Feeling our way forward: emotions, leadership, and the future of care

As we come to the end of the first phase of our action research exploring organisational anxiety, one theme has consistently emerged: hope. Rooted in Isabel Menzies Lyth’s theory of social defences, i.e. the ways in which groups avoid the anxiety evoked in the work of caring, our project has highlighted the importance of emotional honesty in leadership practice in health and social care.  

From the outset of this work, we deliberately dived into exploring the tension and discomfort that people often experience when working in organisations whose purpose is to care for sick and dying people. This was so we could examine what honestly acknowledging the more challenging aspects of working life could mean for leaders and their teams. The reflections shared by members of our action research group were personal but at the same time common across the group. By naming and exploring the emotions that came up, we surfaced insights which speak to the realities of leading through the complexity and challenges of health and social care now.

Hope that ebbs and flows 

We began with hope – that working more deeply with Menzies Lyth’s ideas would help create healthier workplaces, where staff could do their best work for those under their care. That hope ebbed and flowed, dimming when the scale of the challenge felt overwhelming. Our group members repeatedly experienced frustration, especially around disengagement and the emotional toll of leading change in environments resistant to it. This wasn’t just about others not engaging – it was about the limits of what could be achieved, and the cost of trying to lead differently.  

People spoke of self-doubt, a sense of never doing enough and feeling depleted: ‘That level of energy… has resulted in quite a lot of frustration. And if I'm honest with myself, it has moved into apathy.’   

These disclosures brought to light important aspects of organisational life that are often hidden. By naming their feelings and understanding them as shared across the group, and their organisations more widely, participants began to see their own experiences as part of a bigger, human and structural story. 

Our collective hope was reignited through connection and shared purpose. We increasingly coalesced around a belief that change is possible, that leadership can make a difference, and that dialogue can shift entrenched patterns. This helped put everyone’s experience into perspective, including the self-doubt and sense of not doing enough. We started foregrounding accountability rather than blame, and a sense of new possibilities emerged. As one member said: ‘There’s no point blaming the government and having this learned helplessness… I want us to start having a conversation about what we’re doing to cause the problem and how we can change.’  

That shift towards agency is one of the most powerful outcomes of this work. It shows how committing to emotional honesty and collective reflection can unlock more resilient, relational and effective ways to think and lead. Towards the end of our work together, one participant summed it up: ‘I don’t want to end this project in a frustrated negative state… I’m going to end this now on a feeling of hope that this might be something that actually makes a proper difference.’  

What could this mean for leadership in health and social care? 

This project hasn’t offered easy answers. But it has reinforced three key insights, which strengthen our belief that people matter: 

1. Leadership is an emotional process. Emotions shape how we show up, how we relate, and how we lead. Yet our systems often reward detachment and control. When we create space for emotional reflection, we create new possibilities for connection and change. 

2. Leadership is a relational process. Relational leadership is not about having all the answers, but about being present and engaging with others in ways that are compassionate, clear and honest. This means recognising that leadership happens in and through relationships that shape and are shaped by the emotional climate of our organisations. 

3. Reflection and dialogue must be ongoing. Emotions aren’t problems to fix, they’re data to understand about what happens when we try to work together. They tell us what matters and where our attention is needed. By embedding reflection and dialogue into our work, we can build work cultures that are more humane and responsive – something needed now more than ever. 

Where next, what now? 

If any of this resonates for you, please join our conversation by: 

• Sharing your reflections in the comments.  

• Forwarding this blog to your network and ask people how it lands with them. 

• Expressing interest in attending a one-day gathering in 2026 to help shape our next steps together as a community of practice. The intention is to create a space for honest conversation where we share experiences and new perspectives can emerge. Rather than offering ready-made solutions, the day will be about experimenting, reflecting, and seeing what feels possible – both individually and collectively. Click here to register your interest.

This work has shown us that even in the current context of health and social care, moving towards more humane and responsive organisations led by relational and compassionate leaders is possible. This is what The King’s Fund stands for – and many other organisations and good people across the country. We look forward to hearing from you.