Making a home in a new family is no small matter. The unconscious ease with which a content mother and her own lively two year old meld bodies and minds as she mediates his world to feed him or limit danger or to extend his horizons, may appear fluid and natural. But as all of us who have observed babies at close quarters know, such a beautiful relationship is hard won. It requires a carer sufficiently free of his or her own survival needs, one whose own psychological development has proceeded in a ‘good enough’ way, and intact healthy brains on both sides. The disposition of carer and infant and the match or ‘fit’ between these two will play a part. The inborn capacity of each to tolerate frustration will be important, and may influence their capacity to repair ‘ruptures’ in a felt sense of attunement. A legion moment-by-moment steps in their psycho-bio-social dance will have to accrue to construct the living dynamic of a secure base. Put in this way every well-attached child is not far short of a wonder. Fostered and adopted children, together with those who have had multiple family losses through violence and conflict, have so often not had the chance to achieve this, and certainly not at the very start when it mattered most. They do not arrive in new families with the happy freight of security, but instead with the vexed baggage of relational trauma.
And so in this special issue we are pleased to present seven papers which investigate and theorise precisely this matter of the struggle to make a home in a new family from multiple perspectives: the internal dynamics of finding or making a home, the powerful emotional effects of caring for emotionally ‘unhomed’ children, our therapeutic technique and our involvement and interventions as a professional group in the UK today. How can we best understand the complex internal landscapes of these unhomed children and how can we best help them become firmly settled within their new families?
Our title for this special issue aims to capture a central theme from all these papers but owes most perhaps to Simon Cregeen’s notion of finding ‘a place within the heart’. We lead with his paper which tackles the difficulties of children who arrive in new families bringing with them internal parental objects that are untrustworthy and abusive. Cregeen argues that the transformation of these to more benign objects requires the new parents to be able to make room internally for the projected parental objects of their adopted children and to receive these with non-judgemental curiosity in order to be able, in due course, to offer a new imagining of the original birth couple from which their children were born. His emphasis on the internal work which may need to be done by adoptive parents and which may need to be facilitated by a skilled psychotherapist is distinctive here, illustrated by his work with a couple who could only begin to fully embrace the children they had adopted once they had first re-worked established fears and defences regarding their own creative capacities.
Joshua Durban’s following paper takes us deeper into the heart of the psychological homelessness and the ‘nowhere-ness’ of his title, on a rich and intense theoretical journey into the workings of these very primitive states of mind. Theory is interwoven with intensely painful clinical material in which we meet a very young boy in a state of almost complete breakdown following a series of traumatic disruptions – suicide, murder, illness – and a father equally traumatised by his own part as a soldier in the conflict which is still being waged about them all. Durban contends that a state of ‘nowhere-ness’ exhibited by this little boy, who initially presents as profoundly autistic, is a consequence of archaic anxieties-of-being that leave him with no sense of himself as a boundaried entity. He draws out the relationship between this and a psychic state of homelessness and offers theory both about the ordinary developmental construction of an internal ‘home’ and the recovery journey through treatment that is offered by the possibility of finding a home for the first time in the person of the psychoanalyst. Despite the horrors inflicted on (and possilbly by) father and son, this is ultimately an uplifting read and timely for those of us working with refugee children who are living, both geographically and internally, so ‘far from home’.
With both Anne Hurley and Monica Lanyado’s papers we are brought sharply into the consulting room with small children suffering in similar ways. Both show us how controlling, appropriating children can be caught up in attempts to avoid dependency by commandeering the other in an omnipotent wholesale manner, behaviour which does not further secure attachment, a sense of home, but rather mitigates against it. Hurley views all this through the lens of narcissism, contrasting the ordinary narcissism of her royal title with the pathological narcissism of a child who turns towards him or herself in the context of inadequate holding as a side-step from loss or separation. Hurley emphasises that babies are, even in utero, relational creatures and it is delightful to read of how a very neglected little girl in foster care, who starts out relating by ‘frantic collision, intrusion, annexation’ can move into a phase of compensatory experience with her therapist and even to some pride in her own development – a return to an ordinary narcissism necessary for a sense of healthy self-worth. Lanyado’s work is well known to many and it is perhaps no surprise that in her paper she encourages us to notice and give weight to signs of developmental growth in our young patients, even when this may mean altering established boundaries. There is an important discussion here about the place of kindness and acts of kindness within a therapeutic relationship which echoes Durban’s earlier advocacy of ‘reparation in action’ as a therapeutic tool. Lanyado makes a case for moving beyond only voicing the truth of what ‘should’ have occurred for the traumatised child to co-constructed transitional phenomena that each have powerful compensatory and developmental aspects. In terms of our theme, that of making a home in a new family, it is our capacity as psychotherapists to notice when a previously ‘unhomed’ child is on the cusp of this ‘putting down roots’ that is key.
The two papers which follow these are lively explications of qualitative research investigating the emotional experience of those caring for children who have to move to try to make their home in a new family. Gillian Sloan Donachy’s research analyses her interviews with a group of carers who have had to give notice on very young children whom they had fostered and pays especial attention to the finding that many described a loss of their own sense of identity under the stress of the children’s unrelenting behaviour. She makes the case that without a reflective space within which to understand and contain the powerful projections being enacted by these very traumatised children, paranoid-schizoid perspectives dominate. What comes across so painfully is that these children remain ‘unhome-able’ not because they are not offered committed thoughtful and loving carers but because their internal landscapes are full of the unreliable and abusive parental objects that Cregeen writes about.
Sophie Boswell and Lynne Cudmore bravely invite us to consider the ‘blind spot’ in the human systems around children who are leaving foster carer for ‘forever homes’ with adoptive parents. We hear directly from the foster carers and adoptive parents on the matters of both their own feelings about moving the children and, most significantly, what they believe to be the emotional experience for the child. Boswell and Cudmore hypothesise convincingly about what is being avoided by the adults all agreeing that ‘the children were fine’ and draw robustly on the attachment literature to evidence what we can know are likely to be the emotional consequences for the children who are moved. They are uncompromising in their advice about what skilled support should be offered all round to enable parents and carers to stay alive to the emotional experience of the child before, during and after a move of home, despite apparently compliant behaviour.
Our final paper, a report on a national survey of how UK child psychotherapists are involved with Looked After and adopted children, is a worthy companion at this point. A timely piece, by Fiona Robinson, Patrick Luyten and Nick Midgley, their report blends statistical findings that collate how many of us are working with these children and what kinds of interventions we are offering as a professional group, with narrative responses regarding our thoughts and concerns about how we find ourselves having to approach work with this cohort of often very distressed and unwell young people. It is hoped that the ‘hard fact’ in the details may be of some help for child psychotherapists who have a role in creating or commissioning services whilst the narrative conclusions may spark future research projects to evidence the conclusions we draw from our clinical experience. The Research Digest follows, on the allied theme of relevant research in the field of Looked After and adopted children, gathering abstracts on a variety of studies investigating treatment approaches and clinical experience in the field. Within this issue we are also pleased to be able to offer a series of book reviews of books on diverse topics including the therapeutic imagination (Jeremy Holmes), a new book on understanding the work of Melanie Klein (Margaret and Michael Rustin) and the practice of parent–infant psychotherapy (Tessa Baradon and Michela Biseo).
Reading the collection in its entirety a disjuncture in our thinking comes shamefully into focus. Whilst abandoned dogs are routinely ‘re-homed’, our un-homed children are only ‘Looked After’ and, when things go wrong, become subject to a ‘placement move’. It seems we can bear to understand that a dependent, possibly traumatised, pet will be needing a new home yet as a society, even as a self-identified caring society, we appear collusively adept at avoiding the reality that a human child is having to make a new home, usually with no choice in the matter and often with little time to accept, negotiate or digest the impact of the transition. Perhaps, unconsciously aware that home is so much more than the place or even the people, that home is an aspect of attachment, co-constructed between dependent players in the crucible of early relationships, we are loathe to acknowledge the inherent emotional cost and the potentially enduring impact for those who are our own home-grown refugees. The collected papers of this special issue encourage us as psychotherapists working with children to keep our eyes fully open to the internal worlds of those who are trying to find their way in a new family and, we hope, offer readers a wealth of perspectives and inspiration as to how we might wish to go about it.
Note: We are grateful to the group of authors whose agreement to delay hard copy publication of their papers has allowed this collection to be drawn together into one issue. These include: an updated review of the evidence base for child psychotherapy co-authored by Nick Midgley, Sally O’Keeffe, Lorna French and Eilis Kennedy; a piece by Sheila Levi in which she writes about the use of psychological testing to both advocate for and further the therapeutic work with a young autistic boy; a paper by Peta Mees exploring and delineating the state of mind assessment. Readers are encouraged to look out for these which will be published online concurrently, followed by print later in the year. Going forward we anticipate special issues on themes of gender identity, on work with refugee children, on trauma and dissociation and on the impact of the new technologies and would especially encourage submissions on clinical practice or research in these areas.