This is an adaptation of the first part of an M.A. dissertation by Angus Burnett. It is about leadership, task and organisation in a therapeutic community for children. The M.A. in Therapeutic Child Care at The University of Reading was run by Adrian Ward, Dr. Linnet Mc Mahon, Paul Cain, Deborah Best and Theresa Howard at the Dept. of Community Studies from 1989 – 2006. The book ‘Intuition is Not Enough’ ((1998) Eds. Ward, A. & Mc Mahon L. Routledge, London) captured the model of group work and reflective practice that underpinned all aspects of the course. The course and book continue to influence many people across the field of specialist child care and beyond. Angus Burnett is head of Referrals and Partnerships at The Mulberry Bush School. Part 2 will be published in our June 1st Edition.
This beginning is not really a beginning. To hazard a guess, it is probably a midpoint but that depends on where you consider any journey to have started. I write this because, as this chapter will describe, there has been an evolution to the question that forms the basis of this study. That question concerns how the experience of being new in a leadership post contains vital opportunities through understanding oneself to understand the organisation and the task. I propose to show that self-awareness and analysis is needed to deploy that information in promoting and stewarding healthy change and growth for individuals and the organisation.
In the next chapter, I will introduce key theoretical concepts from the literature that should help to clarify the ideas in this essay. The methodology section will then follow the nature and evolution of the enquiry set out below. It will also discuss ethical questions and other problems raised by the nature of the enquiry.
It is also necessary in this study to make links to the context surrounding a new leadership post. I believe that therapeutic cultures are dependent upon the historical past of the wider organisations to which they belong as well as current organisational dynamics. For this reason I will give brief histories of the two therapeutic organisations that I refer to in the paper.
Finally I will refer to my own experiences of becoming a Director of a small therapeutic community. I will show how a knowledge of current practice and history, alongside an internalised model of practice, can be used to analyse the interactions between ones inner models and the external world of practice. This analysis can then provide insights with which to guide and plan future directions in the work.
Preparing for the Journey
In writing follows I often had a clear sight of the road ahead; I knew what the question that I wanted to answer was and often, in idle moments, this question would act as a map, and a clear route from beginning to end would unfold before me. However, when the times came around to commence on a stage of the journey, as I sat down to write I would find the map inadequate. It did not describe the dense undergrowth that needed to be cleared. Neither did the map allow for blizzards and snowstorms that disorientated. Nor for the doubts over whether I had the right map for the area I was trying to cover, was it too big or too small? Did it give the right amount of detail? How did the map fit into a wider picture? Did I have it the right way up?
Originally my question arose out of ongoing experiences at work that will be familiar to managers. I became a Director of a small therapeutic unit for emotionally disturbed children. The work of this unit was to provide care, treatment and education to children who had suffered emotional privation, deprivation and abuse.
The children lived together in a large house and went to a dedicated building for education, a quarter of a mile away. The experience that will be familiar not only to managers but also to residential workers and teachers working with children concerned the tensions that arise out of having two distinct sub- or inter-groups, those of the house-based staff and the school-based staff. There was constant blame in both directions of one team ‘letting the other team down’ or ‘setting them up’, not understanding or valuing the work of that team, or criticizing the quality of work done with children. It seemed to me that there was no reflection taking place on the dynamics of working as separate teams within an organisation, particularly in working with such needy and damaged children whose experiences had not been ‘good-enough’. For this to be occurring, without analysis, in a unit that purported to be psychodynamic seemed to be a waste of time, energy and, most importantly, opportunities for furthering the work. I thought that helping the teams to understand the theoretical concepts and to begin to reflect on group dynamics may enable the team(s) to work better together. If the individuals within each team and the teams themselves could begin to understand and recognize ‘basic assumption activity’, the unconscious group defences against pain (see Chapter 2), it may help them face the tensions and anxieties inherent in their areas of work and reduce the ‘projections’. Historically this had not been part of the understanding of the work and, although the residential team received training in psychodynamic care, the school employed people trained as teachers who had no training in psychodynamics.
This was not the first time that I have managed a team in residential psychodynamic work and it seems that it may be profitable to compare how I brought a psychodynamic understanding of the task and the lessons I learnt from the previous post to reflect on my experiences in my current post and to think about how this may shape future work.
Once again, as I began to write, the question seemed incomplete. The terrain I was mapping out seemed clear as far as parameters went: there were the organisations that I managed and, looking slightly beyond, the geography and history of the wider organisations to which they belonged. I knew the approach that I wanted to use and the theoretical reference points were well established through previous workers and writers on psychodynamics, on therapeutic residential care and on organizational dynamics. The approach that I wanted to take for this piece of writing needed clearly to be a reflective position, comparing my experiences of becoming a manager in two different settings and of steering teams into becoming more psychodynamically based.
In outlining my experiences of managing two therapeutic units for emotionally disturbed children, I will attempt to describe how the experience of the first one became internalised in me and helped to inform my practice in the second. The internalised model included not only theoretical understanding but also an ability to reflect on myself and others.
Later chapters will explore the histories of the two organisations within which I have been a manager, as I attempt to demonstrate how therapeutic cultures are influenced by past and present contexts, and then to describe my role within them. Firstly, however, I will give a brief outline of therapeutic community work and explain the keys concepts that inform and define the thinking within the organisations. These concepts were crucial to my attempts to nurture a therapeutic culture within the relatively new project with which I was then involved.
Although not all of the roots of therapeutic residential childcare can be found within psychoanalytical thought, it is from these theories that key concepts have been taken to help staff understand the work undertaken with the emotionally damaged children who are placed in therapeutic communities. It is worth acknowledging that these theories have a context of their own and stem from a western European society and reflect a westernised view of identity and what constitutes a healthy ‘self’. As Owusu-Bempah states, ‘This conception of the self is alien to most cultures outside the West. These cultures emphasize interdependence, and so prepare their children for reciprocal relationships in adulthood with the social, physical and spiritual worlds.’ (1997: 305). The societal context for the work that I am describing, however, is predominantly western European and it is not the intention in this paper to explore the cultural relativity of therapeutic community work. Future work may be fruitful in exploring the efficacy of the therapeutic community approach for children trans-culturally placed within them as well the fact that so few children are (Fitzgerald cited in Kahan 1994).
For therapeutic work truly to take place within communities there needs to be an understanding of and willingness to study personal and interpersonal dynamics. At management level, though preferably not confined there, it is important that there is an understanding of group and organizational dynamics. As this paper will be discussing the work within therapeutic communities, it is important at this point to define the concepts and theories that I will be referring to.
The work of children’s therapeutic communities can, simplistically, be seen as containing and transforming disturbed young people. In psychoanalytic terms, ‘containing’ takes on an emotional context that avoids the disassociation between a person’s emotions and their actions. In this model, a healthy individual is able to mediate the influences of his thoughts and feelings on the outside world and its influence on them. Such a person is said to be a ‘container’, a concept derived from the psychoanalytical work of Bion (1967). The emotional development of the children placed in therapeutic communities has left them prey to powerful and painful feelings that they are unable to understand and articulate. Healthy adults are therefore employed to provide a containing function to those children whose early experiences have left them with an impaired ability to control the ingress and egress of stimuli with the outside world and consequently the behaviour that results from this disability.
If a number of such children are placed together, as they are in a therapeutic community, then there is a potential for a chaotic melee of action and reaction to manifest itself. In trying to describe how such settings attempt to contain and work with such difficulties, other concepts and terminology will need defining.
Therapeutic communities often find it useful to think organisationally in terms of ‘layers’ of containment that allow spaces for the dynamics to exist and be understood: the child is at the centre, with individual adults, staff-teams and the organisation itself forming the outer layers.
The earliest psychoanalytical view of the self is formed of the id, superego and ego.
According to Freud, the personality consists of three parts. The id, largely in the subconscious, is the source of the basic drives of libido and aggression and is governed by the pleasure principle. The superego, most of which is conscious, holds the internalized views of authority figures and acts as the ‘conscience’ trying to inhibit the id’s drives. The ego, largely conscious, mediates between the id, superego and outer world.
(Daniel 1997: 336)
These concepts underpinned Donald Winnicott’s thinking, and Winnicott’s thinking underpins much of the theory behind therapeutic childcare. Winnicott introduced the idea that a new born infant is awash with stimuli from both within and without but the infant does not have the means to distinguish and separate the stimuli. He simply experiences them: ‘In the beginning the infant is the environment and the environment is the infant’ (Winnicott 1986: 72). At this point there is no inner and outer world, no self and no container. In an ideal setting there is one continuous seamless experience for the early infant. If the experience provided by the parental figure (Winnicott, writing in the mid-Twentieth century, usually refers to the mother as provider) is ‘good-enough’ then the infant is able to separate out from the parent and the environment and realise his own distinctness.
The earliest stages of development are seen as a process of unfolding…and self-appropriation of the disarray of sensation and motility held together by the conducive milieu of maternal care. What can be described as ‘instinct patterns’ can be constituted, in any meaningful sense, only in relation to the mother.
(Phillips 1988: 124)
This implies that the child’s development is determined by how well the parental figures ‘held together’ and mediated the relationship between the instinctive drives of the infant and the vicissitudes of the immediate environment.
Winnicott writes that, eventually,
…the infant separates out objects and then the environment from the self. There is a half-way state in which the object to which the infant is related is a subjective object.
Then the infant becomes a unit, first momentarily and then almost all of the time. One of the many consequences of this new development is that the infant comes to have an inside. A complex interchange between what is inside and what is outside now begins, and continues throughout the individual’s life, and constitutes the main relationship of the individual to the world. This relationship is more important even than object-relating and instant gratification. This two-way interchange involves mental mechanisms that are named ‘projection’ and ‘introjection’.
Introjection is the process whereby the qualities of someone external become represented by an imagined model in the subject’s inner world. The superego mentioned earlier is formed by the introjection of parental figures. I will go into more detail about projection a little later.
Winnicott termed this development the maturational process whereby human beings move ever closer to integration,
‘Integration’ is a word that comes in here, because if one can conceive of a fully integrated person, then that person takes full responsibility for all feelings and ideas that belong to being alive. By contrast, it is a failure of integration when we need to find the things we disapprove of outside ourselves and do so at a price – this price being the loss of the destructiveness which really belongs to ourselves.
Projection is the process whereby an individual needs to disown his feelings and instead, find them outside of himself. It need not be confined to destructive feelings. People can find it hard to accept as part of themselves many different types of emotion and perceive others to be more clever, kinder or attractive than themselves. Although it may not always be destructive impulses that are projected onto others, the process is always to the detriment of being fully human or integrated. Once, someone that I managed planned to take some of the children out on a trip. She came to me and explained what she wanted to do and told me the plans, potential problems and solutions. She had clearly thought in detail about the trip in a very intelligent and conscientious manner. I could foresee one minor problem that needed some consideration and mentioned this to her, to which she replied earnestly, ‘Oh, Angus you think of everything’. In this case, the worker had fulfilled her task by planning a trip well and then by seeking advice and consent from her manager. During this latter part of the process, however, she projected intelligence and an ability to plan thoroughly onto me, the manager.
The children that I am describing in this paper can be termed either unintegrated, where the consistency of care has not been attained, or fragilely integrated and, therefore, prone to collapse. Both types of children tend to be extremely anxious and lacking in trust that the environment will support them. Their backgrounds are of inconsistent, unpredictable and sometimes chaotic environments. They very often have also suffered neglect and abuse at the hands of adults. The fact that these children’s emotional inner worlds are still nebulous, volatile and chaotic, that they are unable to distinguish between inner drives and outer influences, compounded by extreme experiences such as abuse, means that they are very likely to utilize defences such as projection (Freud 1896).
Defences are the psychological mechanisms that protect the inner world from unbearable feelings. Everyone has defences, they enable us to survive in the world. They enable us to cope without overwhelming pain or rage with the minor setbacks that are part and parcel of everyday life. However, defences erected to protect against an uncontaining environment may not adapt easily when the environment changes, leading to maladaptive behaviours and unhappy individuals. For example, a severely abused child who is bullying younger children may be defending against his own feelings of vulnerability, which needed protecting when he was being abused. For adults, who have attained some degree of containment, a healthy dialogue may allow projections to be recognised and owned. This is not always a simple task, as the very fact that an impulse was projected in the first place means that it was ‘unwanted’ and the process of re-owning it may arouse defences. For the type of disturbed child that I am describing, it is beyond his abilities to re-own the unwanted and intolerable emotions because he does not have the containing facility to do so. Attempts to engage in a dialogue at this point in his development is futile. The adults need to survive, contain and process the projections as a good-enough parent would have done, until the child feels safe enough to begin to own his thoughts and impulses without the fear that he will be annihilated by them.
Projection, however, is not the only process that the adults have to survive and tolerate. Other phenomena described by psychodynamic theory are projective identification and transference/countertransference.
Projective identification is a concept introduced by Melanie Klein (1946). It acknowledges that the attributes being projected by one person already reside in some form within the second person. Projective identification concerns itself with the interplay between the two sets of emotions, those being projected and those of the receiver of the projections. In this process, for example, a child who is not able to acknowledge his own source of aggression may project it out and perceive an adult to be persecutory and antagonistic. The adult on the receiving end of these projections may have his own conscious and unconscious feelings of aggression aroused and start reacting angrily towards the child. The adult has identified with the child’s projected aggression and has become part of the dynamic, which is then enacted.
‘Stephen’ and his sister had been sexually abused by his parents. The abuse had been sustained, systematic and, through a paedophile network of his parents friends, widespread. Stephen did not present himself promiscuously as many children with these experiences do, nor were there problems around his contact with other children. Communication around his past did not involve inappropriate disclosure or high defences. He could talk quite frankly but confidentially to adults in the unit about what he had suffered at the hands of adults and knew that what had happened was wrong. However there would be no affect in his conversation.
A strong feature of Stephen’s interactions with adults however was his feeling that often they were being unfair and persecutory. Once he was in this state of mind it was easy for the adults involved to feel incredible feelings of frustration; conversations with Stephen at this point did not ameliorate the situation which then led to higher levels of frustration for him and the adult(s). This could often lead to feelings of anger, as well as to dismissive attitudes and punitive behaviour by staff. Both Stephen and the adult would feel like helpless and angry victims. These powerful feelings were projected by Stephen. Adults, all of whom will have experienced ordinary early feelings of helplessness and anger, will have had those feelings aroused in them and sometimes acted on them. This is a classic example of projective identification.
TRANSFERENCE AND COUNTERTRANSFERENCE
The ways in which people have treated and responded to us in the past also shapes our interactions in the present. Consciously this can, rightly or wrongly, take the form of assumptions and generalizations. When we unconsciously perceive and respond to people based on the internalised models we have of previous encounters and experiences with other people it is transference.
Transference is the experiencing of feelings, drives, attitudes, fantasies, and defences towards a person in the present which are inappropriate to that person and are a repetition, a displacement of reactions originating in regard to significant persons in early childhood. I must emphasize that for a reaction to be considered transference, it must have two characteristics: it must be a repetition of the past and it must be inappropriate to the present.
(Greenson 1965: 171)
When early experiences and relationships have been inadequate and damaging, as is the case with disturbed children, the transference with new carers is likely to be not only inappropriate but also deeply destructive.
‘Charles’ was a little boy who had been very traumatically sexually abused. In his early years he was often kept locked in a room and only saw adults when they came in to abuse him. His relationships in the nurturing environment of a therapeutic community were characterized by persecution, paranoia and anger as well as the constant undertow of his sexualized feelings towards the adults caring for him. Charles was transferring all of his experience of relationships with early carers onto his current ones, which, when reflected upon, could give adults important information into Charles’ internal relationships.
The countertransference constitutes the feelings and impulses aroused in response to the transference and is a response to the first person’s psychopathology. The countertransference in work with damaged children can be deeply disturbing to the new carer who may be responding both to the child’s psychopathology and to his own less visible psychopathology brought to the surface by his new relationship If one is able to retain, as far as possible, self-awareness and a reflective capacity, then these processes can be identified and used as tools to understand the communications of the child’s inner world of the self, windows into the subconscious and unconscious.
The unconscious dynamics that I have explained so far describe the interactions between two people. What happens when a third person is introduced? Or a fourth? If there are more people present, the potential to reach an objectivity is greater as the opportunities for people to recognise projections and transference issues occurring between others increases. The problem arises with the fact that these people are subject to the same interpersonal dynamics. These dynamics now have the potential to weave into complicated lattices of defence.
Our experiences of being and working in groups are often powerful and overwhelming. We experience the tension between the wish to join together and the wish to be separate; between the need for togetherness and belonging and the need for an independent identity. Many of the puzzling phenomena of group life stem from this, and it is often difficult to recognize the more frequent reality of mutual interdependence.
(Stokes 1994: 19)
People within a work place come together to perform a task. Although they may have different roles within the workplace, if the overall task is not performed successfully then the workplace may cease to exist. For example, an accountant within a car factory would not describe his job as making automobiles but if he does not do his job well the factory may go out of business. This overall purpose has been described as the primary task (Rice 1958).
The idea of the primary task, complex in itself, does not convey the complexities of organisations. Lawrence (1975) developed the idea of primary task further and usefully made distinctions which are here cited by Miller (1993: 17):
the normative primary task as the task that people in an organisation ought to pursue (usually according to the definition of a superordinate authority), the existential primary task as that which they believe they are carrying out, and the phenomenal primary task which it is hypothesized that they are engaged in and of which they may not be consciously aware.
Basic assumptions, explained below, can give us insight into the interplay between these three aspects of the primary task.
Obviously the workplace satisfies other purposes for individuals such as providing an income and the implicit social and psychological needs such as those mentioned above by Stokes. If work forms part of the sense of identity of an individual then the question can be posed, how do we choose which identity we want? Most people would say that they were either interested in a particular type of work or that it ‘pays the rent’. Yet why ‘choose’ an identity as an accountant, or, for that matter, a therapeutic childcare worker, as a way of paying the rent. The answer may lie in the relationship between how we perceive ourselves and how we wish others to perceive us. These views and wishes are formed by the introjected objects from our early lives and are therefore not all available to the conscious. Similarly, this is true for the people with whom we interact and so identity can be seen to be a construct based on conscious interactions and also between the unspoken and unseen interactions of the unconscious worlds of individuals within a group.
To sum up, there are characteristics in the individual whose real significance cannot be understood unless it is realized that they are part of his equipment as a herd animal and their operation cannot be seen unless it is looked for in the intelligible field of study – which in this instance is the group.
(Bion 1961: 133)
Bion called this tendency for an individual to find himself drawn to a particular type of career in order to fulfill unconscious internal needs valency (1961). People within one work setting may have been attracted by similar internal needs to do that type of work; it may well be that they also have similar defences against some of the anxieties inherent in that particular workplace. When these defences combine together the staff begin to operate in basic assumption mentalities. According to Bion there are three types of basic assumption, basic assumption dependency (baD), basic assumption fight/flight (baF) and basic assumption pairing (baP).
In baD, the group behave as if the purpose of the task was purely to meet its own needs and wishes rather than having them indirectly met through performing the task: ‘The leader is expected to look after, protect and sustain the members of the group, to make them feel good, and not to face them with the demands of the group’s real purpose.’ (Stokes op.cit: 21). In this scenario the leader may be expected to provide a rule book or answers that cover all events, or to provide resources such as more staff or funds.
The baF group tends to perceive its task as being under threat or precarious. Time is taken up either in expectation that ‘someone’, often the leader, will do something to alleviate the situation or in talking and protesting about the situation without taking recourse to effectively planning to do the work. Here, the staff-team may engage in endless discussion over how current legislation prevents them from engaging with the task properly. Under these circumstances, the staff may either limit their work or expend energy in protesting rather than on fulfilling the primary task.
Finally baP groups operate with the unconscious phantasy that some future event will lead the way out of the present difficulties and behaves as if a unity between two members of the team or between one member and some external figure will bring about these changes. Here, for example, the fantasy may be that some work undertaken by the leader and a head of referrals will, in the future, bring in the ‘right’ children or more funds.
There are times when the solutions sought in the examples above may be appropriate and objective tasks. By definition, though, this is not basic assumption activity which concerns itself with an avoidance of the task and the anxieties that it generates.
Of course within any medium to large organisation there will exist subgroups, some informal ones such as social groupings, and formal ones such as teams and departments. Projection can and will take place between these groups, who may have differing basic assumption tendencies.
Sometimes the splitting process occurs between groups within the institution. Structural divisions into sections, departments, professions, disciplines and so forth are necessary for organizations to function effectively. However, these divisions become fertile ground for the splitting and projection of negative images. The gaps between departments or professions are available to be filled with many different emotions – denigration, competition, hatred, prejudice, paranoia. Each group feels that it represents something good and that other groups represent something inferior.
(Halton 1994: 15)
The creation of formalized groups can alleviate some of the problems mentioned above. For example, a local authority may form a Forum for Black and Ethnic Minority Workers, a smaller organisation may have a Women’s Sensitivity Group. As well as offering mutual support for the members of such groups, they can also become a focus of the fantasies and resentments of other workers. Rather than alleviating such projections, these groups have the potential to provide conscious ways of dealing with them by maintaining a focus on working towards the primary task and by being alert to the basic assumptions that lead to defensiveness, reaction, ritual and politics. To do this, the group must strive to remain aware of the individual and collective influences it contains by examining its thoughts, feelings and actions. This ethos has been named by Main (1967) as a ‘culture of enquiry’.
We can see here the parallels between a healthy individual and a healthy group or organisation: the ability to contain, reflect, analyse and mediate the interchange between within and without. An organisation that knows where boundaries exist and that allows a conscious exchange between people or systems has been termed the ‘sentient system’ and ‘sentient boundary’ by Miller and Rice (1967). In a psychodynamic therapeutic community, it is important that the whole system and the subsystems within it have a knowledge of all the processes described above if they are to understand the task and the phenomena of daily life. This understanding is necessary if people are to maintain a healthy, creative and therapeutic culture and not get mired in repetition, ritual and defensive practice.
This chapter has outlined the key and most complex theoretical concepts of which this paper makes use again and again. However, I have not yet talked of the works of pioneers of therapeutic communities such as Barbara Dockar-Drysdale. These important ideas will be referred to and explained as they arise in the context of the rest of this paper.
PART 2 will be published in our June 1st Edition.