Human Growth and Development
Concepts of Human Growth and Development
Xenia
An idea that is helpful when thinking about Xenia is attachment theory and Bowlby’s internal working model, as discussed in HGD: 67ff. If the kinds of interactions that Tracey has observed are typical (and they may not be of course!), what kind of internal model might this suggest that Xenia is building up about herself, and about what she can expect from those around her? And how would this internal model play out in her interactions with other people? Also relevant is Winnicott’s notion of mirroring (HGD: 44). Winnicott saw mirroring by a carer as essential to the development of a sense of self: if your needs and wants are never reflected back to you, they never quite seem real. It would appear to be something like this that Tracey has in mind when she worries about the effect on a child of living with carers who are unresponsive to her needs. It seems to us that this process might be part of the explanation of Xenia’s isolation at school. There is some evidence (see, for instance, England and Sim, 2009) that chronically depressed carers may cause difficulties for their children’s development because of their lack of emotional availability.
But Deanna is right to be concerned about an assumption that, just because someone has a mental illness, they cannot be a good parent, and this is something to be aware of too. After all, no parent is always responsive and available, and most parents are preoccupied at least some of the time.
A family systems (HGD: 224) perspective might also be helpful in thinking about the three-way relationship between Estrela, Xenia and Pedro.
Estrela refers to cultural differences between Britain and Portugal, regarding what is appropriate for a child to do. Tracey and Deanna need to recognise that such differences may exist, but of course this doesn’t mean that risks can be ignored. They will also need to be aware of the difficulties involved in communicating in a language that is not your own or through an interpreter.
Tracey
Tracey is a child care social worker, and her focus is quite properly on the well-being of the child. This does not mean this it is her business to judge parents in any kind of moral sense, certainly not, but it is her job (for better or worse) to come to judgements about whether or not the care a child is receiving is likely to cause harm to a child. Of course, given that no parent is perfect, she has to balance this with a judgement about the likely harm that might be caused by any intervention (this is particularly important in cases where intervention might include actual removal of the child from a family).
Tracey’s own personal biography is important to think about too (see Case J: Tracey Green). Tracey is aware that this influences her thinking. She knows what it is like to grow up in an unhappy family, and she has had a positive experience of foster care. The unconscious process known as countertransference (HGD: 38) can occur with professionals in which they identify those people they work with figures from their own past: Is Tracey identifying Estrela with her birth mother, perhaps, or Xenia with her younger self? This will give her valuable insights – she may well have a better insight into what life is like for Xenia than would a social worker with a happier background – but it also creates the danger that she will confuse Xenia’s experience with her own. What Xenia is going through is different from what she went through, and what was appropriate as an intervention for her as a child will not necessarily be appropriate as an intervention for Xenia now. She needs to be careful not to use Xenia to act out her desire to rescue her own childhood self. This is another human being with different needs.
Deanna
Deanna’s job is to support adults with mental health needs so it is entirely appropriate that she sees Estrela as her primary client (or patient) here, and that she seeks to protect Estrela against unfair discrimination on the basis of her mental health problems. The danger of this is that she may focus so much on Estrela that she forgets Xenia’s needs. Removing Xenia from Estrela (should that ever become an option: things are nowhere near such a point!) would indeed be terrible for Estrela, but that on its own in itself cannot be an argument against considering it, should there be evidence of serious harm being done to Xenia in her home environment, because Xenia has needs of her own. (By the same token, of course, there is a danger that, in her identification with Xenia, Tracey will fail to recognise the needs of Estrela, or indeed of Pedro: it’s a danger Tracey herself is at least partly aware of).
Like Tracey, Deanna has her own biography (see Case L: Deanna Whitworth and Zoe Scott) and, like all of us, she will not be immune to countertransference. It is possible that one reason she is so defensive of Estrela and Pedro (apart from the professional reasons already mentioned) is that she too is in a relationship with a woman (Zoe) who is a parent, but who also has a mental health problem: in Zoe’s case this takes the form of a problem with drink. It’s possible that a question mark over the viability of Xenia’s family, or the ability of Estrela to parent Xenia, may feel to her like a challenge to her own family set-up. Perhaps this might contribute to a hostility towards Tracey which goes deeper than a purely professional disagreement (her letter is quite an angry one) and which Tracey may be picking up as one of those ‘undercurrents’ which she talks about. (And in exactly the same way, Tracey’s frustration with Deanna’s apparent desire to minimise any concerns about this family, may also be experienced by Deanna as a similar uncomfortable undercurrent, though we don’t know her feelings on this, and she would not be likely to express such a thought in a professional letter.)
Deanna was also a carer for her own mother when she was a child. What part does this play in her thinking now? While unhappy childhood experiences may make some professionals anxious to ‘rescue’ children from family circumstances that remind them of their own, others professionals may be keen to defend families that remind them of their own, perhaps in order to avoid facing distressing material from the past.
It is interesting that, while Deanna is resistant to the idea that Estrela’s lack of availability to her daughter could be a problem, she herself proposes that Estrela’s own problems are rooted, in part, in the lack of availability of her mother during Estrela’s childhood.
More on Countertransference
Carr (1989) notes that in child protection-type cases countertransference is common and that, depending on their life histories and the stage of life they are at themselves, professionals can fall into various ‘countertransference reactions’ (CTRs) in relation to families. One of the commonest of these is the ‘rescuing the child’ CTR, where the professional strongly identifies with the child and can see little or nothing of value in what the parents are offering, feels a strong desire to rescue the child from them and is resistant to any suggestion that the parents may have strengths or positive qualities which are of value to the child. Another common CTR is ‘rescuing the parents’ where the professional ‘experiences a strong desire to support the parents,’ feels an ‘intense sense of outrage at social circumstances such as unemployment, poor housing or social isolation which places stress upon the parents’ and seeks to minimise, deny or discount evidence that points to ‘parental incompetence and factors which suggest the child is at risk’ (Carr, 1989: 90).
References
Carr, A. (1989) ‘Countertransference to families where child abuse has occurred.’ Journal of Family Therapy 11 (1): 87–97. Available online at: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j..1989.00335.x (Accessed July 2018).
England, M. and Sim, L. (2009) Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington: National Academies Press. Available online at: https://www.ncbi.nlm.nih.gov/books/NBK215116/ (Accessed July 2018).