Benner is concerned with the practice of professionals dealing with health and illness, growth and loss, as these are experienced by individuals in a clinical setting. She proposes that there are four aspects of people’s humanness that enable them to grasp situations directly in terms of their meaning for the self. These are embodied intelligence; background meaning; concern; and situation. Billing sees the principles that Benner articulates in relation to these as providing an alternative and more useful way of looking at the impact of change on people than that embodied in the characteristic grief cycle, as identified by Elisabeth Kübler-Ross. In another interesting series of posts in his Changing Organisations blog, Stephen Billing introduces the work of Prof. Patricia Benner and draws implications from it for leaders of organizational change. I haven’t previously come across Benner’s theories. So Billing’s summary of her work and his accompanying commentaries are very welcome and thought-provoking.
Oppositional or complementary?
For a number of years, Kübler-Ross's five-stage process (denial, anger, bargaining, depression and acceptance) has been adopted by the change community as a practical way of understanding people’s likely emotional response to imposed change. And the thinking behind this framework is embodied in the coalition-building strategies outlined in Informal Coalitions, albeit in a modified form. At the same time, I see the nature, intensity and duration of people’s psychological and emotional response to change as being highly conditioned by what I’ve referred to in the book as their “personal frame of reference” and by the natural “relationship dynamics” of organizational life.
So I agree that there is much more to this important aspect of the change process than suggested by a ‘one-dimensional’ application of Kübler-Ross’s framework. And I see significant parallels between the dynamics of change embodied in the informal coalitions perspective and those inferred by Billing from Benner’s work in the caring professions.
At the same time, I don’t believe that the potential insights that can be drawn from Benner’s and Kübler-Ross’s work are necessarily oppositional. Rather, I believe that they offer complementary ways of understanding the in-the-moment responses of people to formal organizational change initiatives - and indeed, to the ups and downs of everyday organizational life.
Billing is right to question the unthinking application of the grief cycle to change situations. It has become something of a clichéd response and is often applied in a ‘blanket’ way. Kübler-Ross herself cautions against seeing the process in mechanistic terms, even in its intended context of individuals who are terminally ill. However, properly used, I don’t see it as preventing the personalized approach to individual change that Billing advocates and which I support. If it is used as a lens for viewing people’s uniquely personal reaction to change, I believe that it can add further insight.
A both-and approach
Billing shows how Benner’s work provides a perspective on why and how life ordinarily “go[es] smoothly without effortful conscious attending," and why and how changing contexts can “cause breakdown in this smooth functioning”. Where such changes are viewed as negative by individuals, this breakdown is likely to generate psychological and emotional responses that inhibit effective behaviour. And it is here that, properly applied, Kübler-Ross’s work can provide further useful guidance for managers.
It seems to me that Benner’s work throws light, in particular, on how individuals appraise, both consciously and sub-consciously, their capacity to deal with the demands presented by new situations. Where situations are perceived as stressful, a negative emotional response will result, along with physiological and/or behavioural changes. Kübler-Ross’s work suggests the characteristic patterns that such responses might follow.
In summary
Overall, I found Billing’s mini-series on Patricia Benner both insightful and provocative. I agree wholeheartedly with the need for managers to pay attention to the individual, in-the-moment reactions to change, rather than resorting to generalized models, assumed responses and ‘paint-by-numbers’ approaches.
And his exhortation for managers to shift the focus of their communication away from message passing to what I would call joint sense-making and relationship building is spot on (see here for more on this). At the same time, I prefer to see the insights that Billing has drawn from Benner’s book The Primacy of Caring and those arising from Kübler-Ross’s On Death and Dying as complementary, rather than mutually exclusive.
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