Torben  Alne is the headmaster of the Observation and Treatment Home for Children with psycho-social Difficulties, Meeqqat Illuat, here in Greenland and I am Conni Gregersen, a psychologist in The Section for Childrens Homes and Other Day and Night Homes/Institutions. We both are functioning under The Department for Families, The Greenland Home rule Government.

We want  to discuss our hypothesis of why we in these years experience an increasing number of children with sereve emotional damages and personalitydisorders in our treatment home and to tell about our basic ideas of treatment to these children.

Torben has been working in the social workers area here i Greenland for more than 30 years, and I have been here for almost 10 years. Our hypothesis is coming out of our practical work, and we of course hope to wake somebodys interest in investigating this field …

 

Our subject is an increasing number of children, who

  • is difficult – if not impossible – to reach in contact, who
  • is difficult – if not impossible – to make attachment to, who
  • suffer from lack of confidence and trust, and
  • suffer from lack of  ability to develop social skills.

We talk about children with a lack of abilities in attachment, confidence and other deeper emotions and feelings to other people.

We know these children from other places in the world as ”early damaged children”, but untill resently we had very few of them here in Greenland. Why do the number increas  now?

We have always had children with difficulties in managing their feelings, but they usually have a sense of what attachment is, and it is possible to engage them in responsibility to some extend. In this paper we will refer to the two groups of children as ”the new” and ”the old” children, because we in this connection are not interested in the differential diagnosis of the children, but the way they react in primarely the pedagogic treatment.

Treatment of those children demand a very structured pedagogy. Predictabitily and recognizability are keywords or core ideas in the treatment. We sometimes meet the suggestion, that when you are to work that structured, it must be very sad and heavy around the children, without fun or joy in daily life, and to emphasize, that this is not the case, Torben has made a line of pictures of the children from Meeqqat Illuat. So while I am on the heavy and sad words of this workshop, Torben is on emphasizing, what is the really important aspect, namely that respect and predictability in the daily work with these children make it possible for them to raise vitality – and joy follows ”by itself”.

The children of cause have their hard times in accepting the structures at first. It can be necessary  to hold the child in certain situations, to prevent him from damaging him self or other people, and it has to bee part of the treatment to make connections in the child to his feelings and emotions – and to traine him to channalize feelings and emotions in proper ways. This is part of training his independence, and you will see, that daily life tasks as well as expeditions, fishing and hunting are used as tools in the work. And you will see, that most of the time in treatment is not heavy and sad –  so, the pictures are NOT just for your entertainment – it is part of the paper.

And we kindly ask you to hold your eyes and ears open to take in from both channals at the same time. If you do so, you will get a touch of the polarization, you meet in treating damaged children – and a touch of the demand of being open on all channals if you want to get a deeper contact with children, who are either unaccustumed to or even afraid of contact.

 

The paper

Our hypothesis has grown out of our knowledge about concrete childrens lifestories. There are lots of resemblences – and there is one certain difference between the stories of the ”new” children and the ”old”ones as it has fallen in our eyes:

Both groups come from families with lots of psychic and social problems, and typically abuse is involved. Alcohol, fysical violence, sexual abuse – all this is seen in the stories of both ”old” and ”new” children. So they all have experienced serious abuse and neglect.

Often wee recognize heavy trauma too, such as suicide or homicide in the nearest family to be part of the childrens history. All this is general for the children placed in childrens homes, both the ”old” and the ”new” ones. Heavy abuse and neglect – patterns of abuse is an integrated part of their lifes and tend to impress their personalities from young age. So why are some of the children able to attach while others are not? – Same story – different lives …

There is one remarkable difference in the stories of  the children, and this is about early caretaking. In our work wee usually  make genograms for the childrens families, and when making and reading these, we discover, that while it is easy to find ressourcefull family members/adults in the ”old” childrens families, it is difficult in the ”new” childrens famiies. There is a fatal lack of adult persons, able to manage their own lives –

Habitually babies are taken good care of in Greenland, even in occations, where parents do not manage too well – adult familymembers seem to have taken responsibility for the baby and the neglecting parents seem to accept this way of doing things, to the better for the baby. (Of course it is not that simple in reality, but tendences point this way).

Contrary to that, the ”new” childrens histories often is about wandering around, looking for a place to bee, looking for food in random places – even from quit young age. and we do not find signs of other family members trying to organe strategies for caretaking of the baby.

In the history of the ”new” children we get a picture of misserabitily or lack of ressources all over the family. Our hypothesis then is, that nobody has taken over, when the parents failed in caretaking. And seemingly nobody has reacted upom experiencing the obvious lack of caretaking for the baby. How comes, that people has stopped taking care of ”other peoples” babies?

One hypothesis on this comes from our knowledge about  conditions in Greenland in the 1960’s and ’70’s. At that time the consumption of alcohol in Greenland was very high, up to 22 liters of pure alcohol pr. adult person pr. year. In the same period people were obliged to move from smaller to bigger towns, and some families were spreed around. The young people and young adults from that time are now grandparents, and we assume, that part of the grandparents nowadays are not available for their grandchildren because of not being in the same place as their children and grandchildren – and others because they have integrated the indifference in lifestyle, that often follow severe alcohol abuse. It would bee interesting and helpfull in social work to have some investigations on that subject. I relation to society’s planning on the child-care area wee need more information on these subjects.

It would help those children if social authorities could effectuate adequate arrangements for the children as babies.

We know, that the social authorities sometimes place babies acute in foster- og childrenshome care because  they have been left alone. We do not know exactly, to what extend the children wee have in the childrenshomes, have been left alone in their babytime, but we can see, that there have been nobody to make attachment to them in infancy, since they do not at all manage attachment.

And even though it is hard for a baby to be rejected from his mother, given to the grandmother or another fostermother, it is not necessarily fatal for his development, as is the very extensive neglect following insufficient and random caretaking.

We think, that one reason, why the authorities have been slow to act upon the ”new” children is, that the lifestyle in these childrens familis and the lifestyle of the ”old” childrens families, as seen from outside, look alike. The difference is not that visible for outstanders but it really makes different imprents in the baby, whether he is taken carefully and sufficiently care of – even if not by the morther – or the caretaking has been casual or insufficient.

We know, that it takes lots of lovefull caretaking to bring a usefull personality through. The ”food” for developing the self is love and contact in a certain way, that is recognizabel to the baby.

When the human baby is born, he is helpless, even though he already has some competences. Most of the body is ready for use at birth, just not the brains (therefore he is that helpless), and today it is known, that lovefull caretaking is necessary to mature the brains, and thereby make it possible for the baby to bring his ressources and talents to development.

The baby is activily seeking for contact and attachment, and he needs to be met. He is an active partner in the game of life, and it is in his relating to the mother/caretakers, that the baby develops his personality. The baby soon recognizes certain behaviors, feelings, athmospheres and is quick to learn recognizing faces, moods, rythms and so on.

The proces seems to start from birthtime (or perhaps even earlier) out of a withborn organizing proces. The baby organizes his experiences from the beginning – some are alike, others not – and seems simultaniously to recognize the organizing process, while it happens. This makes the first ”spots” of experiencing a self. It seems to please the baby, when this proces takes place organizing and recognizing the organizing – everyone, who has ever been recognized by a baby, will know, what I meen by this: It is a pleasure for a baby to recognize – you can see and feel it in the baby’s explotion in vitality and joy.

The children, we talk about, has been cheated from enough of the is kind of experiences.

Sometimes a bad circle is started: the mother has too little energi for the baby – she does not react on his crying, and he just lies there, helpless. He stop to cry. The mother, perhaps is satisfied with having an easy baby – not demanding his mother all the time. But the baby suffers from too little ”psychic food”, so his organization of the world and his self never really comes to start. Without sufficient rythm in daily life, the organizing proces must fail.

The childs has so to speak had too little to work with, so that the personality – like muscels not used, is ”atonic”. The babies tend to bee quiet, they lose vitality, sleep a lot, stop exploring the world – they grow into very ”easy babies” …

Later in their lifes, they fail in most of lifes tasks, because they do not know how to do the most basic things: attaching to other people, feeling trust, and feeling, what they need. They tend to be like big babies: unmatured, impulsive children, without ability to understand their part in relations with other people, specially other children. They seem unable to learn by experiences – things ”just happens” without the child being able to se or feel his own part – and possibility – in it.

 

TREATMENT:

To treat the children we use pedagogy and psychotherapy,  and we have to start at the point of their deficits and to use their resources too. We have to create an emvironment so predictable, that the children can experience things happen in certain rythms to try to awake their own inner organizing process, that is necessary to build up the self. Therefore we use a structured pedagogy, where dayly life runs strictly after certain attitudes, norms and plans, according the needs of the children, and with caretakers, trained to balance in the very difficult line of being kind and firm at the same time.

The staff members need to feel humble respect for the children and to get knowledge about the deficits in the children. Our experience is, that without knowledge and training, the professionel caretakers will often fall in one of many traps, the extremes are something like:

  • One is to feel sorrow for the child, meet him as if he is a helpless baby, doing everything for him – and thereby once more cheat him for learning what he has to learn to manage his life – and not respecting his ressources and talents and
  • the other extreme is to be strict to the extend, that plans are followed for their own sake and not for benefit of the child. The child then is still not met and gets no help to find his inner organizing proces.

There are lots of traps in treating these children – grounded in the fact, that the childrens deficits are basic – and so fatal, that most people will react inadequatly on their behavoirs – if not trained to look behind the childs behaviour and go against her own natural reaktions in the situation.

It is hard to understand, that a boy or girl, who during a long period of time can succeed in steeling in the stores and hiding the stuff without beeing detected – that this child in reality does not know, why it is wrong to steel. But the fact is, that the child hides his stuf, because he reads in other people, that it will cost trouble to tell about it – or eventually because he is ordered or treathened from somebody.

Just like the normal baby needs to experience things repeated in a lovefull athmosphere, the emotionally damaged older child has to experience caretaking repeated during a long time, before it can awake his inner organizing process and make tracks in his psychie.

But of cause the caretaking must be ajusted to the need of a child, not a baby. He has to be related to in respect with his competences, and to use thes as tools in developing himself inside.

Our hope is, that social authorities will take good advantage of babies being neglected, to prevent fatal damages in their personalitydevelopment – and to promote this, we hope too, that somebody will be interested in doing som investigatings, that can move us from hypothesis to concrete knowledge about what lies back the differences between what we have called ”old” and ”new” children in treatment of abused and neglected children in Greenland.

Thank you for you attention