I’ve always felt that these young people don’t stand a chance in life, there are massive stumbling blocks along the way…
This is a response by Kate Wells to the recent article by Louise Tickle in the Guardian on April 25th 2015. Kate is a retired social worker of many years experience. She agrees that more needs to be done to help young parents who have suffered abuse and trauma in their own childhoods – but she is not optimistic that therapeutic intervention will be the solution that some hope for.
I read the article in the Guardian on Saturday “Are we failing parents whose children are taken into care” and the concern expressed by Judge Stephen Wildblood QC and barrister Judi Evans, about the lack of help for parents caught up in care proceedings.
For very many years I have worked with people who live on the margins of society and are amongst the most deprived and disadvantaged people in society. I’ve met many “Leahs” who have suffered childhood trauma, be it sexual abuse, physical/emotional abuse or severe neglect and are ill equipped to provide good enough parenting to their own children – it’s often a case of “children bringing up children” as there is a significant gap between the chronological and emotional age of these young mothers. Typically they form relationships with young men with similar backgrounds and end up in a high rise flat, experiencing a range of difficulties – financial problems, mental health problems, learning disabilities, domestic violence, isolation, lack of support, drug/alcohol abuse etc.
I’ve always felt that these young people don’t stand a chance in life, there are massive stumbling blocks along the way and it’s small wonder that apathy sets in and they look for some relief in drugs/alcohol. And as the article highlights when one or two of the children are removed, they become pregnant again, and are involved in “serial monogamy” which is an added problem as now there are “step children” in the mix.
How easy is it for people to change?
Why ‘love matters’ – the importance of the early years
I share the concerns of the Judge and the barrister but I suppose I am not as optimistic about the possibility of change, especially when childhood trauma is the root of the problem. I too have read many psychological reports talking of parents needing therapy for 2/3 years whatever…..and I’ve always felt that was a cop out as any competent therapist will know that it could take many more years of therapy with no guarantee of sufficient change to enable good enough parenting, plus there is the issue of cost, with private therapists charging approx. £50 per hour and very little available on the NHS.
The thing is I have an absolute belief that the die is cast very early on in life, and right from the child’s earliest hours, days, weeks and months, the foundation will be laid, positively or negatively and the first year of life is of extreme importance developmentally, and by 3 years of age, the foundation is laid for the rest of the child’s life.
There is even evidence that a baby in utero can be affected by tension in the mother, domestic violence etc. Sue Gerhardt a psychotherapist whose work has been primarily concerned with working with the disturbed or malfunctioning relationships between babies and their mothers, explains in her book “Why Love Matters” the way in which there is evidence that the quality of care a baby/child has in its early life can affect the pathways in the brain, and the development of our “social brain” and the biological systems involved in emotional regulation.
The challenge then was for her to put this scientific knowledge of human infancy at the centre of our understanding of emotional life. Most importantly and of particular interest in the debate about the success (or otherwise) of therapy for parents struggling with providing good enough care for their babies, her research led her to the view that if the will and resources were available, the harm done to one generation may not be transmitted to the next: a damaged child need not become a damaged and damaging parent.
Gerhardt acknowledges that well intentioned governments have recognized the need to support family life, and have put measures in place to do so, e.g. tax credits and parenting classes. She stresses how politicians are well aware of the cost to society of dysfunctional families with the links to crime, violence and drug abuse. She uses the analogy of meagre efforts of support to families, to pouring money into the maintenance of a badly built house, the problems due to poor foundations may be temporarily alleviated, but nothing will change the fact that the house was not well built and will always be high maintenance. Likewise with human beings whose foundations have not been well built. Although extensive repairs can be undertaken later in life, the building stage, when adjustments can be made, are largely over. For prevention to be effective it needs to be targeted at the point when it can make the most difference.
Can later intervention have an impact on early deprivation?
To return to the issue under debate – “These foundations are laid during pregnancy and in the first 2 years of life. This is when the “social brain” is shaped and when an individual’s emotional style and emotional resources are established.”
Exactly what resources would be needed to provide parents with the “therapeutic tools” to ensure that they understood the importance of the need for a pregnancy free from tension and stress and how to make secure attachments with their babies in their first 2 years of life, is not detailed in Gerhardt’s book. I think she has made some remarkable discoveries in relation to how the development of the infant’s brain can affect future emotional wellbeing, backed up by the latest findings in neuroscience, psychology and biochemistry, but I remain skeptical about both the specific resources that would be needed and more pertinently about the availability of funding for such therapeutic intervention.
The parents (like most of us) only have one model of parenting, which was abusive/neglectful and so will repeat that pattern with their own children, just like people who have had a secure and nurturing childhood will repeat that pattern with their children. I don’t mean that every abused child will go on to repeat that pattern as some parents ensure that their children do not suffer as they did, but we are talking about parents and children caught up in care proceedings.
We’re talking of course about the “cycle of deprivation” and no one has ever found a way of breaking into that cycle. I am old enough to remember Keith Joseph (Tory Minister of State for Education and Science) horrifying us all in 1974 by declaring that “classes 4 and 5 should be prevented from breeding.” The present government talks of “troubled families” but this is a euphemism of course, as families in receipt of state benefits are referred to as “benefit units” in Universal Credit speak, but I digress………
The true cost and consequences of childhood trauma
I realise I might sound like a “fatalist” but I don’t believe that therapy can in fact help the majority of parents who have themselves suffered childhood trauma – indeed I think the Judge’s comments about a parent being offered therapy at the beginning of the pregnancy (or when one or more child/ren have been removed) demonstrates a complete lack of understanding of just how much emotional harm has been inflicted on the young parent in their own childhood, and how that continues to cause emotional pain through the lifespan.
None of us can know how it feels – we can only imagine, but I have spent many hours sitting in smelly, grubby flats with a young mom who is mildly depressed, she hates the flat, she and the boyfriend are arguing, she has no money, there’s little food in the kitchen and the toddler lies listlessly on the floor sucking from a bottle, the TV is on and an older child of 3 or so is staring vacantly at the screen and when bored, starts to tussle with the toddler and is dragged off by his mom and shouted at – he starts to cry and throws himself on the floor and she tells him to shut the fuck up…..there are a few broken toys and the situation is indeed bleak. The children are still at home but there is growing concern and if eventually they are removed, will she benefit from therapy to help her keep any more babies that she will have. Maybe, but I think the “damage has been done” many years ago and like “Leah” she will carry that emotional pain with her, and prevent her from being a good enough parent or being able to sustain relationships and have any kind of fulfilling life.
What can we do?
Having said all that I certainly think the FDAC is an excellent idea. I am really surprised that a Judge has set this up and another Judge is replicating the programme elsewhere. Are they human after all!? Judi does make the point of course that not every parent will be able to access any therapy that is set up, but if it means that some parents can be helped to prevent their child being removed, then it has to be a success.
I think another way of helping young parents is for LAs to recruit and train more foster carers who are able to take “child and parent” placements. We had just 2 in our area and were carefully chosen, as they absolutely had to have empathy with the young parents, empathy in spades, because any whiff of judgment or even criticism would defeat the object. There was a varying degree of success, but the resources were not available to extend the scheme and this was back in 2000, before the budgets were cut to the bone.
But who will pay for it?
There is also the issue of finance for therapeutic intervention as advocated by the Judge. I wonder if he is aware of the way in which this coalition has demanded massive savings from all public services (including legal aid) so this can’t have escaped his notice! There was never sufficient funding for therapy when I was working for the LA (and retired in 2004) and now they are struggling to cope with their statutory responsibilities, as are the NHS, police, teachers etc. And if this government are re-elected they will shrink the state to the size it was in the 1930s and will pursue their agenda of privatisation for all public services, whilst cutting more and more from benefit claimants.
There is mention of “Leah” being left without support, and only offered a room in a hostel, but again Housing Authorities under the Housing legislation have no duty to house single homeless people and demand for housing far outweighs supply, and so where does the blame lie? With politicians who make the law surely. I don’t suppose there are many Labour voting Judges, or barristers for that matter, though that may be unfair.
I really will end now……..be interested in your thoughts.
Further Reading
You may be interested in reading further about the research of Karen Broadhurst, funded by the Nuffield Foundation which looks at the issue of mothers who have successive babies removed from their care. This is known as ‘recurrent care proceedings’.
The website for the study is here. The overall aim of this study is to generate evidence to inform service development in respect of the timing, content and mode of delivery of services designed to intercept a cycle of recurrent care proceedings. Further quantifying recurrent care proceedings at a national level will also provide policy makers with the necessary data to enable the economic costs of this problem to be estimated.
Your article is good at explaining the enormous difficulties in engaging mothers in the course of therapy they might need. This type of therapy is really only available to people who fund themselves and, invariably, there are always uncertainties about how it works in practice and how long it takes.
However, I was surprised at the way you used the arguments from Sue Gerhardt to justify early intervention. Her book has obviously had an influence on social work practice. Unfortunately, there is a curious absence of any ethical debate about the shift towards more decisive interventions and the social work process becoming more legalistic in recent years. I feel that more attention should have been given to the difficult philosophical questions about parents’ rights when policy changes were introduced. After all, theories from neuroscience that the child’s brain pathways being fixed by the age of three, and unchangeable, are no more than theories.
The conspiracy of silence about the ethical dilemmas means that the only debate that takes place is about children’s rights vs parents’ rights. I think it is much more complicated than this and touches on difficult questions about how much state intervention in family life is acceptable, and what is meant by the welfare of the child. Part of the problem is that the term ‘safeguarding’ has been used to mean whatever professionals want it to mean and this cannot be challenged because we are all in favour of the ‘safeguarding children’.
Thank you for your comments Hilary. I am still trying to find my way around the CPR website! I’m not altogether sure I follow your last 2 paras, relating to my comments about Sue Gerhardt’s book. I wasn’t really using Gerhardt’s work wholly and solely to “justify early intervention” – rather that her findings added to the body of knowledge about attachment theory and the importance of a secure attachment pattern forming between mother/father/caregiver and infant right from the first hours, weeks and months of birth if the child is to thrive and fulfil his maximum potential in life. I seriously doubt that Gerhardt’s book has had any influence on social work practice; I am a retired social worker/manager and certainly wouldn’t have had the time (or if I’m honest, the motivation) to read this book and I know that in the intervening years between my retirement in 2004 and the present time, the workloads of social workers and managers have become unmanageable. I have read your profile and note that you experienced this kind of situation in the 90s and so will be well aware of the stress that work overload causes.
Why Love Matters explains why loving relationships are essential to brain
development in the early years, and how these early interactions can have lasting consequences for future emotional and physical health. This second edition follows on from the success of the first, updating the scientific research, covering recent findings in genetics and the mind/body connection, and including a new chapter highlighting our growing understanding of the part also played by pregnancy in shaping a baby’s future emotional and physical well-being.
Sue Gerhardt focuses in particular on the wide-ranging effects of early stress on a baby or toddler’s developing nervous system. When things go wrong with relationships in early life, the dependent child has to adapt; what we now know is that his or her brain adapts too. The brain’s emotion and immune systems are particularly affected by early stress and can become less effective. This makes the child more vulnerable to a range of later difficulties such as depression, anti-social behaviour, addictions or anorexia, as well as physical illness.
The above paragraphs are of course “lifted” from the back of the book but the important issue I think is the fact that “when things go wrong in relationships in early life, the dependent child has to adapt too” and the theory of attachment helps us to understand the sorts of adaptations a child will make in any given situation in order to keep themselves safe and so form different patterns of insecure attachments, e.g. avoidant, ambivalent and sadly there are situations in which the helpless child cannot adapt his behaviour because of the extreme abuse or neglect he suffers and is therefore diagnose as having an “attachment disorder.”
As I understand it Gerhardt has evidenced that changes in brain pathways in early life can have a lasting effect on future emotional and physical health, but certainly does not present a case of the child’s life chances being fixated and for change to be impossible. There are many children of course who will make successful adaptations to enable them to survive in an environment that is not particularly child-centred and nurturing, and in my view these children (in the words of a Sir James Munby in a recent Judgement will receive “sub optimal” care) which he asserts is “good enough” – and I wonder how deep the murky waters of “sub optimal” care have to go before it becomes “significant harm”
and then of course what is meant by “significant harm” – or what is meant by “safeguarding” is the question you pose. I think this is less complicated to define – as in keeping a child safe.
I agree it is a valid point that we need more and better information about the neurological implications of ‘bad parenting’ – I don’t know a huge amount about it but I am aware that there have been criticisms of Gerhardts work as lacking a proper evidential basis.
I am a parent in this situation. I cannot access the therapy as the NHS does not have the resources. I have had an NHS psychological assessment, the only finding was PTSD caused by events in my adult years not my childhood rather than the condition the court expert labelled me with. So I will never get the court ordered therapy. The expert who was a nearly retired man Indian origin, which is a fact ;not a racist remark, had extremely limited understanding of domestic violence, the law around it in the UK and how a victim would present. He did not even mention the possibility of PTSD.
I admit I was vulnerable to this type of abusive relationship. I have myself accessed a considerable amount of resources and now see what happened clearly. I am no longer vulnerable. My emotional maturity is certainly more than 3 years old. I think it is rot that people cannot change, they can with the right support and if they are prepared to.
We have an extremely unequal society, and to some extent society is responsible for family failure. For instance I tried to ask for help from various authorities including the police for a number of years. After the last incident the police did not check their database before releasing the offender , conduct ABE interviews nor did they record the physical evidence which included my back door being forced. Just look at Oxford and Rotherham if you want to say that society does not fail and it’s all down to personal responsibility. I would suggest that not all parents in care proceedings are beyond help, resources need to be in place. As for the cost , it actually costs on average around £36,000 per year to keep one child in foster care, how can that be cheaper than actually helping a family stay together?
I have read the judgement, and the judge rightly flagged up concerns about the system. A person does not choose to be be born disabled,black or gay and in theory at least discrimination is unlawful. Why is it lawful to take discriminate against someone because they are too poor to afford therapy ?
Well there’s the question. I have asked in another post if this can be lawful – it certainly doesn’t seem to sit well with our Article 8 obligations to take positive action to keep families together. As ever, the answer is money. Therapy is unlikely to be a quick fix solution for ingrained problems. Therefore it is going to be a costly intervention. Probably not as costly in the long term as NOT helping, but thinking long term doesn’t seem to be an ability our politicians have.
I have just read your response to my post ANON and am in agreement with you on most of the issues you raise. I think there is a world of difference between sustained childhood trauma and trauma experienced in our adult lives. In your case it seems you are talking of being the victim of domestic violence. Do you mind revealing that “condition” with which you were labelled by this “court expert” who had no understanding the effects of domestic violence on a woman. It is unbelievable that he did not consider that you would be likely to be suffering from PTSD.
You are obviously a woman with a great deal of insight as you mention that you have an awareness that you were “vulnerable” to this kind of abuse, and presumably you know the roots of that vulnerability. Sometimes it’s simply a case of extreme naivety isn’t it – at aged 22 years I married a man who was physically abusive to me. I had led a rather sheltered life with nurturing parents and was possibly over protected. I thought all men were like my father and of course soon found out that this was not the case, and was able to break free and later get a divorce.
I am so glad that you are now emotionally stronger than you were in the past though I think we are all vulnerable to a greater or lesser extent in certain situations – it’s part of the human condition I think. I seem to have given completely the wrong message in my post about this issue of the “foundations for life being set by the age of 3” and of course you are no longer functioning like a 3 year old (!) and I absolutely believe many people can change so long as the motivation is there, the person has some insight into their past difficulties and some ideas of the root cause, and there is the right support, as you say. I’m sorry if I gave the impression that life was “set in concrete” at 3 years! I was trying to point out that the “foundations” for life are formed in those early years, positively or negatively, or maybe somewhere in between. When we talk of “our past” it can mean childhood but it can also mean what happened yesterday, or last year, and in your case you obviously suffered trauma in your adult life. Maybe the “foundations” that were laid in your early life gave you the emotional resilience to finally break free of the abusive husband/partner.
I am in total agreement with you about the inequalities inherent in this society. There is a myth that we are born with equal opportunities and this is so transparently not the case isn’t it, and in a capitalist society like ours, the most deprived and disadvantaged people in society are pushed out into the margins of society and life is a constant struggle. I have spent many years as a social worker attempting to help such families, but all that was ever achieved was “papering over the cracks” because the odds are stacked against people from the word go……….I think I made this point in my post.
I think this issue of the police not taking reports of domestic violence seriously has always been the case, but at least there is now more media focus on this failure, especially with the Oxford and Rotherham cases that you mention. There is also more media coverage of women who are murdered by their husbands/partners even though they have reported “threats to kill” and domestic violence repeatedly to the police. It is a sad fact is a so called civilised society that still 2 woman a week are murdered by a partner/husband. Beyond shocking!
I totally agree that wherever possible parents should be offered help to overcome their difficulties in order to prevent care proceedings in the first place or as the Judges and barristers are now recommending to prevent permanent removal of their children by adoption. The point I was making in my post was that sadly for many parents they would not be able to make use of “talking therapy” for all the reasons I outlined in my post. You are clearly someone who could make very good use of therapy and of course the funding should be there for you, and possibly many others in your position. The thing is LAs are desperately short of money because the govt have demanded massive savings in the budgets of all public services, to the extent that they are having to make all kinds of cuts in service delivery, and in the worst cases are unable to carry out their statutory responsibilities, and so I know that there is just not the funding available for therapy for parents caught up in care proceedings. I put the blame fairly and squarely with the govt and I fear the situation will worsen over the next 5 years as they pursue their privatisation agenda.
It seems your child/ren was removed from you? If so is there any possibility of a re-unification.
I don’t know if you’ve ever heard of EMDR (you’d need to google) it’s a therapy that is particularly effective for PTSD and I’ve heard many people speak very highly of it. Apparently this therapy differs significantly from conventional psycho-dynamic therapy which makes links with the past and present and people are encouraged to talk about their past trauma, which in some cases makes things worse. I don’t know exactly HOW this therapy works, but it is apparently quite speedy and effective. Another therapy I’ve heard of for PTSD is “re-wind” therapy which I think is similar to EMDR.
I have just noticed this http://www.marilynstowe.co.uk/2015/04/30/cost-of-care-system-reaches-3-5-billion/ . I actually was wrong about the cost of care it appears to be at least £40,000 per year per child. So the money is being spent perhaps just not in the right ways. ” A stitch in time saves nine”
Just a suggestion but how about every family that is troubled or however you want to label them being allocated a pot of money , I am sure it would be far less than £40,000 and intervention to help them being funded from that. They could even be empowered by including them in the process. It is after all how you would treat someone with a physical problem. Perhaps local authorities could then receive a bonus for every child diverted from care proceedings. I think Ian Forced Adoption would like that.
Thank you Kate for such a detailed and sympathetic reply. I am supposed to have a personality disorder according to the court expert, so two to three years of therapy. I can see some reasoning behind this, however there were considerable problems with the court process which lead to a distortion of facts.
When I finally saw a NHS psychologist , I told her that I had a personality disorder and after a two hour assessment ,she said I had PTSD. I have now been on a waiting list for 11 months. I am unlikely to be seen as she told me the service was being cut back. In my area unless you are a serious suicide risk you rarely get to see either a psychologist or a psychiatrist for treatment.
Like yourself I am a DV survivor and I definitely was too trusting and lacked self esteem! I have not had a chaotic lifestyle until I was involved with my partner . Interestingly his childhood had been chaotic in a number of ways.
I have accessed a voluntary peer support group, alongside other courses and that has given me great insight and tools . I do wonder if peer support could be explored as an option, it is after all a relatively cheap therapeutic tool. I cannot say what type of support on a public forum, but I would be happy talk privately if you are interested. I am happy for Sarah to pass on my email address.
Hello again “anon” – Personality Disorder is very much a “catch all” diagnosis I reckon and should only be diagnose by a consultant psychiatrist – it’s generally known as Borderline Personality Disorder, but more recently seems to have changed to Emotionally unstable/intense PD (as seen as less stigmatising) but the whole issue of MH is stigmatised as far as I’m concerned.
I’m was wondering if you were doing the “Freedom Programme” though don’t know much about it.
Yes happy for you to pass on your e mail address via Sarah.