ABSTRACT
Every institution builds its own characteristic defences. There are many ways in which, in order to carry on, these defences—many of them unhealthy in themselves—are strengthened. This includes institutional defences as well as individual ones, and Menzies Lyth approached her work diagnostically, picking out "the problem of student-nurse allocation as a presenting symptom". Menzies Lyth understood the particular stress on nurses of being so close up to the patient. In their day-to-day work, they can expect to have extremely close physical contact with the patients (washing and dressing) and to encounter severe illness, major suffering, and subsequent disturbed or regressed behaviour. This situation undermines their own defences in the same way that mothers caring for small children are put in touch with their own infantile defences and yet have to maintain their adult position. The chapter focuses on the journey from the prison gate to a patient on the hospital wing, rather than on the interview with the patient.
