ABSTRACT
The concept of organizational culture as an unconscious collective defense system, that S. Freud himself somehow sensed, was thoroughly explored by W. R. Bion, and further developed from different perspectives by Elliot Jaques and Isabel Menzies the group analysis, the so-called “institutional psychotherapy,” the various socio-analytic “schools,” in the UK, USA, France and elsewhere. Splitting and isolation, combined with the enduring myth of the rational nature of the organization, are among the main reasons that can explain why inside the healthcare system. Clinical and caring cultures coexist with administrative and managerial ones, usually ignoring each other or, worse, fighting together, sometimes openly but more often in the shadow, with serious detriment for the quality of provided services and the involved people’s wellbeing. The resulting institutional “sleep of the reason” then creates its typical monsters: paranoia, mutual denigration, demoralization, witch hunting and scapegoating, bullying, mobbing, organizational malaise and burnout, perversion.
