‘It's not you; it's us!’: the relevance of mental health team psychodynamics to the care of individuals with complex emotional needs

Abstract

As the support for trauma-informed approaches and awareness of the power imbalances within the caring relationship are increased, this article proposes that it is time to revisit the issue of team dynamics and their potential impact on responses to individuals with complex emotional needs. Considered through the dual lens of psychodynamic theory and complexity, and using the role of the psychiatric liaison nurse to illustrate points made, it is argued that mental health teams have the potential to experience intense emotions and anxieties that arise from systemic conflict, reflecting the inner experience of individuals to whom they deliver care. Where these anxieties are not contained and remain unresolved, teams may resort to using primary defence mechanisms to protect themselves, potentially leading to invalidating responses and care that is retraumatising. Recommendations to enhance team effectiveness and to mitigate the potential preventable harms that might occur because of team dynamics are discussed.