by Professor Søren Hegstrup and a research team
What is holding?
Winnicott
The concept of holding was first introduced by a British paediatrician and psycho-analyst called Donald Winnicott. In his eyes holding is based on the physical relation between a mother and her child. A child does, or doesn’t, feel safe in its mother’s arms. The arms are presumed to be a prolonging of the developing foetus held in the uterus. Winnicott has enlarged holding to the total emotional and physical environment created by the mother, and the mother’s capacity to hold the child in her thoughts and react intuitively on the needs of her child.
By doing this, the mother expresses her love, concern, acceptance and interest in the child. Based on the safety the child experiences in being held by the mother or a nursing environment, the child starts to see itself different from his mother and discovers itself and the world. The child also knows that the mother will be there for him if he needs it, and he learns not to have constant contact with the mother.[1] This enables the child to experience even more.
Winnicott finds the development of a “true”[2] or “false self”[3] in the child really important. This seems to be the result of the child constantly having to accomplish the mother’s needs and just recognising and expressing parts of himself that are accepted by the mother. The essence of holding is not the material but the emotional environment. It is the reliability of our presence and our recognition of who the person is and what he feels. Via communication with our clients and through trials to put their experiences, feelings and views as to who they are in relation to us in words, they feel held.
Martha Welch
Winnicott has also inspired child psychiatrist Martha Welch to develop a method called Holding therapy, which she presented in her book Holding Time (1989). It gives advice – according to its subtitle – How to Eliminate Conflict, Temper Tantrums, and Sibling Rivalry and Raise Happy, Loving, Successful Children.
The aim of Holding therapy is to develop a bond, trust and a feeling of security between an adult and a child. The purpose of Holding therapy is that the adult sets limits and restraints for the child, placing him/herself as a physical barrier.
The therapy consists of holding the child. But there is much more to it than mere holding. Various response stages during the therapy, in both the parent and the child, are recognised.
Welch writes,
“I have found that the responses of parent and child in holding usually go through a specific sequence: 1 Confrontation, 2 Rejection and 3 Resolution. [4]
The first stage reached during holding is one of confrontation as the child protests at being held. Sometimes this initial phase results in a happy exchange between the two. Stage two is rejection as the child struggles to get away. As this happens, the mother expresses her feelings and concerns to the child. At this point the mother uses her strength and tenacity to prevent the child from breaking away from her embrace. As the struggle intensifies, there is eventually and invariably a dissolving of the struggle as the relationship becomes tender and intimate, with intense eye contact, touch and conversation relating to feelings. This is the final stage of resolution and is marked by feelings of closeness and contentment.”[5]
The therapy has been used with autistic children, and while a cure for autism is not claimed, the results are deemed to be impressive. Holding Time is about how parents, especially mothers, should use Welch’s techniques with normal and slightly disturbed children and it can be used also in institutions for therapeutic purposes.
Therapeutic Crisis Intervention
What kind of help and how it is given make a crucial difference to the young person’s learning from experience or being set back.
One of the principal purposes of control and discipline is to enable young people to develop inner controls, so that in time they learn self-control, establish feelings of worth and self respect and are motivated towards improved behaviour. It is recognised, given the reality of the problems of the young people in care, that there may be an occasion where extreme forms of behaviour are shown.
Therapeutic Crisis Intervention training is a crisis prevention and intervention model designed to teach staff how to help children learn constructive ways to handle crises.
The skills, knowledge and professional judgement of staff relating to crises are critical factors in helping young people learn constructive ways of dealing with emotions such as frustration, failure, anger, rejection, hurt, and depression. It is by our example as social pedagogues that we shape the behaviour and influence the growth of the young people in care.
The main purposes of Therapeutic Crisis Intervention:
- Preventing crises from occurring
- De-escalating potential crises
- Effectively managing acute crisis phases
- Reducing potential and actual injury to children and staff
- Learning constructive ways to handle stressful situations
Physical restraint:
All other approaches must have been considered or exhausted before resorting to physical restraint. Physical restraint may be defined as the limitation of a person’s ability to move freely in their environment, impaired by another person or persons. While as social pedagogues we can understand the reasons for distress, anger and acting out, certain behaviours are deemed unacceptable. However, it is important to note that it is the behaviour which is unacceptable and not the young person.
Physical restraint of a young person should only be used when,
- the young person’s actions pose a danger to him/herself;
- the young person’s actions pose a danger to others.
It is good professional practice following an incident of physical restraint to resolve the issues that started the incident, and each episode of physical restraint must be formally reported and recorded.
Holding as a restraint method
As time passed, holding was less and less used the way it was intended by Winnicott. Holding is now more than ever used as a restraint or “use of force” method. In practice it is less about holding the child’s emotional and physical environment and more about using force to get the child to calm down. This process can be quite brutal and have the opposite effect on the child, as described in the next paragraph “Children’s experiences”.
Children’s experiences
At the present time all the information available about this topic is based on the article Children’s views on restraint written by Roger Morgan. The main reason for preparing this report was that children had told him, in a previous study[6], that staff should know how to restrain properly and without pain. It was important for him to know how children look at restraint, how they experience it, and what they feel during and afterwards. In preparing this report Morgan met up with six different groups of youngsters in different parts of England. There he asked them about different aspects of restraining. In the following paragraphs we will highlight the issues that came up for the youngsters.
Prevention
One of the first things the children pointed out is prevention. Before being restrained there is usually a build up of anger and agitation. It is the children’s opinion that pedagogues should be aware of this. Furthermore, the children said that it is an important skill of professionals that they should be able to avoid having to use restraint. It is usually only a minor disagreement which, due to the staff’s intervention, ends in restraint. So staff should only, in the youngsters’ eyes, cut in when it really gets out of hand and not be constantly looking for and intervening in small disputes. The youngsters also feel that the staff should talk more to them while restraining them.
When to strain
The children have some clear views too about when to use restraint. They do say that it is sometimes necessary, but it should only be used when someone is “in clear danger” of getting hurt or if there will be severe damage to property. The youngsters who were consulted felt, though, that restraint was used much too often, in situations where there was no severe damage, whether material and human. Staff should be able to differentiate between “messing around” and real fights.
Restraint should also only be used as a way of comforting the child when s/he has a rough moment or to help him/her to regain self-control, and not as a punishment.
How children feel
The third part of the study focuses on how the children feel when they are restrained. A lot of youngsters said that they did not know what restraint was, how it was done and when it was used before it actually happened to them. This made them panic even more, because they had no clue what was going on. It is the youngsters’ opinion that they should be made aware of the use of holding and restraint when they get admitted. They feel that it should be made clear on which occasions it could happen, why and how.
Another important point regarding the experience of being restrained is linked to past experiences. A lot of youngsters who are in secure units or psychiatric wards are there because of sexual and/or physical abuse. For these youngsters it can be really hard and confronting to be held or restrained. This will, obviously, bring back memories which will heighten their anxiety and anger, and result in the youngster fighting even more to get out of this situation, eventually leading to an even longer restraint.
Most of the youngsters also said that they felt even more agitated after being restrained. During and after restraint they said they felt depressed, felt as if they were nothing and felt claustrophobic, panicky, hurt, angry and revengeful.
It was not only being restrained themselves that gave young people these feelings, but also seeing other people getting restrained affected them.
How to restrain
The children were also asked how restraint should be done. Something everyone agreed on was that it should not cause any pain. If restraint caused pain the children did not see it as restraint anymore but as physical abuse. The same reason was given if being restrained stopped them from breathing. Again, they pointed out that all staff should be properly trained to apply restraint without giving pain or getting the youngsters even more agitated.
Another reason why staff should be trained is that youngsters learn to get out of restraint after it has happened a few times. Other results were that restraint should never be the cause of bones being broken or involve sitting on the young person’s head. They should not involve a number of people holding young people down or piling up on them, and if one was holding a weapon, the weapon should be taken away first. Last but not least, they pointed out that holding should calm them down and not make them angrier.
Alternatives given by the youngsters included giving a chance to calm down before restraint was used, talking to them in a nice and proper way, giving the youngsters space, and providing them with a “safe room” where they could calm down. The youngsters also felt that everyone’s action plan should mention how this individual should be dealt with if he lost control.
Professionals’ views
Behandelingshjem Hvidborg
This institution is located at Neergaards Allé 6, 2650 Hvidovre, in Denmark. The researchers had an interview with Gisle Ag, psychologist. Behandelingshjem Hvidborg takes care of children between 7 and 13 years. At that time there were sixteen residents and nine children who attended the service during the day.
One of the institutions contacted stated that they were working systemically and therefore did not use holding. Gisle Ag was asked what he thought about this. He said that in Hvidborg they worked environmentally. He added that, in his eyes, environmental and systemic approaches were complementary and should not be considered as opposites.
Gisle Ag said that holding was sometimes used as a restraint method in Hvidborg but only in those situations where there was too much risk that the child might damage him/herself, others or high-value property. There were very strict rules for physical contact between children and staff. If holding was needed, the entire process had to be written down and this file had to be sent to the municipality. Over recent years it had become illegal to use holding. The staff in Hvidborg were not trained in holding or restraint.
On Winnicott, Gisle said that Winnicott’s concept of holding is the mother telling the child that nothing would happen to it, that she was there to keep the child safe and that the child just had to trust her. Here lay a problem. Most of the children in Hvidborg did not have trust in anyone. Again, using environmental therapy, they organised the child’s life, thus demonstrating that they could trust the pedagogues. Structures were used to develop trust and to get to know what went on in the child.
Examples:
- If they tell the child they will do something together, they make sure it happens.
- On Friday mother comes to pick up the child, the entire day the child will look out to window to see whether mom is coming or not.
Winnicott also mentions the concept of the “good enough mother”. This means that what people do, as parents, is mostly good enough, even though it might not be perfect. If the upbringing is not “good enough”, there might be problems. Gisle enlarged the concept of “good enough” parenting to include pedagogues. Of course pedagogues will make mistakes, as they are all just humans, but here in Hvidborg they preferred to say, “You could have done that better”, but still it is “good enough”Containment[7] was used a lot in Hvidborg. Gisle Ag defined it as “being able to tolerate the feelings of the child that it projects on you and afterwards give that feeling back in an adapted form so that the child can cope with it.”
Examples:
- A child says to a pedagogue that he stinks. The pedagogue asks the child why he thinks/says that. The pedagogue looks into what the child feels and why it says something like that.
- To parents, “You find it hard to bring your child here; it is.” This is comparable to Nagy’s concept of “recognition of injustice”.
Playing back the feeling could happen hours or even days after it was projected on the pedagogue. Sometimes the common third was used here. For example, the pedagogue went for a walk in the woods with the child and then started the conversation.
Containing could be hard on the pedagogues but supervision was organised to speak out about it. In Hvidborg there were two forms of supervision:
- “Doorstep supervision” which took place when the pedagogue talked about an experience with a child to another pedagogue or came to Gisle Ag to talk about it.
- Organised supervision, which happened every other week and was designed to ensure that private matters did not get mixed with professional work.
Even if the use of holding were legal, Gisle Ag would not use it. It was his opinion that this method is too violent, too much of a technique and involving feelings too little, and that it is hard to reflect whilst holding. He saw holding as giving the child a limit but felt that it was equally important to be interested in what went on, on the way to the limit.
Sparregården[8]
The target group in Sparregården is boys and girls between 12-18 with psychosocial problems, problems with relations, behaviour difficulties and problems in school. Thanks to Karin Brunbäck the researchers had the chance to ask one of the social pedagogues there some questions.
In Sparregården they did not use holding often, but results had been good with youngsters they had used it on. Very often it started with a situation where a boundary was needed but then the situation escalated. It was very important to have many staff members around since it was not possible to carry out safe holding with just two pedagogues. The most important thing was to keep calm as the situation could be very scary for the young person. The best thing was when the youngster’s key person was there and was the only one making eye contact with him. Holding could go on for hours and one of the most important things was that everyone was aware of what they were doing and why they were doing it. When the young person calmed down they usually started to cry and talked, as they wanted to release the pressure they were containing.
In Sparregården all staff members were educated in this method and their knowledge was updated regularly, with supervision and guidance from a psychologist.
In the fall of 2007 Landsstyrelsen (inspector) said that not enough research had been undertaken concerning holding, so Sparregården was advised to stop using this method.
Karen Scott
The researchers met Karen Scott in Døgnkontakten, a crisis centre for teenagers located in Copenhagen. Karen worked in this institution years ago. There she had her first, and worst, experience with the use of holding as a restraint method.
A girl came home and looked drunk. She started to smash the windows with her arms. For Karen Scott this really was a severe situation since the girl could badly injure herself. She first tried to talk to the girl in the hope of calming her down. This had no effect. This is when Karen Scott decided to use force. She sat on top of the girl, who was face down. This resulted in the girl having a panic attack. Every time Karen Scott tried to loosen her grip on the girl they were back to the starting point. The situation ended with six policemen carrying the girl out of the service. She was admitted to a psychiatric ward where she was held securely and given a lot of medication. It took the girl twelve hours to come out of her tantrum. After this situation – and till this day – Karen Scott still felt bad about this experience.
Later Karen Scott used holding again but more in the way it was intended by Winnicott. She put her arms around a child, holding him firmly but safely. They were able to have a conversation about what was going on, the child was given space and he could look around but still there was enough grip to have control of the situation.
Karen Scott’s experiences working as an inspector can be found in the next topic.
Pedagogues’ views on aggression[9]
“Children who hate” will invariably be given to violent fits of rage, accompanied by a total loss of control, from time to time. They will hit, bite, kick, throw anything within their reach, spit, scream, swear, and accompany all this by disjointed and meaningless movements, lashing out at things or people without apparent reason. In short, they will show total destructiveness together with total abandon comparable only to the fits or rage of the little baby in the cot. Such behaviour may arise spontaneously from within at any time, or it may be a reaction to something in their surroundings that brought it on. What brought it on may only slightly be related to what they express. It is sufficient for them to be frightened, insecure, and reminded of an old trauma.
The worst thing about it, however, is that, in such moments, the child also loses – temporarily – all relationships he has had before with the adults around him and the ego is suddenly stripped of all channels of communication. This makes pedagogues powerless. Neither fear of consequences or of law, nor authority nor respect seem to have any effect, and even the ties of love and friendship, where they have been developed, are out of commission. In fact for the pedagogue this is the hardest part to take; the adult so proud of his successes in establishing a good relationship of some sort with the “children who hate” will suddenly see it gone completely.
Pedagogues said, “Assuming we are stuck with it and cannot, for a change, allow the youngster to run through a twenty to fifty minute orgy of disorganised attack, we may have to hold him physically, either to remove him from the scene of danger and involvement, or to prevent him from doing physical damage to others or himself.”
Pedagogues want to make it quite clear what are they calling physical restraint here has nothing whatever to do with physical punishment. Since there is so much confusion about this in lay thinking and even in the theories of professionals, they wish to explain.
They are against the application of physical punishment in any form whatsoever under any circumstances. Even for the normal child they reject the idea that physical pain will ‘teach’ the youngster, that the entrance to the character of a child leads through the epidermis of his hindquarters or that physical pain will solve things by giving a child the chance to pay for his sins and thus end his guilt feelings.
The implication of physical punishment is always, no matter how mild a form is being used, that physical violence will ‘change’ a child, or will motivate him toward a more social approach to life, people and values. Sometimes it is admittedly meant to be a ‘behaviour stopper’ only, but even then the pedagogue can show the enormous price he pays for such a technique in terms of its poisonous by-products, even should the surface goal be achieved.
The pedagogue will not respond to the child at the same level to wild lashings with arms and tongue. He will, rather, continue to talk soothingly to the child in a low voice, using primarily content-empty wordage meant to calm the waves of excitement. He will answer the child’s screamed insults by quietly saying, “Take it easy, kid, everything is O.K. There’s nothing to worry about. Everything will be all right again. Just take it easy; nothing to worry about; everything is all right.”
Pedagogues think that to succeed, all our behaviour during the attack, however, has to be foolproof, so that there is nothing on their side to back up the youngster’s own triumphant, self-commiseration or paranoid interpretations of the event. Pedagogues’ behaviour during the attack is in no way dictated by humanitarianism or sentimentality: it is simply the logical conclusion of a concept of “total warfare on the youngster’s pathology”, of a consistent strategic approach.
Pedagogues said, “Frankly, it took us a while to get over being somewhat ashamed of having to hold a child, until we finally discovered the full impact of the real strategic issue behind it. We soon learned that some of these extreme situations are only the result of something we missed and could have been prevented at the time by wiser programming or by a quicker predictive hunch”.
Legal aspects and supervision
UN Convention on the Rights of the Child
There are some articles which preclude the right to use any form of physical restraint. Especially in Article 19:
States Parties shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse, while in the care of parent(s), legal guardian(s) or any other person who has the care of the child.
Staff may be authorised to restraint children with no advice on appropriate techniques or training. Given this lack of clarity, children’s rights may be breached and the UN Committee on the Rights of the Child has called for a review of practice. There are also risks for staff, who want to be clear about what they can do and cannot do when using physical intervention with children.
The legal issues are therefore complex. Several areas are potentially relevant and could involve charges of assault against staff by a young person where restraint has been used, as well as charges by staff against young people in the same circumstances and accusations of failure in the duty of care where a restraint has not been used and injury has resulted.
Danish legislation
When using holding as a restraint method in institutions designed for residential accommodation for children and young persons, the law in Denmark is quite clear:
Restraint (…) shall be used only if absolutely required in the given situation.[10] Holding can only be used if (i) there is an imminent risk that the person may cause substantial injury to him/herself or others, and (ii) it is absolutely necessary in the given situation.[11]
If the institution uses holding to restrain a child or a youngster, the institution is obliged to make a report about what happened.
(4) Any forcible measure taken shall be registered and notified by the facility to the municipal council of the municipality of location in respect of the facilities supervised by the municipal council, cf. section 148 a below, and to the regional council in respect of the facilities supervised by the regional council, cf. section 5(7) above. [12]
Though reporting after every restraint situation is obligatory in the legislation, it does not happen as often as it should.
Supervision
Institutions designed for residential accommodation for children and young persons are supervised by inspectors from municipalities. Inspectors – such as Karen Scott – are obliged to undertake a general inspection of every institution at least twice a year. One of these has to be an unannounced inspection where they have not informed the institution about it beforehand. Inspectors can also carry out surprise inspections if they have a reason to suspect that something is wrong.
The other form of inspection is an individual one; in this form it is the local social inspector who placed the child in the care of this institution that makes the inspection. Here it is the municipality that provides the inspection. There are two possibilities. The municipality can establish its own unit of inspectors. They then mostly undertake a bimonthly inspections. Another option is that the municipality hires a private institution to do the inspections.
All the reports made by institutions (e.g. concerning holding situations) go to the inspectors, who look into them in order to make conclusions and take further measures. For example, if the holding numbers in some institutions are getting too high or if the same youngster has been held alarmingly often, the inspectors take a closer look at what is going on. They try to find out if there is something wrong with the methods the institution uses, and to give guidance about alternate methods because, again, the goal is to use holding and other kinds of restraint as little as possible.
The inspectors have the right to give warnings or even to take away the institution’s licence to practise. There was, for example, one case where staff members forced a youngster to shower with her clothes on to show her who was in control. That particular institution was ordered to apologise to the girl; it was given a serious warning and a request to change their practice.
The Human Rights Act
The aim of the Human Rights Act 1998 is to give further effect in UK law to the rights contained in the European Convention on Human Rights and it is legally enforceable in the UK. It establishes important protections from abuse by the state, organisations or employers. Article 3 prohibits “torture or inhuman or degrading treatment or punishment”. This is taken to include techniques such as “flooring”, “bear hugs” and techniques when a young person’s face is pushed onto the floor, compromising dignity of young people.
Employers´ Responsibility: A Duty of Care
Under Health and Safety legislation (Health and Safety at Work Act 1974 in the UK) employers must ensure their staff’s welfare against foreseeable risks and provide adequate training to ensure a safe working environment.
Ethical Considerations
The use of physical restraint is an emotive subject, especially when that restraint is carried out by adults on children. Indeed, from our research the validity of using restraint at all is sometimes contested. What is clear is that whatever position is agreed answers have to be provided to the practical issues faced by residential staff in managing the challenging and violent behaviour of some of the young people they work with.
Where these answers are lacking staff, children and others are placed at increased risk. From our research much of the literature on this topic complains of just such a lack of clarity and consistency at both governmental and institutional levels. This lack of clarity has had the effect, in some cases, of pushing incidents of restraint underground where they cannot be monitored.
Reflections
On holding
Holding can be a useful method, especially when it is used the way it was intended by Winnicott. For social pedagogues it is important to avoid the use of restraint, and this can be done by communicating with the child. Some of the researchers have used it, even though not everyone knew it as a method.
Our main reflection after reading the text Children’s views on restraint is that the pedagogues were insufficiently trained. We also felt that they failed to act as professionals at all in the way they dealt with the children’s aggression. The pedagogues used their power and position to oppress the children. It came across to us that the pedagogues saw themselves as being above the children, instead of equal. Nevertheless we found this a really interesting study, especially since it gave us the children’s view and experiences.
On the other hand we felt that this text only provided us with one side of the coin. We know that it focuses on the children’s views but for this particular project it would have been interesting too to see the pedagogues’ views on it. The young people who were interviewed might have been affected by a situation involving a pedagogue before the interview, or the influence of peers might have caused them to exaggerate. We find it hard as a group to come to any concrete conclusions because of this. This must also make it hard for inspectors to get a clear view of situations, which brings us to another reflection: the importance of documentation and recording.
We feel documentation is the only concrete evidence for finding out what the standards of practice are, what works and what does not. We found, from our interview with the inspector, that there were a lot of disparities between services in reporting. This could be because the unnecessary use of force is illegal regarding Danish legislation. Some pedagogues might think that if they report every situation where they used force, the inspectors would investigate them or subject their methods to closer scrutiny.
Regarding inspections we feel there should be more than the two obligatory inspections per year, especially when it comes to unannounced inspections. This might give a clearer view of the way that institutions really function and what standards need to be improved.
Conclusions
We feel children are being placed at risk by the unregulated use of physical interventions. The staff need a clear explanation and they cannot get one. Children may be subjected to unnecessary suffering as a result of this lack of direction. Therefore we feel that it is really necessary that staff are trained.
A further danger of the current lack of regulation is that individual staff members may be left with an inappropriate level of responsibility in deciding what to do.
Given these dangers it can be argued that there is a need to impose a single model of best practice across services.
It is suggested that we can never entirely eliminate the need for restraint in some situations. However, by establishing a sound ethical framework which addresses staff and user needs and rights, supported by clear guidance and policy and relevant accredited training, we can hope to minimise harm and safe guard staff and users.
References
http://www.childrenintherapy.org/proponents/welch.html
http://www.naturalchild.org/jan_hunt/holding_therapy.html
http://hauki.haukipudas.fi/psyko/rollit/holding.html
http://www.srmhp.org/0102/attachment-therapy.html
http://www.primal-page.com/holding.htm
R. Morgan, (2004), Children’s Views on Restraint Newcastle upon Tyne, England
H. Brembeck, B. Johansson, J. Kampmann, (2004), Beyond the competent child. Exploring contemporary childhoods in the Nordic welfare societies Roskilde University Press – Roskilde, Denmark
H. Buckley, (2003), Child Protection and Welfare – Innovations and interventions Institute of Public Administration, Dublin, Ireland
P. Share, N. McElwee, (2005), Applied Social Care Gill & Macmillan, Dublin, Ireland
M. Eysenck, (2004), Psychology: an International Perspective Psychology Press Ltd, East Sussex, England
D. Winnicott, (1986), Holding and Interpretation The Hogarth Press, London, England
F. Redl, D. Wineman, (1957), The Aggressive Child The Free Press, New York, USA
UN Convention on the Rights of the Child
Documentary: Grief – a peril in infancy (1947), A. Spitz
This paper documents a research project carried out by following students: Berten De Mol, Dovile Petrosiùtè, Michelle Fahy, Mika Värränkivi, Niina Borg. They studied on one of Professor Hegstrup’s courses in the autumn of 2007. He was the students’ research supervisor and was responsible for editing the paper.
Søren Hegstrup is Associate Professor at University College, Sealand, Denmark.
Email: [email protected]
[1] Object permanence; Piaget.[2] True self: the instinctive core of the personality, the infant’s capacity to recognise and enact his spontaneous needs for self-expression.[3] False self: a mask of the false persona that constantly seeks to anticipate demands of others in order to maintain the relationship[4] Holding Time (1988), p. 25[5] http://www.primal-page.com/holding.htm[6] Safe from Harm
[7] Bion’s concept of “containment” is based on the idea that the child projects feelings, which are frightening, painful, stressing or unbearable in any other way for him, into his mother. The mother experiences the feeling herself and is capable not to go into it but to contain these feelings and transfer them back in a modified and embraced form so the child can unravel them and reintegrate them as it’s own emotions.
[9] F. Redl, D. Wineman, (1957), The Aggressive Child. The Free Press – New York, USA
[10] Consolidation Act on social services, Ch. 24
[11] Consolidation Act on social services, Ch. 24
[12] Consolidation Act on social services, Ch. 24