A Psychiatric Residency in the Era of COVID-19: A Bionian Perspective

Coronavirus disease 2019 (COVID-19) is currently ravaging health systems across the world. Psychiatric trainees are at risk of exposure to patients with COVID-19 given their clinical roles in emergency and inpatient psychiatric settings. This article represents a case study of group dynamics in which we reflect on our own experience as psychiatric residents at a Boston-area hospital system in the era of COVID-19 and apply Wilfred Bion's concepts of the “work group” and the “basic assumption group” processes of group operation. We assess dynamics between trainees and administrative leadership both at baseline and in the current pandemic. Since navigation through crises is more effective if group leadership recognizes and responds to basic assumption behaviors, we propose suggestions to enable health system administration to successfully lead health care organizations through periods of societal turmoil. We posit that these principles apply across settings, specialties, and provider types. In addition, we use our observations to indicate future directions for expanding Bion's theories in the contemporary context.

Bion's Group Psychotherapy for Dramatic Personality Disorders: An Empirical Study in a Public Mental Health

Educational objectivesPsychotherapy is the most preferable intervention for personality disorder patients and group psychotherapy offers the possibility to increase the self-perception through resonance and mirroring processes. When a group is disorganized and emotionally tensioned generates regressive movements, which make it a basic assumption group.PurposeTo highlight the change of a group of patients after the inclusion of a new patient named Margherita.MethodsThe patients were included within the group run by two psychotherapists after a cluster B personality disorder's clinical diagnosis (except for antisocial personality disorder), confirmed by SCID II and by a set of individual interviews aimed to prepare the patient to the inclusion within the group.ResultsMargherita, from the first sessions, showed the tendency to coercively polarize the attention on herself through themes of discouragement and helplessness, posing a threat for the members’ identity and resulting in a disorganization of the work group, which became a basic assumption group.ConclusionsThe temporary disorganization of the group with the consequent regression to a worse functioning condition has subsequently allowed to revitalize the group and to avoid its dissolution. After the temporary regression, indeed, the work group was restored and started again to function even based on the new patient's problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Leadership Development From A Systems Psychodynamic Consultancy Stance

This research aims to measure the impact of a leadership development programme presented from the systems psychodynamic stance. The aim was to develop psychoanalytically informed change leaders to lead change and transformation in the continuously changing and transforming New Economy network organisation. In order to do this, a group relations training programme was presented for 30 leaders. Qualitative assessment using grounded theory during post-intervention focus groups interviewing indicated the group’s awareness of psychodynamic leadership behaviour such as the regression towards frequent pathological leadership personality characteristics, regression towards unconscious group- and organizational processes such as the basic assumption group, the covert coalition and socially structured defense systems against change and transformation. Insight was also gained in the new leadership role and the taking up of personal authority in the network organisation that needs to function as a systemic whole. Limitations in the study are noted and Recommendations are made to enhance change leader skills for leadership in the New Economy network organisation. OpsommingHierdie navorsing poog om die impak van ‘n leierskapsontwikkelingsprogram wat aangebied is vanuit die sistemiese psigodinamiese perspektief, te evalueer. Die doel was om psigoanalitiese ingeligte leiers te ontwikkel om verandering en transformasie in die gedurige veranderende en transformerende Nuwe Ekonomie netwerk organisasie, te lei. Ten einde dit te bolwerk is. ‘n Groep -verhoudinge-opleidingsprogram is aangebied vir 30 leiers. Kwalitatiewe evaluasie deur van begrondingsteorie gebruik te maak gedurende, die post-intervensie fokus groepe het ‘n groepbewustheid aangedui van psigodinamiese leierskapgedrag soos die regressie na dikwelse patologiese leierskapspersoonlikheidskenmerke, regressie in onbewustelike groep- en organisatoriese prosesse soos die basiese aanname-groep, die koverte-koalisie- en sosiaal-gestruktureerde-verdedigingsisteme teen verandering en transformasie. Insig is ook in die nuwe leierskap rol en die opneem van persoonlike outoriteit in die netwerk organisasie wat moet funksioneer as ‘n sistemiese geheel, bekom. Aanbevelings word gemaak om die leierskapsrol in verandering in terme van vaardighede in die Nuwe Ekonomienetwerkorganisasie, te bevorder.