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The walls within: working with defenses against otherness

Online Conference 5-11 July 2021

Analysis of a Consultative Effort from the Perspective of Three Theories: Classical, Object Relations and Self Psychology

The consultants theoretical orientation will influence his/her capacity to observe psychodynamics during two important processes in the activity of organizational consulting: the entry process, and the diagnosis. How the consultant conceptualizes unconscious forces and how they are placed into a formulation of the organizational dysfunctions will be the thrust of this presentation. We will begin with a case presentation of a consultation to a hospital Intensive Care Unit. This unit was experiencing low morale and conflict. The diagnosis will focus on the nature of the task of the unit and how this task can be understood from the perspective of the three major psychoanalytic theories. In addition, we will analyze the case from the perspective of the relationship between this unit and the hospital administration, in particular the CEO who was retiring and the units relationship with the larger hospital environment. How would a classical object relations and self-psychological organizational analyst understand these organizational conflicts? When one consults to an organization the consultant enters into the organizations group processes. Some refer to these processes as the organizations culture, collective psycho-dynamics, departmental dynamics, etc. The consultants theoretical orientation will influence how he/she observes and assesses the organization from the point of entry and arrives at a formulation. The following is an introduction to the case that will be analyzed. The case in its entirety will be given to the participants prior to the symposium, along with the consultants process notes. Three panelists, representing the classical, object relations, and self-psychological positions will present their analysis of the case. A chair will facilitate discussion. CASE ANALYSIS The consultant received a call from the director of Nursing at a small community hospital. She asked the consultant to consult to the staff of an Intensive Care Unit (ICU). The director explained that the unit was experiencing an absenteeism rate which was five times greater than the hospital in general She reported that morale was low, and the nurses were in constant conflict with her and the administration. She continued, the nurses in this unit were continuously complaining and were in conflict about the scheduling of work shifts and duties. In addition, the director stated that the nurses were not responsive to physician orders, and the formation of a viable and harmonious working staff unit was non-existent. The head of the ICU was spending increasing amounts of time away from her staff, isolated, often closing her door and remaining inside her office for long hours. The CEO, a long beloved and respected man was soon to retire. The director of Nursing and several other administrators were actively involved in recruiting his replacement. References Czander, W. (1993). The psychodynamics of work and organization. NY: Guilford Press. Levinson, H. (1972) Organizational diagnosis. Cambridge, MA: Harvard University Press.