Earlier this year, I had lunch with the CEO of a well-known health care organization. While we were catching up, I noticed deepening furrows on her forehead and new lines of weariness around her eyes.
“I have just lost my VP of Nursing,” she said with a sigh. “Right now, we are understaffed in almost every department; there are not enough providers, not enough clinical staff and mostly inexperienced support staff.”
The CEO went on to explain many people were also burned out from the stresses of the pandemic and its fallout. “As a result, many clinical staff were not up to the stress physically, never mind emotionally and psychologically, and they are still suffering from the trauma of it all.”
The story is the same everywhere in health care. While many organizations offer wellness programs that include chiropractor services, mindfulness and meditation programs, yoga, massages, and some even have a room where people can take a break and lie down in a quiet space, the problem, as this health care executive pointed out to me, is that few people avail themselves of those opportunities.
“We had to stop our mindfulness and meditation program as only one or two folks would show up. The same with yoga. We keep that going, but not even a handful participate regularly,” she told me. “I don’t understand. Everyone claims they are burnt out, stressed and anxious, and yet they won’t take advantage of the tools provided.’
Getting Beyond Wellness Programs
Due to the unrelenting pressures, many people are burnt out and don’t even realize it. All they know is that it does not feel good to be at work anymore. They are overwhelmed by the endless demands, and they have nowhere to take their feelings of impotence and frustration. They have little time or space to deal with their own unprocessed emotions and the secondary trauma they deal with every day.
While having access to wellness support is important, staff need more. They need to be able to express and process their experiences and emotions, something many managers run from. Management has a huge role to play in helping staff deal with their stress and feelings of burnout. The well-being of staff cannot be dumped at the door of HR nor assumed to be resolved by yoga and meditation sessions. Staff need a more wholistic approach. They need the support of others. During stressful times, managers need to manage differently.
Organizations are social systems and leading and managing the organization as a social system entails the execution of two tasks: a primary task and a secondary task. The primary task centers on the organization achieving its main objectives or goals. Effectively carrying out the primary task is critical to the organization’s survival. The secondary task is to take care of the emotional life of the people in the system.
Organizations, like people, need emotional health. An emotionally healthy system is one where anxiety in the system is contained to the point where it keeps people motivated and engaged, and fear does not overwhelm and overpower their ability to learn, be creative and to perform.
Leaders and managers need to understand the importance of taking care of these two tasks in tandem. Human emotions are not a waste of time.
Managing Groups and Emotion
In 1920, shortly after the end of WWI, a few insightful medical practitioners who had dealt with the neurotic disorders that resulted from the brutal trench warfare, founded the Tavistock Clinic in London. These medical professionals were the first to diagnose PTSD. Their work signaled the beginnings of the understandings of trauma, and they arrived at the conclusion that trauma was pervasive throughout society, it just had not been diagnosed and understood.
This work provided the basis of what is now termed group relations and was largely shaped by the findings of English psychiatrist, Wilfred Bion.
Bion, having served during WWI, joined the Tavistock team where he studied, among other things, the mentality of groups; how they deal with fear, stress and emotional trauma. He gained insights into the complexity of leading groups and the critical importance of understanding that the group has a life of its own and must be led and managed as such. His work highlighted how groups split, defend and protect the group from any change they think will threaten its survival. He also observed how the group, under caring facilitation, can provide healing to its members.
Group relations also introduces a new dimension to leadership where the emphasis is on containment rather than control or movement. The question this raises for leaders is how most effectively to contain emotion, especially anxiety, in the organization. If anxiety is insufficiently managed it can become an organizational way of life that blocks creativity and change.
The work of the Tavistock Clinic and the field of group relations was enriched by studies carried out by Kurt Lewin, a German American social psychologist, who coined the term group dynamics. Lewin’s work focused on how the environment affects individuals and the behavior of the group. Lewin insisted that groups, both formal and informal, become unified systems that must be understood on their own terms. By focusing on the group-as-a-whole, the leader or manager is able to understand what is inhibiting healthy organizational development, change, learning, communication and action. By paying attention to the dynamics of individuals within a group, managers gain insights into not only the anxieties and defenses of the individual but how this is being mediated by the group and how these can be compassionately handled to release pent up energies.
Some of his observations included that groups, just like individuals, develop defenses against difficult emotions such as the avoidance of pain, the fear of uncertainty and the handling of trauma. Denial and resistance are also strategies used to deal with the problem. The psychological behavior of splitting, which involves making some people good and some bad, is a well-known strategy for projecting uncomfortable or scary feelings onto others. This takes place at both the individual and group level.
Containing Anxiety
The question this raises for leaders is how to contain emotion most effectively, especially anxiety, in the organization. If anxiety is insufficiently managed it can become an organizational way of life that blocks creativity, adaptability to change and optimal functioning. One might infer that the struggles health care in general is facing reflects uncontained anxiety in the system.
Unfortunately, few managers or leaders are adept at understanding how to manage or lead a group, how to use the group to generate creativity and learning and how the group can help its members heal and grow. Weekly group meetings or daily “huddles” don’t cut it. That is not managing the emotional life of the group.
Instead, meeting time should be set aside where the group’s innate feelings and emotions establish the agenda, where they share their anxiety, sense of incompetence, frustrations and feelings of impotence in a safe place that is compassionate and understanding.
Over the last two decades, we have been drowned by books, articles, workshops and seminars on emotional intelligence and the need for empathy and compassion. Here is the opportunity to really put it into practice.
It is time for leaders and managers to roll up their sleeves and do some real managing. Now is the time to work with the group as a collective and help beleaguered workers do the work they long to do, which is to provide quality work or care while feeling cared about themselves.
Annabel Beerel, PhD, MBA, MA, is an executive leadership adviser, speaker and author of several books, including “Rethinking Leadership: A Critique of Contemporary Theories 2022.” For more information, visit annabelbeerel.com.
Current Issue - April 2024