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21 JANUARY 2009
NO 1390
Caring for children
The common idea that only the sick child, and never the well, needs special emotional supports and helps from the adult is simply an error. For the well child is not immune from pile-ups of severe emotional intensity when overwhelmed by confusion and conflicts from within. Nor is he exempt from intensely complex reactions to experiences and events from without. Of course the child who is "sick," as compared to well, is more chronically bombarded from both these directions, within and without. But when the well child fails to meet such a "bombardment" adequately, he may look and behave much more like a legitimately disturbed child than his usual normal self. For instance, from within, the well child may experience a flare-up of an impulse to do or say something that he might not ordinarily consider acceptable. Or his mood may swing from depressed to elated, from apathetic and bored to "high" and overexcited. From without, consider the degree of regression that can be produced in perfectly normal children when they are confronted by a new sibling, lose a friend, experience the traumas of death or divorce. Or think of what a kid may go through at the hands of a bully or a group manipulator in the classroom, the betrayal of a trusted, admired friend, the torment of taking or not taking a dare, of peer ridicule, preexamination panic, illness or injury – and a host of other highly probable external events that can never be anticipated as to exact time and place. Certainly, the normal kid can be expected to handle such crises either from within or without better than his sick peer on the average, but that does not mean always; and the critical issue for the well child is: is he ready at the time they hit? If not, he needs, quite unmistakeably, emotional first aid from the adult – parent, teacher, camp counselor (or what have you) – who is in charge of his life at that moment. The reader will find that what the authors describe in The Other 23 Hours as the everyday requirement diet, as far as child handling is concerned for their disturbed children, is transferable to the normal crises of normal childhood.
But crisis after all, whether from within or without, is the unexpected, the unplanned. This book is not only about how to meet unplanned events but perhaps, even more, about how to plan a day-to-day environment for children, albeit sick children. And here, again, the same old question: only for the "sick?" In a sense, and on a sliding and sometimes very slippery scale, every environment is planned where people live together. No environment really just falls together by chance. Every place where people live on a group basis, where there is some degree of interdependence, some mutual need confrontation and meeting, there has to be some structure. Otherwise there is chaos. This book is very concerned with structure and its effects on a day-to-day, even hour-to-hour basis, on the life of the child in the small group. Again, using the ego psychological orientation of Aichhorn, Bettelheim, and Redl (although these are not identical), the authors are concerned with demonstrating how the other 23 hours away from the one hour of clinical exchange that we call the psychiatric interview can be planned around the ego's function for the purpose of supporting and nourishing its functioning and development. Attentiveness to and implementation of very common structures in the "life web" of almost any child – routines, certain adult responses that the child may expect on a planned basis, certain activity programs – are here examined for what they both give to, as well as demand of, the ego of the child and how the balance between "giving to" and "demanding of" the ego of the disturbed child is arrived at. From here, the "transfer step" to the normal family setting, the foster home, the camp, and the classroom, all of which deal with many similar if some different structures – "markers" Dr. Trieschman calls them – affecting the lives of children, will be quite apparent to the reader.
DAVID WINEMAN
Wineman, D. (1969). Foreword. In Trieschman, A.E.,
Whittaker, J.K. and Brendtro, L.K. (Eds.). The Other 23 Hours: Child
care work with emotionally disturbed children in a therpeutic milieu.
New York. Aldine de Gruyter. pp. vi – viii.
