Residential Care with Evacuated Children: Lessons from Clare
Winnicott
Joel Kanter
Unknown to many today, Clare Britton Winnicott (1907-1984)
was one of the leading British social workers of the 20th Century. Beginning her
career working with evacuated children with special needs during World War II,
she became a leader in the postwar movement to transform child welfare services
in England, directing the first course to train social workers in child welfare
practice and later directing the Home Office’s initiatives in training child
care workers.
Her wartime experiences supervising five hostels in
Oxfordshire with over 80 children who were unable to remain in ordinary foster
care has considerable resonance today. Many of these children came from the
lower socioeconomic strata of Britain’s urban centers and had minimal contact
with parents endangered by Nazi bombing and overseas in military service.
The challenges of this work under chaotic wartime
circumstances cannot be underestimated. Caseloads were large, resources were
limited, social work had no recognition in the community and trained personnel
were rare.
Many believed that adjustment would be facilitated if the
child’s contact with the past was severed. Clare recalled how:
children clinging to their own clothes [were] given an
anaesthetic to enable the clothes to be removed” and many parents rarely
communicated with their children. When possible she took a day to travel to
the city and look up the parents. When she returned, the children “would
rush up and say, ‘Miss have you seen my mum?’ ‘When did you see my mum
last?’ And it was quite hard for them when I had to say, ‘I can’t see your
mum every week. Only every now and again.’ But it did awaken some parents to
their own responsibilities in regard to the children. Because I could say,
‘Look he’s missing you terribly. What about a note? Give me something to
take to him.’
(Kanter, 2004) .
This simple intervention may seem commonsense today, but it
foreshadowed our contemporary awareness of the need to respect the child’s
attachment to their parents, no matter how distant or problematic.
Clare Winnicott’s understood that successful residential
care did not merely involve the competent physical care of children, but also
required staff to understand and acknowledge the objective reality of children’s
losses and traumas. She observed that:
our real aim … to keep children alive … By keeping
children alive I am of course referring to maintaining their capacity to
feel. If there are no feelings, there is no life, there is merely existence.
All children who come our way have been through painful experiences, and
this has led many of them to clamp down on feelings and others of them to
feel angry and hostile, because this is more tolerable than to feel loss and
isolation…
To feel a sense of loss implies that something of value,
something loved, is lost, otherwise there would be no loss. Awareness of
loss therefore restores the value of that which is lost, and can lead in
time to a reinstatement of the lost person and loving feelings in the inner
life of the child. When this happens, real memories, as opposed to
fantasies, of good past experiences can come flooding back and can be used
to counteract the disappointments and frustrations which are also part of
the past
(Kanter, 2004).
But while children in residential care have positive
memories of their prior life experiences, they all have experienced the trauma
of “the failure of their own homes or foster homes to tolerate them and their
difficulties any longer”. Clare noted that all children in care:
have known the frightening experience of “things having
gone too far”. Help has been sought, and decisions made, and life as they
have known it disintegrates. The point of breakdown may have been reached
early or late in the child’s experience. The home may have disintegrated
quickly at his first efforts to prove its worth, or it may have stood a
great deal up to that point and given much that the child needs. Each child
has come a different way to the point of breakdown, and each story with its
inextricable tangle of cause and effect is peculiarly the child’s own,
however similar symptoms and behaviour difficulties may appear
.
But whenever children come into residential care, even if
they appear “relieved and hopeful“,
we know that they come straight from the scene of
conflict; and bring with them a deep sense of failure and guilt, which must
eventually be reached if they are to be helped. In fact, it seems that the
important function of the hostel is to help the child eventually to
reconstruct the past however bad or good it has been.
And thus ensues the all too common scenario of a honeymoon
period followed by a phase of intensive behavioural disturbance. Clare noted
that many children reach an initial stage when they:
are sure enough of the hostel to transfer their home
difficulties into hostel life, thus “saving” their own homes and enabling
them to construct a perfect home in phantasy – on a totally unreal level.
Those of us who have worked in hostels are all familiar with these wonderful
homes which even the child from the worst background can create, and will
often actually run away to find. If the hostel can stand firm and allow the
children to work through this stage, then gradually real relationships with
hostel staff can be formed, and slowly the child can build up ideas of home
based on real experiences in the hostel.
It is commonly said that what every child needs in order
to be good is a good home, but we know that for these difficult children who
have known repeated failure, the answer is not so simple. They cannot enter
into a good home and become part of it, until the idea of a good home has
first been created or revived in them. When the idea is firmly established
over their own personal failures, and their phantasies of having a good home
of their own are based on experiences in the hostel, and are not subjective
and idealised, then the child may be said to be ready for a home of his own.
It seems to me that the hostel must build up this idea of home in the
children, while at the same time accepting them as they are and tolerating
their difficulties.
Coming to terms with the reality of one’s prior life traumas
and disappointment is one of the major challenges of residential care, a process
eloquently illustrated in the recent film “The Antoine Fisher Story”. To
facilitate this process, Clare recommended that residential staff initiate a
personal talk with each new child
about his home and the facts leading up to his leaving
it. Sometimes the child would add bits to the picture, but almost always the
hostel warden was able to give information and straighten out a good deal of
confusion. The main point of this talk was to let the child feel that the
(staff) had all the facts about his life, however unpleasant they may be,
firmly held together. This undoubtedly gave security and relieved anxiety,
and was the first step towards integrating the past and the present.
As children’s services increasing adopt a simplistic
behavioural paradigm, new referrals are as likely to arrive with checklists of
problematic behaviour as comprehensive social histories. And the here-and-now
focus of many facilities may discourage staff from attempting any historical
research. Clare recalled that one adolescent boy asked her
“to find out where my father is now. I know he was in
prison, but he should be out by this time.” As a psychiatric social worker
in the scheme, I was in most cases actually involved in the child’s initial
break from home or foster home and, throughout their stay in the hostel, the
children connected me with the past and the future, and relied on me to make
the outside world real to them. Consequently, I spent much time tracing
parents, and brothers and sisters and other relatives, and in giving the
child as true a picture as I could of the family set-up and the whereabouts
of its members. This was a difficult business, because the all too frequent
lack of response led to unhappiness and confusion for the child, but I am
sure that it had to be done.
Helping children in residential care build up an “idea of
home and all that it means” and integrate this with a more realistic view of
their prior life experiences is the central tenet of Clare Winnicott’s approach.
But while sensitive to the inner experiences of the children, she recognised
that sometimes the children benefited from the staff’s activities:
To take one example, we found that the children
benefited from some central project or activity being carried on by the
staff independently of whether or not they took part in it. We discovered
this by accident one day when the children had an unexpected holiday. The
Hostel Warden and his Assistant had planned to cut a tree down and saw it up
for the fires – and they carried on with their plan while the children
played round them in the garden. Sometimes the children stood and watched,
or helped a bit – then they ran off on their own pursuits – and returned
later – and so on. At the end of the day the job was done, and the children
enjoyed it, although they took almost no part in it. They were unusually
contented and happy that evening.
After that, for each holiday the Warden planned some
piece of work for himself and his staff to put through, and the children
played round them – sometimes helping a bit when they felt like it – but the
important thing was that the work was always put through – more quickly if
they helped – but if they didn’t, it got down just the same. This was found
to be by far the most satisfactory way of dealing with the holidays, and
brought real contentment to the children.
It was this same group of children who, earlier in the
hostel’s life had asked anxiously each night “who’s going to look after us
tonight?” or “who’s going to play with us?” The emphasis had entirely
changed, and they found far greater satisfaction in fitting in round the
adults, and letting the grown-up world exist in the middle of them – than
they had when the grown-ups tried to fit in round them, and create a
childish world for them. We found them increasingly capable of creating
their own world, when they had become quite sure about the reality of the
grown-up world.
A keen observer of children in care – of their internal
world, their behavioural manisfestations and the surrounding environment – Clare
Winnicott reminds us that the essential challenges of residential care transcend
time and place, that creating an inner “home” is as important as adjusting to a
given residential setting.
Sixty years later, I work with Samuel, a 14 year old African
boy who is a refugee from a civil war. Abducted by an insurgent force at age 8,
he spent three years travelling with a band of rebels, returning home to find
his father missing and his mother in a refugee camp in a neighbouring country.
Resettled with his mother and siblings in the United States, finding “home” is
still elusive as he moves from family home to foster home to group home to
detention home. The nomadic life of the rebel army lives on as Samuel searches
for a home strong enough to “hold” him, allowing him to integrate a past as a
child soldier and a future in a new land. We are still searching for the “alive”
part.
References
Kanter, Joel (Editor) Face to Face with
Children: The Life and Work of Clare Winnicott. Karnac, 2004.
All other citations are from the transcript
of a November 1946 transcript of a National Association of Mental Health
conference on the evacuation and its lessons.
For more information on Clare Winnicott, see
www.clarewinnicott.net
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