ABSTRACT
In this chapter, the author provides impressions of, and aims to make a case for, the influence of unconscious psychodynamics on the task and performance of the organization itself. He also aims to make reference especially to the personal stress that results from working in mental health, and its effects on organizational function. The author also provides the explanation of noncollaborative working, finding it in the unconscious and collective reactions to the stress of working with psychosis. He presents evidence of a continuing existence of the dynamic of helplessness beyond institutional psychiatry, into community care. Community care does offer a degree of deinstitutionalization, but it is a very small effect. The gist is that the stress of encountering and working with psychotic people is not attended to, and that it emerges as organizational “pathology”, in the old mental hospitals, as the phenomenon of institutionalization, but in the newer community care as a persisting social isolation and passivity in patients.
