Psychoanalytic Psychotherapy (September 2005), Vol. 19, No. 3, 233–245
CONSCIOUSNESS-RAISING AND WELL-BEING IN PUBLIC SPHERE ORGANIZATIONS: A HISTORICAL
REVIEW OF PSYCHOANALYTICAL APPROACHES - GARY WINSHIP
This paper traces a lineage of ‘organizational depth psychology’ from Freud through
to post-Bion perspectives on organizational consultancy. In reviewing the psychoanalytic
approach to organizations two dominant strands emerge; first, that theories seem
to be constructed around a critical conception of institutions and, second, that
the active process of organization al consultancy, deriving from this critical base,
is inclined to consciousness raising through the disruption of familiarity in the
culture of the organization. The challenges of de-stabilization in the process of
organizational progress, survival and decay are considered.
IMPETUS
It is an underpinning idea in this paper that clinical practice in a public sphere
service like the NHS is indubitably linked to its organizational context. Armstrong
(1997) refers us to the task of holding ‘the institution in mind’, that is to say,
to fully understand the dynamics that flow between the patient and the therapist
one needs to be cognisant of the institutional dynamics within which the work proceeds,
ensuring that the special and intimate understanding in the process of therapy does
not evaporate when we turn our attention to the group, the team or organization.
This type of institutional self-scrutiny ought not to be the preserve of institutions
such as the Cassel, Henderson or other therapeutic communities where institutional
self-consciousness has been incumbent in practice, rather it is a challenge for all
clinicians to keep a second eye on how the organization ticks.
233
ORGANIZATION MENTALITIES
In Group Psychology and the Analysis of the Ego, Freud (1921) simply, although astutely,
observed that the organization of both the army and the church were shaped by transference;
an upward structure of feeling that could be cast in terms of the bonds of parental
identification. It may seem like a rudimentary idea now that the organization of
the army and the church could be mapped to patriarchal authority in the family, though
at the time it was a radical idea and somewhat heretical when Freud proposed the
transference in the church to be borne from the bonds of an illusion. Freud had before
been concerned with the organized rituals of culture and religion in Totem & Taboo
(1912) and he would extend this work in Civilisation & Its Discontents (1929) where
he offered a bold analysis of the entire organization of mankind. His method was
to develop his ideas about the psyche, gleaned from intensive clinical practice and
research, and set them against the collective organization of human exchange in groups
and institutions. He was never inclined to prove or disprove these sweeping assertions
although he amassed enough hypotheses to stimulate the interest of others.
The concern to elucidate the nature of human relations through dialogical exchange
in psychoanalysis certainly anticipated, if not influenced, the evolution of industrial
psychology; beginning with the famous Hawthorne Experiments between 1924–1927 led
by Elton Mayo (1933) at the Western Electrical Company in Chicago. Mayo pioneered
a non-directive form of interviewing which involved researchers developing open conversations
in a manner not dissimilar to the Freudian technique of ‘free association’. The researchers
found that the non-directive technique enabled the study participants to speak more
candidly and answers were found to be vastly more illuminating than those derived
from closed questions. Most participants would answer dutifully ‘yes’ to the question
‘do you like your foreman?’, whereas when a subject was broached in a non-directive
way with an open question, a more accurate rendering of the truth seemed to emerge.
The experimental research at the Hawthorne otherwise involved the modification of
a whole a range of working conditions; for example changing the length of breaks,
increasing or reducing hours, changing light intensity and so forth. These alternating
changes were maintained for a set period of 12 weeks during which time output and
efficiency from the factory (telephone manufacturing) was measured. The most unexpected
finding contrary to previous studies was that the changes in any of the working conditions
(either helpful or unhelpful) did not necessarily impact on output. Instead, the
researchers noted that the peer group relations among the workers were more influential,
and indeed some sub-groups of workers exerted such strong peer pressure as to restrict
output. So it was a coherent and interpersonally satisfied group of workers that
was far more productive than an incoherent or antagonistic group. It was a significant
discovery that is now taken as rudimentary today, although at the time it stood in
direct contradiction
234
to the stick and carrot mentality of workforce management. Workers were not primarily
governed by economic motives alone, rather work stood for a more fundamental primary
group activity perhaps arising from an essential need for benign social engagement.
This finding was re-confirmed again and again in subsequent studies of group working,
for instance in Miller’s (1975) study of weaving. Mayo’s classic research became
a benchmark for aligning the emotional condition of the worker with his capacity
for productivity. It was a post-Marxist or at least Marxist-inspired corrugation
of interest in human interaction. Marx had set out a framework for appraising the
well-being of the industrial worker amidst capitalism arguing for an ethical precedent
for fairness, equality and humanitarianism in the organization of labour. In envisaging
a Utopian world where everyone was satisfied working to their capacity each according
to their needs, Marx outlined an economic theory based on an emotional premise of‘happiness’.
We therefore might locate both Freud and Mayo engaged in a sustained pursuit of understanding
those emotional conditions that alleviated the worst effects of alienation and misery.
Freud (1933) sparingly referenced Marx mounting a brief refutation of his ideas but
none the less posited Marx as an ‘undeniable authority’ (Freud 1933: 176) (cf. Fromm
1961, 1970, Hinshelwood 1983, Frosh 1987). Although Freud was primarily concerned
with familial micro-pathology, it is not hard to see that psychoanalytic theory as
the most honed nvestigative tool of emotionality and well-being might become something
of a disc in the backbone of a new body of industrial psychology; if a happier worker
was more productive than an unhappy one then the conditions which determined the
emotional life of the worker were necessarily subject to investigation.
THE ORGANIZATION OF MENTAL WELL-BEING: THE FIRST BASE OF PSYCHOANALYTIC ORGANIZATIONAL
CONSULTANCY
The application of psychoanalytic group theory in organizations was presaged during
the Northfield Experiments in Birmingham, England, during the 1940s when group ideas
were applied to the treatment of shell-shocked soldiers (Harrison 2000). Arising
out of these Northfield experiences John Rickman published important papers which
went against the mould of his psychoanalytic training by examining the shift from
2 to 3 to ‘n’ person psychology (Rickman 1950). This paradigm shift towards group
theory, combined with the post-Mayo influence in industrial psychology lent impetus
towards the establishment of the Tavistock Institute of Human Relations. The Tavistock
Institute was founded when the Tavistock Clinic became part of the National Health
Service in 1947 and the Institute established itself as a separate non-profitmaking
association. It was funded in the first place by the Rockefeller foundation in the
USA and from its inception the Institute was closely linked with Kurt Lewin’s Research
Centre
235
for Group Dynamics also in the USA (Rose 1989). Lewin was concerned to address what
he saw as the shortfall in social science of a theory of the dynamic system as a
whole. He advanced a structural account of social processes which offered topographical
concepts of the social field that mirrored some of the representations of theory
in other scientific fields such as atomic physics (Miller,1993). Lewin’s field theory
offered conceptual way of conceiving the sum total of the system beyond the sub-parts
of its gestalts. That the system might be prey to unconscious dynamics offered a
foothold for psychodynamic theory to be embedded with systems theory; a defining
principle thereafter for theTavistock approach.
One of the key moulds of the Tavistock approach was set by Wilfred Bion who, like
John Rickman, had been fleetingly involved in the Northfield experiments. Bion’s
compact ideas about group dynamics as they emerged from Northfield along with his
prior experiments with leaderless groups as a recruitment tool for assessing leadership
qualities among officers, set a new tone for psychoanalytic work. These clinical
experiments eventually coalesced in his seminal book Experiences in Groups (Bion
1961). Bion argued that the psychoanalytic approach, whether in individual therapy
or in a group approach, was dealing with different facets of the same process. The
two methods (individual and group approaches) provide the practitioner with a rudimentary
binocular vision. The observations tend to fall into two categories, whose affinity
is shown by phenomena which, when examined by one method, centre on the Oedipal situation,
related to the pairing group, and, when examined by the other, centre on the sphinx,
related to problems of knowledge and scientific method (Bion 1961: 8).
In other words, Bion saw the group as concerned with the riddle of the sphinx while
the individual was concerned with the Oedipus complex. Experiences in Groups certainly
set a number of riddles and was more inclined towards a sociology of knowledge than
it was towards clinical theories of mental process. Bion’s actual contribution to
groups was brief and his analysis of organizations was likewise limited, the exception
it might be argued, is his writings at various points about the ‘Establishment’.
Bion took to using a capital ‘E’ whenever he referred to the Establishment and his
distaste for it emerges most vehemently in his War Memoirs (Bion 1997) where he berates
his younger self for being a conformist in the army. Bion’s terse ideas about groups
left more than enough space for others to translate his dense thoughts into theoretical
frameworks of greater utility. Among these thinkers were: Tommy Wilson, Harold Bridger,
Eric Trist, Hugh Murray, Kenneth Rice, Elliot Jacques, Isobel Menzies, Garth Higgin,
John Hill, Fred Emery, Frank Heller, Henry Dicks, Douglas Woodhouse, Elisabeth Bott
236
Spillius, Eric Miller and Gordon Lawrence, and others from the Tavistock Clinic,
notably Jock Sutherland, Pierre Turquet, Robert Gosling, John Bowlby and Mary Barker
(Sher 2003: 110). The Tavistock Institute established a rigorous group relations
ideology and a training programme that later culminated in the ‘Leicester Conference’,
which was inaugurated in 1957. Ken Rice transported the Tavistock group relations
model to the USA in the 1960s and a number of institutes were established in his
name in the 1960s (for a list of A K Rice Institutes, see Obholzer and Roberts, 1994:
212). Bion himself only took part in one of these group-relations conferences in
the USA in 1969 and as he reported in a letter to his wife he was not overly impressed.
Ken Rice, looking white-haired and older, was the same as ever. It soon became evident
that RS was very nervous, as this was his first experience as Director of the Conference.
He was scared stiff of AKR. and self, though I did not get wise to this, or its extent
quick enough or I would have tried to keep my mouth shut. After the plenary I was
so unfortunate as to be talking when the meeting ended and the Staff walked out.
I had not realised that according to the real rules of Groups – as laid down by Ken
– he insisted on split second termination of each meeting, and by the time I had
finished my sentence the Staff had disappeared round the corner and I couldn’t find
where they had gone &ldots; It ended with my being very depressed and inclined to
pack my traps and clear out (Bion,1985 cited in: Sher, 2003: 129). Bion was not particularly
a fan of institutions nor of group conferences. Sher (2003) argues that we can locate
this antagonism towards institutions as a reaction to the death of his first wife
in 1945 during the birth of their daughter when Bion perceived the hospital to have
failed. To my mind the disappointment with the hospital must have compounded Bion’s
already welldeveloped scepticism of the folly of people in large groups after the
First World War. One might say that Bion’s suspicion of institutions has percolated
through the discourse of psychoanalytic organizational theory ever since. As Lawrence
(2003) re-confirmed later it was still the sphinx that merited being the object of
organizational study: To state the issue starkly, in organization al consultancy
the focus is on the sphinx; Oedipus is left to the therapist in his/her consulting
room, or is left as a private matter for the individual (Lawrence 2003: 205). We
know that the Sphinx is a beast who appears to relish the act of homicide with a
teasing riddle that defeats all that come upon her, until Oedipus solves the riddle.
The Sphinx is not woman, yet not quite creature. The Sphinx is an amalgam of identities,
a caricature of psychopathy that only the foolish, the brave or ambitious dare to
take on. So the psychoanalytic theory of the
237
organization begins with the beast organization as larger than oneself that ought
to be avoided or approached with intellectual prowess. In positing the organization
as Sphinx, Bion’s behest set a particular tone of suspicion that has remained resonant
throughout the generation of psychoanalytic organizational theories that followed;
for instance in Elliot Jacques’s (1955) and Isobel Menzies-Lyth’s (1960) charter
theories about defensive processes in organizations at the fore (Menzies Lyth, 1988;
1989a). In his work with organizations Jacques noted that the changes in institutional
structure had the potential to arouse sometimes catastrophic anxiety in staff and
that various emotional defence mechanisms such as sublimation, splitting, denial
and so forth, were deployed to counter the anxiety. Thus the defence mechanisms that
had been observed in psychoanalysis were transposed into a theory of how people functioned
in organizations. Elliot Jacques was first known as a diligent research assistant
to Melanie Klein, observing and transcribing the analysis of 10-year-old Richard
in Narrative of Child Analysis (1961) for which he wrote the foreword. His Kleinian
clinical orientation became best known in his paper ‘Death and the mid-life crisis’
(Jacques 1965). It was, however, in his study of organizations that he made his biggest
impression. In his later years he turned further away from psychoanalysis, although
he continued to be interested in forms of institutional defence, for instance in
the field of military leadership theory for which he received the accolade of the
joint Chief of Staffs Certificate of Appreciation in 1995 from General Colin Powell
for his ‘lasting contribution to the defence of the USA’. Menzies-Lyth (1988; 1989a)
deepened Jacques’s interest in the way in which individual defensive systems became
routinized as institutional procedures. In her study of a hospital Menzies-Lyth noted
how systems of nursing were constructed to defend the nurse against any form of emotional
intimacy. For example patients were referred to as numbers and tasks were separated
out so that no single nurse had to deal with a whole patient, for instance one nurse
was responsible for all the dressings while another nurse dispensed medication. In
studying other organizations, for instance a day nursery and a fire brigade, she
noted varying degrees of similar defensive systems of operation. She came to a rather
sombre assumption about institutions, which she concluded were inherently bad objects:
"Unfortunately I have come to a depressing conclusion that institutions have a natural
tendency to become bad models for identification; and the bigger the institution,
the more likely this is" (Menzies-Lyth 1989a: 42).
Menzies-Lyth went further and argued that the inherent organizational pathology was
reflexively located in the pathology of individuals who came to be identified in
these organizations, that is to say, a pathological organization attracts a pathological
individual. She remained adamant about this until the
238
end of her career, asserting that the NHS was essentially a bad object of identification
(personal communication 1998). Elliot Jacques (1995) rejected the assumption that
individuals projected their psychopathology into the organization; rather he argued
that it was the role that was faulty; that badly organized systems were more problematic
than badly organized individuals. Furthermore, he argued that he did not consider
organizational transference or the existence of an organizational unconscious as
viable theory, indeed he felt these technical concepts applied tended to obscure
the task of organizational analysis (Jacques 1995). He sought to develop a model
whereby the system, the functions and job descriptions, lines of accountability and
so on, could be analysed without any reference to the individuals who held these
positions. In regard to analysing these systemic issues he claimed, ‘Not one of them
is illuminated by individual psychodynamics or indeed by group dynamics’ (Jacques
1995: 362). It was to the consternation of many colleagues and students of Jacques
that he submitted this serious change of direction. We might note the similarity
between the way in which Jacques turned towards an exploration of organizational
roles rather than personnel and the later work of the philosopher Jurgen Habermas
who similarly became concerned to understand ‘bureaucratic proceduralism’ where matters
of social progress could be embedded in statutes that could stand against the passing
whims of individuals (Winship 2003).
Thus, Jacques became concerned to ensure that the organization was healthy enough
to withstand the folly of the transitory individuals who might inhabit certain roles
in it. In this way Jacques might be said to have finally rejected a pessimistic Bionian
stance.
CREATION AND UNCERTAINTY AND THE FUTURE OF PUBLIC SECTOR CONSULTATION
Reflecting on the development of Tavistock method during the 1960s Miller noted how
the consultant was required to stay alert to the task of revealing unconscious process:
"Nearly all Tavistock research at that time (and most of it since) was, like clinical
research in medicine conducted through professional relationship, within which the
research worker was usually also a consultant and was always taking professionalism
responsibility for the consequences of his intervention in the client system. There
was a shared recognition that both individuals and groups develop mechanisms to give
meaning to their existence and to defend themselves from fear and uncertainty &ldots;
these defences, often unconscious and deeply rooted, are threatened by change: consequently
it is an important aspect of the professional role to serve as container during the
working through of change, so as to tackle not only the overt problem but also the
underlying difficulties" (Miller, 1993: p.7).
239
In developing the capacity to reveal unconscious processes Miller said he became
adept at using psychoanalytic frames, such as transference and countertransference
finding his subjective reflections were as revealing to framing the understanding
of an organization as they might be to the therapist in the relative field of the
therapeutic dyad. We can see how psychoanalysis, as Miller suggested, offered a value-added
dimension to the type of symbolic interactionism that emerged as a method of social
science in the 1950s and 1960s. That is to say, not only was it accepted that the
researcher and the research field had a dynamic interweave, but here in psychoanalytic
theory was a precise set of tested assumptions that could explain the mechanisms
of interpersonal exchange played out between researcher and participant. Hereby Miller
suggested that the organizational consultant was the measuring instrument and that
it was necessary to utilize this tool, learn how to calibrate the findings and also
ensure that there were safety checks (like supervision) to ensure that the instrument
did not become a distorting tool. Miller also argued that the procedure of organizational
consultancy required the resources of more than one consultant and where necessary
a team of consultants; a model that Menzies-Lyth deployed. The remit in improving
the organization of peoples remains essentially the challenge of examining the personal
discontinuities of alienation that lie at the nub of workforce stress and discontent;
no matter what the environment or workplace the task is always one of weighing up
the staff’s negative feelings of anger and resentment towards the organization against
the sense of fulfilment and job satisfaction (Rance 1998). This was the challenge
that Isobel Menzies-Lyth (1988, 1989a, b) saw as voicing the interests of the lower
prestige group. Although she made no direct reference to Goffman’ work there is much
to compare her work with his study of the Asylum where it is the lower prestige group
of the in-mates whose position is highlighted. Elton Mayo had identified that one
of the problems of undertaking social research was that ‘none of the social sciences
equips a student with a single social skill that is usable in ordinary human situations’
(Mayo; cited in Brown 1954: 95). In this way a clinical psychoanalytic training may
have lent a sturdy basis to the researcher skills. However, an assertion that a trained
therapist is better equipped to do organizational study needs to be tempered. One
might argue that a psychoanalytic training does not necessarily prepare practitioners
to be socially skilled. Indeed, one is often struck by the coldness and lack of social
skills in many psychotherapists. There would be some grounds to say that it is a
lack of social skills that draws many therapists into the profession and Winnicott
even suggested that those who had a ‘capacity to be alone’ were suited to the job.
The aspiring psychodynamic therapist finds themselves drawn to a profession where
being alone and in a sense anti-social activity is legitimized in their day-to-day
work. The organizational consultant probably needs to adopt a more engaging poise
than the aplomb normally associated with the psychotherapist-patient
240
liaison. None the less, the task of burrowing into the unconscious of a group of
staff in an organization has resonance with the therapeutic task in the dyad or small
group therapy session.
In her own notes Menzies-Lyth (1988: 117) described the conjoint task of the researcher
whose dominant role was that of therapist where the deployment of highly structured
questionnaires she said, was not appropriate and that she preferred the familiar
use of individual or group interviews with the aim of achieving ‘free and undirected
communications from the informants’ (1988: 119) akin to the therapeutic technique
of free association. The merits of this type of organizational free association is
no better exemplified than in Gordon Lawrence’s (1998, 2003) work on the use of dreams
presented by clients during a consultancy. He adapted the idea of consultancy and
action research by dream analysis and called it a method of ‘social dreaming’. Another
illuminating account of a piece of therapeutic-based consultation is by Elieli (2001)
where he drew particular attention to value of the organizational consultant being
able to deal with question of resistance from participant clients. If you recall,
Freud said that the first task of psychoanalysis was tackling the question of the
patients’ resistance so Elieli (2001) deployed this notion as a first base too. In
his case study he was charged with the task of helping a social work team to reflect
on the implications of a major change in the overarching managerial structure of
the organization. The staff were immediately hostile, resistant and somewhat depressed,
not only about the initial consultation day but about their work generally. Elilie
did not attempt to treat this depression and resistance but rather used the emotional
timbre of the staff group, combined with historical facts about what had happened
to the team, in order to arrive at an understanding about problems dynamics of the
organization. My own experience of organizational consultancy since 1989, has been
mostly in the public sphere. The duration of my input has varied from 6 months to
5 years and my case loads have included units at a special hospital, two community
mental health teams, a young offenders’ institute, five in-patient units, a boarding
school and a university psychodynamic counselling course.
The largest organizational reviews I have undertaken have been with the Commission
for Health Improvement (since 2000) where a team of up to ten have undertaken a week’s
‘root and branch review’ of an NHS Health Trust. My impression is that external psychodynamic
consultancy has been sought out, while simultaneously being the subject of some vilification.
This ambivalence mirrors the paradox of psychoanalytic psychotherapy in the NHS where
there has been a substantial increase in the number of non-medical psychotherapists,
at the same time as well-known NHS psychotherapy departments have been dismantled
or closed, for instance the Ingrebourne Centre (Cambridgeshire) and the Henderson’s
Webb House (North West England), Maudsley (London) and Winterbourne House (Berkshire).
There appears to be a ‘push-and-pull’ antagonism between psychoanalytic psychotherapy
and the NHS, that is to say,
241
psychotherapists are attacked and demanded, and simultaneously reviled and revered.
This antagonistic phenomenon is reflected in the satellite location and function
of psychotherapists in the NHS. This is a precarious position and as Hinshelwood
(1994) has pointed out, the relevance of NHS psychotherapy relies on the capacity
of its practitioners, while being split off and assigned with a range of phantasies,
to still remain engaged with psychiatric colleagues without getting submerged by
the unconscious anxiety that leads to despair and madness. The attacks on psychoanalytic
psychotherapy are a by-product of a whole cultural system says Hinshelwood (1994)
and it is towards making sense of ‘cultures’ rather than ‘systems’ that he suggests
that we turn our attention in unfolding the way in which we study organizations (Hinshelwood
and Skogstad. 2002). The psychotherapist comes to represent a way of being that is
‘uncomfortably at variance with the dominant culture’ (Hinshelwood 1994: 287), thus
in the prison the consulting psychotherapist is seen to represent the split off aspects
of gentle human communication that are denied by the dominant culture of the prison,
while in the busy acute hospital ward the psychotherapist is seen as slow and reflective
compared to the quick response and action that is the culture of the milieu.
It is not hard to see to how the profession of psychotherapy becomes viewed suspiciously
as a potentially subversive activity given this ‘counter-cultural’ position. While
I agree with Bob Hinshelwood about the assignation of counterpoise phantasies, I
think he rather understates that it is actually a function of psychoanalytical thinking
to be inside or ‘underside’ the organization in order to subvert the dominant culture
where necessary. To be inside and irrelevant is as meaningless as being outside and
isolated. To fail to adopt a critical or dialectical position in relation to the
dominant culture, which Bion and Menzies-Lyth argue as inherently dangerous, may
be rather more inclined to pathological conformism than good diplomacy. In this sense
there is no misunderstanding when colleagues perceive the radical nature of psychoanalytic
thinking; we might say that the organization ought to be suspicious.
Psychoanalysis has built its most impressive and influential work on radical hypotheses
that across time and the drifts of paradigms, have stood to become pillars of new
convention. The clinical challenge is one of de-constructing the faulty premises
of self and organization (whether this is a public service or commercial industry),
offering the dialectical space for the necessary process of objectivity in evaluation
and self-reflection. This is how the patient gets better. This timbre of psychoanalytical
subversion might also challenge the potential stagnation of cultural order of an
organization. We can see how this tone was set by Bion (1960) in one of his first
group experiments when he asked the group ‘why they thought it was a good idea to
introduce themselves to each other by name and how this social convention would alleviate
their depression’. The group, having up until that point been fairly
242
congenial, suddenly lurched into such a silence that Bion felt he’d rather made a
‘gaff’. Bion would review this ‘gaff’ and later he decided that this type of intense
observation of orthodox modes of being was the object of continual inquiry and interpretation.
It became something of Bion’s modus operandi to set truth on its head, and he seems
to have deployed notions of chaos theory in his theoretical leverage to explain the
miasma of detail he saw in his clinical work (Rustin 2001). We might say that Bion
exacted a type of therapeutic anarchism in order to envisage new prospects for his
patients.
So it might be that the psychoanalytic organization al consultant has the temerity
of benign subversion in order to agitate the counter-culture of a group or team towards
a burst or drip-drip, as the case may be, of organizational change. The expert breaks
the cycle by allowing uncertainty to legitimately exist. Indeed, Bion’s idea would
be that the Organizational Consultant has to, by implication, de-stabilize the Establishment
in order for true clarity and knowledge to emerge. The organization’s contact with
the psychodynamic consultant is likely to be uneasy in a way that the cool aplomb
of the psychodynamic therapist does not aim to put the client at ease. There is the
example of the consultancy that Menzies-Lyth undertook with the London Fire Brigade
in 1965 when she and colleagues successfully won the tender to examine the Brigades’
problem of recruitment and staff retention she told the organization that of course
it was neither her nor the Tavistock Institute’s practice of ‘accepting the client’s
own diagnosis of his problem’ (1988: 159).
The consultants’ task is one of balancing the pathos of Dionysian frenzy, reprehensible
as it may be, but necessarily interlocking with the artistically preserving force
of Apollonian reason. In considering the challenges facing psychoanalytic psychotherapy
in the new NHS it may be timely to re-vitalize the courage of Menzies-Lyth et al.
in facing the nature of the beast although with the value added that we can augment
our understanding of institutional defences with other conceptual diagnostic frames
that can embrace a wider range of cultural knowledge (as Hinshelwood suggests). Indeed,
public sector organizational manoeuvres are now so driven by the internal market
that we might need to consider mechanisms that are described more in terms of the
worst effects of competition where psychotic or even psychopathic functioning is
countenanced. We need to consider the way in which a propensity to self decay, suicide
and homicide are played out in the dynamics of the organization; inherent mechanisms
that are apparent in Bion’s model of the sphinx who is at first homicidal and then
suicidal. It seems advisable to anticipate these organizational dynamics rather than
waiting until the crisis has rent its damage, as has been the case in some accounts
of organizational collapse where leadership folly has run well-being into trouble
(Hartnup 1994).
REFERENCES
Armstrong, D. (1997) The institution in mind. Free Associations, 1, 1–14
243
Bion, W. R. (1961) Experiences in Groups (London: Tavistock)
Bion, W. R. (1997) War Memoirs (London: Karnac)
Brown, J. A. C. (1954) The Social Psychology of Industry (Harmondsworth: Penguin)
Elieli, R. B.-L. (2001) An organization looks at itself: psychoanalytic and group
relations’ perspectives on facilitating organizational transition. In L. G. Gould,
L. F. Stapley and M. Stein (eds) The Systems Psychodynamics of Organizations. Integrating
the Group Relations Approach, Psychoanalytic, and Open Systems Perspectives (London:
Karnac,
67–90)
Freud, S. (1925[1917]) Mourning and Melancholia. In Collected Papers, Vol. 4 (London:
Hogarth)
Freud, S. (1983[1912]) Totem & Taboo (London: Routledge, Kegan & Paul)
Freud, S. (1959[1921]) Group Psychology & the Analysis of the Ego (London: Hogarth)
Freud, S. (1972[1929]) Civilisation & its Discontents (London: Hogarth)
Freud, S. (1933) The question of Weltanschauung. SE, 22, 158–182
Fromm, E. (1961) Marx’s Concept of Man (New York: Frederick Ungar)
Fromm, E. (1970) The Crisis of Psychoanalysis – Essays on Freud, Marx and Social
Psychology (New York: Holt, Rinehart & Winston)
Frosh, S. (1999[1987]) The Politics of Psychoanalysis (London: Macmillan)
Harrison, T. (2000) Bion, Rickman & Foulkes and the Northfield Experiment. Advancing
on a Different Front (London: Jessica Kingsley)
Hartnup, T. (1994) The state, the institution and the patient: A three-way collision
at the crossroads as a hospital fights closure. Psychoanalytic Psychotherapy, 8,
3–15
Hinshelwood, R. D. (1983) Projective identification and Marx’s concept of man. International
Review of Psychoanalysis, 10, 221–226
Hinshelwood, R. D. (1994) The relevance of psychotherapy. Psychoanalytic Psychotherapy,
8, 283–294
Hinshelwood, R. D. and Skogstad, W. (2002) Irradiated by distress. Observing psychic
pain in health care organisations. Psychoanalytic Psychotherapy, 16, 110–124
Jacques, E. (1955) Social systems as a defence against persecutory and depressive
anxiety. In Klein, M. Heimann, P and Money-Kyrle, R (eds) New Directions in Psychoanalysis
(Tavistock & New York: Basic Books, 478–498)
Jacques, E. (1990[1965]) Death & the mid-life crisis. In E. Bott-Spillius (ed.) Melanie
Klein Today, Vol. 2 (London: Routledge)
Jacques, E. (1995) Why the psychoanalytical approach to understanding organisations
is dysfunctional. Human Relations, 48, 343–349
Klein, M. (1961) Narrative of Child Analysis (London: Hogarth)
Lawrence, W. G. (ed.). (1998) Social Dreaming at Work (London: Karnac)
244
Lawrence, W. G. (ed.). (2003) Experiences in Social Dreaming (London: Karnac)
Mayo, E. (1946[1933]) Human Problems of Industrial Civilisation (London: Pelican)
Menzies Lyth, I. (1988) Containing Anxieties in Institutions. Selected Essays (London:
Free Association Books)
Menzies Lyth, I. (1989a) The Dynamics of the Social. Selected Essays, Vol. II (London:
Free Association Books)
Menzies Lyth, I. (1989b) Day care of children under five. In The Dynamics of the
Social. Selected Essays, Vol. II (London: Free Association Books, 215–247)
Miller, E. J. (1975) Socio-technical systems of weaving. Human Relations, 28, 349–386
Miller, E. J. (1993) From Dependency to Autonomy (London: Free Association Books)
Rance, C. (1998) Organisations in the mind. The interaction of organizational and
intrapsychic perspectives. In S. Hardy, J. Carson and B. Thomas (eds) Occupational
Stress (Cheltenham: Stanley Thomas, 44–56)
Rickman, J. (1950) The factor of number in individual and group dynamics. Journal
of Mental Science, 96, 770–773
Rose, N. (1989) Governing the Soul. Shaping of the Private Self (London: Routledge)
Rustin, M. (2001) Looking in the right place: complexity theory, psychoanalysis and
infant observation. Paper presented at the conference on Origins & Evolution of Attachment
Theory & British Object Relations. University of Virginia, Charlottesville, 5–8 April
Sher, M. (2003) From groups to group relations. Bion’s contribution to the Tavistock,
‘Leicester’ conferences. In R. M. Lipgar and M. Pines (eds) Building on Bion, Vol.
2: Branches (London: Jessica Kingsley, 109–144)
Trist, E. (1985) Working with Bion in the 1940s: the group decade. In M. Pines (ed.)
Bion and Group Psychotherapy (London: Routledge, 1–46)
Winship, G. (2003) A Habermas Kritik. Free Associations, 10, 223–235