Containing Anxiety in Organizations and Groups

by Augusto Cuginotti

We are living in a moment of continuous change and adaptation that has taken people out of their comfort zone: it is no longer known whether we are working at home or living at work, also how our relationship with family, friends and colleagues has been constantly impacted and has impacted us, etc. There is a long list.

Are we prepared for all the inconsistencies we are facing in our lives today? If the world was already volatile, ambiguous and uncertain, now we have entered VUCA-191 mode, one more step away from the certainties and securities that served to calm us, from our soothing projections of the future that seemed guaranteed, even in some areas of our lives.

Collectives, groups and organisations accompany people in these uncertainties

In this reality, organisations are getting in touch with something similar to what Isabel Menzies Lyth described in the 60s when she was studying the behaviour of nurses in British hospitals.

Isabel recognised that the nurses’ task was of great emotional weight. As you can imagine, caring for people comes with another, less technical and perhaps more complex job: maintaining a balance between the demand for empathy and closeness with the patient and the detachment and objectivity necessary for the profession, in general, hanging between taking good care of the other but also of oneself and the collective system to continue to work.

In her observations, there were structures and processes to help support nurses in this balance, but what was not accounted for were the emotional aspects and anxieties generated when the specific context did not match the established expected norm.

In one case cited, for example, it was part of a mandatory checklist to clean the patient at a specific time in the morning. Still, the nurse was conflicted because it was a patient who had finally been able to sleep after a difficult night and to comply with the checklist, she would have to wake him up. What would it mean to be a good nurse in this scenario?

Isabel, who studied the experimental psychology of the individual and the dynamics of the social world, discovered that both people and organisational structures were unprepared to deal with the intensity of anxiety installed in the system.

What I would imagine as a result was a receipt for burnout. People with a very high stress level have difficulty concentrating on tasks and tend to have less social flexibility when in conflict. Together with that, an oversimplification of complex situations, fulfilling blind checklists and procedures regardless of context.

Impact on Decision-Making


Sometimes it is not about how or what to decide, but whether we can handle it.

Isabel Menzies Lyth


The most striking discovery was that the system accommodated itself to minimise the need to make decisions. Personal and collective strategies were created not to recognise or postpone decision-making.

One path of action, in the case studied by Isabel, the nursing centre created precise instructions of conduct that relieved the weight of the contextual decision. Who has never heard the attendant on the telephone: “Unfortunately, the system does not allow…”?

When decisions were inevitable, great lengths were taken to depersonalise the decision-maker and avoid responsibility. One way was to delegate the decision to higher hierarchical levels using a narrative of ‘checking and rechecking’ that slowed the response speed and increased the middle management’s workload.

About this strategy, she writes: “Taking responsibility may generate satisfaction and reward, but it always involves some conflict”. In an environment with high anxiety, conflict can be a danger to the self-preservation of those who take it and perhaps the integrity of the group itself.


Change, as well as decision making, increases stress since it implies leaving aside a family present for a relatively unknown future.

Isabel Menzies Lyth


  1. Nothing complex can be worked out using simple steps;
  2. To follow simple steps is the human being wanting to control anxiety, being their own or the systems;
  3. Always remember step number 1. :)


The fact that there is no pre-mapped process to contain anxiety and how it unfolds does not mean we can do nothing. On the contrary, Isabel believed it was possible to have an idea of a direction to walk and that solutions could emerge through concrete movements in the system instead of generating abstractions about it.

So before all the talk about safe-to-fail for determining vectors in complex systems, Isabel shared a very similar thought:


This approach, through the construction of models and their progressive modification followed by the dissemination of successful models proved successful in building and rebuilding other types of social organisation.

Isabel Menzies Lyth



Read more

Menzies Lyth, Isabel – Containing anxiety in institutions – selected essays, volume 1. Free Association Books Ltd.

  1. VUCA is an acronym for Volatile, Uncertain, Complex and Ambiguous. VUCA-19 is an infamous attempt to add COVID-19 to the mix. Sorry about that.