ISABEL MENZIES LYTH AND ACTION RESEARCHbjp_1165 146..151

Lynn Barnett

abstract A brief history of the author’s long contact with Isabel Menzies Lythleads into a description of the latter’s professional training and development and herwork with colleagues at the Tavistock Clinic with whom she had first worked duringthe Second World War when applied social psychology was first developing. Theinfluences of Malinowski and Kurt Lewin are discussed. Then follows a detaileddescription of Isabel Menzies Lyth’s consultation to a day nursery project carried outby Alastair Bain and the author.This spells out how the values and concepts of IsabelMenzies Lyth were applied in this Action Research. The nature of the primary task;the need for a clear organizational structure and roles; a defensive organizationalsystem resulting from anxiety; the need for personal autonomy and individualresponsibility; the importance of close attachments between staff and children;reflective practice; management of anxiety and dissemination of findings.

Key words: Isabel Menzies Lyth, defensive organizational structures, day nurseries,action research, attachment, primary task

I worked with Isabel Menzies Lyth in her role as consultant to a TavistockInstitute action research project in a day nursery for the Department ofHealth and Social Security, between 1975 and 1979 (Bain & Barnett, 1986).But our paths first met 70 years ago.

In 1939 Isabel was a student at St Andrews University and I was the babydaughter of Oscar Oeser, then head of the Psychology Department whereshe was studying and where she first met Eric Trist who was also on the staff.Trist helped her find various jobs, first in the War Office during a vacationand later in WOSB (the War Office Selection Board). Here Isabel met futurecolleagues John Bowlby and Hugh Murray. She later joined the CivilResettlement Headquarters of the British Army, established to help Britishex-prisoners of war to re-settle back into civilian life. After the war Isabelbecame one of a small group of creative social scientists, working at thenewly established Tavistock Institute of Human Relations where she againmet up with Eric Trist; others in the group were Elliott Jaques, HaroldBridger and Wilfred Bion (who later became Isabel’s analyst).

The legacy begun during the war, of applied psychological work in militaryhospitals, officer selection, and civil resettlement continued; individual andgroup psychology was now applied to the workplace in post-war Britain.

lynn barnett phd is a child and adult psychotherapist and an anthropologist. Herphd is from the University of East London. Having retired from the National HealthService, she lives in England and Australia and continues to work on her cross-cultural video infant development series and to consult to children’s institutions.Address for correspondence: [le.barnett5@googlemail.com]

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© The authorJournal compilation © 2010 BAP and Blackwell Publishing Ltd, 9600 Garsington Road,

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Later, Isabel trained at the London Institute of Psychoanalysis andbecame a highly regarded child and adult psychoanalyst broadly in theKleinian tradition, but continued to develop an equally distinguished careeras a researcher and organizational consultant, most significantly in thecontext of nursing, health care, day nurseries and other children’s institu-tions. However, her work also included projects on fire-fighters, centralheating, motor-cycle and scooter riders (boys liked to take their motor-bikesinto their bedrooms and were afraid of falling into holes at night), andchildren’s sweet-eating habits (boys liked sweets which ‘exploded in themouth’, girls preferred ones that they could suck) (see Menzies Lyth, 1988,1989).

I took part in the project on sweet-eating habits and this was the first timeI met Isabel professionally. I was intimidated at first, finding her outspokenwith strongly-held views. However, having recently completed an M.Phil. inanthropology, I was fascinated by her methodology which seemed to besimilar to fieldwork in this discipline.

Margaret Mead (1928) was the first anthropologist to be particularlyinterested in the psychology of childhood and adolescence during her field-work in the South Pacific (having been taught and much influenced by Boaswho had a biopsychological approach). Malinowski (1929, 1931) hadinvented intensive ethnographic fieldwork which involved residence in thefield, learning the language, observation, gathering case material, verbalreports and participation in all community activities. This was in order tounderstand a society from ‘the natives’ point of view’. Malinowski was alsointerested in Freud, famously debating with him on the BBC about theuniversality (or not) of the Oedipus complex. These fieldwork methods, andKurt Lewin’s Field Theory (Lewin, 1997), were favoured at the TavistockInstitute at this time and were certainly part of Isabel’s practice, particularlythat of trying to understand an organization from the point of view of thoseinside it.

In addition to the methodological similarities, there was something uniquein how Isabel combined ‘field work’ (now called action research) with whatshe had gained from psychoanalysis. This was the practice of using research-ers’ subjectivity as an instrument of knowledge, i.e. using countertransfer-ence. This is currently learned in clinical training through infant observationbut it was a new methodology in the 1960s. It was a way of understandingunconscious dynamics that were neither verbally reported nor often evenphysically observed by researchers.

From 1975–1979 Alastair Bain and I worked on the DHSS-funded actionresearch project for which Isabel was the consultant and we carried outthe field work. The aim was to design an optimum system of day care forchildren under five years of age and again, as in her Orthopaedic Hospitalproject, the main aim involved working with the staff to change the indis-criminate group care of young children and high levels of staff turnover, then

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common in most nurseries and other children’s institutions, which she hadfound so damaging to young children’s mental health in her previous workin day nurseries (Menzies, Robertson, Scott & Gwynne, 1971).

It was during this work that I recognized Isabel’s unique approach, linkingknowledge of the unconscious and organizational dynamics in individuals,groups and institutions. Among all the analysts at that time, I think she andHarold Bridger (and earlier in her career, Elizabeth Bott Spillius [Bott,1957]) were the most interested in applying such an encompassing vision ofboth internal and external factors. She was a careful and thoughtful listenerand at our weekly consultation meetings always identified the crucial issuesneeding discussion, distilled from our lengthy reports of proceedings, obser-vations and feelings about the children, parents and staff in the nursery.

Looking in closer detail one can identify her major values during thiswork. We were often reminded by Isabel to help staff keep in mind thenature of the primary task of the nursery, i.e. to support the developmentof healthy young children. The main focus of this was meeting their attach-ment needs which necessitated maintaining continuity of care. This in turnnecessitated developing communication between the nurses and parents –before the project it was only the matron whose role it was to speak withparents.

Isabel stressed the need (as in any institution or organization) for clearorganizational structure and roles within it; particularly the need for staffto know ‘who is in charge’. This was difficult to identify in the nursery asit was part of the then Social Services Department and most decision-making was always ‘higher up’ when we began work. For example, as wellas responding to departmental directives, the matron had 44 forms to fill inmonthly for the Department. She was able to reduce this volume, havinggained more insight and more autonomy as the project went on. She alsodelegated much more to the room nurses, particularly dealing with ‘their’children’s parents.

The anxiety and resulting defensive organizational structure we identifiedas resulting from the staff’s (and parents’) avoidance of being in touch withthe pain and guilt caused by the separation of young children from theirparents or carers where no alternative attachment figure was available.

Isabel helped us analyse the components of this defensive system. Firstly,there was a domestic culture of care which focused primarily on the physicalcare of children and the orderliness and cleanliness of the nursery. Chil-dren’s emotional needs were largely unrecognized; they were treated asmore akin to objects that needed to be potted, cleaned and tidied up.

Secondly, multiple indiscriminate group care was practised. Nurses sawthemselves as interchangeable and their importance to individual childrenwas denied. There were constant staff changes. When we first began work,the yearly turnover rate was 438%. (When we left it was 159%.) Childrentoo were seen as ‘the same’ and therefore all needing ‘equal attention’.

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A third part of the defensive system against experiencing emotional inti-macy with children was not only minimizing contact between staff, childrenand parents but also with referring social workers. This meant that thechildren’s social milieu was not taken into account.

A fourth component of the defensive system was a dependency culturewithin which there was absence of thought and curiosity.A feature of depen-dency cultures is the belief that others will do the thinking for you – others,such as ‘authority’, the matron, the doctor or the researchers. Nurses foundit difficult to think as they experienced a series of disconnected episodes ofattention first to one child then to another; they felt that ‘things happen’; achild behaved in a certain way for no good reason or because of innatecharacteristics. Behaviour was not seen as the result of relationships (Bain &Barnett, 1986).

As the project developed, nurses began to want more personal autonomyand individual responsibility (other major values of Isabel). They began tounderstand their importance to the children and their own individuality.They wanted to organize permanent small groups of named children foreach named nurse rather than indiscriminate group care and to be able toplan their holidays (or leaving) in advance so that known staff could replacethem.The former was achieved but the latter was difficult to achieve becausethe Social Services Department had a system of late advertising for tempor-ary agency staff and recruitment practices that led to a gap of three to fourmonths between a permanent staff member leaving the nursery and anotherjoining, so inevitably the gap was filled by a succession of strange agencystaff. One child aged 5, who left the nursery after attending daily for just overtwo years, had experienced 20 major caretakers (nurses who stayed for morethan a month) plus numerous temporary staff.

Emphasizing the need for individual close relationships between carersand children reflected Isabel’s belief in the importance of attachment longbefore this became universally accepted. Her stress on ‘what is possible’ andher belief in the importance of understanding and working with the politicaland policy-making environment surrounding a project led to meetings withrelevant Department staff which often became quite heated as Isabel wasforthright and could become quite fierce in argument, for example, whendiscussing the long delay over staff appointments. This she felt was unnec-essarily complex, involving the Assistant Director of Social Services givingreasons why there should be a replacement, then obtaining the approval ofthe Director of Social Services, the Chief Officer of Personnel and theChairman of the General Purposes and Establishment Committee!

Reflective practice was another important value championed by theproject. This was enabled during the weekly face-to-face discussionsbetween nursing staff and researchers in each of the nursery rooms and withthe matron. Being given permission to talk about their own personal histor-ies and their feelings, good and bad, involving children, parents and the

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nursery as a whole, also gave the staff a model which they could thenimplement in their work with parents.

Staff were asked to ‘draw how you see your room’ at various times duringthe project. This was an innovative projective technique learned throughfamily research. The staff drawings provided data concerning conscious andunconscious feelings, perceptions of roles and the nursery generally. Forexample, ones done in the early phase of the project showed the effects ofindiscriminate care and the negative feelings this aroused. One nurse said, asshe drew: ‘I don’t imagine individual children, except for O . . .’ (a veryunhappy new toddler who would only stop desperate and continuous cryingwhen on her lap), ‘the others are just round and about’. Another said: ‘I seemyself as encumbered all about with crying ones who are pushing the othersaway . . . I thought of a mass of children around me’ (Bain & Barnett, 1986,p. 72). It was interesting that, as the project continued, staff drawings beganto include parents and named children.

The matron said at the end of the project that other nursery heads hadimagined that the research would end with a list of instructions aboutchanges they would all have to make, but, she said: ‘I can’t evenexplain . . . to my husband so how can I explain . . . to them . . . it’s a changein me that’s taking place, it’s very hard to put into words’ (touching herheart) (ibid., p. 81).

The fact that this anxiety could be managed both within individual nurserystaff as they were supported in becoming more observant and self-aware,and through changes in the organization of the nursery, was the importantconclusion to the project. It is often maintained that this kind of researchincreases anxiety but in fact it makes existing anxiety conscious, which leadsto finding ways of dealing with it. This increases the emotional involvementof staff and leads to greater job satisfaction and stability, all of which wasfound in this single case study of one nursery.

Isabel always maintained that the demonstrated capacity for change inone organization (or one part of an organization) needed to be disseminatedso more change could be generated. However, dissemination is not withoutits difficulties. When we reported on our work at conferences and meetingsnursery staff tended to say: ‘But this doesn’t happen in our nurseries’!

Similar denial occurred when James and Joyce Robertson reported on theemotional consequences of young children staying in hospital without theirparent(s). It was only after they started to show their films that doctors andhospital administrators began to act (Robertson & Robertson, 1989). Thisled me into my own film work concerned with cross-cultural infant devel-opment and children’s institutions of various kinds (Barnett, 1987, 1988,1989, 1993–2005, videos 1987–2005). There is a reality to the moving imagewhich cannot be denied as can the printed word (Barnett, 2006).

So, through working with Isabel, I came to understand the importance ofthese values when working with individual patients or institutions, and I

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believe that, in principle, they are still relevant today, 30 years later. I alsolearned that change may be very slow, something about which she too feltfrustrated.

After the day care project ended, was written up and began to be dissemin-ated (and Isabel’s practicality and dislike of jargon helped enormously), Icontinued my working relationship with her because she supervised one ofmy adult psychotherapy training cases.

Gradually, as we discovered other common interests such as gardening,cats and mutual acquaintances, we became friends. Her last weekend awaywith her husband, Oliver Lyth, was spent in my small 16th century cottage inDevon. Oliver made a lovely pen and ink drawing of it which Isabel gener-ously gave me after his death.

References

Bain, A. & Barnett, L. (1986) The design of a day care system in a nursery setting forchildren under five. London: TIHR Occasional Paper no. 8.

Barnett, L. (1987) Buddle Lane: A Day Nursery Becomes a Family Centre. Videotrilogy.

Barnett, L. (1988) The Anna Freud Centre: The Nursery School and the ToddlerGroup. Video trilogy.

Barnett, L. (1989) Enriching Day Care: A Comparison of Different Principles andPractices. Video trilogy.

Barnett, L. (1993–2005) Four video series on cross-cultural infant development inWestern India, Nepal, Finland and UK. (For all video details contact: le.barnett5@googlemail.com)

Barnett, A. (2006) Creating and using video for teaching child development and thecare of young children: Learning from experience. International Journal of InfantObservation 9(2): 179–89.

Bott, E. (1957) Family and Social Network. London: Tavistock.Lewin, K. (1997) Resolving Social Conflicts and Field Theory in Social Science.

Washington, DC: American Psychological Association.Malinowski, B. (1929) Sexual life of Savages in North-Western Melanesia. London:

Routledge.Malinowski, B. (1931) Culture. Encyclopedia of the Social Sciences 4: 621–46.Mead, M. (1928) Coming of Age in Samoa: A Psychological Study of Primitive Youth

for Western Civilisation. Introduction by Franz Boas. New York, NY: Blue RibbonBooks.

Menzies, I., Robertson, J., Scott, S. & Gwynne, G. (1971) An Action Research Studyof the Day Care of Children Under Five. Report to the DHSS. Tavistock Instituteof Human Relations.

Menzies Lyth, I. (1988) Containing Anxiety in Institutions. Selected Essays, Vol. 1.London: Free Association Books.

Menzies Lyth, I. (1989) The Dynamics of the Social. Selected Essays, Vol. 2. London:Free Association Books.

Robertson, J. & Robertson, J. (1989) Separation and the Very Young. London: FreeAssociation Books.

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