OK, SO a few recent issues in my life have forced me into thinking long and hard about a lot of things in life. What's most recently on my mind is the role of psychoanalytical and psychodynamic family therepy in child protective services. (whoa! Heavy shit)
I'm not going to go into the reasons this has been brought to the fore in my life, those of you who know, know, and those of you who don't, don't need to, it's not fair to the parties involved K?...Kay!
I would at this point like to make the disclaimer that what follows are only my views as a non-trained observer of ocurrances withing my personal experience and there is no intention for malice, or slander of any kind to any person(s) living or dead, nor companies, authorities or institutions of any kind.
We're going to look at a case study, we'll call them family A, as patients of the Families unit at The Cassel Hospital (www.thecasselhospital.org)
Family A Consists of Adam, a 25 year old caucasian male, his 18 year old girlfriend, Anna, her 2 year old son Alex and the couple's infant son, Andrew. At the time of admission into the Cassel for initial "Assesment" Alex had been living in foster care under an interim care order (Childrens Act 1989 Section 31) for eight months, having been removed from the family home under an emergency protection order (Childrens Act 1989 Section 12) After police were called to the family home following a domestic disturbance.
The home was found to be in an appaling state, with refuse, clothing, and toys jumbled across the floor, so much so the carpet could barely be seen. Washing up was piled across every surface in the kitchen, and the 19 month old baby wearing nothing but a diaper in his crib, the rest of the furnishings in the room were an old chair and a plastic toybox.
Assesing the emotional state of both parents and the physical state of the home environment the police concluded that for his own safety the child should be removed from his parents care while further assesment could take place to the ability of the parents to care for the child and the risk of significant harm to the child from the neglect. At this point, Anna was approximately three months pregnant with the second child.
At an initial meeting with the primary social services case worker the next day, the couple were assured that the matter could be resolved expediently, that if the couple made significant efforts over a ten day period to improve the home environment to the satisfaction of the social services team that the child would be returned to their primary care with ongoing assesment and support from child welfare services. A court date was set for a review of the initial EPO and the couple diligently, with the help of friends, family and neighbours, set about making their previously dingy flat into a more suitable environment for a child, including repainting, and attended the court hearing, paint still underneath fingernails, hoping to be reunited with the boy, whom they had only been able to see three times in this period.
Due to the nature of childcare proceedings being closed proceedings, it is both unlawful, and unethical of me to disclose what occurred at hearings to which I was not a party and can have no legal knowledge of events. I can however report the outcome of the hearings.
Instead of being reunited with the child, The court appointed Guardian ad litem acting on behalf of the best interests of a minor child unable to understand complex proceedings or unable to adequately comprehend the possible outcomes, raised in a meeting, concerns for the mental health and stability of the young mother and requested that further time be given for more detailed assesments to be undertaken.
The child remained in foster care, and the couple dutifully appeared in front of a variety of psychiatrists and other "experts" who all gathered a variety of opinions on if there was a mental health problem at all, and if there was, what was it. A loose "diagnisos" of possible Borderline Personality Disorder at a sub threashold level was given and a lot of theoretical and hypothetical scenarios and prognoses were offered before a overwhelmed and baffled 18 year old as a barrier to getting her child back, and also a threat to the child in her womb being able to stay in her care after the birth.
Meanwhile the legal arguements raged on, A mother wept for the absence of her child and a 19 month old met his second birthday in foster care, visits allowed between mother and child just three times a week. And then Anna gave birth to her second son, Andrew.
Despite the apparent concerns over her ability as a caregiver, Andrew was allowed home with the family, with no further precaution than the ongoing involvement of social services, as indeed there could only be with the ongoing case anyway.
The Cassel Hospital was brought up, a therepeutic community environment where the whole family could be together, it seemed to offer everything, Socio-psycho therepeutic counselling, supervised care of the children, an oportunity for the concerned to properly asses the level of care, as well as offer guidance and support, as well as a chance for the couple to prove they were able to take on board the concerns of others and improve the quality of care they were giving the children.
At an inital assesment cost of £72,500 for the family there was a lot of unwilingness on the part of anyone to accept the cost of the potential this unit could offer, but it was eventually settled, with Social Services agreeing to fund the assessment and the family moved to the unit.
Suddenly, two adults and two young children with no recognised or diagnosable mental health disorder were plunged into an apparent disarray of therepy sessions, group therepy, family therepy, parent/child therepy. Reprts where thrown about, aparent contradictory reports. Two things from this I remember Anna saying to me most clearly. The first was, What is it they expect from me, I sit in my therepy sessions and stare out the window, I don't know what they want me to say"
This is essentially the basis of my arguement about the inapropriate nature of this aparently renowned environment. A scared 18 year old young mother of two, fighting against the thing every mother fears the most, losing her child(ren) struggling in an adult world, pressurised by demands to perform to satifaction. How are we helping that mother by sitting her down with a therepist and expecting her to talk, when she fears every word she says will be used to condemn her as a mother, as a parent. How are any of us expected to be able to exorcise our inner demons with that kinds of weight on our shoulders.
Could you open up and reveal the side of you that haunts your dreams if you thought your parenting skills would be determined upon every word you said? If you knew every few weeks your words, or rather an interpretation of your words, would be trotted out in front of a panel of "experts" and used as part of a basis to decide if your child could stay with you? Could you face that pressure now? And could you have handled it at 18?
Or would you sit, silently staring and wonder what it is they wanted to hear from you?
The Second and somehow more poignant comment of Anna's I remember was about her younger son. As she sat with me, talking and crying, she looked right at me and said: "They tell me I don't love Andrew" This shocked me, I know these people are supposed to be experts but I saw Anna with that baby, constantly cradled in her arms, as if she was afraid if she put him down she wouldn't be able to pick him up again, and perhaps in a way, she was right. Watching her with him, feeding him, changing him, singing to him, I did not doubt for even one second that Anna didn't pour all the love she could into that baby. There was none of the weary chore-ishness to the way she dealt wiith him. She loved him, and she cared for him.
But this does raise an interesting issue in my mind. From the time before Andrew was born, Anna knew there was a possibility of him being taken from her care, more or less at any moment. How many of us could form a bond under situations like that? We often hear of parents of premature infants who find it difficult to bond at first, this is natural sellf presservation, we form barriers to prevent being hurt. Yet if Anna was a mother who's baby might die, she would have recieved support and help with forming attachments to him, instead, she was critisised and judged unfit as a mother for the self same natural instict in us all.
Eventually after six months of "treatment" Anna found she was no longer able to cope with the pressure of this "Psycho-therepeutic Community" and attempted to take her own life. She left both her sons with foster carers, took an overdose, crawling underneath the crib in the bedroom that had been her sons, this broken, beaten and shattered young woman of 19.
She was found in time by her father, and at this point, withdrew herself from treatment at the Cassel, subsequently deciding to place both her sons for adoption.
Now my point is (I'm sure I had one somewhere) This may be a bad case in point, but it IS a case, and that's the issue. How was this a more functional approach to reuniting difficult families? What has happened to us as a society that we feel that the magic panacea is a good therepist and the right balance of medication. Why was an 18 year old with, admittedly abysmal parenting skills, but, no diagnosed mental health condition forced into institutional life and broken down to the point she felt her only escape was to take her own life, surely the idea was to be able to better function in the world, not to destroy lives?
What has driven me to this post though, is recently I have been speaking to Anna again, who's life is still marred and haunted by the past. Her general air of such defeat. Somewhere between the fragments she allows me to see I know there is still the steely core of determination I once knew in her, the "I can beat the world" attitude, underneath the layers of worthlessness and degradation enforced upon her by "experts", those who essentially experiment with treatments using people's lives.
What Anna proves to us is sometimes those experiments fail, and these are real lives that are being played with, it's not a statistic on a piece of paper it's a person, who sits alone at the end of it, condemning and condemned, wishing for the end.
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) "no-one else would take this shit from me"
