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  • Writer's pictureElizabeth Nugent

To The NHS Worker who called me.

By Dr Libby Nugent, First Published Nov 15 2021 09:46AM

You messaged me asking to talk and I agreed to zoom. We met online and you told me how fed up you are, how you feel exhausted at work and how you couldn’t bear being there anymore. You said maybe you just needed better supervision and support in your workplace.

I said you sounded very unhappy and wondered if you needed to enjoy your life a bit more and how important it is to have community, rest and creativity. You wondered how you could get more of this in your work. Maybe apply for a new job? The place you work at the moment is so underfunded and under-resourced. Everyone at work always tells you how creative and innovative you are, how much you help effect change and the hope your presence carries for others. Maybe you just need to be in a better supported team? You wondered if there was a way your work might pay for external supervision? But then the service is so underfunded and there would be just no space to think it through with someone. Maybe you could set up a staff supervision group, you could do it as a pet project, after hours? We then talked some more about the impossibility of this as your colleagues are exhausted. We came back to leaving your job and you said the people you work with are so vulnerable, you couldn’t bear to walk away.

I wondered if you might look for a therapist. But you felt that this was not really a personal issue and more about finding a way to hold your work space more effectively. This was a systemic problem, not personal and you just needed to find the right systemic change. I disclosed that I had never managed to create that kind of charge and didn’t know how. Also I had to leave the NHS to then find out that the unrelenting to do list that is everywhere in the NHS, was also inside me.

We discussed how socialism is so important to you and how you felt worried by how many mental health practitioners were leaving the NHS. It felt immoral. I said there are a lot of complicated narratives around leaving. I said I know leaving can feel like you are betraying something vital. I said I’m not too good at being a socialist, but then I also think always having to be good is overrated. You agreed with my poor socialism, we laughed. Sort of. Then you said awkwardly maybe you just need to find the right team? I didn’t reply to that. You looked alarmed.

You needed to go.

We ended the call. I now know I won’t be hearing from you again.

The moment has gone and we can’t go back but this is what I wish you could have known:

There are reasons why I love fairytales and myths: they help me think about painful aspects of myself without needing to cut off or run away. One thing they have particularly helped me with is my relationship with the ability to mother myself. My relationship with the mother archetype.

When thinking about the mother archetype in fairy tales and myths, psychoanalysts generally follow the Brothers Grimm frame of ‘mother’ being both the loving birth mother in stories as well as the stepmother who symbolises the dark side of motherhood. The Grimm brothers travelled around Europe collecting stories told only by word of mouth, typically by women to other women in weaving rooms and to their children. Importantly many of the stories the Grimms brothers collected began with no step mother, only any mother who might be loving, abandoning, self sacrificing and devouring. In the Grimm brothers’ revisions they slowly separated out the positive from the negative aspects of the mother, elevating one aspect and denigrating another until the wicked step-mother was born. The potent uptake of these male written stories, replacing the female oral tradition and then given their revised patriarchal form is one way of noticing the loss of society’s ability to value the feminine.

Our culture’s wounding and belittling of the feminine and its values has led many mothers to mistrust the world and men to a greater extent than ever before, and this mistrust inevitably becomes part of the emotional heritage of our children.

– by Massimilla Harris, Ph.D., and Bud Harris, Ph.D., from Into the Heart of the Feminine

So many health care professionals are the child of a mother suffocated by her lack of self and social worth. Her devaluation is evidenced in her lack of support, constrained sexuality and denied social position beyond the success of her children and husband. Eventually she internalises her worth as being only found in her usefulness to others. The NHS is sometimes referred to as a kind of mother. She also is a mother suffocated by chronic underfunding, ever increasing expectations of quality of care and relentless shifting political climates

As the child of the mother in these stories, you inherit the feeling of being unheard, invalidated and an awareness that you (or some part of you) is so unloveable and bad it should not exist at all. The mothers in these stories want to love their children but to do so they need their children to fit in, to not take up resources, to be good, useful and well behaved. Just as Mother is trying to be. Mother has enough going on without more chaos being added. The child learns to kill off their unwanted messy parts- they see mum’s torment and want to help. The child learns to be useful too.

As one person put it in Understanding and Healing Emotional Trauma by Daniela Sieff:

When I am hungry, I am not fed. When I’m exhausted, I’m not allowed to rest. When I need to move, I’m forced to stay still.”

If the child can be useful to mum in this way, then maybe mum will be ok and everything else will fall into place. Jungian analyst Marion Woodman calls this narrative the Death Mother.

Marion Woodman described that the “Death Mother is born out of despair. It is incubated by the crushed hope of an unlived life. Death Mother is the shadow side of disappointment. When you look into the eyes of death mother you see they are glazed over with hopelessness. You see a blank look; there is nobody at home. You see an unconscious, frozen and profoundly wounded body-psyche devoid of authentic feeling. You see somebody with desperate need to be in control. You see someone who is driven by will power.

At some point in the repetition of this experience the child internalises her. The child learns to be disapproving, denigrating, even repulsed by their impulse to live their own life - it’s just greed, indulgent selfishness and lack of social conscience. You tell yourself you just need to care about others more, you just have to do what is right. The self, the body becomes something to be mastered and tamed. You can become possessed by the Death Mother and be completely unconscious of it. Your motivations are cleverly disguised from everyone, even from yourself: we see a leader of social conscience, a strong work ethic, admirable self-discipline, a purity of religious faith and NHS heroism.

The death mother always says she is grateful. She knows what she is asking. She waves and cheers as you go to work. Your work will set us free, she says. She rewards you with more responsibilities, letters before and after your name and gold star certificates. She knows what she is asking but …. If only she had more money, more time, and was better supported. These are exceptional times. We all need to compromise, to sacrifice. She is right. There can be a terrible cost to others when we set limits. But these are always exceptional times. She says maybe if you try harder, become more efficient, more effective, have the right attitude, just surround yourself with positive people who care too - doers, who understand the severity of the problem. It will be better next week, next month, next year, next supervisor, next job, next generation. Then finally Mother will be safe, secure and she will know her value as will others. Finally then she can care for everyone in the magnificent way that only she knows how to best. My mum, the NHS, the best mum in the world.

In work your internal death mother is easily evoked. The smallest amount of feeling you might let people down or be seen as difficult can render you immobile. But the brighter you shine, the darker your shadow. The best way to describe her influence on you is your emotional collapse, paralysis, even a longing for the oblivion of death. This is the heart sink and collapse you feel when you said no, but they came back and asked again. You wish for a different life , but then feel shame at the thought of people knowing your selfishness. Instead you take the extra patients, move the annual leave, silence your objections in the meeting. You say yes to work and sorry but no to your partner, your friends, your children. You say it’s just this once, again. If only I had more time, more support, more resources, then I wouldn’t need to say yes. It will be better next month, next year, next job, next generation.


Daniela F. Sieff (2019) The Death Mother as Nature’s Shadow: Infanticide,

Abandonment, and the Collective Unconscious, Psychological Perspectives, 62:1, 15-34.

Marion Woodman and Daniela F. Sieff. “Facing the Death Mother to claim our lives”

Massimilla Harris, Ph.D., and Bud Harris, Ph.D.. Into the Heart of the Feminine.

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