We need to find the courage to face up to children’s pain

Let me begin with a story.  It is a story of good intentions.  It is also a story of denial.

I was delivering training on attachment two weeks ago, at the Kinship Carers Event hosted by Children 1st.  One of the audience members spoke of her distress at an episode that had happened to an acquaintance — a grandmother who had taken over formal care of her 2-year-old grandson, in the role of Kinship Carer.

The problem for the grandmother was that she found herself in disagreement with the child’s social work team.  They felt the child should be enrolled in nursery.  He was showing speech delays and did not seem to be confidently mixing with other children.  They believed that time in nursery would address both these problems.

The grandmother took a different view.  Her grandson was anxious and clingy.  She thought that what he needed was more time with her, in order to strengthen his sense of security and trust.

The social workers replied that the Scottish government had recently increased nursery hours for all looked after 2-year-olds.  This demonstrated a belief that nursery is important for this group of children.  Therefore, they stood by their view that her grandson should be spending time in nursery.  The worried grandmother, though, refused to act.  She continued to refrain from taking the child to nursery.

The result of the clash was that the social work team came to her home.  They stated that if she would not take the child to nursery, it was their responsibility to do so.  They then lifted the screaming child from her arms, planning to take him to nursery in their own car.

This was the point at which the grandmother gave in.  She was anxious that if she did not agree, the child would be removed from her care entirely.

As this story was spontaneously shared with the gathered audience of nearly 100 people, the room rippled with gasps.  Several attendees put their hand to their mouth, and by the end, at least one person had started to cry.

Why would professionals think that it was helpful to a young child to lift him, screaming, from his grandmother’s arms?  I have no doubt they would have been well-intentioned.  I can imagine that they were dealing with a large case load and that they were under pressure to make decisions they could defend.  And I am very aware that we only have one side of the story here.  Had they been present on the day, they could have added details that would help us to understand their perspective.

Still, I find myself asking:  what led them to conclude that it would be helpful to a terrified toddler to be forced into a strange car, with the intention of taking him to a foreign place full of more strangers?  Maybe they couldn’t see his terror?  Maybe they couldn’t see the grandmother’s fear either?  Maybe they thought his resistance would quickly pass?

These are important questions to ask — because I am hearing an increasing number stories like this one.  To many people they sound unbelievable and even inhumane.  In all of them, children’s fear is ignored or denied.

Here is another I received last week, this time via email (which I was given permission to retell).

This story comes from experienced foster carers, who had recently ‘moved on’ one of the children in their care to adoptive parents.  The child had come to them as a newborn, less than 24 hours old.  She had been with them for over two years when she was placed with her new family.

That sounds like a good news story:  an adoptive family has been found for a fostered child.  Its what David Cameron hoped for when he unleashed his vision in 2014 for an ‘adoption revolution’.

However, the foster parents were concerned about the way in which the transition had been handled.  It took place over a mere 10 days, with the child spending time in both homes.  The final visit to the adoptive home was described by them as “very emotional”, with the child “crying and hanging on to her foster mum” as they left the house.  The plan was that the adoptive parents would keep in touch about her progress, but that was not sustained.  It was a full three weeks after the ‘handover’ that a meeting was reluctantly agreed by the new parents.  That came with the condition that the meeting take place on ‘neutral territory’, rather than either of the homes (which would have felt familiar to the child).  Afterwards, the foster carers requested a second meeting, but that was refused.  The refusal had the support of the adoptive parents’ social worker.

The most straightforward way of telling this story from the child’s perspective is that the transition has probably left her dealing with bereavement.  For her, the foster carers aren’t ‘carers’.  They are her mum and dad.  She has become attached to them; it is with them that she feels safe.  Her adoptive parents are as yet strangers, and they will remain so until they become extremely familiar.  Is 10 days enough to achieve such a sense of safety?  If it isn’t, then the sudden disappearance of her parents will feel like abandonment.  They have, for her, died.  Abandonment and bereavement count as major traumas in a child’s life.  A major new study, published only a few months ago by a team at John Hopkins University, provides the latest evidence of its impact – if empirical data are necessary to convince us of the lasting trauma that childhood bereavement causes.

This couple, who choose to foster young children, know that a problem is now lurking.  Their email to me finished with the fear that the long-term relationship between the child and her new adoptive parents has already been compromised, because of the way in which the transition was handled.  They are right.  Children who are grieving a bereavement do not have the emotional availability to form robust new bonds with strangers.  Who can be open to new experiences when you are suffering from sadness?

There is one other element of concern in this story.  The foster carers had the sense, on the occasion of the single follow up visit, that the adoptive parents felt threatened by the child’s obvious affection for them.  This little girl insisted on being picked up, held, and engaging with them.  Of course she did.  They are her parents.  She missed them.  She pined for them.  Being in their company again is the solution to her sadness.  It isn’t the science that is needed to understand this; it is compassion.

I am not attaching blame or criticism to anyone here.  I am simply trying to help us think, by exercising extreme curiosity.  What was the thinking of the lead social worker who supported such brief transitional arrangements?  Was he/she fully up to date with all the information we now have on attachment, trauma and loss?  Were the adoptive parents schooled in this information, and were they supported in applying it to their particular situation?  Were they warned just how hard it would be, in the early days, to balance their own longing to love a child against that child’s longing to love someone else?  Why did adoptive parents and social workers have the power to determine transition arrangements, as opposed to foster carers, who will by now know this child’s emotional needs better than anyone else in the world?

It seems that despite 70 years of attachment science, we still don’t get it.  We continue to be inured to children’s feelings.  Despite the Scottish context of GIRFEC, the Early Years Framework, the Early Years Collaborative, and the aim to be the ‘best place in the world to grow up’, we still too often fail to see things through a child’s eyes.

In particular, we have not learned the devastating lessons of 1950s hospital care.  I have written previously about this period, when parents were severely restricted from visiting young children.  The 1952 film, ‘A Two Year Old Goes to Hospital’, produced by James Robertson, was created to help viewers comprehend the fundamental necessity of emotional safety for young children.  It showed the disastrous consequences for children when that need is not honoured.

Robertson gathered many stories from the public about hospital care at the time.  Those stories of the 1950s and 60s have an eerie similarity to the stories I heard last week.  Here is an example, taken from his 1962 book, Hospitals and Children (pg 74):

“My husband and I nearly broke our hearts when we went to visit our daughter, during the visiting period of 6.30 – 7.00 pm.  She just screamed and clung to us, nearly choking us.  She had to be forcibly removed from us by the Sister.  My husband was moved to tears, as well as me, when we got out of that ward.  Fortunately, she was allowed home after 48 hours.  I think she must have cried all that time.”

It is deeply unsettling to think that, seven decades on, we could still be damaging children in a similar way, albeit in another sector of care.  The nurses of the 1950s were good people.  They had to be well-intentioned, seeking to provide adequate care.  What we now know is that good intentions were not enough to prevent them from inflicting lifelong damage on their young charges.  Here is but one story that illustrates this regrettable outcome, which I received from a reader in response to the last blog I wrote about Robertson’s work.

“I found your piece painful to read, as I was a child in an isolation ward for six weeks, along with my sister, for scarlet fever.  It was so terrible for us, and for my mother too, who could hardly talk about it. These scars are still very evident in both our lives today.”

Is there a serious problem today with some of the policies operated by Children’s Services?  If so, what do we need to do to accept that situation and to correct it?  The answer is not to seek more scientific knowledge.  We are drowning in that.  Rather, what we need is courage:  the courage to face up to children’s pain.

James Robertson, along with his wife Joyce Robertson, came to the conclusion that the key driver behind poor practice was adults’ repression of distress.  It is simply sometimes too hard for adults to deal with the depth of children’s pain.  They frequently become overwhelmed by that distress.  So adults repressed their feelings.  Here’s how the Robertsons put it, in a lecture delivered in 1970:

“There is a tendency for even the best-educated and the best-motivated of people working with young children to become to some extent habituated to the states of distress that are commonly found in young children…The worker’s defence against pain may cause him unwittingly to avert from the child whose extreme distress is painful to see.”

In the 1950s, then, well-intentioned professionals were ‘unwittingly’ damaging children.  It seems that in the 2010s, we are still doing so.  But I’m not so sure we are ‘unwitting’ these days.

My doubts arise not just from the fact that we have so much more scientific knowledge to draw on.  They also come from the many agencies and individual professionals who have highlighted the ways in which pressures are warping social services.

Here, for example, is social worker Deborah MacDonald talking openly and bravely about repression, in a 2013 film about the attachment training Aberdeen City Council has been delivering:

“Sometimes children have been through such traumatic circumstances that, as social workers, we don’t want to think or feel too deeply about what they’ve been through, because we’re limited in what we can do for them.”

A similar discussion about repression can be found in the 2012 review of attachment training conducted by CELCIS.

“For many newly qualified social workers, it seems possible that the overwhelming experience of dealing immediately with frightening and painful child protection cases and confronting the loss and hurt of looked after children can undermine the learning about attachment that was achieved during qualifying courses.”  (pg. 24)

We are no longer unwitting.  We know emotional safety is paramount for young children, and we know that adult repression can interfere with our providing it.

We can stop this damage.  We professionals don’t have to inflict trauma on yet another generation of children.  We don’t need more good intentions.  What we need is courage:  the courage to face up to children’s pain.