I am doing a “shadow shift” at a therapeutic community – it is part of their recruitment process – when I first meet Sam. He has just turned 10, he is skinny and small for his age with lank, greasy hair and wears Wellington boots and a black, quilted coat – both of which he refuses to take off indoors. Sam tells me he has lived there for a year. He seems fairly keen to get to know me – much to my relief because I am equally keen to show my potential employers how well I interact with children.
Sam and I play a game of his devising, which essentially amounts to us throwing his teddies up-and-down the stairs. Nevertheless, he will remind me of this in the years to come whenever he discusses the first time we met. Sam’s teddies are important to him and he gives key staff members specific teddies to look after when they go off shift. After a few months, I am granted the honour of looking after “Sleepy”.
I take Sleepy with me whenever I go home and dutifully return him when I come back. Sam insists I take Sleepy on holiday with me – so I photograph him on the beach in the South of France. One day, another child’s soft toy goes missing and Sam, in a panic, gives me all his teddies to take home – about 30 of them in a bin liner. To some extent this is narcissistically gratifying. So, I wonder what it means when I find Sleepy torn apart and cut to shreds on Sam’s bedroom floor.
You see, Sam is very disturbed – paranoid, violent, sadistic and, at times, psychotic. Mad by any reasonable definition of that word. The early years of looking after him were marked by frequent, lengthy and very violent restraints – I am physically hurt by Sam more than any other child I have looked after – as he bites and scratches and digs his nails into my flesh: “You like that don’t you? You like that!”.
These outbursts can be triggered by anything or apparently nothing – indeed when a new manager starts she wants us to devise “positive handling plans” for each child – a process which involves working out what a child’s “triggers” are. Later, Sam kicks off and a colleague turns to me and says, “well…that’s trigger 847” (the new manager does not last long). Sam’s paranoid fantasies, which he experiences as very real, are part of the problem – if he becomes violent when asked to hand in his Playstation, he is not just railing against a boundary – he genuinely believes we are only taking it so we can play on it during the night.
Still, however horrendous it has been, when he is eventually ready to settle for the night I always give him a hug and kiss him on top of his head. And each time, Sam will mock pull away: “aargh, Jack”. It is our little routine – until one day when he is nearly 13, I decide he is perhaps too old for it, so I say goodnight without the kiss. Sam appears in the lounge a few minutes later, “what, Sam?” I ask rather irritably, he looks hurt and points to the top of his head. The hug and kiss continue from then on, until the last time I say goodnight to him before I leave – when he is 15 years-old.
Sam’s disturbance manifests itself in many other ways too – one look at his bedroom will tell you that. As would any attempt to help him tidy it, as he argues and fights with you about the prospect of throwing away an old crisp packet, a small piece of broken plastic from a CD case or an old tissue.
When Sam has been at the community for four years, there is talk in a review of him being moved to foster care – this is an absurd and ridiculous joke, no foster carer in the country could manage Sam and the very act of moving him would set him back years. Sam is unsettled and scared by the prospect of having to leave. However, perhaps a sign of his development, there is no gross acting-out – he decides instead to write a letter to the Prime Minister. I encourage this – I want him to be able to write down the reasons he wants to stay and I hope this can turn into a letter to “the panel” who will decide Sam’s fate. How Kafkaesque this mysterious panel must have seemed to Sam.
Over the years, there was some progress with Sam, the violent outbursts decreased in frequency – if not intensity – and he seemed more able to tolerate frustration. And there were other small victories – such as when he told me I could throw away anything in his room that I thought was rubbish but he could not watch – this sounds trivial but was very difficult for him.
We developed another private joke too – each time we would see each other we would stare at the other out of the corner of our eyes and say, “Oh…it’s you” as if we were sworn enemies – Sam would then give me a hug.
But throughout this time, Sam remained very troubled and disturbed and just a few weeks before I left he attacked me as badly as he ever had and my arms were covered in blood. We often wondered what would happen to him in adult life – we knew for certain that he would continue to need lots of support and psychotherapeutic intervention. It was always hard for Sam and us to consider the day he would finally have to leave.
Sam turned 18 a few weeks ago – and the local authority solved the problem of where he should live and how to support him by moving him in with an older brother who Sam had met twice in his life before and not for many years – a man who is a known drug dealer. They also refused to fund any outreach or work by the community to help Sam with the transition.
To say this decision is grotesque hardly does it justice – it is straight out immoral. And even from a simple financial perspective, it makes no sense – why risk wasting the millions that have already been spent on his care, while dramatically increasing the chances of Sam ending up in prison or a secure mental health hospital? I worry every day, since I heard, about how he is coping.
This case, like all the others I write about is disguised and, usually, I hope no one reading my blog recognises the child I am talking about. This time it is different – I hope the people involved in what happened to Sam do realise who I am writing about. And if you are one of them – don’t think you can let yourself off the hook by blaming “systemic problems”. Systems are just people making decisions, and you made a terrible one or colluded in it. If you feel shame or guilt – and I hope you do – this is entirely healthy, it is the emotional and psychological mechanism which should prevent you from behaving in the same way again.