Summer/Fall 2023 Issue 6
Looking Back as We Move Forward:
Ellen Ziskind, LICSW, CGP
In this series, NSGPeople will interview long-time NSGP members, to both look back on their lives as group therapists and reflect on the history of NSGP.
“I think for most of us in our generation, all the generations represented here, NSGP was in some ways absolutely central to our identification as a professional, central. It was the community. I wonder if that is true today for the newer people coming in, and if not, why not and what we might do to make it more so.”
- Scott Rutan, A History of The Northeastern Society for Group Psychotherapy (1996)
When Scott and I did this interview, he offered to send me his curriculum vitae. I should have perused it before printing so that I could have filled my paper tray to the very top. It comes to 26 pages from 1962 to the present. It is filled with academic and hospital appointments, awards and honors, committee work and offices held, editorial boards, teaching gigs, hundreds of presentations around the world, pages upon pages of published articles, book chapters, and books. Psychodynamic Group Psychotherapy is now in its 5th edition (co-edited with Walter Stone and Joe Shay). The book has been translated into several languages including Italian, German, Hebrew, and Chinese. I’ve known Scott as an NSGP member and teacher for decades but had little idea of the enormity and scope of his contributions.
When Scott became the Founder and Director of The Center for Group Psychotherapy at the Massachusetts General Hospital (1985-1996), he was responsible for the group therapy training of psychiatric interns and residents. He required them to participate for one year in the Observation Group he and Anne Alonso (past president of NSGP, now deceased) ran there and to lead a supervised psychotherapy group for two years. This sounds quite remarkable to us today, to have the observation and leading of psychotherapy groups play such a central role in the training of psychiatrists – or anyone else in the mental health field, for that matter. Jerry Gans, Cecil Rice, and Norm Neiberg were among the people who supervised those residents and interns. What, I asked Scott, led him to see groups as so core in the healing process?
In his doctoral training at the Danielson Center for Pastoral Counseling at Boston University (now the Danielson Institute), he said he was exposed to group therapy “at a very high level.” Three of his supervisors (including Henry Gruenbaum) were group therapists and very active members of NSGP. He observed Norm Neiberg’s group for two years and then Stanley Kantor’s. It was there that he first observed, ran, and was supervised on groups. He was convinced that groups had the potential for healing and transformation that was unlike any other treatment modality and he has dedicated most of his professional life to them.
Scott added that his father was a musician in both jazz ensembles and the Chicago Symphony. When major jazz musicians came to town, they would gather in the basement of his family’s home and play into the night. From these experiences, he sensed that there was something about people doing things together that had a kind of alchemy, that the community was larger than the individual and could create things of a different magnitude than people doing things alone. “It was obvious that a choir was more grand and powerful than even the best tenor.”
At the MGH in those days, he said that there was a waiting list for people to get into individual therapy and some of them had waited for months. These were people nobody wanted to treat because they had all been hospitalized multiple times. Scott said that in order to be invited to become a member of the Observation Group, a person had to have been on this waiting list for seven to eight months. He wanted to demonstrate in a very dramatic way the healing power of groups. This waiting list was the well from which he and Anne (and later Sara Emerson, Nina Fieldsteel, and Annie Weiss) drew their members and in the 25 years that the group existed, there was not one psychiatric hospitalization. Scott attributes this to the “holding” capacity of groups and to the efficacy of group leaders containing powerful emotions by “sitting silently” and observing.
These were the years when psychodynamic psychotherapy was at its pinnacle. Sitting and “bearing the affect of the group” was held to be perhaps the most important function of the leader. When I observed Anne Alonso leading the group at the MGH in the 1970’s (she and Scott alternated rather than co-leading), I remember her telling the observers at the end of one group in which she had said almost nothing, that the very best led group was the one in which she barely, if ever, spoke.
And yet, it seems important to balance the impression this stance might create with some of Scott’s other beliefs about the role of the group therapist, which sounds more relational. He came to understand that people have something in common with skunks. “Skunks are nice animals but when they get scared, they stink up the joint.” It was these defenses, the fear that people felt around getting close, despite their yearning for connection, that could be seen and treated in groups. He understood that if he could both appreciate the armor worn to defend against closeness and create a safe enough environment in which the armor could incrementally be relinquished, this was the goal. He added that over time he became less interested in theory and technique realizing that creating safety was the sine qua non, the essential ingredient in group therapy.
So much did Scott believe in the importance of beginning group therapists observing groups that, in his own private practice, he invited one beginning group therapist at a time, for one year, to sit silently on his sofa and observe the group in session. After it ended, he and the observer would talk for a half hour about what had transpired. Eventually, so many therapists ended up as group members that he had to end this practice for the sake of confidentiality.
Scott joined both NSGP and AGPA around 1970. He describes NSGP as “active, enthusiastic” and at first, made up exclusively of white, male psychiatrists. “Very psychodynamic, …not very inclusive demographically or theoretically…. I’m very glad to see how NSGP has opened its doors. In its earliest days psychologists were a bit suspect, and social workers and psychiatric nurses need not apply.” Over time, the boundaries of the organization relaxed and more disciplines were welcomed.
When asked if there are things he missed about NSGP, Scott said, “I miss the power and enthusiasm that NSGP had in the past. For some reason, group therapy as a whole is losing support. AGPA and every group therapy society that I’m familiar with are all struggling with membership and programming.” Scott spoke of the years during which all sorts of groups were enormously popular: Esalen, T-Groups, even Bob Newhart playing a group therapist on a much-watched television show. “People came running to groups…and you could have as many as you wanted.” He commented that people are still “starved for connection,” which is one reason social media is so compelling.
When I asked if he had memories of NSGP in its earlier years that he thought would be of interest to its newer members, he said, “Oh, so many. We used to conduct the “Collegial Seminar Series” in Cambridge. This occurred on Wednesday evenings, I think monthly. A member of NSGP would speak on a topic and the meetings were open to the professional public free-of-charge. They were very popular and drew between 25-50 participants.”
“My favorite Collegial Seminar session was by Bob Weber on “Acting Out.” He forgot the meeting and didn’t show up! Fortunately, Bob lived nearby and was quickly roused. Naturally, he used the incident to make his topic come alive.”
“The Annual Conferences have always been a highpoint for me. When I was President, 1978-80, the Society was having some financial troubles so we began the Annual Conference. There had been a much smaller gathering that had been held occasionally but the formal, three-day conference began then. Arnie Cohen, Suzanne Cohen, Babette Whipple, and Jane Calhoun were on the team that put that first conference together.”
I asked Scott how being a group therapist had influenced who he is as a person today. He said, “I’m much more optimistic. I’ve been able to see and confirm that beneath whatever off-putting, distancing behavior individuals might use to protect themselves, they are always doing their best to be ‘in’ relationships, not out of them.” He added, “It made me a better person. I’ve never met a person I didn’t like if I could get under their defenses.” People who are afraid of closeness are “sending out a signal…they’re like burn victims who want to be hugged but it hurts too much. How can I help that person get closer?... People are fundamentally good. The power of the group can either hurt or heal.” He added that, as we have witnessed recently, groups are enormously powerful and they can easily go in the wrong direction. “We’re trying to use that power to help people grow.”
Scott retired from doing groups several years ago. I asked him what he missed most about them. First, he said, “The good news was that, for the first time in 50 years, I got to enjoy evenings! I also sighed a breath of relief because I saw a lot of people in group carrying significant sadness and depression. More than I had expected, I felt the responsibility for those patients’ lives.” And then he added, “But, I missed and still miss hearing the life stories and enjoying teasing out life stories from the interactions in the groups.”
As part of this series reflecting on NSGP’s history, NSGPeople will include an excerpt from A History of the Northeastern Society of Group Psychotherapy (1996) that may be relevant to the organization today. This document acknowledges that it describes only “part of the story,” as it limited its focus to “a history as viewed through the eyes of the past presidents.”
“All living things change: plants, animals, people, groups, organizations, communities, and nations. From simple beginnings they graduate to greater complexity, and sometimes, after a brief flourish, they cease to be. Sometimes it may be many years or centuries before cessation. From a genetic perspective, recreation, and then another beginning, accompanies most cessations. However, unlike humans, genes care little that another beginning has a different identity from its demised predecessor. To the extent that genes care, it is to maintain continuity to guarantee their collective survival. Thus, as all living things change, so all living things require continuity and enough stability to guarantee their existence and that of their genetic progenitors.”
- Cecil Rice, A History of The Northeastern Society for Group Psychotherapy (1996)
“(Scott Rutan) felt he had to protect and enhance the Society, even if it meant sacrificing the interests and needs of individual members who had been running the organization. Such a position involved major shifts in the existing structure and, therefore, tension and conflicts. Scott's impression was that the Society was stagnant. It had emerged from an idea of a few people who had not anticipated that the Society would grow as it has. When he came to the presidency, the Society was still small, getting smaller, and was run by a correspondingly small group of people (Norman Neiberg, Henry Grunebaum, Hal Boris, and Stanley Kanter are those who immediately came to mind). Although they were very hospitable to him and seemingly not geared to keeping other people out, he still found it a hard group to break into. He realizes in retrospect that he had to take power away from them in order to do what he felt needed to be done. He came to the realization that his task was to help transform the Society from a "mom and pop operation" into a well-functioning, well-organized business.
A "mom and pop operation" in NSGP meant that decisions were negotiated through personal networks, and not through structured channels. Scott believed this kind of operation resulted in elitism, which had not served the organization well over time. The contemplated transformation required drastic change in the way the Board functions. He realized that a few people were doing all the work of the organization, and that most of them were on the Training Committee. It was his impression that the training committee had become synonymous with the Society. In his view, the Board had effectively been rubber stamped for the Training Committee. He wanted very much to bring new people into the organization, and to encourage non-active members to be more active. To this end, he decided to limit the length of time a member could serve on committees. Under Scott's aegis, the Board became a working partner with the president of the Society.”
- A History of The Northeastern Society for Group Psychotherapy (1996)