Changing Dynamics of Care. By Dr. Keith White

The residential community called Mill Grove began in 1899, seven years before John Bowlby was born, and over fifty years before the publication of his ground-breaking work, Maternal Care and Mental Health (WHO, 1951). For much of its history it has sought to care for children in need/at risk by creating a substitute family or alternative household environment.  Children, singly or in groups of siblings, lived away from their birth families, in what was generally conceived and thought of as a children’s home. However distinctive the home was, there were many in the UK throughout this period that had a number of characteristics in common.

As Bowlby’s work on separation, loss and attachment began to enter academic and professional consciousness there was a gradual shift towards supporting children in their own families and communities rather than removing them from those who had been significant others for them from birth.  One effect of this over recent decades has been that less “unaccompanied” children have come to live at Mill Grove, as more parents have been living here with their children.  Another consequence has been the increasing pre-school provision on the premises for local families.

In this article I want to explore just one aspect of this change: the different dynamics that it creates within a residential community.  In doing this there is no presumption that one way of living is inherently better than the other.  In the former (pre-Bowlby) period the adults (significantly my grandparents and my parents with others helping them) modelled and taught patterns of life and behaviour in keeping with what they believed to be best for the children.  This included just about every aspect of personal and social life from dawn to dusk, week-days and week-ends, school terms and holidays, the four seasons.  It included standards of dress, language, table manners, boundaries and discipline, religious beliefs and behaviour, and much, much more.

Now some of these patterns of life came as a surprise to children whose families had operated in different ways and with contrasting values.  The home felt distinctly middle class to those coming from the working class East end of London, for example. But over time (and often on reflection years later) they often came to appreciate the consistency in the way life was patterned and experienced.  It was the caring adults who shaped the immediate social environment, not their birth families.

When parents and children come together to live at Mill Grove we seek to support the bonds of attachment and that means that a parent will continue to have a major share in the way their child is brought up.  This can work smoothly when we can support it with a good consciencea, but it creates some chronic difficulties when we can’t.  Let’s take eating habits.  The mores and tradition of Mill Grove is that during main meals a child learns to have a little of everything that has been prepared, thus ensuring a reasonably balanced diet.  Several children and their parents have a different approach, and it is possible that children will choose only the food that they like, thus having (for example) no vegetables or fruit.  How is this conflict resolved?

Then there are expectations about bedtimes, both the actual time in question and what putting a child to bed entails.  Baths, showers, stories and prayers may be replaced by far less predictable patterns. Electronic devices may be available to young children all through the night.

At the heart of all this is the question of what constitutes “good enough parenting”. What if a parent leaves her child to cry loudly and continually during a meal-time?  What if a parent leaves her young child alone? What if the way a parent responds to a child or young person is inappropriate both in words and actions?  What if a parent has mental health problems and cannot relate to a child consistently because they do not hold the child in a healthy mind?

A constant thread in all this is how to balance the needs of the child on the one hand and the parent on the other.  It is a chronic issue in mental health and in my experience shows little sign of being grasped let alone addressed in any systematic way.

The challenges in a residential community multiply when one takes into account the fact that there may be more than one parent living or staying at Mill Grove.  Then there is likelihood that there will be different expectations and values between some of the parents.  How do we arbitrate?  And how do we advocate and model consistent boundaries?  Some mature readers will immediately be aware that this sort of scenario is well-known to many grandparents.  In fact it gets to the heart of much grand-parenting in practice. Much of social work and residential care has near its core the parent-child relationship (in many varieties), and perhaps we would do well to open up the thinking and practice to the way extended families operate around the world.

Once this line of exploration is pursued it becomes pretty clear that there is a virtually unlimited range of possible challenges created by this change in the dynamics of care.  Imagine a classroom where the children’s parents are always present, and then think of the challenges this would present to the teacher. That may clarify some of the issues that are likely to arise. The reason I ask such questions is because I do not know the answers.  What’s more it is dawning on me that if anything it is an art rather than a science.

Clearly there needs to be good and open communication between the parents and the carers, but there will still be many times when a parent is unaware that he or she is acting in ways that we consider to be inappropriate. So some things never come up for conversation or review because they are not seen as significant.  We do not have formal reviews or meetings as part of our way of life, and are reluctant to introduce them because of the risk they pose to the normality and informality of our life together.

As I said earlier the difficulties are not an argument for separating children and parents as used to happen decades ago.  It is important to support bonds and bonding between children and parents who are “good enough”.  But no one should underestimate the wisdom, patience and resilience required in such a setting.  And what if it is “good enough” sometimes, but not at others?

What we do find is that there is an ethos understood by a critical mass of people at Mill Grove that helps to provide something of an agreed way of living some of the time, but some interaction between parents and children falls outside these limits.  Occasionally we have to intervene to safeguard one or more children.

Perhaps most frustrating is the knowledge that children are not being allowed or encouraged to reach their potential: the parents’ view of life is understandably restricted, and it is extremely hard to enlarge their vision. If you have possibilities and options in mind that do not exist in the mind or imagination of the parent or parents, then there is little hope of passing them on.  No person can understand what they do not know.  So walking in the forest at autumn time, may be supplanted by yet another trip to a shopping mall; individual computer games replace reading stories together; playing games together inside or out is rarely considered; television is a default mode; conversation is stilted and tends towards restricted codes and sound-bites; the world is parochial.

Looking back over such a list it becomes apparent just what a gap there is between traditional working class and middle-class values.  They have probably always co-existed in much social life worldwide, but it is a particular challenge when they collide in a single family household.  Given the wisdom of the nostrum that “it takes a village to raise a child” perhaps one of the keys is to conceive of Mill Grove as a village.  That could make a lot of sense.

However it might have come across, the purpose of writing this piece has not been to extol one set of values or lifestyle over another, but to muse on a dynamic that creates such profound and continuous challenges in daily life and experience that I am having to go back to the drawing board again and again.  In this as in so much else I find that the learning curve is steepening.  And as always, it helps to have a well-developed sense of humour.


Keith J. White

27th October 2015