Part II of a two-part series on the contrasting treatment of deprived and delinquent children. (See Part I here) Sula Wolff was born in Germany, trained in medicine and psychiatry in the UK, practised in Cape Town and New York
The basic problem of treatment for delinquent children, whose main defect is in their conscience structure, is how to help them acquire an inner set of stable standards and values. Often severely delinquent children are also deprived and the treatment problem is a dual one. Most successful treatment approaches have used group methods and these have been particularly rewarding in institutional settings.
The pioneer in this field was August Aichhorn whose book Wayward Youth was first published in 1925. It is a reflection of his genius, but also of the lack of progress in the treatment of delinquent children, that after thirty years little has been added to his original contribution.
Severely delinquent children, like deprived children, do not benefit from interpretative psychotherapy alone. They require intensive twenty-four-hour-a-day treatment. The popular notion that undisciplined, impulsive children who do not care about the consequences of their acts and are incapable of guilt feelings, require merely firm and consistent discipline has given comfort to a great many people working in approved schools and in children's homes. Such institutions are with few exceptions run on disciplinarian lines and while children are in residence their behaviour is often kept in check. There is however little evidence that a regime of enforced discipline and order contributes anything to children's personality development. They accept unavoidable external restraints while they last, but they do not become identified with them and are no more able to exert inner controls than they were before.
In 1918 Aichhorn, a school teacher turned psychoanalyst, founded a home for delinquents that was run on very different lines. All children in his care had experienced gross parental deprivation in the past and had suffered from extreme severity and brutality in their upbringing. His first aim was to compensate the children for their past deprivation of love. He deliberately made the institutional environment as enjoyable as possible for children and staff alike. No demands were at first made on the boys and Aichhorn insisted that all staff members were affectionate, permissive and non-aggressive “even in response to aggressive attacks from the boys. The experience that their own aggression did not evoke retaliation was new for these children; it was unexpected and provided the essential corrective experience. When aggression was not met with counter-aggression it ceased to be satisfying and in fact led to intense outbursts of frustration and misery, and the first inklings of a guilty conscience. Aichhorn describes a regular sequence of behaviour shown by the asocial and aggressive delinquent boy in response to this permissive environment: an increased sense of his own power, more frequent and more violent acts of aggression, followed later by tears of rage when counter-aggression was not forthcoming, then a period of sensitivity and, finally, conforming behaviour. The emotional crisis which most boys experienced, and which was often deliberately provoked by the staff, contributed to the change from delinquency and unconcern for other people to increased tolerance of frustration and affectionate relationships with others. In time this group of serious delinquents established their own standards and values in the home and all of them later became adjusted in society.
Among the children in his care, Aichhorn distinguished between those who were asocial and aggressive, in constant conflict with their environment but with no inner conflicts and those in whom delinquency was merely an expression of an underlying neurosis. It was the first group of children who benefited most from the therapeutic community he created.
In a recent review of the literature on juvenile delinquency Donald West stresses the need for adequate diagnosis and for the careful selection of children for specific treatment approaches. The efficacy of different treatment methods cannot be judged on the basis of results with unselected groups of delinquents.
Ernest Papanek set up a community at Wiltwyck school in New York similar to Aichhorn's. A study of his treatment results confirmed Aichhorn's finding that the therapeutic community approach was more successful in the case of delinquents whose socialization had been defective than in neurotic children with internal conflicts. A comparative study of Wiltwyck boys and boys living in a typical public reformatory where discipline was rigidly enforced, demonstrated the superiority of a therapeutic community approach. Thirty-five boys from each institution, similar in age, social background and the nature of their disorder were compared on a series of personality tests. It was found that Wiltwyck boys became less anxious the longer they were at the school while reformatory boys became more anxious. Authoritarian attitudes and prejudice decreased with length of stay at Wiltwyck; prejudice increased in the reformatory. Wiltwyck children tended to view the world as good rather than evil, to be satisfied with themselves, to see their parents and other adults as loving, and to be much more closely attached to the staff of their school. In the children from the reformatory all these attitudes were reversed. They saw the world as evil rather than good; they viewed adults as punitive and they had few attachments to the staff of their school. These findings tend to bear out the ideas of Papanek who is quoted as saying: “Punishing teaches the child only how to punish; scolding teaches him how to scold. By showing him that we understand, we teach him to understand; by helping him, we teach him to help; by cooperating, we teach him to cooperate.”
Deprived and severely delinquent children require total care. The reparatory processes necessary to make good their defects of ego and super-ego development, that is, of emotional and intellectual functioning on the one hand and of conscience structure on the other, can occur only when the child spends twenty-four hours a day in an actively therapeutic environment. Moreover, recovery from gross deprivation or distortion of the socialization process in early life takes many years. It is not surprising that society has not yet found a way of meeting adequately the treatment needs of these children.
These have been two brief extracts from Wolff, S. (1973) Children under stress (Pelican Books)