Love and hate in good enough residential child care

Date Posted: Thursday, 28 January 2010

This is the text of a seminar which I presented at the NCERCC conference “Understanding Residential Child Care” held at Leeds on January 28th, 2010. It is a text in rough proof and is a work in progress but most of all it was a seminar which was a privilege to present to a very tolerant audience. Those who were present at the seminar will notice that , to my shame , I have not included in the text the lyrics of “Ye cannae shove yer grannie aff a bus” which I performed extempore with little artistic or technical merit while we were considering the role of a mother. I have now corrected this critical omission in a note following the reference section.

Love and hate in good enough residential child care

Introduction : psychodynamic theory and residential child care

Our subject today, love and hate in good enough residential child care is underpinned by psychodynamic theory which has its base in the psychoanalytic theory and the work of Sigmund Freud and of those who have followed him and developed upon his theory. Psychodynamic theory recognises not only our conscious world but our unconscious world. The unconscious mind according to psychodynamic theory is populated with desires and fears that are too socially unacceptable or too unbearable to bring to our conscious mind and so they are repressed often from infancy and childhood. In the United Kingdom as a theory of individual development one of the psychodynamic schools of thought, informed by Kleinian and Winnicottian theory suggests that newborn babies are born full of conflicting and untintegrated desires and fears which the infant cannot differentiate or make sense of, and which may be expressed both separately and often simultaneously as desire, terror, omnipotence, and hate (Klein, 1946, Winnicott, 1947 & 1965). I should say here that much of the thinking which lies behind my presentation today is drawn from my interpretation of the ideas of D.W. Winnicott, the English psychoanalyst and paeditrician, who has been a significant influence on thinking about residential child care, as well as child care in general, both in this country and across the world. What Winnicott described as the ‘good enough mother’ – a term which in more recent times has been generalised to mean the good enough principal caring figure – has the capacity to absorb the infant’s unintegrated feelings and to return them in a form which the baby can accept. In this way the baby is helped to begin to make sense of his feelings and so develops towards achieving an integrated inner world. He begins to sense that he is an individual separate from but in relation with, his principal caring figure. How well this integration process is achieved determines the future psychological development and wellbeing of the child.

Other theorists such as W.H. Foulkes and W.R. Bion have developed psychodynamic theory and related it to human groups and the way individuals act within the group. Residential child care workers and educationalists like Homer Lane, August Aichhorn, A.S. Neill, Fritz Redl, Fred Lennhoff, Melvyn Rose, Bruno Bettelheim and David Wills amongst others have adapted psychodynamic theory to create residential therapeutic communities for the group care and education of troubled children and young people. It can be argued that the therapeutic community is the apex of achievement in residential child care in England. Kajetan Kasinski (2003) has written an excellent brief developmental history of the therapeutic community movement “The Roots of the Work” which occupies a chapter in Adrian Ward et al’s excellent book Therapeutic Communities for Children and Young People. No doubt there are those who will disagree with me but I have argued that the therapeutic community movement has tended to see itself as a very specialist service within what is already a specialist area of child care and by the latter I mean the whole world of residential child care (Sharpe,2005). Of course there is strong evidence to suggest that there are youngsters whose emotional difficulties are much more complex than others and who may be helped by care based on sound specialist psychodynamic therapeutic principles, (see for instance ,Little & Kelly, 1995) but it seems to me, and I notice this is an idea which is gaining credence, that all children in residential child care, are dealing with deeply felt emotional difficulties (see Finlayson, 2010). My own view is that the ideas and practice which have emanated from psychodynamic work in therapeutic communities like Peper Harow, Shotton Hall School, Barns School, the Cotswold and Caldecott Communities to name a few, should have been developed in all spheres of residential child care. At a time when we are considering which direction residential child care in England should be going and when we are increasingly courting the social pedagogue model of residential child care, prevalent in some countries in Europe, it is encouraging to hear voices like that of Jonathan Stanley, the manager of NCERCC, acknowledging the need to look for a model of residential child care that embraces the excellent psychodynamically based residential child care practice which has been developed in England. I would also recommend to you the book Milieu-Therapy with children : Planned Environmental Therapy in Scandinavia edited by Hans Kornerup (2009) that describes residential child care in Denmark and other Scandinavian countries which for me is a convincing demonstration of how social pedagogic practice can merge with psychodynamic practice.

The theme of the conference today “Understanding Residential Child Care: Valuing the effect and effectiveness of daily living ” suggests that our understanding of residential child care is incomplete. I think it healthily implies that we have not found the holy grail and that there are still things to understand and I believe that amongst those things we remain uncertain about are those of which we have an inkling of knowledge and understanding and yet which we perhaps unconsciously resist because to allow them into our conscious mind is threatening to us. Among these are love and hate.
Love, Hate and Transference in residential child care

When thinking about love and hate in residential child care I am sure that you will be aware of what might be called transference love and transference hate. Every day children project displaced loving and hating emotions into residential child care workers. This phenomenon which psychodynamic theorists call ‘transference’ (see Freud, 1912, Racker, 1968) is considered to be the unconscious transference of feelings a child holds about a significant adult (usually a parenting figure from whom the child is temporarily or permanently separated) (Freud, 1912). Although it is sometimes confusing or alarming for the inexperienced residential child care worker to receive these displaced feelings, they can be used by the worker for therapeutic benefit. These feelings may be hostile or may be positive idealised feelings. A child may unconsciously associate the worker with an idealised deceased attachment figure or at the other extreme associate her with an abandoning parent. For instance :

Celia said she knew right away that her keyworker Lisa was just the right person for her. Celia said Lisa would protect her from the other kids. Celia said that Lisa was the first person to really understand her and she felt she really understood Lisa.

When Tariq came to live in the children’s home his keyworker, Joanna introduced herself to him and told him that she would be a special worker who was there to help him while he stayed in the children’s home. Tariq politely thanked her for saying this but said he didn’t waste his time talking to women. For many weeks despite all her persistent attempts Tariq not only refused to talk to Joanna but would leave any room he was in when Joanna entered.

Once these feelings are transferred the recipient, that is the residential child care worker, experiences what Paula Heimann (1950) in psychodynamic terms described as ‘counter-transference. Through reflecting on how the transferred feelings affect her (her counter-transference) the worker can gain insight of the anxieties and fears of the child.

Celia’s keyworker, Lisa, at first felt overwhelmed by Celia’s expressions of love. She did feel special when Celia said she was such a great keyworker yet she did not feel that she could live up to Celia’s expectations of her. After thinking about this with her supervisor Lisa gained an inkling that Celia had transferred her idealised fantasy of the mother who had left the family home when Lisa was two years old. This insight helped Lisa understand and contain Celia’s feelings of devastation when in the coming weeks the reality of Celia and Lisa’s relationship shattered Celia’s fantasy.

Tariq’s dismissal of his keyworker Joanna made her feel useless and hated. On reflection she could understand that her relationship with Tariq had not developed to the stage in which he might justifiably dismiss her and ignore her and she began to understand that he was transferring his feelings for his mother whom he later revealed had not protected him from the bullying of his father and who, though she had said that she did not want Tariq put into care, in Tariq’s view had not stopped his father for arranging that this should happen.

The use of reflection (both instantaneous and over a period of time) is emphasised here because it is all too understandable that workers’ first primitive reactions to what a child transfers upon them will be to accept the feelings literally. Such a response can lead to therapeutically unhelpful developments. This is not to argue against all spontaneity. It is important for children to see the residential worker as a human being warts and all but it does demand that the carer has an awareness, sensitivity, tolerance and insight of herself as well as of the child. It asks too for a capacity for instantaneous reflection and the ability to remain an adult in the most emotionally harrowing situations. It is human nature that when an adult is told by a youngster that she is hopeless and hated that the worker may begin to feel this and in the same way a worker, told by a child that she is everything the child believes an adult should be, may become euphoric. If these feelings are taken literally and acted upon the worker ceases to be an adult.

Of course a healthy love between a caring adult and a child may develop over a time and in an article to be published in a forthcoming issue of the goodenoughcaring Journal (June, 2010) the residential child care worker Jane Kenny will describe how her keyworking relationship with a troubled boy during his three years of living in a children’s home developed from hateful transference and counter-transference into a creative respectful loving relationship.

Good enough residential child care : love and hate directed from the residential worker towards the child

We give love so many meanings. These meanings can be sexual, maternal, paternal, narcissistic, sororial, fraternal, religious, platonic, and many other things. We believe that each of us needs to be loved, and we take for granted that every child needs a parental figure’s love. Indeed Winnicott (1965) suggested that in order to love we need to have been loved ourselves. Yet there has developed a tacit consensus that when it comes to looking after other people’s children we should distance ourselves from the concept of love. It is as if we say, ‘We can look after other people’s children but let us tread carefully around the idea of loving them’. It can seem that there is something not quite savoury about loving other people’s children. Unlike our own children, siblings, or parents, who have our love in them and whose love is in us and who therefore are an integral part of ourselves, other people’s children, particularly those who do not behave in socially accepted ways, are kept at a distance. We may tolerate them but not for too long. It may also be that those of us charged with caring for, or educating children who are troubled, are all too aware that these children have been the victims of emotional, physical and sexual abuse, and so we may be wary of how such a child will respond to a loving adult however appropriately that love is profferred.

Another reason why as residential child care workers we may be resistant to the idea of committing our love to the children we are caring for is that it implies a presumption of taking on the parental role of good enough parenting and this calls for a commitment and a stickability through thick and thin to other people’s – at times seemingly very ungrateful – children. If we do take on this concerned and loving commitment to children we take on the maternal role on behalf of a society whose culture idealises the maternal role – and I believe that male as well as female residential workers are required to be maternal and paternal as well as parental. To be a mother you must love your child and you must protect him. Society is devastatingly critical of those who take on the maternal role. Don’t social workers and residential child care workers just know it if they are judged to have failed to protect children when they take on the maternal role on behalf of struggling parents. In my view these workers become the scapegoats, the beating boys, of the conscience of a society which has failed to provide sufficient resources for these troubled youngsters and their families.

Yet most people who become residential child workers are deeply concerned about the children in their care. They understand that the children have suffered a deficit of love but absorbing the problems of troubled young people and their families is a complex task and making relationships with unhappy youngsters is taxing and yet these are fundamental residential child care functions. Inevitably the emotions this work stirs within us are hostile as well as loving. These hostile feelings need to be recognised and then contained by our feelings of concern and love if residential child care is to replicate Winnicott’s good enough mother who gives her child sufficient loving concern to make him feel that life is worth living. To do this residential child care workers must provide, and attempt to compensate for, the love and concern which has been broken or lost. It may not be possible for a residential child care worker to hold an angry teenager in her arms and to comfort him as she might a baby but she may have to demonstrate this metaphorically in the caring milieu she and her colleagues offer to the child. The complexity of the residential child care worker’s role is something that I believe has been sorely underestimated. If the needs of children placed in residential child care are to be met then it seems me their care should be provided by people who have the potential to give the children good enough care.

In thinking about the kinds of people who could provide good enough residential child care I thought it would be useful for a moment to make a short diversion in order to consider why people decide they want to become a residential child care worker. I intend to do this by offering to you some of the reasons applicants seeking their first post in residential child care have given for applying. These have all been extracted from interviews I have attended in the last five years.

I am still quite young and I feel I will be able to understand the problems of the young people better than an older person because I will talk their language.
I am a mother and I have successfully brought up children of my own and so I think I know what teenagers need.
I never experienced problems as a child and my parents brought me up well and I think this will stand me in good stead in helping youngsters see how to avoid problems.
I know what it is for parents to break up when you are a child. I know the pain they are going through and I’ve made sure my own kids didn’t go through it and I want to do the same for these kids.
I’ve spent most of my career working in commerce and when I was made redundant I thought it was time for a change of direction because think I’ve always been good with people.
I know I want to work with children and young people. I want that as a career – it may be teaching, it may be social work but I see this as an opportunity to open the gate.

As rationales for joining our profession, some of these may seem more impressive than others. I think that they can all be valid reasons for wanting to take on our work as long as we recognise that they are not altruistic idealistic statements. They contain what psychoanalysts like to call ambivalence. They carry within them love and hate. Let me try to illustrate this by giving you my interpretation of two of the examples I have cited above.

Example 1

“I am a mother and I have successfully brought up children of my own and so I think I know what teenagers need.”

One interpretation of this statement might be, “She is a mother and having brought up her own kids successfully she knows about bringing up her kids and loving them and so she will not tolerate anyone who says she can’t look after all children.”

Example 2

“I’ve never experienced problems as a child and my parents brought me up well and I think this will stand me in good stead in helping youngsters see how to avoid problems. ”

A possible interpretation of this statement might be, “He has been loved as a child and brought up well by his parents and so it will not be difficult for him to put anyone who is straying on to the right path.”

You may not agree with these particular interpretations of the interview responses and you may have examples that come to your own mind which contradict my thesis but my contention is that if these applicants for posts in residential child care have the potential to develop an insight of their own capacity to love and hate then they have a valuable therapeutic tool. This a tool that would give them the potential as residential child care workers workers to have intellectual, but more importantly, emotional insight of their ambivalence and act upon it. I am suggesting that only workers who understand their capacity to hate as well as to love can give children good enough residential child care. This is asking a lot of a person. Let me be clear people who have this insight do not need a first class honours in psychology or have trained for 6 years to become a psychotherapist but they need to gain the capacity to reflect honestly not only about what is going on in the inner world of children they care for but equally importantly to reflect on what goes on in their own inner world. It is my view that this can only be achieved by many, many well supervised hours of personal reflection over a period of years. This is why I believe no one should be allowed to walk off the streets to do this job and allowed to participate in it fully after a few hours of induction and the promise of NVQ level 3 training.

I have been suggesting that there are feelings in our inner world which we resist because unconsciously we fear they will be unbearable to us. Amongst these are love and hate. The idea that a parental carer both hates and loves the growing infant, child and adolescent was first mooted by Winnicott. He argued that the good enough mother must know her hate for her infant before the baby even begins to scream his terrors at her. He considered that only in this way could she understand and contain the infant’s hate. For Winnicott (1947) the good enough mother cannot stop herself from doing this and must do this otherwise how can she cope with ‘a baby who is ruthless, treats her as scum as if she is an unpaid servant and a slave ; a baby who is suspicious of her, who refuses her food and makes her doubt herself’ (Winnicott, 1947, p202). Winnicott suggested ‘the most remarkable thing about a mother is her ability to be hurt so much by her baby and to hate so much without paying the child out and her ability to wait for rewards that may or may not come at a later date’ (Winnicott, 1947, p202). I wonder if you recognise that baby and certainly Winnicott drew likenesses between the unintegrated baby and children in residential care who lacking love and consistent nurture in their childhood remained at varying stages of unintegrated anxiety, fear and terror.

Winnicott placed great emphasis on the role of the mother but made it clear that good enough care could only be provided if the mother received emotional and practical help from another supportive parental figure. I think this is an important idea for those who take on a keyworking or special carer role for an individual child in residential care. In order to nurture a troubled child and to enable him to survive in a way that makes him feel life really holds out hope for him, the keyworker must be helped to survive her task. This can only be done by the emotional and practical support of the worker’s colleagues who create an environment for the child which is conducive to consistent concerned care. This is a team project. Adults caring for troubled children need to work together.

Our child rearing culture has changed since the 1940s, 50s and 60s when Winnicott was developing his theories and while his focus was on the central role of the mother, increasingly psychodynamic and attachment theorists accept, as I believe society generally does, that the mother may not always be the central figure in the nurturing of a child. There is a growing recognition that outside of that early state of reverie between a mother and her newborn infant, others have to take on the good enough parenting role. Winnicott’s theory has been generalised by his followers to the extent that it is thought that any parenting figure be it mother, father, grandmother, foster carer and not least residential child care worker should be aware of their own potential to hate if they are to be able to absorb the hate of a child and process it to the extent that it can be returned in a way which the child can accept. Residential child care workers may find it difficult to digest the notion that they carry within them hatred for children. Possibly it is the unacceptablility of hatred – our fear and disgust of it – that makes us resistant to the idea that we contain hatred within ourselves and so it is driven from our conscious thought into our pysche’s bottom drawer. Yet those nagging anxieties remain and not only do we have to deal with them and with our own unacceptable feelings but we have to deal with both the love and the hatred that the troubled youngsters we care for transfer on to us. This a rich mix.

The psychoanalyst Rosie Parker (2005) suggested that for the most part as parenting figures our hatred is largely invisible. It is concealed and contained by love and concern but that at times of stress hate outweighs love, even if momentarily, and our hate becomes an easily identifiable conscious affect. It is critical that residential child care workers are trained to have the awareness to identify this and to moderate its influence.

If I may I will suggest why this is so by reading you a short case vignette. The event, which I have substantially disguised, occurred in a private children’s home which consistently received “satisfactory” to “good” inspection reports. The staff were well-meaning and caring and were trained to NVQ level 3.

Edward’s story

Edward, who was 13 years old had been placed in a children’s home with his sister Emma who was a year older than him. At the time of which I am writing he had been at the children’s home for about a year. Brett, a residential child care worker and Edward’s keyworker, thought he had built up what seemed a very healthy relationship with Edward. Edward always rushed to see Brett when he came on duty and was keen to join in any activity Brett suggested they should do. They particularly enjoyed making music together on the guitar and a keyboard. The managers of the children’s home were concerned that the relationship between Edward and Brett was more of a peer relationship than that of an adult and child one, but since Edward seemed so content with the situation, the relationship was allowed to continue along the lines it had developed. When his sister Emma’s placement was abruptly ended, and she was placed at a distant boarding school, Edward became unhappy and displayed this by being demanding and verbally aggressive to his peers and the staff. A few days after his sister’s departure, Edward demanded his pocket money a day early, and Brett refused to give it to him, because it was breaking the home’s rules. Frustrated and angry at this refusal Edward approached the senior member of staff on duty and demanded his pocket money. Harassed and tired following interaction with other children, the senior member of staff agreed to give Brett his pocket money early, rationalising this by saying she knew he was unhappy because he was missing his sister. As she gave Edward the money Brett walked up to them and said that Edward should not get it. The senior member of staff told Brett that on this occasion she was making an exception. Edward said to Brett, in what Brett thought was a triumphant way, ‘See, you were wrong, I should have got the money, and I’m getting it’. Brett, feeling defeated by Edward and unsupported by his senior colleague, remarked as he started to walk away, ‘Yeah, Edward, thanks a lot.’. Edward rushed towards Brett and shouted, ‘What do you mean by that you wanker ? I know where your girl friend works and I’ll make sure she gets raped’. In an instant Brett rushed towards Edward and punched him on the side of the head. Brett told the senior worker that he was going home and he didn’t care if he lost his job. Subsequently it was discovered that some weeks before the incident Edward and Brett had been out on a shopping expedition, and Brett had pointed out to Edward the place where his girl friend worked which was a hostel for young men leaving care. Later, Brett also disclosed that at the time he assaulted Edward , a young man at the hostel where his girl friend worked had tried to assault her sexually. Of course, Brett lost his job, and given the regulations which govern child care, it is almost certain that he will not be able to continue his child care career. Following the incident Edward was confused and devastated. His sister had suddenly been separated from him, and now he had lost a relationship which had seemed to carry hope for him but which now reinforced for him that adults he believed should care for him, seemed inevitably to abuse him.

You will notice that the words hate and love do not feature in this excerpt but I hope you will agree that much of what occurred was predicated on those feelings. I previously observed that the proximity of love and hate in our feelings about the children we look after represents our ambivalence towards them and for me the story about Edward and Brett demonstrates this proximity and ambivalence. If we acknowledge this and reflect upon it and allow this to inform our practice we can provide good enough residential child care. If we do not what we provide will at best be deficient and at worst as we have seen it may be catastrophic.

Residential workers may have difficulties with the idea that they may hate the children they care for because there is an assumption that hate is the opposite of love, when of course – as can be seen from Brett’s story – it sits beside love. Surely it is indifference and parental omnipotence which is the opposite of love. Attachment theorists like John Bowlby, Mary Ainsworth, Peter Fonagy and Jeremy Holmes have provided powerful evidence for this.

Good enough residential child care is a team project

Winnicott placed great emphasis on the role of the mother but made it clear that good enough care could only be provided if the mother received emotional and practical help from another supportive parental figure. I think this is an important idea for those who take on a keyworking or special carer role for an individual child in residential care. In order to nurture a troubled child and to enable him to survive in a way that makes him feel life really holds out hope for him, the keyworker must be helped to survive her task. This can only be done by the emotional and practical support of the workers colleagues in creating an environment for the child which is conducive to consistent concerned care. This a team project. Adults caring for troubled children need to work together.

To conclude

In thinking about love and hate in residential child care to an extent from a psychodynamic approach we have been considering how unique the children and young people residential child care workers care for are, and we have also been considering how unique residential child care workers are. The role of a residential child care worker is parental and but it is parental in a way which is both much more intense and focused but no less committed than the kind of parental role taken on in a family.

There is an assumption in much of the child care literature that parents love their children and we have considered the idea that they may need to recognise their capacity to hate their children too if they are to absorb and process their children’s fears and anxieties. I have argued that good enough residential child care workers also need to have these capacities .

We have considered some of the moral and cultural shibboleths that create tensions around the ideas of love and hate in residential child care work.

We have also thought about some of the reasons why people bring themselves to do the job of a residential child care worker and tried to identify from these who may have the potential to become a conscientiously reflective worker.

We have also considered the ambivalence a residential worker feels in her relationships with children and the proximity of love and hate in these.

I think if I were an outsider listening to what I have been saying today I would be thinking what an awesome job being a residential child care worker is. My own experience of it is that it is a very special and satisfying job that can bring with it much sadness but more frequently than we might think much joy and fun. If there is a message in what I have been talking about today (and I don’t necessarily think there has been a conscious ‘big message’ because I am sure most, if not all, of what I said here is known to you), the best I can hope for is that I have given you a welcome reminder of what you already know but sometimes forget. If there is a further message then surely it is that we need to know ourselves if we are to give the kids we care for something good enough that makes life worth living.

References

Finlayson, N. (2010) ‘CAMHS must target children in care’ in Children and Young People Now Accessed 19.01.10 at http://www.cypnow.co.uk/bulletins/InCare?news/978003/CAMHS-target-children-care

Freud, S. (1912) ‘ Recommendations to physicians practising psycho-analysis’ in Standard Edition Vol.12 London Hogarth Press

Heimann, P. (1950) ‘On counter-transference’, in The International Journal of Psycho-analysis Vol 31 pp 81-84
Kasinski, K. (2003) “The Roots of the Work” in Therapeutic Communities for Children and Young People Ward, A., Kasinski,K., Pooley, J., & Worthington, A., (eds) London Jessica Kingsley Publishers

Klein, M.(1946) “Notes on Some Schizoid Mechanisms” in Envy and Gratitude and Other Works 1946-1963 London Vintage (1997)

Little,M. & Kelly,S. (1995) A Life Without Problems :The achievements of a therapeutic community Aldershot Arena

Kornerup, H. (ed) (2009) Milieu-Therapy with Children : Planned Environmental Therapy in Scandinavia Denmark Forlaget Perikon

Parker R. (2005) Torn in Two London Virago

Racker, H. (1968) Transference and Countertransference London Karnac Books (1991)

Sharpe,C. (2005) ‘Residential Child Care Can Do with All the Help It Can Get’ in Free Associations accessed at http://www.human-nature.com/free-associations/sharpe.html or at http://goodenoughcaring.com/Writings/Writing46.htm

Winnicott, D.W (1947) ‘Hate in the Transference’ in Winnicott : Collected Papers: Through paediatrics to psycho-analysis. London: Tavistock Publications (1958)

Winnicott, D.W. (with Winnicott, C.) (1947) ‘Residential Management as Treatment for Difficult Children’ in Human Relations vol 1 pp1-87

Winnicott D.W.(1965) Maturational Processes and the Facilitating Environment London Tavistock Publications

Charles Sharpe, November, 2009

Note

Oh ye cannae shove yer grannie aff a bus

(Sung to the tune of “She’ll be coming round the mountains when she comes”).

Oh ye cannae shove yer grannie aff a bus.
Oh ye cannae shove yer grannie aff a bus
Oh ye cannie shove yer grannie ‘cos she’s yer Mammy’s Mammy
Oh ye cannae shove yer aff a bus

Ye can shove yer other grannie aff a bus
Ye can shove yer other grannie aff a bus
Ye can shove yer other grannie ‘cos she’s yer faither’s mammy,
Ye can shove yer other grannie aff a bus