ABSTRACT
This chapter provides an overview of significant change and institutional learning occurring in a small psychiatric organization in the shifting context of health care in the United States. The dynamics of the institution indicated a systematic confusion between power and authority. Authority derives from a shared task, and members of different subgroups in the institution did not seem in agreement about the task. Power relates to the availability and deployment of resources. The chapter provides the distinctions between power and authority, and points out significant problems in institutions. It also focuses on symbolic communication about shared unconscious institutional functioning. The chapter also deals with the narcissistic investment of a chief executive officer. It also provides the readers the learning of organizational life. The existing organizational structure had the medical director and administrator leading a hierarchical organization.
