared threat anywhere (Yeomans, N. 1965a, Vol. 4, p. 51).
The Handbook notes that theories of
behaviour of crowds and audiences apply to Big Group.
My interviewees all confirmed the following:
- Creating a collective mood tuned to healing that
colours the collective reality as healing, is itself therapeutic.
- Within Fraser House, the realized (in the two-fold
sense of ‘made real’ and ‘understood’) reality/context, the shared
meanings about ‘what we are here for’, and the collective mood, were all
healing.
- All participants (apart from newcomers) shared
memories of previous Big Groups where healing had occurred in the shared
cultural locality of the Unit’s Big Group Room. The very space in the room
had become healing space. Healing memories were anchored (Hanlon 1987) to that space.
Given the
prevalence of pathology, Big Group as ‘healing stimmung’
was still riddled with people doing their best with pathological repertoires,
including dysfunctional beliefs about the world and each other, as well as
problematic values, attitudes and habits and pervasive self-doubt. All of these
were being constantly held up to community scrutiny and challenged. Neville had
highly refined competences to ensure functional interaction in this
dysfunctional seething.
A lot of Big
Group was like theatre with vocal people sometimes being rather passionate and
rowdy. This was attested to by Neville, Chilmaid and Bruen (interviews April, 99). Big Group meetings were
sometimes extremely frightening and challenging. Despite this, the context was
framed as healing and very tightly controlled.
People were learning to be able to make value and moral based
discriminations in discoursing about everyday life issues rather than just
using utility as a criterion, or being unable to express themselves
at all.
ON NEVILLE’S ROLE AS
On the Side of
Constructive Striving
Every person I interviewed connected
to Fraser House said that Neville’s group process skills were way ahead of
everybody. In the following section I endeavour to unpack some of his
processes.
To repeat, Neville was continually
scanning everyone (including various factions and isolates) to sense mood,
theme, value and interaction (Bruen in April 1999).
Neville discussed his own process in a monograph entitled, ‘The problem of Taking
Sides’ (Yeomans, N. 1965a, Vol. 5, p. 46-47). Neville’s process for working with destructive
non-ecological behaviour was as follows (Yeomans, N. 1965a, Vol. 5, p. 66). Whenever Neville was with more than one person, he was
always on what Neville called ‘the side of the constructive striving’ of
everyone present - their ecological bits (defined by Neville as ‘what was
functional in the context’) – what Neville called, ‘the free energy’. This is
isomorphic with the Keyline principle, ‘make use of
the free energy in the system’ (Yeomans, N. 1965a, Vol. 5, p. 66). The essence of this process was that Neville never took
sides verbally or non-verbally. When carrying out therapy with family and friends
within Big Group, Neville did not take the side of any one person. Rather,
Neville took the side of, or supported what he called ‘the healthy component of
a role in the relationship between the individuals concerned in that unfolding
context’ (Yeomans, N. 1965a, Vol. 5, p. 66).
The following quotes are taken from Neville’s ‘The problem of Taking Sides’ monograph (Yeomans, N. 1965a, Vol. 5, p. 46-47)