Introduction This chapter is based on research by the authors into the change processes in public organizations in Sweden. A central issue of the research project has been the formation of a West Sweden region. The focus of this chapter is, therefore, the conceptualization of the term region and its operation in practice. A particular generalization concerning Swedish public organizations is that they are said to experience different kinds of identity crises with regard to intangible subjects, i.e. political legitimate issues, together with more tangible ones such as economy and efficiency. Running parallel to this has been the current recession in Sweden, comparable only with that of the 1930s, with its increased unemployment and decreased industrial investments. This alone has created a demand for change. When the world changes it moves from one category to another. The introduction and conclusion of such a change is fairly straightforward, but the intermediate period is incredibly difficult due to the fact that it is absolutely essential to include the past when considering the future.