ISP Newsletter Editorials – 2011
February
At a personal and professional level I have had to deal with the announcement that the Cotswold Community will be closing this summer. I worked there for 27 years, so it has been a big part of my life. I learnt everything I know about therapeutic child carer there. It was one of only two institutions in the country that successfully changed from being an Approved School (junior Borstal) to a Therapeutic Community in the late 1960s. The Community was guided by some amazing consultants such as Barbara Dockar-Drysdale, Isabel Menzies Lyth, Eric Miller and Paul Van Heeswyk.
Analysing the demise of the Cotswold Community is important as I am sure lessons can be learnt. Everyone will have their own take on it but for me a crucial factor is the loss of the therapeutic task during the last ten years or so. As the place gradually became like other residential schools the high fees couldn’t be justified and consequently referrals dropped considerably.
We know that children need to have good endings but how does a residential centre achieve this for itself? At the Cotswold Community there are several objects which are historically and emotionally important, for example a large wooden hippo that was carved in memory of a young person who died fifteen years ago. I’m trying to arrange for it to have a new home at the Planned Environment Therapy Trust’s Archive and Study Centre in Toddington, Gloucestershire. It is worth having a look at their website: www.archive.pettrust.org.uk The Archive and Study Centre is situated in some lovely grounds which would be a fitting home for the hippo.
The other project I have been involved with is the making of a film, “Bearing the Unbearable”. Christine Bradley, who I first knew at the Cotswold Community, has been the driving force behind the film. She enlisted the help of people she got to know during her career, eg, Jonathan Stanley, Robert Tapsfield (Fostering Network), Adrian Ward (Tavistock Centre) and Peter Wilson. The film consists of several discussions between two people covering a particular area of work. The interviewer is Julie Peasgood, who is a television presenter. I found myself “on the couch” with Robert Tapsfield discussing fostering. The filming took place about fifteen months ago at Maidstone Studios, so it has taken a long time to become available – just in time for the Oscars!
April
I wonder if any of you heard Zadie Smith (the author of White Teeth, The Autograph Man and On Beauty) defend libraries on Radio 4 recently? It was a powerful polemic. Here is an extract:
I GREW up in a London Council flat decorated with books, almost all of them procured by my mother.
I never stopped to wonder where these books came from, given the tightness of money generally – I just read them.
A decade later we moved to a maisonette where she filled the extra space with more books, arranged in a certain pattern. Second-hand Penguin paperbacks, then the Women’s Press books , then Virago. Then several shelves of Open University textbooks on social work, psychotherapy and feminist theory.
Busy with my own studies and oblivious the way children are, I hadn’t noticed that the three younger Smiths were not the only students in the flat. We were reading because our parents and teachers told us to. My mother was reading for her life.
About two-thirds of those books had a printed stamp on the inside cover, explaining their provenance: PROPERTY OF WILLESDEN GREEN LIBRARY. I hope I am not incriminating my family by saying that during the mid-80s it seemed as if the Smiths were trying to covertly move the entire contents of that library into their living room. It was a happy day when my mother spotted a sign pinned to a tree in the high road: WILLESDEN GREEN LIBRARY, BOOK AMNESTY. They next day we filled two black bags with books and returned them.
……Later I learnt what a monumental and sacred thing a library can be. I have spent my adult life in the sort of libraries that make Willesden Green’s look very small indeed; to some people clearly, quite small enough to be rid of without much regret. But I never would have seen a university library if I had not grown up living 100 yards from the library in Willesden Green. Local libraries are gateways – not only to other libraries but to other lives. Of course I can see that if you went to Eton or Harrow – like so many of the present Cabinet – you might not understand the point of such lowly gateways, or be able to conceive why anyone would crawl on their hands and knees for the privilege of entering one.
It has always been, and always will be, very difficult to explain to people with money what it means not to have money. If education matters to you, they ask, and if libraries matter to you, well, why wouldn’t you be willing to pay for them if you value them?
They are the kind of people who believe value can only be measured in money, at the extreme end of which logic lies the idea that people who fail to generate a lot of money for their families cannot possibly value their families as people with money do.
My own family put a very high value on education. Like many people without money, we relied on our public services. Not as a frippery, not as a pointless addition, not as an excuse for personal stagnation, but as a necessary gateway to better opportunities. We paid our taxes in the hope that they would be used to establish shared institutions from which all might benefit equally.
We understood very well that there are people who have no need of these services, who make their own private arrangements, in healthcare and education and property and travel and lifestyle, and who have a private library in their own houses.
Nowadays I also have a private library in my own private house, and a library in the university in which I teach. But once you’ve benefited from the use of shared institutions you know that to abandon them when they are no longer a necessity is like Wile E. Coyote putting a rope bridge between two precipices only to blow it up once he’s reached the other side – so that no one might follow……
May
A few weeks ago the BBC broadcast a documentary, “A Home for Maisie”, which was about the process a family went through in deciding whether or not to adopt her, having previously been through two adoption breakdowns. Several ISP people saw this documentary and were affected by it. I was impressed, amongst other things, in the way the film showed Maisie’s panic rages, which were mainly directed at her foster mother and how these rages were worked with, knowing that this behaviour could be the “deal breaker” to the adoption going ahead. This is something I try to describe in our Therapeutic Childcare training.
In Friday’s Times there was an article about this family and their therapeutic approach. Much of what they describe as “reparenting” we cover in the Therapeutic Childcare training, using different words to describe the need to reach the hurt infant within the young person’s defences. Here are some extracts from the article, “How infant’s games in the bathroom can help angry older children feel at home”, by Rosemary Bennett.
……Yet as we chat the house is quiet, even though there are five hungry children upstairs. How can it be that children who have suffered at the hands of violent, alcoholic or drug-taking parents, have become a large, happy family?
“It is not always this quiet,” Mrs Clifford said, “Some of the children were very violent when they arrived. Others were shut down. One of our sons was so closed he could not even feel hunger. He had survived by having no needs, and keeping his head down.”
The couple put their success down to the parenting style they have pioneered, which seeks to fill in or re-create the care that children have missed during years of neglect or abuse.
“Reparenting” starts with an extensive mapping of the child, patiently observing her behaviour, and then piecing that together with what is known about her early life, working out what has been missed.
The gaps are then filled with activities that may appear quite unusual: bottle-feeding a 6-year-old, using dummies at bedtime, spoon-feeding, finger games, periods of close eye contact and hugging and physical contact, the kind that a baby would normally receive. There is constant narrative, describing to the child what is going on and why.
Mrs Clifford gives an example: “When Maisie went to use the loo she would smear shampoo and lotions all over the bathroom. We worked out it was because she was never allowed to play with water when she was 2 or 3. Messy play is important for children and they love it. She was 8 but needed to be able to play like an 18-month-old.”
The days of smearing shampoo around the bathroom are now over. Maisie still has problems, and angry or violent outbursts. Mrs Clifford is usually on the receiving end. “I try and think it is not me she hates, but the hurt coming out. I get close in beside her, never fully withdraw. I say, ‘I know you are angry but you can’t kick and punch. You are still my little girl and I still love you.’ I have to stay calm.” Many of the older children have been on the same journey themselves and can help.
…….Not everyone is a fan of “reparenting”. Educationalists in particular do not like treating a child of 8 as though they were much younger, fearing that it will hold back progress at school.
But Mr Clifford said they have to consider how young the child is inside. “And look at the evidence here. We have taken nine of the most damaged children, virtually unplaceable. We have kept all nine children and all nine are doing well. The breakdown rate for adoption is at least one in five, probably closer to 40 per cent for older children. We must be doing something right.”
August
On Saturday the 9th July I had the unhappy experience of attending an event to mark the closure of the Cotswold Community, where I worked from 1972-99. Like me a lot of people served their apprenticeship there and returned to acknowledge their appreciation of that experience. There were some other ISP people there: Mark Thomas, Simon Peacock and his wife Jo (who both worked there) and Jim and Debbie Hamil, who also met while working there. Several senior managers from the Mulberry Bush and SACCS attended having previously worked at the Cotswold. Many ex-staff members are eminent psychotherapists, which demonstrate one of the positive consequences of an organisation that was based on sound principles with an excellent training programme. There were several ex-young people, now middle-aged men, attending. Their stories were largely very encouraging. Some went through crises but had the strength to come through and make a go of their lives. One man remembers my wife reading him Roald Dahl stories as a boy and he in turn reads them to his children. Hearing things like this helps you to realise that these seemingly small things can make a big impact later.
I’ve written an obituary for the Cotswold Community for Young Minds magazine. Here is an extract:-
“The Cotswold Community’s therapeutic work was to help emotionally unintegrated boys achieve emotional integration, a stage in development which would normally be achieved before the age of three. The fact that this reparative work was taking place with boys in the age range 9-16, whose age appropriate needs also had to be addressed, meant that this was complex therapeutic work. Barbara Dockar-Drysdale’s consultancy was to the staff teams of the group living households and the education area. The therapeutic model was that the residential workers would be trained and supported to provide therapeutic child care. This was a very different model to residential child care where the child might see a therapist once a week. Emotionally unintegrated children need therapeutic management 24 hours a day. Staff had to be trained to take full advantage of the moments in a day when a child might drop their defences and be receptive to being cared for. It was this daily process over many months that basic trust was achieved, the cornerstone for ongoing therapeutic work.”
This approach to therapeutic child care, briefly outlined above, is the same as ISP’s approach using the skills and involvement of foster carers instead of residential workers. ISP is also able to benefit from a team of therapists who can see children when they are ready for it.
I went from the Fun Day to the Womad festival on the 30th and 31st July. I suffered severe withdrawal symptoms in June when Glastonbury took place so this was my substitute experience. The main attraction being that we didn’t have to camp as it takes place just 5 miles from where I live. The weather was perfect so camping wouldn’t have been so bad. Unlike Glastonbury where you can’t put a sheet of paper between the tents, there was loads of camping space at Charlton Park (Womad). It is also a much smaller festival with just 35,000 people compared to 175,000 at Glasto. I can’t say that I’m a committed follower of world music so I was a bit worried that there wouldn’t be enough to interest me. The highlights were Baaba Maal’s (from Senegal) performance on Saturday night and Penguin Café on Sunday afternoon. “Baaba Maal has a voice of such soulful authority that he might be singing about his gas bill and you would still be moved”. (Review in the Times on the 2nd August.) It’s a great family festival with lots to do for kids. Great food from around the world is available. Two of my grandchildren enjoyed having their feet nibbled by fish in the World of Wellbeing.
October
On Saturday, 1st October, I flew to Tampere in Finland with my good friend Paul Van Heeswyck (Consultant Child and Adolescent Psychotherapist). We’d been invited by Pirjo Tuovila, another good friend, who organises a conference each year in Tampere Hall. Pirjo is a Psychologist. For ten years she has been organising these two-day conferences on the emotional development of children suffering from attachment disorders. Each year she invites a speaker from another country – mainly the UK and USA – as the main contributor to the conference. I was the first person she invited ten years ago. Paul has also been the centrepiece of one of Pirjo’s conferences. This time it was Dan Hughes (you can tell her speakers have gradually got better!). Paul and I were invited to be respondents during the conference. We weren’t sure what this meant exactly but assumed it was to help overcome the Finnish reticence to ask questions or make critical comments in public. I must say I haven’t found this was too much of a problem.
I took some notes during Dan Hughes’ lectures. Here are some quotes:
“When children feel safe they become engaged with other people. When they feel unsafe they become defensive and either fight or take flight.”
“Acceptance of the child helps to create a sense of safety. Adults being judgemental leads to defensiveness.”
“The tone of voice is important. When children are lectured it is usually in a monotone voice and this leads to defensiveness.”
“When grownups talk to babies there is a lot more feeling in the voice. It’s more of a story telling voice. Children are engrossed by the story. When speaking with children use a friendly voice, with inflections and friendly posture.”
“Notice the non-verbal language to intuit if the child is feeling safe.”
He used the word “intersubjectivity” to describe the therapeutic process – both parties involved are open to influence each other.
“If you are not open to being influenced by a child, you are not able to influence him/her.”
“Match the affect that’s coming from the child – that way they know you get it. Calmness often escalates feelings.”
“Most trainings stress therapeutic neutrality. It’s important to show feeling.”
“Kids may use anger management skills when they are calm, not when they are angry.”
“If my motive is to fix him he won’t want to do it. It’s enough to know and understand.”
Throughout the lectures, Dan Hughes emphasised the importance of PACE.
P = playful (break from the hard times – regulating emotions – laughter – humour)
A = acceptance (adolescents stop talking if they feel judged. Explore what they are saying without judgement)
C = curiosity (grownups need to be curious – what’s going on in the inner life of the child?)
E = empathy (I experience your experience. I get it)
“Guilt helps attachment. It is linked to empathy – able to feel what it’s like for others – and leads to modifying behaviour, repairing the relationship.”
“Shame cuts you off from other people, therefore, gets in the way of attachment.” “I deserve it”, in response to abuse and neglect. Difficult to get children to face their behaviour and change when they feel shame.“If I don’t resist his resistance it generally goes away.”
“Adults who are securely attached are most likely to have securely attached children. This is also the best environment for insecurely attached foster children.”
Towards the end of the conference, Dan Hughes showed a slide of his “Attachment Pledge”. I managed to get a copy. Here it is.
ATTACHMENT-FOCUSED PARENTING AND FAMILY THERAPY
Conference at Tampere Hall, 3 and 4 Oct 2011The Attachment Pledge
By Dan Hughes, Ph.D.I Will Strive To Help You……………………..TO FEEL SAFE HERE
I Will Discover…………………………………What Is UNIQUE About You
I Will Relate To You With PACE…………….Playfulness, Acceptance, Curiosity, Empathy
I Will Discover Your…………………………..STRENGHTS & VULNERABILITIES
I Will Listen To You Very Hard………………To understand Your Experience
I Will Give You What You Need……………..For Safety & Success
I Will Remember………………………………That You Often Feel FEAR & SHAME
I Will Never Leave You……………………….When You Are In Distress
I Will Not……………………………………….Forget You When We Are Apart
I Will LOVE & ACCEPT YOU………………. Especially When I Address Your Behaviour
I Will Remember……………………………… Why You Argue With Me, Ignore Me, And Do Not Trust Me
I Will Help You To Discover………………… What You And I Both Think, Feel, And Want
I Will Teach You………………………………By sharing My Experience Of You & The World With You
I Will Always Remember…………………….That Attachment Relationships Are Very Important To You
I will Be Very Clear…………………………..In Telling You What Is Happening & What Is .Going To Happen
I Will Provide You………………………With Routines & Rituals That You Will become Comfortable With
I Will Care For Myself………………………..So That I Am Better Able To Care For You
I Will Discover…………………………………The Song That Is In Your Heart
And…………………………………………I Will Sing It To You When You Forget It
December
On the 15 November ISP Sussex held an event to celebrate the opening of Burgess Hill centre. Leslie Ironside delivered a lecture, “managing the Madness – reflections on fostering”. I enjoyed it very much. One of the things I jotted down during the lecture was “The Echoes of the Mind Tree”.
Leslie explained how to use this visual aid with young people to help them to think about their behaviour, to try and understand the meaning of the behaviour and why it might be happening now. I think this is a very important part of therapeutic child care.