A Trainee’s reflections on how Menzies Lyth (1959) helped me to make sense of an experience in training

Isabel Menzies Lyth

Isabel Menzies Lyth

Having first encountered the Menzies Lyth ‘The Functions of Social Systems as a Defence Against Anxiety’ (1959) paper in the second year, this has influenced my understanding of organisational culture on placements during training ever since. I also found these ideas particularly helpful following a rather tricky experience I had working with a staff group.


I was attempting to work with a group of staff to help think more about the physical health needs of patients, and in particular the psychological components of this (motivation, self-esteem, peer influences etc). Initially this had been met with a favourable response and some acknowledgement that the physical health of the particular client group could benefit from more attention. However, as I proceeded with some ideas as to how change may be implemented, I was met with much less favourable responses, and claims that actually the patients were in rather good physical health so there was no need to do things differently! The sudden change in response was stark and at the time baffling; needless to say my enthusiasm soon turned to disappointment.

Whilst I’m aware there were a number of factors influencing the response of staff, ideas from the Menzies Lyth (1959) paper helped me to make sense of what had occurred and to learn from the experience. I feel the aims of my intervention were largely at odds with a more medical model of risk management which dominated the service at the time. Whilst this approach allowed the service to function with a challenging client group in a challenging time, I believe what I was asking was for the service users to be thought about differently, perhaps more holistically. However, as Menzies Lyth (1959) writes, to operate in such a way would bring staff into closer psychological and emotional contact with the service users which was a difficult proposition for an already stretched staff group.

Whilst in this particular instance I may not have been able to achieve my desired aims regarding physical health of patients, I have learnt a valuable lesson around how we as aspiring clinical psychologists can best work with other healthcare professionals. Based on this reflection, I feel that in a similar situation in the future I would need to better account for the needs of staff to ensure sufficient support and emotional containment for them is in place before considering any changes to how the service may operate.


– Tim Siggs, University of Leicester DClinPsy, 2012-2015 cohort.

Menzies Lyth, Isabel (1959) ‘The Functions of Social Systems as a Defence Against Anxiety: A Report on a Study of the Nursing Service of a General Hospital’, Human Relations13: 95-121; reprinted in Containing Anxiety in Institutions: Selected Essays, vol. 1. Free Association Books, 1988, pp. 43-88



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