Contents Vol. 22.1

Published June 2022

Articles

The American Adam—caught between the myth of innocence and the guilt of perpetration
Beate West-Leuer

Abstract
The collective sense of male identity in the US is founded on a mythic hero that has permeated American literature since the nineteenth century: the American Adam. He is an innocent outsider, living free to conquer the “Wild West” within or—with the loss of the geographical frontier—beyond the national borders of the United States. Through the military machine, a man can release himself from the demands of society and recreate his sense of innocent masculinity. This male ego ideal continues to be influential as the guiding principle for the political leadership of the USA. This is exemplified by psychoanalysing a documentary film about a Vietnam veteran and by an in-depth comparison of the “Adamic” quality of two recent presidents
with two of Melville’s literary protagonists: Billy Budd and The Confidence Man

Suffering at meaning: containment in crisis
Aideen Lucey

Abstract
When anxiety about survival is high it can interfere with the capacity for containment in organisations. The very anxieties that are in such need of containment can be damaging to ways of functioning that are necessary for containing relationships. In certain organisations the ability to tolerate painful feelings is limited and as a result the capacity for containment is impaired. As a consultant working in these circumstances the task that is required is that of building or rebuilding the container before thinking, in Bion’s sense, can take place. Having an awareness of the state of the organisational container can help the consultant to make a judgement about the
level of complexity they are likely to encounter in the work and enable them to plan interventions accordingly. Using examples from my consultancy practice I describe a process of “suffering at meaning” as the way in which containing relationships might be developed so that painful experiences can be faced

“… When what’s needed is imagination”:using remote platforms for group relations and organisational practices.
Jo-anne Carlyle, Jolita Buzaitytė-Kašalynienė, Erika Speičytė Ruschhoff, Chris Tanner
Abstract
This article positions itself at a particular moment in time to benchmark the shift to online working for group relations and organisational consultancy practices.  Drawing on varied experiences of working online during the global pandemic of 2020, the authors describe the impact that remote working is having on traditional assumptions about systems-psychodynamic work. It contributes to an appraisal of what different approaches are needed in the online sphere. It discusses the opportunities for more global participation and the current challenges to existing cultural assumptions. The article is structured around the themes of: setting the scene—opening the window to online working; losing and finding ourselves in the online space; the renaissance of lateral approaches to leadership; the question of where the unconscious goes in 2D space; and finally looks at implications for structuring the online space, including design issues for workshops and conferences.

Is there a doctor in the house?  Systems-psychodynamic research into general practitioners’ experiences of changes in healthcare delivery
Elizabeth Greenway

Abstract
My qualitative research uses a psychosocial approach to explore GPs’ experiences during changes in healthcare delivery prior to the impact of the Covid-19 pandemic. The challenges of running everyday general practice under the neoliberal paradigm meant that GPs were retiring early, and that new GPs were hard to recruit. Even before March 2020, the biopsychosocial model of medicine was contending with many complexities, including workforce shortages, an ageing population, increasing incidence of chronic comorbidity, and the development of clinical technologies, to name but a few. General practice is also challenged by the requirements of com- missioning, bidding, and contracting in order to sustain income and viability. What defines GPs’ primary tasks, roles, and systems, and how are GPs’ motivations and identities affected by this situation of clinical complexity and financial challenge? My research reveals three types of GP and an ecosystem’s model of the organisation-in-the-mind, involving various social defences and valencies for individual and group functioning

Lost in the present moment—an action research study on employee experience of involvement in change processes in the public sector in Denmark
Susanne Broeng
Abstract
This article focuses on the importance of organisational culture in organisational change processes and development, and is supported by an action research study of a change process in the public sector in Denmark. The main objective of the study is to gain insight into employees’ subjective experience of involvement in change processes. By examining employee experience, this study takes us a step away from the main theme of research in change processes that focuses on organisational change management. The conclusion of the study points out four main themes, which are as follows: 1) the employee experience of involvement in change processes was a feeling of not being involved even though a formal involvement was prepared; 2) the groups presented different reactions to the experience of not being involved, from developing containment in one group to regressive avoidance behaviour and social defence in others; 3) organisational social defence was a main factor in developing a “them” and “us” culture between employees and the management; and 4) there was a lack of organisational containment stemming from overwhelming emotions and the lack of a shared meaning and understanding between employees and the management.

Micromanagement in the workplace
Seth Allcorn

Abstract
Micromanagement is a toxic management style where the executive or manager oversees the smallest of workplace details. Organisation members are subjected to a soul stripping process where their thoughts, feelings, and actions are closely scrutinised. This dynamic collapses interpersonal space and personal integrity. The micromanager strips others of their self-confidence and self-efficacy leaving them uncertain what they should think, do, or feel without permission. Organisational performance is compromised. Micromanagement is an all too common but under examined feature of organisations. It is explored here for its toxicity and underlying individual, group, and organisational psychodynamics using object relations and group relations theoretical perspectives. Consultants, executive coaches, governing board members, executives, and employees will benefit from this systematic exploration of micromanagement in the workplace by developing better appreciation of the underlying psychosocial dynamics of micromanagement that can be a way of life at work.

Accounts of Interventions

Managing accelerating complexity and inter-group conflict in the care of critically ill children
Ernest Frugé, Michael Sprehe, Melody Brown-Hellsten, and Laura Loftis

Abstract
Modern medical care for critically ill children meets the definition of a Volatile, Uncertain, Complex, and Ambiguous (VUCA) situation with an additional “R” factor of high risk (suffering and potential death of a child). The circumstances of care for a critically ill child create a unique psychological, social, and technical crucible for all involved, one primed for conflict. This article will trace the evolution of our study of inter-group conflict between physicians in the care of critically ill children from initial observations to broad, systematic surveys and qualitative analysis of practitioner focus groups. Our findings indicated that unconscious inter-group dynamics, shaped by setting variables, can significantly impair collective work towards the best interests of patients in these fraught circumstances, making “integrative decision-making” difficult to achieve. Patterns in inter-group relations clearly suggested the use of splitting as a social defence. The findings and related hypotheses provided clues for strategies to mitigate the impact of these dynamics. This article concludes with a description of the design and pilot testing of a structured method of case review designed to provide containing structures tuned to the specific context with the ultimate aim of facilitating integrative decision-making and optimising co-ordination of care for complex cases.

Speaking Out

Ed Shapiro—the discussion “Why do I have to do this? And why not?” Institutions, integrity, and citizenship under threat
Joseph (Yossi) Triest
Abstract
Ed Shapiro’s important and thought-provoking article deals with civic ethics and is organised around three critical points: a call (1) for taking personal authority in order to protect the group from (what is perceived as) its destructors (Why do I have to do this?); an offer for (2) doing it by being emphatic with the “enemy” (in what way is he right?); and (3) encouragement to reveal “active citizenship”. The discussion challenges those questions by asking: Do I have to do this? Always? And why me? Do I have to understand the other? Always? Under what conditions? And is it really possible, taking into account our unconscious attitudes towards “otherness”? The discussion refers to the timing and the sociopolitical con-text of Shapiro’s article—namely turbulent times and a deep disappointment of present-day leadership—and interprets his challenge as a call for the return of the individual almost as a “Nietzschean hero”—namely, to differentiate him/herself even from the group-as-a-whole. Some unconscious aspects of the challenge which Ed Shapiro puts before us are discussed, referring to the inherent tension between “what should be” and “what is actually happening”.

Ed Shapiro responds
Abstract
In response to Dr Triest’s discussion of his article, Dr Shapiro focuses on the way polarised relationships might be integrated in the process of joining an institutional mission. Any effort to listen across polarisation (“How are they right?”) requires containment of aggression and the discovery of a shared task, a third perspective to the dyad in opposition. Dr Shapiro offers, as an example of listening across polarisation, his own effort as an American citizen to find himself in Donald Trump.

Book Review
Danse Macabre and Other Stories: A Psychoanalytic Perspective on
Global Dynamics by Halina Brunning and Olya Khaleelee

Bicester: Phoenix Publishing House, 2021, 360 pages.
Reviewed by Gilles Amado