ISP Newsletter Editorials – 2008

February

During the period that I have been with ISP I have occasionally written about the death of someone who taught me a great deal during my working life. One such person is Isabel Menzies Lyth, who died on the 13 January, aged 90. I got to know her in the 1970s when I joined the staff of the Cotswold Community. She would spend 2 or 3 days at the Cotswold Community every few months and then produce a working Note for us all to work on. Her primary focus was the organisation as a whole and she facilitated change in the management structure as well as day-to-day practical matters, eg, transferring the responsibility for producing meals to the household the children lived in from an institutional central kitchen. She was a remarkable person and I was somewhat in awe of this powerful, cigar-smoking woman. Her obituary appeared in The Scotsman. Here are some extracts:-

“Isabel Menzies Lyth was a distinguished psychoanalyst and social scientist and a pioneering figure among the founding group of the Tavistock Institute of Human Relations, when psychiatrists and psychologists who had worked together in wartime applied their skills and understanding of groups and organisations to the challenges of the post-war world.

Her achievements are recorded in her collected papers, “Containing Anxiety in Institutions” and “The Dynamics of the Social”. In the most famous paper, first published in 1959, “The Functioning of Social Systems as a Defence Against Anxiety”, drawing on her experiences working with nurses at King’s College Hospital, she was able to analyse the dynamics of an organisation in a new way, exposing the hierarchy as protective of self-interest and self-doubt in managers and subordinates……

Isabel became one of the small group of creative and dedicated social scientists, including her mentor, Eric Trist, who, after the war, worked at the Tavistock Institute, continuing the legacy of applied psychological work begun during the war in military hospitals, officer selection, and civil resettlement. This understanding of individual and group psychology was then applied to the workplace in post-war Britain. Others in this group were Elliot Jaques, Harold Bridger and Wilfred Bion (who later became her analyst).

She became a highly regarded child and adult psychoanalyst in the Kleinian tradition, and continued to develop an equally distinguished career as a research consultant, most significantly in the context of nursing and health care. She was a powerful staff presence at the internationally famous Leicester conferences on authority, leadership and organisation and was never afraid to explore the psychotic nature of groups…..

She consulted to several institutions, including the Cotswold Community, a residential school for adolescent boys, child guidance clinics and a rehabilitation unit for patients with intractable psychotic disorders….

Isabel could be fearsome, and going against her will was a hazardous act. If these were faults, they contributed paradoxically to the affection in which she was held. They were more than made up for by her being immensely kind, loyal and compassionate, and generous with her friendship and understanding. She was also dogged and brave, showing great fortitude in the last days of her life, and ever commanding respect.”

I’m tempted to say, “They don’t make them like that any more,” but that’s probably not correct. Maybe it was the war years which brought forth some remarkable people. I wrote a paper about her consultancy to the Cotswold Community, “The Experience of External Consultancy”, which can be found here on the website.

Quite by chance, or synchronicity, I opened the magazine, Kent Director (which I rarely look at) after writing about Isabel Menzies Lyth’s death, and saw this article by David Shemmings (Professor of Social Work at Kent University). This owes everything to the work of Isabel Menzies Lyth, especially her research on “Social Systems as a Defence Against Anxiety”.

“The emotional side of an organisation”

“A few years ago, a large organisation was the subject of a television exposé revealing poor professional standards. Senior managers each stated that a range of actions had been put in place, including targeted training programmes, a revised performance audit system, random spot checks and an anonymised ‘whistleblowing’ procedure.

There was some temporary improvement, but as soon as the heat died down standards soon slipped again. It’s worth pointing out that these were not recalcitrant or poorly-motivated staff. When a situation like this occurs, it is wise to consider the emotional side of the organisation, sometimes called the ‘unconscious at work’.

Most people have trouble processing and dealing with anxiety. We try and stave it off by erecting defences. Instead of looking at it, analysing it and then dealing with it, most of us pretend it isn’t here or, we know it is, but we try to ignore it. The problem with this, albeit unconscious, strategy is that it actually works for a while. However, repressed or denied emotion has an unfortunate habit of returning unannounced and in a different form later on.

So, if someone pretends not to be feeling sad, they are likely to experience a different emotion – perhaps irritability, depression or anger some time later, usually when it is least expected. A good deal of research shows that organisations are places where people unconsciously develop poor work habits as a way of handling such anxiety. Doing so offers temporary relief.

For example, when people worry about failing to succeed, or if they work with demanding people they will adopt work practices which offer respite from the anxiety. In a classic study nurses woke patients in the middle of the night to give them a sleeping tablet…..and they couldn’t see what was wrong!

The message to business leaders and managers is straightforward. Ignore the emotional side of the organisation and you risk losing untapped, valuable human resources as well as developing inefficient work practices.”

Another piece in Resurgence which interested me was about Nonviolent Communication. This is an extract:-

“Give me all your money now!”

In a narrow alley in London, this was how Aniruddha responded when, late one night, a tall man jumped out of the darkness and blocked his path.

Aniruddha connected with his feelings and the universal needs underlying those feelings: “I’m scared, vulnerable. I need safety, security, courage.” This gave him enough inner strength to focus outwards on the man’s feelings and needs: “Are you desperate and needing money to survive?”.

“Don’t talk to me. Just give me all your money. Aren’t you scared?” The man could immediately sense that if Aniruddha talked to him in this way, the spell of disconnection that put him in a state where he could attack another person would be broken. In fact he was already awakening from this spell, to ask about the feelings of the human being he was trying to rob.

“Of course I am feeling scared and shaky. At the same time I want to help you and meet your need for money.”

The man tried to re-establish disconnection, “I said don’t talk to me. Just give me the money.” But he didn’t manage to disconnect entirely, and revealed more of himself. “I’m hungry and I want some chicken.”

Aniruddha, now in the flow of connection, empathised, “So you are feeling hungry and need to eat?”

He took the £9.50 he had in coins out of his pocket and, giving it to the man, said, “There you are, have your chicken. I wish I could give you more.”

This expression of care again broke the spell of disconnection and the man again enquired, “Aren’t you scared?”

“I am feeling scared. I am also feeling concerned about how I will get home. I haven’t got any money left.”

“You are a very generous person. I need only £2 for my chicken. Take your money back,” and the man poured the £9.50 back into Aniruddha’s hands. Aniruddha, still holding out his hands, said, “Take the £2 for your chicken.” The man refused. So Aniruddha picked out £2 and put it into his hands. The man said, “God bless you!” and disappeared into the darkness.”

The profoundity of this exchange is astonishing. Instead of an outcome where one person meets their needs at the expense of another, and both people are left dehumanised and needing help to restore their trust in people and in life, both are left more humanly connected, and with their immediate needs met.

When reading this I thought of those must-win arguments we get into with children. If only we could step aside and speak to the underlying need rather than the surface, challenging behaviour and words. Easier said than done, I know.

March

A book I have been dipping into during the last few months is, “Bloody Foreigners” by Robert Winder, the story of immigration to Britain. It is a very substantial book written in a very accessible style. You get some funny looks when you read it on the train. Or, even more disconcertingly, looks of approval. The general theme of the book is what an amazing contribution immigrants have made to the culture and prosperity of Britain during the last 2 millenia, and the hatred and persecution they have suffered for their troubles. Troubles indeed in getting to Britain in the first place, a rather cruel form of natural selection, so that only the strongest and most resourceful made it here, hence the valuable contribution upon arrival.

This book also throws up some very interesting facts. For example, I’ve always assumed that golf was invented in Scotland, but apparently not so.

“The greatest Dutch contribution to Scottish life is the game of golf, which began as Het Kolven, and involved knocking a ball across ice at a post. In 1457 James II declared that ‘golfe be utterly cried down and not be used,’ but kings have only so much power. If cricket is a West Indian game invented by Englishmen, golf may well be a Scottish game invented by the Dutch”.

Here is another example:-

“In 1773 curry made its first appearance in a British restaurant, on the menu of a coffee house in the Haymarket. A few years later, S K Mahomed arrived in Dartmouth. At the turn of the century he would set up, in Brighton, some sought-after Indian vapour baths, which promised to cure various ailments to restore tired limbs. Today we could call it thalassotherapy. Mahomed brought with him a word – shampoo; from the Hindu champi, massage – which would attach itself irrevocably to the British sense of personal hygiene.”

On the 29 February I attended a conference (with Pete Johnstone) at The Centre for Emotional Development in Brighton. This centre is run by Leslie Ironside (Child and Adolescent Psychotherapist) who also works with ISP Sussex. The title of the conference was “Managing the Madness – Thinking about change, leadership, diversity and difference in organisation life”. I’m very interested in the dynamics of organisations so unsurprisingly was drawn to the theme of this conference.

The highlight of the day for me was the presentation by Phillip Stokoe, who was a replacement for one of the planned speakers. Phillip Stokoe is the Clinical Director of the Adult Department of the Tavistock and Portman Trust. He is also a Consultant Social Worker, Psychoanalyst and an Organisational Consultant. I liked his style of delivery and I immediately felt tuned in to what he was saying when he described his first experiences in social work, in a residential centre for very troubled and troublesome young people, which was similar to my own experience.

He described a model of working with organisations to facilitate change towards a “healthier organisation”. He identified 4 factors for health in an organisation.

1. Primary Task – everyone in the organisation, whatever their role, needs to be clear what this is and be working towards it.
2. Shared Principles – again these need to be articulated and understood and acted upon. You can find ISP’s aim and principles at the beginning of our “Statement of Purpose”. One of the things we aim for is to be “a community of adults who demonstrate, through their working relationships with one another, a model of integration”. I don’t imagine any of us would disagree that this is important and yet it is one of the most difficult to achieve.
3. Hierarchy of Decision Making – being clear who is ultimately responsible for making the decision. I liked the way Phillip Stokoe said, “The point at which I cannot make a decision I have a duty to advise.” This encourages participation in the decision making process and gives the decision maker the best possible information and range of views before he/she makes the decision. This is very different to the situation where people keep their views to themselves either out of fear or bloody-mindedness, leaving the decision-maker in a dangerously isolated position.
4. Good Practice: The Container – this is perhaps the most difficult to describe briefly. He said, “a healthy organisation delegates authority and draws up anxiety”, which for me summed up “the container”. It is being able to see feedback as nourishing not an attack. Also recognising that important information usually comes in the form of impact. In healthy organisations these impacts are not reacted to defensively.

Anyway I hope I have given you a flavour of what he was trying to say and why I thought it was valuable to our work.

May

You will also find a flyer for a documentary about the Mulberry Bush School which is on TV very shortly. I haven’t seen it but I am sure it will make interesting viewing and highly relevant for the work of therapeutic fostering. The Mulberry Bush was created by Barbara Dockar Drysdale, in 1948, a pioneering Child Psychotherapist who developed therapeutic management of extremely disturbed children in a group living and education context. They are celebrating their 60th anniversary this year so have considerable accumulated experience to share.

“Often in the course of my work, I am asked by parents or by staff in residential places, or by children themselves, to do something about a symptom. I am brought such a particular symptom either by the person to whom it belongs or by a person or people who are affected by the symptom. In both cases the symptom is usually quite detached from the person. An obvious example of this separation is to be found in bed-wetting and soiling. I am told about ruined mattresses, endless washing, smell, and so on, or alternatively about solutions – bells ringing at the first drop of urine, special rubber sheets or nappy-like contrivances to avoid the wetness spreading. Sometimes I am told about elaborate systems of rewards and punishments, but even then one gets the feeling that everybody – including the child – is ignoring the psychic importance of this symptom for the child, and his need to have his symptom, and for us to contain him-and-his symptom, which is really part of him. (A colleague pointed out to me recently that people speak of a child wetting the bed, rather than his or her bed.

From my particular point of view, the bringing together of the child and his symptom is often the first and most fundamental step in his treatment. Should one fail to help him to achieve this bit of integration, we are likely to build up a recovery round a hole – whatever the symptom may represent in the child’s experience.”

(Extract from, “Bringing the symptom and the patient together”, by Barbara Dockar Drysdale from her book, “The Provision of Primary Experience”, 1990 Free Association Books)

June

I am a member of the Commonwealth Club and receive their Annual Report. In the latest edition was an extract from the Commonwealth Lecture delivered by Dr David Suzuki, who is Emeritus Professor of the Sustainable Development Research Institute, University of British Columbia. The title of the lecture was, “The challenge of the twenty-first century: setting the real bottom line.” I was blown away by it and would like to share some of it with you.

Economists believe the economy can grow forever. Not only do they believe it can grow forever, which it cannot, they believe it must grow forever. Since World War II they have equated economic growth with progress. Nobody wants to stop progress, but if economic growth is what we define as progress, who is ever going to ask what an economy is for? With all this growth are we happier? How much is enough? We do not ask those questions. We have fallen into the trap of believing that economic growth forever is possible and necessary.

I am going to show you why this is absolutely suicidal. Anything growing steadily over time is called exponential growth and whatever is growing exponentially has a predictable doubling time, whether it is the amount of garbage you make, the number of taxis on the road, the amount of water you use, or the human population. So, if the population is growing at 1 per cent a year it will double in 70 years; 2 per cent a year it will double in 35 years; 3 per cent – 23 years; 4 per cent – 17.5 years. Anything growing exponentially will double predictably.

I am going to show you why it is suicidal to think we can keep growing forever. Let me give you a test tube full of food or bacteria that represents our world. I am going to put one bacterial cell into that test tube (representing us), and it is going to divide every minute. That is exponential growth. So at time zero you have one cell; one minute you have two; two minutes you have four; three minutes you have eight; four minutes you have 16. That is exponential growth and at 60 minutes the test tube is completely full of bacteria and there is no food left, a 60-minute cycle.

When is the test tube only half full? Well the answer of course is at 59 minutes; but a minute later it is filled. So at 58 minutes it is 25 per cent full; 57 minutes 12.5 per cent full. At 55 minutes of the 60-minute cycle it is only 3 per cent full. So, if at 55 minutes one of the bacteria said to its companions that they had a population problem, the other bacteria would be incredulous because 97 per cent of the test tube would be empty and they had been around for 55 minutes. Yet they would have only 5 minutes left. So bacteria are no smarter than humans and at 59 minutes they realise they only have a minute left. So they give massive amounts of money to scientists, and in less than a minute those bacterial scientists invent three test tubes full of food. That would be like adding three more planets for our use. So it would seem that they (and we) would be saved.

What actually happens is this – at 60 minutes the first tube is full. At 61 minutes the second is full. And at 62 minutes all four are full. By quadrupling the amount of food and space, you buy two extra minutes! How do we add even a fraction of 1 per cent more of air, water, soil or biodiversity? We cannot. The biosphere is fixed and finite and every biologist I have talked to agrees with me: we are past the 59th minute. So all those leaders saying that we have to keep the economy growing are saying that we have to accelerate down what is a suicidal path.

We have to set a new bottom line, a bottom line dictated by the reality that we are biological creatures, completely dependent for our survival and well being on clean air, clean water, clean soil, clean energy and biodiversity. We are social animals who need strong families and supportive communities, full employment, justice, equity and security and freedom from racism, terror, war and genocide. And we remain spiritual beings who need sacred places in the natural world that give us birth.

September

When a small group of us from ISP went to the IFCO Conference in Wisconsin in August 2005, one of the workshops, which I missed was about food in the care and treatment of children. To make matters worse it was described as the best workshop of the conference. I was thrilled, therefore, to receive an email from Charley Joyce, one of the presenters of this workshop. I managed to persuade her to send me their paper, “Hoarding Food; Hungry for Security”, which she co-wrote with Rick Delaney and will be a chapter in the book they are writing, “Behaviour with a Purpose”. This is an extract from the chapter.

“Food issues can be central in a child’s world and resistant to change; additionally these issues surrounding food can bedevil and bewilder [carers] who ask, “Why does the child steal food from us? Why can’t the child get over it? Why does the child not ask for food instead of taking it on the sly? Why does the child doubt us when we say there will always be enough to go around?”

The short answer is neglect. The longer answer is that the neglected child has often had to survive or adapt to abhorrent, sub-standard parenting through superficial and obsequious compliance and over-compliance while adopting a view that they alone take of their needs.

In short, the child feels insecure, unworthy of care, and lacking in a sense of partnership with [carers]. They do not truly feel that their [carers] are available and sensitive providers. When we state that the child steals food, it may frame our understanding in a way that doesn’t acknowledge that the stealing is not merely an act of dishonesty, simple naughtiness, or an inability to understand right from wrong. These interpretations minimise the child’s history of neglect and that which has been done to misshape his perceptions of food, nurturance, and parents.

The child does not view his neglectful parents as partners in the meeting of his needs but rather as an obstacle to overcome, bypass, or omit in the meeting of his needs. It’s a survival mentality developed in a hardscrabble early life where the child had to look out for himself, as no parent watched out for his needs.”

November

I recently came across a paper written by The New Economics Foundation (you can access it via their website), “A False Economy: How failing to invest in the care system for children will cost us all”. Usually I find these papers very dry and uninspiring but not this one. I will give you a taster by quoting an extract on “European comparisons – social pedagogy and risk”.

Social pedagogy is a system of theory, practice and training that supports the overall development of the whole child. It can be defined as ‘education in the broadest sense of the word’. Social pedagogy takes a holistic view of young people – looking at all aspects of a young person’s life skills.

The essence of social pedagogic practice is the conscious use of relationships between carers and those living in residential care to help young people to develop their life skills safely and without fear of rejection.

In our survey of carers in the UK, some reported as little as 17 hours of face-to-face contact per week with the young people in their care. By contrast, in social pedagogy the emphasis is on group activities and on incorporating everyday tasks, such as cooking and housework, into the therapeutic/educational process. This is fundamental to therapeutic child care but is not understood or valued in the UK.

A 2006 study by Petrie and colleagues that compared the UK to Danish and German systems found a marked difference in the way risk was approached by carers. In one of the vignettes, researchers asked staff what they would do if a child woke up crying during the night. European staff were more likely to answer that they would give the child a hug, or make a hot chocolate. UK staff, on the other hand, were more likely to answer that they would check the policies and procedures. The researchers suggested that this difference was accounted for in part by carers’ training in Germany and Denmark, which enabled them to be confident about using their personal judgement, rather than the more typical UK approach of relying on procedures.