The management of violence in disturbed children, 1971.
Barbara Dockar-Drysdale.Consultation in Child Care Papers on Residential Work Volume 4
This paper was read late in 1970 as my contribution to a seminar on violence run by the Department of Health and Social Security. The material at the end of the paper was an experiment for use in discussion groups, and was sufficiently successful for me to wish to repeat the technique.
An outbreak of violence in any human being, grown-up or child, is always frightening to a degree, because we know, consciously or intuitively, that here is the expression of feelings so terrible as not to be containable. We are sometimes conscious of violence in ourselves which we cannot always successfully contain, but which most of the time is deep in our unconscious: potential, but untapped. The explosion of another’s violence reminds us of this potential in ourselves, perhaps of occasions when even to some much lesser extent our own violence has come into our consciousness and may have to some degree been acted out in our environment.
During the first year of life, babies change from being contained (by their mothers and the holding environment) to becoming ‘containers’. There are no feelings stronger, deeper, or more overwhelming than those which are already experienced at this early date. The ‘ordinary devoted mother’ (Winnicott) can contain the baby’s rage and her own feelings as long as this is necessary – until the baby can contain his own feelings.
Many of the children in our care have not become containers: at five, ten or fifteen years they may still need a lot of containment in order to integrate into whole, containing people. In the meantime, they are liable to act out their intolerably violent emotions in many ways, damaging to other people, themselves and their environment.
Winnicott defined panic as ‘unthinkable anxiety’. Much violence is caused by panic states: thinking is an essential way of containing feelings. Communication of such thoughts to others can be an unknown safety valve – if the thoughts are not there, they cannot be communicated; the anxiety is then so terrible and primitive as to be unthinkable, and the child reaches a panic state in which he may be totally immobilised, or dreadfully active.
One could say that the communication of violent feelings in words to another person is a symbolic way of finding a person able and willing to contain the child and his feelings.
A neurotic, integrated child (ie, a well-established ‘container’, with boundaries to himself and an inner reality within him) will be able to make such communication if it can reach consciousness. An integrated child has many means at his disposal of containing terrible feelings. For example, he can repress his violent aggression, or he can convert this into a symptom, or he can sublimate the aggression, putting it to some useful purpose. Usually a neurotic, integrated child will only experience the occasional twinge of panic with which we are all familiar; he is only likely to explode briefly and in a localised way into violence, and is usually able to put his feelings into words – even though these may be screamed.
The deprived, unintegrated child has no such resources. Where the integrated can respond to crisis, the unintegrated reacts to what he feels to be the threat of total annihilation. For him, conflict is not the question, but rather survival, not only for himself but of everything. Annihilation of the kind I am describing is something comparable to ‘the end of the world’. Even integrated people can experience this dread now and then, but they are not constantly exposed to the threat of infinite destruction, in the way that deprived and unintegrated children seem to be; nor do they have to manage annihilating forces within themselves. Unintegrated people simply overflow into violence; integrated people disintegrate into areas of violence – they are much less at risk than the former group.
At the present time, groups in residential places are a mixture of integrated and unintegrated – this demands tolerance of a high degree of incompatibility by children and staff: I have written elsewhere about this and would draw your attention to this aspect of the film John, in which an integrated toddler was exposed to the full blast of unintegrated peers, with appalling results. There would perhaps be less disastrous effects of separation if the dangers of incompatible mixing were more generally recognised.
In any community home there are likely to be several unintegrated, uncontaining children who are certain to break down into violence which will harm others and themselves. Unintegrated children are not especially disturbed by these explosions which come into their ‘scene’. Integrated children are terribly threatened by violence because they can disintegrate, which unintegrated ones cannot do because they have never been ‘in one piece’ and are not whole people.
The grown-ups involved in such a situation are also frightened and disturbed, and this can affect them in all sorts of ways, depending on individual personalities. Institutionalisation and hierarchical management are defences against these fears. Workers may ‘switch off’ feelings, depersonalise, become cold and pseudoobjective, and hand over the ‘happening’ to superiors, or become violent themselves.
Descriptions of violent behaviour in children tend to be detached, in a way which leaves the grown-up in a superior position. The grown-up may become ‘angry’ and the child has a ‘temper tantrum’. The grown-up asserts, in such a context, that the violence is that of childhood – there is a deep unwillingness to face the fact that grown-ups are not so different in reality, and are also capable of having temper tantrums. It is difficult for a grown-up to admit that he has behaved violently towards a child, because he feels himself to be too mature for such behaviour. Really it becomes essential for the person working with children to be well aware of the possible violence within himself. We all know the gentle, patient person who arranges (unconsciously, of course) for a child to act out his violence while he stays calm and ‘good’.
‘Punishment’ is often a rationalisation of violence – grown-ups can act out, denying the real causes within themselves which lead to their violent actions.
If one can see all acting out as a breakdown in communication – an area in which the individual cannot contain and think about his feelings, then one’s attitude is more honest and less defended, so that one is actually more free to take appropriate action and to make comments which are valuable to the chid.
Thinking about children and violence, I find myself considering two phases: (1) before the violent act takes place, and (2) after the act of violence has been committed. Anticipation of violence calls for good observation, empathy, and a feeling for dynamics – ‘one thing leads to another’. Too often ‘another’ has been reached without ‘one thing’ having been observed and registered.
Panic states are, in a sense, psychosomatic. One can observe physical symptoms in a child one has come to know. Pallor, trembling, change of voice and breathing, dilation of the eyes, and a desperate restlessness may all be signals of an approaching storm. At this stage, insulation and containment may save the child and the environment from disaster. There was much to criticise in the film, ‘Warrendale’ 1, but here at least an effort was made to contain the child and his feelings in time. The point is often made that ‘nothing has happened to cause the outbursts of violence’. The truth is that we may not have realised what has happened to the child in terms of his inner reality. Something – a look, a word, a circumstance, may have set up a chain of associations which will have forced him to remember through feeling ‘other voices, other rooms’ (Capote).
Emotionally deprived children are traumatised at a stage so early that they cannot realise, symbolise or conceptualise what has happened to them: they ‘remember’ only through feeling. There is no way of containing traumata. This is how I understand the aetiology of panic states and the violence which springs from them.
Panic is contagious: adults, even experienced workers, can catch panic from children. This contagious quality is generally recognised in crowd panics (football disasters, fires in cinemas or theatres, for example) but is less easily seen in individual panic states. This infection partly explains the immobilisation which can beset grown-ups confronted by violence. One has to hold on to one’s identity, to guard the frontiers of one’s self in a situation. To contain the child and his violence is not the same as to merge with him.
There is a tendency to identify with violence in a very primitive and unconscious way. I knew a family once – all grown up – which contained a schizophrenic brother, hospitalised from time to time, but for the most part living at home and causing chaos. An elder brother who owned a shop had just installed a large plateglass show window; the schizophrenic one, in a moment of rage, smashed the new plate-glass window to smithereens. When the family told me of this disaster, there was unmistakeable envy in their voices – envy of the ill brother who could do this terrible, violent act and ‘get away with it’!
Often, in the therapeutic institutions where I work, children have said to me, ‘I really don’t know how I came to do it’, in describing some act of violence. But often, going carefully over the events of that day, we have been able to find a terrible build-up of unnoticed tension, leading to final breakdown. The child may even have been actually conscious of the tension and its causes, but there has been no opportunity to communicate this to a grown up in time. So here the child and I are, in retrospect, trying to talk about what should have been in the future and is now in the past.
A boy, Tom, aged nine, at the Mulberry Bush some years ago broke windows for no apparent cause, and with tremendous violence. It was finally possible to link these explosions with a breakdown in communication with his mother. When this happened – when no letter arrived – Tom became convinced that she was dead. Waiting for the news of her death produced tension and panic so terrific that the smashing of glass produced temporary relief.
I have spoken of moments of panic violence in integrated children, and of prolonged panic states leading to violence in unintegrated ones: there is another more rare category of violence, but one which I suspect is more common than one would suppose. This is the violence displayed by a more or less integrated child who has a psychotic pocket. This pocket of madness is not emotionally linked to the rest of him: he has integrated ‘round a hole’. This means in effect that he can suddenly depart, as it were, into the mad bit of himself, so that an apparently well-behaved, sensible boy can suddenly commit violent crimes; and having done so, return into the major, sane part of himself. The mad bit is hidden from himself, as it is from others, although there are unmistakeable clues as to the presence of the psychotic pocket.
We are concerned here today with all these kinds of violence, whatever form they may take, as we meet children’s outbursts in residential treatment. All violence has a quality or orgasm: it is preceded by an intense spiral of excitement, leading to climax and followed by relief and subsidence. Panic is, at its climax, a kind of traumatic orgasm. Violent behaviour has always sexual undertones, sometimes conscious ones. The sexuality can, however, range from displaced infantile greed (delinquency) to genital sexuality (rape). There are often particular fantasies which accompany the violent behaviour. Essentially, however, I believe that children are swept along by violence: they can do terrible things in cold blood, but these are usually sadistic and not necessarily violent. Violence, as I understand the phenomenon, implies a loss of control, a helpless rage.
The management of violence, as I have indicated earlier in this paper, has two phases. Ideally, there should be anticipation, so that the violent act does not have to take place. Failing anticipation, there must be containment and control of the violent out-of-control child in a panic. Essential at both stages is communication: although the child does not seem to hear a word one is saying at the time, he will remind one, years later, of communications made in such circumstances. All acting out is broken down communication, and we can build a bridge even in a welter of flailing legs and arms, gnashing teeth, spitting mouth, and snarling, shrieking voice. If you can communicate, he can hear. What one communicates depends on each individual child and the context, but there are basic assumptions which we can start from – the child’s helplessness, the echo of early trauma, the helpless infantile rage (however big he may be). So that, for example, when a boy yells, ‘Leave me alone’, it is appropriate to reply, ‘I promise not to leave you’. The most valuable thing we can do in such circumstances is to continue to be alive, reliable and concerned. I always hold on when a child is in a panic state; I hold his hand, trying not to lose my hold, and I continue to communicate. I may have an arm round the child. We may be standing or sitting; he may be lying on his back, or whirling around me; but I try to hold on, and if I do lose my hold on his hand I re-establish this as soon as I can. This is not so difficult, because part of him wants to be held. Presently, he will be the one who is doing the holding, and the worst is then over.
Anticipation very often precipitates the panic state: but we are then in a position of strength to hold the child and his rage, and to prevent the violent act which would have followed. Really, every act of violence which we have to consider in retrospect is basically a failure in management.
Bruno Bettelheim, in his book, The Children of the Dream, concerning Kibbutzim, which some of you may have read, writes:
Conversely, being sure of one’s place might explain another striking contrast to what is typical in our society, and why kibbutz childhood is such a happy age. Not once did I observe any physical fighting among kibbutz children. Not once – beyond the age when they push each other down in the playpen – did I see a child pushing another, not to mention hitting with hand or object. This does not occur in the kibbutz. I asked about it repeatedly, and the answer was always the same; while there are disagreements, they never go beyond verbal expression. There are no fights about things like who comes first, or who sits where. Compared with the frequent fighting that seems typical in our society among pre-school and grammar-school children, life in the kibbutz at this age is peaceful indeed.
Of course, it helps that there are no possessions to fight over and no social distinctions. But much of the fighting at this age in our society originates in the child’s feeling that he has no place that is rightfully his. He must fight to assert it and then to maintain it – whether the unending fight explodes in physical violence, or is carried on in more hidden form.
Here we might pause to consider Robert Ardry’s, ‘Territorial Imperative’, which in human beings means basically ‘room’ – emotional and physical – in which to be an individual.
Very often this is not available to severely deprived children. On the other hand, the idealised institutionalisation which dominates a kibbutz denies the child the right to be an individual. In this connection it seems important to consider what Winnicott wrote about depression.
The main thing is that depression indicates that the individual is accepting responsibility for the aggressive and destructive elements in human nature. This means that the depressed person has a capacity for holding a certain amount of guilt (about matters that are chiefly unconscious), and this allows for a searching round for an opportunity for constructive activity.
Our violent deprived children have not reached this position. I have spoken of containers; destructive feelings and guilt must be contained if the person is to have a real identity.
I want now to consider the actual presence of violence and how we can manage the child and his violence in a therapeutic and non-punitive or retaliatory way. I assume this is the problem for all of us; we may understand the causes of violence, but how do we actually deal with violent behaviour?
Some years ago, James, a ten-year-old, was provoked by a younger boy, on whom he then made what was really a murderous attack; if he could have killed the younger boy he would have done so. Intervention took place instantly, but we had not been quick enough to anticipate disaster. I spent the next hour trying to keep in touch, physically and emotionally, with James, who was tied up in knots on his bed, shrieking obscenities (the violence had taken place in a dormitory). I kept on talking; about James, his pain and anguish, his intolerable panic state. He did not seem to register what I was saying until suddenly he screamed at me, ‘People like you don’t understand people like me – I’ve murdered love!’ He felt that he had destroyed everything.
Anther boy aged thirteen, who was very tall and strong, took up a large lump of coal and threw it at my head – he was only a few yards away. I could see that he was going to do this, but there was no one near enough to intervene: so I froze in my tracks and the coal whistled past my ear. A moment later he was stumbling over to me, white and crying. He said, ‘I’ve always known I’d have to try and kill you.’ His mother had left him and his father.
There was a ten-year-old, Jeremy, who was epileptic and very disturbed. When he first came to us from a mental hospital, he would stand in the middle of his bed, swing a full hot water bottle round his head, and shrieking, ‘I’m going to throw it at you’. I used to stand at the end of the bed, talking to him, and ultimately he would burst into tears, throwing the hot bottle on to the floor. His parents had been terrified of him. In this case holding was not necessary.
Peter used to hit people – children and grown-ups – with all his strength: this was so sudden as to be impossible to anticipate.
He was a large tough thirteen-year-old. We discovered that he could not believe that he could reach anyone: the blow was a distorted communication. Interpretation brought him enough trust to reach out to others.
Compare these outbursts of violence with the case of a small patient of mine, Edward, aged four, who described the monsters in the garden who threatened him at night. These were his own uncontainable violent feelings, projected on to his environment. It is true that Edward did not commit violent acts, but neither (at that time) could he contain these terrible feelings. He became threatened by them from outside himself; he took up a paranoid position, living in anguish and fear.
All these children were unintegrated: the violence of integrated people is much more localised – in fact they partially disintegrate into violence. The more integrated the person, the quicker and easier will it be to re-establish thinking and communication, thereby enabling the child to complete the experience. I think that the concept of the complete experience is important in this connection. Nightmares are usually interrupted dreams – the dreamer can find no solution, so he wakes. In the same way the child can feel unable to resolve some intolerable situation: he tries to ‘wake up’, to escape from the terrible stress, but he is awake, so he collapses into panic. As I have said earlier, this can take the form of violence or immobilisation, even the loss of consciousness.
In all these examples I have given there has been a breakdown in communication: the restoration of thinking in words restores stability, and makes the dangerous feeling containable. It is an awful fact that well-meaning people can provoke violence by irrelevant and inappropriate value judgements. For example, a child desperately trying to reach communication with a grown-up may be termed ‘attention seeking’. When we ask someone, ‘Are you paying attention?’ we mean, ‘Are you listening?’. Of course children need, and ask for, our attention: what they are saying is urgent. Equally, when an infuriated youngster shouts an answer to some accusation or criticism, he may well be told not to ‘answer back’. I have never been able to understand this ridiculous phrase. This kind of grown-up behaviour can trigger off violence in every form: people are shutting off the safetyvalve of speech. Perhaps one of the problems lies in the fact that one tends to understand what a child is saying (or what he is likely to say) in such circumstances to be an accusation. If, instead of accusing us, he attacks someone else, or smashes the place to smithereens, or sets fire to a barn, we do not have to understand what he might have said. We can just be angry with him for what he has done, and get rid of our own feelings of guilt.
Actually, the establishment of communication with disturbed children always leads to a torrent of accusation in the first place, directed against ourselves and everyone else. It is essential in therapeutic work to be able to accept the reality of the feelings expressed, and not to waste time arguing about the facts, which are probably quite otherwise but are in any case irrelevant.
How one responds to violence or to communication of violent feelings depends on the kind of person one happens to be. One person may say, ‘How can you talk about your mother like this?’, when in reality the grown-up would like to say some pretty awful things about his own mother but is not in a position to do so. Or he can say, ‘But you know Miss A is always so kind to you….’, when everyone else knows that Miss A does not get on at all well with this particular child.
A terrifying fact is that behaviour can be interpreted incorrectly as violent, and such interpretation can be accepted by the child on to whom it is projected. A boy in a residential place met a staff wife out walking with her dog. She was carrying a chain lead. She did not know Johnnie, who had just arrived, but greeted him. He trailed along behind her, making vague remarks; he asked to carry the chain, which she gave to him. He walked on, swinging the chain, and presently he said that he wanted to show her a damaged puppy nearby. She followed him, but there was no puppy. She asked him for the chain, which he gave to her, and then took off his jersey, twisted it, and slung this instead of the chain ‘as though it were a rope’. There were various myths concerned with violence and this boy, and when this episode was reported to me there was the implication that violence was present just below the surface. In fact, the ‘damaged puppy’ represented Johnnie himself; the chain or lead and the ‘rope’ of jersey were links to a grown-up, a seeking for dependence, in a strange place (I know enough about Johnnie to be sure of this). If Johnnie had collected this projection (he did not) he could have felt that he was a violent person.
On rare occasions a woman may be really threatened by a violent boy in a residential place. He may need to be physically controlled for her safety and his own. Whenever possible she should call for help from a man, rather than involve herself in physical struggle with the child. Nothing is more disastrous than for a woman to lose her role and act like a man, using her strength to overcome a boy. Some women seem to need to show how physically strong they are, but in doing so they lose their emotional strength (in the same way it is sad when a mother has to be a father to her son).
Men may use much more strength than is necessary in order to control a violent child: perhaps because they assert their masculine power which is threatened; perhaps because there are homosexual elements present, although unconscious. In the same way, women can be sexually aroused by a struggle with a violent boy or girl. Because this is unconscious they may provoke this sort of battle in order to obtain sexual excitement. Really it is very seldom necessary to use physical force, although holding a child firmly with one’s arm round him, or holding his hand, may be very necessary. To react to violence with violence is only likely to promote more violence: there is a narrow margin between ‘strength’ and ‘violence’.
There is also what I think of as ‘institutionalised violence’, the extreme versions of which are execution and killing in battle. Here, violent acts are rationalised by organisation and hierarchy. One sees this in the use of violence in punishment. Such acts – beating, for example – are organised with great care, with respect for hierarchy, rules and ceremonies: in this way the face of violence is masked. In Ireland in the eighteenth century the hangman wore a horrible mask in order to hide his identity from society.
I have been in institutions where there is excellent order and control, reasonably benign authority, and no sign of violence in management of children. On the other hand, the children seem too quiet, too passive: on further investigation I have found that in such a place the newcomer is exposed to violent treatment so that he becomes afraid. There is then no need for more than threat – discipline and control can be easily maintained. One is reminded of a disturbed small child who shows one a fly which he has already half stunned, saying, ‘Look how tame it is – it doesn’t want to leave me.’ Of course there is a lot of collusion involved in such a state of affairs: people are often thankful to wear blinkers.
Gang violence in a place has much in common with this kind of institutionalised violence. Children in a delinquent group in a subculture will also commit violent acts (under cover of ‘initiation’, for example). The leader of such a gang is liable to have a psychotic pocket. Subcultures flourish in a punitive climate in which violence is implicit when not explicit. Some people assume that this kind of subculture is ‘part of the scene’. This is not a valid assumption: lack of communication between staff and children can lead to the first signs of subculture. There is no reason why such a growth should flourish unless there is collusive anxiety present in the adult group (who will have a subculture of their own). Confrontation, recognition of the ‘storm centre’ – the delinquent hero – and establishment of real communication, will remove the need for the subculture; which, in a group, is rather like autism in an individual.
When a grown-up hits a child in a moment of rage, this is a violent act which must never be denied. Nobody ought to strike a child, but if this happens the fact should be communicated to others, and the child should understand clearly that the grownup has been unable to control or contain his anger. Certainly a blow in anger is preferable to a planned beating, because we are not deceiving the child or ourselves in the former circumstances.
You will have noticed that I have drifted over a wide field in this chapter. The point is that this is a large field; violence is as it were the infra-red of every spectrum. The possibility of violence is always implicit in every situation that involves people in relation to one another, because violence is there in all of us. The more conscious we can be of our own potential violence, the less likely are we to become violent ourselves, and the more able shall we be to understand and manage violence in others when this is necessary.
AN EPISODE OF VIOLENCE
Henry, aged eight, was a very disturbed boy of high intelligence, placed in a residential special school for maladjusted children. This was the first day of the summer term. His mother had brought him on the afternoon before to the station to meet staff from the school, who had come to London to bring children back to the school in ——–shire: Henry and his mother had arrived just in time to catch the train.
The night before, Henry had overheard a terrible outburst of anger between his parents, during which his father had threatened once again to leave him and his mother. His mother had spoken softly, and he could only hear the murmur of her voice going on and on.
After returning to the school, there had not been a suitable moment for Henry to speak about his anxiety to a ‘special’ grown-up because of the general rush of settling down in the school. The child care worker to whom he would have communicated his anxiety as he had done in the past was on leave. This worker was kind and gentle: she always listened intently, was appalled by his father’s outburst and deeply sorry for his mother – it comforted Henry to talk to her. When Henry’s mother came to the school, Mary, this worker, would listen to her complaints about her husband with deep sympathy. Henry’s father rarely visited the school: Mary did not talk with him in her soft, quiet voice – she could not bear to do so.
On the morning in question, Henry was no longer thinking about his worry, but was chatting to other children and to the child care staff, who were helping them to get dressed. One of the children said, ‘I wonder if it’s going to rain…’ and Henry said, ‘Of course not, look how blue the sky is’ (there were quite a few dark clouds). He was not hungry at breakfast. At assembly, the children said the Lord’s Prayer: towards the end, Henry stopped saying the well-known words, and did not even think them inside himself. Later, his teacher, who was a man whom Henry knew and liked well, asked the children to write an essay about ‘My Holidays’. Suddenly the whole horror of the situation at home came back into his mind: he sat, staring in front of him, and was startled when the teacher asked him, ‘What’s wrong?’ Henry started to write, ‘I went to the zoo….’ At lunch time, he still was not hungry. He felt awfully full, stuffed, it was as though something was choking him. People asked him if he was ill, but he shook his head. Anything said to him now seemed like a blow, which made him wince, and any contact became intolerable. He no longer knew what was causing him such anguish which seemed to engulf him. He went out after lunch into the playground in a daze.
Suddenly another boy punched him in the back. This was not a hard punch, but Henry felt a burning behind his nose; he shivered all over and turned white. In an instant, he had thrown himself screaming on the other boy, knocked him down, and tried to strangle him. Staff intervened, and with difficulty pulled Henry away from the boy he was attacking and held him while he screamed and kicked. They tried to understand what had gone wrong, but he was too distressed to speak or even think. He was put to bed for the rest of the day. On the following morning he got up as usual……..
1 ‘Warrendale’, Allan King, 1967