The Second-in-Command JOHN A. TALBOTT, M.D. Chief, Comprehensive Clinical Service Payne-Whitney Psychiatric Clinic New York, New York
VIVIAN MBA-MPH Columbia New York,
H. GODBEY,
A.B.
Candidate University School New York
of Public
Health
Individuals who are second in command in organizations have common problems that resultfrom their role, as illustrated in a hypothetical example of the relationship of a first-in-command and second-incommand in establishing a day hospital. The authors believe that firsts and seconds can function most effectively by accepting inevitabilities-for instance, that competition exists and that perfect communication is impossible-and recognizing that the relationship has great potential for destructiveness as well as many advantages. They discuss the needs to define boundaries on the basis of skills and personality variables and to respect individual identity. #{149}Thecommand structure of mental health organizations is one of the areas in which many psychiatristadministrators lack practical information. Perhaps that is because psychiatrists regard the exercise of power and authority as something a bit shameful, to be done but not discussed or examined. If so, it is regrettable, for often the interplay between individuals in an organization determines the success or failure of the programs. There are two common types of command structures in mental health organizations. In a direct-command structure, the chief, chairman, director, or superintendent has several coequal subordinates-service chiefs, department heads, or division directors-who carry out the activities of the organization. Corporations and universities frequently operate within this structure. In Dr. Talbott’s mailing address is 160 West 94th Street, New York, New York 10025; he also is clinical associate professor of psychiatry at New York University. Dr. Talbott formerly was deputy director of Meyer-Manhattan Psychiatric Hospital in New York City, and Ms. Godbey was hospital administrator there.
Syndrome
the second model, common in military and governmental organizations, a second-in-command is interposed between the chief and his subordinates. To our knowledge only Jones has written about the relationship of the firstand second-in-command in mental health systems.’ It is frequently one of the most important variables in the successful functioning of the organization. We have made several observations about the second-in-command model, based on our experiences working in and consulting with military, governmental, academic, social, and health organizations. Both of us have functjoned as firsts and seconds. We believe that individuals who are second-incommand have common situations and problems, and that these problems result from their role rather than from their personality features or program factors. We call these problems the second-in-command syndrome; it has recognizable symptoms or behavioral patterns that differentiate it from other conditions. A hypothetical example will illustrate what we believe are problems common to the relationship of the first- and second-in-command. The deputy director of a state hospital realizes that better services could be provided to the catchment area, located some distance away, if a day hospital were established in the community. Knowing that the director has recently launched several taxing and innovative projects and might not be willing to take on another project, he considers the best way to approach him about it. He decides to approach him directly, rather than planting the idea with the chiefs of service or maneuvering the director into thinking the idea is his own. The director seems receptive to the suggestion and proposes that it be discussed at the next staff policy meeting. While his response could signify open and honest agreement with the proposal, it may also be a ploy; the director may be reserving judgment, avoiding a negative response, or setting up the project to fail by not wholeheartedly endorsing it. (The director also could have openly expressed reservations to the deputy so he could later claim the idea as his own.)
1
M.
versity
VOLUME
Jones, Press,
26
Beyond the Therapeutic New Haven, Connecticut,
NUMBER
10
OCTOBER
Community, 1968, pp. 29-33.
1975
Yale
Uni-
659
At the policy meeting, the director announces that he favors the deputy’s proposal and asks for staff’s reactions about its feasibility at the present time. His announcement may reflect his desire to encourage participatory decision-making, or to avoid accepting responsibility for making the decision himself. It may also be a token gesture if he has already made up his mind to proceed. The staff’s immediate response is positive. Subsequently, however, several chiefs of service approach the deputy to discuss their reservations about it. Some service chiefs make trial-balloon comments that they hope the deputy will transmit to the director. Others present issues they hesitate to take to the director because they are troublesome or unpleasant. And it is clear that one chief thinks there may be a power struggle within the policy group and is trying to make the deputy a political ally. The difficulties presented by one service chief are especially pertinent, but the deputy is not sure whether to present them to the director or try to handle them himself. The information is unpleasant, but the deputy decides to present it candidly, even though he is aware that his honesty might be misperceived by the director as disloyalty. He also outlines the power play and the potential divisiveness, thus foiling the service chiefs attempt to play one administrator against the other. Because of the deputy’s experience, personality traits, and work skills, the director decides to delegate the responsibility for planning and implementing the day hospital to him. In return for being relieved of the major workload and accountability for the project, the director relinquishes any claim to personal credit for the day hospital. That decision is difficult for him, since he is tempted either to retain the major share of the work and its accompanying glory or to assign the deputy the more menial operational tasks while he enjoys the rewards. During the next six months the deputy finds an appropriate location for the day hospital, recruits staff, and, together with the staff, establishes goals and policies. In all instances, problems are resolved without recourse to the director. However, a later problem is not successfully resolved. The number of patients at the day hospital depends entirely on referrals from social and mental health agencies. Thus it is crucial to establish firm liaisons with the directors of the agencies, yet the deputy lacks the status to do so. The liaisons remain tenuous, and there are few referrals. At this point, several chiefs of service question the deputy about the need for the day hospital, in view of how few patients it serves. The deputy is reluctant to discuss the problem with the director, primarily because he feels he should be able to resolve the matter himself. However, one of the service chiefs tells him that his reluctance may instead be based on his shame over the apparent failure of the project and his competitiveness with the director. Under this pressure, the deputy reports the problem. The director responds by
660
HOSPITAL
& COMMUNITY
PSYCHIATRY
reassuring his deputy that he will be able to work out the problem himself, just as he solved previous difficulties. Because of the director’s seeming lack of response to the problem, one of the service chiefs approaches the director, and he convinces him that the problem merits his personal attention. The director believes that in this case it was appropriate for the service chief to abandon established channels and go over the deputy’s head-to make an end run-but the action raises the possibility of undercutting the deputy’s authority. The director does so, without informing the deputy. The director brings up the problem of the day hospital at the next staff policy meeting, identifying the lack of community participation as a crucial factor. As a result of the director’s perceptive comments, the staff see him as the knowledgeable authority (the good guy) and the deputy as a failure (the bad guy). At the next hospital case conference, an acknowledged expert on day hospital psychiatry points out that referrals will not be made unless all appropriate community agencies are actively involved in planning for and operating the therapeutic program. He stresses that only the director can guarantee this cooperation, by involving his counterparts. Later some staff members comment that the tables have been turned, since it now appears that the director has been at fault and the deputy is the good guy. The clarity with which the visiting expert has presented the solution enables the director and the deputy to recognize that they can join their talents in a complementary way. Thus the combination of the director’s professional status and clout and the deputy’s suitability for the task increase the likelihood that the day hospital will be successful. RECOGNIZING
THE
DANGERS
The relationship between the first-in-command and the second-in-command is frequently one of the most important variables in the successful functioning of an organization. Firsts and seconds can maximize the advantages of the alliance and avoid many of the dangers (the second-in-command syndrome) by recognizing the inevitabilities of the relationship and keeping certain cautions in mind. . The second is not the first. There may be any number of reasons why the second isn’t the first, including inexperience, unwillingness, lack of credentials, or disfavor with higher authorities. The second’s skills and expertise may be on a par with those of the first, and there may be considerable sharing of responsibility, but by the nature of his role the second never has the ultimate authority or sole power to do or act. The deputy in the example was not able to negotiate successfully with the directors of community agencies solely because of his position. #{149} Competition exists. When two capable, dedicated, an4 energetic administrators work in close proximity, competition is inevitable. Healthy competition may
‘1
j
generate an explosion of creative ideas. However, such circumstances as a lack of challenging work, an overwhelmingly difficult job, or a surfacing of personality quirks may produce a destructive rivalry. An additional factor is that the second frequently aspires to the first’s position. In our example, the deputy’s idea for a day hospital came at a time when the director himself recently initiated several innovative projects. Later the apparently mounting hostile competitiveness was forestalled by the observations of an objective outside consultant. #{149} Perfect communication isn’t possible. Frequently information is directed at either the first or the second, or perhaps only one of them is present at an important meeting. Even if great effort is made to faithfully share and report information, differences in presentation, priorities, and style will result in gaps and misunderstandings. Generally the administrative pair can live with these difficulties as long as they sincerely attempt to maintain open channels of honest communication, as a component of the shared power relationship. When our hypothetical director delegated the task, he failed to include a mechanism for feedback on the progress of the day hospital. As a result, communications broke down to such an extent that the director did not respond to the deputy’s request for help. #{149} The relationship has great potential for destructiveness. The intimate sharing of personal and professional strengths and weaknesses makes the first and second exceedingly vulnerable to each other. Furthermore, both have needs for power, status, and credit. If the needs of either are not met, there is a great temptation to exploit the other’s vulnerability. The second-incommand may attempt to look better (appear the good guy) or present himself as the power behind the throne by withholding information from the first, allying with subordinates against him, or appearing to work harder or have more talent than the first. On the other hand, the first-in-command may attempt to make the second look inadequate by unilateral decision-making, by not sharing information, or by delegating little authority to the second or undercutting his authority. Or the first may respond to inappropriate end runs, scapegoat the second by making him appear responsible for the first’s failure, or hoard power, credit, and status. A further potential for destructiveness lies with subordinate staff, who may try to manipulate the first and second against each other for their own gain. Our case history outlines numerous options open to the director and deputy at each step, several of which might have resulted in destructive personal conflicts and the failure of the project. But for the sake of a happy ending, we never allowed our principals to yield to destructive temptations. #{149} The second can abuse his influence on the first. By virtue of his close association with the first, the second has certain unique functions in the organization. Because he does not have the ultimate responsibility, he has a perspective on the operation that the first lacks
and that he should share with the first so better decisions can be made. The first is often isolated and thus depends on the second to serve as an additional eye, a confidant, and a sounding board. In addition, the second-in-command must continually resolve his conflict between loyalty to the director and loyalty to organizational goals. If he sometimes chooses organizational goals, he risks being perceived as personally disloyal to the first-in-command, but avoiding the loyalty issue will result in the sort of blind loyalty typical of Presidential staffs. The second-in-command may also abuse his unique relationship with the first by flattering, manipulating, or deceiving him, or by planting ideas in order to build a power base or get his own way. In our example the deputy did not abuse the relationship; he presented both the initial idea and the problem he was having directly to his superior. #{149} The first and second must define their functional boundaries. Our illustration indicates that the principals probably follow the sound practice of dividing their workload on the basis of experience, skills, and personality variables rather than on whether the job is menial, ceremonial, prestigious, or creative. The director correctly assessed the deputy’s strengths in being able to carry out the task. His error was in assuming that, because the deputy was so well qualified, he could take total and final responsibility for it. To function effectively together, firsts and seconds must have a clear understanding of their collective personal and professional strengths and weaknesses. Their ongoing relationship, the lines of access and communication they establish with their staff and with outside agencies, and the assignment of duties should reflect this understanding. #{149} The unity of purpose cannot interfere with individual identity. All seconds-in-command have two overriding needs: the need for identification with the first, and the need for individuation. It is absolutely essential that the second be able to stand in for the first at all times. But if he is merely a junior version of the first, he feels like, and appears to be, a puppet, and he does not enhance the management team. The alliance between the first and the second should be based on their shared philosophy, goals, program priorities, and policies and on agreed-on procedures. A mutuality that makes use of the principals’ complementary traits-together they may be conservative and liberal, impulsive and contemplative, relaxed and obsessive, and peopleand process-oriented as opposed to productand task-oriented-means that better decisions can be made. However, it is equally important for effective functioning that the second has his own turf, role, and style. All firsts-in-command and seconds-in-command should be aware of the advantages and disadvantages of the organizational structure they operate within. They should avoid both denial and acting out if the management team is to function for the maximum good of the organization.U
VOLUME
26
NUMBER
10 OCTOBER
1975
661
VIVIAN MBA-MPH Columbia New York,
H. GODBEY,
A.B.
Candidate University School New York
of Public
Health
Individuals who are second in command in organizations have common problems that resultfrom their role, as illustrated in a hypothetical example of the relationship of a first-in-command and second-incommand in establishing a day hospital. The authors believe that firsts and seconds can function most effectively by accepting inevitabilities-for instance, that competition exists and that perfect communication is impossible-and recognizing that the relationship has great potential for destructiveness as well as many advantages. They discuss the needs to define boundaries on the basis of skills and personality variables and to respect individual identity. #{149}Thecommand structure of mental health organizations is one of the areas in which many psychiatristadministrators lack practical information. Perhaps that is because psychiatrists regard the exercise of power and authority as something a bit shameful, to be done but not discussed or examined. If so, it is regrettable, for often the interplay between individuals in an organization determines the success or failure of the programs. There are two common types of command structures in mental health organizations. In a direct-command structure, the chief, chairman, director, or superintendent has several coequal subordinates-service chiefs, department heads, or division directors-who carry out the activities of the organization. Corporations and universities frequently operate within this structure. In Dr. Talbott’s mailing address is 160 West 94th Street, New York, New York 10025; he also is clinical associate professor of psychiatry at New York University. Dr. Talbott formerly was deputy director of Meyer-Manhattan Psychiatric Hospital in New York City, and Ms. Godbey was hospital administrator there.
Syndrome
the second model, common in military and governmental organizations, a second-in-command is interposed between the chief and his subordinates. To our knowledge only Jones has written about the relationship of the firstand second-in-command in mental health systems.’ It is frequently one of the most important variables in the successful functioning of the organization. We have made several observations about the second-in-command model, based on our experiences working in and consulting with military, governmental, academic, social, and health organizations. Both of us have functjoned as firsts and seconds. We believe that individuals who are second-incommand have common situations and problems, and that these problems result from their role rather than from their personality features or program factors. We call these problems the second-in-command syndrome; it has recognizable symptoms or behavioral patterns that differentiate it from other conditions. A hypothetical example will illustrate what we believe are problems common to the relationship of the first- and second-in-command. The deputy director of a state hospital realizes that better services could be provided to the catchment area, located some distance away, if a day hospital were established in the community. Knowing that the director has recently launched several taxing and innovative projects and might not be willing to take on another project, he considers the best way to approach him about it. He decides to approach him directly, rather than planting the idea with the chiefs of service or maneuvering the director into thinking the idea is his own. The director seems receptive to the suggestion and proposes that it be discussed at the next staff policy meeting. While his response could signify open and honest agreement with the proposal, it may also be a ploy; the director may be reserving judgment, avoiding a negative response, or setting up the project to fail by not wholeheartedly endorsing it. (The director also could have openly expressed reservations to the deputy so he could later claim the idea as his own.)
1
M.
versity
VOLUME
Jones, Press,
26
Beyond the Therapeutic New Haven, Connecticut,
NUMBER
10
OCTOBER
Community, 1968, pp. 29-33.
1975
Yale
Uni-
659
At the policy meeting, the director announces that he favors the deputy’s proposal and asks for staff’s reactions about its feasibility at the present time. His announcement may reflect his desire to encourage participatory decision-making, or to avoid accepting responsibility for making the decision himself. It may also be a token gesture if he has already made up his mind to proceed. The staff’s immediate response is positive. Subsequently, however, several chiefs of service approach the deputy to discuss their reservations about it. Some service chiefs make trial-balloon comments that they hope the deputy will transmit to the director. Others present issues they hesitate to take to the director because they are troublesome or unpleasant. And it is clear that one chief thinks there may be a power struggle within the policy group and is trying to make the deputy a political ally. The difficulties presented by one service chief are especially pertinent, but the deputy is not sure whether to present them to the director or try to handle them himself. The information is unpleasant, but the deputy decides to present it candidly, even though he is aware that his honesty might be misperceived by the director as disloyalty. He also outlines the power play and the potential divisiveness, thus foiling the service chiefs attempt to play one administrator against the other. Because of the deputy’s experience, personality traits, and work skills, the director decides to delegate the responsibility for planning and implementing the day hospital to him. In return for being relieved of the major workload and accountability for the project, the director relinquishes any claim to personal credit for the day hospital. That decision is difficult for him, since he is tempted either to retain the major share of the work and its accompanying glory or to assign the deputy the more menial operational tasks while he enjoys the rewards. During the next six months the deputy finds an appropriate location for the day hospital, recruits staff, and, together with the staff, establishes goals and policies. In all instances, problems are resolved without recourse to the director. However, a later problem is not successfully resolved. The number of patients at the day hospital depends entirely on referrals from social and mental health agencies. Thus it is crucial to establish firm liaisons with the directors of the agencies, yet the deputy lacks the status to do so. The liaisons remain tenuous, and there are few referrals. At this point, several chiefs of service question the deputy about the need for the day hospital, in view of how few patients it serves. The deputy is reluctant to discuss the problem with the director, primarily because he feels he should be able to resolve the matter himself. However, one of the service chiefs tells him that his reluctance may instead be based on his shame over the apparent failure of the project and his competitiveness with the director. Under this pressure, the deputy reports the problem. The director responds by
660
HOSPITAL
& COMMUNITY
PSYCHIATRY
reassuring his deputy that he will be able to work out the problem himself, just as he solved previous difficulties. Because of the director’s seeming lack of response to the problem, one of the service chiefs approaches the director, and he convinces him that the problem merits his personal attention. The director believes that in this case it was appropriate for the service chief to abandon established channels and go over the deputy’s head-to make an end run-but the action raises the possibility of undercutting the deputy’s authority. The director does so, without informing the deputy. The director brings up the problem of the day hospital at the next staff policy meeting, identifying the lack of community participation as a crucial factor. As a result of the director’s perceptive comments, the staff see him as the knowledgeable authority (the good guy) and the deputy as a failure (the bad guy). At the next hospital case conference, an acknowledged expert on day hospital psychiatry points out that referrals will not be made unless all appropriate community agencies are actively involved in planning for and operating the therapeutic program. He stresses that only the director can guarantee this cooperation, by involving his counterparts. Later some staff members comment that the tables have been turned, since it now appears that the director has been at fault and the deputy is the good guy. The clarity with which the visiting expert has presented the solution enables the director and the deputy to recognize that they can join their talents in a complementary way. Thus the combination of the director’s professional status and clout and the deputy’s suitability for the task increase the likelihood that the day hospital will be successful. RECOGNIZING
THE
DANGERS
The relationship between the first-in-command and the second-in-command is frequently one of the most important variables in the successful functioning of an organization. Firsts and seconds can maximize the advantages of the alliance and avoid many of the dangers (the second-in-command syndrome) by recognizing the inevitabilities of the relationship and keeping certain cautions in mind. . The second is not the first. There may be any number of reasons why the second isn’t the first, including inexperience, unwillingness, lack of credentials, or disfavor with higher authorities. The second’s skills and expertise may be on a par with those of the first, and there may be considerable sharing of responsibility, but by the nature of his role the second never has the ultimate authority or sole power to do or act. The deputy in the example was not able to negotiate successfully with the directors of community agencies solely because of his position. #{149} Competition exists. When two capable, dedicated, an4 energetic administrators work in close proximity, competition is inevitable. Healthy competition may
‘1
j
generate an explosion of creative ideas. However, such circumstances as a lack of challenging work, an overwhelmingly difficult job, or a surfacing of personality quirks may produce a destructive rivalry. An additional factor is that the second frequently aspires to the first’s position. In our example, the deputy’s idea for a day hospital came at a time when the director himself recently initiated several innovative projects. Later the apparently mounting hostile competitiveness was forestalled by the observations of an objective outside consultant. #{149} Perfect communication isn’t possible. Frequently information is directed at either the first or the second, or perhaps only one of them is present at an important meeting. Even if great effort is made to faithfully share and report information, differences in presentation, priorities, and style will result in gaps and misunderstandings. Generally the administrative pair can live with these difficulties as long as they sincerely attempt to maintain open channels of honest communication, as a component of the shared power relationship. When our hypothetical director delegated the task, he failed to include a mechanism for feedback on the progress of the day hospital. As a result, communications broke down to such an extent that the director did not respond to the deputy’s request for help. #{149} The relationship has great potential for destructiveness. The intimate sharing of personal and professional strengths and weaknesses makes the first and second exceedingly vulnerable to each other. Furthermore, both have needs for power, status, and credit. If the needs of either are not met, there is a great temptation to exploit the other’s vulnerability. The second-incommand may attempt to look better (appear the good guy) or present himself as the power behind the throne by withholding information from the first, allying with subordinates against him, or appearing to work harder or have more talent than the first. On the other hand, the first-in-command may attempt to make the second look inadequate by unilateral decision-making, by not sharing information, or by delegating little authority to the second or undercutting his authority. Or the first may respond to inappropriate end runs, scapegoat the second by making him appear responsible for the first’s failure, or hoard power, credit, and status. A further potential for destructiveness lies with subordinate staff, who may try to manipulate the first and second against each other for their own gain. Our case history outlines numerous options open to the director and deputy at each step, several of which might have resulted in destructive personal conflicts and the failure of the project. But for the sake of a happy ending, we never allowed our principals to yield to destructive temptations. #{149} The second can abuse his influence on the first. By virtue of his close association with the first, the second has certain unique functions in the organization. Because he does not have the ultimate responsibility, he has a perspective on the operation that the first lacks
and that he should share with the first so better decisions can be made. The first is often isolated and thus depends on the second to serve as an additional eye, a confidant, and a sounding board. In addition, the second-in-command must continually resolve his conflict between loyalty to the director and loyalty to organizational goals. If he sometimes chooses organizational goals, he risks being perceived as personally disloyal to the first-in-command, but avoiding the loyalty issue will result in the sort of blind loyalty typical of Presidential staffs. The second-in-command may also abuse his unique relationship with the first by flattering, manipulating, or deceiving him, or by planting ideas in order to build a power base or get his own way. In our example the deputy did not abuse the relationship; he presented both the initial idea and the problem he was having directly to his superior. #{149} The first and second must define their functional boundaries. Our illustration indicates that the principals probably follow the sound practice of dividing their workload on the basis of experience, skills, and personality variables rather than on whether the job is menial, ceremonial, prestigious, or creative. The director correctly assessed the deputy’s strengths in being able to carry out the task. His error was in assuming that, because the deputy was so well qualified, he could take total and final responsibility for it. To function effectively together, firsts and seconds must have a clear understanding of their collective personal and professional strengths and weaknesses. Their ongoing relationship, the lines of access and communication they establish with their staff and with outside agencies, and the assignment of duties should reflect this understanding. #{149} The unity of purpose cannot interfere with individual identity. All seconds-in-command have two overriding needs: the need for identification with the first, and the need for individuation. It is absolutely essential that the second be able to stand in for the first at all times. But if he is merely a junior version of the first, he feels like, and appears to be, a puppet, and he does not enhance the management team. The alliance between the first and the second should be based on their shared philosophy, goals, program priorities, and policies and on agreed-on procedures. A mutuality that makes use of the principals’ complementary traits-together they may be conservative and liberal, impulsive and contemplative, relaxed and obsessive, and peopleand process-oriented as opposed to productand task-oriented-means that better decisions can be made. However, it is equally important for effective functioning that the second has his own turf, role, and style. All firsts-in-command and seconds-in-command should be aware of the advantages and disadvantages of the organizational structure they operate within. They should avoid both denial and acting out if the management team is to function for the maximum good of the organization.U
VOLUME
26
NUMBER
10 OCTOBER
1975
661
