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94 NOVEMBER 2006
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practice

What is Milieu Therapy?

Gustaf Jonsson

The first part of a chapter (to be concluded next month) from James Whittaker and Al Trieschman's book Children Away from Home ...

To you who are a newcomer to the Children's Village, welcome! This welcome comes from the adults in the village, not from the children. For most of our children you are a very suspect person. From them you will meet with open scorn and concealed suspicion. This greeting will probably meet you: “Who are you, you old bitch?” Or, “Who is that bloody bastard?”

And that is the way it is. You are an old bitch or a bloody bastard. These children have their reasons for saying so, for that is the experience they have had of adults, and you are an adult. In the Children's Village we have only emotionally disturbed children, who have suffered in their earlier surroundings, due to the treatment they had from adults. That is why they came here. The Children's Village is not the place for normal children but, as it is called in official language, a home for neurotic and emotionally disturbed children.

That the children have suffered does not mean that they all have had a poor, overcrowded home, that they have had drunkards as fathers and negligent mothers. There are also children in the village coming from socially acceptable homes, but in all cases their emotional life has been disturbed because they have not received the security which they need. This is not said as an accusation against parents or others who have taken care, Reprinted with permission of the author in personal communication to the editors ..., of them. It is not always so easy to have to do with children, not even when they are one’s own.

There are no evil children
From the first moment in the Children's Village you will have to understand that unhappy children are not usually romantically pale with sorrowful faces and shy, quiet manners. This is false romanticism. In the Children's Village you are in the world of reality. Here you find unhappy children who express their longing for understanding and tenderness in a language which is natural to them: swearing and pestering and using foul language, kicking and punching and stealing, playing truant, bad table manners, sex talk, smoking and boasting.

There is a “true story,” psychologically true, about Mr. Average Swede. On his way home from a drinking party one beautiful spring night he passes a park in Stockholm where the cherry trees are in full bloom. Mr. Swede’s heart is filled with joy and emotion in the presence of the Beauty of Nature. He grasps a lovely spray of blossoms exclaiming: “Are you blooming ... ” and then becoming embarrassed by his own emotions, he continues the sentence as a true Swede: “Are you blooming, you bloody cherry tree?” Remember that story sometime when you meet a child in the village who greets you: “Hello, you old bitch!”

You will have to understand from the beginning that expressions of sympathy and desire for contact in the Children's Village may take unusual forms both in words and actions. “I like you, will you be my friend?” might very well be expressed by curses and a blow in your stomach. The question is if this method of expression is not often a guarantee for the genuineness of the emotion.

Anyway, you will have to understand that it does not do to dismiss these children as evil or foul-mouthed. The first commandment in the Children's Village thus reads: “There are no evil children.”

In the Children's Village you will find not only aggressive, noisy, and destructive children, but also shy, anxious children. These I do not need to say much about. You will like them in any case. But the longer you stay here the more clearly you will see the truth in our basic principle: that the difference between an abandoned, weeping boy and an impertinent, swearing blackguard is only on the surface.

Are the children allowed to do as they like? Do we not bother about the children swearing? Do we think it is desirable that they let off steam by swearing, fighting, stealing, and breaking windows? Should children be “allowed to do as they like"?

No, and again no!

Let me once and for all underline this sentence: In the Children's Village the children are not allowed to do as they like. I know that it will not help much to say this, because for the next thousand years of the existence of the Village it will be the popular opinion, anyway outside the Village, that in it there is a crazy doctor and other blue-eyed idiots who believe that children must do as they want if they are to be happy.

The thing is that the children simply do not know what they want. Typical for neurotic children is that they are dominated by conflicting impulses, both to do and not to do a single act. This rule might apply to all of us, because the real motive behind our behavior in important matters is very often determined by subconscious factors hidden from ourselves. That this deep truth is concealed from so many of us is due mainly to our well-developed ability to rationalize, to find a motive after the act has been done. What really determines our behavior is often emotion and not reason. Because the children do not know what they want, or both want and do not want a thing, it is clear that they often get into a serious dilemma if we let them continue. They will develop guilt feelings for what they have done, and try to get away from these feelings by continuing their behavior; and then the vicious circle is completed. To let off steam in a psychological sense does not mean to act in a way that was earlier forbidden. The emotion that follows the act is psychologically the main point. If that emotion is fear, the child's condition will be worse if he “acts out.” The theory that children shall be allowed to do what they want is a simplification to the point of absurdity. As a popular notion it is crazy. It has never been postulated by any of the prophets of so-called “free education.” It has been invented by the slanderers of the Children's Village, and we decline it with thanks!

The Chinaman's fatal mistake
Once upon a time, there was a boy in the Children's Village who became annoyed at the many foreign visitors who walked around in the Village to have a look at us. He reacted by writing a satire. It dealt with a Chinaman visiting the Village who only understood Chinese, and thus he was subject to a little misunderstanding. He thought that the children were the staff and the adults were patients. In his report on his travels he described very colorfully how the staff, by all possible means, tried to arouse the patients from their apathy and get them to be active. The patients went around in their kitchens, cooking and cleaning. The staff poured syrup in their hair, threw eggs in their ears, smothered their pancakes with pepper, and emptied the garbage can into their soup. But the patients only continued in their morbid apathy.

We might learn something from this story. It illustrates a rule discovered in other institutions where an attempt has been made to treat neurotic children according to psychoanalytic principles. The rule says that passivity fro adults is wrong, because the children experience this passivity as apathy and lack of interest in them. Everybody knows that the most infernal method of making people helplessly enraged is to keep cool, calm, and collected when they swear and rave. In Sweden it is known as the “wife-tormenting method.”

No laissez-faire system
It is thus no use standing looking at the children when they are breaking windows and tearing down curtains. There are some dangerous people who have read a little modern psychology and got the idea that one should not intervene. This is not psychology, it is quackery.

No saint’s halo
The quack treatment will result in giving the child guilt feelings, and provoke his anxiety through your going around like a saint, patient and submissive. Such a saintly attitude might be ennobled to a therapeutic attitude if account were also taken of the feelings aroused in the child, perhaps to speak to him about his feelings, explain, understand, and thereby have a calming and reassuring effect on the child. But this needs good insight in analytic therapy and cannot be practiced in a small house with many children where each of them needs different treatment. To act the saint in everyday life is, in psychological terminology, to have a masochistic attitude and testifies mainly to a neurosis in oneself.

No martyr halo either
In child guidance work a certain kind of mother is sometimes met with, the so-called martyr-mother. It is she who says to her child: “How can you behave like that to your mother who is so kind to you and has given up so much for your sake.” There is a male variant, too, the martyr-father, who sacrifices everything so that his son may enjoy what he desired in vain out of life. These parents are themselves neurotic and their parental love is unsound. In the Children's Village this sort of thing does not fit in.

We do not expect thanks from the children. You win nothing demanding gratitude. Should gratitude be of any value it must come spontaneously, and not be forced. As I said before, these children as a rule have no reason to feel gratitude toward adults, considering the way we have arranged conditions in our society for them.

No detailed advice
Now what shall a poor inexperienced girl do with these difficult children? What is to be done when the children do not eat, do not want to go to bed, smash windows, steal, play truant, kick and scream? That is what people ask in the papers, after lectures, in letters, and so on. You too. But from us you will get no answer. We cannot answer that question. And that is of fundamental importance. One shall not be able to answer that question.

There is no patent advice for every particular situation. Children are so unlike. One child rejects food for one motive and another does it for quite another reason. It would then be wrong to treat them both according to the same prescription. It is the same with the window breaker and the child who is cruel to animals, the thief, or any of the other types we welcome to the Children's Villlage.

You will be forced to try to understand every child and his particular problems before you can handle him correctly. That is not learned in one day, and it is not meant to be. You must, however, grasp from the beginning that it is necessary to know a great deal about a child's earlier life to be able to understand him. Then you will see the truth in the French proverb: to understand is to forgive.

It is intended that you shall gain this knowledge about the children as individuals by attending the evening conferences and house and school meetings which are held regularly each day or every other day. There you will have a chance to discuss what you should have done when Tom did so and so or Bill behaved in some other way. Such questions can possibly be answered or at least discussed.

Learn to know yourself
It is not only the children who are crazy in their own way. Even we adults are different. We too all have our particular craziness. When you work with children in a place like the Children's Village you will discover that both the sweetness – and the horror – of this job are that no one gets off Scot free. Whether you want it or not, an upheaval occurs in the depth of your soul. We all have our inhibitions and our complexes (mikos), and when we observe children who, unpunished, can do what we ourselves once wanted to do, but were not allowed to, it will provoke a very special agitation inside us. When we see a boy openly smoking it will awaken old memories about how we wanted to smoke as children but dared not. Still worse is to experience children who spoil food, dirty themselves all over, use exhibitionist sexual language, or do something else connected with past desires and impulses within us which we, normally enough, have learned to control.

You will also find that there are certain children you cannot stand and others you will love very much. Observe that your colleagues feel sympathy or antipathy for quite other children. Even this is connected with impulses and needs within ourselves. By observing your own reactions and contemplating them you increase your self-knowledge and acquire living psychological knowledge beyond books and gray theories.

Many small emotional waves may become a great storm. There is usually a delay, an incubation period of a few months, before the symptoms appear. Then you will get one of two variants, an extrovert or an introvert type.

Those who get the introvert form will say something like this: I will not do, I am not fit for this sort of work. Tiredness and sleeplessness and attacks of weeping are among the symptoms.

Those who get the extrovert form will say something like this: The ideas of the Children's Village and this foolish doctor are mad, it cannot go on like this. There must be some order. No human being can stand this.

In the first case, the criticism and agitation are directed against one’s own ego, in the second case one’s feeling of insufficiency is projected onto the surroundings.

This is not of course the basis of all criticism of oneself and the ideas of the Children's Village. There are good reasons for criticizing both yourself and the Village; but you must find your way to a realistic criticism, not a feigned criticism.

For obvious reasons the treatment of debutant sickness will not be dealt with here. It calls for individual sessions with someone either within or outside the village who understands psychotherapeutic methods.

What I want to say is that one shall not immediately condemn either oneself or the Village as inadequate. That is why I mention the illness. It is an occupational disease in the Village and similar institutions.

Be yourself
Thus to do a good job in the Village one must learn to know the children and to know oneself. Then everything goes of itself. One cannot give general advice on how to stop a boy breaking windows or what to do with a girl who is continually stealing. In these cases everyone has to find his own melody. If you want to ask advice, you certainly may do so. But do not try to run away from the strain of feeling your way and thinking out your problems yourself. For some it is natural to show his feelings openly and directly to the children. For others a quieter manner may be more natural. We reckon that there is a Happy, a Quiet, a Shy, and perhaps a Crazy among us in the Village.

To feel lice on your own skin
For those who want to learn mental child care the Children's Village has something to give which cannot be read in books. That is why we consider it important that the students should have at least one month practical work in a house. Nobody knows what lice mean without having felt them on his own skin, and nobody knows what problem children mean before having felt them.

This is what happens. One comes to the village, has read a little about modern child psychology, listened to lectures, participated in study groups, and so on. That is all very well. But there is one important lesson remaining. You wake up one morning feeling bad. Your head aches, you are tired, want to cry. The discomfort is creeping under your skin. The children are rowdy. You do something which is contrary to everything you have read in your books or heard at lectures. You lose your temper, scold a child or grumble at everything, burst into tears, or do something which you later consider absolutely wrong. In the evening or the next day, perhaps a moment later, comes the morbid paleness of reflection.

This experience is precious. Then one knows something more and something very important on how a mother and father of a problem child may feel, or his teachers or someone else who lives in daily close contact with such children. For everyone who will be working in social guidance clinics, visiting homes as a social worker, and so on, it is necessary to know how it feels for those one tries to advise. All this is well-meant advice on showing more patience or more tenderness and affection toward the children seems rather meaningless and even cynical if one cannot at the same time give the mother or father or teacher strength to follow the advice.

One might add that nobody really knows what enuresis means who has not had to make the bed of a bed wetter, or what encopresis is who has not had the job of washing soiled pants. Anyway, one learns to understand the mothers better.

Do not scold the mothers
Much of the contact with the parents goes over the telephone. They often ring up the house parents, mostly to complain or criticize, seldom to thank or praise. It is psychologically instructive that these complaints very often come from parents who have themselves been criticized for neglecting their children or have been considered unfit to take care of them. It is only human to try and cancel out this criticism by criticizing others who now have the care of their children. That is why their criticism sometimes is unreasonable and out of proportion. You will have to take it calmly. It is part of our job to be criticized and slandered.

Our good neighbor, the director of the Hammagarden reformatory school, once played “red Indians and Whites” with his boys. In the course of the game the boys captured their director, bound him to a tree, and danced their war dances around him. Next week the rumor went around that at Hammargarden the director ties the boys to the trees in the forest and whips them. The director’s comments on this rumor was the only correct one: “Well we have our job and our salary so that this sort of thing may be said about us.”

Do not, then, take it as a personal insult, and become bitter, when unjust accusations are directed at you by the relatives of the children or others. There is a good rule for answering complaints on the telephone. In simple language: let people bark until they have finished. In psychological terminology: let them discharge their emotions. One shall not contradict, not discuss, just keep silent and take it.

[This chapter will be concluded next month]

This feature: Reprinted with permission from Whittaker, J., & Treishman, A. (1972) Children away from home. Aldine.

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