Albanian GA History

History of Group Analysis in Albania
The impossible can be possible
10 years after the dictatorship fall, in 2000 the first generation of psychologists were graduated in the University of Tirana, the major of the few public universities in Albania at that time, in the Faculty of Social Sciences. This Faculty opened in 1991, initially named Faculty of Social Work and provided educational programs in Social Work and Philosophy-Sociology. One year after, it was renamed as the Faculty of Social Sciences and was composed by three departments: the social work, the psychology-pedagogy and Philosophy-Sociology, this later a reformed version of the former one during the communism period.

Psychology was until this moment an unknown science, or mostly related to the pedagogy theory and practice. Those who had knowledges about Freudian theories or ideas had to keep them secret and not to share with the others in an open way. When the first psychologists and social workers entered in the psychiatric milieu, some of the psychiatrists would say proudly that the “only one who knew Freud first and tried to “apply” some of his ideas with patients was a senior psychiatrist”.

Personally, I met Freud through literature. During the high school years, reading was a very useful protection from the ugly reality full of financial difficulties for many families, moral chaos, unsafety, uncertainty and many illusions. “We want Albania as all Europe” was the slogan of those years. None had idea how this could happen, it was just a naïve wish. It was “Freud” by S. Zweig the book who incepted in me the curiosity about psychology and the projection of myself as a pain healer. After that I started to read every Freud’s book translated and published in Albania, but unfortunately, they were not translated as well as Zweig was. Talking about Freud, admiring, criticizing him would remain easer than reading and understanding him for next years of my education.

In 1997, while this first group of psychologists had just started their training the most traumatic events in the post-dictatorial period of the history of Albania occurred. What was called a Civil War and it is known by the world as such was not exactly a civil war. There was nothing “civil” in that. It was a real nightmare; the death drive was walking in the streets of the towns of Albania. Precipitated by the fall of the pyramidal schemes, the economic damage was severe for many Albanian families and fatal for some of them. People who had lost money, power, job, illusions, serenity had the opportunity to have guns in their hands as a result of the opening of the weapons storages from who knows why and who. Those who chose to have guns, to keep and use them regained thus something lost. Those who didn’t choose to take a Kalashnikov in their house remained with what they had lost and the risk to lose more.

It was as living in a preverbal stage. Paradoxicality was normal. The Kalashnikov shots’ sound was the sound of that time. In many towns was established a very wired routine of shooting every evening after the sunset reminding the chorus in Greek antique tragedies singing to gods, asking for help since the human reason and sanity was quite lost. This was the carrefour time and the spectacle of Kalashnikov shots in the same time, or as it would be in a horror movie the time for vampires to go out for hunting. Many innocent and delinquent people were killed in these crazy months, and the terrible sound effect of those guns used purposely or just for fun echoed for many years later in Albanian lives.

Years after the Albanian people developed another custom, that of lighting firecrackers during all the December or even before, anticipating the holiday season. We had to live with this custom until very recently when some law changes happened. Now, there were the children and teenagers who enjoyed so much scaring people in the streets with the abrupt noise of the firecracker, those who in 1997 most probably were new babies or still in their mom’s womb. The need for repetition something unable to be verbalized, perhaps, was the reason behind this behavior.

In 2000 when the first clinical psychologists were graduated in Albania, a reform in the psychiatric service had already started as an initiative of the WHO – Albanian and the Ministry of Health. This reform aimed the deinstitutionalization of psychiatric patients through the development of alternative services as Community Center for Mental Health, Residential and Day Center. This reform happening was a good timing for the development of the psychotherapy in Albania. It was the need for well trained professionals who would help the process of introducing a new approach to the mental ill people and to the existing mental health professionals and social environment, which made possible the start of a training in Psychoanalytic/Psychodynamic Psychotherapy. This training was provided by the European Association for Psychotherapy with the initial support of the WHO-Albania and financially fully covered by the trainees.

In 2007 a group of 14 mental health professionals were certified as psychoanalytic/psychodynamic psychotherapist. Some of them started to practice as psychotherapists, some of them went to live abroad and some stopped practicing psychotherapy. One of them started his life in UK, the one who would come back years after to begin another chapter of psychotherapy in Albania, that of the Group Analysis.

Sporadically in the following years few people were qualified and graduated abroad in European Universities. The academic curricula in the Public and new private Psychology Schools began to be dominated by the Cognitive Behavioral approach. This influenced the education of some young professionals in the CBT school in the last decade parallel to the development of psychodrama, body psychotherapy, Adlerian therapy and only recently schema therapy and EMDR therapy. Actually, in Albania there are not trained professionals in couple therapy, family therapy, working with teens, as well as there are a lot of psychologists untrained in any psychotherapy training who have opened a private clinic and see patients with no supervision.

In December 2014, 7 years ago, Bob (Robert) Harris an IGA member was invited to have a speech about the Group Analysis in the 2nd Congress of Psychotherapy in Albania. This invitation came as a result of some previous ideation and planning discussions of a group of psychotherapists, members of Albanian Association for Pychotherapy led by Anxhela Gramo (the current chair of the Group Analysis in Albania) on further training on supervision or group therapy. This idea seemed to be incepted in a professional discussion between Anxhela and Erald Bekteshi, one of the abovementioned qualified psychotherapists who moved to London with his family and became himself group analyst trainee. This group of psychotherapists were very doubtful about the possibility of development of the group therapy in our country. “Suggesting to patients to be treated in a group of Albanian people?”, “Don’t’ even think about”, “Ok, maybe group supervision, yes, it’s a good idea, but so many years of training to go there… no, better no”, “Group therapy in Albania where everyone knows everyone is an impossible mission”. These were some of the opinions shared in that “historical discussion”. Besides myself, Anxhela and Erald, no one else was interested to go for this project. Anyhow, the idea and the wish for this training blossomed outside this group very gradually especially with the persisting work of Anxhela, who used all her personal and professional network in order to make possible the start of a series of introductory weekends finalizing with the official start of the Foundation Year in 2016 with a group of 15 participants. In 2016 was also established the association “Group analysis Albania” to take over not only the project of this training but to develop further the group analysis in Albania.

In the autumn of 2019, the Qualification Course approved by the IGA London UK, directed by Bob Harris, with the engagement of Val Parker and Eugene Clerkin as training group analysts, and of Sue Einhorn and Angelika Golz as training supervisors finally started. The number of students was already reduced. The time in between these phases had caused its loss. All of the trainees are women. Some of them used to know each other in other settings before the training, and some of them had close relationship going on. “The impossible” was present. A lot of such dynamics had to be administrated. As the custom is, since we are in Albania and Balkan, before the first block would take place, an earthquake occurred in Tirana in the middle of the Shadow Workshop. This was only the prelude of another stronger one in November, two days after the second block of training. A very shocking experience, which arose a lot of insecurity, unsafety issues, flight reactions, helplessness feelings and a big question of what’s worthy in this training. Another block weekend in the sunny and polluted Tirana, and the next block had to be online via zoom as the Pandemic started and most of the world was quarantined inside walls, windows and screens. A lot of resistance against this obligatory change of therapeutic and training setting was expressed by the trainees. Three members dropped out during these two years. The good side of the online learning experience was the opportunity for all the trainees to take part in pretty much more online events than would be possible in the live version. A lot of exchange between trainees from different countries, and between different groups and organizations was made possible. Membership of Group Analysis Albania (GAA) at GASI and EGATIN was a great opportunity for its members to feel the lost connectedness and belonging during Pandemic.

Actually, the Qualification Course is in its third year. The number of trainees is reduced from 12 to 9. Four group analysis trainees have started running their groups during 2021 and the rest is struggling with the group formation. Along with this, an experience of community groups started in 2018 until nowadays as a means to reach the community through “group being” and “group thinking” as well as to help the trainees to catch the huge range of the variety and complexity of the group dynamics and shapes. In 2017 the first large group was held in one public youth center in Tirana in the mental health day – a lot of young people, mental health professionals among them, gathered to talk about drug’s use and mental health. This meeting was followed by bimonthly community group meetings in another youth center. It seems like the youth is the only safe space where the newness’ growth and development can be held. The participants in these medium to small groups are young people as well, most of them young women, but not only women. There were the efforts of mostly a small group of trainees which kept alive this activity despite what happened: the earthquake and the lock down due to the Covid 19 pandemic. This autumn the community group activity started its third year with more maturity and thoughtfulness.

All this happened during the long governance of the Socialist Party, three mandates in a row, not necessarily because of the good governance, but possibly because of the lack of a good enough opposition. With no doubts this period of time could be called as the “just do it” and “let’s not think” years of the history of this country. The transitional phase is still in process, part of which includes the endless construction and reconstruction of new buildings, new roads, etc., which means an unceasing deconstruction of the old. No time to think about anything. There is a rush to make money by whatever means and disregarding to any moral and ethical principle. One of the slogans of the PM during the election was “There is no time to rest, only work, work, work”. It seems a good and motivational sentence, but it implies as well the urge to act and not to think, not to make questions, and not to waste time waiting for answers.

In this last decade the number of young professionals migrating to European countries, especially Germany, as well as in USA is highly increased. Along with the unemployment, the domestic violence, the human trafficking of children are some of the deepest wounds of the society as the drug/alcohol misuse and gambling are destroying quite a lot of families’ equilibrium. The education system is failing to find out the fittest system trying for many years one reform after another. The corruption in public health system remains still one of the reasons why young people choose another country to settle down in a safer environment. Mental health issues don’t belong to the concerns of the Ministry of Health for more than 10 years now. Public mental health services are almost inexistent, although fortunately mental health professionals are available and willing to contribute in those public services where they are actually employed. The justice system? Some serious anti-corruptive processes are in progress, but the loss of hope in justice is deeply rooted. Hopelessness and helplessness are the two main orienteers of many of the behavioral and style lives of people at different ages.

Becoming a group analyst in this background, and in this strange time the world is, arise a lot of questions. What is the worth of working with groups? Why groups when distance between people and countries is emphasized? How helpful can group analysis be in Albania? Certainly, there is a lot to be discovered, to be thought about, to be noted and reflected upon. So far, our experience as the object of the above history, as trainees of this training, as travelers of this journey, as traumatized and retraumatized people, as depressed as we are, has shown that we, our people, need to learn to think and to remember. Just acting seems so easy and simple, though very dangerous and damaging as a gun shot just for fun, but the blind bullet of which reaches a kid playing in his yard. To think and reflect, to remember what has happened seems sometimes unbearably impossible.

One of our famous writers said “There are words that cry, and there are tears that speak”. Translation of tears in words and connecting words with emotions, transformation of the collective amnesia in memory is what group processes can attain. The impossible can happen.

Sonila Mecaj
sonilamecaj@hotmail.com

Open group for the community – an Albanian experience – Irena Beqja Shtraza, Anxhela Gramo

Botuar në revistën “Gruppenanalyse” të Institutit të Analizēs së Grupit, Heidelberg, Gjermani. Shtraza & Gramo. Eine offene gruppe für die Gemeinschaft – eine albanische Erfahrung. “Gruppenanalyse”. 2021(31)

https://gruppenanalyse-heidelberg.de/zeitschrift-gruppenanalyse.html?fbclid=IwAR2PEAOVHXtl24RwVxxROQXt-3AqFlbjU5uBk-ROht3TNBElUCqFoIbNRsg

Summary
The article gives a snapshot of the Albanian group-analytic journey through the explorative experiences with/in the community. A truthful account of struggles and dilemmas, as well as enthusiasm and trust is illustrated through recollections, reflections and integration of a complexity of dynamics and group (intra-group) processes. The Albanian initiative, though structurally different from RC projects, shares the same aim, that of learning the language of human connection. The privilege and the responsibility for building trust in a traumatized society represent a challenge for the founders of group analysis in Albania. The description of this initiative brings a closer look at the interaction of the matrices at play when social becomes individual and the past becomes the present. By adapting and responding to the trainees’ group needs, the team came into contact with the capacity to create and provide – an open group for the community – the space and the time that Albanians have been deprived from.

Introduction
It is not easy to be the youngest at the group analytic field and one of the most socio-politically oppressed among the citizens of the European community. The history of our open group for the community reflects the experience of the Albanian Association for Group Analysis, an experience of becoming by creating our space through our initiatives. Sometimes, it felt uncomfortable, triggered shame and doubts about growing up properly. It was encouraging to be given the trust to explore in writing the trajectory of our community group; in other words, the process of how we created a transitional space for ourselves to manage the emotions of a toddler: a school of group analysis in
Albania.

The beginnings of the Albanian group-analytic journey
Introduction to group analysis in Albania started in 2014. This acquaintance was initiated by two Albanian psychotherapists in collaboration with Robert Harris, a senior group analyst from the Institute of Group Analysis, London. Among thirty students who attended introductory courses in group analysis since 2015, a core group of twelve trainees moved to the qualifying course, and at the moment ten trainees are moving ahead with the program. The same group of students represents the founding members of the association “Group Analysis in Albania” (GAA). The training program is organized by the Group Analysis in Albania in collaboration with the Institute of Group Analysis, London. Enthusiastic about the new experience of discovering ourselves in groups through groups, we were not much aware of the boundaries at the very beginning. Parenting ourselves exposed us to a great vulnerability because we couldn’t survive our “multiple roles” and “new lives” without interdepending on each – other. Fears of surviving not losing oneself were present. Our group came to life through groups’ life composed of the same people. As suggested by Earl Hopper (2003), a traumatized society is characterized by the failure of dependency. Thus, interactions between interpersonal, organizational and societal matrices were/are at the heart of the dynamic processes in our organization, which are as well projected and manifested into our community groups, too. It is now a tradition in Albania to organize awareness events on the occasion of mental health day. Invited to give our contribution to a new way of reflecting about mental health issues, our association thought of offering a group experience, away from boring round tables talks. This is how we started on October 2017. To our surprise, approximately 70 people showed up, among which youngsters, parents, teachers and professionals. We decided to have a group of three facilitators because the responsibility and anxiety was enormous. The rest of trainees sat with participants and allowed themselves to associate freely with the group material. Participants were invited to sit in concentrically arranged circles for 90 minutes and talk about drug abuse and addiction. It seemed like the community responded to a topic of a great sensitivity because the drug’s theme brings us all closer to the fear of annihilation (Hopper, 2003) provoked by the cumulative social and political traumatic experiences embedded in the Albanian society. At the beginning, the exchanges between participants looked like drowning boats asking for help. While the group started talking about the preoccupation thoughts and feelings of drug abuse, this shifted to denigration of those who abuse with drugs, while it ended with the screaming need of the participants to speak up for oneself and a covert need of longing for understanding. The youngsters talked about their lack of freedom and the restrictions felt by parents and society; while the parents expressed their helplessness and fears of failure helping their children. The person suffering from drug addiction was perceived either as “wrong who needs to be fixed” or, as “devil who needs to be condemned”. It was clear that this group experience brought into open air taboos which divided participants into those who fear and those who understand. Shame, an unrecognized anger and tears of a deep sorrow were the dominant features in the group process. At the end, while parents and teachers left with disappointment because of their expectations coming to this group to get advice about drug addiction, youngsters left with feelings of liberation and satisfaction, asking for further group experiences like this.

A creative endeavor’s structure, process and content
Encouraged by the response of the community and inspired by the wish to start exploring the social traumas of Albanians, a population indelibly marked by a 50 years long and repressing dictatorship, the trainees, though yet very young in their new journeyas future group analysts decided to experiment something new – running open experiential groups with the community. Open, monthly, median-size (de Maré et. al., 1991) groups with a duration of 90 minutes, located in the capital, Tirana. It was quite an experiment, a jump into the unknown and it took an enormous courage to start. An appropriate space was found where a large circle could be set, announcements were made on the institutions FB page, all social links of the trainees were used to let as many people know about the group. Based on the feedback received after the first community group experience, our immense confusion about what we were creating, the team thought that this new, daring setting needed a topic, as an axis to seize for all those curious, yet confused who could join. For several months different topics were proposed, trying to keep it as vague as possible, until the day came when the team decided that it was time to just keep it simple – naming it as it simply was, an experiential open group for the community. In the beginning only few people joined our open group, resulting in a median group where often time the trainees outnumbered the other group members. The group was most attractive to young women, usually university students. However, in these three years of the life of this group, many people join time to time, some staying loyal to the group and some not coming back. Mental health professionals, young men, different professionals aged mostly 25-40, but also parents of group members. Not rarely, there were members that showed up without prior notice, or group members that would bring in a friend. They were always welcomed, extra chairs were always available. Since the beginning, the setting was loyal to the basic fundamental rule, that of free association, encouraging members to express all that would come to their mind in the ‘here and now’, giving space to all possible sensations, images, reflections and dreams. This rule required infinite reminders from the team. Being an open group with new members almost each time, the team was repeatedly faced with the new comers’ question ‘what is the topic of this gathering?’. The team’s persistence paid off, and a group analytic setting was finally established, each session at a time. The community members were finally ‘onboard’. The team’s goal has been to facilitate a process aiming the introduction of group psychotherapy for the community, for a population who has always relied only to the family group as the trusted one. Taboos and secrets are kept locked into the family circle, while shame was installed as the controlling instrument of one’s life. Freedom was a word, which started to be elaborated after 1990’s, yet holding an exotic meaning which would put people in trouble also in now days. Thus, the team’s wish is to offer as de Maré suggests … a transformative process that converts what does not make sense into understanding and meaning, because learning to dialogue is a difficult process for the group, similar to the task of acquiring a new language (de Maré et al., 1991). Our open community group has its own challenges, fairly representing the struggles of the society it is born in. Fragmented communication, symptom of the dysfunctional intimacy in communities as a result of trauma (cit. R. Harris, 2020) remains a continuous barrier towards dialogue. Group members’ defensiveness is often very accentuated as a result of the very nature of this open group, with new members almost each time, while the oldermembers long for intimacy. Intellectualization is often used as a mean to foster connection, although it is continuously challenged and addressed.

Supervision and team meetings
The small group of trainees, the team, has worked and continues to work hard to take care of the larger group, while learning something new each time, very often by trial and error. It has sometimes felt like a dangerous experiment, but somehow the excitement and the trust in the group outmatched the fear. Preserving our team’s cohesion was not an easy task, because every trainee had their own way of approaching a group experience. Supervision with the course director, was an essential process, sometimes, resembling more to salvation from any sort of perceived threats. Being interdependent on each-other, we could not afford loss, yet, we were more prone of reenactment of trauma by producing conflicts and responding to them. Pre and post team meetings helped in sharing sensations, associations, reflections, sometimes also to identify possible counter-transferences within the team, which could undermine the group’s process. While maintaining one’s personal style and own specific way of being in the group, the team members shared the same understanding on the whole team’s crucial role as a container group for the group members.

Adapting and responding to the needs of the community
The community group sessions went on monthly for a period of two years, with breaks during the summer months. September would come and the team would be back in the community Centre, on the last Wednesday of the month, 17.30 sharp, welcoming the old and new group members. After the September 2019 earthquake that hit Albania, the group’s ‘shelter’, the building was damaged and suddenly the space where to come together and talk about the frightening experience we had all shared was lost. Faced with the immense anxiety caused by the earthquake, there was need for an improvised, temporary solution. Another free space where to come together was found. There was an obvious need to come together more often than usual, the trauma was too vivid, the ground was still shaking every day and night. Those ‘special’ weekly group sessions organized as a response to the earthquake, somehow solidified the grounds of our group, paradoxically while the real ground was continuously shaking, scaring us all to death. The unforeseen events were not over and while still trying to recover from the earthquake, the COVID crisis knocked at the door. The shaking and cracked buildings that sheltered people were to become the obligatory refuge during a forced quarantine. Where was life safer? Outdoors risking to get infected or inside a cracked building and shaking foundations? Challenged but also motivated, the team decided to start running the group online. Technology did wonders, people joined the online group and were thankful for having restarted. To sum up… trust in the group Endeavors are not always meant to work, but this one seems to be working so far. Although we were backed up with ongoing supervision, it has always felt adventurous and exciting. Maybe the courage, persistence, sense of adventure of the team may have been key to what has been created. The team chose to trust the group, aware that the thirst for trust was enormous. And building trust in a traumatized society where no-one trusts anyone is quite a challenge. Maybe, this process helped us to trust each-other in a different way. As mentioned earlier, this group experience was created out of our desire and need to survive our growing experience as organization founders and trainees. While sitting in the community group for three years, we have learned the language of human connection. Maybe this is the reason why we chose to trust the group. It was our unconscious need to repair from trauma and recreate ourselves in a Winniottian way (Winnicott, 1971). This makes our community group quite unique. One could also think that these characteristics have inspired and motivated the group participants as well. This would give an answer to why they come and sit in the group again and again, month after month, bringing friends and embracing an increasing sense of belonging in an open group, with new members almost every time. It was when the oldest group members started showing less and less anxiety whenever new members joined, that the team felt the degree of the accomplishment of what has been created with love, creativity and trust in the group. The Albanian team is testimony that the development of community experiential groups growing out of the fundamental principles of therapeutic community models, especially in traumatized societies like ours, is possible.

References
de Maré, P. B. (1972). Perspectives in group psychotherapy: A theoretical background. London:
George Allen & Unwin.
de Maré, P., Piper, R., & Thompson, S. (1991). Koinonia: From hate, through dialogue to culture
in the large group. London: Karnac Books.
Harris, R. (2016). Lecture on The Social Unconscious and Traumatized Society. Personal Collection of R. Harris, Institute of Group Analysis, London, UK.
Hopper, E. (2003). The fourth basic assumption: Incohesion: aggregation / massification or (BA)
I:A/M. In: Traumatic Experience in the Unconscious Life of Groups (pp. 66-90). London:
Jessica Kingsley.
Winnictott D.W. (1971). Playing and Reality. London an New York: Routledge Classics