07 September 2010

Paradoxes of group life: Is the profession of nursing caught in a self-referential bind?

Group life is permeated with contradictory thoughts, actions and emotions. Groups bound together by a purpose often spend time trying to negotiate and unravel the contradictory forces associated with relating to each other in a meaningful way. Such negotiations often result in a paralyzing circular process of conflict, enmeshment and paralysis rather than reflection and transformational dialogue. Smith and Berg (1987) in their classic work, Paradoxes of Group Life, note that making the invisible, paradoxical nature of group life visible helps unravel some of the paradoxical dynamics of conflict.

Clustered under the three essential group concepts of belonging, Smith and Berg identify tensions associated with identity, involvement, individuality and boundaries. Under the concept of engagement, they discuss tensions and issues associated with the dynamics of disclosure, trust, intimacy and regression. The issue of speaking in group life is explained in the dynamics of individual versus collective voice, authority, dependency, creativity and courage.

Group life revolves around several paradoxical tensions. Consider the complementary dynamics associated with tensions between the individual~group, self~other, conscious~unconscious processes, dependence~independence, stuckness~movement, framing~reframing, participation~control, disclosure~non-disclosure, fear~courage, isolation~intimacy, belonging~not belonging, splitting~connecting, and issues of introjection~projection.

Smith and Berg suggest the dynamic responsible for the paralysis and difficulty in group life is a “self-referential bind.” They write: “When a social entity uses itself as a mirror through which it judges what it is like, it often only sees those parts of itself that confirms what it wants to know, that is, that it will enable it to remain as it wants to be. Systems that are self-referential create binds for themselves that are difficult to get out of” (1987, p 48).

The bind that groups create is the paradox that emerges as a result of projections and introjections as groups engage in splitting and fractionation around issues of identity (we-they) and issues related to errors of logical type. Projections are defined as taking something from the inside and mapping it to the outside. Introjections are the mapping of outside onto the inside. Projections and introjections are forms of displacement, where some dynamic that belongs in one place is moved to another.

When the projection~introjection dynamic is co-mingled with subgroup formation in group role taking, collective splitting results in social interactive processes that are paradoxical and paralyzing. Multiple frames create conflicts that appear to be irresolvable and foster double-bind situations that elicit multiple contradictions and meanings. Framing and reframing these contradictions in different ways leads groups to developmental insights that evolve the group beyond intractable, paralytic dynamics. Reframing changes the meaning, content or context of a situation so people develop new insights about intentions and actions.

So, as I witness the dialogue and debate surrounding the Advanced Practice Registered Nurse (APRN) consensus model, and ponder consequences of the Essentials of Doctoral Education for Advanced Practice Nursing on the future of master’s degree education, and consider services the profession will provide to the public, and explore the fifth iteration of the Draft Masters in Nursing Education Essentials document, I ask myself: As a profession, are we caught in a self-referential bind? How might we reframe all of the contradictions in such a way that we gain insights that move us beyond intractable, paralytic dynamics?

What do you think?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.