If interprofessional working is such a good idea, why is it so difficult to accomplish?

Why is it so difficult to achieve things when professionals from different professional backgrounds try and achieve things together?

In a recent consultancy where I was asked to support the trustees of an organisation to talk about strategy, I was struck by just how unskillful they were in the discussions they were having. The meeting comprised some very eminent people, yet some of the things they chose to talk about would have surprised a disinterested outsider. For example, they spent twenty minutes talking about whether they should or shouldn’t put titles in front of their names when they came to record the minutes from their meetings.  The discussion wasn’t just about apparently trivial detail but there were more things going on in the room than it was possible for me to articulate out loud. It was not an impressive performance. They had clearly got into habitual ways of talking about the work which did not do justice to the scale of organisational difficulty that they needed to address.

How is it that experienced and professional people can make such a hash of talking together about what they might do?

Norbert Elias

The sociologist Norbert Elias might be one person to look to for an explanation. Elias has written extensively about how the interweaving of human intentions in society gives rise to unexpected outcomes as we try to achieve things together. Because we are interdependent we are constantly engaged in asymmetric power relationships with each other. Power is not a property that anyone has, but is a condition of ther relating with others: it fluctuates. I may have a position of greater formal authority over you, but I may need you and your expertise to accomplish one of the tasks I am responsible for. Together we are obliged to negotiate how we will cooperate. Although I aspire to dealing with you rationally, I cannot prevent my anxieties and emotions intervening in the way I behave towards you. I am both involved and detached at the same time, never totally one nor the other.

So it was as I worked with the trustees in the room. Their intentions to have a rational discussion were constantly undermined by their need to assert their status, their unspoken desires, and the fluctuating power relationships with each other. The ebb and flow of the discussion was influenced by each of the participants, including me, but no single one of us was in control of what was happening. Although I was not a fomal part of the group I was not immune from the interweaving of intentions as participants appealed to me, or criticised me in support of their own arguments. There was no place outside the group which many popular books on facilitation would lead you to believe that there are. I could not be ‘an objective and detached observer’ who knew what was best for the group.


Elias’s description of the ‘blind social forces’ that govern our lives comes very close to the idea of emergence found in complexity science. Emergence arises where the interacting of many agents gives rise to global patterns that no one could have predicted. There is no way of mapping cause and effect, and there is no possibility of disaggregating the many and complex interelationships that brought the patterning about. It is not that any outcome is possible, since the interactions are constrained by the characteristics of the agents who are interacting and by other objective structures, such as the length of the meeting, for example. The patterning will tend in a particular direction but will be nonetheless surprising and above any one agent’s ability to control what is going on, no matter how powerful.

If we take together Elias’ ideas on the way that humans engaged in asymmetric power relations interrelate and the concept of emergence we might conclude that when different people come together to achieve things, lots of unexpected things will happen. A group of professionals with their various disciplines and ways of seeing the world, conditioned by their own anxieties, fears and emotional responses to each other, is a potent mix. Both rational and irrational things will arise as a consequence of this interrelating.

New skills

In order to function well it behoves people who come together to get things done to develop the skills which enable them to pay better attention to what happens when they interact. They need to become more detached about their involvement. Participants in a meeting need to be able to trip themselves up, with others, to ask themselves, ‘what is it that is going on here?’. By paying attention to the interweaving of their intentions and making it more explicit, groups of professionals may have a better chance of moving on their habitual ways of behaving. They may leave themselves more open to new ways of understanding themselves and each other, which has the potential for transforming the way they come to talk about the work.




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