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Sewing the Group Back Together: Swans, Silence, and Symbolic Labour in the NHS

  • Writer: Elizabeth Nugent
    Elizabeth Nugent
  • Sep 10, 2025
  • 3 min read



I am on the ferry to the Isles of Scilly again, heading for the annual family camping trip. The crossing, the salt wind, and the gradual slowing into days shaped by tide and weather always bring both anticipation and unease. The rhythm here strips away the cushioning of daily life and exposes something rawer: a bodily sense of both vulnerability and connection.


This landscape calls up what I have also known in grief, the abrupt shock of the real, the stripping away of pretence, and the reminder of life’s fragility. Beauty and pain arrive together, inseparable. To remain is to accept both, and in doing so to meet a more elemental part of myself that simply submits and endures.


Mary Oliver captures this stance in Wild Geese: the call to let “the soft animal of your body love what it loves”, and to find place within the “family of things”. This poem always recalls for me the fairytale of The Seven Swans: the sister who must endure years of silence and weave nettle shirts to lift her brothers’ curse. Her task is a parable of grief and loyalty, in which pain and creation are bound together. Nettles sting, yet they also yield fibre strong enough for fabric. This paradox, pain transfigured into something sustaining, becomes a powerful metaphor for the work of repair within groups and systems.


Sibling relationships embody a mix of rivalry, loyalty, and endurance. They are among the longest and most formative bonds we know, shaping identity through both differentiation and connection. In The Seven Swans, the brothers’ enforced silence represents a rupture in communication and cohesion, while the sister’s labour reflects the role of the sibling who mediates, absorbs, and repairs. This mirrors the dynamics often found in groups, where one member becomes the container for tensions others cannot hold. Group analysis helps us see how these unconscious roles, rooted in shared histories, continue to shape present relationships, whether in families or institutions.


The dynamic of masochistic sadism, in which suffering and cruelty become intertwined, can also become embedded in multi-disciplinary teams. In this pattern, some members take on disproportionate emotional burden, silently absorbing distress and systemic pressures. Others, through disengagement or institutional inertia, become unresponsive or dependent, mirroring the brothers cursed into swan-form. Hierarchies and neglect sustain the cycle, with pain functioning as both glue and barrier to change. This ritualised suffering often remains unspoken, making it difficult to disrupt. Attempts at change can provoke resistance, as if the group fears losing its identity. Yet without disruption, the cycle persists, sacrifice is normalised, and burnout follows.


Repair, if it comes, is never straightforward. Reflective practice groups, for example, sometimes provide a container for dialogue and ambivalence, helping teams surface the unspoken. Yet they can just as easily be co-opted into rehearsing the same roles of sacrifice and silence. Activism within such groups may offer clarity of purpose, but it is not dialogue, and can close down the very uncertainty from which new understanding might emerge. Facilitators too are vulnerable to using the group as a place to feel useful, rather than allowing for discomfort and for meanings to evolve in their own time. In such moments the work of repair is avoided, even as the appearance of it is being performed.


Swans, long symbolic in European traditions, embody transformation, liminality, and grace. Their flight between water and air reflects thresholds between states of being. The nettle shirts, painfully woven, are garments of protection and restored identity. Together they symbolise the possibility of moving from rupture to repair, silent suffering transformed into something that restores speech, relationship, and cohesion. Yet the fairytale does not promise ease: the sister’s labour is isolating, misrecognised, and nearly fatal.


In NHS teams, the resonance is clear. Groups are often fractured by scarcity, stress, and institutional demands, yet their survival depends on the unseen, often unrecognised labour of repair. What counts as repair, however, is rarely obvious at the time, and can only be known retrospectively. The lesson of The Seven Swans is both cautionary and hopeful: transformation may come, but it is slow, costly, and uncertain. To sew the group back together requires something more than endurance. It requires space for ambivalence, for speech as well as silence, and always with the risk that no resolution may emerge.




If you’re interested in exploring these themes in practice, I am currently offering seasonal closed Reflective Practice Groups:


Also there is a new quarterly group: 

 
 
 

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