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    3.no More Gosts partII

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    vilkal

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    © All Rights Reserved
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    of 12
    alone, to @ public ilthe mid-1900s, ‘even for a short >arents, especially awe made him feel ssnew brother that supplanted him in der sister Clarissa new baby’. Why? yishe saw him asa 1 that Jung experi- itisofien atthe cost sachment, and by gree. Typically they care and affection ae adult Jung, But and security as his removed him from It was that over six ehehad to continu- ‘and consequently 1 trait that remained ais frst years under e' like throwing ink 1 him suddenly from Svwrecking his study y are all too familiar EXORCISM OF TRAUMATIC MEMORY IN CHILDREN AND ADOLESCENTS 4 Significant ilnesses and accidents Children who come into the care system will often, a a direct result of either neglect or actual physical abuse, have experienced a disproportionate number of injuries and accidents during their early years. Graves’ experiences were ‘more related to his character and constitution than they were to mistreatment, but nevertheless, hisill luck continued with the curious regularity by which he became unwell, or suffered accidents and injuries. Having recovered from scarlet fever, he contracts pneumonia, then measles (1929, p.234), has @ near miss climbing a quarry face (p35), breaks his two front teeth (p.11),distocates both his thumbs (p.48), breaks his nose boxing (p.10), damages his shoulder at rugby (p.77) and, finaly, is struck unconscious by a rock the size of a cricket ball while climbing (p.60). In one later episode that must be unique in the annals of war, Graves describes how (aged 19) he was talking to the Chief Supply Officer om the telephone in a thunderstorm when the line was struck by lightning, ‘An electric shock spun me round” he notes, ‘and I could not use @ telephone without sweating and stemmering until some twelve years later’ (p.65). In his typically detached manner, he describes this as ‘an inconvenient accident’, But in Fact, his response demonstrates, even before he had arrived in the trenches, how pre- disposed he already was for traumatic reactions to injury War wounds ‘The circumstances surrounding the most traumatic event in Graves’ war are strikingly unusual. But my experience of reading the case histories of children is that almost every child's case has features that are'svikingly unusual’ and itis often to these oddities that one's attention can be best focused. ‘A few days before his twenty-first birthday Graves is hit by a bursting shell (1929, p.181). Apart from superficial wounds he writes that a ‘piece of shell had also gone in two inches below the point of my right shoulder-blade and ‘came out through my chest two inches above the nipple’ (p.181). In the 28 lines that describe his injuries Graves’ prose is precise, pedantic, unemotional, isjointed, full of sides, bracketed information and incidental remarks." This is symptomatic of a post-traumatic response. As Kalsched (1996) puts it ‘In ‘rauma...we see the psyche operating not to link but to de-link ~ to split and disassociate’ (p.66). His inability to access any real Feeling about his predica- ment is aptly demonstrated by the following: 2 For example, he notes how fast he must have been running 10 have avoided emasculation, and how his possession of a book of poems by Nietzsche led his peers to think he might be a German spy. so (CHILDREN AND ADOLESCENTS IN TRAUMA 1 ws semi-conscious now, and aware of my lung-wound through the short- ness of breath. It amused me to watch the litle bubbles af blood, like scarlet soap-bubbles, which my breath made in escaping through the opening in my ‘wound. The doctor came over to my bed I felt sorry for him; he looked as though he had not slept for days. (Graves 1925, p.182) ‘To most of us, Graves’ objective, unemotional tone seems inhuman but itis typical of someone trying to avoid closely identifying with their experience. ‘When Graves first mentions the moment of his severe wounding, a horrific battle in which his battalion lost a third of their men, he doesn’t write that he ‘was shot and badly injured but merely ‘I was one of the casualties (p.180). The repression of the emotional impact of these experiences was to have a lasting effect on Graves ‘Transforming rauma Considered untikely co survive, Graves was lef for 24 hoursin the corner of the dtessing-station among the dead and dying. The next morning the orderlies, clearing away the dead, found him still breathing (1929, p.108). Unfortu- nately, a telegram had already been sent to Graves’ parents reporting their son “died of wounds’ and some time later Graves enjoyed the dubious honour of reading his own obituary in The Times(p.182). So deeply affected by this expe- rience was he that Graves felt he had died, and not died, was alive, But not alive. ‘War had been a traumatic interuption to the continuity of not only social history but also Graves’ own sense of reliable selfhood. By saying goodbyeto all that had gone before, he turned the experience of being shot through the chest into a religious transfiguration, a death and a rebirth, ‘Two images, Bernini's sculpture ‘The Ecstasy of St Theresa’ (1645-52) (see figure 2.1 on p.51) and Ernst Neizvesiny’s more recent ‘The Prophet’ (1966) (see figure 2.2 on p.52), can help contextualise Graves’ experience. In the first well-known image, the flaming arrow striking Theresa represents God's penetrating love. This wound leads to everlasting life. Kenneth Clark (1969) quotes St Theresa's autobiography, at: the supreme moment of her life: how an angel with 2 flaming arrow pierces her heart repeatedly. The pain was so great that screamed aloud, but simultaneously felt such infinite sweetness that wished the pain to las ter- nally. It was the sweetest caressing of the soul by God.” (p.191) In fact, St Theresa mentions being pierced by a ‘spear’ rather than an arrow, As the spear is drawn out of her chest by the angel, t Theresa's entrails were also drawn out leaving her ‘on fire with a great love of God’ This experience of replacement is of central importance: something is removed from the ad through the short- sof Blood, lke scerlet gh the opening in my for him; he looked as 4 ns inhuman but itis vith their experience. wounding, a horrific doesn’t write that he «sualties'(p.180). The ‘was to have a lasting ats in the comer ofthe norning the orderlies, 129, p.108), Unfortu- ats reporting their son he dubious honour of + affected by this expe- was alive, but not alive ity of not only social 3y saying grodbyeto all shot through the chest 3t Theresa’ (1645-52) » recent ‘The Prophet” Graves’ experience. In ing Theresa represents ng life. Kenneth Clark J with a laming arrow hat screamed aloud, but shed the pain to last eter- Bod.’ {p.191) rather than an arrow. As eresa's entails were also sd’. This experience of is removed from the [EXORCISM OF TRAUMATIC MEMORY IN CHILDREN AND ADOLESCENTS 51 subject while something different is left behind leaving the subject changed. Similarly, in “The Prophet’ the figure is either removing or replacing what appears to be his heart, and in this deeply physical moment the figure’s ecstatic Figure 2.1 Bernn’s ‘The Eensy of St Thera’ expression shows that same mental distancing which mightallow for a creative teansformation of the experience. In these sculptures then the metaphorical wounding is also potentially a healing, We might think of Hamlet's There is nothing either good nor bad but that thinking makes it so’, or to bring this concept more up co date and locate it in relevant context, van de Kolk states that ‘A critical variable that determines the long-term effects of abuse or neglect appears to be the meaning the victim gives to the event’ (van der Kolk and Fisler 1994, p.2), Thus painful experi- ences can be creatively transformed into newly relevant and meaningful experience as Anthony Storr exhaustively shows in The Dynamics of Creation (1972) and Solitude (1988). An obvious example of such a transformation might be the liberating identification of traumatised children as ‘survivors! rather than ‘victims’, Represion ‘Throughout his biography, Graves’ declarative memory, his memory for facts and events, is vividly rendered, But he could not, either then or late, recall the 32 CHILDREN AND ADOLESCENTS IN TRAUMA Figure 2.2: Neievesn’s The Prophet’ ‘war in ‘its fall intensity’ (1929, p37), as a felt experience. Much of his subse- {quent life can be read as an attempt to repress and to sublimate that ‘intensity’ into frantic bouts of work, Graves wrote over a thousand poems, 14 novels, 10 translations and about 30 works of non-fiction. Even so, 60 years after World War I, an old man, with no strength leftco resist the repressed memories and emotions, that earlier self began to re-emerge. Initially, Graves suffered ftom ‘flashbacks, unbidden and intrusive memories of traumatic events that many residential care workers will recognise. One account of an intrusive and traumatic memory, striking Graves prior to his mental decline, is given by Cindy Laracuen, the thitd of Graves’ muses, in an interview: In the taxi, he suddenly gave a terrible cry and the driver turned round. His hand was slippery wet. He had just eamembered how he'd been given up for dead in France, He had been thrown on toa cart full of bodies. When he came to, there were all these dead bodies around him. (de St Jorre 1995) Later, such intrusions became a more prominent feature of Graves’ life, until eventwally the impression of being back in France became complete. This was a state of mind in the 1970s and 1980s that remained with him far longer than the actual period of his experiences in France (Seymour-Smith 1982, p.110). States of mind borne out of certain intolerable circumstances cannot easily be exorcised, and this mental regression aptly demonstrates the extent to which ach of his subse e that ‘intensity’ ems, 14 novels, costrength leftto «self began to fen and inteusive re workers will striking Graves tied of Graves’ tured round. His been given up for ies. When he came ve 1995) Graves’ life, until plete, This was ¢ mm far longer than ith 1982, p.110}. s cannot easily be extent to which EXORCISM OF TRAUMATIC MEMORY IN CHILOREN AND ADOLESCENTS 53, ‘traumatic memories, ghosts and nightmares, unless addressed and exorcised, can be carried throughout life Running the gauntlet Children coming into residential care often do so because there are no other 's of facility where they could be safely cated for. The extremity of their behaviour reflects exactly the extremity of the abuses they have suffered. By comparison, Graves’ experiences, though they were unpleasant and undoubted affected him, were artefacts of the period in which he lived. He was not inten tionally neglected or hurt by his parents. What he shares in common with “Tooked after’ children isa lack of containment and continuity in his earlier ‘years, He found it difficult to process and adjust to the amount of change and disruption that it was his fate to beat. ‘The frst key, then, 1 the treatment of traumatised children who live in res- {dential care has to do with the replacement of continuity, the replacement and sustaining of the safe and containing rhythm of natural life, which must also include the rhythm of reciprocal relationships with caring adults. One way to achieve this is by placement in a therapeutic community that uses well-struc- tured group work, including a shared daily routine of regular mealtimes, domestic chores, school, leisure activities and meetings, in which adults and young people come together to discuss and consider events and dynamics that impact on the community as a whole. As Dwivedi (2000) writes, ‘Since most hhuman problems arise in the setting of group life, many can be solved in a group setting’ (p.164)’ Further, given that children have often been excluded from their own communities, therapeutic communities can be thought of as practice communities, providing a multitude of opportunities to be involved in socio- as well as psycho-therapeutic interaction. ‘Yet there are strong tendencies within the care system and within individu- als providing care working against the sustaining of an ordered therapeutic ex- perience for young people. First, we will look at the care system and, second, those providing care. ‘Most of us are familiar with the old military punishment of ‘running the ‘geuntle’. Here the unfortunate victim has to run between two parallel lines of ‘men who viciously strike him, usually with knotted ropes and sticks, The test of courage is to reach the end no matter how bruised or battered. This, one 3 Research comparing outcomes suggests that ‘groups were atleast equally effective, and more economical in two-thirds ofcases making more individual reatment ime far those who needed it p-166). Effectiveness probably hat to do with children pot feeling 50 outnumbered by adults and being able to use the empathy and support of each other. 34 CHILDREN AND ADOLESCENTS IN TRAUMA ‘might imagine, is how the care system might feel to some young people who ‘unwittingly find themselves being ‘looked after. Why should this be so? Often, those who mistreat children do not see themselves as abusers because they resist acknowledging their own traumatic experience, They justify theit actions and thus they cannot take responsibility for what they do to the child. If we think of taking responsibility in terms of responding to what happens, we can see that children have to respond because no one else in their immediate social network does so effectively. Children respond by severe acting-out. Consequently they draw attention to themselves as a ‘problem’ rather than a symptom of the abusers, or society's, problem, On these terms they enter the care system to meet us, residential social workers and other pro- fessionals, who will try to «teat them. ‘What appears to disrupt treatment are the ghosts that are built into the care system structurally of projected into it by children and young people them- selves. For example, Louise Emanuel (2002) describes how organisational dynamics contribute t0 one aspect of children’s deprivation within the care system. She suggests that the primitive defences used by children and their families against anxiety ‘get “re-enacted” in the system by care professionals, ‘who are recipients of powerful projections’ (p-164). Defences such as ‘uncon- scious attacks upon linking’ prevent clear thinking and this in tun prevents the use of referral to outside agencies that might provide valuable support for those ‘working with heavy caseloads. Thus a ‘social services department may then replicate these children’s original experience of neglect, allowing them to fall through a hole in the “net’-work’ [i (p 164). In ecognition of Kasinski and Rollinson’s (2000) attempt to highlight the dilemma of looked afier young people who are ‘beyond the family’ and have ‘no clear clinical category’ that might help to draw attention to their needs, Monica Lanyado (2003) has suggested the term ‘multiple traumatic loss’ to describe what such children suffer. For Lanyado, these early losses are traumatic because they represent the ‘most important relationships in their vul- nerable lives’ (p346). But part of her reason for choosing the term ‘multiple traumatic loss has to do with the care system. She writes that: for most children in care, the ordinary process of time that is needed in order to go through the usual process of mourning, has often also been filled ‘with an accumulation of further losses and changes which it becomes almost impossible forthe child to metabolise. (9.346) During my work st Donyland Lodge and in other children’s services, I had have the opportunity to read in detail the case histories, and particularly the chronologies ofthe large numbers of young people who are referred to us each year. These case histories showed again and again how adverse situations, such as separations, episodes of severe neglect, and often traumatic events, end to ree bei ha be jus asl th ot young people who auld this be so? selves as abusers experience, They for what they doto responding to what no one else in their respond by severe aves as a ‘problem em. On these terms tkers and other pro- re built into the care voung people them- how organisational ‘on within the care {children and their y cate professionals, neces such as ‘uncon sin turn prevents the blesupport for those partment may then lowing them to fall smpt to highlight the the family’ and have ation to their needs, sle traumatic loss’ to ese early losses are ‘ionships in their vul- 1g the term ‘multiple s that: time that is needed in s often also been filled rich it becomes almost dren's services, I had and particulary the are referred tous each {verse situations, such matic evens, tend to EXORCISM OF TRAUMATIC MEMORY IN CHILDREN AND ADOLESCENTS 55 recut, Lucy, for example, who had a history of abandonment and rejection, being sent from one of her parents to the other, was due (0 arrive at the community in a week’s time, She had a clear transition plan including wo overnight stays and a leaving party at her current children's home where she hhad developed significant relationships with two key workers. However, because of miscommunication, Lucy became angry when her mother, who had just sat down to eat a meal that Lucy had made for her at the children's home, was asked to leave. Lucy’s behaviour aftr this incident led to her also being asked to leave the children’s home. From there her social worker placed Lucy in ‘crisis unit. The crisis unit only had a bed for a limited period and so, ironi- cally, Lucy was sent home to her mother’s house despite the difficulties emerging from even planned, supervised contact. From home Lucy arrived at the community with a face painted with make-up and a big smile. She avoided, where possible, interacting with adults but involved herself immediately with other young people whom she felt would be more reliable. ‘Young people living through these circumstances ate likely to develop an uncanny sense that the past is never too far away. Paul Russell (see Guss and Kriegman 1999) suggested that trauma is ‘a disorder in which memory is confused with perception. To whatever degree’, he writes, there has been trauma, itis inappropriately over-remembered and rendered as present experi- cence’ (p3). At its worst, the care system seems to have been designed to encourage exactly this confusion of the past with the present. Multi disciplinary teams replicate families in conflict, shift patterns replicate frag mentation, confusion and loss, reviews replicate arbitrary authority, placement moves replicate mismanaged transitions, assessment and diagnoses replicate jndgement and blame. The model of therapy could be described as one in ‘which healing occurs through desensitising young people by over-exposure to painful familias. (OF course, this view does not apply to the entie looked after children's sector, which includes increasingly rigorous legislation co safeguard children's welfare, and the provision of a number of highly professional and well-managed children's homes. Certainly, within therapeutic communities considerable thinking and energy has gone into, and must continue to go into, modifying the potentially negative aspects of the system so that they remain functional but ate not experienced as repetitious of the past. Lacer, I will explore how these potentially negative experiences can be helpfully modified to this end, Developing sensitivity Having looked briefly a the care system, we now move on to examine the ole of our individual professional involvement. Selma Fraiberg’s chapter entitled 36 (CHILDREN AND ADOLESCENTS IN TRAUMA "Ghosts in the Nursery’ isolates one of the mechanisms of transgenerational abuse, Fraiberg eral. (1980) suggest that what leads a parent who was abused to abuse their own child isthe repression of the affect, or the emotional intensity, connected with their own experience of abuse. Ifthe affect is repressed, it must re-emerge as a ghost, which haunts the child’s nursery. Parents who later allow themselves consciously to experience the emotional pain of their own abuse, on the other hand, recognise their tendency to behave towards their infants as their own parents behaved towards them. Through the acknowledgement of theit own hurt and self-insight these parents strive to protect their children from the experiences they themselves went through. Their awareness of their ‘own potential to abuse becomes a protective factor. Perhaps then, our awareness of our potential to mistreat young people, albeit indirectly though the misapplication of systems devised to protect them, ‘might also be a protective factot. Perhaps we fail to recognise that our own ghosts come to work with us and haunt the corridors of our communities and children's homes. Often, when children change placements or when they begin to engage more fully in therapy, their own ghosts are very much with them, and the effect of this determining presence may be that behaviour spirals quickly into violent or chaotic acting-out. At this point, because of our own fears and concems, staff and caters can begin to believe thet the young person is inap- propriately placed, or needs a higher staff ratio, ora specialist service that the team do not have the required training or resources to provide, or they will fil ‘tomanage the young person effectively, and that the sky is surely falling down, The reference here is to the children’s story ‘Chicken Licken’, because the sequence where Chicken Licken tells his tale to Cocky Locky, Ducky Lucky, Drakey Lakey, and so on, aptly demonstrates the growth of a falsehood, which Foxy Loxy eventually takes advantage of (Dale etal. 1986, pp-42~3). This scenario, and I use the word ‘scenario’ because there is always something ‘dra- matic’ implicit in these events, demonstrates what Andrew West called the ‘ripple effec’, He writes that, afier a traumatic event, the effects of trauma spread out like ripples in a pond, affecting many people in a variety of ways’ (Dwivedi 2000, p82), These effects may be represented in what we rightly call ‘placement breakdown due to acting-out’. But whose acting-out isi? In these situations we can be so terrified about the trauma that seems about to befall us— the trauma of finding ourselves as, at one time or another we have all been, tunable to think, incompetent, inadequate and out of control - that we don’t stop to question the basic assumption —is the sky really falling down? But by staying with and thinking about the acorn (or trauma) that hit Chicken Licken cn the head we might be able to avoid meeting Foxy Loxy. As Louise Emanuel (2002) writes: of transgenerational at who was abused to + emotional intensity, ‘tis repressed, it must rents who later allow ‘of their own abuse, wards their infants as icknowledgement of wrotect their children “ir awareness of their streat young people, ‘ised to protect them, ognise that our own our communities and ‘sor when they begin much with them, and \wiour spirals quickly of our own fears and ‘ung person is inap- alist service that the wide, or they will fil surely falling down, Licker’, because the Locky, Ducky Lucky, afa falsehood, which 986, pp.42-3). This says something ‘dra- ew West called the the effects of trauma in a variety of ways’ 2awhat we rightly call in-out is it? In these nsabout to befall us 1er we have all been, ntrol ~ that we don’t falling down? But by at hit Chicken Licken ¥-As Louise Emanvel EXORCISM OF TRAUMATIC MEMORY IN CHILDREN AND ADOLESCENTS. 57 itis important to recall thatthe heartbreak has alteady happened before the involvement of any other profesional, the catastrophe has occured, in infancy or young childhood, usually within the birth family. This primary heartbreak, like deprivation, enters the care system, impacting on staff throughout the institution. (178) ‘The disaster that carers seck to avoid, sometimes by terminating a young petson’s placement, may be analogous to the catastrophe that occurred years before and led to ther initial entry into the care system. What young people in these circumstances requite isthe rational consideration of their needs. Perhaps the young person's behaviour isa learned adaptation to the family network, «which enabled them to have a measure of control but is mismatched with the cate network. If alternative means of control wete placed atthe young person’s, disposal, would their acting-out be reduced? Or, perhaps the young person is attempting to bring about the end of this placement in order to re-experience and try 10 come to terms with the inital loss of their social and familial networks? Yer such acknowledgements are difficult ro make under the duress of violent and uncontained attack. Russell believes that there is no treatment process that does not include some area of therapy for the therapist, and thus the major resistance t0 ‘treatment is that ofthe therapist, nt the patient. He writes with an honest sim- plicity that: ‘we resist feeling ourselves what things were really like for the patient, We tell ourselves we know their history, but its not possible 0 do this ‘work without resistance against feeling the pain’ (Guss and Kriegman 1999, pp.17-19). However, it is exactly the use and management of feelings or the self-regulation of emotion ~that adults must role model effectively to children. In is Book The Coumage 0 Creat(1975) Rollo May proposed anew kind of physical courage, a‘courage of the body: the use of the body not for the devel- ‘opment of musclemen, but for the cultivation of sensitivity’, what Nietesche called ‘learning to think with the body’ {p.15), Itis such a form of courage that rust be cultivated amongst staff working within residential cate with trauma~ tised children and adolescents. Getting in touch with feelings When children are responding to trauma by acting-out they are also often avoiding their own affect or painful emotions. Thus the second key to the treatment of trauma is to help children find a way to get in touch with painful emotion to which they might rather sty goodbye. The difficulty here is that because in residential care the life of children and adults is so powerfully 38 CHILDREN AND ADOLESCENTS IN TRAUMA interlinked, there is an unconscious, or at least an unspoken tendency to avoid rocking an already unstable boat.* ‘The answer to this problem has something to do with just being with a child, n a dedicated and structured space, whether in a group or an individual meeting. Nothing pacifies our concems about difficult situations more than simply being in them and becoming familiar. Claire Winnicott (1964) tales about children ‘needing the opportunity to see us in action so that they can ‘Weigh ts up...and one day they may have the courage to test us out’ (p.90). She talks about children needing usin their livesas people with whom ‘they do not ‘communicate’ even though this might mean having silent sessions, or activities that place few demands on the child, for example, reading to them, ot watching TY. She goes on: If we can accept thisrole of the person with whom they do not communicate, ‘without seeking to force our way in, then one day the situation could alter, but if we do not put ourselves in this position and contract out, ther is little hhope that it will alter. ‘The notion of contracting out takes us back to the beginning of this chapter and to the importance of rhythm and continuity, of which trauma is a painful interruption, The contract we make with young people in residential care needs to say that we are reliable and even predictable, that we will meet, indi- vidually or as a group, regularly in a pre-arranged place and ata pre-arranged time and for this set activity. The sense of predictability and containment that

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