The Necessary Task: Death Mother, Sibling Society, and the Crisis of Care in the NHS

“The wish to be endlessly needed is one of the most exhausting forms of love.”—James Hillman

We inhabit a care system that is fracturing—not merely from budget cuts or staff shortages, but under the weight of its own mythology. The National Health Service (NHS)—a vast, intricate weave of human effort, compassion, and suffering—transcends its role as a healthcare institution. It has become a psychological crucible, reflecting a deeper crisis: the fantasy of limitless caregiving. This is the archetypal delusion that care must never falter, never tire, never refuse. Yet nature imposes limits on all things—except the stories we tell ourselves about what care should be.

The NHS as a Psychic Field

The NHS employs over 1.3 million people and serves more than a million patients every 36 hours (NHS England, 2023). Beneath these statistics lies a stark reality: clinicians, support staff, and managers stretched beyond capacity, trapped in a system where demand perpetually outstrips resources. This is not merely logistical failure—it’s psychological collapse. The NHS embodies what Carl Jung termed the collective unconscious, a shared psychic space where archetypes govern behaviour and meaning. Here, the caregiver archetype—noble, selfless, inexhaustible—collides with the material limits of bodies and budgets, generating a tension that threatens to unravel both individuals and the institution.

Jungian analyst Marion Woodman provides a lens for this unraveling: “The Death Mother is the part of the psyche that says: If you stop, you will die. If you rest, you will disappear. If you are not endlessly needed, you are nothing.” This archetype haunts the NHS, twisting care into martyrdom, blurring boundaries, and framing rest as betrayal. Imagine the old woman in the shoe, her chaotic home overflowing with children she cannot sustain—an image of emotional congestion and moral overwhelm. Clinicians bear this burden: expected to nurture without limit, absorb pain without breaking, and sustain the system even as it saps their vitality.

The Sibling Society and the Loss of Containment

This psychic field extends beyond the maternal into the cultural, reflecting what Robert Bly called the Sibling Society. Bly argued that modern cultures, stripped of elders, rituals, and the capacity to process grief, devolve into a flattened, anxious state where all become siblings—competing for recognition, survival, and purpose. In the NHS, this dynamic is palpable. Junior staff, often in their twenties and thrust into high-stakes roles, are expected to wield elder-like wisdom. Senior clinicians, meanwhile, are muzzled by bureaucracy, overwhelmed by caseloads, or spiritually depleted by unprocessed trauma. The 2024 NHS Workforce Survey found 44% of staff unable to meet patient demand, with burnout rates surging—yet the system offers no sacred space, no initiation into resilience, only the relentless churn of the rota.

Group analysis, rooted in Jungian and psychoanalytic traditions, sharpens this critique. S.H. Foulkes described the group matrix as an invisible web of relationships that binds individuals together. In a healthy matrix, vulnerability is shared, authority is earned, and grief is witnessed. But the NHS’s sibling-like structure frays this web. Clinicians become isolated nodes, not interconnected souls. There is no elder to hold the holder, no ritual to bridge exhaustion and renewal. As one NHS worker recently told me, “Who will hold me while I hold everyone else?” This plea reverberates through wards and waiting rooms—a cry for containment the system cannot answer.

The Death Mother’s Spell: Care as Addiction

Marion Woodman, bridging Jungian psychology with somatic awareness, saw how the wounded feminine—present in both genders—manifests as compulsive self-sacrifice and disconnection from the body’s wisdom. “The addict is often someone who has tried to be good for too long,” she wrote. In the NHS, this addiction is to care itself—not from weakness, but from a conditioning that equates worth with usefulness, and usefulness with exhaustion.

This is the Death Mother’s spell: a psychic pact where love is earned through suffering, and value hinges on endless giving. In Jungian terms, this mirrors possession by an archetype akin to Ananke, the Greek goddess of necessity and fate. Paired with Chronos (time), Ananke binds mortals to inescapable cycles and tasks. For NHS staff, this is the tyrannical call to serve—an echo of Hercules’ mythic labours, heroic yet dehumanising. The Death Mother emerges not just as a personal shadow, but as a divine force, her altar heaped with the offerings of exhausted souls.

The NHS reinforces this entrapment culturally: praising those who work late, guilting those who take leave, shaming those who admit they’re drowning. NHS Digital’s 2023 wellbeing data showed 38% of staff reporting work-related stress severe enough to harm their health, yet the system frames such struggles as personal failings rather than structural wounds—or as tribute to this relentless deity. The paradox is brutal: the more care you give under this spell, the less alive you feel. Woodman might call this anima possession—an over-identification with nurturing that obliterates the self. Yet, mythically, it’s a divine mandate that elevates care beyond human limits.

Breaking this spell means renegotiating our pact with these gods. Care, though sacred, must be reclaimed from Necessity’s grasp and returned to the human realm, where boundaries and rest become acts of reverence for life.

The Necessary Task and the Failure of Ritual

NHS staff face a mandate: to care without limit in a system without resources, to witness pain without space to grieve, to remain “professional” amid inherent trauma. The 2022 NHS Staff Survey reported 30% of staff experiencing at least one traumatic event—patient deaths, violence, ethical dilemmas—in the past year, yet only 17% felt supported in processing them. Jung would term this a failure of temenos—the sacred container for transformation. Without it, trauma festers, and systemic shame becomes personal: “Why aren’t you coping?”

This is not individual weakness, but a collective failure of ritual and ethics—a culture that forgets to honour limits. In Jungian terms, the NHS lacks coniunctio, the union of opposites balancing giving and receiving, effort and rest. Instead, it clings to perpetual sacrifice, leaving staff in a state of hollow camaraderie—surface-level connection devoid of soulful depth.

Reimagining Care: A New Archetype

For the NHS to endure, the story of care must shift. We need an archetype beyond the martyr or sleepless mother—one rooted, cyclical, and reciprocal. Drawing from Jung’s concept of the Self—the integrated psyche—this archetype would embrace:

• Grief as part of care: Acknowledging loss, not denying it.

• Refusal as love: Setting boundaries without guilt.

• Death as sacred: Honouring life’s natural end and rest as reverence, not failure.

This aligns with group analysis’s focus on interdependence—care as a shared act, not a solitary burden. Practically, this demands systemic shifts: mandatory debriefs after traumatic shifts (offered to only 12% of staff, per NHS data), peer-support networks rooted in group-analytic principles, or rituals to honour caregiving’s emotional toll. Psychologically, it requires valuing the clinician who rests as much as the one who perseveres.

An Ethic of Enough

This is for the NHS worker whose nerves are frayed, whose mind is constantly distracted by images of unsaved faces. For the clinician caught in the Death Mother’s grip, pouring soul into a system that rarely reciprocates. For teams without elders, rituals, or release:

You are not broken. You carry a collective wound—a society that demands care without reciprocity, fetishising resilience while starving its roots. It is ethical—and essential—to imagine care that is embodied, not performative. Your limits are not flaws, but thresholds—a doorway to yourself. In Jungian terms, this is individuation: reclaiming wholeness amid chaos. In group-analytic terms, it’s belonging without losing yourself.

Cross that threshold. Breathe. You are allowed.

Reference List

• Bly, R. (1996). The Sibling Society. Addison-Wesley.

• Foulkes, S. H. (1964). Therapeutic Group Analysis. International Universities Press.

• Hillman, J. (1997). The Soul’s Code: In Search of Character and Calling. Warner Books.

• Jung, C. G. (1968). The Archetypes and the Collective Unconscious. Princeton University Press.

• NHS Digital. (2023). Staff Wellbeing Report. Retrieved from [NHS Digital website].

• NHS England. (2023). NHS Key Statistics. Retrieved from [NHS England website].

• NHS Staff Survey. (2022). National Results. Retrieved from [NHS Employers website].

• NHS Workforce Survey. (2024). Workforce Wellbeing and Demand. Retrieved from [NHS website].

• Woodman, M., & Dickson, E. (1996). Dancing in the Flames: The Dark Goddess in the Transformation of Consciousness. Shambhala.

• de Maré, P. (1991). Koinonia: From Hate, Through Dialogue, to Culture in the Large Group. Karnac Books.