Psychoanalyst who closely examined the psychological dynamics of groups, most notably in a famous study of nurses.
Isabel Menzies Lyth, the distinguished psychoanalyst, was best known for her analysis of the dynamics of the nursing situation. But her work on health care was embedded in lifelong commitment to investigating and supporting processes of change in individuals and their institutions.
She wrote of her work: “Anxiety has been a central issue, how anxiety, its experience and expression and the related defenses, adaptations and sublimations are a major factor in determining personal and institutional behaviour.”
Her method of research and consultancy, honed in the postwar Tavistock Institute of Human Relations, was to “get people talking freely, individually and in groups, and to make observations in the field; to try to understand the deeper psychological meaning of this data within the context of relationships in society; then to try to set out the findings in such a way as to expand the client’s understanding and help orientate him towards finding a more appropriate way of tackling his problems.
This apparently simple method was deployed in projects commissioned by government, local authority or voluntary bodies, and commercial organisations. The range was wide – from the unconscious meaning of ice-cream and chocolate to fire-brigade recruitment; the interaction between a town in southeast England and its surrounding mental hospitals; the relationship between hospitalised children, mothers and nurses in an orthopaedic unit.
Menzies Lyth believed that institutions might be extremely difficult to change in their essentials, for they did actually modify the personality structure of their members, temporarily or permanently. It was this effect that she investigated in what has long been knows as her classic study, “The functioning of social systems as a defence against anxiety”. Published in 1959 in Human Relations, and reprinted many times, it started from commissioned research. The Tavistock Institute was asked to investigate a problem of nurse wastage in a London teaching hospital: student nurses, once qualifying, were not being retained. Through interviews and observations throughout the hospital, Menzies Lyth proposed a radical account of the dynamics of the situation: reduced to its essentials, she argued that the anxiety stimulated by the nursing task – with its proximity to intimate body processes and issues of life and death, and by extension to a primitive realm of “unconscious phantasies of ill, injured, dying and dead people” – produced social defenses that permeated the structures of the hospital. A central theme was the relative ineffectiveness of these defenses.
Nurses, she argued, were deprived of the potential for job satisfaction by the way in which the task was split up into impersonal elements, a splitting which she saw as stemming from the unconscious need, institutionally, to keep human suffering at a distance.
The paper was controversial within the nursing profession, although it remains extremely well known and has influenced generations of students.
Menzies Lyth was disappointed at its relative lack of influence on hospital management – although the more recent move to the “named nurse” on many hospital wards reflects a gradual shift towards the kind of change that she advocated.
Isabel Menzies was born in Fife in 1917, the fourth child of a minister of the Church of Scotland. She took a double first in economics and experimental psychology from St Andrews, where she lectured for some years before joining the War Office Selection Board and, later, the Civil Resettlement Headquarters of the British Army. Here she worked with the group of psychoanalysts that came together in the Tavistock Institute after the war.
She trained and became a highly respected child and adult psychoanalyst herself, becoming a training analyst of the British Psychoanalytical Society in 1960. She had an equally significant role as a group-relations consultant, particularly at the Tavistock Institute’s international “Leicester” conferences on the dynamics of authority and leadership.
Influenced by the work of Wilfred Bion (who was also her second analyst), she had a deep respect for the psychotic processes in groups, and their capacity to emerge without warning, and for the need, as a consultant, to remain open to their study without being blown off course by them.
After 1975 she moved to Oxford, where she married the psychoanalyst Oliver Lyth. With her husband she contributed to the evolving interest in analytic theory and practice in Oxford, a collaboration cut short by Lyth’s death in 1981.