Roles, Boundaries and Vulnerability in Care Providing Institutions


A 3-day Residential Group Relations Conference
in collaboration with the College of Pastoral Supervision and Psychotherapy (CPSP)


Primary Task

The primary task of this temporary learning organization is to cultivate, through direct experience, multiple perspectives including the individual, the interpersonal and the group-as-a-whole for the purpose of understanding how our relationship with patients and others who receive our care is impacted by the complex social systems we work in.

It is often the case that we perceive a group as merely the product of individual perceptions and actions. During these few days we will have the opportunity to experience the inverse. That is, the individual perceptions and actions as the manifestation of the group. While it is actually both, our strong preference for the former blinds us to the power and influence of group forces at the expense of our effectiveness and reduced ability to thrive in complex social systems.

Purpose of this conference

The purpose of this conference is to improve our work though:

  • developing a deepened awareness of how we take up our professional roles in complex systems
  • seeing how the individual and group unconscious is ever present and impactful
  • applying some theoretical knowledge in real-time in an open learning environment
  • experimenting with new behaviors and taking risks

Concepts and Methods

Wilfred Bion is one of original founders of what was later referred to as the Tavistock method of studying group dynamics and social systems.  Bion developed his theory about group dynamics by applying psychoanalytic method to understand how groups can or cannot stay on task during stressful situations. While much of his initial work was in an English military hospital during World War II – all groups provoke some level of anxiety in individuals since we both have a hunger to belong to them as well as a fear of being consumed by them. While this may be in part representative of early family experience this dynamic continues throughout our lives in groups. The omnipresent anxiety of group membership significantly impacts the balance between a group’s ability to function productively on an agreed upon task or defensively – often as cross purposes to the stated task. Bion makes this distinction with the terms “work group” and “basic assumption group.”

According to Bion, groups, like dreams, have a manifest, overt aspect and a latent, covert aspect. The manifest aspect is the work group, a level of functioning at which members consciously pursue agreed-on objectives and work toward the completion of a task. Although all group members have hidden parts or particular areas of vulnerability, they rely on internal and external controls to prevent these hidden parts or more regressive elements from emerging and interfering with the announced group task. They manage their irrational thinking and combine their skills to solve problems and make decisions.

Groups do not always function rationally or productively, nor are individual members necessarily aware of the internal and external controls they rely on to maintain the boundary between their announced intentions and their hidden parts and vulnerabilities. The combined hidden parts of group members constitute the latent aspect of group life, the basic assumption group. In contrast to the more rational work group, this group consists of unconscious wishes, fears, defenses, fantasies, impulses, and projections. The work group is focused away from itself, toward the task; the basic assumption group is focused inward, toward fantasy and a more primitive reality. Tension always exists between the two; it is balanced by various behavioral and psychological structures, including individual defense systems, ground rules, expectations, and group norms.

While in the helping professions, especially those connected with illness and end of life, there may be awareness of vulnerability and powerful unconscious forces, there may be less attention given to the multiple systems and various groups that interact, intersect and impact the task of helping. These influences include the present and absent family members who may come and go over time, the other health care professionals with equally variable presence and their complex authority relationships (for example, doctors & nurses), the hospital or institutional structure, the relationship between the Chaplain or Counselor and the institution (for example, in-house or freelance), the political and economic forces operating (for example, healthcare system and insurance) and many other forces that can complicate the ability to stay present with a patient at a critical moment in their lives.

Conference Structure

While the use of the term “conference” to describe this event has its origins in early group relations work, it implies a more traditional type of learning than the one we describe. Roles, Boundaries and Vulnerability in Care Providing Institutions will in fact be a temporary organization created by staff and participants (referred to as members in our terminology) for the purpose of both experiencing and studying the birth, life and death of this temporary organization. During our time together we will have the opportunity to see how we take up various roles, how we find authority, leadership, connection, vulnerability, creativity, confusion and clarity. While this is a temporary creation, apparently artificial, members and staff will find it to be a startlingly real representation of our work environment and a unique opportunity to experiment and learn proportionate to our willingness to engage in the process.

Some of the Learning Possibilities

Learn about group dynamics from participation in groups that vary in size, structure, and task.

Learn how our personal autonomy and ability to act is impacted by the group

Observe the impact of individual characteristics such as race, ethnicity, nationality, gender,
sexual orientation, and age on authority and power.

Recognize personal and collective reactions to well defined and ambiguous authority and how
one finds their own authority

Understand the difference between the stated task of a group and the task it actually appears to
be pursuing.

Conference Structure

The conference provides a variety of group events through which the primary task may be explored. These events are briefly described below:

Conference Opening

In the opening the conference staff and members (participants) meet together to begin working in person. (In this method of study interactions that occur before the conference opening are also considered as part of the emerging organization). In the opening, the Director provides an overview of the conference and introduces the staff. An opportunity is also provided to begin the interaction between staff and membership and the method of working in the “here and now”.

Small Study Group: SSG

Each member participates in a small group. The task of each Small Study Group is to study the behavior and dynamics of the group as they actually unfold in the “here-and-now”. The group is assisted with its task by a staff consultant who will focus on illuminating the group as a whole dynamic.

Large Study Group: LSG

All members plus two staff consultants meet together as a single group with the task of studying behavior as it happens, again with the focus on whole group dynamics. Seating is arranged to elicit some of the experience of being in very large or disconnected groups where face-to-face interactions are limited or inhibited. It is an opportunity to experience how membership in larger groups impacts our abilities to take up authority and leadership. Also under study is the impact of wider systems beyond the group as they influence individual and group behavior.

Institutional Event: IE

All members of the conference and the staff group participate in the Institutional Event in order to examine the evolving conference institution. In order to more organically understand what is emerging in the institution members form themselves into groups of their own choosing and interact with other groups, including the staff, to study how the system can be understood from it parts.

Opportunities are available to examine the processes of group formation and to consider the dilemmas inherent in representing, or exercising authority on behalf of one’s group. Members are encouraged to request staff consultation during this event to help make sense of the emerging system..

Dreams, Associations, Sensations Event

This event is an invitation to all members and staff to share dreams, associations and sensations as they arise both from our own inner life and what might be elicited by hearing others. These two morning sessions are intended to accentuate the underlying reality of our personal and collective unconscious in order to make it more visible and accessible throughout the conference.

Moving Integration Exploration Event

In this event all members and staff are invited to move in silence in a common space in order to use the wisdom of the body in motion to integrate experience and to access a deeper layer of knowing. During this event be aware of your own body/mind, the environment and the others around you. In particular notice how you sense and connect or disconnect with members of the group. In motion without any particular direction we may discover important clues about the nature of our group.

Role Analysis and Application Groups

Members meet in a small group (differing from their other small group) with a staff consultant to explore the roles they have taken on during the conference and what they might want to change or maintain. Later in the conference the groups will explore outside work roles and the application of conference learning to them.

Post-Conference Video Group

This is an open opportunity for staff and members to continue exploring conference learning and its application to work roles. A signup sheet will be provided at the conclusion of the conference for interested members.

Role of Staff

While the staff have more proscribed roles than the members (participants) they too are participating in the emerging temporary organization and are experiencing the same systemic and personal forces at play. Their role is to discern the group forces at play and then to reflect them back to the members only when such reflection would be helpful to the learning. Staff do not function as facilitators to make things go smoothly or manage social conventions nor do they, during most conference events, provide consultation to individuals. This is done intentionally in order to highlight the full life of the group and all its visible and hidden parts and avoid reinforcing the usual understanding that a group is only a collection of autonomous individuals. This may at first be off putting since we are accustomed to being individualized however once we see this as intentionally shifting an automatic pattern of perception, it can be revelatory. Staff also operates in most events with a “here and now” approach. That is, maintaining a primary focus on what is happening in the present rather than past and future.

Staff are chosen for their ability to maintain an intense and reflective focus on the primary task. Staff development and training during the conference further supports that focus.

As part of the conference design, the way in which the staff exercises leadership and authority, as individuals and as a group, is available for study.


Jack Lampl, Director, is the past-president and current board member of the A K Rice Institute for the Study of Social Systems and of Grex. He has been collaborating with CPSP for the past three years to enhance the quality of clinical training and broaden the exposure to group relations concepts. He is a regular staff member at group relations conferences at the Leadership Institute of the University of San Diego.

Micki Seligson, M.Ed, Associate Director, is a Jungian Analyst, former board member of AK Rice Institute, Senior Research Associate, Project Director, Founder, The National Institute on Out of School Time, Wellesley College Centers for Women, Wellesley MA (ret.)

David Roth, Administrator, is a diplomate CPE supervisor and director of spiritual care at Kaiser Permanente in Northern California, co-founder of NCTS-West, general editor of the Boisen Books Project, and a member of the board of directors of Grex.

Ed Luckett, Jr., Associate Administrator, holds an M.Div. degree, is Hospice and Palliative Care Chaplain for Kaiser Permanente, and Teaching Elder in the Presbyterian Church (U.S.A.).

Additional Consultants

Tom Butler holds M.Div. degree and is in private practice. He is a former board member of the A K Rice Institute.

Miguel Guilarte, MDiv, PhD, is a professor at the Fielding Graduate University. He is also a management consultant, and executive coach. His areas of work include organization strategy, development and communications.

Mojgan Jahan is a clinical psychologist with over 30 years of clinical experience. In addition to treating individuals with chronic medical conditions, traumas, anxiety, depression, and relationship concerns, she conducts workshops and trains other medical providers.

Kate Regan holds a doctorate in Organizational Psychology and Master’s degree in Religion from Fordham University in New York. She has over thirty years of experience working as either an internal or external consultant to  public, private and not-for-profit organizations, including many faith-based groups. She is the President of Kairos Consulting Group in Washington state.

Consultant In Training

Isabelle Reiniger
LCSW is in private Private Practice in Chicago and Evanston, IL, previously Group Psychotherapist, at the Chicago Institute for Psychoanalysis

additional staff may be added



This conference is designed as an integrated experience, so participants should plan to attend all events from the start to the finish.

It is important to note that, while experiential learning such as that available in this conference can be enriching, it can also be stressful at times. Therefore, individuals who are ill or experiencing a period of significant personal difficulty may wish to forego attendance at this time.


Registration Saturday, October 16 1 PM – 6:00 PM & Sunday October 17, 8:45 AM – 9:45 AM

Conference Hours:

Sunday October 18:           10:00 AM ‐ 9:30 PM – Note: Conference begins promptly at 10:00 AM

Monday October 19:          9:00 AM ‐ 9:30 PM – with optional group ending at 10:30 PM

Tuesday October 20:          9:00 AM ‐ 3:30 PM

A more detailed schedule will be provided upon registration.


The conference will be held at Christ the King Retreat Center, Citrus Heights (Sacramento), California. Conference fee includes meals and accommodations. Conference fee includes meals and single-occupancy accommodation with a private bath. The registration fee is per individual and will remain the same, whether you request a private or shared room. If you would like to share a room, please indicate the name of a roommate.


In order to support members’ freedom to experiment in whatever ways they believe will best facilitate their learning, staff members will not report the behavior of any individual member to anyone outside the conference without the member’s authorization. Members are encouraged to maintain the same degree of confidentiality.


Registrations will be accepted through October 10, after which registrations will be accepted on a case‐by‐case basis based on availability.


Fee for CPSP Members
$590: Two nightsSunday and Monday
$715: Three nightsSaturday, Sunday, and Monday

Fee for nonCPSP Members
$665: Two nights—
Sunday and Monday
$790: Three nights
Saturday, Sunday, and Monday

For arrivals on Saturday, nine meals will be provided with registration, from Saturday dinner to Tuesday lunch. For arrivals on Sunday morning, seven meals will be provided with registration, from Sunday lunch to Tuesday lunch.Indicate when you register if you would like a lunch on Saturday due to early arrival (certification or chapter meetings for CPSP members). The lunch is $12 and will be served in the dining room at noon, or you may order a box lunch for $8.Coffee, tea, and snacks will be available throughout the day.



If registration is withdrawn prior to Friday, October 1 , the fee, minus a $25 processing fee, will be refunded. Thereafter, no refunds will be made.

For questions, please email David Roth, Conference Administrator