579335

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GAQ0010.1177/0533316415579335Group AnalysisBeck: Group Analysis in China

Article group
analysis

Group Analysis in China—Challenges in a

Changing Society

Werner Beck

In 1988, a legendary conference took place in Kunming, China,

introducing western psychotherapy to Chinese colleagues. It
consisted of three branches: psychodynamic, behaviour therapy and
systemic family therapy. This conference found an immense echo all
over China and raised a strong desire for training in these therapies
to be set up. Soon, curriculae were created and proffered. A real run
on these trainings followed, most of them in individual therapies.
A group of German psychoanalysts carried out the psychodynamic
training in two-year long courses for Chinese psychologists and
psychiatrists. In 2008, a two-year training course in psychodynamic
group psychotherapy was added for those participants who had
concluded their training as individual therapists.
In the beginning this training was oriented towards the concept
of the German psychoanalyst Hermann Argelander (close to Bion),
but later on was influenced by the model of Foulkes, studying the
standard book of Behr and Hearst, that was soon translated into
Chinese. The participants were members of an experiential group
and of a working and supervisory group as well. Group work was
complemented by daily lectures. The two-year course consisted of
four blocks of eight training days each, comprising 56 experiential
sessions altogether. Towards the end of the course, the participants
had to establish a group of their own, find a supervisor and conduct
the group for a reasonable time. They then had to write a report
about their group, which was discussed in the supervisory group.
This led to the conclusion of the course.
© The Author(s), 2015. Reprints and permissions: sagepub.co.uk/journalsPermissions.nav
2015, Vol. 48(2): 164­–173; DOI: 10.1177/0533316415579335
 Beck: Group Analysis in China 165

I joined this project from 2011 to 2013, conducted an experiential

and a working group, and gave lectures on group analytic theory.
During this period there were six such groups with German
colleagues, who had regular meetings together with the Chinese staff
and the interpreters.
This article tries to sum up the process in the experiential group,
to show the development of the group and its characteristic features
in this very different society compared to our western cultures. Is
there anything that is ‘typical Chinese’ in these 56 sessions? What
could that be? Does the application of the group analytic approach
in such a different culture with such a different foundation matrix
make sense?
There are many questions. I hope this clinical report answers at
least some of them.
Key words: group analysis, training, transcultural understanding,
foundation matrix, norms and taboos, gender roles and relations,
filial and parental roles

The Setting
This is a clinical report about an experiential group process of 56
sessions over a period of two years from 2011 to 2013 in Shanghai/
China in the course of a training in psychodynamic psychotherapy.
The participants had started with two years of training in individual
psychodynamic psychotherapy. The candidates who had succeeded
in concluding this training got the chance to continue with two years
of training in psychodynamic group psychotherapy. During these
two years, the candidates passed four blocks of eight days each,
where they had two experiential groups, a seminar-group, a supervi-
sion-group and two lectures each day. I conducted two groups: an
experiential group and a supervision-group. I spoke in English,
which was translated into Chinese by a very experienced Chinese
interpreter (a female senior physician and psychotherapist of the
hosting institution).
As a group analyst, trained by S.H. Foulkes himself, I worked with
a group analytic approach. In this article I want to report only about
my experiential group, consisting of 14 Chinese psychologists and
psychiatrists (nine women and five men between 30 and 50 years of
age). The participants came from clinics, mental health centres and
psychological counselling services throughout China.
166 Group Analysis 48(2)

The Initial Phase

When I entered the room on the first day, the group members had placed
nameplates in front of everyone. They were written in Chinese, and I
asked them to add their names in Pinyin (Latin alphabet in China). I also
asked for my own nameplate with a translation of my name into Chinese
for the next session. This was greeted with laughing appreciation.
In the beginning, I invited the group to verbalize as much as pos-
sible what might drop into their minds or what they might have on
their minds. I complemented this invitation with Freud’s metaphor,
that they should imagine travelling with me on a train, and that I was
blind. I asked them to describe to me the passing landscape, but this
time their inner landscape.
This was followed by a tense silence, and then the wish for direc-
tion and instruction. I remained silent. They asked me to give them
‘feedback’. I expressed my astonishment: what could I give them
feedback on? They expressed their fears of the silence and of over-
whelming feelings that might rise up during the silence. Some of the
women even started to cry. Some of the men reacted to that sudden
emergence of feelings by anticipating they could not come regularly,
but had to be absent several times. I told them that this was not pos-
sible and they had to come regularly. This led to a lively debate about
my way of conducting the group and my very clear and strict attitude.
Could I possibly be an understanding and patient conductor as well?
They wondered how I would react to resistance to follow the rules. A
robust discussion developed. Finally some women started weeping at
the thought of their very severe and authoritarian fathers. Fantasies
arose concerning being sent away, as several of them had experi-
enced as children, because of the one-child-policy and of them being
female. Heavy weeping and sobbing by the women accompanied
this, as they reported the experience of having been sent away.
I was very impressed by the vehemence of these reactions in the
very beginning, as I had previously expected the western stereotype
of the very reserved and always smiling Chinese.
In one of the next sessions one of the medical doctors came in the
white doctor’s coat, asking whether he had to take it off. This brought
the association of nudism and the question, whether one had symboli-
cally to undress here. This aroused giggling and excitement and even
fears, how far I would expect them to disclose themselves.
A male member of the group now expressed his willingness to dis-
close himself: hoping to get much from me, as a reward for doing so.
‘But,’ he said, ‘after having received much from you, I would like to
 Beck: Group Analysis in China 167

kill you!.’ This stirred up lots of excitement. The men finally reacted
by a rather intellectual debate about the group’s norms and standards,
and about limits and boundaries. This ended with the fantasy that ‘all
fathers should be killed’. Now especially the women defended the
fathers and declared their love for them. This provoked several men to
declare, that they too loved their fathers but that, at the same time,
they were afraid of their fathers’ often drastic and violent punish-
ments. The only way to win over the fathers’ esteem seemed to be by
a high level of achievement and sustained effort. The women on the
other hand, stated that they could only ‘seduce’ their fathers by tears.
My attempts to refer these tears to the group situation and to their
efforts to overcome these strong feelings, were not picked up by them.
I suppose, to begin with, this murderous hatred against the paternal
authorities had to do with the political situation in the country, which
seems to be mirrored in the rigorous style of upbringing in China. But
at the same time, they possibly experienced me being rigorous in my
reaction to the one who announced not to come regularly.
Now the men started to argue about who was ‘the boss’ of the group.
After a while the women complained about too much confrontation in
the group, especially by the men. They missed a greater degree of com-
passion and containment. This was followed by a long silence. Then, a
man expressed his sexual fantasies concerning the women of the group,
and the drastic punishments he had received by his father for playing
doctor’s games as a boy. The women were upset and full of indignation
by the man’s way of changing the topic. The man with the sexual fanta-
sies defended himself: free associations, he stated, were the most impor-
tant activity in such a group. And this was exactly what he was doing.
Towards the end of the first training block, a woman expressed in
tears her guilty feelings about her mother’s suicide: she thought that
she had not taken enough care of her mother. Some of the women
asked themselves, whether one could ever take enough care of one’s
parents, or be at their service. This was accompanied by lots of tears by
the women. At the end of the session the question was raised, whether
within the group, one should act primarily for oneself or for others.
I had tried several times to compare group phenomena with meta-
phors of the old Chinese culture (like Tao or yin and yang): hoping to
facilitate understanding. They reacted with irritation and amusement.
Later on, my interpreter informed me that they were ashamed to hear
a foreigner talk about their old culture, without them knowing much
of it, as they all were children of the Cultural Revolution, and it was
a taboo to talk about the old culture or the Cultural Revolution.
168 Group Analysis 48(2)

Continuing
At the beginning of the second training block two men did not show
up: one who had insisted on being absent several times, and one who
had not yet said a word. A new man was included in the group and
was welcomed with very ambivalent feelings. A report followed
about a man’s friend, who had committed suicide by jumping off a
skyscraper’s roof. The question was raised by this man, as to whether
he had taken sufficient care of his friend. Touched strongly by this
report, a long silence followed and a gloomy atmosphere arose.
Thinking of the two members the group had lost, I asked about their
feelings right now and the question of taking care of each other here
in the group. This was rejected, and the group reproached me for
pushing the group.
For the next session the man whose friend had committed suicide
did not show up. The group reacted with worried fantasies, wonder-
ing whether he himself was this friend he had talked about. Now they
talked about fatal casualties in their families and about sad losses in
their lives. Again the question arose as to whether they had taken
enough care of their group mate.
He came to the next session with sunglasses and reported that he
had gone to a clinic because of severe eye pain. As the doctors there
could not give him a clear diagnosis, he was in panic concerning the
diagnosis. This caused fears, tears and strong compassion in the
group, and again lots of associations of dangerous diseases and trau-
matic events in their lives.
The women raised the question of what to do with strong feelings
and fears: to contain them and keep them in check (what their parents
had expected), or to show and express their feelings? They wondered
what I would like them to do. In China, women were allowed to weep
and express strong feelings, but not the men. In the group, the men
were attacked by the women for holding back so strongly and for hid-
ing behind this stance. In tears, some of the women talked about their
harsh and uncomprehending fathers, admitting that they missed and,
at the same time, hated their fathers. The men conceded that they
hesitated to show feelings and had difficulties in doing so. They were
asked by the women whether they were willing to drop this facade.
Both men and women agreed that their parents had expected restraint
and containment, and that they did not like this inaccessible posture.
They were astonished to agree to such an extent, which led to an
almost euphoric mood where, in the end, men and women held hands
with each other laughing. I was deeply impressed by the openness of
 Beck: Group Analysis in China 169

this debate: questioning the standards of their education and of stand-

ard roles of men and women in China. Anger about the way they had
been raised emerged. They talked about the Chinese taboo to express
negative feelings towards their parents, or even to have such feelings
at all. In talking about these taboos, the taboos seemed to crumble
and the distance between the sexes as well.
The next day a man reported a dream, where during a visit of the
group to his house, the house collapsed. After he had reported his
dream, there was a lot of laughing and joking about the power of the
group. Slowly they became aware of what it meant: that hitherto reli-
able structures could collapse. Fantasies came up that under the ruins
of the house the flames of hell were blazing.
The newcomer in the group reported that his walls were breaking
down as well, that he felt overwhelmed by strong feelings that had
never been allowed by his grandmother, who had brought him up. If
he did show strong feelings, the grandmother punished him by lock-
ing him up. He started crying, and was joined by some women and
finally even by some men in the group. After a while he got up and
started to hug one group member after another and finally even my
interpreter and me. The men said that they had never experienced
anything like that before, and that such strong expressions of feelings
had been forbidden in their families. Funerals and farewells had been
the only opportunity for tears. But they all admitted that they had
longed for such an opportunity. At the end of this session everyone
hugged each other. When I wanted to leave the room, a man stood in
the doorway, wanting to be hugged by me too.
I was deeply impressed by their openness in looking at the norms
and standards of their culture and their questioning of traditional
roles for men and women, sons and daughters. I was so overwhelmed
by their need for catharsis and closeness that I did not even think of
defending the boundaries.

The Old Standards and Taboos in this changing Society

During the following block the women emphasized how difficult it
was for them as women to talk about their womanhood or about sex,
issues which had been a total taboo in their families. They went on to
discuss whether the physical differences of the sexes had any mean-
ing at all. This caused strong contradiction and many tears in some of
the women, as they had been given away as babies because they were
female. This ‘deficiency’, as they called it, had to be compensated by
170 Group Analysis 48(2)

them through lots of service and obligation. The men hurried to state
that they too had to fulfil lots of obligations and duties: to compen-
sate for the ‘privilege’ of being a man. This caused a long and very
sincere discussion on what it meant to be a woman or a man given
that their roles in their families were very fixed and did not allow for
much variation. They agreed that a woman could prove her woman-
hood by becoming a mother, and a man by becoming a soldier. Many
of them felt insecure in their roles as men or women. One woman was
afraid not to comply with the group, as she had been pampered by her
parents and grandparents as the only child. She felt deeply indebted
to her parents: as if she could never compensate for what she had
received. Several other group members expressed the feeling that
they were obliged to make their parents happy. One man reported that
he had wanted to get his father’s attention all his life, and that nowa-
days he was not very eager to become a real grown up man because
he did not know what it means to be a grown up man. Lots of feed-
back followed on how they experienced each other as male or female.
Towards the end of this day, I was informed of my brother’s sud-
den death.

How to Cope with Severe Casualties

As I had to fly back home one day earlier for my brother’s funeral, I
had to inform the group about this fact. My interpreter was willing to
take over the last session on the last day as she was a psychotherapist
as well. Now the group expressed their deep sympathy and compas-
sion for me and wondered how I felt. I had decided for myself not to
answer these questions and remained silent. One man reported that he
could not continue his work for six months after his father’s death
because of his mourning. They were astonished and impressed that I
continued my work, stayed there with them and took care of them.
Several women spoke about their habit of taking care of others,
and not of themselves. As women they always had the feeling of not
being accepted or of being a burden. A very tense and heavy atmos-
phere and a long silence ended the last session before I had to leave.
In the end everybody (the women and the men!) wanted to hug me.
Queuing, they all waited for their turn, and all the women were sob-
bing as if they would never see me again.
Afterwards, my interpreter informed me about the last session
without me, with lots of tears and mourning, as if they were weeping
for me and for my dead brother as well. First they talked about their
 Beck: Group Analysis in China 171

losses of close relatives and finally about me, as if I had passed away
myself: with gratitude and high esteem.

The Termination
In the last block they imagined how it would be without the group.
This led to the fantasy, as to whether they still needed water wings or
could already swim without support. They told me that the last time I
had left, they felt as if I had died. They wondered whether they would
be able to master the situation after I had left them alone. This session
ended in a long and heavy silence.
Then a woman expressed her fear of uttering an opinion of her
own, because she could be attacked for that, and she felt hurt easily.
‘Like a mimosa,’ I threw in. They did not know this plant and asked
for a description, which I gave. The man with the fantasies of killing
all fathers imagined, laughing, how he would seize this plant in his
fist and damage it. I was shocked and angrily asked, ‘damage your
group mate?’ Now he stated, that he had never said anything like that.
‘But the mimosa was standing for your group mate,’ I insisted. He
repeated that he had never said anything like this, and that it was my
fantasy. Angrily I called that a denial. At this point, several group
members were shocked by my anger and how I got into such a quar-
rel. They saw me losing my temper and were disappointed that I lost
my patience. ‘The end of the idealization!’ one man said. They saw
me now as ‘just a man!’ They experienced this as a sign of the rapid
approach of the end of the training, which was associated with pain
and grief. But they were angry as well, that nothing could be done to
prevent it. And they felt that they had not received enough to stand-
alone. To care for them in the future, I recommended that they look
for diligent supervision for their group work. At once, they wished to
do this with me via Skype. But in looking at this possibility, it proved
to be a completely new project intermingled with old transferencial
phantasies.
Another woman reported a dream: nails were sticking in her head
and face, which she had to remove, causing severe pain. But after all
nails had been removed, she felt great relief. In great empathy, the
others told her that they could feel her pain as well and then her relief.
‘The end of all pains?’ somebody asked. To expect this from the
group was in vain, they saw. But they valued this dream as a hopeful
group dream. I think the nails in her face stood for all the pains they
172 Group Analysis 48(2)

received in growing up as women in Chinese culture, and for losing

one’s face and for the possibility of curing that.
The man with the murderous and sexual fantasies was addressed
by a woman, who said that she could not help but see him as a patient.
This lead to an angry and fierce debate. Finally I asked the whole
group, whether they never felt like patients. After a round with feel-
ings of shame and embarrassment, they ended up feeling relieved that
it seemed not so awful to feel like a patient, and that everybody in the
group knew these feelings.
One of the men had not participated for most of the time. He was
asked about his state of mind. He answered that he felt unable to take
any initiative. Therefore he had always sat in the last row during the
lectures, so as not to be seen. He was full of shame as his father had
beaten up his mother and the children all the time. He hated his father
but never dared to confront him. Now the father was dead and it was
too late to confront him.
After death it seemed completely impossible to say anything nega-
tive about the parents. I asked how they felt towards me, as I was
going to leave them soon. They responded with many statements of
love and admiration. I asked for the negative feelings. ‘They are not
allowed!’ was the answer. ‘But in the beginning of the training you
talked of patricide,’ I replied. They remained silent until the end of
this session. This taboo seemed to be too strong.
Towards the end of the last block, again a dream was reported: a
little girl had been neglected and not cared for by her family. So she
ran away, ending up in a park, where she did not know anybody and
felt even more alone. Finally a policeman spotted her and asked for
her name and address. Then he brought her back to her family, where
nobody seemed to have missed her. She was received with dishonour
and ridicule and was punished for running away. Her attempt to free
herself ended up with great frustration. I asked them, how they
expected to be received, coming home after this group training.
Again, there were lots of tears and regrets, because it was all over
now. Soon the atmosphere changed to declarations of gratitude and
appreciation, accompanied by direct declarations of loving me. One
woman said, that for the last session she had put on her most beautiful
dress and had even put on perfume, which she never had done before.
Finally everybody was crying, and they all wanted to hug me, to say
goodbye and pass over some very Chinese presents, and then to take
photos of the group.
 Beck: Group Analysis in China 173

My Conclusions
In the beginning of the training I was surprised at the strong and open
aggression of the men against paternal authority (kill the fathers!),
whilst the women broke into tears and opened up for catharsis. I felt
that there were remarkable differences between the retentive men and
the cathartic women. These differences seemed to be ‘typical
Chinese’. The strength of the taboo against aggression regarding par-
ents, and especially the dead parents, impressed me. This seemed to
be very Chinese too. In the course of the group process, some of these
taboos did alleviate. After some sincere arguments between the men
and the women, the men opened up much more and became very
cooperative and compassionate. The group dream of the collapsing
house symbolically showed the loosing of fixed structures. A strong
wish for closeness developed between the men and the women. The
dream of the nails in the woman’s face showed the immense pain and
suffering they had sustained growing up as women in this culture,
and also the fear losing one’s face, and the hope that all this could be
cured. The dream of the little girl running away showed the wish to
free oneself. But the outcome of this dream showed their need to be
taken care of and the conviction that it was too early to look after
themselves all alone, which I think is very realistic in the context of
this relatively short training. But, at the same time, I was very
impressed as to how much could change in the course of only 56 ses-
sions despite the fact of the very different foundation matrix in the
Chinese cultural context. This experience seems to prove that it
makes sense to apply the group analytic approach even in such a dif-
ferent culture.

Werner Beck is a clinical psychologist, a psychoanalyst, a training group ana-

lyst, a supervisor and a teacher for psychotherapists and group analysts. He is a
member of the IGA International, the Institute of Group Analysis Heidelberg, of
the German Society for Group Analysis and Group Psychotherapy and of the
German Society for Supervision. Address: Beckstraße 52, D- 64287 Darmstadt,
Germany. Email: beck.da@gmx.de
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