ABSTRACT
The primary care reforms have forced each healthcare professional to find a conscious relationship to change and what it represents externally and internally. Since 1990 the NHS mother has, in the unconscious mind of primary care members, been experiencing a symbolic mental breakdown. Resistance to change is a sign of normality, not deviance, because each adjustment to working habits and relationships within a person or workgroup amounts to a loss and leads to an attendant mourning process. The group leader has the double task of keeping an eye on the performance level and on the relationships within the group. In the defensive position of subgrouping and pairing, primary care professionals cope with the stress of change by forming uniprofessional defence leagues and private pairings. Leadership is the key to change in groups as leaders are responsible for regulating the link between the inside and outside world: they are the guardians of the boundary.
