Successive governments have promoted policies which entrench a punitive and controlling way of managing public institutions.
Neo-liberalism isn’t just an economic doctrine. With its obsession with money and markets and targets and competition, it also shapes our emotional cultures. But how does it get under the skin and into the way we relate to one another in public institutions as well as private life?
It’s a sneaky and insidious process. The culture shifts, and we absorb its values without noticing as it becomes more and more difficult to think in any other way. Who has the time to really listen and respond to each other, let alone enjoy playfulness, when financial outcomes override all other considerations? As a result, the quality of relationships inevitably suffers.
These values are passed on to children through parenting practices. As society becomes increasingly unequal, parents are more stressed. And stressed parents—whether the driven, ambitious, wealthy minority or the financially struggling majority—are often less tuned in to their own feelings, and less able to respond sensitively.
Instead of drawing on empathy to guide their responses, they turn to the ‘quick fix’ of punitive practices that are based on external control of the child’s behaviour, like strict feeding or sleeping regimes. Or they resort to threats and physical punishments which are still practiced by a majority of parents in the UK and the USA. These practices tend to produce individuals who are trained to ignore feelings—what’s known in the psychology trade as “insecure avoidant attachment” behaviour.
Cumulatively, this behaviour shapes the culture of society. But I think there are signs that some of the consequences of emotional avoidance are being recognised a result of recent scandals in the UK National Health Service (NHS) and in local government. These scandals show how successive governments have promoted policies which entrench a punitive and controlling—rather than secure and supportive—way of managing public institutions.
One of the most shocking recent examples to make the headlines was at the Mid Staffordshire Hospital in the UK, where some patients were ignored for long periods of time, left to lie in their own faeces, hungry, unwashed, cold or thirsty. One even resorted to drinking water from a vase. In another incident, a nurse was so bothered by hearing a baby crying that she taped a dummy to his mouth even though he was premature and suffering from breathing difficulties. Pressure from the patients’ relatives eventually led to questions being asked, but how on earth had such behaviour been allowed to take place?
The official enquiry which investigated these incidents (the “Francis Report”) found that some of the nursing staff lacked compassion, and were dismissive of the needs of patients and their families. Unfortunately there was no further psychological reflection on the factors that may have contributed to such uncaring behaviour—such as a feeling of being overwhelmed by the demand for a fast turnover of patients, a numbness at not having enough time to care, or a feeling of being traumatised by the emotionally demanding nature of the work itself. Neither the Report nor the hospital managers recognised such possibilities.
However, what the Report did make clear was that instead of a secure, supportive and thoughtful management that might have helped health care workers to deal with these kinds of naturally ambivalent feelings and sustain their empathy, there was an avoidant-style culture of bullying which cascaded down from the top. Managers under pressure from the Department of Health used short cuts to get staff to comply with their directions by “applying career threatening pressure.” Those who raised questions about the quality of care were harassed and threatened with legal action.
This was not an isolated case. Other recent studies confirm the same picture. One report found that nearly half NHS staff had either witnessed or experienced bullying in the last year. This included physical bullying such as being pushed or prodded, or as one person graphically described, having a member of staff putting a hand in their face to stop them speaking. Anecdotally, there is a sense of a cultural shift to a more authoritarian way of doing things. Malcolm Alexander, a lobbyist for patients, put it this way “The thing that really strikes me as something that has changed, is that the hierarchy in hospitals seems more entrenched than ever.”
Why has the culture of the NHS moved in this direction? The key finding of the Francis Report was clear: managers were so preoccupied with cost cutting and meeting government targets on waiting times that they ignored the basics of good patient care. A “command and control” attitude was forcefully promoted by the former head of the NHS, focused on financial targets as well as the achievement of elite foundation trust status or the latest re-organisation of systems.
Managers who don’t achieve these goals face financial penalties and, one might imagine, shame. It seems that one response to such insecurity is defensive—to attempt to control and micro-manage staff—and thus anxiety gets passed on down the line. In these circumstances, compassion for patients is more difficult to sustain. As Alexander puts it, “the interaction between nurses and patients seems to have completely broken down. They are strangely distant. You rarely see them touch a patient.” Fear of losing jobs or funding comes to dominate people’s behaviour, and trust evaporates.
It’s a similar story in local government. In both Rotherham and Doncaster in the UK, for example, there have been extreme failures by Councils and the South Yorkshire Police over many years to respond empathetically to the needs of children. Case after case has come to light where child protection has failed. Most recently in Rotherham, social workers, their managers and local politicians had all known for years that underage girls were being groomed and raped by gangs of Pakistani men, but little action was taken.
Mirroring the behaviour of NHS managers, local councillors actively silenced and coerced those who drew attention to the problem. They intimidated a Home Office researcher and confiscated her research. One motivation seems to have been that the party in power depended on the votes of the Pakistani community, so it was willing to minimise or even deny the reality of abusive behaviour within that community even though some of the child victims had witnessed brutally violent rapes, been doused in petrol, and threatened with being set alight if they did not cooperate.
The official enquiries into these cases described a “macho and insensitive culture” that was incapable of recognising and responding to the vulnerability of children. However, this was not the only sphere in which Rotherham councillors behaved in such a way: they also used a bullying and coercive approach to their own workforce. They regularly issued ultimatums to council officers and social workers, telling them to comply or be sacked.
In psychological terms, their behaviour was typical of the ‘insecure authoritarian’ who attempts to control other people by force instead of engaging them in dialogue. Are these types of individuals attracted to such organisational sub-cultures, or are they produced by the sub-culture itself?
At present we don’t have the research to answer this question. But Susan Long, an Australian management scholar, believes that the problem has less to do with deviant individuals than with instrumental cultures. Dominated by a ‘transactional mindset,’ many organisations become so focused on particular outcomes that they lose the capacity to listen in a relational way to the whole person and their needs, or to respond to the whole situation.
Long goes further by arguing that managerial culture has become “perverse” in psychoanalytic terms, in that it represents a culture of collective self-deception. This culture endorses the pursuit of individual gain at the expense of the wellbeing of others in order to achieve its goals, even if that means denying other people’s emotional realities.
The behaviour of councillors and police in South Yorkshire can be seen in this light. The police overtly downplayed the harm they knew was happening to children. Perhaps because they were under pressure to meet their targets for effective prosecutions (and these cases were often hampered by unreliable witnesses), police officers did not pursue offenders. Instead they blamed the girls for being ‘out of control.’ They denied the reality of children who were being sexually abused and treated them as consenting adults—or even worse, as ‘slags.’
In such an instrumental culture, where the primary goal is to achieve shorter waiting lists or higher grades or successful prosecutions, how can people make a place for listening and relating sensitively to others as individuals?
Maybe the political economy of neo-liberalism requires insecure and aggressive people, instead of secure individuals who are more likely to be open and empathetic? If so, is this what we want? If not, we have to address everything that shapes the neo-liberal culture, from parenting practices to the design of health and education systems to the incentives that run through economic policies.