Residential Treatment: A Total Therapy
Introduction
At the time of writing this paper Melvyn Rose was the Director of Peper Harow therapeutic community. Like the Cotswold Community, Peper Harow had been an Approved School and had to go through a similar dramatic transformation. Both communities took heart from one another through the hard times, of which there were many.
John Whitwell
RESIDENTIAL TREATMENT – A TOTAL THERAPY
Melvyn Rose. The David Wills Lecture given at Mary Sumner Hall, London 11 November 1977.
An extract from “The Journal of the Association of Workers for Maladjusted Children” Vol. 6 No. 1 Spring 1978.
The title contains three impressive words which need definition. These are therapy, total and treatment. Too often they are used not just synonymously for each other, but also, in the context of a residential setting, to mean “a good‟ or “a nice‟ place. Almost anything that is beneficial to people is now described as therapeutic and often the word is not even used in the medical sense of healing the physically injured, or sick, but more as anything that gives a sense of well-being – like a picture outing on a Saturday night, or even a brisk walk in the country.
In the language of this paper, therapy or treatment, refers to the recognition of disturbed behaviour and its causes; and to the deliberate action of workers to bring about changes in personality, which, in turn, will cause more positive behaviour.
My meaning will be clarified when I say that the model in my mind arises from working experience with young people whose behaviour has rendered them incapable of getting on with others in ordinary life; and, in particular, I am thinking of the severely damaged kids at Peper Harow. They are all of at least average intelligence and are aged from a minimum of 14 ½ years. Most of them have been recognised as disturbed for many years and have received intervention ranging from Child Guidance Clinics to Community Homes. Their stories are full of the most appalling trauma, and often they have been subject to years of emotional starvation, because of their parents‟ difficulties – the children of severe schizophrenics, psychopaths and so forth.
So one element of therapy, or treatment, would consist of understanding the disturbed way they think. For instance, Mark perceives comment from adults as an attack, whether it is criticism, which he feels to be a sentence of eternal damnation, or praise, which he has to demean into, “Buttering me up to make me vulnerable to just more attacks from you bastards”. There is Tom, who approached by any member of staff – male or female – cackles hysterically and squeals:
“You‟re queer, you!”
Any suggestion of an interpretation is met by instantaneous denial:
“Tom, you‟re breaking that chair,”
Crack, Twang!
“No, I‟m not.”
Crash!
“You‟re queer, you!”
Splinter!
Therapy would mean the asking of such questions as, “What is he really telling us by this destructive behaviour, which he so blindly denies? If he feels so contradictory, what is the conflict that he can never resolve?” And the sources of such conflict defined, “What does he feel, or what did he feel about those events and relationships which make him behave like this and refuse to recognise what he does?”
And when such questions have been asked, another series begins with more questions such as, “What can we do or provide that will make him change his unconscious attitudes?”
With boys such as these, it is possible to change their behaviour. Under sufficient duress, behaviour can be controlled, but recidivists in prison are surely evidence enough that controlled behaviour is not changed behaviour. Duress removed, the old patterns swiftly re-emerge proclaiming the same underlying feelings.
For kids such as I have described, a few truly therapeutic aspects of their lives, such as a weekly visit to a Child Guidance Clinic, is also not enough. Hence my second word, “total‟.
I hope that the extent of this “totality‟ will become clear as I go on. Suffice it to say, that every aspect of residential life for 24 hours of every day should be seen in the light of similar questioning to that already described. “Why is the rope swing by the river so popular? Is there a pattern to it? If it tells us, X, Y and Z about their feelings, then what other activities can we provide to feed such needs and how can we provide them so that they are acceptable and should the provision and need be interpreted beforehand, or, indeed, ever?” A residential institution that really does regard its bathroom and lavatories as at least of equal importance to its examination results is on the way to becoming “total‟ in the sense I mean.
Such an institution will rapidly establish it‟s own unique atmosphere or environment. Experienced practitioners entering establishments, talk of “The “feel‟ of the place”. There are many ingredients involved in its creation and such an environment becomes a force for change in its own right. It takes some time before these ingredients combine to produce the powerful whole which is greater than the sum of its parts, but when it has been established, and when it does include everything in the life of the community, which can be expected to effect profound and lasting change.
Many people come to Peper Harow and comment on what nice chaps our residents are. “They‟re not really disturbed at all,” they say, relieved, yet feeling cheated at the same time. Nor is it just naïve civil servants, or sensation seeking journalists who say this, but experienced members of the helping professions, too. Occasionally, when some case histories of these smiling, charming, apparently, self-confident kids are presented, they are staggered at the contradiction, for many of these kids have brought whole schools, adolescent units and so forth to a standstill. How are such volatile, impulsive, aggressive and self-destructive kids controlled? We maintain that the environment defuses their aggression. It does not destroy it, emasculate it – it defuses it and makes it safe. In this is the sense of security that most boys have at Peper Harow. There are no walls, but there is a powerful discipline in the atmosphere which is generated not by the staff alone, but by everyone.
The whole community has come to recognise that the “good‟ atmosphere, of which they have often been aware, is richly rewarding for them individually. They find themselves able to become the good person they had always secretly wished themselves to be and which lay hidden behind their emotionally stunted appearance. Thus, the nourishment and preservation of such an environment is seen by them as being very much in their own interests.
Many years ago, whilst working within the Approved School system, I was camping with a group of exceptionally delinquent adolescents on an island in a Scottish loch. The trip had gone well. Mountains had been scaled and rivers canoed, and the last couple of days were upon us. Everyone had enjoyed themselves, had achieved more than they had envisaged, had shared a feeling of brotherhood, but were about to return to the repression where dog ate dog. The contrast was painful. Perhaps it would have been easier never to have experienced the pleasure, not to have known what one was really missing. It is not surprising that all sorts of bad things started to happen. When it came to breakfast on the final morning, there was no food left. I checked and re-checked and was almost sure I couldn‟t have made a mistake. A few minutes later, while I was still wondering whom to accuse and how to go about it, a group had gathered around one other boy. He was forced to empty his kitbag, for all his protestations, the genuineness of which certainly had convinced me, despite the fact that they were being utterly ignored by his interrogators. I was about to step in and angrily denounce the scapegoating bullies, when out tumbled the packet of porridge, the cartons of eggs, cans of this and that … He had saved them against the hard days to come. The group, however, wanted them for breakfast. It had no doubt about its immediate interests and the thief had to capitulate.
It certainly set me thinking, for if the interests of the group could be identified with the interests of the staff, therapists, as on that occasion, the defensive behaviours, the sub-culture, the repressive mechanisms, could surely be overcome by the group in a way that could never be achieved by adult intervention alone.
This example of a group‟s potential for control was given not by Peper Harow kids, but by a vastly different set of boys. I quote it to indicate that this potential exists in all sorts of group. The purpose of the group, however, must be recognisable to its members as being in their own interests and in those circumstances, the individual‟s own weak controls or personality-disordered behaviour is containable by the group. Now having established the idea of a group which treats its self-helping, rehabilitating and growthful task seriously, we have to borrow some of the concepts of developmental psychological theory to understand what our total situation can provide. Many of our kids‟ difficulties, at Peper Harow, for example, began in their first hours of birth, in the first interactions with mother.
Supposing we have a depressed, perhaps schizoid, mother who is ambivalent for her own pathological reasons, about feeding her infant. It is highly unlikely that he will learn how to receive from her and recognise himself as a baby person in his own right. Separation and babyhood independence will be harder than usual to achieve and so will all the sequential tasks.
For brevity‟s sake, let us consider a notional adolescent, whose problems can recognisably be said to have begun like that. All his attitudes, so long established, have been based on anxiety and on a pessimistic view of himself and the world and have subsequently been reinforced by his own realisation of his negative assumptions. He needs two things from the community if he is to have another chance. The first is understanding of how he came to have his present personality – which can occur through traditional psychoanalytic methods. The second is nourishment of his ego. However clearly he can recognise his deprivation, spell out his feeling of unhappiness, of failure, of success and so forth, he cannot come to a position of happiness, of success and of altruistic generosity and of mature relationships, unless he has actually experienced those good things himself which the fortunate child experiences, nor can he reach a mature adulthood.
Yet there can be no real going back to where it went wrong. A 17 year old cannot return through a new and generous, albeit surrogate mother. He needed the real sensory feelings of babyhood when he was a baby, but they could no longer be experienced as they would have been in babyhood. They would be mixed with the additional sensory feelings of manhood.
I will say a good deal more, in a later example, of ways of dealing with this dilemma. It will be centred around one of the primary features of the residential situation – the feeding process. It always seemed sensible to me that if one was to get the boys to relate positively and to accept that their interaction was a prior requirement, then they would have to do all the cooking for themselves – for each other. My experience at Finchden Manor, some years before, convinced me that this was possible. There, too, the boys did the cooking. There were staff in the background controlling the larder, the costs, the menus. There were problems as well as valuable outcomes, of course, and ambivalent feelings about the kitchen and its productions. I entered the kitchen on my first day there. A group of boys leaned against the warm Aga cookers. One asked me who I was and, in response to my reply, he cleared his throat and spat with all his accumulated gob at my feet. There was silence. I protested mildly and then another boy, leaped in, not to my defence, but to the kitchen‟s. “How was a visitor supposed to understand such behaviour in the kitchen? The boy ought to apologise. Only boys could behave like that to each other. A visitor couldn‟t be expected to understand such behaviour, especially in the kitchen‟.
For all this more mature viewpoint, shared by many, the kitchen was filthy. The boys who served at lunch were mightily abused. Boys walked across tables and across the food. Were they working something out of their system or should there have been more control over their attitude towards the “Mum‟ area of their community? This was exactly the kind of situation which later developed naturally at Peper Harow in its early days. It certainly expressed what the kids felt, but they actually longed for something better. However, when they got it in the shape of feasts at Christmas, of lovingly prepared holiday periods, they would run out of the room, muck the table up and destroy what they so badly wanted. Obviously, some basic change was needed, otherwise they could only go on acting out what they felt, rather than be nourished by the good provisions. They needed to change their attitudes and not just control their feelings. I have already indicated that I would say more about what provision could be made to bring this about, but first feel it important to communicate some of the therapeutic understanding which forms a background to our practical work. We have had a research programme in operation for the last two years. I want to quote from the Researchers‟ Interim Working Note because it says so much about models of change which underlie our work.
Initial Findings
The work of Peper Harow lies in its unambiguous commitment to internal psychic change, rather than external behavioural improvement in neurotic, sometimes delinquent and disturbed boys ……..
Every organisation, from factory to school, is involved in change processes of one kind or another. Something enters the organisation, is processed in some way and something different then leaves. So Peper Harow can be described as an organisation which takes in disturbed and sometimes delinquent boys, provides an environment in which psychic change can take place, and less disturbed boys leave. (Hopefully). The process of “conversion‟, (of course) defines the Primary Task of the organisation. At Peper Harow, however, to define Primary Task is a very complex matter ….
In so doing we have attempted to use psychological and sociological frameworks to relate the boys and staff to their institution. Ezriel* suggests that every individual, in relation to his pathology, has a threefold defensive organisation towards himself and towards others. He describes this organisation as consisting of:
- The required relationship which covers ….
- The avoided relationship which is feared because of its proximity to
- The catastrophic relationship
As an example, Ezriel suggest, “that a patient might adopt a submissive behaviour pattern‟ (the relationship he thinks is required) and thus avoid the rebellious relationship which he desires, though partly unconsciously, because he fears that his “rebellious behaviour will inevitably lead to a calamity, such as his annihilating the one person on whom his welfare depends‟.
In most organisations behaviour is “simply either acceptable, or it is not. Whether or not acceptable and co-operative behaviour is defensive, is immaterial to the organisation and thus the motivations behind behaviour are not understood or examined. However, in any enterprise people will pursue unconscious aims and objectives as well as those which subscribe to the “stated‟ aims of the organisation. Lawrence and Robinson* suggest that different kinds of primary tasks are pursued, individually and collectively, by their enterprise.
These are distinguished as follows:
- The normative primary task, which is the task that people in organisations ought to pursue (usually according to the definitions of a super ordinate authority);
- The existential primary task which they believe they are carrying out:
- The phenomenal primary task which, it is hypothesised that they are engaged in and, “yet‟ of which they may not be consciously aware.‟
In most enterprises the existence of the phenomenal primary task is hardly acknowledged and its presence is allowed to break through into consciousness as little as possible.
A therapeutic community however, is designed to excavate the catastrophic relationship – according to Ezriel the most potent dynamic in disturbed behaviour. Bringing unconscious fears into consciousness is a frightening and turbulent process so that a boy may temporarily be more disturbed than before he began the therapeutic process. The therapeutic community, as an institution, takes the full blast of delinquent defensiveness, acting out and direct expression of underlying terrors.
The effect on the staff of exposing them to a situation possessed of such dynamics, more extreme than they are likely to meet elsewhere, may mean that they cope by employing or over acting against psychologically disturbed and/or delinquent solutions in themselves. The problem for a therapeutic community is how to manage and contain, within the organisation, the disturbance of both emotions and behaviour which have to be released and therefore let into the community before a boy can change.
The Researchers continue in their document to examine the construction of a containing and stimulating environment which also examine their concepts in terms of indefinable aspects of the community life. How does a community meeting undermine the false and defensive identity that prevents confrontation with the reality of the self-destructive thought processes and behaviour? How does it control such behaviour sufficiently so that it can be tolerated by the individual and the community and how does it create a nourishing atmosphere in which the disorientated kid feels safe enough to digest and accept growth stimuli?
They list the community meeting, small therapy group, guru, bedroom groups, feasts, rituals, adventure expeditions, education groups, informal relationships. One could add exhibitions, professional workshops and interviews for new boys and new staff, the actual design of the grounds, the role of the staff and many more factors within the overall atmosphere which allows its definable contributory parts to make for growth and change. Nevertheless, the parts in themselves also have very important functions to fulfil.
My main example of what total therapy consists of is bound to be a description of Peper Harow, itself. I can tell you in advance that I cannot succeed in this paper alone in communicating the whole of it. It‟s structure is too complex. I only have time to examine a few aspects of one area of the community life – that relating to food. For each of those items I have just listed, a whole paper could be written. Who runs the community meeting, for example? Is it a controlling agency, an instrument for linguistic development, for socialisation? It also retains a therapeutic potential of its own, is able to raise unconscious feelings to the surface, offer security, interpretation of unconscious behaviour; it mirrors the unconscious interactions within the staff group, the psychotherapy groups, the study groups, the bedroom situation. But additionally, each of those situations listed, in its own turn, reflects what is happening in all the other definable situations. This is clearly recognised by members of the community and is often verbalised. Discussion that has already taken place by the fire, or at night, is referred to by one of the boys as another indication of what, say John feels when, in his group he is busy denying recognition that his current response is part of how he presents himself generally.
How do staff come to be able to use this micro/macro-cosmic situation? Indeed, how are the staff‟s own feelings integrated into this totality? They express tenderness, anxiety and often enormous rage, all of which partly discloses their own personality, but which also can be sublimated into becoming part of the overall treatment process. The new kitchen and dining room, which I intend to use as my example, are still only a part of the whole situation which was therapeutic before they were completed.
In infancy, mother enabled the child to be excited by the shared warmth of their bodies, mutual exploration, smells, sounds and above all, food. But predominantly the baby did not feel so overwhelmed by the good feelings for him to become terrified because there had seemed to be no boundaries, at a time when his main task was to define what was her and what was him. The fortunate secure and satisfied baby was carefully separated in pram and cot very early on, but not abandoned. He felt it was safe to be an individual; was not exposed to more than he could cope with. Extending his relationship with people, with things, with the new situations he encountered, was based on optimism from his experience to date and on the very pleasurable experience of success, which were thence fulfilled as expected. If periods of difficulty, such as beginning school were experienced, the actual outcome would not really be in doubt.
But what about our boys? Their fundamental attitude is pessimistic. They do not expect to have their needs met. They have learned to feel that they have no rights, that they must scream and shout for food, or starve; that even when they have obtained it, it brings no satisfaction, as they have needed to behave so badly in order to obtain it at all that they now need to punish themselves. They were being forced to become, through such screaming effort, sour people, when a sweet relationship was what they had desired, indeed, were entitled to as babies, but would never receive. Of course every mother must be ambivalent at some time, produce stress as well as satisfaction. It is impossible to measure the appropriate extent, except that at one point the baby‟s occasional stressful encounters, will develop its emotional fitness – as it were – whereas beyond such a point, it will be deprived, anxious, demanding and feel less and less satisfied and more and more angry and fearful. The consequences are that the seeds of failure have been sown and they will germinate sooner or later, with more or less serious effect. We have all met kids who were apparently quite normal and successful until adolescence. Suddenly, we hear, “He seemed to go quite mad. He‟s not the child we knew at all.‟ More familiarly, parents have failed to recognise the implications of their child‟s behaviour earlier – a failure with its own implications, of course. With most kids who are so unable to function in normal society that they must leave it, the signs have been clear for years.
I have already quoted the Researchers as saying that, “The problem for a Therapeutic Community is how to manage and contain within the organisation the disturbance of both emotions and behaviour which have to be released … before a boy can change …..‟
“Excavating the catastrophic relationship,‟ they remind us, was releasing “the most potent dynamic in disturbed behaviour‟.*
It is appropriate that at Peper Harow our psychotherapy groups, community meetings, individual meetings between staff and boys should raise to the surface these unconscious fears. However, these are containable only if the boys are equally conscious of primary need being met and thus bring them comfort in their anxiety.
Clare Winnicott reminds us that children need to become aware of loss, “to recognise what has been lost, otherwise they can never appreciate and value what has been lost and so come to seek it and accept it in the future.‟ How can one understand such basic things as “theoretic‟ mothering? Together with an adult‟s understanding the kids need to have actual experience too. This is a slightly different viewpoint to Ezriel‟s. However, their sibling rivalry, their jealously, their envy, is utterly terrible, yet the days of fatherhood are close at hand and how will they tolerate their children being smothered if their own hunger is still unsatiated? In her article, Mrs Winnicott also underlines the importance of object symbolism and the mothering process. Much has been written about deprived children‟s linguistic difficulties. I suggest that even to develop academically, it is necessary to provide compensatory and ongoing primary experiences, or classroom teaching alone, however skilled, will have little effect.
Not that it is easy to perceive how to develop such primary experience and use it therapeutically. I said earlier that I would give an example about food. At Peper Harow we began by asking the question, “Well if the kids really need the babyhood feeding experience in itself, how can we possibly manage?‟ I have already discussed the cartoon idea of 50 wet nurses with 50 hulking teenagers. To be serious, the main reason why such a picture is absurd is because our adolescents are not babies in reality – it is only their emotions that are infantile and it is their emotions which need the baby‟s good experiences in order to grow up. Their size and the changing attitudes and a dozen other problems, however, make a real woman as a surrogate mother, the irrelevant answer, irrespective as to whether the food is Cow “n Gate or good red beef! Instead of the often sentimental talk about homely Mother Earth figures in the institution‟s kitchen, we have to look closely at a baby‟s actual interactions to discover what answers we could provide for his paradoxical need. All the baby‟s senses are at work and not just the taste mechanisms. His oral sensation is not concerned merely with taste and swallowing; it is also experiencing textures of teat and nipple and of regurgitation and of the napkin that wipes his dribbles away; the sound of mother‟s heart next to his ear, more or less peaceful and thence his response; her hand rubbing or patting to bring up wind; the soothing or irritated quality of her voice in all these exchanges. What I say is not news, of course, but to remind us of how complex the feeding situation really is and also how manifold are the messages which the baby is receiving and in how many different physical forms security or insecurity is being reinforced.
Bearing all these things in mind, we have built a new dining room area and kitchen. As in many places dealing with very disturbed children, we have a high proportion of those described so clearly by Bowlby. For a while we had seen the limits of the response they could make simply to the principle of the place. That principle was that they were being given a real opportunity for their recovery and growth, which together with the help offered, made the recipe complete. But for all that principle, the response was as though there had been an emotional power cut – as though there was no electricity to produce the heat which would actually turn the existing ingredients into a nourishing meal. The way they ate, showed their underlying attitudes of hate and total insatiability and would illustrate their great confusion between eating and excreting – or of making a mess, if you like and all that is implied by that.
Very early on in Peper Harow‟s history, we had insisted that the boys did all the cooking and the result was as I have described it earlier – at least in terms of the walls and ceilings being bespattered with decaying food, perpetually dirty floors and pots. The aggression seemed to be worse to me than I had ever encountered. Every night the food store was broken into. We put two locks on – and the hinges were kicked off. We put blast proof hinges on – and the panels were beaten down. We put a steel lining on the door and the very frame and door together were smashed out of the wall itself. Community meetings were then at a very early stage of development, but I remember the ensuing discussion as being one of the first teetering steps towards a therapeutic situation. Our population then was highly delinquent in the criminal sense, but boy after boy began to talk of how he had made tea, pinched boxes of chocolates, even made whole meals during his many burglaries and especially at night. And then, as the meeting progressed, they talked of how they excreted in the lavatory, on the soft carpet, in the kitchen, itself! And last of all, one or two boys, with serious discomfort, described how they had finished the event by smashing everything around them. Even then, there was some embarrassed tittering as one or two boys vaguely associated their mothers with those feelings connected with breaking in and stealing, and with damaging the house into which they had entered illegally.
We established a buttery from that time on. It only consisted of an electric kettle on a table, a jug of milk and jars of tea, coffee, sugar, milk and jam and a loaf of bread, but it was replenished throughout the day and last thing at night and from that day on, the food store has never been broken into. At first, every night boys came downstairs to see if it was still there, but after much wrecking of this “buttery‟ to see if we would really keep it there, the anxiety diminished.
It seemed obvious that while rudimentary responses to behaviour were enough to control it, if they embodied recognition of the motivation for that behaviour, they still could not actually change the underlying attitudes. What would happen – we had to ask – in their older lives in response to sexual intercourse, in response to seeing their own children being fed; or, more likely, when, instead of successful mothering, they were witnessing a repeat of their own childhood, because the kind of women they would marry would be equally as disturbed as they, themselves? But apart from this, even if their behaviour could be modified, in terms of creative energies being released, they would still remain bound prisoners of their unconscious resentment.
Our existing kitchen was far from ideal. It‟s quarry-tiled floor, intended for easy cleaning with mops had become pitted by puritanical scrubbing brushes. The dirt-exposing white tiled walls and twenty-foot high ceiling, echoed until an hour‟s work produced a sensation of being battered and the old fashioned oil-fired stoves roared away like the furnaces of the damned. That kitchen had to go anyway and so there was an opportunity to replan the whole eating structure.
We sat down to think out how we could design our new kitchens to create those feelings, in those who lived there, that the fortunate baby experienced. I said before that the existence of mother figures was not enough. No woman, however, mature could actually survive the habitual hatred of such a group, even if she could recognise their need, recognise that part of them liked her, that she had colleagues and was not alone …. “There was an old woman who lived in a shoe who had so many children she didn‟t know what to do …” Neither could such a member of staff. You cannot satisfy 50 insatiable adolescents. You can satisfy a baby who feels he is insatiable, if you are Winnicott‟s “good enough Mum‟*. There is a real difference however, and the treatment for disturbed adolescents cannot just be based on inner resources of professional people. In the old days, sick people‟s lives depended on devoted enough nurses and doctors, but often, even the most selfless and loving nursing failed in the face of the virulent illness. Since then we have discovered some physical aids in the form of modern pharmacology that have revolutionised medicine. We, in the residential field must surely move towards this – not towards drugs, I may say, but towards the provision of physical resources to help us develop positive feelings in our kids. There are other problems. One might ask if a synthetic treatment is easier to cope with than an actual relationship with a woman. In a predominantly male community, our provision could easily become a defensive ploy against change, despite all the nourishing potential it apparently offers.
For all the caveats, to which we only have time to refer, we decided that our design had to counteract the profound suspicion about the quality of the food – what had happened to it before it had arrived in front of one – thus the kitchen/dining area would be on an open plan. The food would arrive in the kitchen, be prepared and cooked and served, all within the view of the prospective eaters and by those same eaters who turn it was to cook. The washing-up areas would also be within their view. We would maintain the kitchen gardens on the same principle and from seed to the preparation table would be recognisably good and in recognisable sequence.
Every item in the kitchen – think how many there are – was assessed in terms of efficiency; they had to do the job they were supposed to do, or the feeling in the boy using them would be one of betrayal, associated with his past earlier experience. They would also be assessed in terms of appearance – did it look good enough to make an impression on kids whose sensitive response was dulled by traumatic experience – an impression of quality, of warmth? Did it look strong enough not to require testing out by our occasional grumpy Hercules? It would be assessed in terms of feel, the strong texture of a glazed tile, the silky sophistication of stove enamel, the chunky solidity of extra-heavy stainless steel.
In the end we agreed with Bettleheim‟s comments in A Home for the Heart* that the cutlery and crockery should not be institutionalised, but of a very high standard, offering very satisfying feelings when used. We would have glasses at the meal table at main meals, not imitation plastic glass. We would have fish knives when we had fish, bread knives, cups and saucers. Of course, we spent many many months finding exactly the right tableware and months more waiting for delivery. It would have been easier to have gone for the nearly right, except that we were determined that if the principal was right, then we really had to see it through, irrespective of effort or cost. So our table tops were finally made by Robert Thomson, the Mouseman, the only firm in the country to produce seasoned, solid English oak, two inches thick, which includes an adzed surface. Running one‟s fingers across the rippling surface as one sits at the table is a pleasurable experience indeed! Seats, while designed as benches in order to include the principle of sharing, are also upholstered in pure wool; yet again, in a very original weave to obtain individuality while also producing a unique tactile pleasure of their own. The full length curtains are floodlit to bring out the rich colours. They and the carpeted floor, the Hessian covered walls and the sound-proofed ceiling, produce a low and calming noise level. The servery is spot-lit so that even the most ordinary food looks mouth-watering.
One could go on for a long time but the points have been made, not only why one should think of these primary aspects when living in a residential situation in this way, but also of how one can translate the therapeutic principles into the physical and how meticulous one must be – as meticulous perhaps as would be considered appropriate if an operating theatre, for example, were to be planned.
I have taken one example, but the lavatories and bathrooms are no less important. Because, our new lavatories and bathrooms were a much earlier priority, they have not been so meticulously designed. The provision is of a very high standard. The central heating is of a slightly higher level than in the surrounding building. The lavatory cubicles are individually lit and colourfully decorated. But today, I would have had each one painted in different colours, with different lighting units, different lavatory seats and so forth.
In a way, what I have said, despite what it owes to the concept of developmental psychology, is still common sense. Perhaps one can extend it in other directions. We have a group whose members are chosen to meet certain criteria, which will make for potential group homogeneity. One such criterion is high intelligence. Many boys have been ill educated and are years behind in their chronological attainment, let alone in terms of their intellectual ability. The pressure is to shove them into small classes, with a brilliant teacher, as soon as they arrive and to teach them for twice as long as in the day setting, in the hope that they will eventually catch up – and this irrespective of the fact that only yesterday they were educational failures. How can they become educable overnight? First, as in everything else, one must look to the roots of what is wrong, find the point where the excited, exploratory curiosity became blunted; find the time when the boy became frightened, inhibited, withdrawn, pessimistic. Was that when he first started school, first started to walk, first started on solid food? Early personality inhibitions will have affected the child‟s ability to use play growthfully, nourishingly, stimulatingly. And so to the adolescent who arrives promising to turn over a new leaf, who swears he will now work like a Trojan, will never let his parents down again and who will pass all the “O‟ Levels in the book and how soon can he begin?
We reply: “Oh, in a couple of years, perhaps!‟
“A couple of years!‟ He cries in astonishment.
“Well maybe 18 months, then.‟
“But what will my mother say? She expects…‟
“Yes, Yes,‟ I interrupt, “But your mother isn‟t actually here and your needs have got to take precedence over what she wants. While you are here, I‟m sure we‟ll want you to achieve and do all those wonderful things that your mother wants, but we see other things coming first.‟
“What sort of things?‟
“Oh! First you have to learn to play.‟
“Play. What do you mean “play”? What kinds of play?‟
“Oh, Cops and robbers. Mud pies, Climbing trees, Go-karts and things.‟
“But that‟s all kids‟ stuff!‟
“Yes, I know. Isn‟t it fun not to have to grow up for a while? When you have played enough, you will be ready to start all this work stuff, but first play.‟
As with the kitchens, we have brought the business of education into line with the principle of treatment and are now learning to take it further. For if a dining room table can add to a boy‟s sense of inner warmth, can help him to see himself as one who truly matters, whose needs matter, so can the educational programme.
I have no time to detail this. We have a Head of Education and a Head of Creative Studies whose tasks are to liaise closely with the individual members of staff responsible for individual boys; to be continuously assessing at which point education should begin; what the ingredients of learning are, what kinds of boys need to be in which group for a positive and encouraging atmosphere to help the journey towards self-confidence.
I could go on by saying that arranging which boys shall go into which bedroom is an amazingly complicated task, if one is once again to see that what actually occurs is also fruitful. The main purpose of this paper, however, is to stress my belief that every aspect of life in a residential situation can be therapeutic. Indeed, if boys are there because they are maladjusted, then it is an obligation on such an establishment to be therapeutic for 24 hours a day; otherwise they may as well be at home attending some kind of day treatment centre.
An argument, such as is often advanced, that no such place exists in the home situation, is still no reason for sending him to another situation that provides treatment, but not for people with his particular needs. It is like sending someone in need of an artificial leg a spare arm!
I certainly agree with the principles of Section 10 of the new Education Act, which implies that the normal education system should become sufficiently sophisticated to educate handicapped children in ordinary schools, but there are those whose deprivation, traumatisation and maladjustment, are of such a fundamentally disturbed order, that they could never manage, let alone grow, without a fundamental restructure of personality of change of attitudes. This requires a system of living that is as specialised and as different from a home situation as at Peper Harow. To establish such a system requires costly staff/pupil ratios, extraordinarily expensive environments, and above all, staff who can understand the potential around them and use such a sophisticated tool with great skill.
There is no course long enough, let alone sophisticated enough, to train staff for such a profession, nor is there the appropriate professional status for residential workers. We believe that all this can be achieved, once we accept that we should never compromise and pretend that a container system for kids could be called therapeutic. We must not collude with a public that generally seems worried about it‟s human problems, but wishes to duck the real issues it must confront if real solutions are to be found.