288
MIRRORING: ONE VEHICLE TO ORGANIZATIONAL CLARITY LOWELL
COOPER,
PH.D.
The author would like to acknowledge thanks to Doctors Arthur Colman, and Richard Shadoan for their helpful critical readings of earlier versions of this paper. This paper was written while the author was a Staff Psychologist at Mount Zion Hospital and Medical Center, San Francisco, California.
Phyllis Kemper,
overall view of ’psyche’ O FTENmanagement from people directly it level, the
of an orginisation is virtually hidden involved in any of the organisational sub-units, even at a and is even difficult from a more objective, overview position as in the role of an outside consultant to see the whole picture. The concept of mirroring, which will be defined and described in this paper, is generally applicable in attempts to clarify organisational life. The author’s primary familiarity with mirroring processes has been through rather small and relatively conceptually manageable work settings, (as psychiatric organizations, and temporary conferencelaboratory institutions), and so this kind of setting will be focussed on in writing since it does not negatively affect the validity of the concept. In the present paper there will be a definition of the mirroring concept and elaboration of its utility in one particular kind of context. The phenomenon has appeared in a wide variety of social system writing although it has yet to be formally discussed as such. Nor have substantial causative hypotheses been suggested, at least to the knowledge of this author, and this can be partially attributed to an incomplete conceptual understanding of thinking in terms of mirroring. The task of formalising the concept seems the primary one at this time. The organisational orientation in which this paper is embedded is the formal dynamic model of general systems theory as developed by von Bertalanffyl~ and applied to human institutions by A. K. Ricel2. In this model human systems are seen as total functioning dynamic units which are open; that is, while a given system is definably separable from other institutions, its boundary is a permeable one and so the inner working of the system can be and is continually influenced by forces which members of it experience as coming from outside. The total system is also thought of as having sub-units which are definable entities, constantly interacting with and open to influence from other sub-units within the total system. The so-called boundary around both the sub-units within the system and around the system as a whole is a conceptual mechanism for describing two things: 1. A group of regulatory and monitoring functions which go in in all systems, and which can be considered in human organisations (of which business is certainly an example, as well as families and other group configurations) to relate to the management role. 2. An aspect of the internal experience of the organisation member who senses himself to be part of one sector but separate from other sectors within the total system; or, part of one total organisation, and not a part of another organisation with a similar function and geographical contiguity. It is really an experience of a difference; and this usage is an extension and broadening of the boundary concept as developed in ego psychology by Federn5. an
the view of
Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
289 At this point it seems appropriate to define mirroring itself, referring to illustrative material to both concretise the concept and its sub-parts, and demonstrate its utility within an institutional work context. I.
and explanation ofconcept. is defined as a process ofassessment ofinfluence between interacting, bound, social sectors (as sub-units within an organisation, or two or more integral institutions) through which covert and/or overt dynamics in the entire field of interaction are reflected within the sectors. So, dynamic issues on a ward as a whole will be played out within the patient and/or staff groups; dynamic issues within a total psychiatry department will be played out and reflected in various sectors of the department, etc.* As a way of explicating the concept in more detail, specific aspects of this definition will be discussed separately. The phrase &dquo;process of assessment&dquo; refers to the major use of the concept as a working notion in an institution to attempt to understand at any moment in time the work state of a system. While the phenomenon may at times be focussed on when there is something exeperienced by members as wrong in system operation, and then assessment has a more diagnostic purpose, the phenomenon occurs as readily when all is going well. The choice of the word assessment is meant to point out that many processes in human groups are in dynamic flux and whether or not something is seen as wrong with functioning at any one point in time, it is possible to assess the level of functioning by using observations of a mirroring type. The concept is useful insofar as it facilitates in the exposure and understanding of system operation, in much the same way that regular medical check-ups involve assessment or evaluation of physical functioning which may or may not be connected with the presence of illness at the time of examination. The examination process itself clarifies the current working state of the organism. Next, the idea of &dquo;influence.&dquo; Mirroring processes are not intentional brainwashing or manipulation phenomena, but occur primarily out of the conscious awareness of membership of both groups. The nature of the effects is interfluent and transactional (as described by Grinker~), more correctly than influent, in that they occur simultaneously in both directions, and it is when the balance of influence has been upset by prolonged influence in one direction, or when the total organisation can be observed over a period of time from a relatively objective outside perspective, that the effects of the mirroring are dramatically noted. The issue of &dquo;interacting, bound, social sectors&dquo; is an attempt to put in formal terms the idea that mirroring is observed in the context of at least two separate, interacting groups. Since the concept of a boundary around an open system is crucial to understanding this point, it seems necessary to exemplify this concept in a concrete setting. There are many boundaries within a relative micro-unit as a small psychiatric ward, such as separable programme units with relatively clear boundaries, and people who function to control the boundaries. Within psychiatric wards in general (and the unit referred to in particular) the largest bounded systems are staff and patients : a bi-cultural situation. One
Definition Mirroring
* The notion of mirroring is in part based theoretically on the concept of splitting in projective identification, as developed by Klein 9, described and elaborated by Rosenfeld 16, and applied to group settings by Bion 7. The idea of projective identification is a conceptually difficult one but has to do with the individuals (either infant or primitive adult) tendency to split off unacceptable thoughts from within the self and to put them within an out-side object and then experience them as external.
Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
290
psychiatric programme was built with the primacy of this difference in mind (which, incidentally, reflects and builds upon the attempt of Edelson6 to bring such systems thought to psychiatric work).* The ward is seen as the containing two cultures with virtually diametrically opposed value structures: Patients see themselves as being helpless, accepting the hospital in order to be passively changed, having to solve their psychological problems before they can return to their outside life, and in need of curative staff magic. Staff, on the other hand, has values which include the belief that hospitalisation itself is the current major crisis in a person’s life, that independence is better than dependence, and that it is possible to function in a responsible way along with having and solving problems. These sets of explicit, overt values are essentially brought by both patients and staff to all interactions involving them both, and the staff job is in part to transmit their values to members of the patient group through ways in which they function in role. Whenever patients and staff intermingle, or in more formal terms, whenever these two clearly bounded groups intermingle, it is likely and natural, if not inevitable, that processes of mutual influence will occur. So, while ideally it is hoped that staff would influence patients in the balance, we also know that patients will influence staff and at best it can be hoped that such an influence can be controlled in the desired way in most instances-or else staff thinking and action will begin to emulate patients. It is around processes of mutual, dynamic inter-group influence that the concept of mirroring becomes critical. Turning to the &dquo;entire field of interaction&dquo; nation, related to the boundary concept, if
one examines interactions between sub-units or sectors of a ward programme, then information will likely reflect something about dynamics within the total programme, on the ward as a whole. There may be also in such sector interactions, information about the state of the larger department or hospital of which this ward is itself a sector, but such information is likely to be fragmentary and obscure in relation to the direct connection with the ward. And vice-versa, it may be possible to understand what is going on within the wards of a hospital by noting a particular interaction between hospitals, but it is more likely that the information will most clearly reflect dynamics shared by the two hospitals as total institutions. It is supposed that &dquo;the entire field of interaction&dquo; of most useful information will come to light in relation to the largest shared boundary (either between or around the interacting groups). The &dquo;entire field of interaction&dquo; idea refers to this common boundary of the interacting groups. It is quite possible for mirroring processes to move either up or down in an institution : that is, for issues to start at top levels of organisation, and be mirrored in sectors of it, or for issues to rise from a sector to top levels. The only point being made here is that the richest information and maximum clarity will be in relation to the interacting groups themselves and the parent institution of which these sectors are a part. In other words, issues in the lowest common denominator institution will be most clarified. The final phrase in the definition of mirroring to be discussed separately, &dquo;covert or overt dynamics,&dquo; introduces an old but nonetheless somewhat controversial belief that just as an organisation has shared, explicit, overt belief systems and values as to the nature and execution of its primary task, ideas and feelings which can change over time within the life of the organisation, so too does it have more covert (or unconscious) values and beliefs which are out of awareness z
* This work is based on experiences in a small psychiatric unit which has been described by Cooper2’ Cooper and Lofgreng, and Lofgrenlo..
Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
291 of management and members but nonetheless influence daily behaviour. At a small group level, this belief is merely an extension of Bion’s basic assumption notion2, and refers to ’as if’ states of functioning which may be strongly and largely covertly driven. The group might be functioning at any one moment as if (or under the assumption that) its agenda were to obtain caring from the leader, for instance, rather than perform its work task. Basic assumption models are counterposed to work, and insofar as such covert issues are responded to and worked with even covertly, the assumptions themselves change over a period of time. The therapy group is also a familiar setting which can be looked at as having two bound and interacting systems: patients and therapist(s). While this aspect of relative phenomena has been described in some detail by others as Astrachanl and Klein and Astrachan8, it seems worth mentioning as it demonstrates the same issues at a more micro-cosmic, but perhaps more familiar, level. As Astrachan notes, the degree to which reflective processes are focussed on highlights the orientation of the leaders (the management group) since the processes themselves will occur inevitably. Not being oriented towards group processes does not eliminate them any more than a strictly group process orientation means that important peer relations will not develop. The leadership team can only attend to and make sense of a limited quatity of information and and it is within their organising (conceptual) frameworks that particular kinds of phenomena become highlighted or
underplayed.
With a single group leader, mirroring is probably very unlikely to be observed because it will be a matter of the leader being able to attend to splits within himself which create a tension and a desire for unity, a desire which at times may be necessary for continued work in the group. It will more likely be observed when there are co-leaders, and the co-leaders work in such a way as to observe splitting between them, that is, the degree to which issues and splits within membership are put into staff, or splits between members and staff are expressed by one of staff taking members’ view. It would still seem that the observation process is enormously difficult even with multiple staff since staff is itself very much a part of the group system, and there is decreased room for a more distant observational mode. Consultation (or supervision) to leadership is probably the easiest and clearest way of getting at such issues.
Illustration I: In consulting to an ongoing therapy group with male-female co-leadership which worked within a group process model, i.e., interpreting total group phenomena in terms of members’ relationship to the leader or to each other with no explicit focus on individual psychological functioning, a change in the two-person leadership team occurred and a new male staff member entered the group to work with the continuing female leader. The group membership consisted of a rather unstable collection of people insofar as there was high group turnover at this point, and members were mostly patients discharged from the treatment ward described above with diagnosis of
psychotic episode. During their second consultation meeting about the group, the new group leader made an impassioned plea raising doubt about the leadership model because it did not attend to the severe level of disturbance of individual members. During this long and challenging speech filled with examples of severe individual pathology, his co-leader sat quietly, watching and listening intently. Being struck with her acute
Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
292 silence and based on an made that they were
integration of a wide range of data, the interpretation mirroring in consultation a two-fold conflict from within the group. Firstly, that people criticised the model regularly in group, and were at this time perhaps expliciting another difficulty, namely that of a new leader,
was
with
an attempt to test his group commitment to his role within the model. The of them had picked up this conflict in group and had transposed it to consultation so that they represented membership, and the consultant was to play their dilemma in group as to whether to change models or to stand by the old one. It was possible to work rather successfully in consultation with this issue, and such information assisted the leadership team to feel more comfortably restored to their ability to work in role as a team, and helped integrate the new leader.
two
II.
Utility ofConcept viewing inter-group phenomena does provide detailing of the practical meaning of an institution as a dynamic total system, this is not the primary utility of mirroring processes nor even what makes it most interesting from the author’s point of view. The main interest mirroring holds is that is provides an organisation with mechanism for clarification and monitoring of the primary task (as in the above illustration). The primary task of an organisation, as defined by Rice and Miller&dquo;, is that which must be performed if the organisation is to survive, and is particularly useful heuristically in ordering multiple activities ongoing within the system. It is necessary for there to be some means for systems to keep track of their primary task(s)-not so that they will never change and develop, but more importantly so that issues can be dealt with which interfere with what at any one time is seen as the main goals and work to be done; i.e. to increase control over an organisation’s ability to work and over individual’s ability to perform their tasks within it. Observation of vicissitudes of mirroring is one modality through which it is possible to obtain clarity on the momentary state of work tasks. So while on one level it is observed that things are at times hard to contain in open systems and inevitably spread and get larger, when considered from another point of view this is seen as a potential benefit insofar as it makes specific issues more widespread, dramatic, and therefore more likely to be noticed and dealt with by management. A question can be raised as to how a particular issue can be dealt with once it is recognised : interpretation seems the strongest tool (as implied by the above illustration). By interpretation is meant the attempt to put into words as clearly as possible the nature of the overt and covert issues to both, expose them, and facilitate their being understood. It is also through intepretation that opportunities can be offered people to consider more consciously dilemmas they are involved in and attempt to actively control them rather than to be passively carried along by them. Expanding the point: Considering the organisation as a dynamic whole is accompanied by the belief that organisations, as individuals, work not only to maintain a particular level of functioning, but also work constantly to grow, understand, and remove from the path of growth and development such obstacles as overtly-to impede such progressive might be seen or felt-either covertly or crucial tasks as monitoring internal movement. Taking one of management’s such work and growth impediments and it would follow that Miller 14), workings (Rice would be of major concern. The question then hecornes : how can a sprawling organisation of many individuals (and even a therapy group is unwieldy compared to an individual) communicate problems and conflicts? One way is via a mirroring process which will attempt to dramatize issues-as if it were a play being performed While
Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
293 for management benefit. Of course all of this will proceed quite inexplicitly and will feel at the time all too real to participants in their roles in these dramas. In fact, it is posible that staff will not believe interpretive work from management or other staff members, and to set the stage for effective work being done directly around such issues, staff itself needs to understand something about such intergroup phenomena. (One particular model has become available for people to experience some of these phenomena within the safety of a temporary learning institution. 1’he experimental conference developed by RiccI:1 and described in some depth by Rioch 15 and O’Connorl2 provides participants’ focus on problems of leadership and authority as they develop and emerge in a variety of relatively unstructured group contexts within a time-limited laboratory setting). Work in psychiatric organisation pose a particular kind of problem around mirroring phenomena and their use, namely, that one institutional group-the patients-is made up of individuals who are in fact particularly socially unstable and their organisational input is extreme and highly changing. Staff must be quite on top of the day-to-day situation since they become vulnerable to rapid shifts in their own experience of their work role. This is unavoidable, but working with the reflective phenomena gives staff a great understanding of institution phenomena, and generally raises and stabilises moral and job satisfaction. Illustration 2:
During a two week period in ward life, splitting occurred within the patient group which has focussed around a particular patient who herself presented (and perhaps even initiated) the split. The overt issue was the degree to which behaviour could be controlled or not. T’he central patient in question was a rather hysterical person who had frequent seizures (which were without a diagnosable neurological basis), and temper tantrums during which she would became quite violent until physically restrained, amongst a wide variety of other disruptive and attention-getting activities. These behaviours were acted out at all times and places, including therapy groups and community meetings, and were often preceded by tirades during which she would angrily accuse other patients of crazy behaviour which interfered with her treatment on the ward. After a few days of such activity, she had aroused strong feeling in the patient group-some people sympathetically agreeing with her that people could control themselves if they only would, another group being angry at her, not wanting to cater to her need for attention and turning to staff for some protection from her, or walk away from her. To this point the issues were quite clear to both staff and patients, and on this level mirroring issues were quite overt. In spite of themselves staff soon began to split and fight about her. Although there were several subgroupings picking up different aspects of the issue, two basic positions around the mirrored split were : was she capable really of controlling herself and can more be expected and demanded of her, or was she really acting without control and should she therefore be treated with more sympathy and protectiveness. Of course, such issues came up around concrete decisions, as whether or not she should have medication for her seizures. If she was given medication even though diagnosed as having no neurological involvement, was this to really quiet her down and agree with her that she was helpless in the face of her own behaviour? if not given medication, was she being unduly punished for her disruptiveness and treated cruelly? At a surface level mirroring was obvious in just the split in the patient group being reflected within staff. Nonetheless, there was a feeling of walking into a wall ivith one’s eyes open when staff found itself fighting, because issues seemed so explicit. Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
294 In staff meetings there was a good deal of talking about the issues involved on the ward and with this particular case and what became clear were themes which had been much more covert: that staff felt both furious and impotent about dealing with her, guilty about a feeling of neglecting other people, and, possibly most importantly, momentarily shaken in their sense of what their job was with patients. Should they be able to control such behaviour? If so, they were failing? If not, what good could they be? Awareness of and interpretation around these issues refocussed people on how difficult it was for this young lady to accept responsibility for her own behaviour, and how in some sense and to some degree this was an issue for others on the award who had exploited her to underline this rather common patient dilemma to staff-probably with the underlying fantasy that if staff got the message they would then provide magical answers. Of course, such interpretations did not immediately change patient behaviour, and the most immediate effects were undoubtedly at a staff level. Much of the staff splitting and fighting dissolved, and people were able to refocus on a work modality. The information discovered in staff work was put back into the patients in the variety of group and individual forums, and work with dilemmas, discomforts, and fantasies around control of behaviour proceeded in a more appropriate way. The mirroring phenomenon can come to light in many ways, and insofar as it is described as an internal monitoring function and therefore a function of management, in psychiatric settings it will most likely appear in a level of staff work. In the illustration given, staff work as a large group is emphasised with the staff directorate probably taking the lead in interpretive work since their moderate distance from day-to-day activities might free them to function at an observational
available within staff for such mirroring as the director usually meets with people treatment for sectors, reports from various sectors might responsible programme give a conglomerate of information-as pieces of a puzzle-which can be integrated into a more wholistic picture of the organisation. Probably it may be stated in most general terms that mirroring will become apparent to the extent that staff or management can get information about the patients transmitted and exposed in some forum at which intergrative and interpretive work is done. Such interpretive work could be done equally well by a person within staff-as the director or another person whose work role assumes such an integrative function, by an outside consultant, or by responsible self-observation on the part of the staff as a whole. level. Other alternative
means
are
communications, for instance, insofar
Conclusion The concept of mirroring has been defined, explained, and illustrated, particularly around psychiatric settings. While such phenomena have been written about in other settings, the concept itself had not yet been formalised. At least two major questions are raised and need to be taken up in subsequent work : What kinds of processes motivate and cause such reflective phenomena? How do these inter-group phenomena compare and contrast with other such inter-systemic phenomena (as transference-countertransference, parrallel process?). Both questions are crucial and deserve fuller consideration. There has been an attempt here to demonstrate the concepts’ utility and in this context the issue can be raised as to mechanisms for management observation. More appropriately, it would seem is the question of style of thinking, i.e. how information is heard, since it is likely in all organisations-certainly all psychiatric organisations-a variety of forums are avalable in which appropriate staff observIII.
Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
295 ations could be made. How can a staff, or at least critical members of the management team, become familiar enough with the kind of thinking involved to make
of data available to piece together and interpret around mirroring phenomena? there are many ways. At least one which is accessible and formalised is the group relations conference noted above. The authors mentioned describe the conference in great detail, and it is mentioned here as a way of noting one context for learning a way of thinking about inter-group phenomena. Experienced people in organisational work will note that it is also possible to learn such an observational style from on-the-job management or consultation work. The critical issue would seem to be a clinical style of thinking about group and institutions which attempts to see the collectivity as an organism in its own right. The real issue in the presentation of a new concept is not that it provides a basis for selling a conference model or even inherently adds new information, but that it adds another way of approaching complex data with both increased clarity and increased power. When it comes to organisational life, clarity and power are important additions to an armamentarium of survival and work mechanisms. When it comes to psychiatric work, such clarity and interpretive work also adds to therapeutic effectiveness and ultimately staff morale. use
Certainly
REFERENCES 1. 2. 3. 4.
5. 6. 7. 8.
9. 10. 11. 12. 13. 14.
Astrachan, B. M. "Towards a social systems model of therapeutic groups," Social Psychiatry, 1970, 5, pp. 110-119. Bion, W. R., Experience in Groups, New York, Basic Books, 1959. Cooper, L., "Systematic use of groups in an acute psychiatric unit," Group Analysis, 1971, 4, pp. 152-156. Cooper, L. and Lofgren, L., "Clinical use of Bion’s group-process model," 1972 (unpublished manuscript, available on request). Federn, P., Ego Psychology and the Psychoses, New York, Basic Books, 1952. Edelson, M., Sociotherapy and Phychotherapy, Chicago, University of Chicago Press, 1970. Grinker, R. R. (ed.), Toward a Unified Theory of Human Behaviour, New York, Basic Books, 1962. Klein, E. B. and Astrachan, B. M., "Learning in groups: A comparison of study groups and T groups," Journal of Applied Behavioural Science, 1971, 7, pp. 659-683. Klein, M., "Notes on some schizoid mechanics," in J. Riviere (ed.) Developments in Psychoanalysis, London, Hogarth Press Ltd., 1952, pp. 292-320. Lofgren, L., "Organizational design and therapeutic effect," Memorial volume to A. K. Rice, Task and Organization , London, Tavistock Institute, in press, 1972. O’Connor, G., "The Tavistock method of group study," in J. H. Masserman’s (ed.) Techniques of Therapy, New York, Grune & Stratton, 1971, pp. 110-115. Rice, A. K., The Enterprise and Its Environment, London, Tavistock Publications, 1963. Rice, A. K., Learning for Leadership, London, Tavistock Publications, 1965. Rice, A. K. and Miller, E.J., Systems of Organization, London, Tavistock Publications, 1967.
15.
Rioch, M. J., "Group Relations: rationale and technique," International Journal of Group Psychotherapy, 1970, 20, pp. 340-355. 16. Rosenfeld, H., "On projective identification," Contributed to International Colloquium on Psychosis, Montreal, 1969. 17. von Bertalanffy, L., General Systems Theory, New York, George Braziller, 1968. Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
MIRRORING: ONE VEHICLE TO ORGANIZATIONAL CLARITY LOWELL
COOPER,
PH.D.
The author would like to acknowledge thanks to Doctors Arthur Colman, and Richard Shadoan for their helpful critical readings of earlier versions of this paper. This paper was written while the author was a Staff Psychologist at Mount Zion Hospital and Medical Center, San Francisco, California.
Phyllis Kemper,
overall view of ’psyche’ O FTENmanagement from people directly it level, the
of an orginisation is virtually hidden involved in any of the organisational sub-units, even at a and is even difficult from a more objective, overview position as in the role of an outside consultant to see the whole picture. The concept of mirroring, which will be defined and described in this paper, is generally applicable in attempts to clarify organisational life. The author’s primary familiarity with mirroring processes has been through rather small and relatively conceptually manageable work settings, (as psychiatric organizations, and temporary conferencelaboratory institutions), and so this kind of setting will be focussed on in writing since it does not negatively affect the validity of the concept. In the present paper there will be a definition of the mirroring concept and elaboration of its utility in one particular kind of context. The phenomenon has appeared in a wide variety of social system writing although it has yet to be formally discussed as such. Nor have substantial causative hypotheses been suggested, at least to the knowledge of this author, and this can be partially attributed to an incomplete conceptual understanding of thinking in terms of mirroring. The task of formalising the concept seems the primary one at this time. The organisational orientation in which this paper is embedded is the formal dynamic model of general systems theory as developed by von Bertalanffyl~ and applied to human institutions by A. K. Ricel2. In this model human systems are seen as total functioning dynamic units which are open; that is, while a given system is definably separable from other institutions, its boundary is a permeable one and so the inner working of the system can be and is continually influenced by forces which members of it experience as coming from outside. The total system is also thought of as having sub-units which are definable entities, constantly interacting with and open to influence from other sub-units within the total system. The so-called boundary around both the sub-units within the system and around the system as a whole is a conceptual mechanism for describing two things: 1. A group of regulatory and monitoring functions which go in in all systems, and which can be considered in human organisations (of which business is certainly an example, as well as families and other group configurations) to relate to the management role. 2. An aspect of the internal experience of the organisation member who senses himself to be part of one sector but separate from other sectors within the total system; or, part of one total organisation, and not a part of another organisation with a similar function and geographical contiguity. It is really an experience of a difference; and this usage is an extension and broadening of the boundary concept as developed in ego psychology by Federn5. an
the view of
Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
289 At this point it seems appropriate to define mirroring itself, referring to illustrative material to both concretise the concept and its sub-parts, and demonstrate its utility within an institutional work context. I.
and explanation ofconcept. is defined as a process ofassessment ofinfluence between interacting, bound, social sectors (as sub-units within an organisation, or two or more integral institutions) through which covert and/or overt dynamics in the entire field of interaction are reflected within the sectors. So, dynamic issues on a ward as a whole will be played out within the patient and/or staff groups; dynamic issues within a total psychiatry department will be played out and reflected in various sectors of the department, etc.* As a way of explicating the concept in more detail, specific aspects of this definition will be discussed separately. The phrase &dquo;process of assessment&dquo; refers to the major use of the concept as a working notion in an institution to attempt to understand at any moment in time the work state of a system. While the phenomenon may at times be focussed on when there is something exeperienced by members as wrong in system operation, and then assessment has a more diagnostic purpose, the phenomenon occurs as readily when all is going well. The choice of the word assessment is meant to point out that many processes in human groups are in dynamic flux and whether or not something is seen as wrong with functioning at any one point in time, it is possible to assess the level of functioning by using observations of a mirroring type. The concept is useful insofar as it facilitates in the exposure and understanding of system operation, in much the same way that regular medical check-ups involve assessment or evaluation of physical functioning which may or may not be connected with the presence of illness at the time of examination. The examination process itself clarifies the current working state of the organism. Next, the idea of &dquo;influence.&dquo; Mirroring processes are not intentional brainwashing or manipulation phenomena, but occur primarily out of the conscious awareness of membership of both groups. The nature of the effects is interfluent and transactional (as described by Grinker~), more correctly than influent, in that they occur simultaneously in both directions, and it is when the balance of influence has been upset by prolonged influence in one direction, or when the total organisation can be observed over a period of time from a relatively objective outside perspective, that the effects of the mirroring are dramatically noted. The issue of &dquo;interacting, bound, social sectors&dquo; is an attempt to put in formal terms the idea that mirroring is observed in the context of at least two separate, interacting groups. Since the concept of a boundary around an open system is crucial to understanding this point, it seems necessary to exemplify this concept in a concrete setting. There are many boundaries within a relative micro-unit as a small psychiatric ward, such as separable programme units with relatively clear boundaries, and people who function to control the boundaries. Within psychiatric wards in general (and the unit referred to in particular) the largest bounded systems are staff and patients : a bi-cultural situation. One
Definition Mirroring
* The notion of mirroring is in part based theoretically on the concept of splitting in projective identification, as developed by Klein 9, described and elaborated by Rosenfeld 16, and applied to group settings by Bion 7. The idea of projective identification is a conceptually difficult one but has to do with the individuals (either infant or primitive adult) tendency to split off unacceptable thoughts from within the self and to put them within an out-side object and then experience them as external.
Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
290
psychiatric programme was built with the primacy of this difference in mind (which, incidentally, reflects and builds upon the attempt of Edelson6 to bring such systems thought to psychiatric work).* The ward is seen as the containing two cultures with virtually diametrically opposed value structures: Patients see themselves as being helpless, accepting the hospital in order to be passively changed, having to solve their psychological problems before they can return to their outside life, and in need of curative staff magic. Staff, on the other hand, has values which include the belief that hospitalisation itself is the current major crisis in a person’s life, that independence is better than dependence, and that it is possible to function in a responsible way along with having and solving problems. These sets of explicit, overt values are essentially brought by both patients and staff to all interactions involving them both, and the staff job is in part to transmit their values to members of the patient group through ways in which they function in role. Whenever patients and staff intermingle, or in more formal terms, whenever these two clearly bounded groups intermingle, it is likely and natural, if not inevitable, that processes of mutual influence will occur. So, while ideally it is hoped that staff would influence patients in the balance, we also know that patients will influence staff and at best it can be hoped that such an influence can be controlled in the desired way in most instances-or else staff thinking and action will begin to emulate patients. It is around processes of mutual, dynamic inter-group influence that the concept of mirroring becomes critical. Turning to the &dquo;entire field of interaction&dquo; nation, related to the boundary concept, if
one examines interactions between sub-units or sectors of a ward programme, then information will likely reflect something about dynamics within the total programme, on the ward as a whole. There may be also in such sector interactions, information about the state of the larger department or hospital of which this ward is itself a sector, but such information is likely to be fragmentary and obscure in relation to the direct connection with the ward. And vice-versa, it may be possible to understand what is going on within the wards of a hospital by noting a particular interaction between hospitals, but it is more likely that the information will most clearly reflect dynamics shared by the two hospitals as total institutions. It is supposed that &dquo;the entire field of interaction&dquo; of most useful information will come to light in relation to the largest shared boundary (either between or around the interacting groups). The &dquo;entire field of interaction&dquo; idea refers to this common boundary of the interacting groups. It is quite possible for mirroring processes to move either up or down in an institution : that is, for issues to start at top levels of organisation, and be mirrored in sectors of it, or for issues to rise from a sector to top levels. The only point being made here is that the richest information and maximum clarity will be in relation to the interacting groups themselves and the parent institution of which these sectors are a part. In other words, issues in the lowest common denominator institution will be most clarified. The final phrase in the definition of mirroring to be discussed separately, &dquo;covert or overt dynamics,&dquo; introduces an old but nonetheless somewhat controversial belief that just as an organisation has shared, explicit, overt belief systems and values as to the nature and execution of its primary task, ideas and feelings which can change over time within the life of the organisation, so too does it have more covert (or unconscious) values and beliefs which are out of awareness z
* This work is based on experiences in a small psychiatric unit which has been described by Cooper2’ Cooper and Lofgreng, and Lofgrenlo..
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291 of management and members but nonetheless influence daily behaviour. At a small group level, this belief is merely an extension of Bion’s basic assumption notion2, and refers to ’as if’ states of functioning which may be strongly and largely covertly driven. The group might be functioning at any one moment as if (or under the assumption that) its agenda were to obtain caring from the leader, for instance, rather than perform its work task. Basic assumption models are counterposed to work, and insofar as such covert issues are responded to and worked with even covertly, the assumptions themselves change over a period of time. The therapy group is also a familiar setting which can be looked at as having two bound and interacting systems: patients and therapist(s). While this aspect of relative phenomena has been described in some detail by others as Astrachanl and Klein and Astrachan8, it seems worth mentioning as it demonstrates the same issues at a more micro-cosmic, but perhaps more familiar, level. As Astrachan notes, the degree to which reflective processes are focussed on highlights the orientation of the leaders (the management group) since the processes themselves will occur inevitably. Not being oriented towards group processes does not eliminate them any more than a strictly group process orientation means that important peer relations will not develop. The leadership team can only attend to and make sense of a limited quatity of information and and it is within their organising (conceptual) frameworks that particular kinds of phenomena become highlighted or
underplayed.
With a single group leader, mirroring is probably very unlikely to be observed because it will be a matter of the leader being able to attend to splits within himself which create a tension and a desire for unity, a desire which at times may be necessary for continued work in the group. It will more likely be observed when there are co-leaders, and the co-leaders work in such a way as to observe splitting between them, that is, the degree to which issues and splits within membership are put into staff, or splits between members and staff are expressed by one of staff taking members’ view. It would still seem that the observation process is enormously difficult even with multiple staff since staff is itself very much a part of the group system, and there is decreased room for a more distant observational mode. Consultation (or supervision) to leadership is probably the easiest and clearest way of getting at such issues.
Illustration I: In consulting to an ongoing therapy group with male-female co-leadership which worked within a group process model, i.e., interpreting total group phenomena in terms of members’ relationship to the leader or to each other with no explicit focus on individual psychological functioning, a change in the two-person leadership team occurred and a new male staff member entered the group to work with the continuing female leader. The group membership consisted of a rather unstable collection of people insofar as there was high group turnover at this point, and members were mostly patients discharged from the treatment ward described above with diagnosis of
psychotic episode. During their second consultation meeting about the group, the new group leader made an impassioned plea raising doubt about the leadership model because it did not attend to the severe level of disturbance of individual members. During this long and challenging speech filled with examples of severe individual pathology, his co-leader sat quietly, watching and listening intently. Being struck with her acute
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292 silence and based on an made that they were
integration of a wide range of data, the interpretation mirroring in consultation a two-fold conflict from within the group. Firstly, that people criticised the model regularly in group, and were at this time perhaps expliciting another difficulty, namely that of a new leader,
was
with
an attempt to test his group commitment to his role within the model. The of them had picked up this conflict in group and had transposed it to consultation so that they represented membership, and the consultant was to play their dilemma in group as to whether to change models or to stand by the old one. It was possible to work rather successfully in consultation with this issue, and such information assisted the leadership team to feel more comfortably restored to their ability to work in role as a team, and helped integrate the new leader.
two
II.
Utility ofConcept viewing inter-group phenomena does provide detailing of the practical meaning of an institution as a dynamic total system, this is not the primary utility of mirroring processes nor even what makes it most interesting from the author’s point of view. The main interest mirroring holds is that is provides an organisation with mechanism for clarification and monitoring of the primary task (as in the above illustration). The primary task of an organisation, as defined by Rice and Miller&dquo;, is that which must be performed if the organisation is to survive, and is particularly useful heuristically in ordering multiple activities ongoing within the system. It is necessary for there to be some means for systems to keep track of their primary task(s)-not so that they will never change and develop, but more importantly so that issues can be dealt with which interfere with what at any one time is seen as the main goals and work to be done; i.e. to increase control over an organisation’s ability to work and over individual’s ability to perform their tasks within it. Observation of vicissitudes of mirroring is one modality through which it is possible to obtain clarity on the momentary state of work tasks. So while on one level it is observed that things are at times hard to contain in open systems and inevitably spread and get larger, when considered from another point of view this is seen as a potential benefit insofar as it makes specific issues more widespread, dramatic, and therefore more likely to be noticed and dealt with by management. A question can be raised as to how a particular issue can be dealt with once it is recognised : interpretation seems the strongest tool (as implied by the above illustration). By interpretation is meant the attempt to put into words as clearly as possible the nature of the overt and covert issues to both, expose them, and facilitate their being understood. It is also through intepretation that opportunities can be offered people to consider more consciously dilemmas they are involved in and attempt to actively control them rather than to be passively carried along by them. Expanding the point: Considering the organisation as a dynamic whole is accompanied by the belief that organisations, as individuals, work not only to maintain a particular level of functioning, but also work constantly to grow, understand, and remove from the path of growth and development such obstacles as overtly-to impede such progressive might be seen or felt-either covertly or crucial tasks as monitoring internal movement. Taking one of management’s such work and growth impediments and it would follow that Miller 14), workings (Rice would be of major concern. The question then hecornes : how can a sprawling organisation of many individuals (and even a therapy group is unwieldy compared to an individual) communicate problems and conflicts? One way is via a mirroring process which will attempt to dramatize issues-as if it were a play being performed While
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293 for management benefit. Of course all of this will proceed quite inexplicitly and will feel at the time all too real to participants in their roles in these dramas. In fact, it is posible that staff will not believe interpretive work from management or other staff members, and to set the stage for effective work being done directly around such issues, staff itself needs to understand something about such intergroup phenomena. (One particular model has become available for people to experience some of these phenomena within the safety of a temporary learning institution. 1’he experimental conference developed by RiccI:1 and described in some depth by Rioch 15 and O’Connorl2 provides participants’ focus on problems of leadership and authority as they develop and emerge in a variety of relatively unstructured group contexts within a time-limited laboratory setting). Work in psychiatric organisation pose a particular kind of problem around mirroring phenomena and their use, namely, that one institutional group-the patients-is made up of individuals who are in fact particularly socially unstable and their organisational input is extreme and highly changing. Staff must be quite on top of the day-to-day situation since they become vulnerable to rapid shifts in their own experience of their work role. This is unavoidable, but working with the reflective phenomena gives staff a great understanding of institution phenomena, and generally raises and stabilises moral and job satisfaction. Illustration 2:
During a two week period in ward life, splitting occurred within the patient group which has focussed around a particular patient who herself presented (and perhaps even initiated) the split. The overt issue was the degree to which behaviour could be controlled or not. T’he central patient in question was a rather hysterical person who had frequent seizures (which were without a diagnosable neurological basis), and temper tantrums during which she would became quite violent until physically restrained, amongst a wide variety of other disruptive and attention-getting activities. These behaviours were acted out at all times and places, including therapy groups and community meetings, and were often preceded by tirades during which she would angrily accuse other patients of crazy behaviour which interfered with her treatment on the ward. After a few days of such activity, she had aroused strong feeling in the patient group-some people sympathetically agreeing with her that people could control themselves if they only would, another group being angry at her, not wanting to cater to her need for attention and turning to staff for some protection from her, or walk away from her. To this point the issues were quite clear to both staff and patients, and on this level mirroring issues were quite overt. In spite of themselves staff soon began to split and fight about her. Although there were several subgroupings picking up different aspects of the issue, two basic positions around the mirrored split were : was she capable really of controlling herself and can more be expected and demanded of her, or was she really acting without control and should she therefore be treated with more sympathy and protectiveness. Of course, such issues came up around concrete decisions, as whether or not she should have medication for her seizures. If she was given medication even though diagnosed as having no neurological involvement, was this to really quiet her down and agree with her that she was helpless in the face of her own behaviour? if not given medication, was she being unduly punished for her disruptiveness and treated cruelly? At a surface level mirroring was obvious in just the split in the patient group being reflected within staff. Nonetheless, there was a feeling of walking into a wall ivith one’s eyes open when staff found itself fighting, because issues seemed so explicit. Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
294 In staff meetings there was a good deal of talking about the issues involved on the ward and with this particular case and what became clear were themes which had been much more covert: that staff felt both furious and impotent about dealing with her, guilty about a feeling of neglecting other people, and, possibly most importantly, momentarily shaken in their sense of what their job was with patients. Should they be able to control such behaviour? If so, they were failing? If not, what good could they be? Awareness of and interpretation around these issues refocussed people on how difficult it was for this young lady to accept responsibility for her own behaviour, and how in some sense and to some degree this was an issue for others on the award who had exploited her to underline this rather common patient dilemma to staff-probably with the underlying fantasy that if staff got the message they would then provide magical answers. Of course, such interpretations did not immediately change patient behaviour, and the most immediate effects were undoubtedly at a staff level. Much of the staff splitting and fighting dissolved, and people were able to refocus on a work modality. The information discovered in staff work was put back into the patients in the variety of group and individual forums, and work with dilemmas, discomforts, and fantasies around control of behaviour proceeded in a more appropriate way. The mirroring phenomenon can come to light in many ways, and insofar as it is described as an internal monitoring function and therefore a function of management, in psychiatric settings it will most likely appear in a level of staff work. In the illustration given, staff work as a large group is emphasised with the staff directorate probably taking the lead in interpretive work since their moderate distance from day-to-day activities might free them to function at an observational
available within staff for such mirroring as the director usually meets with people treatment for sectors, reports from various sectors might responsible programme give a conglomerate of information-as pieces of a puzzle-which can be integrated into a more wholistic picture of the organisation. Probably it may be stated in most general terms that mirroring will become apparent to the extent that staff or management can get information about the patients transmitted and exposed in some forum at which intergrative and interpretive work is done. Such interpretive work could be done equally well by a person within staff-as the director or another person whose work role assumes such an integrative function, by an outside consultant, or by responsible self-observation on the part of the staff as a whole. level. Other alternative
means
are
communications, for instance, insofar
Conclusion The concept of mirroring has been defined, explained, and illustrated, particularly around psychiatric settings. While such phenomena have been written about in other settings, the concept itself had not yet been formalised. At least two major questions are raised and need to be taken up in subsequent work : What kinds of processes motivate and cause such reflective phenomena? How do these inter-group phenomena compare and contrast with other such inter-systemic phenomena (as transference-countertransference, parrallel process?). Both questions are crucial and deserve fuller consideration. There has been an attempt here to demonstrate the concepts’ utility and in this context the issue can be raised as to mechanisms for management observation. More appropriately, it would seem is the question of style of thinking, i.e. how information is heard, since it is likely in all organisations-certainly all psychiatric organisations-a variety of forums are avalable in which appropriate staff observIII.
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295 ations could be made. How can a staff, or at least critical members of the management team, become familiar enough with the kind of thinking involved to make
of data available to piece together and interpret around mirroring phenomena? there are many ways. At least one which is accessible and formalised is the group relations conference noted above. The authors mentioned describe the conference in great detail, and it is mentioned here as a way of noting one context for learning a way of thinking about inter-group phenomena. Experienced people in organisational work will note that it is also possible to learn such an observational style from on-the-job management or consultation work. The critical issue would seem to be a clinical style of thinking about group and institutions which attempts to see the collectivity as an organism in its own right. The real issue in the presentation of a new concept is not that it provides a basis for selling a conference model or even inherently adds new information, but that it adds another way of approaching complex data with both increased clarity and increased power. When it comes to organisational life, clarity and power are important additions to an armamentarium of survival and work mechanisms. When it comes to psychiatric work, such clarity and interpretive work also adds to therapeutic effectiveness and ultimately staff morale. use
Certainly
REFERENCES 1. 2. 3. 4.
5. 6. 7. 8.
9. 10. 11. 12. 13. 14.
Astrachan, B. M. "Towards a social systems model of therapeutic groups," Social Psychiatry, 1970, 5, pp. 110-119. Bion, W. R., Experience in Groups, New York, Basic Books, 1959. Cooper, L., "Systematic use of groups in an acute psychiatric unit," Group Analysis, 1971, 4, pp. 152-156. Cooper, L. and Lofgren, L., "Clinical use of Bion’s group-process model," 1972 (unpublished manuscript, available on request). Federn, P., Ego Psychology and the Psychoses, New York, Basic Books, 1952. Edelson, M., Sociotherapy and Phychotherapy, Chicago, University of Chicago Press, 1970. Grinker, R. R. (ed.), Toward a Unified Theory of Human Behaviour, New York, Basic Books, 1962. Klein, E. B. and Astrachan, B. M., "Learning in groups: A comparison of study groups and T groups," Journal of Applied Behavioural Science, 1971, 7, pp. 659-683. Klein, M., "Notes on some schizoid mechanics," in J. Riviere (ed.) Developments in Psychoanalysis, London, Hogarth Press Ltd., 1952, pp. 292-320. Lofgren, L., "Organizational design and therapeutic effect," Memorial volume to A. K. Rice, Task and Organization , London, Tavistock Institute, in press, 1972. O’Connor, G., "The Tavistock method of group study," in J. H. Masserman’s (ed.) Techniques of Therapy, New York, Grune & Stratton, 1971, pp. 110-115. Rice, A. K., The Enterprise and Its Environment, London, Tavistock Publications, 1963. Rice, A. K., Learning for Leadership, London, Tavistock Publications, 1965. Rice, A. K. and Miller, E.J., Systems of Organization, London, Tavistock Publications, 1967.
15.
Rioch, M. J., "Group Relations: rationale and technique," International Journal of Group Psychotherapy, 1970, 20, pp. 340-355. 16. Rosenfeld, H., "On projective identification," Contributed to International Colloquium on Psychosis, Montreal, 1969. 17. von Bertalanffy, L., General Systems Theory, New York, George Braziller, 1968. Downloaded from isp.sagepub.com at NORTH CAROLINA STATE UNIV on April 22, 2015
