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Mental Health Services Including NETGROUP |
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KINGSTON MEDICAL LTD |
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Median Groups (1) |
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The term Median Groups was coined by Dr Pat de Maré to describe a particular form of therapeutic group. In the world of statistics, the word 'median' describes the mid-point between the highest and lowest points of a scale. In regard to groups, its significance lies in its ability to be the interface between the small and large groups which we all need to negotiate successfully to lead healthy 'adult' lives e.g. from a small group (family) to the larger group(s) (community, employment, leisure, political etc.)
By definition, a median group does not have the luxury of small groups for detailed interpretive work, but neither does it have the daunting elements of a very large group. The median group encourages dialogue leading to an 'impersonal fellowship' (de Maré). It helps the individual to work through wider socio-cultural conflicts and thereby to function more effectively in a rapidly and ever-changing environment/society.
Dialogue is the central element of this process. The process of reasoning through dialogue is more usually known as dialectic and can be traced back to Plato and Socrates. The observation of one perceptive median group member reminds us of the true meaning of dialogue:
"Some people have to say something, others have something to say."
Quoted by de Maré et al.(1991) Koinonia: From Hate, through Dialogue, to Culture in the Large Group, Karnac Books
SOME RELATED INFORMATION
For a selection of papers written by Dr Pat de Maré and others, visit:
For a selection of papers by S H Foulkes, follow the above link
WHO CAN BENEFIT FROM MEDIAN GROUPS?Here are some typical members of a median group: ‘Frank’: 30s, single heterosexual male, Caucasian, school teacher, living with widowed father. Symptoms of obsessive-compulsive disorder [OCD] (e.g. excessive hand washing and ritualistic behaviour) since early teens. Ten years previously, symptoms became progressively worse at the time of his mother’s serious illness and death two years later. Rituals became more complex and included the need to drive repeatedly to confirm that he had not caused an accident during a routine journey. Consulted a psycho-analyst and attended one-to-one sessions over a period of five years. Some improvement in his symptoms, but he found it difficult to translate psycho-analytical interpretations and break away from crippling rituals, so stopped attending. Referred by GP for psychiatric assessment. Following my assessment, he was started on a course of anti-depressants and offered group support. Complained of side effects within minutes of taking medication; explanations and reassurance given at follow-up appointment – he was able to continue medication for several years without any further side effects. During two years of group sessions, his initial concern focused mainly on his illness, but over the months he was encouraged to look at broader aspects of his life and his inner feelings and difficulties, which had effectively been masked by his OCD. As he became more engaged with the group, he was able to recall some of his psycho-analyst’s significant interpretations, which he had previously found it difficult to understand and respond to. With the need to seek constant reassurance diminishing, the constraining rituals gradually disappeared. He accepted the need to continue anti-depressant treatment; he was able to form a new emotional relationship and to move away from the safety of his parental home. This was followed by promotion to a senior post in his teaching profession. * ‘Sheila’: 40s, Caucasian, divorced, living with her two teenage children. Unemployed, previously worked as model in her 20s, and managed a business with her then husband. Depressive symptoms since her 20s, due to marital difficulties and eventual divorce. Diagnosed by neurologist as suffering from narcolepsy (sleeping attacks), condition confirmed by EEG investigation. Was treated with a combination of anti-depressants and amphetamines. Despite adequate doses of medication and regular psychiatric follow-up, had severe bouts of depression, necessitating two courses of ECT. Then referred for psychotherapy, offered group support. Initially, through profound lack of self-esteem, found it difficult to express herself in a group; when she did speak, she would apologise profusely lest she offend someone. Over a period of eighteen months, she was able to discover that she had conformed with a parental and marital expectation that she should be ‘seen but not heard.’ Even her current boyfriend of two years standing treated her in this way. Through the group processes, as she was able to communicate more spontaneously, the frequency of her sleep attacks reduced enabling her to reduce the dosage of amphetamines – much to the dismay of her neurologist! She was able to break away from the current, emotionally abusive, relationship and rediscover her business skills. Within six months, she found a more balanced relationship with a new boyfriend, who intrigued her by asking her what she would like!! She returned to part-time management of her own business alongside her role as a mother.
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