ABSTRACT
This chapter explores the dynamics of care to see how it might be difficult at times for those whose business is managing therapeutic interventions to show compassion towards those who are doing the work. It argues that why it is important to give greater management attention to care for the carers, and how the containment of anxiety is in danger of becoming a neglected management function. Large organisations—large enough for their members to be anonymous to each other, unacknowledged and unexamined objects of mutual mistrust—are likely to be full of anxiety. There are helpful concepts, developed by psychoanalysts in their exploration of individual development and have an acute relevance when the work has to do with the needs of those in physical and mental distress—working in systems of care. The system of care, which is intended to be responsive and compassionate, becomes itself a receptacle for our own unwanted projections of inadequacy into others.
