Some Thoughts on Isabel Menzies (later Menzies Lyth) and her Work

 

This is the text of a presentation I gave in 2011 at a meeting of the Child Care History Network board members and invited guests which was held at the Planned Environment Therapy Trust at the Barns Centre, Toddington, Gloucestershire.Wednesday, June 1st, 2011

Her life and work

Isabel Menzies-Lyth was a psychoanalyst and a pioneer of the psychoanalytic study of organisations. Born in 1917 in Dysart, Fife, in Scotland, she was the fourth child of the minister of the kirk there, Hugh Menzies. She attended the state secondary school at Madras College in St Andrews. She studied psychology and economics at St Andrews University, and graduated in 1939 with a double first. Her tutor was Eric Trist, who was to become a leading figure in the field of organisational development . It was through Trist that during the war she was able to spend her vacations from her teaching at St. Andrews working with the War Office Selection Board.
At the end of the war she moved to London and was the only woman in a group of psychiatrists, psychologists, psychoanalysts and social scientists who founded the Tavistock Institute of Human Relationships, which offered research and consultation to organisations. Among this group were W.R. Bion, John Bowlby, John Rickman, Jock Sutherland and Elliot Jaques, a rich mix. In this post-war period the influence of Melanie Klein and then Donald Winnicott also imbued the atmosphere of the Tavistock. Isabel’s first project at the Tavistock was to consider how returning military personnel could be best re-settled in civilian life.
As well as her social research Menzies began psychoanalytic training in London. W.R. Bion was her second analyst. It was an analysis which she said she undertook for herself rather than the one she had to do for her psychoanalytic training. So Bion had a great influence upon her. In 1957 she qualified as a child analyst and in 1960 became a training analyst of the British Psychoanalytical Society. Throughout her time at the Tavistock she would see her patients in the morning and carry out social research in the afternoon (Dartington, 2008).
When the Tavistock Institute for Human Relations was founded, psychoanalysis as a discipline and as a way of thinking was influential, and flourished in theory and in practice beyond the world of the troubled individual. Psychoanalysis was making advances in the understanding of groups, of work organisations as well as families and communities and was seen to have relevance to wider social issues at a time of some turmoil in the transition from war to peace. The Tavistock was at the heart of this advance.
Isabel’s pursuits throughout her career were extraordinarily varied. As well as her research and consultancy with health and child care institutions, she wrote also about eating chocolate and about motorbikes. She was a redoubtable presence at the Tavistock’s Leicester Group Relations conferences. I say redoubtable because it was at one of these that she fell out for good with one of her former collaborators, Alistair Bain. They never spoke again but it is a measure of her standing that Bain never lost respect for her or her ideas (Bain, 2008).
For over 50 years she remained very influential as a consultant and as a supervisor in both psychoanalytical and organisational settings.
In 1970 until her retirement in 1980 she acted as consultant for the Cotswold Community and the notes she wrote about this work are archived at the Planned Environment Trust. John Whitwell has written an excellent paper on this period (Whitwell, 1998). In 1975 she married the psychoanalyst Oliver Lyth and moved to Oxford. Her links with the Tavistock became less frequent but visitors to her home all remark on her curiosity about the current goings on there. In 1981 Oliver Lyth died.
Her achievements were eventually published in two books Containing Anxiety in Institutions (1988) and The Dynamics of the Social (1989) when Robert Young of Free Association Books and Ann Scott persuaded her to allow them to collect her papers. Young described her to me as a quietly formidable woman with a slight Scottish brogue. Formidable she may have been but she was also modest. She declared herself amazed that anyone would wish to publish her papers.
Isabel Menzies Lyth died in 2008 at Oxford aged 90.

 

Isabel Menzies Lyth’s methods, research and consultancy

Menzies considered her working method ‘action research’ underpinned by a working ethos which she characterised as the “art of the possible.” She said her consultancy and her research were founded on the conviction of the existence of the unconscious and she believed that psychoanalytic principles could be applied towards gaining greater insight into groups and organisations (Dartington, 2008). She felt that the role of the psychoanalytic approach to investigating institutional practice and analysing its process was to help the client, that is both the institution and its individual staff members, and to  bear the anxieties and uncertainties of the change that inevitably come along in groups and organisations.
She thought this feature was unique to psychoanalytically orientated researchers and consultants. “They stay around”, she said. She was critical of consultants from other orientations who carried out their investigations, left and then sent their clients a report which was a blueprint of what they should do about their problems, thus leaving their clients to do what they could on their own. This is a method that still seems prevalent when attempts are made to re-organise health and social care organisations.

 

Her research : two key papers

I would like to be able to write about all the outstanding research and consultancy that Menzies carried out, but time and space allow me only to deal with a very small sample of her work. Those of you who know little of her and are interested in discovering more should find useful sources in the list of references which follow the text of this article. These include John Whitwell’s aforesaid paper about her work at the Cotswold Community, the recording of a talk given by Tim Dartington to the Scottish Institute of Human Relations, the film of an interview Amy Fraher carried out with her, a poignant memoir written by Alistair Bain, and a complete issue of the British Journal of Psychotherapy which is the record of a symposium held in memory of her life and work
I will touch upon two key papers which I think are representative of her lasting contribution to health and care services and to the human community at large, as well as demonstrating that her discoveries have a great deal to offer residential child care. These two papers are “The Functioning of Social Systems as a Defence against Anxiety” published first in 1959, and “The Development of Self in Children in Institutions” which was published in 1985

The Functioning of Social Systems as a Defence against Anxiety
This is the paper which (though not directly related to child care) is the one – to use celebrity talk – that gave her world-wide fame, and I think it forms the basis upon which all her subsequent social research work and writing is founded. It is a major contribution to our understanding of caring institutions and the human community as a whole. In this paper she shows how groups, institutions, communities and the individuals who belong to them, struggle with, and defend against, the primitive anxieties that are brought up as they try to carry out their tasks, to act upon their values and live their individual lives.
In this study, which Menzies acknowledged was built upon the bases of Bion’s and Jacques’s theories of group functioning, she describes how a teaching hospital with a good reputation, Kings College Hospital London, not only resisted its primary task but developed entrenched ways of working that served to defend the nursing staff from the stresses they experienced while working in intimate physical and emotional relationships with patients who were ill and possibly dying. In some instances these systemised defences acted against the needs of the patients.
I should say that the hospital had approached the Tavistock because it was concerned about how it was allocating student nurses to meet the needs of the hospital at the same time as giving them appropriate experience for their professional training. Menzies understood her relationship with the hospital to be a socio-therapeutic one with an aim of facilitating desired social change and as a psychoanalyst Menzies regarded the difficulties about allocating student nurses as ‘the presenting problem’, a symptom which was socially acceptable but was in fact symptomatic of another, underlying, problem.
One of the conclusions Menzies reached after carrying out a series of intensive and continuing formal and informal consultative interviews with the nursing staff was that a nurse’s close proximity to her patients, the messiness of the tasks she might have to carry out, the potential for the patients’ suffering and death, the patients’ and the patients’ relatives’ ambivalence about the nurse’s care – their gratitude and yet their envy of her skills and the hostility they felt about their dependence on her – aroused primitive desires and fears in the nurse. Menzies argued that these bore a “striking resemblance to the phantasy* situations that exist in the deepest and most primitive areas of the mind”. She suggested that these violent and intense feelings (which Melanie Klein had shown were present in an infant’s phantasy life) were experienced by the nurse as part of her adult life.
The level of anxiety, tension and stress gave rise to (in individual nurses as well as the institution) unhelpful social defence systems. They were unhelpful because they were related to phantasy rather than reality. Such a system occurs, Menzies argued, when there is a collusion between each member of an organisation as each attempts to operate their individual defence mechanisms. For instance, in a hospital every decision might be a matter of life and death and cause a great deal of stress and anxiety.
Menzies called the social system defence against this particular anxiety “ritual task performance” in which each nurse was taught to work by following a rigid task list. The attitude being cultivated was one that understood each of these tasks as a matter of life and death and one to be treated seriously. Consequently student nurses were discouraged from using their own discretion. Feeling distanced from the caring relationship they hoped to have with patients, a high proportion of the student nurses left before they completed their training.
Although from a different work setting, I know from my own experience the processes which Menzies describes in this paper are replicated in both day care and residential child care settings where there can often seem to be an imperative to do something – almost anything – as a reaction to a phantasised anxiety. One example of this that I would evidence is over-zealous and bureaucratic risk assessment procedures which work against the exposure of children to good experiences.

 

Her contribution to residential child care:

The Development of Self in Children in Institutions
I now turn my attention to an example of Menzies-Lyth’s direct and positive contribution to residential child care. Hinshelwood has inferred, perhaps mischievously, from Menzies’s 1979 paper “Staff support systems : task and anti-task in adolescent institutions” that Menzies Lyth did not think much of therapeutic residential care for children, regarding the staff members as naïve and sentimental, losing track of their primary educative purpose by becoming driven to be surrogate parents of the youngsters. In my reading of that particular paper, I am not convinced by Hinshelwood’s interpretation. I think John Cross has this right, when he suggests that residential child care workers have, however difficult and conflictual this might be, to take on both roles as well as a number of others and I sense this is what Menzies was saying too. Certainly it is hard to see how any reading of The development of self in children in institutions could interpret it as other than being supportive of the residential child care task.
In the main, Menzies’s consultancy in residential child care related to therapeutic communities for children, and as someone who practised if you like in the mainstream of residential child care, I have taken the liberty of generalising her findings in this 1985 paper as referring to the whole of the residential child care service. So in what follows I often refer to institutions as children’s homes.
Before focussing solely on this paper, I would like to clear some ground about the criticisms which have been and continue to be made about placing troubled children in a group living setting. Melvyn Rose, the former director of Peper Harow, a therapeutic community for youngsters, understood that one of the primary tasks of his staff was to sustain the meaning and purpose of what seems a potentially volatile group.
Responses to this might include, “Why bring children together if they are likely to combine into a volatile group?” “Is a group living setting suitable for troubled children?” “How can a child flourish in such an environment?” Peper Harow, along with other therapeutic communities for children, have inclined toward psychoanalytic theory to underpin their practice of using the group as a part of a therapeutic milieu in which young people can be helped to feel better about themselves, their prospects and about being in healthy relationships with others.
Here it may be useful to explore some aspects of psychoanalytic theory about groups that were operant at the time Menzies Lyth was carrying out her research and consultative work in residential child care. Freud did not differentiate between individual and group psychology, but held that being a member of a group is a consequence of the group we are born into, or, have an attraction to, or is a group of which we have an unconscious desire to be like the leader (Freud 1921).
The Scottish psychoanalyst, W.R.D Fairbairn, who (unlike Menzies) did not take the high road to England, suggested that all social groups are sustained by libido and that the cohesion of a group is dependent on the extent to which libido is bound within the group, and the extent to which the group can exclude aggression from relationships within the group. For Fairbairn the roots of the social disintegration of a group lie in aggression (Fairbairn 1935).
I would ask you to consider Freud’s and Fairbairn’s positions with the reality of a group living setting. Certainly children resident in a children’s home are not living in a group that is their natural family setting. They are rarely placed in a children’s home because they are attracted by, or identify with, the notion of living there. They are placed in a group care setting because parenting figures have failed them, and other adults have decided that they will stay there. These are pained, anxious, fearful and, at times, angry children. Fairbairn would not have imagined that children with these difficulties when placed together could create a climate conducive to a cohesive, creative group.
Paradoxically, the practitioner, Rose argued that such a group was the very essence of a children’s home. For him the primary function of a children’s home is to use the group setting to facilitate a child’s development from a state of emotionally painful anomie towards a position of the child’s identification with the home and the nurture it provides. However, taking our lead from Menzies’s 1959 paper we can begin to understand however that primitive anxieties about children’s homes will arise among those in the wider community as well as those who are working and living within a children’s home.
This is particularly so if their phantasies are based on a fear that the group care of troubled child is in a state of continuous chaos. This phantasy of chaos with its concomitant notions of disorder and widespread malpractice has acted as an obstacle in the way of residential child care child gaining general credibility.
Bion’s work with groups both during the war and after it, together with the theory which he postulated from this experience, may help us navigate us through this phantasised impasse. He argued that a group brought together to carry out a task oscillates between task-performing positions and anti-task positions.
He isolates three kinds of intra-group relationships. First he describes a situation akin to an institution where there is a rigidly held social order, where the group as the container crushes its contents. Secondly he describes another akin to a revolutionary situation where an idea or a person destroys the established social order, and finally he describes a relationship in which the container and contents manage to accommodate each other so both are able to develop and grow (Bion 1970).
Hinshelwood observes that the first two relationships which Bion describes represent non-therapeutic containing, while the third represents flexible therapeutic containing, in the same way as a mother, though pained by her child’s acute distress, holds the child’s feelings until her understanding is projected into the child so that he may grow as she does in the process (Hinshelwood 1987).
It is possible to extrapolate from Bion’s and Hinshelwood’s positions that it is the mature group, the one which is not in denial of its difficulties, the one which takes time to reflect upon them, that will contain and make sense of any frustrations. Anxieties arise at those times when there is a tendency in the group to move from task-performing mode to anti-task mode.
If this kind of containment is evident, the overtly threatening elements which create a chaotic, regressed infantile group and which are considered normal in a children’s home are managed and become part of the therapeutic process. Nevertheless, life in such a group, if it is not to be intolerably difficult must develop necessary solutions in order to provide the kind of containing environment which will allow opportunities to clarify so far unexpressed relationships, allay anxieties, arrest unhelpful defences and attempt to begin to resolve the problems which arise from them.
Developing solutions in an apparently chaotic environment is a problem for new incoming staff to a children’s home, while a problem for established staff is to communicate a sense of purpose to new children as well as new staff. A great deal has been written about the efforts of those charged with developing a therapeutic group care setting with the aim of creating an internal culture which facilitates personal growth and change among the members of the group (for instance, Balbernie 1966; Bettelheim 1974).
For the inexperienced residential child care worker, this literature helpfully speaks in practical language grounded in psychotherapeutic theory. Yet, and this relates to Menzies 1959 paper, however well prepared a newcomer to residential group work with children may be at a rational level, the actual experience of the variance between the culture of the therapeutic group care setting and that of the wider community makes it less easy to prepare for and to contain emotionally.
A group of human beings rarely, and then only fleetingly, achieves perfection. The community of staff and residents in a children’s home is also subject to the rivalries which split families and other institutions and organisations. The survival of a children’s home depends, just as the survival of a family would, on how it manages itself in the wider social context, and how it responds to the anxieties which arise from departures, separations, failures, betrayals, and human inadequacy.
It is not surprising that for staff in children’s homes, the acting-out behaviour which these issues engender in the resident group expends an inordinate amount of time and emotional energy. It can feel as if the children’s demands are endless and progress can seem non-existent. It may appear to be a child’s fervent wish to frustrate those who are most committed to his care, and to hurt those who persist in sustaining a caring relationship with him.
I hope you see the connections I am trying to make with the Menzies’s 1959 paper; conflict like this is fertile ground for the development of institutional system defences. The challenge for those striving to create and provide all that the children’s home should offer is to provide a group living culture for children who are emotionally stuck with an experience that is dynamic and encourages individual growth, to the extent that when leaving the children’s home a young person emerges who is substantially able to cope with the vicissitudes of family or adult life.
This is an enormous task which begs the questions, “In what ways can staff effectively carry out the group care task of providing children with these opportunities for healthy development” ? My view is Menzies-Lyth’s The Development of self in children in institutions provides some answers.
As I’ve said, Freud claimed that people are drawn into, and remain in, groups because of emotional ties between members and one of the principal processes effecting such an attraction is identification: the process by which a person seeks to be like his parents. Freud suggested that an individual introjects a preferred person or the qualities they like in that person, while at the same time projecting some of the bad or painful qualities of themselves on to others. Accordingly when each member of a group internalises the same qualities as the leader, they can identify with each other (Freud 1921).
Menzies-Lyth, discussing the development of the self in children residing in institutions, suggests that it is through the process of introjective identification that the development of the self takes place. She contends that healthy development depends on the availability of appropriate models of individuals, relationships and situations for such identifications. While acknowledging that these models may be available to the children in the adults who care for them, importantly she stresses that the individual adult’s relationship with the children, together with the adults’ relationships with each other and the ambience of the setting for care, are all also models for introjective identification.
She recognises too that a child’s healthy development may require the management of the child’s identification with inappropriate models, for example other children within the institution. She argues that children in the group living setting of an institution are likely to find the most significant models for identification within the institution as a whole, in its sub-systems and in the individual children and staff.
Like Bettelheim (1974), she sees this process as the basis of the concept of the institution as a therapeutic milieu whose primary task may be described as providing conditions for healthy development and providing therapy for emotionally damaged children. It follows then that all the child’s experiences in the institution contribute positively or negatively to the child’s development, not only through education, individual or group therapy or child care, but also by the more general features of the institution.
Such an aggregate she argues, points to a need to take a wide view of an institution in assessing its effectiveness in carrying out its primary task. This assessment would include:
the whole way the institution functioned
• its management structure, including its division into sub-systems and how these related to each other,
• the nature of authority and how that is operates,
• how it manages anxiety,
• social defence systems built into the institution, and
• its culture and traditions.

These have to be considered in the context of how far they facilitate the provision of healthy models for identification, or alternatively inhibit the provision of such models.
Although it is possible to regard the whole institution as the model, Menzies-Lyth suggests that for the child the impact of the institution is in large measure mediated through its staff who are the individual models for identification. While individual staff have their own personalities with their differing strengths and weaknesses within the institution, she maintains that the extent to which individual staff are able to deploy their personalities, their different qualities, their strengths and weaknesses within the group care setting will depend on characteristics inherent in the institution. She maintains that due attention should therefore be given to maximising the opportunities available for staff to deploy their capacities – she encouraged the frequent exercise of delegation in institutions – and for it to be seen that children respond to them (Menzies-Lyth 1985).

Concluding remarks
The suffix to the title of this talk “the struggle with primitive anxieties” is not Menzies’s phrase. I introduced the word ‘struggle’, because of the continuing frustrations I have faced throughout my career as teacher, as residential worker, as manager and as trainer in persuading myself and others to be curious about our own anxieties, our own phantasies and our own unhelpful defences when we care for, support and educate troubled youngsters. I think that what we can draw from the work of Menzies-Lyth’s message is not that it is possible to arrest these anxieties and their concomitant social defences but that an awareness of these anxieties and how they arise in institutions, together with sensitive sustained management can limit their negative tendencies.
Perhaps Richard Rollinson encompasses this best when he reflects on his time as Director of Mulberry Bush School. He observes that given the nature of the residential child care task it is “pointless to believe that anxiety can be eradicated. It is important to recognise anxiety where and when it occurs and to work on it.” It is, he asserts, the responsibility of the leader to ensure that “anxiety management is happening regularly and reliably at all levels of the organisation”(Rollinson,2003).
I feel certain that if Menzies Lyth’s 1959 research project was carried out today in any caring institution, the same anxieties and defence processes would pertain even if some of the contextual details have changed. This is why her original discoveries continue to have significance.

Note
*Phantasy : Melanie Klein coined this word because what she was speaking of arose from the unconscious and in this way she differentiated it from the more conscious ‘fantasy’.

References
Bain, A. (2008) “Isabel Menzies Lyth 1918-2008 : A personal memory” accessed online on 25/1/11 at http://www.acsa.net.au/articles/Isabel%20Menzies%20Lyth.pdf

Balbernie, R.(1966) Residential Work with Children London : Human Context Books

Bettelheim, B. (1974) A Home for the Heart. London : Thames and HudsonBion

Bion, W.R. (1970) Attention and Interpretation London. : Tavistock. Cited in What Happens in Groups R.D. Hinshelwood (1987) London : Free Association Books. p231.

Cross, J. (2010) ‘An interview with John Cross’ in the goodenoughcaring Journal, Issue 8 accessed online on 1/4/11 at http://www.goodenoughcaring.com/the-journal/an-interview-with-john-cross/

Dartington, T. (Presented and recorded on 1/10/08) ‘Isabel Menzies Lyth and the Art of the Possible.’ The Autumn Lecture presented to the Sutherland Trust at the Scottish Institute of Human Relations. Accessed online on 3/4/11 at http://www.sutherlandtrust.org.uk/lectures/Autumn%20Lecture%202008%20Tim%20Dartington%20web%20edit.mp3

Fairbairn, W.R.D. (1935) ‘The Sociological Significance of Communism Considered in the Light of Psychoanalysis’ in Psychoanalytic Studies of the Personality London : Routledge 1996. pp235-240

Fraher, A. (Film, posted online, 19/7/08) Interview with Isabel Menzies-Lyth accessed online on 30/3/11 at http://webcasts.ispso.org/2008/07/19/isabel-menzies-lyth-interview-by-amy-fraher.aspx

Freud, S. (1921) ‘Group Psychology and the Analysis of the Ego’  in Civilisation, Society and Religion. The Penguin Freud Library. Vol.12 Harmondsworth : Penguin 1991 pp. 95-97.

Hinshelwood, R.D. (2010) ‘Impressions of Isabel Menzies-Lyth’  in the British Journal of Psychotherapy Vol.26, no.2, May 2010. Note : this issue of the Journal is a tribute to Isabel Menzies-Lyth and is the record of a symposium which was held to commemorate her life and work. The symposium which was held at the Tavistock Centre in 2009 was jointly organised by the British Psycho-analytical Society and the Tavistock and Portman NHS Foundation Trust.

Menzies, I.E. (1959) ‘The functioning of social systems as a defence against anxiety’ in Containing Anxiety in Institutions : selected essays by Isabel Menzies-Lyth. London : Free Association Books (1988) pp. 43-88

Menzies, I.E. (1979) ‘Staff support systems and anti-task in adolescent institutions’ in Containing Anxiety in Institutions : selected essays by Isabel Menzies-Lyth. London : Free Association Books (1988) pp. 222-235

Menzies-Lyth, I. (1985) ‘Development of the Self in Children in Institutions’ in Containing Anxieties in Institutions: selected essays by Isabel Menzies-Lyth. London. Free Association Books 1988. pp. 236-258

Rollinson, R. (2003) ‘Leadership in a Therapeutic environment : “What a long strange trip it is” ‘in Therapeutic Communities for Children and Young People (Ward, A., Kasinski, K., Pooley, J., and Worthington, A. eds.) London : Jessica Kingsley, 2003

Rose, M. (1990) Healing Hurt Minds :The Peper Harrow Experience London: Tavistock/Routledge.

Whitwell, J. (1998) “The Experience of External Consultancy in a Therapeutic Community” in Therapeutic Communities Vol.3, no.3 (1998)