Healthy Organisations

Surviving Work in Healthcare 


Philip “The thing that makes organisations go wrong is that anxiety is feared and instead of anxiety being moved up the system managers act to make the people below them anxious, and they then resist that anxiety. We see this in different ways – when politicians decide how clinicians should talk to patients which is completely insane. The freedom that’s absent from clinical work comes about from a fear of anxiety.”

Angela “Targets and box ticking looks very logical and containing – but its got absolutely nothing to do with the work. Its about containing the mangers’ anxieties.”

Philip “Thinking only happens when people feel free to communicate with each other. Usually there would be an expectation that we as consultants for example, are the experts. But one principle we have is that the work with groups is a partnership and we have to assume when we’re working with a group of people that they are expert in what they’re doing. The mind of the human being is a story of consciousness – that the mind develops because we are driven by curiosity. We want to know and we want to understand. But all of us will have explanations of our experience that don’t develop – that are stuck which frees you from the problem of thinking. Organisations, just like individuals will create certainties which stop real thinking happening which confines everyone to a particular way of being.”

Angela “Talking about rigid thinking with health care workers takes us straight into a discussion about bullying, racism, power dynamics at work. This framework for understanding group functioning leads straight into being able to do organisational work.”

Philip “Inquiry and not taking things at face value is important. For instance, a very common problem in any team is splitting. Usually the fixed belief that goes along with splitting is that the problem is to do with personality or ‘personality conflicts’. The team has decided that the issues at work are down to individuals. These individuals become the problem and have to change. Actually individuals represent something thats going on deeper in the system and that they are being recruited to express something about the system.”

Angela “When I’m doing mediation most of the work is about getting individuals separately to think about the other person involved and the organisation to put the problem in context. So that when they get together they have a different way of thinking about their position. When has it happened before? Is it unusual? All those sorts of questions.”
To hear the full conversation with Angela Eden and Phillip Stokoe go HERE.

Surviving Work in Healthcare is a free online resource Surviving Work in Healthcare designed for people working on the frontline. The website is a joint project by Surviving Work and the Tavistock & Portman NHS Foundation Trust offering podcasts, videos and survival guides that take a jargon free, de-stigmatizing and practical approach to addressing the real problems of working in healthcare.



We have developed these resources to be used on the frontline of health care. We hope that you can use them in your activities, meetings and trainings. Just send the link to anyone you think would find them useful. These resources are free –  all we ask is that you respect the copyright and attribute the resources to the authors when you use them.

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