In our last post, we looked at 'the unconscious' and 'avoidance of pain' so in this post we will look at the third of our components of the analytic 'half'of this model - defences:
Defences:
An institution will develop its own defences - usually against the anxieties inherent in that type of work. Its members' defences will have to be broadly congruent with these or staff tensions will rise A staff member whose defences are incongruent may be seen as difficult and they may have to leave.
Staff will be 'self-selecting' for that type of work/institution and they will already have and/or will develop a strong valency for particular defences.
Example: Going back to Isabel Menzies-Lyth and the Acute General Hospital (see earlier posts) the institutional defences included emotionally and personally separating the nurses from the patients. The underlying difficulty that 'The Tavistock' was brought in to address, was the malfunctioning of the institution epitomised by the huge drop-out rate amongst the student nurses.
In our model we would conclude that those who quit, had defences which were more 'mature' than the defences set up by the institution and hence were incongruent with those of the institution, which were instead, more 'primitive' - for instance splitting and denial. Those who stayed, either already had or were able to develop, defences which were congruent with those of the institution.
When an organisation is undergoing change - its defences will no longer be congruent with the task - huge stress may be the result.
Example: A psychiatric hospital in the 1960s - the Littlemore Hospital in Oxford - had a new medical director who decided that all his wards/patients would now be run as a kind of therapeutic community (like the Cassel Hospital - earlier). Other consultants did not want to change from the traditional locked wards, top-down hierarchy from Doctors to Nurses to Patients etc and the solution was to split the hospital in to Part A and Part B.
Almost overnight, patients were moved from one half to the other, with staff hastily re-aligning too - this change was stressful and doubtless caused much anxiety and disturbance, although things did for settle for while afterwards. The stress/disturbance would probably include - certainly in today's era - sickness, grievance, early retirement on medical grounds etc - massively costly to all concerned including, staff, patients, the NHS etc etc.
The point here though, is that staff moved into the half whose institutional defences were most congruent with their own or, one way or another, left the organisation altogether.
Understanding the institutional defences helps us to think about the work, staff, the primary task etc etc in a highly thoughtful and potentially productive, way.
In our next post we will look at another, closely connected, major pillar of this model - i.e., the Paranoid- Schizoid and Depressive Positions.
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