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By Mark Smith Date Posted: December 18 2013 Mark Smith is a Senior Lecturer at the School of Social Work at the University of Edinburgh. Before that he was for many years a teacher and a residential child care worker. Mark is the author of ‘Re-thinking Residential Child Care : Positive perspectives’ published by Policy Press, while most recently he co-authored ‘Residential child care in practice Making a difference’ with Leon Fulcher and Peter Doran. It was published by Policy Press, Bristol as part of the British Association of Social Workers Social Work in Practice series. Not entirely good enough : thoughts on the psychodynamic approach to residential child careI do not come from a psychodynamic background. I began working for a religious order, the De La Salle Brothers and was influenced by Christian perspectives of care but also by a socialist anger at class inequality. And perhaps as a Scot I looked to education and to Kilbrandon’s idea of social education as the most effective response to the children I worked with. I would describe my orientation to practice, still, as primarily a socio-educational one. My understanding of psychodynamic ideas is not particularly well developed. Perhaps because of my own lack of experience or deep understanding of psychodynamic ideas to child care I can come across as a bit sceptical towards them; while I acknowledge some of what psychodynamic approaches have to offer practice I would probably have to admit, also, to harbouring some reservations. Some of these may relate to what I perceive as over-claiming, often by those with an equally superficial understanding of psychodynamic approaches, rather than any more intrinsic shortcomings as a way of thinking. A result of the lack of depth that often accompanies appeals to psychodynamic approaches is that they can come across as a bit motherhood and apple pie, perhaps not surprising when we consider they have their roots in that enduring fixation on the mother/child bond. But first to the positives: I like Winnicott’s idea of the ‘good enough’ parent. It is reassuring for those of us who recognise our limitations as parents and as carers for other people’s children that we do not have to be as perfect as job descriptions might demand of us. My own memories of those care workers who met all the job specifications and were convinced of the rectitude of their own ‘best practice’ was that they were generally not particularly well-liked by kids, who oddly enough seemed to prefer those of us who could be a bit grumpy and pretty stupid at times. I like too Winnicott’s recognition that good enough parenting happened in the small things of everyday living as much as it did in any fancy psychological treatment (Winnicott, 1965). I really like ideas of containment or its corollary in Winnicott’s concept of a ‘holding environment’. I have probably only begun to understand how this might translate into everyday experience over the past few years and I find it useful in different areas of my life. It helps me, retrospectively, to understand how I came, gradually, to feel comfortable with groups of kids and they with me. I’m not sure I was doing anything particularly differently but they began to pick up a growing confidence and authority on my part and responded to it accordingly. In my current job I find it a good way to understand the anxiety that gets into groups of students, while, at a different level altogether, as an occasional football referee and observer of referees I start to see the job as one of managing group anxiety as much as it is about getting decisions right (although that does help). So why might I be more lukewarm? I suppose that in my early years in practice I saw psychodynamic ideas as seeming to focus too much on the individual and paying insufficient attention to structural questions of social class (and the implication of this in the current political climate is that family difficulties are reduced to faulty individual relationships, rather than grinding poverty or inequality and the impact these might have on relationships). Moreover, the idea of therapy or psychological intervention felt a bit esoteric and beyond my ken. I did read A.S. Neill’s Summerhill and was attracted to what seemed to be radical and ‘out there’ about it. I even, for a while, sought to emulate Neill in his fireside chats with children around their family relationships and about sex but, while Neill fled his native Scotland, I stayed and remained hidebound by our pretty unhealthy attitudes towards sex. And my interventions with kids seem to provoke the life-changing outcomes that Neill claimed to witness when they began to recognize and put behind them the burden of their sexual repression. I also came across some of Barbara Dockar Drysdale’s work but again never felt at the time that I really ‘got’ concepts such as the archipelago child, which seemed unduly removed from my own experiences of concrete, challenging and ‘in your face’ children. It is in fact only in recent years that some of these more psychodynamically rooted understandings of child care have begun to make sense to me. Up until then I suppose I felt, perhaps rather arrogantly, that if I didn’t understand them then many of my colleagues in practice would likewise struggle. Even now I would be a bit uncertain as to where transference stops and counter transference begins. And as for projection … My most pronounced reservations, however, centre around the prominence given to attachment theory over the past decade or so. Again, there are aspects of this that I would applaud – I think that attachment validates some of the emotional and often unconscious core of child care work which was lost within overly behavioural or cognitive psychological paradigms or in the bureaucratic and procedural regimes that just about destroyed practice in recent decades. So my doubts probably have less to do with the ideas themselves than with the fact that attachment can seem to be the only game in town at the moment and the postmodernist in me is inherently suspicious of any metanarrative that professes to offer all the answers to complex social situations. And at a practice level I detect some smoke and mirrors in the way that claims are made: children’s homes increasingly badge themselves as attachment promoting places. But that doesn’t seem to stop them moving kids on to other, presumably also attachment supporting homes, when their behaviour becomes difficult or when the sums stop adding up. So we witness serial placements, all in ostensibly attachment promoting establishments, which, to me seems to miss the point somewhat. But where I start to feel most uncomfortable about the way that attachment ideas have been co-opted to residential child care is when proponents start to call upon neuroscience to support the provenance of theories, pointing to ‘black holes’ in the brain caused by faulty early attachments. Now, I have no doubt that many children have had some horrendous experiences growing up which cannot but have had a detrimental impact on their functioning and that this may be able to be picked up in images of the brain. But I’m tempted to say ‘So what?’; I’m not sure that being able to see such images gives too many pointers as to what to do then. Nor am I sure that to consider children to be traumatised is helpful. Paradoxically, I suspect that a presumption of trauma may in fact inhibit workers from doing what is required in working with children in adverse circumstances. I think back to some of my own experience observing practice in a unit that regarded itself as being informed by attachment and trauma ideas. I was never convinced that these were sufficiently understood to usefully inform what workers did. In fact I developed a view that workers actually became de-skilled in the sense that they became afraid to get children up in the morning in case they re-traumatised them. The paradox is that such kids need confident, authoritative (albeit suitably sensitive) workers and regular routines and adult expectations if they are going to start to feel better about themselves; not someone who is going to pussyfoot around them agonizing about what impact they might be having on an MRI scan. I now begin to sound as though I’m on a bit of a roll. And another thing … , this time an epistemological point: I think that much of the attraction of attachment theory, especially when bolstered by neuroscience is that it appears to offer some ‘scientific’ provenance to what we otherwise find hard to describe. This betrays what seems to be a perennial but ultimately self-defeating tendency on the part of child care workers to look to other disciplines, primarily psychology, to provide the philosopher’s stone that will point to what to do, and in the process maybe give us a bit of credibility with other more ‘scientific’ professions. It just all seems a bit too simple; that philosopher’s stone doesn’t exist. The only way forward is to continue the hard grind of everyday care in all of its messiness and ambiguity, perhaps playing hunches informed by psychodynamic insights, perhaps not. We need to go ‘Back to the Rough Ground’ as Wittgenstein recognized, a phrase that Joe Dunne takes as the title of his book on practical wisdom. In all of this I recognize that I am being less than fair regarding the sophistication of many psychodynamic approaches. It is, as I have suggested, the reductionist versions that I’m uneasy with. I find other perspectives, again without professing to understand them in any depth, more convincing; Scottish human relations theorists, Suttie, Fairbairn and Sutherland, understood attachment as a social process rather than the primarily biological and ethological drive identified by Bowlby, and which remains at the core of many current incarnations (see Miller, 2008). The presence of the other within human relations thought is identified as an end in itself, rather than a means to an end such as the management of anxiety. This introduces an obvious philosophical, arguably a spiritual dimension, to early and subsequent relationships. John MacMurray starts to bridge between the psychological and the philosophical when he identifies us as ‘persons in relation’ (Kirkwood, 2012), who come to be who we are only through our experience with others (and not just the maternal relationship). It is these more philosophical perspectives on how we are with one another that, I think, might provide the backdrop against which psychodynamic insights may have something to offer. My final point is that even if psychodynamic approaches to practice might offer some valuable insights they need to be located within an appreciation of what is the wider purpose or telos of residential care; otherwise it becomes something of an intellectual indulgence. My own recent writing has been around the idea of upbringing. Specifically, I draw on the work of the German social pedagogue Klaus Mollenhauer, to argue that upbringing is the overarching task of child care. Upbringing involves adults passing on a valued cultural heritage to prepare children to face the future. It is a moral and cultural endeavour, enacted through caring, inter-generational relationships. Identifying upbringing as, primarily, a cultural endeavour reframes child and youth care away from an over-reliance on ‘scientific’ treatment models to locate it firmly within the social domain. Within this superordinate purpose of promoting children’s upbringing, psychodynamic ideas might provide some powerful insights as to how we might best do so. So, to conclude, I am certainly not dismissive of psychodynamic approaches; indeed of broadly psychological orientations I would say they are the pick of the bunch. It’s just that I think that they are only one aspect of a greater whole, which includes a swathe of social and cultural forces that impact on how children grow up. References Dunne, J. (1993) Back to the rough ground: ‘Phronesis and Techne in Modern Philosophy and in Aristotle, Notre Dame, IN: University of Notre Dame Press. Kirkwood, C (2012) The Persons in Relation Perspective: In Counselling, Psychotherapy and Community Adult Learning, Rotterdam: Sense. Miller, G. (2008) Why Scottish ‘Personal Relations Theory’ Matters Politically, Scottish Affairs 62 Winter, 2008. Winnicott, D.W.(1965) The Maturational Processes and the Facilitating Environment London: Karnac Books, 2005. A recent article on upbringing, Forgotten connections: Reviving the concept of upbringing in Scottish child welfare –is available at Mark Smith, December, 2013 ___________________________________________ Please email your comments about this article to goodenoughcaring@icloud.com
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