57 Organisations and shipwrecks

There’s a quote that’s been attributed to the business writer David Hanna that goes: Every organisation is perfectly designed to get the results it gets.

What this tells us is that the kinds of problems we face personally and professionally today were already hard-baked into the structures we’d created some time before.

So, if you take a profession like physiotherapy for instance, Hanna’s quote reminds us that the problems we now face as a profession are the direct result of the ways the profession was designed in the past.

There’s something very Foucauldian about this quote, not least because it reminds us of one crucial lesson from Foucault’s work: that we are not really the architects of organisations, professional bodies, professionals, even our ‘selves’. Rather, we are the result – the outcome or, to use Foucault’s word, the achievement – of discourses that precede us.

This sounds like an odd way to look at things, in part because we’re brought up to believe we come into the world as empty vessels ready to be filled up with knowledge and life experience, and that we are in a sense the sculptors of our own identity. But Foucault says this is entirely wrong, and that we are already born into an historical and social context, and no-one comes into an empty world as an empty sac waiting to be filled up with ‘life’.

There’s another quote that comes from the French philosopher Paul Virilio that relates closely to this idea. He says “when you invent the ship, you also invent the shipwreck”.

We think of ships being built to sail the oceans, carry people and trade, war, conquer, and so on. But Virilio tells us that ships are really designed to avoid shipwrecks.

Again, this sounds like a really counterintuitive idea, because why would you build something to prevent something happening that that wouldn’t happen anyway if the thing wasn’t built in the first place?

But what Virilio is trying to do is to turn our perceptions on their heads and make us see the world differently.

He showed in his research, for instance, that castles primarily evolved from wooden hill forts because the weapons of assault got bigger: people started using cannon balls instead of spears, so the defences needed to be stronger. The thickness of the castle walls had to repel whatever was being thrown at it. Hence many of the design features of castles (see the film above).

Now, if you think about the physiotherapy profession in this same upside-down way, and apply that thinking to some of these questions, it might help you understand more deeply why we have a physiotherapy profession in the first place:

1. No profession emerges from nothing. They all arrive already fed from a thousand different streams. What approaches to practice and forms of physical therapy already existed when the physiotherapy profession in your locality was born?
2. What were the problems, challenges and needs that physiotherapy responded to when it was established?
3. Were these entirely new challenges, or had they existed for a long time?
4. If so, why create a physiotherapy profession now? (The classic question Foucauldian scholars always ask is “why this, why now?”)
5. Why did your forbears turn to physiotherapy as its answer to social problems and not to some other technologies or mechanisms? What other options were available to them?
6. Whose interests did your physiotherapy profession serve? Who’s needs were best met by its creation? Whose voices were most prominent in establishing the profession?
7. And conversely, whose interests were not served by the establishment of the physiotherapy profession in your locality? Who’s needs were not met by its creation? Whose voices were not heard?