I talked with Arabella some years ago about the Observing Organisations project that I started way back in the 1980s – and from which came the book I edited with Wilhelm Skogstad. Originally my job as a Consultant Psychotherapist in a large mental hospital with a wide catchment area, and some 15 plus trainee psychiatrists, included giving them some understanding of psychodynamics and how it might be relevant to the practice of psychiatry. I was faced with some degree of resistance, and an equal fascination. I needed to turn that into a critical enquiry into an approach which was somewhat alien to standard psychiatry.
My solution was to tap into their concerns about working with madness and mad people, by getting the trainee psychiatrists to think about the institution we were all working in, and one that would resemble the services in which they would eventually be consultants. The hospital was none too congenial as a place of work, and the evident culture of oppression and fear was palpable to them. Also such personal reactions were ignored by the standard scientific approach within the teams they worked with. To my surprise at the time, many of the trainees became very interested in developing their interest in the institution, and not just the science they had to learn.
Not only were they heartened to find a space to consider, investigate, and indeed learn about the psychodynamics that we were all part of, but I too was heartened that it was indeed possible to make something useful out of this more personal inquiry. The observation projects I got them to do in various wards and other sites in the hospital, and elsewhere, gave me an opportunity to think how the subjective experiencing of a culture could complement scientific psychiatry.
The project expanded to some other disciplines that wanted the experience, and became a module for courses at Essex University. I was pleased too that Arabella wanted to consider the project as a part of the training for clinical psychologists. The culture of psychiatric services appears to be often problematic – and why should it not be when considering the onslaught of stress involved in caring for those everyone else in society has failed with? And indeed professional caring of many kinds throws up problems that appear in the culture though they arise from the individuals’ work stress. It is a tragic paradox that the stress of caring tends to numb the very capacity to feel caring!
This is a big issue that young clinical psychologists need to face head-on in themselves, in colleagues and in their work cultures.
RD Hinshelwood, January 2015