Boredom in the counter-transference…

As most of you won’t have noticed, I haven’t written for a while.  I couldn’t think of anything to say.  Taken as a whole this blog is fairly bleak and I noticed the most popular posts were generally the ones in which I lay bare painful autobiographical detail or describe the traumatic experiences of children I have looked after.  There is value in telling these stories of course, but I think it started to skew the way I was thinking about my work and my own past – as if it was all just material to write about.  I gradually became uncomfortable with this.

I noticed too that my more reflective posts, in which I explore  abstract thoughts and ideas –  especially if I strayed too far into psychotherapeutic concepts or “jargon” –  were less popular.  Worrying about all this, I think, gave me writers block of sorts.  I lost sight of why I was writing it in the first place.  Then I remembered I could write about what I wanted and it really didn’t matter if hardly anyone read it.  So here goes…

I should confess, the phrase “boredom in the counter-transference” is not my own, although I really wish it was.  It was a throwaway remark by a tutor on my college course and play on the title of a paper by Donald Winnicott called “Hate in the Counter-Transference” (more of which later).

Very simply, counter-transference is a term from psychoanalysis which refers to the emotional responses the client evokes in the therapist.  More generally it can be used to  mean the feelings a child/adult evokes in a carer/social worker etc.  It is very important to be aware of, and think about, these feelings – otherwise we may act them out in our relationship with the child.

In Hate in the Counter-Transference (which was written in the late 1940’s) Winnicott suggests that the popularity of electric shock treatments and lobotomies, as methods of treating psychotics at that time, was more to do with psychiatrists acting-out their unacknowledged feelings of hate towards their patients  than any evidence that they were  effective treatments.

Winnicott, for those that might not know, was a  paediatrician and child psychotherapist of great acclaim, whose theories and humane writings are still considered to be of great value today.  Interestingly, in the same paper he describes “three months of hell” fostering a traumatised boy during the war.  Winnicott explains how, during the six year-old boy’s “maniacal attacks”, he would physically manhandle him out of the front door and leave him outside irrespective of time of day or weather.  The boy had a bell he could ring when he had calmed down.  Winnicott describes this not as an example of bad practice but as a legitimate therapeutic intervention.  I wonder what Ofsted would say?

Gemma, a 13 year-old girl, is not allowed to smoke.  This may seem self-evident but we look after plenty of older teenagers where we have essentially given up on that particular battle.  Gemma’s social worker is very keen that we do all we can to stop her smoking.   Gemma is determined to smoke.  I am regularly kicked and slapped when I take cigarettes out of her mouth – even this is only possible if I am quick enough – otherwise we end up in pointless and futile games of chase around the trampoline in the garden.

She is not allowed out of the house on her own – due to strong suspicions of her involvement with a local child sexual exploitation ring.  Nevertheless, Gemma runs out of the house several times a day in order to roam the streets asking strangers for cigarettes.  We can’t lock the door – it is not a secure unit, we can’t restrain her to stop her leaving – there aren’t strong enough grounds and anyway, because of her past experience of sexual abuse and being pimped out by her own mother, restraint is to traumatising for her and only to be used when she is actively hurting herself.  So when she runs, all I can do is follow.

Follow her as she climbs over fences, runs through hedges, hides behind cars, and – when I get close to her – kicks and punches me and calls me a pervert.  It’s a game really – if she manages to get away and get a cigarette she feels that she has won.  Sometimes I lose her and she is back at the home before me.  She mocks me for not finding her and tells me how rubbish I am.

I don’t feel annoyed when this happens, I don’t feel concerned, I don’t feel anything other than mind numbing boredom.  Jaded by experience and the knowledge that it will make no difference – we wont stop her smoking and if anything our attempts to do so are giving it a greater allure.  And putting her at greater risk.

This effects how I respond – she calls me a pervert and I pretend to yawn.  I tell her I have being doing the job for as long as she has been alive and have been called a pervert many times – I tell her it’s not going to work.  She threatens me or hits me and tell her I wouldn’t be very good at my job if I was scared of little girls.

What am I doing? I am virtually daring her to up-the-ante, I am telling her she is inconsequential and I am not taking her seriously.  The constant references to “my job” come with the implicit suggestion that it is “just a job”.

I wonder what Donald Winnicott would say?

 

 

An Insecure Base

I said goodbye to Scarlett yesterday – tomorrow she moves to her fifth placement in the 18 months she has been “looked-after”.   She has been with us since Christmas Eve.  I will discuss why in a moment, but first:

What a cold, clinical and straight-out horrible word, it has just occurred to me, “placement” is.  There is a reason we use words like this as professionals – it’s a defence.  It protects us from having to confront the full reality of what is happening.  “Placement” doesn’t have quite the same emotional resonance as “home” does it?

Scarlett’s mum died when she was nine – although she had been slowly dying for a couple of years prior to that.  Mum was concerned about Scarlett’s dad, who she had already separated from, and his capacity to care for Scarlett when she died.  So she made a referral to social services before she did.

And she was right to be concerned, because Scarlett lived with her alcoholic (amongst other issues) dad for four years, in which he appears to have been unable to meet any of her needs.

In her more reflective moments Scarlett is able to give a flavour of these years – how she had to look after herself and her baby half-sister (the product of dad’s new relationship and born just a few months after the death of Scarlett’s mum).  And the constant on-edge terror of living with a chaotic drunk:  “He came home and smashed-up the tumble dryer – just smashed it up.  Who the fuck does that Jack?”

It is hard to understand why she was left in that environment for four years.  Scarlett certainly doesn’t:  “Why did they leave me there? I was so skinny Jack, she [the social worker] could see how fucking skinny I was.”

It is easy to form a narrative where everything was OK until Scarlett’s mum became ill, and make an assumption that she was appropriately cared for until that point.  But this, in truth, is unlikely.  Not least because Scarlett’s mum and dad were together for the first eight years of her life and he did not become an aggressive alcoholic overnight.

And women (or men) who live with people like Scarlett’s dad for 10 years usually have their own issues.  These dynamics are complicated – so you won’t get a nice and simple “woman = good, man=bad” interpretation from me.  Even Scarlett, who, understandably, idolises her mum, describes her as “depressed” (read – emotionally absent, at least some of the time).

So it is easy to understand why Scarlett is full of rage.

It is easy to understand why  she cannot emotionally regulate – she never had an adult to do this for her.

It is easy to understand why she will shout and scream the most appalling abuse when she does not get her own way – in the hope of wearing you down – she would have needed to do this to survive.

It is easy to understand why she doesn’t trust adults and perceives threats when there are none.  How a flash of irritation on my face when she is abusing me can lead to Scarlett trashing the house.

It is easy to understand why she does not go to school – she never has done so she feels exposed and stupid (which she is not).

It is easy to understand why she will abscond and hang-out with “mates” who we consider “high risk” and smoke copious quantities of weed, despite the paranoia and bordering-on psychotic episodes it triggers  – anything to take the pain away.

It is much less easy to know what to do about it.

Whenever I write about the realities of my work someone will comment or tweet about “under-trained staff”.  So for the record, and as I have written elsewhere – yes the training of residential care staff and foster carers is, in my view, nowhere near good enough.  But this is not a silver bullet.  Even if Scarlett was to move to a home staffed by the most robust, Tavistock trained, child psychotherapists and child trauma experts she would continue to behave much as she does now for the forseeable future.  You do not turn around 13 years of trauma and poor care in a few months.

…the provision…of  a secure base from which a child or adolescent can make sorties into the outside world and to which he can return knowing for sure that he will be welcomed when he gets there, nourished physically and emotionally, comforted if distressed, reassured if frightened.  In essence this role is one of being available, ready to respond when called upon and perhaps assist, but to intervene actively only when clearly necessary.                                                                                                     John Bowlby, A Secure Base, 1988

What she needs, desperately, is the thing she has never had – a secure base.  The bitter irony is that the early lack of a secure base and the associated trauma is leading to behaviour which is making it virtually impossible to give her one now.

Because she really is putting herself at risk – and we are not really keeping her safe.  If she is groomed, sexually exploited, raped – then people would legitimately ask questions about why this was allowed to happen.  This is one of the reasons she is being moved.  But she will abscond from her new home and it will take her five minutes to meet exactly the same kind of people we are moving her away from.  There will be no less risk.

Of course, Scarlett’s move is not just about what is best for her.  We look after other children – some of whom she bullies.  It is their home that she trashes, it is they who have to live with her volcanic explosions day-in-day-out.  I get to go home.  It is Michael who stays in his room watching TV, scared to come out.  It is Michael who desperately wants attention from me but can’t have it because I am having to be alongside Scarlett:  “Michael, I promise I will play Mario with you before I go home.”

But there is no benefit for Scarlett in moving her – despite Scarlett desperately trying to see it as a “fresh start”.   She will blame herself – only the other day she told me how she wished she had stayed with her first foster carer, how she had really liked her but “I messed it up”.  She will trust adult relationships even less and the pull of outside associations will be even stronger because she will be even more certain she needs to look after herself.  Scarlett will be even more angry.  She still won’t go to school.  She will probably move home again.

If you are waiting for me to suggest a solution here – I am not sure I have one.  At least not a simple one.

Anyway, back to that goodbye:

Scarlett is visited by a member of staff from the new home.  She is quiet but seems accepting she is moving.  She asks reasonable questions about the new home and essentially tries to make the best of it – she talks repeatedly of a “fresh start”.

Shortly after this she tells me she needs some new underwear and I drive her to ASDA in my car to buy some.  In the car she says: “It’s too late to change it now isn’t it?”  She is referring to having to move – and by extension her behaviour.  I don’t really know what to say, so I swallow hard, “I’m sorry sweetheart.”

A few minutes later we are in ASDA car park – she has dropped one of her two phones in my car and demands I look for it.  I cannot find it.  I am weird, I am a paedophile, I shouldn’t look after children, I have stolen her phone, she is going to have me sacked.  She decides to film me on her other phone – in case I “switch”.   I become frustrated – “Scarlett, if you genuinely believe I have stolen your phone then call the police”.

“Why should I call the police?  Call the police on yourself!”

I have run out of things to say so I say nothing and we sit silently for a few minutes.  Eventually she finds the phone.  We go to buy the underwear but she is not talking to me.  We go home and she does not talk to me for the next two hours.  She goes out.

Scarlett returns three hours later and she is as stoned as I have ever seen her.  A giggling mess.  She has the munchies, I make her endless rounds of jam and toast and sit on the stairs talking to her.

“Jack, are your mum and dad dead?”

“My dad is alive – he lives in Devon.  I don’t know about my mum – I have not seen her since I was five.”

“Five? That’s really young.  How tall were you?”  I show her the approximate height of a five year-old with my hand.

“She just gave you up?”

“Yes sweetheart”

“Why haven’t you looked for her?”

“It’s hard to find someone who doesn’t want to be found.”

“Jack, if you make me a tea I promise I will go to bed.”

I take the tea up to her and stand in the doorway. “Scarlett, I won’t see you again before you leave, so this is goodbye really.  Please try to take care, I really hope things work out for you.”

“You might see me again.”

“Bye Scarlett.”  I turn and leave.

“Jack”, she calls after me.

“Yes Scarlett?”

“You’re weird.”

And that is that.

 

 

Loss and abandonment…

It’s hard to be precise but, as I count them now, I reckon there were 18 adults who at different times across my childhood were responsible for my day-to-day care.  I have only seen one of them, my father, since I turned 16 (I’m nearly 40 now).

Each of these 18 adults represents a loss.  An ungrieved loss.  Of course not all losses are equal – as I have discussed elsewhere, not all these adults looked after me very well and I was glad to see the back of them. Continue reading

The fruits of my labors…

In the kids home I work in there is a fake chalk board hanging on the wall with a recipe for happiness printed on it.  You may have seen the kind of thing, “1 cup of kindness, a pinch of understanding…” etc.   Suffice to say – I hate it. Continue reading

Negative attention seeking…

This phrase is often used (worryingly by professionals who should know better) to describe behaviour which is seen as unhealthy or challenging and seems to be engaged in to deliberately attract the attention of other people. Although this may be factually accurate, the phrase is unhelpful and often used in a way which lacks understanding and is very judgemental, such as:

“Ignore her – she is just negative attention seeking.” Continue reading

They need to trust you not like you…

It is very common to hear relationships between staff and young people in care discussed in terms of whether the young person “likes” a particular adult or not.  Comments such as, “James doesn’t like Sue [staff]” are often heard in staff meetings and handovers.  Or even worse, “Billy and Sue [still staff] don’t get on”.  As if it is a relationship of equals and there is nothing more to think about here than a straightforward personality clash. Continue reading

Some things I remember…

Naturally, given my age, I do not remember much about living at home with my mum and dad or my early years in care. Of course, this lack of cognitive memory does not mean there is not an emotional one. Nothing makes me rock with anger more than when I hear someone describe an obviously traumatic experience in a child’s life and then make light of it with anodyne phrases like: ‘It’s ok, she was far too young to remember.”

Still, I have a few memories – flashes really. They are mine – not things that I was told later and incorporated into my own narrative. I can be certain because they are not those kinds of events. Continue reading

The cost/value of good experiences…

The children’s home I work in now charges £2995 per child per week.  It seems like a lot of money I guess.  I am back working for the same children’s home where I started my career in children’s social care in 2004.  At that time the cost of a placement was £2995 per week.  They have not been able to put up their fees in 12 years.   Allowing for inflation the equivilent amount today would be £4230.

Imagine if schools and hospitals had not been given budget increases for 12 years.  There would rightly be an outrage.   I guess most people don’t use children’s homes and those that do don’t vote. Continue reading

Lying to children…

In the old days (the mid-eighties) when I was in a kids home, they were often run by married couples who had a team of care staff underneath them.  In the home I was in, these staff were called aunties and uncles.  My main memory of them, probably unfairly, is they were a group of middle-aged women who used to sit around, watch TV and darn socks (yes really). Continue reading

They’re my family…

Obviously the word “family” is complicated and painful for all children in care because, irrespective of the circumstances, all of them are united by one simple truth – they are not living with theirs.

Images of “perfect” families abound in popular culture – films, books, even TV adverts, constantly bombard these kids (and, let’s face it, all of us) with idealised versions of what a family “should” be like.  Sure, siblings may argue but they make up in the end, or come together when they need each other – blood is thicker than water and blah, cliche, blah. Continue reading

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