ABSTRACT
This chapter describes the relevance of the "social systems as a defence against anxiety" theory in a complex organizational development consultancy to a Sexual Assault Referral Centre (SARC) and the wider systemic problems that appeared to flow from improvements in the SARC's management team's leadership capability. The "partnership" between Health Trust and police that produced the SARC initially had care and compassion of patients as its primary purpose, but, over time, privileging policing procedures superseded as the new unconscious primary purpose. Work at an SARC—treating and managing dozens of traumatized patients each week, mostly women and child victims of sexual violence—is stressful. The chapter explores the see-saw effects of improvements in one part of the healthcare system leading to crisis in other parts as a consequence of not comprehending a "social systems" concept that could have provided the requisite containment for the functioning of the service.
