Professor Ivor Browne talks to Paul O’Donoghue about parenting, family life and therapy
The Two-Fold Nature of Parental Love
The first statement I would like to make concerns the degree to which love is important in the parent-child relationship, and in saying this I am not just talking about the parents’ acceptance of the child, but also to the way in which they see their child in a positive light and respond to his or her needs.
This statement brings us immediately to the central problem in parenting, namely the question of the maturity of the parents themselves. In situations where parents’ own needs are the basic motivation for having children, where a child is wanted primarily for the parents’ sake, the relationship that develops will be based on the satisfaction of the parents’ needs in preference to the needs of the child. Of course, there will be a lot of loving behaviour in this type of relationship, but this is only one dimension of the love that is necessary.
There are I believe two aspects of love, however, and this I would like to express as my central theme. The first aspect is concerned with the nourishing of the child, providing for his or her physical or emotional needs. Even where the relationship is parent-centred this dimension of love will probably be very much in evidence. The second aspect, or dimension which I feel isn’t emphasised enough relates to the fulfillment of the child’s needs for growth, or more specifically, for the establishment of a healthy self.
To put this another way, love not only includes caring for the child’s need for nourishment, physically and emotionally, but also caring for the child’s learning, nourishing the child’s growth in a manner that, from the earliest stage fosters the movement away from parents. It seems to me that while this dimension of love is not any more important than the first, it tends to be less emphasised. Of course, in cases where parents’ own needs are not to the fore in these relationships, where their loving is genuinely selfless, then the behaviour of the parent will always be in terms of meeting the appropriate need of the child.
Caring for the Need to Separate
Once a secure and selfless loving relationship is in place for the child from the beginning, then a platform becomes available for the child to naturally move away from the parents, and in the process of doing so will begin realising or establishing a self. While the separation becomes more evident during adolescence, the process begins at a much earlier stage. I often think of the example of a child aged 3 or so going to the first birthday party.
At first she will sit on her parent’s knee, but with time and if she feels sufficiently secure, will start to move around the room. If a balloon bursts or something similar frightens her, she will shoot back to the parent. So, children’s experiments in independence are very conditional on knowing the whereabouts of their secure base. Nevertheless, these experiments have already begun and the separation process begins unfolding in the manner of a sliding scale, the child’s dependence on parents diminishing with time. Of course, even if a warm and loving relationship is present, but is of a kind that serves the parent’s need rather than that of the child, this unfolding of the self may be frustrated. A typical example of this arises in the case of school phobia, where the parent can’t bear to allow the child to move away.
One of the emerging difficulties in relation to this phenomenon of separation from a secure base is the extent to which pressure is placed in more recent times on the mother/infant relationship. There is no doubt that the child’s attachment to the mother is a very special relationship, over and above the attachment to other carers. If we take the example of tribal situations, however, we can see how children’s needs of secure relationships are met in a much broader way, spread among many adults. Even though, embedded in this, there still exists that special tie to the mother, it is not so exclusively found. The trouble with our current situation is that we only have the nuclear family, or indeed the single parent family, so that all of the pressure is on that one relationship between mother and child, which makes the whole question of this gradual growth outwards and gradual move towards independence much more difficult.
The institution of the family has changed remarkably in recent times. Historically, in whatever culture we choose to look at, the family has always been some form of extended set of relations such as in the old feudal settlements, the tribe, the village, or the harem. Unfortunately, we have now whittled this down to a single relationship. So, while we talk about the importance of the family, it has in fact been dismantled, and the nuclear family is an artefact that never existed in human society until relatively recently, and which itself now is under intense pressure and being broken down. So, it seems that we are now building into society a dilemma for the growing child who, on the one hand, is motivated to grow, and who, on the other hand, is dependent on a much more limited source of security to provide the base from which this emergence can take place.
While much of what has been said so far offers a somewhat negative view of current society, it is equally important to recognise some of the positive things that are happening. For example, the advent of the creche, even at two or three years of age, is I think a healthy development, providing of course that a secure base in the family is already in place for the child. I have seen myself, in a lot of young children of adult friends, circumstances where the child is already learning that it is safe to move out from their parents in certain ways and for short periods of time – one or two hours – after which they are back with their parents again. So, the notion that it is terrible for a mother to be working is really quite bogus, provided the loving relationship with her child is well established. In fact, in situations where, for example, a single mother is unable to go out to work and is at home with the child all of the time, but who is perhaps quite neurotic and full of immature needs, the potential for damage to the child’s growth is far greater than in the case of a well adjusted, secure mother who is out working and maybe putting the child in a creche for a couple of hours, or who has a good parent substitute, but who is there herself for at least a couple of hours a day really relating to the child in a very positive way.
The Family – A Time-Limited Institution
If we accept that children need the appropriate love of their parents in order to move away from them, and that through the establishment of themselves in the world, they will, in turn, be free from the immature needs that would block the growth of future generations, then we must accept that the family should be a time-limited institution which dissolves over time and eventually comes to an end: that is, the family as a ‘living system’ dies but the members of the family, as individuals, continue on. Unfortunately, in a culture like Ireland this isn’t well recognised. The purpose of the family should be to bring individuals to adult maturity, and by this I mean bringing them to a stage where they have achieved a reasonable degree of independence and self-management.
At least 50%, if not more, of the psychiatric problems I’ve had to deal with over the years come from situations where this hasn’t happened and the person, because of the demands of society, has to eventually face independence while being hopelessly ill-prepared for it. When they make the first move out they are not – in terms of competency and practical skills – in a position to succeed. In terms of the organization of the self, there isn’t a clear self there to enable them to manage themselves, so when faced with the stress of independent living they break down. The ‘self’ with which they face out into life as an adult is a fragmented one. Our understanding of this dilemma has often been unclear, mainly as a result of the traditional medical viewpoint. The person will appear to have grown up, in the sense of developing an adult body, and will appear to be taking the same steps as others, but when they actually have to face the first situation of work or even the Leaving Certificate, they fail miserably and then break down. So we talk then about a breakdown as if that was the beginning of the illness and we put a medical name on it. We talk about the pre-morbid personality, and indeed medical books are full of language like this. The fact is, of course, that the personality has been ‘morbid’ from day one. Here we see how our understanding of the nature of the problem has been misplaced. It is seen as an illness in the same way as where someone is hit by a car and breaks a leg, or where there is a sudden onset of infection in a previously healthy person.
In fact, the person who is seen as ill in this way is not normal in terms of self-management. Their appearance of having been ordinary or healthy is such only because the family, as a ‘living system’, has been managing their life and adaptation up to now. It is with this realisation that we come to see the systemic nature of the individual’s dilemma.
If we are to understand the concept of the family as a time-limited institution and its role in the person’s failure to manage in adult life, we need to consider the relationship that evolves between the two living systems at the centre of the problem. First of all, we have the individual child, a living system in its own right. The second system to be considered is not that of the parents but of the family as a whole, as a separate living system. Now as I see it, the family system – what I call the ‘second order living system’ – is formed when two parents come together as two individuals forming a unity. The infant is conceived and delivered into this system, becomes a part of it, and contributes to the ways in which the family manages the environment as an entity in itself. Because this family is a living system in itself, it has its own need for self-preservation and continuance, and of course, it is this need that builds in an inherent dilemma into the situation. Any living system will tend to want to go on and, try to survive. Therefore, there has to be a tension, if not a conflict, in the individual who needs both to promote this continuance, as a ‘part’, and also his or her emergence out of it as a ‘whole’ individual. It is important to remember that the child is both a ‘part’ (of the family system) and a ‘whole’ (a living system in itself) at the same time, and hence this tension. So the problem for the child is about how he or she can be a part of one system while being the whole of another. Of course, if all the ingredients of parental love, as mentioned earlier, are operating, then there is a gradual transfer from the whole (i.e. the family) into that part, so the part which is the child begins to emerge as a whole in itself having integrated all of its needs from that other social system. I would still say, however, that there is an inherent dilemma, in this situation, but one which won’t pose a major problem, as the life cycle is operating in a healthy way. On the other hand this tension could very easily become a major problem if there is any hold-up or discordance in that cycle. So it needs to be recognised that this dilemma arises of necessity, and because it is a natural conflict there is some of it in all families. All of us have something of this struggle.
It is also worth mentioning at this point that when difficulties are present in the relationship between these two systems – child and family – the problem isn’t just, as it is often seen to be, a question of the parents holding on to the child, but it is also a result of the child holding on to the parents. I have seen many situations where parents, having started the mess, are more willing to escape out of it than the child. I think it’s very important that we see it in this way. Otherwise we fall into a syndrome of blaming parents and seeing them as being engaged in some way in a scheming activity in order to preserve the family.
As the family is breaking down and becoming more isolated in society this struggle is becoming more difficult. Because of the narrow nuclear family or single parent situations that we have today, parents who have failed to emerge successfully from their own family systems, and hence are immature, are themselves rearing children who, when they reach an apparent adult status, are going to be even less mature. These ‘adults’, in turn, will be even less able to form a functioning family that will release healthy seed, but instead will tend to turn the cycle backwards. In other words, they will reverse what should be the end of a cycle so that the family, as a living system, becomes ingrown and the offspring are seen as serving its needs in an endless way.
I think what is wrong in our conceptualization of family life is that we have seen only the need of a family to be caring, and have de-emphasized or not recognised the need for it to dissolve when its task is completed. Effectively therefore the family as a system has to die. Of course the individuals of this system don’t die. In fact as the system disintegrates, not only are the children released from it but so too are the parents. One of the restitutions that modern society has achieved through improved physical health, better understanding and so on, is the second life of mothers. Having had their children relatively early, they are still young women, and whereas in the old days they were literally on the scrap heap by their late 30’s or 40’s and in poor physical health, they are now fully functioning, healthy adults who can go on to have a second life and more creative living.
Restitution in Adult Life
When we talk about helping people who have come from difficult family circumstances, I think we need to consider two major dimensions which, perhaps in an over-simplified way, would fit the old descriptions of ‘psychosis’ and ‘neurosis’.
The people who move into the ‘psychotic’ world – notwithstanding the possibility of genetic elements in their disposition – have, from a learning point of view, failed to grow up and establish a separate self. In other words, these people can be seen to have failed to separate themselves out from their family systems as individual selves in their own right. The other major group that we normally call ‘neurotics’ do achieve an emergence from their families and an adulthood, but at the cost of blocked off areas and the development of highly organised defences. These struggles very often reflect early discordance in their families of origin through brutality, parental alcoholism and other traumas. In this group the adult has managed to separate, and is also able to manage the world, but not having experienced a wholesome start to life, will do so at a high cost. They may, for example, be very anxious, unhappy or depressed. Having failed to assimilate or experience fully the difficulties they encountered early in life, they dissociate and only one dimension of the personality progresses. The personality is consequently a narrow one, and while the individual achieves adulthood in a way that allows him or her to manage the environment, significant aspects of personality have been left behind.
This situation, however, is very different from the failure to assemble a self, which we see in psychotic presentations like schizophrenia. The essential problem here is the failure to produce an integrated self that would allow the person to be bounded so as to enable him or her to manage influences from outside. Unfortunately, not only are these individuals at the mercy of the environment, but they are also at the mercy of their own inner fragmentation. So, under any pressure at all, they tend to split and break down.
This is quite a different view of personality than the psychoanalytic view, in which terms like ‘borderline personality’ seem to indicate an understanding of psychosis as an ‘extension on’ from the neurotic position. My view, however, would be that rather than seeing one as the more extreme form of the other, it might be better to see the two positions as being at opposite poles. The person who has emerged with blocked experience into the adult position often has more strength than the average in terms of being bounded and being able to struggle on. This person is not going to become psychotic irrespective of the presssures they may experience. However, there may be a deep depression and they may have to live with a lot of anxiety and pain.
This distinction, I believe, is a significant one when we come to consider therapeutic approaches that might or might not be appropriate for adults who have come from difficult family backgrounds. In the case of the person who has managed to emerge into adult life with some sense of self, but who has not assimilated significant experiences in their growth due to the traumatic nature of these experiences, it is certainly possible to work in terms of therapeutic regression as a way of opening up the childhood life that has produced their depression or anxiety. Individuals can benefit greatly in this way through the assimilation and integration of those lost parts of their lives and will have the ego strength to undertake this process of change. The therapeutic work, therefore, must always take into account the resources that these people have for holding themselves together as they open up the traumatic islands that have been left behind.
Naturally, as this process opens up, the needs of the individual for appropriate parenting that haven’t been met in the past will surface in the therapeutic situation. I think the essential job for the therapist here is to be careful not to behave in the way the original parents behaved, but to deal instead with the genuine needs that this person has for growth and maturation. Therefore, to be loving only in the sense of caring may actually compound the person’s predicament. When we speak of the therapist’s ‘unconditional regard’, we need to be clear that by ‘regard’ we mean, not only the provision of love and care, but also regard for the person’s learning. This may involve making demands of the person, or not accepting certain behaviours. In this way, the therapist can provide both aspects of love that promote the integration of personality in a way that wasn’t previously possible.
For those, however, at the other pole, whose lives have not facilitated the establishment of a separate self and who have not been able to manage the world as a result, the traditional work of psychotherapy, which creates a temporary dismantling of the personality in order to release parts that have been closed off, is not appropriate. In fact, not only is this approach often useless for them, it may also be quite damaging, for without a certain degree of ego-boundedness, further fragmentation of the personality may occur. Therapeutic approaches in these cases need to be of an educative kind, where the focus is on building the ‘self’. Therefore, the therapeutic process would be aimed at fostering the growth of a previously immature personality in a very intensified way. It is likely that cognitive and behavioural forms of therapy would have a part to play here.
It must be remembered that in these cases the therapist is essentially dealing with a child who for one reason or another has been unable to progress into adulthood in any way other than physical growth. It seems to me, therefore, that the central emphasis of therapy has to be on education, and it is here, I think, that we discover the biggest misunderstanding in traditional psychiatry. By focusing on symptoms and attempting to dampen down the immediate expressional self (hallucinations, delusions and so on) the real problem is being ignored, which is, of course, the failure of the personality to grow. The only thing which can help in these situations is to begin an educative process which would attempt to make restitution for all the things that the person has missed in terms of growing up. This would obviously need to include a broad spectrum of learning and would require a group of teachers or facilitators, ideally working together as a team.
In conceptualising such a system, we can learn a great deal from centres which cater .for the physically disabled or mentally handicapped. These centres provide a range of carers who are fostering certain aspects of learning, and educators who provide for other areas in the person’s development. The difference between the handicapped person and the person who is schizophrenic is that the handicapped person is identified at an early stage as having an inherent – perhaps genetic – difficulty. These children have a limited capacity and will never reach the full potential of an ordinary adult, yet they often progress within these learning environments to a stage where they are more able to manage the world than the medically treated schizophrenic who has a normal, or even exceptional, capacity but for whom opportunities for learning have not been provided. There are, I think, two difficulties here. Firstly, society has failed to provide the sort of therapeutic educational system that would be helpful for these people. Secondly, we haven’t as yet been able to identify, at an early stage, the ‘at risk’ person who will be diagnosed as a schizophrenic or as having a personality disorder in later life. Instead of responding to them by applying a more intensified form of therapeutic education (which happens more slowly over twenty years or so in a centre for physically disabled or mentally handicapped), we supply negative learning situations such as mental hospitals, prisons and other institutions. In this way, we actually compound the situation, offering them, in a sense, ‘post-graduate courses’ in disability and failure.
So, if I could sum up my vision of therapy, I would say that it must be primarily a response to the person’s need for establishing an adult personality that is self-managing, and within this process I would stress that concern for the person’s learning and development is as necessary as the concern for love and care.