Inside-out: A psychodynamic approach to normalisation: Helen Smith and Hilary Brown
Experience shows that maintaining change in services to people with disabilities is extremely difficult, no matter which theories of change are employed. Both psychoanalysis and normalisation have been criticised on the grounds that making difficulties and problems explicit is not enough; attention needs to be paid to the conflicts which will ensue when an individual or an organisation attempts to do things differently. Because of this, it is necessary to understand the ways in which institutions functioned to support staff in their task of caring for people and to defend them from the personal stress inherent in such work. If the regimes which we are trying to replace have in fact grown up to provide a structure which contains the anxiety which the work creates, a change of location will not be enough to reform them. It is important, therefore, to focus on what is going on beneath the surface in new services and on the psychological implications for staff of working in community-based projects, especially those influenced by normalisation.