4. joan camilleri - the role of self-reflexivity in...

WorkBasedLearninge-Journal,Vol.9,No.2.b,(2020)

73

TheRoleofSelf-reflexivityinTransitionLeadership

TrainingintheHealthcareSector

JOANCAMILLERI*

UniversityofMalta,Msida,Malta

Leadersinthehealthcaresector,frequentlyfindthemselvesattemptingtoimproveserviceprovisionbyadoptingevidencebased-bestpractices,asrequestedbypolicy.Notwithstanding,changeimplementationisoftennotstraightforward.Asaninsider-turned-researcherIinitiatedaMalteseNationalHealthcareService-widedoctoralinquiryintothelivedexperienceofleadersduringchangeandtransition,togaininsightintowhichleadershipstylesandmanagerialskillscharacteriseaneffectivetransitionleaderfromapsychotherapeuticperspective.Theinquirywasdividedintotwophases,usingmixedmethodswithanaction-researchelement.Arisingthemesindicatingtheneedforindividualproactiveself-actualisation,developmentatanemotional-transferentiallevelandtheundoingofidentityfollowingorganizational/personalshifts,providedaplatformfortheco-creationofaTrainingManualfocusingonself-reflexivity.TrainingusingtheManualwasofferedtotheparticipantsfacilitatingtheirlookingmorecloselyathowpowerrelationsstalledpersonalandorganisationalgrowthbyhinderingchangeimplementationprocesses.Encounteringtheneedtounblockshame,somemetimpasse,othersmodifiedtheirunderlyingmetaphor/identityenhancingachangeinbehaviourwhileretainingthepowerinherentintheirpreviousidentity,whileothersyetnotedthatthetrainingenhancedtheirmanagerialskills.TheTrainingManualwaswellreceivedinthehealthcarefieldandbeyond.Theresultsoftheinquirysuggestthatself-reflexivityisanessentialelementwhenplanningtrainingforleadersandthatself-actualisation,andself-reflexivityareessentialmanagerialcompetencessupportingtransitionswhileenhancingcreativityandinter-dependence.Thisimpliesthatself-reflexivityneedstobeintroducedinmainstreammanagerialtraining.

Keywords:Leadership,Self-actualisation,Self-Reflexivity,Shame,Power,Identityand

Transitionmanagement.

* Correspondingauthor:JoanCamilleri.Email:[email protected]


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Introduction

AspartofadoctoratebyprofessionalstudiesIcarriedoutaninquiryintothelivedexperience

ofleadersduringorganisationalchange,exploringwaysoffacilitatingtransitionmanagement

training.TheMalteseNationalHealthcareService(MNHCS)wasadoptedasacasestudy.Part

ofthePublicSector,thisorganisationisoneofMalta’smainemployers.Asitmirrorstrends

acrosstheEuropeanUnionandtheUnitedKingdom,wheremanyofitsemployees’trainand

offertraining,resultsobtainedcouldbesharedoutsidetheMalteseIslands.

Theoutlayofthisarticleinvolves:adescriptionofthebackgroundandtheneedforchange;a

literaturereviewwithconsiderationsrelevanttothelocalfieldandresearchdesign;methods

andmethodologydescribehowphenomenologywasadoptedastheoverarchingorientation

andhowCriticalNarrativeAnalysisintegratedwithanaction-researchelementinvolvingan

advocacy-participatoryparadigm,ledtotheconstructionofPhenomenologicalCritical

NarrativeAnalysisasatoolfordataanalysis;Ethicalconsiderationsandmeansusedtoretain

insider-researcherobjectivityfollow;datacollectionincludedparticipative-observationduring

CommunicationsMacroTargetTeam(CMTT)meetings,unstructuredinterviewswith

volunteeringHeadsandreflexiveself-annotations,supportingtriangulation;dataanalysis

supportedtheemergenceofspontaneousthemesformingtheplatformforthewritingthe

TrainingManualincollaborationwiththeparticipants;findingsoftheCMTTsessions,

exploratoryInterviewsandthecollaborativeevaluationoftheManualarethendescribed;a

sectiononself-reflexivityelucidatinginsightsgeneratedfromthestudy,isfollowedbya

synthesis;asectionaboutPost-doctoralworkdescribessomeproducts,thewiderprofessional

influenceofthisresearchandmodificationsinthetrainingmanualinlightofmorerecent

practicesandlearning


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BackgroundandContext–theneedforchange

ReviewingMNHCSworkpractices,andobservingtheneedtofollowinternationaltrends

towardstransdisciplinarycare-plans,andknowledge-sharing(AzzopardiMuscat,etal.,2014;

Grech,2002)theMNHCSPermanentSecretaryrequestedinitiationofaMinistry-wideRe-

engineeringplan,inamechanisticcontextlackinghuman/materialresources.Headswere

encouragedtoadoptacomplementaryshiftinleadershipstyle/managerialskillsfromtechnical

administrationtoteam-management.Technicaladministrationdefinedasensuringresource

availabilitysoclinicalinterventionscouldbeadequatelycarriedout.Team-management

definedasmultidisciplinarycollaborationincareplancreation/implementation,introducing

standardoperationalproceduresandnewservices(NHSS,2014).Theexistingknowledge-

based,labour-intensivecontext,requiredsubstantialrestructuring(Dalmas,2005).

Seniormanagement,seeminglyunawarethatthecollaborativespiritsetforthinpolicy

challengedtheclinicians’individualisticidentity(Micallef,2003),promotedcliniciansto

managers,addingfinancialauditing/businessplanstotheirhabitualinterventions.Facedwith

difficultieswhenjugglingwithachangeinsenseofself/role/style,clinicians-cum-managers

attemptedtochangebehaviour,whilesafeguardingtheirsenseofself/identity(Vassallo,2007).

Work-basedobservationsindicatedthatthetrainingofferedwhilebasedoninternational

standards,metwithlimitedsuccess(Dalmas,2005)asonlyHeadsinterestedinmanagement

attendedtrainingwhichstartedafterchangewasimplemented(Micallef,2005).

AsaseniorpsychologistintheMNHCS,facingsimilardilemmas,Iaskedmysupervisor,“What

canIdo?”Herreply,“Whodoyoubecome?”challengedme.IfIwantedtobecomeateam

managerIneededtoletmytechnicaladministratoridentitygo.Thisinnershiftwasfacilitated

bythenarrativefunctionofthepersonality(Chidiac&Denham-Vaughn,2008),asking“Whoam

I/WhodoIbecome?”duringtheaccommodationphaseofthetransition/developmental

process(Ginger,2006).Identitymodification,requiredcriticalself-reflexivity.Thisobservation

initiatedadoctoralinquiryintotheexplorationofthelivedexperienceofleadersduringchange


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andtransition,togaininsightintomoreappropriatesupportiveinterventions(Barr&Dowding,

2012).

Objectives

Thisinquiryaimedatgaininginsightintoleaders’underlyingprocessesastheydevelopedin

theircontextualchanges;whichmanagerialskillsenhancedthechange/transitionprocess;what

weretheirtrainingneeds/preferredapproaches,andtoco-create/validatearelatedtraining

manual.

LiteratureReview

Changestartsbylettinggocurrentwaysofthinking,feelingandbehaving,sonewwaysmaybe

created,acceptedandadopted(Bridges,2003).Thistransitionprocessentailsmodificationsin

theinterpretationofmeaning(Dima&Skehill,2011;Manderschied&Harrower,2016)which

emotional,transferential,projectiveandspiritualprocessesofbecomingmayhinder/support.

Adaptinghealthilytoshiftsincontextisachoiceonemakeswhenreconnectingone’slife

narrativepre-topost-disruption(Barber,2006).

Integratingmanagerialandpsychotherapeuticchangemodels(Kaplan&Norton,2008;Ginger,

2006)indicatedhow,theoretically,thelivedexperienceoftransitionduringorganisational

changemaydevelop:

Anoverarchingorganisationalgoalissplitintosmalleronesthatmaybecateredforbyits

variousentities/departments.Giventheircentralroleasculturecarriers,leaders,needtobe

thefirsttoadopttherequiredshift(Amado&Elsner,2007;Binneyetal.,2012),topromoteitin

others(Baek-Kyoo,2005;Hawkins&Smith,2013).Asleadersbecomeawarethattheyneed

modifytheirsenseofself/identity,theymayre-enacthabitual,possiblyineffectivecoping

mechanisms(Thomas&Hardy,2011).Increasingleaders’awarenessabouttheirreactionto

change,couldsupportinsight,facilitatingacceptanceandparticipationinthetransitionprocess


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(Gilleyetal.,2011;Farrell,Keenanetal.,2013).Since,transitionmanagersneedtoreform

theirsenseofself/role/identity,tomodelnewwaystoemployees,(Nicholsen&Carroll,2013)

theywouldbenefitfromdevelopingconsciousnessofself-changeovertime(Oysermanetal.,

2004),becomingawareandacceptingwhotheyare,whilerecognizingwhotheyneedto

become.Toachievethis,theycouldengageininnerdialogue,asking:Whataremyneeds?–

identifyingunconsciousaspirations;WhodoIneedtobecome?–enhancingself-awareness,

facilitatingidentitymodification(Gilbert&Orlans,2011);WhatdoIwant?–makingconscious

decisions.Emergenceoftheleader’seffectivestylewouldoccursimultaneouslywithtransition

unfoldingatorganisationallevel,influencedbythewiderfield(Binneyetal.,2012).

Achievingself-changerequiresreflectivethinkingduringwhichonegainsawarenessof

predominantprocessesbycomingintouchwiththeregularinteractionsandpracticestaking

placeinthesurroundingculture(Syedetal.,2012).Thisprocessmaymotivateleadersto

challengethehabitualwayinwhichthingsaredone,andtoadoptrelevantvaluestofacilitate

effectiveserviceprovision(Cartwright,2002).Byreflectingontheirpractices,leaderscould

increaseawarenessoftheirtrainingneeds(Camargo-Borges&Rasera,2013;Gibson&Hanes,

2003).Thisimpliesthatreflectivethinkingcouldimprovegovernancethroughleaders’

appropriateandrelevantself-development(Grey2007).Tothisend,trainingcouldfocuson

increasingself-awareness,understandingtheprocessoneneedstoembarkupontodevelopan

identitywhichenhancesgoalachievementandself-fulfillment(Hawkins&Smith,2013).

Trainingcouldadoptanaction-researchapproachintheformofsupervisedpracticeatthe

workplace,(Hawkins&Shohet,2012)supportingleaderstoreplacecompetencytrainingwith

“learningtolearn”(Gray,2007,478),inaconfidentialsetting,promotingcriticalself-reflection

(Chidiac&Denham-Vaughn,2009).

IfMNHCSleaderscouldcriticallyself-reflectwhileintroducingcare-plans/audits,theycould

facilitateashiftintheorganisation’sunderlyinggoals,policiesandnorms,improving

governance(Kitchenham,2008).SinceBridges(2003)describedtheleadershipstylerelevantto


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transitionandBarber(2006)depictedhowtosupportvariousphasesofchange,itwas

beneficialtofocustheinquiryontheimpactchangeimplementationhasontheleader(Robson,

2002)focusingonlivedexperience,gaininginsightintounderlyingprocessesasHeads

respondedtoorganisationalchange(Reissman,2008).Applyingthisknowledgetotraining

programswouldbenefitallstakeholders(Binney,etal.,2012;Gray,2010;Thomas&Hardy,

2011).

Methodology

Exploringleaders’livedexperiencetobetterunderstandhowtheymaybesupported,required

empathicunderstandingoftheirindividualstory(Cresswell,2007).Thechosenmethodology

hadtoappealtotheirsenseoflogicalstructuresotheycouldfeelsufficientlycomfortablewith

theinnovative.Aphenomenologicaloverarchingorientation,narrativeanalyseswithacritical

thrustincludinganaction-researchelement(Langdridge&Hagger-Johnson,2009)wasdeemed

appropriate.Themethodologyofthisinquirywas,splitintotwophases:

Phase1:–Exploration,description,andinterpretationoftheHeads’livedexperienceswithin

theircontextastheyoccurred,usingfirst-personaction-researchpracticesand

phenomenologicalcriticalnarrativeanalysis.Thisfacilitateddelvingintonewareasof

knowledge,developinginsightintocommonphenomena.Arisingthemeswereusedasa

platformtoco-createaTrainingManual.

Phase2:–Determinationoftheeffectiveness/validationoftheManualwiththeparticipating

Heads,evaluatingitsimpactontheirshiftsofsenseofself/role/identity,usingsecond-person

action-researchpracticesinaparticipatorymanner,andcriticalself-reflective,change-

supportingelements.Narrativeandparadigmicmodeswereemployed.Theformerexplored

Heads’desires,goalsandintentionsthroughtheirstories,thelatterfacilitatedthelogico-

scientificunderstandingofexperiencesthroughempiricalobservation(Langdridge,2007).

Constructionismsupportedtheassumptionofapositionofadvocacy,raisingawareness,

establishingdialoguewithwhatunfoldedinthefieldwhilebeingcriticalofthesame(Camargo-

Borges&Rasera,2013;Figure2).


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PhenomenologicalCriticalNarrativeAnalysis:(PCNA)wasdevelopedbyintegratingcritical

narrativeanalysis(Langdridge,2007)withsecond-personaction-researchpractices(Cresswell,

2007).Criticalmomentswereintroducedintotheanalysesthroughhermeneuticreflexivity

(Langdridge&Hagger-Johnson,2009),involvingacritiqueoftheillusionofsubjectivity.PCNA

supportedtheexplorationoftheHeads’underlyingprocessbyhighlightingidentitychanges,

allowingthemestoemergespontaneouslyinahierarchyofpatternsfromthedatacollected

andflexibleanalysesofHeads’stories/textonacase-by-casebasis,identifyingpatternsof

meaningwithin/acrossdata;presentingthewholeinastructuredmanner(Langdridge,2009).

TheAction-researchapproachentailedtheorganisationsmode,supportingcollaboration

amongprofessionalstoreflexivelyimproveprofessionalpractice(Hughes,2008).Thisapproach

waschosenforitsproblem-solvingfocus,anditsmirroringcoachingmodels’framework

(Hawkins&Smith,2012).Astheinquiryrequiredacriticalself-reflexivefocus,Barber’s(2012)

modelhighlightingactionandcriticalself-reflectionateachphase,wasadopted.

• Pre-contact:Awarenessofconscious/unconsciousprocesses,differentlevelsof

experienceandpersonalpoliticsmanifestedasbehavior,mindset,emotionsand

motivation.

• Orientation:Researcherandparticipantsdrawacontractengaginginpreparatory

activities.

• Identification:Problemsareidentified,remediesdiscussedandsolutionsattempted.

• Exploration:Monitoringtheimpactofstrategiesimplementationonallstakeholders.

• Resolution:Measuringsuccess,terminationoftheallianceandfinalreflections.

EthicalpermissiontocarryoutthedoctoralinquiryinMaltawasobtainedfromtheMaltese

DataProtectionBoardandtheMaltaUniversityResearchEthicsBoard.Theresearchproposal

wasapprovedbytheMetanoia/MiddlesexEthicsCommittee.Beinganinsider-turned-

researcher,whileplacingmeinapositiontogainvaluableinsights,raisedethicalconcerns

(Czarniawska,2004).Acknowledgingmypresenceinthefieldcouldinfluencestudyoutcomes,I

adoptedapsychotherapeuticapproachtointerviewingtodecreasemyimpact,while

attemptingtobeascriticallyreflexiveaspossiblebydistancingmyselffromfeelingpartofthe


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organisation(Frambach,2003).Iadoptedaheuristicapproachtoensurepersonalintegrityand

ethicalexpression(Finlay&Evans,2009)whilefocusingonnotelicitingdesireddata(McLeod,

2010).Democracywasattainedbyadoptinganaction-researchapproach(Hughes,2008).

MethodsandResearchDesign

Theinquiryrequiredaflexibleresearchdesignlendingitselfsystematicallytothecollectionand

analysesofdata-richinformation,facilitatingworkingwithshiftsinsenseofself/role/identity

producingthemes,allowingtheresearchquestiontobere-shapedbysubsequentquestions

(Robson,2002).Datasourceandmethodstriangulationwereadoptedateachphase

(Langdridge&Hagger-Johnson,2009).Itbecameamulti-strandedmetastory,(Bamberg,2006)

diversefromthatofferedbythepoliticallypowerful(Czarniawsa,2004).

SamplingandParticipants:Namesofpotentialparticipantswereobtainedfroman

organisationalconsultant,andaletterwassenttoall.Volunteeringparticipants,heldvarious

postsintheMNHCSrangingfrompublichealth/medicalconsultantstoexecutivemanagersto

healthcareadministrators.Agesrangedbetween31and58years.Theageofappointmentto

leadershippositionsvariedbetween22and47years.Theirlengthofstayinleadershipranged

from9monthsto36years.Allheldapositionrequiringcontractrenewaleverythreeyears.

TheirextentofleadershiptrainingrangedfromnonetoMaster’s-level.Motivationto

participateincluded:-interestintheresearchtopic,findingsolutionsformanagementissues

andintroducingstaffsupport.Fourparticipantsdroppedoutandwerereplacedforthe

evaluationoftheManual.

DataCollection:

Macro-level(socio-cultural)datawascollectedduringattendanceofanInternal

CommunicationMacroTargetTeam(CMTT)sessions.Adoptinganobserver-as-participant

stanceIheardthevoicesofmanagementundergoinganxietywhenfacedwithchange

(Czarniawska,2004).Participants,permittingmyattendance,vetoedaudio-recordingof

sessions,soItookdownconversationsverbatimonanotebookcomputer,notingthepersons

involved,eventsnarratedinatimesequence,andemotionsexhibited(Robson,2002).Thefirst


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HeadtospeakwascodedCMTT1andsoforth.AttendingtheCMTTmeetingsallowedmeto

observetheoutcomesofnon-reflectivechangeimpementation,providingsupportive

informationfortheexploratoryinterviews(Cresswell,2007),.

Micro-level(emotional-projective)datawascollectedthroughexploratoryinterviewsduring

transition,beforethesense-makingretrospectiveprocessandcontextualinfluencesetin,

decreasingfaultyrecall.ImettheHeadsapproximatelyonceeveryfourmonthsatT1-T2-T3

overayear.Interviewsscheduledbyappointment,wereconductedattheiroffices(Gray,

2007).Headsallowedmetorecordtheinterviews.ThefirstinterviewedHeadwascodedH1

andsoforth.Thisprocessgavethemtime/spacetonarratetheirstoryfromtheintroductionof

theorganisationalshifttotheirnewrolesfollowingcontractrenewal,demotionordismissal

(Nicholsen&Carrol,2013).Reissman’s(2008)fivephasesofrepresentationwereadoptedfor

theinterviewing,transcriptionandrelatingprocesses:

T1theresearchquestion;“Whatisyourlivedexperienceofchangeandtransition?”wasasked

atthestartoftheinterviews.“Whatmetaphorsymboliseswhoyouareinyourcurrent

position?”wasaskedattheend.Interviewsweretranscribedandanalysedbetweensessions.

Arisingthemesfromindividualparticipantsweresenttothempersonallyforfeedback.

T2andsubsequentinterviewscommencedwiththequestion“Whatareyourreflectionsonthe

themesarisingfromthepreviousdiscussion?”Trainingneeds/desiredapproacheswere

explored.AdraftTrainingManualbasedonarisingthemeswassenttotheparticipants

betweenT2andT3.

T3-themesarisingfromT2andthedraftTrainingManualwerediscussed.

AnamendedTrainingManualwasSharedamongstparticipantswhovolunteeredfortraining.

TodeterminetheeffectivenessoftheTrainingManual–Ifocusedonprocessstudies,

encouragingstakeholderstoparticipateindecision-makingatallstagesoftheaction-research

cycle(Fillery-Travis&Lane,2006).Theevaluationconsistedof:training-in-activitywitheach

participantindicatingwhatwaslearnt;thePCNAofexitinterviews;andmetaphoranalysis

(Lawley,&Tompkins,2013;Figure3overleaf).


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Figure3:ActionResearchSpiralforDeterminingtheEffectivenessoftheManual

DataAnalysis:DuringthePCNAofthetranscribedmaterialtopic-centerednarratives,linkedby

themeswereadopted(Reissman,2008).Commonpatternsofmeaningwereidentified,

appreciatingwhatfelloutofthispatternandworkingwithboth.Datasetswereplacedinto

codesproducingathematicmap.Narrativesweredeconstructedasking‘Whichothervoices

needtobeheard?Thesynthesis,intertwinedmyinterpretationsofthedescriptions,withmy

observations(Langdridge,2009).

Findings

Participative-observationofCMTTsessionsfacilitatedinsightintotheHeads’experienceof

ongoingchange/implementationandoutcomesofnon-reflectivefacilitation.Exploratory

interviewssupportedinsightintoHeads’underlyingprocesses,trainingneeds/preferred

approachesandtheoutcomesoftheirnon-reflectivemanagerialinterventions.Findingswillbe

presentedusingthePCNAstructure.

Orientation:Discussing identified topical life

stories, translating key issues into a training

manual

Implementation: Training participating Heads over a

three-month period

Exploring the impact through constant feedback

from participants & supervision

Critical Reflection on the outcomes with various

stakeholders


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Participative-observationofCMTTsessions:ElevenCMTTsessions,werefacilitatedbyCMTTF

betweenJune–July2012.Headsnominatedbyadministration†astheirrepresentatives,were

taskedtocreateguidelinesenhancinginter-employeeandinter-entitycommunication.CMTTF

plannedtoconvincetheHeadsthatitwouldbenefitMNHCStobecomealearningorganisation,

andintroducethepositionofCommunicationsCoordinatoratDirector(CCD)level.Onehoped

someHeadswouldbecome“multipliersoftheprocess”(Session#2,line1).StatingthatCMTT

outcomesdepended“onthepersonalityoftheleader”(Session#9,line17)CMTTFsetthe

canonicalnarrativeasherowhoenterstoturntheorganisationaround.Oneappearedunaware

thattheHeadsregardingCMTTFasrepresentingMNHCSadministration.Theywerecautiousof

embracingtheprescriptivedocument,sincetheyhadtoaccountfortheiractionstotheabsent

decision-takers.Rhetoricincludeddistancingthroughsecond-andthird-personpronouns,and

self-referentialitythroughtheegocentricI.Verbalisationssuchas“people...donotliketosee

change”(CMTT10,Session#6,line127),coupledwithawarytoneofvoice,indicatedattempts

toplayfortimeuntilthepicturebecameclearer,whileappearingtosupportthe

communicationsdocument‡settingthecounter-narrativeaschangeterrifiesusintoinaction;

anonymityprotectsus.

TheMNHCSnon-reflectivechangeimplementationprocessesinvolved:Seniormanagement

leadingthroughpersonalitycult(shadownarrative)createdcoregroupstocarryouttheir

directions,precipitatingasilo-mentality,usv.themculture.Reportedly,theyadoptedthisstyle,

tocamouflagelimitedmanagerialskills,whilecontrollingotherHeads.Middle-management

belongingtothecore-groups,encounteringanoppressiveattitude,feltdeterredfromvoicing

theirfeelings/initiatives,asmanifestedwhentheCMTTHeadsadoptedverytentativelanguage

todescribepotentialinitiativesverbalizing,perhaps,if,maybe.Headsrespondedfroma

perspectiveoffearofsanctions/self-gain,withunderlyingfeelingsmorelikelytobeenvy/spite:

“Managementwantsanemployeeto...becreative,butwhencreativitydoesnotwork,[they]

be-Headhimwithascimitar”(CMTT2,IntroductorySession,line39).Livinginconstantfearof

† Senior management and administration are used interchangeably in this section. ‡ Reference to document in the text means the communications document.


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beingshamed,mistrustingtheirstaff’sabilitytomaintainconfidentiality,CMTTHeadsshifted

blameoflimitedefficiencyontosabotagecarriedoutbysubordinates:“Theproblemiswhen

lowerworkersdoharmonpurpose”(CMTT9,Session#2,line78).Heads,identifyingwiththeir

oppressorsbecameoppressiveand/orinfantile.“Goodcommunicationisthatwhichgetsyou

whatyouwant”(CMTT11,IntroductorySession,line36).Apparentlylackingself-reflexivitythey

distancedfromself-growth-theshadownarrative.Lowerechelons,excludedfromcore

groups,reportedresentment,withbottom-uprebellionand/oradaptation,joiningtheirunions

inanattempttoredressthepowerdifferential,severingcommunication.

CMTTF,infact,didnotconsultwiththeCMTTHeads.Onedeflected§theirseveralwarnings

abouthowtheyfelt,erroneouslysupposingthatonecouldchangetheirmind-setduringthe

documentationprocess.Oneappearedunawarethattheproposals,triggeredtheshow-

stoppingoverallnarrative-Wewillalldowhatwehaveto,sowhenchangeimplementation

fails,weallsaveface,andpredominantthemeMNHCSpiècedurésistance,propose,stop

(silence),wait(togaintime),abort(tosafety).OnegavethepoliticallypowerfulHeadswhat

theywantedtoavoidconflict,solesspowerfulHeads,gainedtimethroughstrategicrequests

forclarification,makingcounter-suggestions,untiltheygaverisetoascenariotheycould

control.Discouragedbythepercievedlackofcollaboration,CMTTF,exclaimedthatunlessall

agreed“wecanforgetit”(Session#11,line34).CMTTFimposedtherecruitmentofaCCD

deeminghimnecessarytocreate“asingleperspective”(Session#7,line,19).Headsvoiced

resentmentthatanotherDirectorcouldbegivenpowertotellthemwhattodo.CMTTF,

negotiatedtheinsertionofthetermcooperationinthedocument,allowingthemtocollaborate

if/whentheydeemedfit,renderingCCDdependentonindividualgoodwill.Adilutedversionof

theoriginalproposalwasrubberstamped,gettingthejobdonebutonlyonpaper–shadow

narrative.

§ In gestalt psychotherapy this means turning away either an internal stimulus or one from the environment, preventing awareness (Ginger, 2006)


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ThemainobstructiontoaneffectiveoutcomeemergedinSession#3whenCMTTFaskedthe

Headstodiscusstheiridentity.Overwhelmed,mostprojectedanimageofcompetence,

emphasisingprideintheirprofessionalstatus:“Wearethosewhoarecontributingtoachieve

thegoals...”(CMTT5,line5).InSession#7,askedtoreflectabouttheiridentityandvalues,

Headsreiteratedthattheirsenseofselfemanatedfrom“prideinthe…professionalstate”

(CMTT10,line74).CMTTFgaveup:“Ifwehaveaproblemunderstandingwhoweare,we

cannotgoforward”(line,43).EnjoyingprideintheirstatusHeadsdefendedthemselvesfrom

commitmenttochangefearingitsloss:“Thisisego”(line104),verbalisedCMTT5.

ExploratoryInterviews:occurredbetweenJanuary–December,2013whileparticipantswaited

foradministrationtoeitherrenew/terminatetheirthree-year-termcontractorre-

instate/demotethemafterchangesinpoliticaladministration.Narrativesevidencedanxiety,

fear,anger,frustration,resentmentandfeelingirrelevant.Feelingswereattimesovertly

expressedwhileatotherscamouflagedasover-composureand/ordeflectedintoabitter

humour.InterviewedHeadsalsodistancedfromtheirnarrativesusingsecond-andthird-

person,singularandplural,adoptedtheself-referentialegocentricI,projectedanimageof

excellence,hidinginternalconflict.DistancinganddetachmentappearedtobeMNHCS-wide

copingmechanisms.Incoherencebetweenverbalandnon-verbalprocessesre-elicitedthe

themepublicv.privateselves.

a) HeadsUnderlyingprocesses

DuringInterview#1,Headsfeltchallengedbytheresearchquestion“Whatisyourlived

experienceofchangeandtransition?”askingabouttheirexperienceofratherthanhowthey

implementedchange.Evaluatingtheirimpactontheenhancementofthequalityofservice

provision,Headsassessediftheyweregoodenoughforre-instatement.Theynarrated

adjustingtocircumstancesthroughaseriesoftransitionalcrises,habituallyjuggling(shadow

narrative)inaconditionedmanner.Narrativesechoedperusedliterature(Gilbert&Orlans,

2011;Thomas&Hardy,2011).Viewingtheinquiryaschangeagencyseniormanagement


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belittled/ridiculedit,evokinganexpert–amateurinteraction:“Youcan’tmakethenervous

calm.”(H13,line40)verbalisedsarcastically.Middle-managementtendedtoevokeadominant

teacher–studentinteraction:“Look,letmetellyou!”(H2,line11;H8,line6).Caughtinthe

sameorganisationalshame/blamenarrativeasCMTTHeads,theyalsowerereluctanttodiscuss

theirprivateselves/identity.Tore-establishpowerdynamicssomerequestedacopyofthe

methodology,othersalistofreferencestoensuretheresearchhadsolidscientificbasis.

Proposingpolicyupdateswasviewedasanopportunityto“Increaseconsistent,reliable

services...”(H1,Int,#1,lines14)enhancingquality,accessibility,andsustainabilityofservice

provisiontotheserviceuser(canonicalnarrative).Creativechangewasdiscouragedwith

“innovations…thrustuponyou...mostofthetime,youjustabsorbthechange”(H5,Int.#1,

lines14,18).

InterviewedHeadsechoedCMTTHeadsnarrativesofnon-reflectivechangeimplementation

processes.Thoughseniormanagementpreferredadoptingevidence-basedresearchmethods

whenattemptingtoimplementchange:“thatdoesnothappenmuch”(H9,Int.#2,line28).

Peerswereapproachedwith“scientificargument”(H2,Int.#2,line26),however“personal

psychologyandtheotherperson’spsychology”(H5,Int.#1,line73)wereessentialtoelicit

individualgoodwillgivingrisetotheoverallnarrative:It’snotwhatorhowmuchyouknowthat

mattersbuthowwellyougetonwiththosewhomatter.Middle-management,deemed

“incompetent…[had]…tothinklike…”(H2,Int.#2,line26)seniormanagement.Lowerechelons

wereapproachedthroughchangeagentsadoptingmanipulativetechniques.Whenpersuasion

failedseniormanagementresortedtoimpositionsettingtheshadownarrativepowerisin

givingdirectionnotinbeingofservice.Shiftingblameontolowerechelons’resistanceto

change,Headsjustifiedtheneedforautocracy,andlackoftransperancy.Theyfailedto

acknowledgethattheadoptionofconstrainingcommunicationstyles,ledtoelectivemutism

(silence)and/orfrustratedacting-out(unionisation),settingthecounternarrativestrivingfor

consensusorchestratesinaction.

HeadsalsogotcaughtintheMNHCSviciouscycle:“evolvingandchanging[notnecessarily]into

somethingbetter”(H4,Int.#2,line88),becomingslowlybutsurelydesensitized,detachedand


87

alienatedand/orleaving.Theyrealizedthatgoinghighercouldentailmeetingmore

constraints,precipitatingfrustration.ThemoredistantHeadsbecamefromthecorebusiness,

themoretheyriskedidentitycrises:“It’s…easier…toempathise…whenyoumeet…the

person…usingtheservice”(H6,Int.#1,line26).Speakingoftheirlifeasleaders,theytookdeep

self-supportivebreathsfollowedbysilence.Self-actualisationsloweddownspiritual-emotional

regression,providingsufficientintrinsicrewardsandenergytoprotectoneself:“Surviving

is...momentofreflection...beinghappydoingwhatIdo”(H3,Int.#1,line116).

ByInterview#2,havingreadtheemergentthemesfromInterview#1Headsfelttheywere

losingcontrolovertheresearch.Thisprecipitatedfurtherpoliteannihilation/ridiculeaspartof

abelligerentdiplomaticargument.Whilefeelingdispleased/furiousatwhatemerged,they

couldnotdenyit:“Iwastakenaback…IwasmoreofaguineapigthanIrealised”(H5,line8).

Toretaintheirtop-downexpertidentityintact,participantssplitmeintobadlistenerwhenI

questionedandgoodlistenerwhenIempathised,beinghappiestwhenwhatIsaidwas‘exactly,

exactly’whattheyintended.Theinterviewsendedonarelievednoteforre-instatedHeads,

disappointmentforHeadswhoaccepteddemotionwithambiguousgraceandfuryforHeads

whoexperiencedtheirdemotionasnarcissisticinjury.**

DetachedfromtheirinnerselvestosurviveMNHCSpractices,hidfrustrationandanxietyunder

aveneerofover-composureandego-centricity,livinginfearofbeingshamed.

b) Managerialskillsandvaluesforchangeimplementation

DuringInterviews1#and#2Headsdisclosedencounteringdifficultywhenpracticingskills,they

learntduringtraining.Theyactedasiftheywerefollowingmanagementtheorybuttheintent

wassurvival,theavoidanceofshameandblame.

Activelistening,acknowledgement,andequityaimedatensuringloyalty,ratherthan

understanding.Heads,disseminatedinformation/knowledgeabouttheorganisationcautiously,

disclosingevenlessaboutthemselves,believingthatthiscouldleadtolossofpower:“sharing

** A narcissistic injury occurs when a person reacts negatively to perceived or real criticism or judgment, boundaries placed on them, and/or attempts to hold them accountable for harmful behaviour (DSM-5, 2013)


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innerfeelingsenoughgains...trust,toomuch...becomesshaky”(H15,Int.#1,line10).Heads

notedthatbuildinggoodworkingrelationswithpeersresultedingreatercollaboration,

howevertheysetclearpowerdistancesbetweenthemselvesandthestaff,reducingthelatter

toanamelessmass;“…thestaffhastobenefitaswell…givehimawin-winsituation”(H2,Int.

#1,line83).ForHeadsoutcomeevaluationwasanongoingexerciseassessingwhetheronewas

attainingthedesiredresults.Thisapproachentailedbeing“abletoaccept,failures,mistakes”

(H15,Int.#1,line52),“...find[ing]waysofimproving”(H1,Int.#2,line12);saying“…‘look,this

didn’twork,’weneedtoadapt”(H3,Int#1,line17).Negotiation,persuasion,andorganisation

techniquesaimedatachievingawin-winsituationforasmanystakeholdersaspossible;“Idon’t

trustthemandtheydon’tunderstandme….so,youbuildtrust”(H1,Int.#2,line48,53).

Whileacknowledgingthatbeingauthenticandhonestcouldgeneratetrust,Headsnotedthat

survivalrequiredflexibilty,shrewdnessandopportunism,possiblyalsomanipulation:

“sometimes…youmayneedtosayahalf-truth(H13,Int.#2,line49);“Youcan’t,(triplicated)

occupycertainpositionsandnothaveathickskin”(H9,Int#1,line30).Commitmentand

passion,involvedowningaprojectwhichreflectedone’scause:“Ifyoudon’tsucceedtryand

tryagain”(H13,Int.#1,line11).Whenpassiondiedone“movedon”(Int.#1,H3,line116;H12,

line83).Patience,tenacity,perseveranceandresilience,wereessentialgiventheslow,

unfoldingofchange.Acceptingthesituationand,workinginthehere-and-nowwererelatedto

lackofcontinuityratherthanmindfulness:“constantly,understandtheconstraints...results

taketime”(H15,Int.#1,lines56,57).Self-controlinvolvedbeinglogical,awareofnegative

feelingstoretainclarityofvisionandthought,focusingonwhathadtobedone:“recognizethat

asituationisabouttoescalate…thecircleofenemiesneedstobeconvertedintoacircleof

friends”(H1,Int.#1,line84,96).

RespondingtothedraftTrainingManualsentbetweenInterview#2and#3,Headsnotedthatit

wasevidentthattheManualhadbeenwrittenbysomeonewhoknewthefieldverbalising

“you’veinvented…anadapterplug…wecanthinkaboutchangingourprocesses”(H14,Int.#3,

line28).


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c) Trainingneedsanddesiredapproaches

DuringIntervew#3declaredtrainingneedstendedtoself-referentiallyaddressthe

developmentofpre-existingpredispositions,safeguardingpositionsofpower.Skillsrequiredto

functionwithintheMNHCSwerenotfoundinmanagerialbooks/trainingas:“newmanagersdo

notevenknowwhatskillstheyaregoingtobeneeding”(H1,line46).Theseskillscouldbe

impartedtochosenacolytes:“Youcannotinclude...aday-to-daypersoninthis...da”(H2,line

39).

However,whenrequestingfurthertrainingaboutethics,moraldevelopment,facilitatingthe

emergenceofthetrue-self,focusingonenhancingprofessionalismandincreasingawarenessof

howfartheyhaddevelopedintheseaspects,Headsexhibitedawarenessoftheirneedto

develop/rediscovertheirhumanity:“thepatient[asactiveparticipant]needstobecomethe

ethosoftheorganisation”(H2,line43),

Trainingapproachesrequestedincludedinteractiveseminars/workshopswhereinHeadscould

discussissues,exchangingsolutions.One-to-onecoaching/mentoringsessionsby:“someone…

wiser…atthesamelevel...tosharegrievanceswith”(H9,line89),would“allowthesituationto

growanddevelop”(H15,Int.#3,line119),avoidingsufferingassociatedwithlearningfrom

one’smistakes.Reflectionasaformofpersonaldevelopmentwashighlighted:“It’svery

difficulttobringaboutchangewhenyouyourselfhavenotgonethroughshortstopofsuspense

changes.Thenyoucansaythatyouleadbyexample”(H9,line67).Headsrequesteda“training

manual[offering]sufficientflexibilityforthepersontorevisitwhatonehadlearnt”(H1,line

44).

PCNAofInterview#3highlightedthatareflexive-tool,couldcircumventtheorganisational

narrativetellmewhattodosoIknowwhattoresist.ThiswasaddedtothedraftTraining

Manual.

WritingtheTrainingManual:Discussionswithstakeholdersindicatedthatitwouldbe

beneficialiftheTrainingManualdrewon:-Gray’s(2006,2007,2010)executivecoaching

approachwhereintrainingwouldfocusondailyworkplaceinterventions:Denham-Vaughnand


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Gawlinski’s(2012),coachingmodel,sotrainingwouldbebasedonfield-relationalandgestalt

theory:NicholsenandCarrol’s(2013)suggestionsthatthetrainer/researcher,practicingself-

awareness,wouldempathisewiththeleaderwhopractices:a)self-observation,followedby

self-disclosure;b)self-examinationthroughreflection/feedback;andc)self-development

throughtransformationbynewknowledge:andBarber’s(2012)multidimensionalapproach

whichfacilitatedengaginginfiveformsofinterventions,helpingparticipantsdevelopformsof

intelligence/skillatvariouslevels.Table1outlinesthefacilitativeskills,relationshiplevels,and

typesofintelligenceaddressed.

Table1:Multi-LevelAmalgamationforHolisticInquiry

FacilitativeSkill RelationshipLevel Intelligence FosteredSkill

Engagingthephysical-sensory

environment.Facilitatingawareness.

Negotiatingthe

workingalliance

Sensory

intelligence.

Observation

andlistening.

Respondingtosociocultural

environment.Organisational

dynamicsandethicalboundariesare

exploredandrecognised.Strategies

arecontracted/implemented.

Asabove. Social

intelligence.

Inquiryand

communication

Acknowledgingtheemotional-

transferentialclimate.Focusingon:

client/organisationbiography,

resources,learningorientations,

discoveringemotionalblockages.

Idealiseddimensionof

relationshipvspower

politics;shadowside

ofcontractual

relationship.

Emotional

intelligence.

Coachingand

counselling.

Surfacingtheimagined-projective

shadow.Drawingattentionto

unconsciousprocessesanddynamics.

Asabove. Self-

intelligence.

Mindfulness

andself-

awareness.


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Locatingintuitive-spiritualqualities.

Theattitudeoflisteningwithout

fittingwhatonehearsintopre-

packagedconcepts.

Authenticrelationship,

accurateperceptions,

willingnesstobe

honest.

Transformation

occurs.

Intuitive

intelligence.

Reflectiveand

envisioning.

TheTrainingManualdevelopedintothreesections:

Introduction:-Theconceptofleadershipandhowsynergisticlearningsupportsself-

developmentwerediscussed,exploringhowthereadercouldadoptcriticalself-reflection

duringtransition.

Self-ReflectiveTool:-Replyingtosetquestions,onecouldidentifyproblems,seekingremedies,

criticallyself-reflect,attainingbehaviouralclarityandawarenessthatone’spracticeischanging.

Self-ReflectiveManual:-Supportedthereadertolearnfrompersonalobservationandcritical

self-reflection,facilitatingthecultivationofanewsenseofself/identity,andthedevelopment

oftransitionalleadershipskills/relatedroles.Conceptualframeworksandmodelsuponwhich

thetoolwasbased,werediscussed.

d) TrainingOutcomesandEvaluationoftheManual

TrainingcommencedMarch2014,withthirteenparticipatingHeadsandtwonewvolunteering

Heads–fifteeninall.Duringaninitialmeetinganup-datedversionoftheManualwas

presentedtothemofferingthemachoicetoreaditontheirown,orworkthroughitwithme.

FiveHeadsoptedtoreaditandmeetfordiscussions.TenHeads,identifiedareastheyrequired

traininginandweworkedtogether.Thissectionwilldiscussresultsobtainedfrom:training-in-

activity;PCNAofExitinterviewsandmetaphoranalysis.Exitinterviewsoccurredonemonth

followingtrainingallowingHeadstimetoworkontheirrespectiveprojects.Metaphors

verbalisedduringInterview#1werecomparedtothoseofferedduringtheExitInterviews


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evaluatingpossibleshiftsinsenseofself/identity,managerialskills/leadershipstyleand/or

learningstyle,notconsciouslyverbalized,onacase-by-casebasis.Asprojectivetechniques

mayrevealwhatparticipantsdonotnecessarilyknoworwantknownaboutthemselves,Iasked

thempointblankwhichmetaphorsymbolisedwhotheywere,demystifyingtheprocess,

increasingtrust(Edgar,2004).

Training-in-activity:Heads’projectswerediscussedduringthree/fourmeetingsheldovera

three-monthperiod.Processnoteswerekept.AllHeadsindicatedthatorganisationalissues

arosewhenprojectsreachedtheexplorationphase(Barber,2012)-monitoringtheimpactof

strategyimplementationonstakeholders,possiblybecauseadoptingatop-downapproachwith

subordinatesrenderedmonitoringdifficult.H14notedthatwhenbuildingcommunication,the

bestplanwas“comingdowntoearth,onlevelwiththestaff.”H15startedhavingcoffeeinthe

kitchen,togivethemessage“Iamapartofyouatlowerlevel.”Trainingsupportedthemto

developawarenesssotheycouldidentifytheirvalues,andthensupportthedevelopmentof

awarenessinothers,soallcouldbecomeawarewhichvaluetheymightneedtochange/adopt

tosuccessfullyachievedesiredoutcomes.

ThreeHeadsadoptingguidelinesexplicatedbytheManualcommencedprojectsdiscussingthe

wayforwardwithcolleaguesandsubordinates.Theyfoundthisexercisedemanding,however

agreedit,‘unexpectedly’facilitatedthesmoothflowoftheproject.TwoHeadsrequested

team-buildingfortheirentity.Thoughthisachievedthedesiredmanagerialgoal,itset

subordinatesonthepathtodifferentiation.Feelingtheywerelosingcontroloverthestaff,the

Headsdevelopedinternalconflict.Notwithstanding,theyreportedthatthisactivitylefta

positiveimpressiononseniormanagement,promotingmanaging-up.Headsseekingto

enhancetheirinteractionswithsubordinates,ratherthantheirownself-development,became

moreeffective.

ExitInterviews:Headswereaskedsetquestionstoevaluatethetrainingoutcomes:

Askedwhattheyconsideredtobeofsignificantlearningforthemselvesandhowtheybest

learnedfromthemeetings,Heads,voicedappreciationforthewaytheManualintegrated

managementwithpsychotherapy,logicalthinkingwithempathy:“thewayitisstructured[and


93

the]questions[madeyou]reflect...renderingyoumoreempathic”(H1,lines5,7);“Itcameat

therighttime...he...he...sometimesit’sgoodtohavesomethingthat...helpsyoufilteryour

thinking”(H13,line34).Heads,notedthattheyfoundtheManualtime-consuming,requiring

in-depththinkingpriortoinsight.

Askediftheywereawareofanyself-growth,duetotheworkcarriedoutthroughtheReflective

tool,Headsreportedalimitedincreaseinself-awarenessandself-reflexivity,whichtheytended

tointellectualise,justifyand/orrationalisetosomedegree.Headsdeemedtheoutcomeshad

commencedduringtheexploratoryinterviewingprocess,wherein‘hard’questionshad“started

self-reflection...maybebeforeIdidnotgiveitanyattention”(H10,line4).Focusedonself-

reflection,theManualcouldnotbeusedasasetofmodels/directionsindicatingwhatHeads

weremeanttothinkand/orhowtoreply.Headslackinganinternallocusofcontrolfoundthis

difficulttodigest.SoundingsurprisedH10andH13respectivelyverbalised;“Thatthingmade

me…stop,thinkandplan…IhaveatoolIcanuse”(H10,line2);“You…makethetimeto

actually…reflect”(H13,line3).Blamefortheincreaseinundesiredself-awarenessandself-

reflectionwasattimesshiftedontome,asauthorof‘thething.’

OtherHeads,whileappearingangryatunplannedpersonalchange,reportedfeelingcontent

whentrainingsupportedachievementofmanagerialgoals.ThismirroredtheCMTTnarrative–

theywantchange,wedonotwantself-growth.Self-reflection,whilegivingresultsmighthave

precipitatedunblockingofshamewhichHeadswantedtoavoid:“Itexposedmetomy

deficiencies...Ithink(H2,line5);“Iwasfindingithardtoadjust[todemotion]…Longreflective

silence…BecauseI…I…neverreallythoughtaboutit”(H13,lines4,20).OtherHeadsyetused

theManualtoservetheirpurpose:“Theformsofthinking…helped…wecanmakeabetterteam

witheachother”(line11).WebeingH3andmyself,asH3distancedfromthestaffwho

neededtraining;“You…needtoresistthetemptationthatafterthingshavereachedfullcircle,

yousay‘Didn’tItellyou?’...otherwiseyougetintotrouble”(H6,lines26,29).These

verbalisationsimpliedthatthemainthemebehindresistancewasprofessionalnarcissism.

Askedifthisworkhelpedthemdeveloptheircurrentformofintelligenceand/orexposed

themtootherformswhichtheyalsodevelopedandtowhatextentitdidso,eightHeads


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reportedashiftinoneofthevariousintelligences:self-,emotional-,social-,imaginative-,

and/orspiritual;fivelearntanewlearningstyle,shiftingeitherfromabstract

conceptualisationtoactiveexperimentationorviceversa.Activeexperimentationofthe

guidelinessupportedsomeHeadstodiscoverindividualneedsformanagerialtrainingand

otherstoobservethattheyneededtostop,stepback,andthinkpriortoplanning,actively

counteractingtheMNHCSnon-reflectivechangeimplementationprocess.

ElevenHeadsclaimedthattheManualhelpedthemachievetheirtrainingneeds;tenHeads

claimedithelpedtheirpersonaltransition;thirteenHeadsnotedthattheToolsupportedtheir

abilitytoself-reflect,enhancingawarenessofwhotheywereandwhotheywantedtobecome.

IdentityworkandMetaphoranalysis:Metaphorschosendistinguishedbetweenmaleand

femalearchetypes(Morgan,2006)echoingCMTTandExploratoryInterviewnarratives:-

• malearchetypesincluded:Gandhi,MandelaandRobinHood:Thesecounter-culture

metaphorsechoedtheCMTTandInterviewedHeadsrespectivenarratives:theherowho

turnstheorganisationaround,wantsapersonalitycultandpowerisingivingdirection

notinbeingofservice.

• femalearchetypesincludedtheoldhumpedtree,thegnarledpineandthewiseold

person:Relatedtodeformityandoldage,theanti-thesistoHealthwhoismale,these

metaphorsechoedtheHeads’narrativestheywantchange,wehavetojugglearoundto

survive.

Pre-andPost-metaphoranalysisevidencedhowHeadsveeredtowardschangethatmaximized

power.H3describingoneselfasthecaptainofaboatwithholesinit,gatheringateam

togethertofixthem,evidencedone’sintenttoextendone’spersonalitycult.Morefrequently

howeverchangewascarriedouttoretainpower.FollowingdemotionH15shiftedone’s

metaphorfromarideronaroller-coasterbeingmainlyatop,toawiseoldpersonadoptinga

lowprofiletryingtoblendwithone’ssurroundingsstillexertinginfluence.Powerretentionalso

tooktheformofminimisingshamefulconnotationsbyusingeuphemisms:holesratherthan

shortcomings(H3)


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SomeHeadsfounditeasiertospeakabouttheirprivateselvesthroughmetaphor.The

oppressedHealthcareadministratorschosedeformityagnarledpinebatteredbytheelements

andahumpedtreeofwisdomwhichcouldspiraloutofcontroltodescribewhotheyhad

becomeasaresultofcopingwithseniormanagement.

DuringtheevaluationofthetrainingmanualsomeHeadsappreciatedtheintegrationof

professions,becomingmoresensitivetothefeelingsofothers,andmoreempathicwiththe

paceofthechangesoneiscarryingoutwiththeother.Theadoptionofempathy,andco-

creationwasstalledbythedominant,masculinearchetypalorientationoftheexistingculture

anditsunderlyingnarrativeswhichwereintrojectedbyotherHeads.Thediscoveryofthis

issuecouldonlybecarriedoutthroughdialogueandself-reflexivity(Chidiac&Denham-

Vaughn,2018).Headsagreedthatdespitebeinglimitedbytime,theircolleaguesand

themselvesneededtostopandthink,andthattheManualhadfacilitatedthatprocess.

Self-reflexivity:Supervisionandkeepingajournal,protectedmetemporarilyfrombecoming

ensnaredinMNHCSpractices,assumingtheroleofrebellious/adaptedchildand/oridentifying

withtheoppressors(Evans&Gilbert,2005).Findingmyselftryingtoremaincalmand

composed,despitetheridicule,belittlingandsplitting,Igainedinsightthatsenior

management’scoldindifferencecouldbeaformofself-defence.InformedbyEtherington

(2004),thatresearchersneedtodelicatelytreadthepathwaybetweentheirownpossible

narcissismandneedforcontrol,andthatoftheirparticipants,Ididmybesttoholdmy

presuppositionsatbay,whileadoptingpsychotherapeutic,activelistening.TheHeads,unused

tothisapproach,apparentlymistookitasasignofweakness.AsIdidnotactasanexpert,I

wasanamateurtowhomsomeHeads,impartedtheirskills.Beingcognisantoftheasif

managerialtacticsIbegantorecognisethemwhentheywereusedbymydirectlinemanagers.

Asaninsider-researcher,Iwassurprisedattheextentofthenegativeimpactfromtheongoing

lackofcontinuity.Headsweregiveninsufficienttimetolettheircurrentsenseof

self/roles/identitygobetweenoneshiftandanother,sobynecessity,theylivedinthehere-

and-now,practicingsecrecyasasurvivaltactic(Shapiro,2013).Thisworldviewprecipitateda

senseofinsecurity,pervasivemistrustandfearoffailureleadingtotheshame-blamenarrative


96

resultinginthealienation-demotivationprocess.Consequently,Headsdevelopedegocentric

self-referentiality,personalitycultleadershipstylesandcoregroups,limitingpolicy

implementationatstrategiclevel,decreasingthequalityofserviceprovision.Thisprocess

resonatedwiththepointraisedbykeynotespeakersattheJointActiononMentalHealthand

WellBeing:DrivingMentalHealthatWorkinEurope(2014),thatevenifpolicyweredrawn

followingprofessionalresearchandinterventionsrespectethicalevidence-basedbestpractice,

implementationisnotstraightforward.

Synthesis:InlinewithNicholsenandCarrol’s(2013)conclusions,thisresearchconfirmedthat

theundoingofpowerisadifficulttaskforHeads.Findingitdifficulttolettheiroldgrandiose

identitygo,evenwhenthisbecamenecessary,Headsdevelopednewidentitiestoretaina

semblanceoftheirlostpower.Adherencetothesocialcontract,andself-transcendencewas

limitedasHeadsdistancedfromaprofessionallyethicalidentityforsafety(Hamilton,2008)

resortingtoegocentricself-referentiality(Langdridge,2007).Thisisnotrestrictedtothelocal

scene.Encouragingmanagementtoinvolveemployeesatanearlystageofthechangeprocess,

Psy-ga(2013)advicesmanagerstomodelonchameleonsevokingtheherothatentersthe

organisationtoturnitaroundwhileappearingtomergewiththe

background/company/employees.Thisresonateswiththeidentityleader(Haslametal.,2011;

Steffensetal.,2014)whocreatesanimageofwe-nesstobringaboutchange.Thisleadership

stylelackingself-reflexivity,ledCMTTFtoachievelimitedoutcomes.Deflectingfeedbackfrom

theCMTTparticipants,CMTTFremainedunawarethatonewaslosingtheirtrustand

collaboration(Stetler,2014).Theconceptofthechangeimplementeraschangecatalyst,

remainingunscathedbytheimplementationprocess,wasandisstillfoundinmainstream

managerialtraining(NHS,2010).MNHCSHeadsmightbenefitfromheedingPsy-ga††(2013,105

-109)thatwhen“managerialstaffexpectfromemployees,conductwhichtheyarenotyetable

todeliver,employeesmaysimplyfeeloverloaded.”Leadersviewinghumandevelopmentasa

valuearemorelikelytoachievedesiredgoals(Huppert&So,2013:Leggett&James,2016).

†† Published under the auspices of the Federal Association of Company Health Insurance Funds and supported by the German Federal Ministry of Labour and Social Affaires under the New Quality of Work Initiative.


97

Post-DoctoralWork:Productsandthewiderprofessionalinfluenceofthisresearch:

FollowingtheHeads’suggestion,Iwentoutand“explained[themanual]to[others]”(H1Int.

#3,line18).H2’sverbalisationthattheManualcould“bridgebetweenprofessionswhichare

notnecessarilywithinhealth”(Int.#3,line13)foretoldtheManual’sfuture.Wantingtoshare

theirdevelopmentinself-awarenessandself-reflectionMNHCSHeadsaskedmetostartteam-

buildingsessionsintheirrespectivedepartments.Knowledge-sharing,meaning-making,self-

actualisation,andcriticalself-reflectionprovedessentialtocreateacollaborativeenvironment

inwhatwasessentiallyadominant-submissive,shame-blamescenario.

Movingbeyond:CollaborationwiththeCommissionforDomesticViolence,in2017,ledtothe

settingupofthePeer-to-PeerCaseStudyResearchGroup,promotingself-reflexivity,

knowledge-andmeaning-sharinganddiscussingevidence-basedbestpracticewithinarelated

taskforce.Commissionersprovideduswithplatformstodisseminateoutcomes.Wehelda

WorkshoponMarch2019sharingourfindingswithpeersandHeadsofDepartments.

Workshopsinself-reflexivitywerealsocarriedoutwithemployeeshailingfromvarious

MinistriesincludingHomeAffairsandEducationaswellasattheUniversityofMaltawhereI

amnowemployedasHeadofCounsellingServices.

Modificationsinthetrainingmanualinlightofmorerecentpracticesandlearning:The

TrainingManualisbeingpreparedforpublication,andisthebasisofapost-doctoralstudyto

furtherexploretheroleofself-reflexivityintransition-managementtraining,supportingleaders

todevelopahybridpractioner-researcheridentity(Barber,2012).Armsby(2013)highlightsthat

theintegrationofprofessionalandacademicidentitiesisbeneficialasoneidentitysupportsthe

other.ThisresonatedwithmydoctoralexperiencewhenIfoundmyself‘reflexively

understandingasaperson,expressingasaprofessional,repositioningmyresearcherstance

intothatoftheacknowledgedparticipant’(pg.15).Inhindsight,Irealisedthatself-

actualisationthroughthedevelopmentofadoctoralidentityprotectedmefromembarkingon

thealienation-demotivationprocess,whilemyidentityofpractitionerprotectedmefrom

gettinglostinavortexofhelplessnessuponlosingsightofthecorebusiness,theclient.The

Manualwouldcontinuetotraintheleaderinself-reflexivedialogueasatoolfortransition-


98

management-thepractitioner(Chidiac&Denham-Vaughn,2018);whilesupportinghim/herto

developresearchskills,particularlyappreciative,holisticinquiry–theresearcher(Breslowet

al.,2015).Thiswoulddistancefromtheproblem-solvingapproachriskingdevelopmentof

shame/blame,focusingonapassion-centredmindset,fuelledbytheperson’sneedforself-

developmentandtranscendence(Waters&White,2015).

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Notesoncontributors

JoanCamilleri

JoanCamilleri,M.ClinPsy.D.Psych.Prof.Stisaresearcherandpractitionerworkingattheinterface

betweenpsychology,wellbeing,andorganisationaldevelopment.Sheiscurrentlyemployedatthe

UniversityofMaltaasHeadofCounsellingservices.

4. joan camilleri - the role of self-reflexivity in...

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