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This book, carefully edited by David Armstrong and Michael Rustin, owes its origins to a two-day research colloquium dedicated to re-examining Isabel Menzies Lyth’s seminal (1960) paper ‘A case-study in the functioning of social systems as a defence against anxiety: a report on the nursing service of a general hospital’. Collections of papers to appreciate, develop or interrogate an idea that has caused a paradigm shift can be spoiled by sycophancy or repetition and deplete the original source let alone the secondary ones. However, this accessible, thoughtful and richly varied book allows a rethinking of Lyth’s work as well as an appreciation for the applications of psychoanalytic thinking into organisational work.
Isabel Menzies Lyth, a child and adult psychoanalyst and social scientist who died on 13 January 2008, was one of the pioneering founder members of the Tavistock Institute of Human Relations, established in 1946. Her work has continued to aid all working in hospitals as it showed how the frontline work of nurses left them more vulnerable to the powerful projections and pressures that came directly from their patients as opposed to those furthest away in management who were freed from these. Indeed, as a wartime nurse who benefited from Lyth’s understanding once jokingly explained to me, ‘From a management point of view, patients interrupt the smooth working of a hospital!’
Lyth’s work continued to be crucial for child psychotherapists as she showed the importance of parental presence in hospital wards and highlighted the damaging practice of indiscriminate multiple caregiving. In this way, like Bowlby, she was committed to the importance of attachment and key workers for vulnerable children and adults, but her main and continuing influence both in her lifetime and following her death has been in applying psychoanalytic theory to the workplace. By understanding the specific impact of the client group on staff and institutions and balancing the impact of inte