The following are: (a) a letter from Deanna Whitworth to Tracey Green in which, at Tracey’s request, she has put together her thoughts about this family, and (b) some notes that Tracey has put together to collect her thoughts about the family prior to a supervision session.

Deanna’s letter:

Dear Tracey, Thank you for asking me to put in writing some of my thoughts about the Veloso family. Just to be clear, I have discussed all of the following with Estrela, as I like to be completely open with my patients about the information I am sharing about them.

As you know, Estrela is an immigrant to this country from Portugal. She came here nine years ago to work in the airline catering factory where she met Charlie, the father of Xenia, a Brazilian man who she had a relationship with, on and off, over four years. He was violent and abusive, she says, and eventually she managed to split up with him. He subsequently returned to Brazil before Xenia was born, and Estrela does not know his current whereabouts.

When she was with Charlie, who was very controlling, and did not like her socialising outside of the home, she learnt very little English, but her English is excellent now, although she herself is very modest about this, as she is about most things, and says that her English is terrible. She met Pedro two years ago when he started working at the plant, originally also as a packer but then as a forklift driver. As you know Pedro is 12 years younger than her, something Estrela’s family in Portugal very much disapprove of, but, as Estrela says ‘Love is love’.

What I want you to know is that Estrela is an amazing woman. She struggles with a profound clinical depression that has required hospitalisation on three occasions, and has resulted in several suicide attempts. Medication helps but it doesn’t fix the problem, and she goes through periods when just to get out of bed in the morning at all is a huge challenge. She also struggles with feelings of worthlessness and self-hatred that go back to a very unhappy childhood in rural Portugal with a violent and abusive stepfather, and an emotionally cold and unavailable mother. But underneath all this she has a tremendous spirit, and is funny, feisty and irreverent. Pedro and Xenia adore her and she adores them. She would do anything for them and they know it. She lives first and foremost for Xenia. She has told me many times that Xenia is what keeps her going during the dark times.

Pedro is a sweet guy and has a loving relationship not only with Estrela but with Xenia. As I mentioned, he is a lot younger than Estrela and freely admits that he is still ‘a bit of a child’. (Estrela sometimes says, usually with a smile, that she feels she has two children not one.) But Pedro adores Estrela and Xenia. It is true as you say that he is out a lot. He is part of a football team made up of young men from the local Portuguese and Brazilian communities, and spends a lot of time with his team mates, playing football and socialising. And, yes, several times a week he does not come home until late. He’s not good with other people’s distress. He finds Estrela’s depression very difficult to cope with, and this is how he manages. He also goes back regularly to his family in Portugal: he is the youngest of four and is very close in particular to his mum. Yes, it would be great if he spent a bit more time at home and a bit more time with Xenia, but he is who he is, and, though he has his limitations, he is also a warm, funny, lively guy, who provides for his little family and is much loved by Estrela and Xenia.

You are concerned that Xenia does rather more to help her mum at home (like fetching things, tidying and preparing snacks) than most primary school kids would do. I’m sure that’s true, but I have to say that I visit many parents with mental health problems, and of course their kids worry about them and try and help them more than kids would do whose parents didn’t have those challenges. I don’t think this means their parents are necessarily exploiting them or misusing them. Surely it is natural for members of any loving family to notice each other’s needs and to try and help out?

I was sorry to hear, when you first got in touch with me, that Xenia had missed several days of school this term. I spoke to Estrela about this two weeks ago, and she gave me her word that she would not keep Xenia off school again, unless Xenia herself was ill. Unless you tell me different, I believe she has been attending regularly these last two weeks? (By the way, it’s obviously not an excuse for keeping Xenia back from school, but Estrela is concerned that Xenia is getting teased and ostracised at school, for being a foreigner, and for having a mum who is (Estrela’s words) ‘a nutcase’. Maybe some work is needed with the school?)

I do not think, as you seem to do, that there is any evidence that Estrela may be unable to provide Xenia with adequate parenting. In fact, in my opinion, Estrela is a great parent who loves her daughter deeply. What is more, if she lost Xenia she’d lose her entire reason for living. I really do believe that Estrela would not survive such a trauma (and that is the view of her psychiatrist also). But, be that as it may, it seems to me that the problem here is not really Estrela at all but (a) the depressive illness which is outside of her control, and (b) the fact that she is not provided with anything like enough support. Neither of these things are her fault, any more than it would be her fault if she was physically disabled or had a physical illness. Would we be questioning her parenting if she was sometimes confined to bed by some kind of physical illness?

My suggestion, therefore, is that we stop discussing whether or not she is a good enough parent, and instead start talking about the support she needs in order to be able to parent as well as she desperately wants to do.

Yours Sincerely, Deanna Whitworth, Community Psychiatric Nurse.

Tracey’s notes:

(She’s written them to gather her thoughts prior to talking about the case with her supervisor, Jeff. She knows these notes are too subjective to put on the file, so they’re for her own eyes only, and she’ll put them through the shredder when she’s done.)

I feel very worried for Xenia, but I’m rather confused about my own feelings about the case: (1) because of the very different perspective of Deanna, Estrela’s CPN, an intelligent, confident woman, whose experience I respect and who (I have to admit) I find a bit intimidating and also (to be totally honest) just don’t like all that much, (2) because there’s nothing very specific to put my finger on, (3) for some reason (which I also can’t quite put my finger on!) I’m finding all this very upsetting and can’t seem to stop thinking about it. I feel like there are undercurrents here which I can sense, but don’t fully understand.

So here goes. I’ll start with my worries about Xenia. Her teacher reports that she is difficult at school. She doesn’t fit in with the other children. She is loud and aggressive with them when they don’t want her to play with them, and of course this makes them even less likely to want to play. She can be spiteful. She’s never really to be seen just playing with other kids, but is either on her own, or on the fringes of groups who are trying their best to ignore her. In class, she can be disruptive, refusing to sit still, or be quiet, or loudly complaining about other kids: complaints which, as far as her teacher can tell, don’t seem to have much basis in fact. She’s also been caught stealing from other children several times: coins, small possessions and food.

One reason she steals food may be that she absolutely wolfs down food at lunchtime, and she’s had to be told off a few times for snatching food from other kids. Her teacher has the strong impression that she doesn’t often get breakfast before she comes in. (Xenia denies this, but is very vague and sometimes contradicts herself when asked about what she’s had to eat.) On several occasions she’s come in with her clothing put on incorrectly – a T-shirt inside out, a cardigan buttoned up the wrong way – as if no one was there at home to point out her obvious mistake. She missed 17 days of school last term (I think Deanna is underplaying this a bit when she describes this as ‘several days’!! That’s about 2 days out of every 5!). Her non-attendance is due, as far as I can tell, to some combination of Estrela not feeling up to bringing her in (Pedro leaves for work too early to be able to help), Estrela wanting company, and Xenia begging not to have to go (all three explanations were offered to me in the course of one interview).  Estrela also says Xenia is bullied at school for being foreign (seems unlikely as more than half the kids in the school are first or second generation immigrants, including a good number of Portuguese kids), and (which is possible) for having a mother with mental health problems. She gets into fights with Josh Harris, another kid who tries to get attention by throwing his weight around, but whether this is him bullying her, or six of one and half a dozen of the other, I’m not sure. He does tease her, apparently, but of course Josh’s mum (see Case G: Dudley/Harris family) also suffers from depression.

I can’t get much out of Xenia herself other than monosyllables and shrugs. On each occasion she’s been watching TV when I arrived, and I’ve had to ask her to turn it off. She has a flat and affectless manner with me, but I notice that, even before giving me a yes or no answer to a question like ‘do you get ill a lot?’ or ‘are you enjoying school?’, she will always look across rather anxiously at her mother so as to read her mother’s expression before answering. I’ve tried to talk to her when her mother isn’t in the room, but she doesn’t really open up then at all.

Her mother acknowledges that Xenia is her ‘little helper’ who she sends to fetch things for her. The first time I visited, Xenia sent her to make me a cup of tea. When I questioned whether it was a good idea for a six-year-old to make hot drinks, she told me we Brits were obsessed with health and safety and where she comes from, children were treated as competent human beings.

Estrela has always been reclining on the sofa with a blanket on each of the three occasions I visited. She’s rather overweight and smokes a lot. I can’t say I find her funny or irreverent in the way that Deanna describes, but I guess that’s because I have a different relationship with her. I did sense hostility though. I sensed a determination to give me the barest minimum she could give without actually being overtly rude. Not such an unusual response, I have to admit, and you can understand it when you think about what it must be like to be a parent receiving a visit from a social worker, but she very definitely gave the message that I was poking my nose where it wasn’t wanted.

Her depression was certainly evident. There was a real bleakness about her, a kind of despair even, as if she’d seen right through life. I also found her rather cold: cold when she talked to me, and cold when she addressed Xenia. At one point, tears came into her eyes when she said she couldn’t bear to be parted from Xenia but – and this may well be unfair – it seemed to me that this was all about self-pity rather than about what Xenia herself might or might not need.

As to Pedro, well, again I’m not quite seeing the ‘sweet guy’ that Deanna describes. I only managed to see him at all on my third visit, although on both previous occasions I’d been told he’d be in, and had specially visited in the evening so as not to miss him. On the second visit, Estrela told me he might have stayed away because his English wasn’t very good, so I sorted out an interpreter for my third visit, and really pressed Estrela to give me a time when he’d definitely be there. This was 8pm, – pretty late for a home visit – and when we arrived he still wasn’t there and didn’t get in until 8.30, at which point his first action was go to the kitchen to get himself a sandwich, listening to some Portuguese radio show rather loudly on his phone while he prepared it, and not joining us until 8.40. He was jokey and flippant and once made a sly comment in Portuguese which the interpreter was too embarrassed to translate, but I gathered was a personal comment about me (something on the lines, I gathered, of my looking stiff and stuck up: maybe ‘Has someone shoved a stick up this woman’s arse?’). He is a very good-looking young man in a kind of obvious, boyband sort of way. And oh boy does he know it! He has a kind of flashy, superficial charm, which seemed to work on Estrela who became quite giggly and girly in his presence, but I found it rather off-putting. His first action when he came in was to give Estrela a rather lingering kiss while pinching one of her cigarettes. He then acknowledged me and the interpreter, and shook hands with us, though he didn’t apologise for keeping us waiting. He didn’t acknowledge Xenia at all until rather later in the conversation. We were talking about her, and he called her over in a jocular tone to come and sit on his lap. She looked very stiff and uncomfortable, and it all felt rather staged. Soon afterwards he took a call on his phone which he answered in Portuguese, lifting her off his lap so he could leave the room for several minutes and answer it in private.

When it comes to Xenia’s problems at school, both Pedro and Estrela say that Xenia is just standing up for herself against bullying and teasing. ‘I was just the same’, Estrela said with a shrug, ‘I didn’t like school either’, (though, as I gather from Deanna she came from an abusive family, I’m not sure why I should find that reassuring.) The adults poo-pooed any suggestion that they might be asking too much of Xenia at home. She makes the odd sandwich, they told me, perhaps fetches her mother her phone if it’s in another room, and maybe runs a hoover round if a visitor like me is expected.

‘And you love hoovering don’t you?’ Pedro said at this point, giving her a pinch on the cheek, at which she didn’t answer but for some reason blushed violently.

I suppose there really is nothing much to go on here, but her school is very worried for her, which is why I visited: I trust the instincts of that teacher. And now I’m worried for Xenia too. I just don’t feel there’s anyone outside of school who’s either willing or able to notice her needs. I feel both adults, Estrela and Pedro, are, for different reasons almost entirely focused on their own agendas. (And on each other’s, I suppose – there’s a kind of giggly lovers’ thing going on between them – but hardly on Xenia’s at all.) I can’t prove that, I’m not sure what I could do about it even if I could prove it, but that’s how I feel.

But even as I write this, I sense that Deanna sees me as a bossy, judgemental, naive social worker, who is writing off Estrela as a parent without even trying to understand where she’s coming from, or how it must feel to be her. Part of me thinks that perhaps she’s right, and then another part of me kicks in that says, no, dammit, I know what it’s like to live with a parent who can’t give you her attention because all her attention is elsewhere. I know it from my own experience. And then I feel angry with Deanna for the assumptions she seems to be making about me, and her seeming belief in her own moral superiority.

But she’s cross with me, I suppose, about the assumptions I seem to her to be making about Estrela, and my seeming belief in my moral superiority.

Whether Deanna’s right or wrong, I’m not sure there’s much I can actually do, and I guess Jeff will tell me that I need to move on to other cases. But why is this preying on my mind so much?