Therapeutic foster care - Berry Street Childhood Institute

• The child who recognises the hatred or
murderousness implied by the parent's acts of
abuse is forced to see him/herself as worthless
or unlovable.
• The parent may deny or distort the meaning of
the abusive acts, the parent may claim beliefs or
feelings at odds with their behaviour, and the
child may not be able to make any sense of the
parent's behaviour or their explanations of such
behaviour. For example, a parent may say “I'm
doing this for your own good”, or “I'm doing
this because I love you”, or “I'm doing this
because you really want me to”.
• The lack of a capacity for reflection on the contents
of one's own mind or the minds of others is
connected with intersubjectivity, as it is learnt in
the early pre-verbal caregiving relationship.
To cope with relationships we all need to be able to
think about what other people might be thinking. We
all 'read' people, we read their faces and gestures and
we make quick, often accurate, assumptions about
what they might be thinking. We do this all the time,
checking out our assumptions with questions, looks
and gestures. It is a large part of our communication
with others, our ongoing intersubjective
relationships, and if we can't do it we place ourselves
at a great disadvantage. Not being able to do this
leaves such people intensely vulnerable in intimate
relationships.
Traumatised children in out of home care
Trauma, neglect and a lack of early security are often
played out in foster care placements. Daniel Hughes
has a list of common qualities present for many
abused and neglected children that make it difficult
for them and their parents or caregivers to establish a
positive relationship:
• They work very hard to control all situations,
especially the feelings and behaviours of their
caregivers.
• They relish power struggles and have a
compulsion to win them.
• They feel empowered by repeatedly saying
'No!'.
• They cause emotional and, at times, physical
pain to others.
• They strongly maintain a negative self-concept.
• They have a very limited ability to regulate
their affect.
• They avoid reciprocal fun, engagement, and
laughter.
• They avoid needing anyone or asking for help
and favours.
• They avoid being praised and recognised as
worthwhile.
• They avoid being loved and feeling special to
someone
• They are enveloped by shame at the origin of
the self (Hughes, 1997, p. 2-3).
These patterns of difficulty reflect failings in the
development and integration of the basic body-self,
of affect, behaviour, and cognition that occurs during
the first three years of life. Each difficulty most likely
reflects a combination of both a lack of affective
attunement or regulation and excessive shame.
“These children perceive caregivers as violent, cruel,
rejecting, and unpredictable. Safety is increased through
avoidance, silence, denial of one's own feelings and
thoughts, lying, manipulation, and developing an attitude
of constant vigilant control over one's environment”
(Hughes, 1997).
Intervention
Bruce Perry's research indicates that the earlier
intervention is applied, the greater chance for
recovery. Children who are neglected and abused in
infancy stand the greatest chance of recovery if
intervention is applied in the first year of life. The
older the child, and the longer they have been
exposed to trauma, the more difficult it is for them to
recover. However, the presence of other caring adults
in the child's life will build resilience, maintain hope,
and provide a different template of possibility (Perry,
2006). Recovery from trauma will not occur unless the
child is safe. There is no hope for recovery from
trauma if the trauma is still occurring. This means
ensuring that not only is the abuse or neglect no
longer occurring, but that the child is feeling safe and
secure where they are living. This does not only mean
no one is actually hurting them, it means that the
adults in their lives acknowledge the hurt they have
suffered, nurture them in appropriate ways, contain
their difficult behaviours, and most importantly, keep
them in their minds. To be happy, we all need to know
that there is someone who cares about us and thinks
about us, thinks about what we are doing, and how
we are feeling. This is the basis of security. “Trauma
robs the victim of a sense of power and control; the guiding
principle of recovery is to restore power and control to the
survivor. The first task of recovery is to establish the
survivor's safety. This task takes precedence over all others,
for no other therapeutic work can possibly succeed if safety
has not been adequately secured” (Herman, 1992/1997,
p. 159). Recovery from trauma also requires the
creation of a relational network of people who are
committed to and invested in the child.
Humans are fundamentally relational beings. In prehistoric
and traditional communities there is no self
and other. All are connected. The human brain is
designed for this kind of milieu. Most of us in Western
society have adapted to the changes in social life
(although we could point to the high rates of anxiety,
depression and other forms of physical, emotional and
mental ill-health in our community). However, this
relational poverty affects those children most at risk of
abuse and neglect much more profoundly. The more
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