boy told his aunt how sorry he was he had broken her sundial. The old lady looked at her young relatives with amused puzzlement and told them that the sundial had been broken for years.
Elly’s comprehension is still too primitive to tempt me to offer her any interpretation of her behaviour; the ‘why’ and ‘because’ of human motivation are words and realities she does not yet understand. But even if she did, I would think carefully and long before I told her why she did a thing, remembering this story and knowing how easy it is for an admired adult to convince a child of his own interpretation. Not all therapists are as cautious as the English analyst who warned me against ‘constructs’. In the case histories I have read I have come across interpretations both brilliant and ingenious, and the more ingenious they are the more they frighten me. An interpretation must be pretty obvious if it is to be safely offered. I have read of a little girl, no older than Elly and talking no better, whose psychiatrist guessed from obscure words and actions that she feared she had injured her mother. And so she may have. No one ever found out, for she did not get well. But it is well to be humble in the face of facts; for a therapist to verbalize that a child, for example, feels guilt may liberate it from an oppression it cannot face, but it may also suggest a responsibility that was never felt and create guilt where none existed. A parent, seeing so much more of a child than does a professional therapist, will be chary of interpretations, both because he has not been trained to make them and because he feels his immersion in a complex reality which at any time may prove them simplistic, or harmful, or wrong. One can know too much as well as too little.
Yet I am far from denying that parents know too little. I do not mean to make ignorance a virtue; it is one only under the rather special circumstances that obtain when specialists know — as Mark Twain remarked of the human race in general — ‘so many things that ain’t so’. Yet although many of them may know — about castration- anxieties, masturbation, rejecting parents, and the like — many things which in particular cases are not so, they also know an immense amount that is, and that a parent will have to learn. One of the most famous of child psychiatrists, whose therapy for disturbed children depends on a complete separation from their parents, has written that Love Is Not Enough, and he is right. One must know
I learned what I had to from Elly, slowly and painfully, she and I together. But I would have learned faster, and with fewer gaps, if I had been in contact from the beginning with skilled and sympathetic professionals (the plural is deliberate). People whose profession is working with children — I do not limit my statement to psychiatrists — possess a great arsenal of the techniques of siege-warfare. Lacking access to it, I had to develop my own, with difficulty and duplication. I had nothing to guide me but common sense and a till then unverbalized knowledge of three normal childhoods, to which I could add the imperative that an eminent mathematician has given as a two-word definition of the scientific method: ‘Try everything.’ When I came to read case histories, it comforted me to find that was what the professionals were doing. They might indeed have theories to guide them, but they led to no agreed-on therapeutic regimen. Qualified, trained people dealing with children like Elly were trying everything, drugs and shock treatment, massage, all kinds of play therapy — even love. [15] But they were in contact with each other and with professional literature, while we were alone. No one person, trained or untrained, will think of everything, or even everything in the limited range of possibilities relevant to one particular case. It was for this reason that I profited from those case histories, lacerating as I found them, and that I was glad of the chance to observe the Institute people and the English analyst operate with Elly. Four hours at the Institute, four with the analyst — that was my training until Elly was four and a half. Then fifteen hours or so at the Blankshire Nursery School — if only they had come earlier! Later, Elly’s present psychiatrist suggested I visit Dr Carl Fenichel’s League School for Seriously Disturbed Children, where I was welcomed and acquired in a day suggestions for months of work. These experiences were the most valuable help I could have had, but only the last was planned and recommended. The others occurred almost by accident and there were not nearly enough of them. Professionals conscious of the problem could have helped me to have many more. Far from underrating professional knowledge, all I wanted was for the professionals to let me watch them work. But this desire was so unorthodox that it took years for me to reach a point where I could articulate it. I was, at the time I needed to, quite unable to make it known, and I am afraid I can guess what would have happened to such a request at the place where I was told that case histories were bad for me. Yet with all the expertise about, it is strange that in the mid-twentieth century a mother should be left to her own devices and such assistance as she can get from
Parents need help, but not in the current American under-standing of the phrase. They may need it from the same people, but they need a different kind. I appeal for a breakdown of the separation between parents and the psychiatric profession. At present it is common practice for a child to receive psycho-therapy for months, sometimes years, without its mother or father having any direct conversation with the child’s psychiatrist. Especially is this true in large clinics, where the social worker exists as a kind of mediator (or buffer) between psychiatrist and parent. It is thought best that the parent, even of a small child, know nothing of what goes on in those privileged sessions, and the only way she may hear what the expert actually thinks of her child’s case is if he is kind enough to speak to her if she passes him in the hall. Yet there is so much that she must learn that he could teach her.
How can parents learn? They can read, and they can watch and listen. Yet they find out fast that psychiatrists do not like them to read; display of the slightest knowledge of their child’s problem suggests exactly that cold intellectuality which many professionals expect to find. Even after I met psychiatrists who trusted me enough not to veto professional literature, they did not encourage reading, or suggest what it would help me to look at in this vast field with which I was almost completely unfamiliar. Even from my random reading I learned something-here was a child astonishingly like Elly, there a technique that seemed worth trying. How much more might I have learned from an intelligently selected bibliography, especially if I had been able to discuss what I read with a professional?
And if I learned from reading, how much more might I have learned from watching? Let parents into the therapy rooms and the special schools. The difficulties are obvious, but they can be overcome. An observer’s presence may disrupt the therapy, and children — especially other people’s children — cannot be made into guinea pigs. Fair enough. Use microphones then, and one-way glass. An untrained observer will not understand what she sees. Convert, then, the session with social worker or therapist into a question-and-answer training period. If the mother’s reactions need analysis, they will be better understood, by both her trainer and herself, in the mutually experienced context of the therapy room than when shakily reconstructed from memories and dreams. But the parent’s personality may be totally unsuited to this kind of work. Of course — in many cases it is bound to be so. But the radically unsuitable are less likely to wish for such training. If they should, they can be excluded after they have proved themselves so.
Severe mental illness in children is far too widespread for it to be possible to provide intensive professional treatment for every case. The answer must be to train nonprofessionals[17] — unless there is to be no answer at all. Above all, it must be to train parents to do with skill and effectiveness what they have got to do anyway. Mothers (and fathers who have time) will make ready pupils, as people do when they are learning what they have immediate need of. And it may happen that their training will pay social dividends beyond their own particular cases; such parents, if the time comes when their own child’s need is no longer paramount, may make use of what they have learned in helping others. The professionals may find that they have unwittingly created a corps of valuable assistants who will amply repay the time and effort that have gone into their training.
I have spoken so far of the special advantages of parents of abnormal children — those they possess by the very nature of their position, and how they might be enhanced by sympathetic training. I must not overlook, however, another advantage — not a special one, this one, but so commonplace that it is easy to forget it entirely or to doubt its relevance. This is the homely expertise already possessed by parents of normal children. I have often thought of the Institute psychiatrist’s musing words — ‘It’s hard — it’s very hard — even to bring up normal children.’ It is hard, perhaps, but it is something that millions of people have done. When viewed from the vantage point of the expert, conscious of the vast field of parental error, it may indeed seem miraculous that children ever grow up undamaged. Yet most of them do. Parents must not sell themselves short. Let them be conscious not only of how little they know, but how much. [18]
Without guidance, through Elly’s worst years, I brought up Elly as I had brought up my normal children, with no more knowledge of psychology than Dr Spock affords an unpractised mother. Perhaps I should not imply that that knowledge is a little thing, for Dr Spock is the premier example of a psychiatrist who is loving, wise, and good. His book was written for ordinary parents of normal children — it is not a handbook for the nurture of psychotics.
