Surviving Childhood Adversity

Mary Montaut talked with

Robbie Gilligan,
Lecturer, Social Science Dept. Trinity College Dublin.

“Surviving Childhood Adversity” – a Multi-Disciplinary Conference 
held July 2-5, 1992. Organized by the Dept of Social Studies, TCD.

The Conference was planned as part of the 400th Anniversary celebrations at Trinity 
and as an outstanding event in the history of the Dept of Social Studies. We have of course held conferences before, but never one with such an international range of
 speakers. The major areas of interest of the Department are Child Welfare and
 Mental Health, though we run also Addiction Studies and Counselling Courses.
 The strengths in the Social Work training are Mental Health and Child Care, which 
are reflected in our other courses as well. We searched round for a long time to try
 and find a theme that would capture the interests of people in the Dept and the idea
 of Childhood Adversity seemed to be important, both in the sense of adversity 
experienced in childhood by children currently, and adversity as it reverberates
 down through adulthood after being experienced in childhood. That clearly 
brought together Mental Health and Child Care concerns. We felt that the word 
”Surviving” was important because it is vital to look at issues of resilience and 
strength, at people’s assets, as well as being concerned with pathology and deficit.
 The notion of surviving captured the idea of people having a core of capacity to
 withstand what has happened to them and to move on.

Childhood Adversity is more than Child Abuse. We were very anxious not just to
 conceptualize in terms of abuse. I think that this subject has been badly 
misrepresented in recent times. Child abuse has been seen largely in terms of
 physical abuse, until say five or ten years ago, and the media particularly have
 contributed to a situation where the public perception of child abuse is that it equals 
sexual abuse. We would say that is too narrow a conception of abuse. We see it in
 terms of physical, active abuse in terms of neglect, and also in terms of emotional
 abuse. There are dangers about it becoming so broad that almost any behaviour is 
seen as abusive, so you have to retain a certain level of specificity, but nevertheless it 
is reasonable to argue that emotional abuse can be identified and recognized. So 
you have physical abuse, emotional abuse, neglect and sexual abuse, but these are
 not discrete categories – they can exist together.

Childhood Adversity

We were not concerned just with forms of abuse. We wanted to look at other kinds 
of adversity that children may encounter through loss, illness, disability, poverty and 
social structures that oppress in some way or another. Looking at adversity in this way 
allowed us to have a broader perspective and to look beyond the relationship of the
 child and the abuser or beyond the family in which that relationship occurs. We had 
speakers at the conference who approached the question of adversity from a Social
 Policy perspective – a professor from eastern Europe looking at the effects of social 
change on families and children in eastern Europe, and Professor Hilary Graham from
 Warwick University was looking at the impact of the coping mechanisms of women
 rearing children in poverty. There were also papers about child protection in different 
countries. In Britain, for instance, the system tends to respond to abuse by using the
 law as a lever – extracting co-operation, we might say, from parents who are judged to
 be in some way failing or abusive. But in some of the European countries, for instance 
in Holland and to some extent in Belgium and Germany, there is a movement which 
is trying to work on a more permissive basis with parents. Now this is the heart of a 
great controversy and debate within the field, and it was interesting to have that 
viewpoint represented and discussed – about the possibility of opening up that kind of 
approach where you would try and offer in a non-judgemental and non-threatening 
way, help to parents who find themselves in difficulty. There are issues unresolved 
about how far that guarantees safety to children who are currently being abused, but 
on the other hand, people who support this approach would argue that, in the long
 run, children’s best interests are probably best served by their parents if that
 relationship can be preserved, and that you are more likely to engage parents in the 
whole process of recovery and healing and rehabilitation if it is done in terms which 
are respectful of their dignity and not coercive. But it’s a difficult issue. The Dutch
 situation has traces of this more liberal tradition and of the more conventional model
 that we are familiar with where the state, although it has a caring dimension, wields
 this implicit iron fist inside the velvet glove, in terms of court proceedings and so on.
 We also had Americans who were looking at the broad range of services to support 
families whose children have to go into care. David Finkelhor, a world authority on
 child sexual abuse and a sociologist who studies issues of family violence and sexual 
abuse, discussed recent developments in the way that people view child sexual abuse. 
We had somebody speaking from a Third World perspective, from the Van Leer 
Foundation which is a major philanthropic foundation, who spoke about their work in 
promoting support services and community development projects working with 
young families round the world. We were genuinely trying to get a global perspective 
on this issue of Adversity, from Third World disadvantage right across to, say, lone
 parenting or women trying to raise kids on their own in Irish cities or other cities in 
the western world.

International Perspectives

This conference brought together people from thirteen different countries, a whole
 range of disciplines, and there were also lay people – people who were users of 
services, who contributed to workshops. Besides the nine plenary sessions, there
 were forty-five workshops, and there was a very rich tapestry of opinions 
represented. We sought to create a space in which a wide range of opinions could be 
aired and debates could take place. There were a lot of controversies. For example, 
the British delegates tended to emphasise very strongly the implications of gender
 perspective in terms of a conventional radical feminist analysis of problems, saying
 that the solution lay in an understanding of the patriarchal source of the family and
 social economic problems. There was a certain tension between their perspective
 and that of certain of the Irish delegates, who, while they would be sympathetic to 
some of that analysis, wouldn’t believe it was necessary to adhere to it relentlessly.
 That kind of tension made the conference very lively.

It was also very refreshing to have an encounter between researchers and 
practitioners. I think it was stimulating for practitioners to be able to tune into the
 cutting edge of research findings from different projects and investigations. Equally 
I think, it was stimulating for researchers to engage with people who were working 
out there in the real world. That was one of the characteristics of the conference,
 that you had a lot of spectra represented, and that you were working through the 
tensions caused by having so many different polarities between the academic and the 
practitioner, between the professional and the lay, between people from different 
disciplines or jurisdictions, and so on. It was that kind of mix that gave the
 conference a rich feeling. At the end of the day, there was a fairly up-beat mood,
 which was encouraging because, in a sense, a lot of the material was potentially
 depressing. There may be a tension between having services which are adult-centred
 and ones which are child-centred. Certainly in the British system they have run into
 difficulty where there have been serious episodes like the death of a child under the
 close surveillance of the state services – people say, how could this have happened? 
The social workers have tended to become too adult-centred, partly because they
 are relating all the time to the adult even if their business is the child’s welfare. They
 don’t actually, manage to have enough knowledge of the child, not enough
 understanding of the child’s inner world, not enough of a rapport with the child, so
 that when they are visiting a family with a concern about a child, they are actually
 talking to the parents or care-takers and not actually having any meaningful rapport
 or communication with the child. The parents needs of course are very considerable
 – in emotional terms, they may often be operating at the level of a child or 
adolescent themselves and have a capacity to draw in the worker, and the worker 
loses sight of the child. This is especially an acute problem where you have workers
 who are over-stretched and have to deal with far too many different cases. They are 
not getting enough support supervision, so they lose the capacity to retain
 detachment and in some countries they may not even have adequate training,
 though that is not a situation which applies here.

The Irish Situation

One of the things that struck people visiting was that we tend to be a bit too ready
 with the poor mouth, and we seem to be talking ourselves down here about our 
own provision. Certainly our legislative framework in this field goes back to 1908.
 This is still the current legislation and, although it is being gradually replaced, the
 process of replacement is going to take a long time, so we’re still facing another
 three to four years operating the 1908 legislation in relation to child protection and 
child abuse. But if you leave that aside, and also leave aside the fact that our services 
are under-resourced, with not enough personnel and regional disparities in terms of 
the availability of certain types of treatment or community-based support to
 families, there are two things which strike me:- one, the calibre of people working 
in the services here compares very well with anywhere else, and two, that at a level 
of training we compare quite well. Because we have not a very bureaucratized 
system (possibly a consequence of the scarcity of resources) we have people at the
 front line who are very experienced. In many other countries, for example the 
United States, the least experienced people are in the front line. You begin to see 
your own home situation in perspective. All the delegates found it helpful, going 
back into their home situations, to have had glimpses into other systems and maybe
 to have seen some of the strengths and weaknesses more clearly in their own.

There is another strength of the Irish system which is a rather paradoxical
 consequence of the under-developed or under-resourced policy or structure. There 
is actually quite a lot of space left for people to use their own initiative and be quite
 creative. I think culturally we have a flair for being creative and flexible under stress
 or under adversity, that we can actually make more of a situation than people in 
other systems. I’m struck by encounters with other people from other cultures – in
 recent times, England and Germany – where people really get quite thrown if the
 situation doesn’t fit the rules. They don’t know how to react, whereas I think Irish 
people tend to be better able to just take responsibility for themselves. They come 
up with the best answer they can see in a given situation, not being slaves to the
 rules. I think that is quite an important difference and it does have a bearing on the
 way that professionals operate. Irish people are therefore better able to cope without 
a whole panoply of regulations, rules and structures. I think the trend is towards a 
greater bureaucratization of responses, and I think that is probably desirable up to a 
point, but we’ve to be careful not to make bureaucratization a god and lose sight of 
the job we are actually trying to do, which is to create a humane system of responses 
to help children and their parents.

Not Just Rescue Work

The major area which suffers at the moment is long term therapeutic programmes
 for children. There is a lot of emphasis on the acute crisis, the investigation and 
referral of abuse, trying to manage the case in such a way as to protect the child from further abuse. The emphasis is on responding to the emergency, rather than
 looking at the long haul consequences of the abusive experiences and trying to heal
 the trauma. We are still only scratching at the surface of understanding what effects 
abuse has. It seems that the picture is complex. It’s not just the nature of the actual
 abuse experienced, it’s what the child is bringing to that experience, strengths and 
resources or deficits. There is a whole host of factors which may mediate the impact of 
the abuse on the child – age, gender, the response of other adults in the child’s 
network. Certainly abuse does not affect all children in the same way, but each child
 differently, so we must be careful about generalizing that all children need long 
periods of therapy, but those children who do, do not have access to it at the moment 
because of the emphasis on the immediate, acute, investigative phase and because of
 lack of resources. More speculatively and perhaps more controversially, I suggest that 
there may also be a lack of confidence or skill about the more long-term work. The
 implications of merely being the fire brigade, of merely being the ones who mop up,
 are very corrosive for people’s morale and their own inner well-being as workers. I
 think that there is something restorative in working in a healing way with people and 
not just coming in with the sirens blazing and being involved in heavy, confrontative 
work. That is quite draining emotionally, and it gives you a distorted view of
 humanity, affecting your own level of trust in other human beings. So I think that
 childhood adversity may carry a very high cost, not just for the child, but also for the 
professionals who are trying to respond to the situation.

I don’t think that people have conceptualized sufficiently the need for healing for
 abused children, or taken the point that, obviously, many children who are 
manifesting very disturbed behaviour are actually manifesting the effects of abuse.
 Public opinion is only just coming to recognize that child protection and welfare is
 not just about the immediate rescue of the child. Rescue in fact as a concept is actually 
fairly unhelpful, because it can indulge a rather simplistic view of the problem. There
 may be a need to act decisively and rescue children at times, but to think that’s the
 solution to the children’s problems is very simplistic indeed, and there are also 
complex problems raised by a rescue or investigation. Very often the child’s long-term
 needs, perhaps of being helped to recover from deep and fundamental trauma require
 very complex, long-term work. Even if we had the resources, it is very difficult to find 
adults who have the skills and stamina, the right motivation and inner strength and
 level of self-awareness – and, most importantly, who like children. It is essential that 
people who work therapeutically with children do actually like them. That is a very
 therapeutic message that children should get – that they are actually liked, both as an 
individual and as a breed. It’s easy to overlook that.

I think that the conference achieved a certain esprit de corps. At least it emerged 
that there were some common values and assumptions, even if we did not agree on 
every iota of detail, about the rights and needs of children and their families. People 
came away with lots of refreshment, stimulated by many new ideas and also the
 rediscovery of old ideas, and by crossing between Mental Health and Child Care.