Professional doctoral theses: D10D

Inner self-critical voices are scrutinising, attacking, and discouraging. They are also a pervasive part of human nature, which seems to have become more dominant in current times. This qualitative research study examines the effects of self-doubts and self-criticism on individuals holding a leadership role at a point of transition in the workplace.

Taking a systems-psychodynamic perspective, this study aims to explore the origins and consequences of self-doubts, looking at both the individual (intra-psychic) perspective as well as the systemic (psycho-social) aspect of self-doubts. Situated within the social-constructivist paradigm, case study was chosen as a research design strategy and Grounded Theory methodology was used for data analysis. Semi-structured interviews were conducted with a sample of eight participants in leadership positions who had experienced a role transition while working in commercial organisations.

Key findings suggest that the impact of self-doubts might be linked to the individual’s self-worth, sense of belonging, and need for external validation. An elite group identity, created as a social-defence mechanism, is collectively and unconsciously developed by members of an organisation to deal with self-doubts anxiety. Looking beyond the individual’s intra-psychic experience, another significant finding in this study is linked to the specific characteristics of the wider organisational and societal contexts in which these leaders operate, and the impacts of these characteristics on these individuals. The overlap between the individual and the system seems to create a re-enforcing cycle of self-doubts anxiety, which might have detrimental consequences for individuals and organisations. On this basis, it is recommended to create space for self-reflection and interventions at individual, group, and organisational levels, using an integrative approach to deal with the impact of self-doubts.

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The aims of the study are firstly to investigate the suitability of the work discussion method as a consultancy change intervention in solving specific work issues in the organisational context of public sector services, and secondly to consider the viability of work discussion as a research method.

This study has little substantiating research precedence to draw on and as such is one of discovery and understanding. The work discussion method is a systematic experiential small group process founded on the principle of the importance of emotional experiences, both conscious and unconscious, of work and the workplace in shaping understandings of role and of organisational life. This consultancy application of work discussion is a process of reflecting on specific issues with the intent of evoking a changed state in either thinking and or changed behaviours. As a method it is both concerned with individual learning and with shared learning.

This is a small in-depth qualitative study following the principles of grounded theory and informed by systems psychodynamic theory. The research participants of this study come from a range of children’s and young people’s education and welfare services, predominantly in the public sector but also including one partner service from the voluntary sector. The findings of this study suggest that the word discussion method when applied as a consultancy change intervention has merit. The research participants during the life of the research study made notably changes to their understandings and or behaviours in their work situations.

This thesis uses biographical narrative interviews to follow the lives of four individuals who have been successful in a variety of creative careers. It explores the development of their individual creativity through the inter and intra-psychic experiences that have helped or hindered the development of their creativity; how these early experiences manifested in later life and the relevance this has had on their careers and on the organisations they have existed in.  

The findings show four main states of mind / valences in the enactment of creativity: connecting, disrupting, outsiding and storytelling, and explores how they emerge through the participants’ experiences. There is an exploration of the interconnected relationship of each of these valences and how the participants’ creativity flows between them from the point of initiation to enactment. It also explores the way the participants create a space that invites others to join them in their creativity and how organisations can either give them a space for their creativity to emerge and flourish or become too restrictive for it to be initiated.  

Finally, this thesis places the findings in the context of existing theories within the psychosocial field of individual and organisational research to consider possible implications for the wider field of study. 

Over recent decades, ‘lean’, ‘activity based’ and ‘agile’ working environments characterised by a non-proprietorial use of space and resources, networked communication, and porosity between experience in public, private and organisational contexts have proliferated within organisations. As this transformation of the physical territory for office work has taken place, the concept of the ‘vanishing organisation’ was proposed (Cooper and Dartington, 2004; Cooper and Lousada, 2005) to provide an account of how in a networked society, established mechanisms for sustaining emotional containment in organisations, through the maintenance of concrete and symbolic boundaries, appear to no longer function or even exist. The research explores the extent to which the contemporary workplace might be supportive of or deleterious to emotional containment in organisations and its implications for theory, practice and research within the systems psychodynamic approach to consulting.

Social photo matrix focus groups were convened at four organisations which deployed elements of ‘lean’, ‘activity based’ or ‘agile’ workplace design to record narratives of the felt experience of place at work, with further data gathered from detailed case notes covering the researcher’s engagement with each organisation and personal reflexivity, in part drawing upon their personal memory of place in a transient institutional, organisational and domestic context as a military child. In-case analysis was carried out using a grounded theory exercise where social photo matrix transcript text was used to develop axial codes which for each workplace abductively invoked Freud’s exclamation in the Aetiology of Hysteria of “saxa loquuntur!” [the stones speak] (Freud, 1896), as well as its manifestation of ‘murality’ (Cox, 1995; Adshead, 2019), a concept developed within forensic psychotherapy to refer to the experience of an instrumentally derived and beneficial experience of ‘wallness’ realised through the pairing of a bounded perimeter with an emotionally containing organisational and institutional culture. This exercise generated rich and emotionally evocative data for each site relating to the felt experience of place, as well as tentative indications of the manifestation of patterns of emotional attachment (Bowlby, 1969; Ainsworth et al., 1978), basic assumption function (Bion, 1962) and ‘commensal’, ‘symbiotic’ and ‘parasitic’ forms of containment (Bion, 1970). Further cross-case analysis of the gathered grounded theory axial codes helped develop the hypothesis that rather than instrumentally facilitating emotional containment, the workplaces served to both reflect the particular forms and levels of containment arising within each organisation’s already-existing culture, and in certain circumstances, to reinforce them.

This action research project lays the groundwork for a living theory of practice related to the creation of holding environments at work in the context of organisational transition, development and change. I understand holding environments at work to be interpersonal or group based relationships that help individuals to manage situations that trigger potentially debilitating anxiety, loss or excitement in the workplace.

The action research project was carried out over an eight month period in a university setting. There were two projects co-existing in parallel. There was the project on which I was working within the university, which was a business and executive coach training programme for seven senior leaders, and there was the doctorate thesis action research project which inquired into the creation of holding environments at work. Inquiring in the present tense with triple attentiveness to the outer data of sense, the inner data of consciousness, and the intellectual data of my understanding, I show how I created a holding environment, and how, the seven senior leaders began to learn how to create holding environments for their own organisational clients. The university was going through major organisational change at the time of the project.

The results show that seven key elements emerged in relation to the creation of holding environments. These include negotiating with key parental figures within the organisation, creating psychological safety in the group, the use of dreaming and reverie, communicating with group participants including attuning, mirroring and marking, affect regulation and mentalization. In addition, holding environment-in-the-mind also impacted on how holding environments were created in the university setting. The application of this research to a broader context is discussed as well as how this research might be useful for organisational consultants and leaders in attempting to create holding environments at work.

Having encountered significant resistance in both leaders and myself as a consultant when providing systems-psychodynamic cultural feedback, I set out to investigate the experience of illuminating the unconscious elements of organisational culture, both for organisational leaders, and for the researcher.

Taking a single case study approach, within the Royal College of Surgeons, I applied psychoanalytic observation alongside a systems-psychodynamic supervision group to gather both conscious and unconscious data around organisational culture. I also incorporated organisational members’ experience of culture through focus groups and captured my own experience in a research log. Characterising organisational culture as ‘ways of being’, thematic analysis generated twelve cultural themes which I then illuminated with organisational leaders in a feedback loop. I captured leaders’ experiences of cultural illumination in subsequent interviews and recorded my own experiences in narrative form. Interpretative phenomenological analysis (IPA) of leader experience yielded four master themes – Positive Awakening; Stimulating or Stuck?; Group Therapy; Painful or Painless?

Applying a systems-psychodynamic perspective, I hypothesised that leaders dealt with these positive, negative and nearly unbearable experiences of cultural illumination by splitting good/bad elements between themselves and utilising myself as a metabolising container of organisational anxieties. Conducting IPA on my researcher narrative generated three master themes – professionally engaged, hopeful & relieved; defensive, wary & impeded; useless & guilty. Discerning countertransference, I interpreted ‘useless and guilty’ as a 13th cultural theme and unconscious way of being. In a systems-psychodynamic frame, this could be understood as the organisation unconsciously processing the uselessness and guilt which arises for their surgeon members around death in surgery so they can continue to operate.

This research has innovatively applied IPA to researcher narrative as a means to access and interpret researcher countertransference in psycho-social research. It has also offered a practical methodology to illuminate organisational culture at both conscious and unconscious levels.

My research uses a psychosocial approach to undertake an exploration into general practitioners’ (GPs) experiences of current changes in healthcare delivery. Under the impact of the neoliberal paradigm and the challenges of running a general practice, GPs appear to have been retiring early, and it has been hard to recruit GPs for some years. At this time, when we are seeing an ageing population, increasing incidence of chronic comorbidities, and the development of clinical technologies, the biopsychosocial model of medicine has to contend with much complexity. Moreover, the nature of primary care is such that the business of general practice is also being challenged by the processes of commissioning, bidding and contracting required to sustain income and viability, with some practices joining together to form primary care networks in order to survive. All of these varying elements beg the question: what defines GPs’ primary tasks, roles and systems, and how might their motivation and identity be affected by this situation of clinical complexity and financial challenge in the healthcare context? Bringing in concepts from systems psychodynamics and organisational consultancy, this thesis considers both the doctor- and organisation-in-the-mind.

Using a qualitative approach to explore these dynamics, semi-structured interviews were undertaken with 12 GPs at different stages of their career, with different interests and responsibilities. Ten themes were identified as pertinent to the sample, to varying degrees: 1) the long-term patient relationships – dependency and intimacy; 2) identification with the role, and the GP surgery as a second home; 3) underpinning ethical value systems; 4) satisfaction in one’s role as a clinical GP; 5) the systemic leadership role; 6) being overwhelmed by the context; 7) a business-minded approach to the financial state of the surgery and context; 8) determining one’s own timetable; 9) one’s own family or illness as a motivator; 10) family aspiration as a motivator.

Three major clusters of responses were identified, revealing three GP types with varying social defences and valencies for individual and group functioning. iii The neoliberal paradigm, together with managerialism, changes in funding methodology, the erosion of social support systems, an ageing population, advanced medical technologies and other issues, appear to have disrupted GPs status as the family-doctor-in-the-mind committed to caring for patients from cradle to grave. An increasing ambivalence about meeting the demands of patient dependency, and a turning away from the responsibilities of full-time partnerships in general practice, is an identifiable trend. In addition, my research identifies the alternative allure of entrepreneurial activity and engagement with both organisational demands and novel clinical pathways in the wider system of healthcare. Through the application of the metaphor of the periodic table, a hypothetical model is tentatively offered comprising the three GP types in order to consider not only the effect on individual GPs but also the possible impact on general practice as an institution.

This qualitative study was based on the experiences of three female leaders in the charity sector in the UK. The research question was developed to focus on understanding what motivated their sense of resilience, and if their experience was reflected in current literature on resilience in leadership. The topic was inspired by my own experience of being a female senior leader, and a curiosity about whether the leadership role amplified or undermined the experience of resilience for women leaders.

Women leaders were invited to be considered for the study through an open call on key professional networks The study was undertaken in part during the global pandemic and as such there were some modifications including virtual interviewing. The research method included two interviews with each participant, and they submitted reflective logs. An advisory group of three additional female leaders were recruited to form a reflexive space in which we could interpret the data and think together about the meaning and relevance to the research question. By exploring the theories from a systems psychodynamic understanding of leadership, resilience and feminist theory, the research used a constructivist epistemological lens to interpret the findings from interviews, reflective notes, and advisory group discussions.

The study revealed insights into the complexity of women’s experiences within their leadership role and considered how we can understand the intersectional demands of role, the ‘social’ task of a charity and the hostile environment towards women. The study revealed that women leaders are at greater risk of experiencing challenges in their role related to their gender, these included discrimination, micro and macro aggressions in the workplace. The consequences of these threats created psychological processes i.e., social defenses against anxiety, shame and envy. I have called this process for female leaders The Joan of Arc Effect.

The Joan of Arc Effect described several dynamics relevant to the experiences of female leaders, it includes the idea that resilience is motivated by a need to survive, which can be a paranoid schizoid formulation of resilience. In addition, leading charities can create the conditions for leadership shame, which has associations particularly for women. These leaders do not anticipate or have additional support from other women, they cannot rely on a sense of sisterhood. In conclusion, the research identified what has been helpful for women leaders and these have been termed The Mitigations. They can support women to move from a paranoid schizoid formulation of resilience to a depressive position functioning of resilient leadership that relies on feminist principles of deep reflection and communalism. The study has recommended that Feminist Leadership could be considered as a model which is inclusive of the Mitigations and drives the conditions for equality.

The research on which this dissertation is based was conducted in two steps. In an in-depth literature review, various approaches to group-as-a-whole phenomena from psychoanalytical and non-psychoanalytical perspectives were identified and described.

The second step comprised interviews with six participants in working groups in organisations. Interpretation of their reported experiences revealed group-as-a-whole behaviour patterns, which can be made visible with a model that differentiates between task-oriented and non-task-oriented behaviour and between active and passive behaviour.

Use of the psycho-social perspective showed that it is not only the researcher who is in contact with a number of anxieties around groups; this phenomenon affects other group participants as well. The usual defence mechanisms are keeping one’s distance and trying to control the group.

This study examines how a member of an organization comes to recognize and react to wrongdoing in their workplace. The impact on an individual of perceived systemic processes at the level of the organization and the wider culture which encourage silence or grant voice is analysed within a social constructionist framework. This focus allowed a more holistic understanding of the decision to speak out or remain silent in the context of organizational wrongdoing.

The aim was to produce a plausible and explanatory account of bystanding and whistleblowing, acknowledging that those processes are complex and co-constituted from the interplay of social and psychological processes. In a small way, I hoped to generate testable hypotheses about key processes which explain how people situated within a specific set of norms, faced with organizational wrongdoing construct meaning and make choices about ethical practice. Nine participants, drawn from a range of organizational contexts, who had raised concerns about wrongdoing within their employing organization were interviewed individually. They were asked to narrate their biographies up to and including the process of speaking out about their concerns. Two further participants, who were bystanders in two of the whistleblowers’ incidents were interviewed using the same approach. The interview data was analysed using grounded theory. The research procedure gave participants space and a process which provoked reflection and some newfound perspectives.

Initially an analytic account of the stages and processes leading up to speaking out or remaining silent was obtained. Then the data was re-analysed, using the Transforming Experience Framework (Long, 2016) to explore in greater depth how the organization-in-the-mind was composed in each case. The goal was not to develop a causal explanation but to reach an understanding of how self, role and system interact in shaping a whistleblowing episode. Investigating the complexity of the full situation of inquiry requires that discourses at the cultural level, should also be examined. Therefore, I conducted a supplementary study of representation of whistleblowers in film. I explored the relationship between historical contextual factors and the changes to the portrayal, of the whistleblowing act, to draw out how discursive concepts construct the subject of the whistleblower. Popular films featuring whistleblowers were sampled across decades and their narratives were scrutinized using situational analysis.

Findings showed that the pathway to speaking out has shared stages and processes, but that the route to speaking out or keeping silent is both iterative and highly individual. Systemic factors were found to inform the process at every stage. Whistleblowers attachment to a contested version of the primary task, when they perceived the alternative version of task to be associated with perversity led them towards raising concerns. Experiences of occupying roles in their earlier life were reflected in how they managed their attachment to organization. Being let down was also formative. Those experiences collectively pushed them towards a new attachment to a parrhesiastic self and to attempts to rescue the organization. The bystanders were aware of the same problems within their organizations but, helped by an allegiance to an alternative professional discourse, were acquiescent. The cultural context of the ‘market civilization’ shaped the discourses and practices operating within the organizations in the study and contributed to the construction of what was recognizable behaviour within the organization.

The implications of these findings for professional practice were discussed. The results point to the value of enabling consultants and other change agents to understand the systemic constraints which make wrongdoing invisible or deter staff from challenging what they see and to develop strategies to empower people within organizations to reach a position where they are prepared to speak out.

This thesis is based on a research study conducted into understanding the uncanny and mystical influences developing leadership thinking. Using biographical interviews, the study examines how leaders use such alternative perspectives during periods of rupture and uncertainty in their professional careers. I will also consider how personal and professional biography is convergent in participants’ understanding of the need for irrational thinking in response to the increasing logic of work. The thesis will go on to explore how the formation of superordinate objects may provide containment when other complex systems appear unable to do so.

This thesis explores dimensions of culture in the UK financial services. Through narrative interviews, it considers the experience of the industry and examines how culture can be formed through influences stemming both from the industry’s internal dynamics and wider societal contexts.

The study analyses how the dimensions of culture might influence behaviours that have had an effect on the UK’s economy, such as the global financial crisis of 2008. The study further questions whether the crash was the product of the culture that existed before the crisis and which persists within the industry. The overall system – consisting of consumers, firms, regulators and governments – is taken into consideration.

This is a select yet focused study and the unit of analysis is individual narrative interviews, through which the study attempts to access some of the systemic dynamics that may be present in the industry. The study does not claim to define culture in a singular sense, in what is a complex and diverse industry; instead, it attempts to draw out key themes from the data set that could shed light on the dimensions of culture.

This study uses a systems psychodynamics approach, which takes into account the idea of unconscious group dynamics and open systems. Grounded theory has been employed to analyse the data and form a theoretical understanding.

This study provides a systems psycho-dynamic exploration of leadership development in next generation members of family-owned businesses. Utilising biographic narrative interpretive method (BNIM) and grounded theory, it analyses five self-narrated life stories of family business successors. The research uncovers how the interplay between family dynamics, family and business systems, and societal context shapes leadership development. Key findings reveal that the family system, often reflective of the business’s emphasis on efficiency, success, and competition, profoundly influence the leadership trajectories of the next generation.  

Three distinct relational patterns emerge. Firstly, those who are seen as “natural successors” are required to conform to family expectations, enclose subjectivity, and renounce authorship (“the restrained”). Other patterns suggest that if an adequate facilitating environment is offered, rivalry and competition can encourage intellectual and creative capacities and foster a desire to later join the business (“self-authorised competitors”). However, if not being seen as a potential successor is seen as rejection, this may trigger unresolved feelings of envy and jealousy, which in turn spur a narcissistic need to “prove the world wrong” (“the rebellious”). These three patterns are understood as transitory states of mind, or momentary related positions, that are dynamic in nature.  

The concept of “virtuous betrayal” underscores the need for next generation leaders to challenge and transcend established familial norms and covert agreements, fostering personal growth, differentiation, and the development of personal authority whilst preserving a sense of interdependence amongst family members. The research suggests that successful succession and the assertion of authority by the next generation are contingent upon resolving the Oedipal complex and providing adequate reflective space within the family system. Additional findings connect leadership development to the capacity to disentangle oneself from unconscious group alliances, which enables next generations to challenge the meritocratic ideal and maintain a more realistic perspective of the wider social context. 

Systems-psychodynamic scholars have paid limited attention to organisational dynamics in organisations whose task includes addressing climate change, but the experience of working in such organisations is increasingly significant as the climate crisis intensifies.

This phenomenological study convened a group of leaders in organisations that engage the UK public on climate change (climate change communication), for seven meetings over eleven months. The results are analysed and the experience explored using an innovative combination of Co-operative Inquiry, Interpretative Phenomenological Analysis and a systems-psychodynamic lens. Methodologically the study contributes new links between these three fields and proposals for how Co-operative Inquiry can be appropriately managed.

The study identifies seven themes: exclusion, shame, sexualised excitement and threat, splitting, a sense of fragility, an uncertain relationship with authority, and difficulties with grieving. These themes represent social defences that can be seen as characterising the experience of participants’ work. The emotional flavour of these social defences resonates with the climate emotions proposed by the existing body of climate psychology literature. A tentative proposal is made that working in this field constitutes a traumatic epistemological, social, and emotional experience; and that the fact of the traumatic experience, and the fear of annihilation that its elements carry, is the ‘unthought known’ in this work.

Organisations that engage the public on climate change, it is proposed, may unconsciously activate a version of the ‘internal establishment’ that exists to defend against the unthought known, with the establishment unleashing perverse dynamics and other defensive mechanisms such as shame, with a particular focus on maintaining the split polarities and thereby preventing genuine connection with others who are different. New connections are made between climate trauma theory and organisational social defences. Psychoanalytically-informed and ecopsychological trauma scholarship are explored to identify steps that could be taken to support people working in climate change communication and related fields. Further research is proposed, including organisational observation and biographical exploration.

This thesis studies the dynamics of lateral collaboration in corporate organizations by focusing on how senior leaders experience lateral relations in such contexts. Increased business complexity and the nature of organizational challenges require enterprise collaboration across boundaries, where leaders cannot exercise their formal hierarchical authority.

This research is an in-depth mapping of lateral relations and the dynamics they induce. It studies the inner experience of role-holders. It allows those leading and studying organizations to consider enabling conditions for enterprise collaboration at a senior leadership level. The study comprises four independent cases of senior leaders, using the biographical narrative interpretive method (BNIM). Each in-case analysis surfaces subjective inner relational and authority models that influence the subjective experience and choices of a role-holder within lateral relations. Discerning patterns in dynamics and experiences across cases allowed the development of an ontological picture of lateral relations in leadership that could be studied independently.

The findings showed three distinct phenomena of relational dynamics: mental ranking (MR), relational dimension confusion (RDC) and relational morphing (RM). Studying their causation produced a definition of the attributes of lateral relations and the evolved nature of formal authority in contemporary organizations. These findings can aid leaders and organizational practitioners to navigate challenging dynamics and contextualize their experience, whilst becoming more task effective in collaboration. Finally, the thesis places these findings within the historical evolution of systems psychodynamic thinking of the lateral and the vertical axis. It highlights the need to continuously re-examine ontological definitions when studying highly subjective relational phenomena within contemporary organizational paradigms in which authority and hierarchy keep evolving.

Little is known of the professionals who dedicate their careers to advancing science in the pharmaceutical industry: What might it mean for them to leave home and join this industry with its double focus on health and wealth? This qualitative research explores the experiences of migrant professionals who go to work in Switzerland’s highly regarded pharmaceutical industry, considering the question of how they take up their role given the concerns of health and wealth – easing suffering and creating profit. The question arose from my coaching work with migrant professionals where I noticed a pattern of addressing issues regarding role, power and authority through exploring the younger self whilst bracketing off the present self. This study’s research data draws from qualitative depth interviews with migrant professionals who work with or adjacent to the science. The lack of extant research opens up an opportunity for new ideas to be created using Biographic-Narrative Interpretive Method for data generation and Grounded Theory for analysis, and finally distilled into 3 ideas. The study looks at the research data through the lens of systems-psychodynamics, which, like a microscope, examines the less visible material, including unconscious communication. The ideas are: 1. A permanent state of temporality: competition and entry being regulated as migrant professionals contend with the tensions of health and wealth. 2. The bonding of migrant professional and molecule: the industry’s health and wealth focus creating an intense relationship between migrant professional and molecule. 3. Emotional refugeeism: a social defence against projections into the migrant professional and focusing on the task’s ‘uncontestable’ good. The implication for practice is a deepening view of social defences amongst migrant professionals in this industry. It may have relevance to sectors reliant on migrant professionals with a double humanitarian and financial task.

This thesis is based on a research study conducted into the experience of head teachers in their role of leaders in primary schools. Using biographical interviews, the study examines how participants have negotiated periods of change and challenge in their professional role.

I will also consider how personal and professional biographies converge in participants’ understanding of role, leadership, organizational change and stress, and how wider organizational, political and social forces impacted upon those in role. 

The thesis will then go on to explore and attempt to extend some of the thinking related to the concept of the organization‐in‐the‐mind (Armstrong, 2005), which appeared, through the narratives of each participant to have considerable relevance to their understanding of professional role and indeed perhaps more significantly their performance in role.  

The purpose of this study is to explore the relational territory between the arts-related consultancy organisation ABS (not its actual name) and sixteen clients, during a period of six years. The company set out, at the start of this period, to explore the potential of bringing together the practice of consultants who used a Tavistock, or system psychodynamic approach, to organisational consultancy with the practice of artists whose aim was to promote or facilitate creativity. The motivation for the study was the frustration felt by the researcher (the co-founder and CEO of the company) and her colleagues that clients didn’t seem to take the work seriously and wanted to book ABS to do something other than the combination of consultancy and creativity being offered.

An approach based on Grounded Theory was developed and adapted to fit the specific kind of data used in the study – mainly the researcher’s own process notes, email communications with clients, and accounts of various sorts of meetings.

The study discovered a series of unconscious roles to which consultant, artist and client were assigned in this context – ultimately exploring a dynamic of three in which the consultant was excluded from a pair consisting of client and the artist in-the-mind of the client. The study explores the possibility that the partnership was set up unequally at ABS and this may have pre disposed the pair, of consultant and artist, to splitting – and played a part in attracting a particular set of clients, at a particular time, pre disposed to make use of such an unequal pairing. The potential for developing the dual technology originally imagined is re-examined in the light of these findings.

Accounts of consultancy in other contexts are reviewed. The researcher suggests that her whole context approach to assessing the work of her company is unusual and adds to the field a particular sort of account which differs from the more usual case study or review of themes in client organisations.

Increasing technology use in the organization of human services is seen as essential to achieving greater efficiency and effectiveness. However, the promises may not be realised if technology generates processes and structures that are misaligned to the primary task of the service. How and why this occurs, and the role of unconscious and emotional factors, is insufficiently understood. There is limited guidance on how to work with technology in complex services where anxiety, and defences against it, may be a significant factor.

Drawing on systems-psychodynamics, actor-network and process theory, this research addresses these gaps through a methodology in which human and technology are seen to operate symmetrically in the ongoing formation of organizations. The research studies child welfare and mental health services as an ‘extreme case’ for technology implementation as the site of significant transformation and powerful human dynamics. Data are gathered via a visual method known as the social photo-matrix in which participants, all practitioners in these services, generate and respond to images on the theme of ‘technology at work’.

It is found that technology reduces an organization’s capacity for processing emotion which leaves staff with increased anxiety and fewer ways to modify it. Technology mediates organizational processes to make them fit the models of measurement and efficiency by which it operates, and transforms the reality of services both on the ground and in the minds of the people within them. It is concluded that these processes make staff less available to provide compassionate, empathic care for service users, and generate organizational processes that may not be aligned to the task of providing human services. The implication for leaders and consultants is that it is only possible to realise the promises of technology if it is engaged with thoughtfully, in an environment where anxieties can be managed.