Organizational blind spots: Splitting, blame and idealization in the National Health Service

Abstract

The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. AbstractThe paper examines the escalation of commitment to failing strategies from a psychodynamic perspective as an affective process connecting organizational, systemic and individual levels.We propose a theory of organizational blind spots to explain how such escalation of commitment occurs. Blind spots develop an organizational defence mechanism for coping with problems resulting from attempts to implement unrealistic strategy or policy goals.Unrealistic strategic aims mobilize and reinforce blind spots through processes of splitting, blame and idealization, thus enabling organizations to persist with unsuccessful courses of action. Organizational blind spots arise when leadership and/or operational members in organizations are unable to acknowledge unworkable strategies. Vignettes from the National Health Service in England (the NHS) are used to illustrate how blind spots sustain an illusory possibility of success while commitment to a failing strategy escalates. The theory of blind spots offers a novel social-psychological approach to understanding how these dysfunctions of strategy develop and become institutionalized, putting organizations in jeopardy and threatening their survival.

Atmospheres of mistrust and suspicion: Theorising on conflict and affective practice in a child protection social work agency

“…This supports the findings of Fotaki andHyde (2014) andMenzies Lyth (1960), who collectively found managers developing blind spots and clinging to inappropriate but familiar practices to avoid the possibility of change. Here we learn that this situated affective activity was a malpractice which was firmly in place before Bill arrived and rather than change it, he went along with it.…”

“…A F shows how the concept of affect emerges between people, affect is not always limited to direct social interaction but also influenced by processes, structures and wider society (Fotaki and Hyde, 2014). I therefore begin this section by exploring the wider context of child protection social work.…”

A Wicked Problem? Whistleblowing in Healthcare Organisations Comment on "Cultures of Silence And Cultures of Voice: The Role Of Whistleblowing in Healthcare Organisations"

“…They rightly argue that hero or villain labels are value judgements subject to interpretation and post-hoc rationalisation; one may be legitimated as a whistleblower after having been successful in having concerns upheld. This tendency for wholesale idealization and blame plays an important part in creating organisational blind spots 5 that prevent awareness of difficulties that may be evident to those outside the organisation. As a form of organisational membership activity, whistleblowing is not well-understood.…”

“…Not only do senior organisational members (and those representing institutional interests) become less able to hear (as the whistleblower is blamed for their persistence) but they also become committed to a failing course of action. 5 At an institutional level, there remain questions about what sorts of protections whistleblowers might be afforded (outside the organisation) regardless of whether their complaints are upheld. For example, a safety culture may encourage open questioning but a lack of organisational protection for employees may mitigate against this.…”

Public anxiety and health policy: A psychodynamic perspective

“…No single perspective can explain all the complexity that is policy development. However, there is a growing body of literature using psychodynamic theories to explore discontinuities in policy-making and the containment of anxiety in organizations (Obholzer and Roberts, 1994;Fotaki, 2006;Diamond and Allcorn, 2009;Fotaki and Hyde, 2014). This literature applies psychodynamic theories to explain inherent contradictions in policy formation related to unexpressed and therefore unexplored individual and collective unconscious desires and fears.…”