The Defended Self: Psychodynamics &
communication in the workplace.
Professor Kenneth Walsh
School of Nursing, Midwifery and Indigenous Health
University of Wollongong.
Illawarra Shoalhaven Local Health District.
Professor Jackie Crisp
School of Nursing
University of Technology Sydney
Associate Professor Cheryle Moss
School of Nursing
Monash University
The Change Discourse in Organisations
• Bureaucracies are of course, archetypes of [technical] orientation.
This…orientation encourages managers … to view their role as being
responsible for controlling any disturbances to the status quo. The
emphasis is on formality, rules and regulations. People are regarded as
atomistic, passive and rational in their responses; and assessments of
results/outcomes are based on technical efficiency (Carr, 2000:289).
• Our experience of organisations is that people do not respond to this
technical orientation in passive or rational and predictable ways. And
paradoxically the administrators, managers and staff themselves, whilst
appearing to hold this world view, do not conform to it either; although
they may expect it of others.
The Psychodynamic Perspective
•
Human beings adopt various defensive mechanisms in order to avoid
mental pain or conflict, or to control unacceptable impulses.
•
These mechanisms vary from being almost wholly conscious, in which
case they can be undone by a few words, to being so totally unconscious
that they are only revealed by years of psychotherapy.
•
The end-product of these mechanisms is often a form of maladaptive
behaviour or a neurotic symptom.
•
The behaviour or symptom often has an expressive as well as a defensive
function, containing the avoided feelings or impulses in a disguised form.
The Psychodynamic Perspective
• The behaviour or symptom often has damaging consequences for
everyone, not least for the individual in whom the mechanisms are
occurring.
• Although the individual may well be aware of the self-destructive
consequences of what is occurring, the forces involved are so strong that
he/she is usually powerless to control them.
• One of the ways in which damaging consequences occur is through the
setting up of vicious circles between the individual and the people in
her/his environment.
» (Malan, 1982)
Defence Mechanisms
• Our Ego’s defences allow us to continue to function even when we are in
significant psychological pain.
• But just like pain killers they only mask the symptom and leave the cause
untouched (Kets de Vries, 2007).
• These defences are essential to our ability to do our jobs.
• Paradoxically they are also the very mechanisms which, (in the absence of
other outlets for our anxiety) can distance us from the humanity of the
patient and ultimately lead to a lack of compassion (Goodrich and
Cornwell, 2008).
The Triangle of Conflict
Defence
Anxiety
Hidden Feelings
Three Paradoxes
Paradox 1:
• The technical structural-functionalist view of organisations and the way
they behave and cope with change, does not accord with the reality of
change. However we still tend to ignore this fact and favour overly
simplistic perspectives.
Paradox 2:
• Health care environments are highly emotional yet we tend to strip them
of emotion and fail to acknowledge the anxiety inherent in the system.
Paradox 3:
• Anxiety is a dominant emotion in heath care. The causes of this anxiety
and the defence mechanisms they trigger, make communication and
change difficult, yet we try to cope with these issues using a technical
structural-functionalist view which is blind to this (see paradox one).
Splitting or the “Manic Defence”
• When anxiety is high people may manage this anxiety by splitting off the
good and the bad elements of their existence. The good elements are
introjected into the self and the bad elements are projected onto others
(Voyer et al 1997) who are often unconsciously punished through an
emphasis on doing and measuring.
• “through this emphasis on metrics, the managers deplete the organization
of the physical, financial, and perhaps most importantly the psychological,
resources its members need to succeed. (Voyer et al, 1997: 480).”
Resolution of the Paradox
• Firstly, recognise that not all communication and decisions in health
services are made from a conscious and “rational” perspectives.
• Secondly use processes which break down the underlying assumptions
behind the binary thinking of “Us” Vs “Them”.
• Thirdly recognise the triggers of anxiety in ourselves and others and
consciously adopt communication and behaviours that maximise inclusion
and minimise the need for defensive manoeuvres
In Conclusion
• “We can start to overcome our defences when we stop acting and start
thinking, when instead of working to sustain normality we let go to extend
and deepen our awareness (Hirschhorn and Young 1993:162)”.
Walsh, K., Crisp, J. and Moss, C. 2011. Psychodynamic
perspectives on organisational change and their relevance to
Transformational Practice Development. International Journal of
Nursing Practice, 17 (2): 205-212