Paper given to the Portuguese Association of Child and Adolescent Psychiatrists. 17th October 2008.
- Bom Dia. I am very pleased, and greatly honoured, to have the opportunity to address this gathering on the important subject being covered by the Conference – how, despite our best intentions and efforts, we adults can sometimes have a “disorganising”, and occasionally damaging, effect both upon the children and young people we seek to help and upon ourselves. How can we recognise this difficult reality and what might we be able to do to “re – organise” ourselves and our work, and restore, perhaps even in some unexpected ways, more hopeful outcomes for the children? I shall try to offer some thoughts that will contribute to our understanding and our practice.
Some of you may know me as the former Director of the Mulberry Bush, a therapeutic residential school for young children in Oxford, England. In recent years I have been working as an Independent Therapeutic Consultant to groups and organisations offering similar provision for their child or adolescent residents. I enjoy my work since it still keeps me close to adults and children trying to learn, change and grow together towards personal health and social integration. I have always preferred operating largely outside of the clinical consulting room. My investment has been in the therapeutic management and treatment of psychological disturbance and disorder within and through group and institutional settings. This work still develops important 1 to 1 relationships, but ones which are nurtured in the work context of people living and learning together not just in a group but as a group as well.
Technically this might not be an “in – patient” environment in the medical sense, but it is very similar in many respects, and many of its members, children and adults alike, can often feel very “impatient” with the frustrations and challenges that accompany the living together in close proximity – an experience with which some of you are likely to be familiar. And our experience has shown us that, while there are important differences, there are also many overlaps between the issues that arise in more formal 1 to 1 therapeutic work and those encountered while meeting the needs of individuals in group living and educational environments. So my comments, I hope, will prove of interest to you, whatever the focus of your own practice.
- I will confess to having been very anxious at times when preparing this presentation, and I still feel a bit anxious even now. My fear has been and remains that I shall fail today, that for you who have come here to the Conference in understandable expectation of a valuable experience my contribution will offer nothing of worth to reflect upon. After agreeing with the conference organisers a topic and title that might be of interest and value, I began organising my thoughts. First, I researched books and journals, seeking references to this topic of Failing in our work. I became increasingly anxious when it seemed that there were few if any direct and substantial contributions from our professional colleagues on this subject. Then even more worrying for me – I could not find in the limited literature available that “final word” on Failing which I could pass on to you so that everything would now be perfectly clear. Therefore I had no choice but to look first and foremost to myself and my own experiences of failure in order to produce something worthwhile to present to you.
Now Nietzsche said, “Only thoughts that come from walking have any value.” Therefore I decided to go for a “digestive walk,” free from any particular preoccupation and holding my mind open to whatever might emerge by way of “valuable thoughts”. Unusually in England this year the sun was warm and shining, drenching the Michaelmas daisies and goldenrod in light while they swayed in a gentle breeze. Everything was in place for these thoughts of value to emerge and guide my words to you.
Except, none did; not even a glimmer of a single such thought. Only mundane, practical ones came into my head – “don’t forget to get the new insulation cover for the water tank; oh, yes, you need more cereal, and milk; hey, that early autumn sun is wonderfully warm.” But none of this richness of walking, warmth and natural beauty transferred into a richness of thought. I guess Nietzsche would have said, “Well, that’s the thing about walking for valuable thoughts; sometimes it works and sometimes you only have a good walk.” But I was not consoled by this realisation. I had failed, and I was going to fail you in turn. How will I speak to you about this important matter if I don’t have any deep, insightful, profound thoughts to dispense?! So I was even more nervous; you wouldn’t get what you wanted, what you needed – a “good feed”. However, since it wasn’t realistic to hope either that the day of this conference would never arrive or that I would simply not attend, I finally accepted that if I was going to fail you, I’d at least give it a “good try” first rather than give up and be resigned to failure before failing.
So in this experience of mine I was encountering the dilemma and challenges that can face us in our work quite regularly – the uncomfortable worries or fears that we might fail, long before we actually do on occasion. That made me feel ready to try to say something of use, based on my own experiences and only supported by what others have written.
III. To begin I turned to literature of a different kind. In a Samuel Beckett play, Worstword Ho, the character says, “So you tried, and you failed. No matter. Try again; fail better.” So far as I can understand Beckett at all, he seemed to strive to endure what he experienced as the utter meaninglessness of life by embracing it and being even more meaningless – as much perversely as paradoxically overthrowing life’s meaninglessness. In fact he is reputed to have declared that he hoped there was a Hell; he’d make sure he got there after death. Then he’d really give them hell so that they would experience it fully for the first time! For some this suggests that Beckett retained an irreducible spark of hope that life could have some kind of meaning. For me he sounds pretty bleak and doesn’t grasp the potential of our “meaning making” beyond the mere perpetuation of an intolerable life. It really feels more like a dystopian take on the Hell that Dante described, but with neither the beauty of the language in the Inferno nor the hope of the journey through it with a wise guide.
In fact I think we can understand what Beckett wrote about failing differently. We can see it as a comforting recognition that, being human, we will sometimes fail. But we can try again. In this way I tend more toward Winnicott who in his familiar paradoxical manner can see failure as positive, a success even, in particular circumstances, or Victor Frankl, who in writing of his experiences in a concentration camp offers even out of that hell on earth the prospect of a “Tragic Optimism” for going on living even in the face of terrible adversities and death – which I would call a courageous Hope.
- It may well prove useful to remember some things about failing that we already know. Here are the Oxford English Dictionary definitions of “to fail” –
- Be unsuccessful in an undertaking; judged not to have passed; neglect to do something
- Disappoint expectations; become weaker or less good; desert or let down (!)
- Deprive of a position [as in “I held you in high regard, but you failed in that position”]
The word, fail, itself is based on the Latin “fallere” – to deceive! Little wonder then that we don’t willingly face our failures or the prospect of them. Most often to fail is a negatively weighted act and failure a burdensome state. Not surprising either that we can find it hard to see any benefit from admitting our failures, let alone exploring them. Perhaps that’s why politicians in the UK are fond of saying, immediately after a political mess erupts or is exposed, “We need to draw a line under this and move on.” – usually into the next unexpected, unwelcome and unexamined mess.
Closer to our professional world, we have to acknowledge that we tend to look, talk and write about our practice when it goes well and are often less keen to stay with failing. Along with being human, there is our professional pride which can be at stake. And in most professional trainings barely a word is said about failure as we gear ourselves for success – as cure preferably, but at very least as significant improvement, regardless of the internal and external pressures that affect our practice. It is as if there is a deeply embedded taboo about bringing it directly under scrutiny. Yet in the 16th Century Montaigne pointed out, “Our life consists partly in madness, partly in wisdom. Whoever writes respectfully only about the latter leaves more than half of it behind.”
With this in mind, I shall relate to you some of my failures, from modest to spectacular. One time long ago, 5 years or so into my career (and during my psychotherapy training no less) I came across Rose, age 10, in her room. A very troubled, emotionally damaged child, her bedroom was regularly a “complete mess”, made all the more so because she was so good at collecting up masses of items of clothing that had been left around or that she’d bought at local charity sales – few of which fitted her and all of which would burst out of bags, drawers etc and contribute to the mess. On top of that Marion, a staff member to whom she was very close had recently left. I am ashamed to say therefore that coming upon Rose on her own in her mess, and being certain of my deep professional knowledge, I had the “therapeutic” notion that just then what she most needed were boundaries, structure, order(!). So immediately I gathered every single item of this “jumbled mess”. And I threw it all out of the room into the corridor, telling her she needed to tidy her room. If anything came back in, it had to be put away properly in her chest of drawers or her locker. I then walked off, proud of my decisive intervention.
A few days later I was relating my “intervention” to a colleague, and she said that she had to clear the mess up from the corridor later that day when she found Rose still sitting on her own in her now empty room looking out at the mess. You know, I think it was only then that I first felt truly ashamed of what I had done to that child in the name of “care”. While I never did such a thing again, I also never apologised to Rose. In fact we all pretty much made a mess of our work with Rose, not least because at that time little was known about child sexual abuse, and in retrospect it was clear she had been and was still being sexually abused when at home. Maybe we could not have known as fully then as today what the signs might have been, but nothing excuses my coarseness to a child much in need of genuine concerned caring attention. And while my action was perhaps a small contribution to her hurt, it was a contribution that was neither needed nor acceptable. I had covered up as “treatment” my arrogant ignorance of what the child really needed. It doesn’t help either to know that my and our failures to understand Rose were also ultimately failures to make enough difference for her while she was with us. She now is resident in a secure mental health hospital.
Could we ever have made enough difference? I don’t know, but it makes our failures, my failure in the moment stand out even now as part of that not knowing. The Stoic philosopher, Seneca, declared, “Why waste time crying over particular moments in life; the whole of it calls for tears.” Well, yes, perhaps; and yet some things do call out for extra tears. My mistreatment of Rose can be seen as a very minor “sudden rush of blood to my head”, easily forgiven if not excused. But it is precisely because it is a minor detail that it should be acknowledged as a serious failure. For in fact creating and sustaining a therapeutic way of living and learning depends fundamentally upon our conscious caring attention to the countless small details of everyday living. When attended to thoughtfully they provide the backcloth for the children to feel secure enough to begin to hope that the adult world may finally prove itself to be reliable and trustworthy. In this incident I strengthened not Rose’s hope but her hopelessness. As the Canadian author, Robertson Davies, observed, “How readily the qualities of [adult] authority and power can be brought to the service of the wildest nonsense and cruelty.” We have been warned.
- In fact part of me even now wants to reassure myself that my nonsensical actions didn’t really propel Rose further on to catastrophe in even a small way. And I realise that reassurance, in service to easing pain, guilt and anxiety and to bringing order to messy situations, can often contribute to and compound our failures. In my experience when I have found myself trying to reassure an anxious or troubled child it is often myself I am trying most to reassure, shoring up my own crumbling confidence as I suggest to a child or the group in so many words that “it will be alright; it doesn’t really need to hurt, and with no real pain necessary, there need be no harm”. Sometimes too it is our professional certainty that produces an arrogant reassurance as we seek on the basis of our wider experience and knowledge to persuade a child that things are not really as awful as they are seeing or fearing them.
Whether out of anxiety or arrogance, reassurance is often hasty, almost always ill advised and thus futile and a failure in our efforts to truly help children. In the mid 1980s I left the Mulberry Bush for 5 years to lecture at Reading University. We adults had agreed the then Director would tell the children of my pending departure at a community meeting just before lunch. After that session, which went well, I had planned to join Luke and Tuan (both nearly 11) at their table as I often did. Each of them had developed a special relationship with me over nearly three years. In fact Tuan had developed a very witty way with words that we all enjoyed and that sometimes displayed a grounded maturity well beyond his actual years. We three had done some important work, and both boys had changed and grown impressively in themselves and in their trust that grownups will recognise and meet their needs. I was a little late to lunch, having been held back by some other children asking me to clarify precisely why, when and where I was going. I had been anxious about how the two would take the news, and although our Consultant had advised me that they may well take it hard, I was feeling rather reassured as I approached the table because neither of them had appeared badly upset at the community meeting.
You can imagine how I felt when I reached the table and Tuan, ignoring me, turned to Luke and said with angry resignation, “So really, what’s the use of getting to know somebody well, when all they do is go away?” My blood suddenly felt like it was draining down my body, through my legs and feet and out my toes. It was an actual physical sensation, and luckily for me the table was such a height that I could kneel down across from them and lean forward on the table to listen and catch up with my own racing heart and panicky thoughts. Facing them and the enormity of their upset, I desperately wanted to reassure them – e.g. I wasn’t really leaving them, not entirely. I was still going to live down the village and would only be 200 metres away. I could easily visit them regularly; they will see me in the village, and anyway we had already achieved most of what they had needed to so it was a good time to go etcetera, etcetera, etcetera…
It was only through just holding onto our Consultant’s earlier observation that I didn’t blurt out all these reassurances, false and irrelevant as they were to the boys’ concerns. Instead, feeling almost physically sick (“bloody awful” as the English accurately say) and with slumped shoulders, I could only listen as they discussed their angry feelings of being left behind, ignoring me still. Finally I looked at them and said “I know it really hurts, and I feel bad too that soon we won’t be together like we have been. I can’t make it better for you now, but I do hope we’ll be able to spend some time together before I leave so we can have a proper ‘goodbye’, even if it feels awful just now.” We then ate quickly and mainly in silence, until both boys left together to go out and play before afternoon classes. I did not follow. Both boys kept a physical and emotional distance from me for several days and then we did get closer again – to talk about different ways of going, how it can feel and how you can still feel good about someone who is no longer with you. Mainly they wanted to enjoy a few more times what we had already been doing together. On my leaving 8 weeks later there were tears and heartfelt hugs.
For children who have suffered abandonment, neglect and often sudden, unexpected departures or losses of people during their early and unpredictable lives, the separation from someone with whom they have formed a positive relationship is never welcome, however inevitable. There is ample scope for false reassuring – to deny the pain of all parties, the pain being “inflicted” and that being suffered. I left that table with a large part of me still wanting to make it all right, to soak up and take away the pain of reality. Perhaps that is why I immediately remembered Tuan and Luke when some years later I read a paper by Winnicott, Dependence in Various Settings (1963). While commenting on the psychoanalytic relationship, he also had residential child care settings in mind. His point was that early on in the relationship it is crucial to be reliably present. Thereafter, when the relationship is established, it is not enough simply to offer a reliable presence and other good experiences that build trust as a corrective to earlier failure. At some later point to help the child to get well we must also fail. And when we do, it awakens the anger of the child which could not be safely expressed – and emotionally “held” – at those earlier times. This time, however, on the basis of a healthier, “holding” relationship, the child can have, show and survive their anger and despair without fear of retaliation by anger or by false reassurance that denies again the pain. Winnicott says, “The operative factor is that the patient now hates the analyst for the failure that originally came as an environmental factor, outside the area of the infant’s area of omnipotent control, but that is now staged in the transference. So in the end we succeed by failing – failing the patient’s (or child’s) way.”
For Tuan and Luke their way was to be angry and resigned with me for a time, without me “making it better” by reassurance or demanding their acceptance of reality. For them I think I failed in a useful way, just, and largely unintentionally! This wasn’t always the outcome with adults or children leaving the Mulberry Bush. Here are my notes of an individual session with Brian in February, 1981:
When I came to visit the children for the first time since coming out of hospital [I’d torn my Achilles tendon and was in plaster from toe to hip], Brian was at the back of the first group who rushed to see me. Soon after the others had had their say, he came forward and said, “Yea, Richard, can you please get me … (pause) my special time”. He was only looking partly at me when he said this. He didn’t look well, glasses missing, a sore on his chin rubbed raw again and his ear equally raw in a large patch. His cough, only recently gone, was also back again. I suggested we talked on our own soon, but added that I understood how difficult it was for him not to have had his “special thing” (crisps with a drink in his special glass – while lounging in a full bath).
Speaking to some adults later, it was clear that he was having a rough time. Lorna had had two sessions with him the day before. After consulting the Director I told Brian that I would be doing his special thing next day, though not upstairs. He took this message in with no outward show of feeling in either direction.
I fetched Brian from Class Group next day and we sat on the green stairs. He tucked into his crisps and he asked about my leg (in plaster). In time I told him that while in hospital I had thought about the important talk we two should have about how he feels about his social worker’s plans to find him a foster family. Rather than replying to that, he said that he needed to go to the toilet. On his return he was very agitated, telling me:
1) a girl at his children’s home had been run over and killed by a lorry while she had been on crutches.
2) a comet was coming from far out in space and was going to crash into the earth. America was sending up a rocket to deflect it into the sun.
Brian continued to walk about in agitation, rubbing his hair and chest and really trying to say something, coming towards me then turning away. I let him carry on and after 3 minutes he stopped, looked at me and said, “Richard, do you ever feel like telling somebody to push off?” (I thought he was meaning about me asking questions he didn’t like to think about/answer). I told him that I did on occasion feel that way. Clearly this wasn’t enough. There was another 30 second pacing and he came over to me and said “You be the foster child. I come over to you and say “Hi, how are you?”. I replied: “O.K. thanks”. Brian: “What have you been doing?” I: “Oh, nothing much.” Brian: “Seen anyone?” I: “No, have you?” Brian: “See what I mean Richard? What if they (Foster parents) ask me questions and I have nothing to say or don’t know the answers? I’m afraid that I’ll get angry and tell them to push off”.
I said I understood why he might be worried about so big a change for himself. However, in families people more often have things to say than not since questions like he asked would be asked when he came home from school. I also reminded him about the traditional family “joke” – “Where are you going?” “Out”. “What are you going to do?” “Nothing”. He smiled at that.
When I said it had been a long time since he had been in a family, he agreed although he was very unclear about how long he had lived in children’s homes. He said about his family “They didn’t take care of me well. She didn’t know very much; my Dad was all right”.
Then he returned to our play acting. “You be the foster boy again. Say I come along, ‘Barge over’” As he said this he came aggressively towards me and in sitting down pushed himself against me, face jutting out towards mine. I suggested to him that before a child is accepted into a foster family, the parents always consult their own children about whether they would like a foster brother. Once the child came everyone in the family was ready to welcome him. At this point, or indeed from when Brian first began his play/communication, he had become more animated and less wooden. His special thing finished off on a cheerful note.
I was impressed by Brian’s presenting the problems he was facing to me in so clear a fashion. I made a point of telling him that, all his fears considered, I still reckoned he could benefit from being in a family again and he would contribute something to that family. He had acknowledged too that part of his worry had to do with that fact that
1) he wasn’t worth all this fuss (in his own estimation) and
2) he was fearful that if he began to look forward to fostering actually happening it would fail to happen and he would be sadly disappointed.
One final point. As we had suggested to Val from the Fostering Foundation, Brian was confused about so much, including the time scale involved in being fostered and Val’s actual role. I reassured him on both points, not, I suspect, for the last time.
Please note my final comment: “I reassured him”. This reassurance came home to me 16 years later. I received a call from a psychiatric nurse in an inpatient ward in the west of England. A young man had been found wandering lost and confused and had been admitted. He could only give his name, Brian, and mentioned Richard at the Mulberry Bush. Did I know him? Clearly it was Brian; I gave some basic information about him and where he had lived. I also offered to come and visit Brian if he wished it. I never heard back. It was then I went back to my notes, and I cringed when I read the last sentence of that session. On that occasion and in that relationship my reassurance wasn’t “failing in the patient’s way”, however well intentioned. In retrospect, for lots of reasons it was always going to be a high risk strategy to place Brian in a family. My reassurance was at best premature. At worst it placed an ultimate expectation on him to make it work. After all, I seemed to be suggesting, it’s so natural. Perhaps I should always feel like my blood is draining out of me so I don’t talk too much and too soon!
- In fact as you will know it is hard to get a balance. Alongside occasions of guarding against reassuring, there is the risk of worrying, or more accurately “excessive worrying”. In The Ailment, Tom Main wrote about this phenomenon when he was the psychiatrist at the Cassel Therapeutic Community Hospital in London many years ago. He identified those “special patients” who strongly attract the intense attention and efforts of staff to help them and who equally strongly resist all those efforts, while continuing to demand special status and showing what Main calls “a remarkable capacity to distress those who looked after them”. In a reflection group set up to address these phenomena he came to the realisation that the worry people initially had about this population began as a genuine caring concern for them – since, before arriving with them, all of them had serious and enduring difficulties from a very early age with little effective help. What he also noticed was that the staff worries shifted into a different kind of worrying. That is, in English another definition of worrying is when an animal, usually a dog, chases and harasses sheep. If not stopped, the dog will continue to “worry” the sheep, snapping at their heels without ceasing, until their hearts give out from panic and exhaustion or they are caught in the wire around the field or plunge into a river and drown.
Main recognized that his staff were worrying so much about these patients that they were getting caught up in this other “worrying” and chasing them relentlessly. However, unlike the sheep, these “special patients” with their longstanding, apparently intractable problems were more wily. They kept well ahead of the “worrying” staff and often led them to breakdown as they tried ever more desperately to help them, and not fail like everyone appeared to have done before.
Now children like those at the Mulberry Bush often fit exactly the profile of the “special patient”, and some touch staff particularly, suggesting a special helplessness, predicament and vulnerability. And, as at the Cassel, they also make us, staff, feel “special”. They prick our egos, our omnipotent determination to be specially attuned experts – to the point that we concentrate excessively on the behaviour and don’t look enough at the dynamic context or the relationship. Then when our failure to help becomes increasingly apparent we become especially alarmed, angered and shamed, which is real “worrying”. The hunted has become the hunter!
Van was 8 when he joined us and he stayed for 3 years. Born in London, his parents were both from Belfast, Northern Ireland. Dad was from the heart of the Catholic/Republican side of the city; Mum from the Ulster Loyalist Protestant side. Two tribes, no longer actively warring after many generations, but far from living in harmony even now. Parents met as students in London, fell in love and were married there with no other family members from “either side” in attendance. They were disowned. Until, that is, Van was born. Then paternal grandfather turned up while baby was still in hospital and insisted he would be named Van, after grandfather’s own father. Mother could not resist but declared later that it felt like her baby had been stolen from her. The “war” then came to London – Van’s parents now fought endlessly and viciously over him; whatever one said, the other undermined.
By the time of his arrival with us, Van dealt with the impossibility of his position and the pain by behaviours that suddenly and violently erupted and were uncontrollable by school and his mother, who was now separated from father. Dad himself got Van to behave through regular bribery and delinquent collusions with him that mirrored his involvement in the criminal drug world he inhabited in part to secure funds for weapons for the IRA.
Nor was Mum an uncomplicated character herself. While largely meek in her demeanour, she occasionally showed another side. Once, she and Dad returned Van from a holiday with his hair shaved to a skinhead cut. I was clearly astonished, and Mum said to me, “What, don’t you like it? I love it this way; I really love it.” As she spoke she was rubbing Van’s shaved head, and her voice had, I felt, a distinctly sexual edge to it. Van looked up at me with a face partly sneering, partly bemused.
Typically too, and only partly unconsciously, Van had taken it upon himself to bring his parents together, if not happily, then at least through a shared anxiety about his highly dangerous behaviours. In this he was struggling against not only an entrenched family dynamic but the weight of long history as well. With us, Van behaved just as chaotically, but most staff felt deeply for his obvious and impossible predicament that parents could see but were unable to ease in any important way. It was as much our special worry for him that ensured we tolerated his often wild and dangerous actions. He seemed so vulnerable at other times, on one occasion weeping terribly when Dad was arrested and imprisoned for a time, blaming himself for it happening and absolutely refusing to see the reality we tried to put to him. As he blamed himself and resolutely continued his dangerous behaviour – jumping out windows, violently attacking people, once putting his fist and arm through a window and lacerating himself – many staff, while often anxious and distressed, resolutely continued to try to help with compassion, in other words “to worry the patient”. By that time I think Van was sometimes just trying to get away from our relentlessly “understanding persecution”. In the end Van left us without our ever having helped him contain enough of his impulsive behaviour or even noticing sufficiently how often we were simply “worrying the child” and getting caught up in the family dynamics of organizing around him as the problem.
Some years later he came back to visit, quite grown up and driving his own car (which I wondered for a moment if he’d stolen!). We had a happy reunion, and I was interested to learn that he was gainfully employed in the car parts business and had not been in trouble with the police for over 5 years. He commented, “I thought that if I hadn’t let the Mulberry Bush help me, I’d better do it myself or I’d be in prison like my dad.” Once he got some distance from our dedicated worrying of him, he could make use of himself and his experience with us.
Since encountering Van I have been far more alert to “special children” and the risk of “special worrying”. I also understood for the first time the true importance of the school founder’s, Mrs Dockar – Drysdale, concept of “concerned neglect” – at those times when we come to feel personally guilty as we find it impossible to meet the needs of a child. Rather than trying to help by “worrying” the child or blaming others for the failure, she recommended instead that staff openly acknowledge this inability with the child while restating that, although not being able to actively help just then, they do continue to be concerned about him or her – a useful antidote to the “worrying” tendency.
VII. You would be forgiven, nevertheless, if you were thinking now that I have set you on an impossible course to steer, between the Scylla of trying too hard (and “worrying”) and the Charybdis of trying too little (in the guise of “concern”). Yes, there are risks in these waters we sail. Perhaps, however, we face less a demand for perfection – to get the quantity of our engagement exactly right all the time – and more an invitation to focus on the quality of our trying. Of course even that is no easy option, especially when we are often facing the “trying” child as we try to hold our tiller steady in stormy waters. [Interestingly in English the word “trying” does not only mean “making an effort”; in another definition it is an adjective, meaning “severely testing one’s patience” – which many of our patients, pupils or residents in treatment do.]
To really try with “quality” can be quite a “trying” challenge. Again the writers and philosophers have long known this. Nietzsche declared, “In the interval between failure and success… must come pain, anxiety, envy and humiliation. We suffer, sometimes over long periods of toil.” He observed that many give up trying because they have an incorrect idea of how much time, effort and pain is required to work through to what we seek to achieve(The Gay Science). And Sophocles wrote, “Ta mathemata pathemata” – “Things truly learned are things suffered.”; . More prosaically, in the popular British reality television programme, Dragon’s Den, one of the judges made the same point in an interview. He’d had nothing at the age of 29 and was still sleeping on friends’ couches, scraping a living by buying old cars at auction, repairing and then selling them. Then one day he bought an ice cream van, and while fixing it up, he noticed other such vans that always had long lines of waiting customers. He decided to keep the van and sell ice cream himself.
Now in his early 50s he is a multi – millionaire, all from beginning with one van. He said, “People sometimes say how lucky I was; they’d also had an idea and really tried to make it a success, but it didn’t work out so they gave up. I asked how long they had tried. They would answer, ‘Oh, at least 18 months, or 2 years.’ That’s not trying! I had to keep trying all the time, failing a number of times on the way. Only now that I have so much money can I finally stop trying and turn my attention to something else.” There is that quality of trying, which is a determined “keeping trying”. Just like another good quality “tryer”, Thomas Edison, the inventor of the usable electric light bulb. He said “It took me over 1,000 attempts to achieve a workable bulb; but I hadn’t failed before. I had discovered more than 1,000 ways not to build a light bulb!” Clearly the quality of perseverance and aspirational determination keeps one open to learning from experiences.
A key feature of this healthy determination to persevere is the capacity to tolerate uncertainty, the uncertainty about whether or in what way things will unfold. In engineering or in life, this is challenge enough. When we are trying to treat troubled children, who may often be at serious risk as well, uncertainty can be greatly infused with anxiety, saturated even. Mason (1993), when leading a team engaged in Child Protection work, realised that at such “saturated” times we can fall into a position of “unsafe uncertainty” This position can drive us either to premature, panicky or omnipotent action or freeze us into impotence and inactivity, too overwhelmed to think and intervene wisely. He proposed to his team that they accept that regularly they will not know everything that might be necessary in order to keep some children completely safe. However, instead of seeking this absolute certainty they will focus instead on establishing what they do know at that time and what they think they don’t know but will have to discover, while remaining open to uncovering other relevant things they may not yet have considered. He called this “A Position of Safe Uncertainty”, and it enabled his team to stay actively engaged despite the huge responsibility and continuing uncertainties. I believe all professionals will recognise these respective positions and understand what a contribution holding a “Safe Uncertainty” can make to our efforts to try to help in positive, active ways.
Of course achieving a capacity to hold this Position rarely happens quickly. It takes time and practice in dealing with the countless uncertainties we regularly face. Nor is it only “Kronos”, chronological time, that matters; it is also “Kairos”, a time in which things emerge or unfold according to their nature – as perhaps we recognize through the Old Testament psalm, “To everything there is a season”. Seasons and safe uncertainty don’t simply arrive with the ticking of a clock; no, they emerge, grow and come to fruition in the fullness of their own time. In this respect, therefore, all professionals are adults, according to their chronological age. Most, although not all, are also “grown – up”. That is, mature in their being and in their professional practice! But there will still be much to learn if they, indeed we, are to keep maturing. One aspect of this mature practice is espoused by Margot Waddell, principal psychotherapist at the Tavistock Clinic. While consulting to social work teams, she realized they must deal with the challenge of “living in two worlds” (1989). In one “world” they can be very busy indeed, providing practical, financial or statutory support and oversight – in effect, a service through a sometimes frantic “servicing”. In the other they can offer a service by “serving”. This requires the worker to sometimes stop rushing around “doing” and to begin “being” as well. That is, staying alongside their clients, offering them emotional understanding and showing them that they are not entirely alone in their difficulties and that, since the worker can bear them and the impact of their difficulties without collapsing, perhaps the clients too might feel able to survive and in time thrive. That service by “serving” is a crucial feature of our therapeutic treatments too. After all, “therapy/therapeutic” derives from the Latin “therapeutes”, which means “an attendant” to Aesclepius, the god of healing.
In “attending therapeutically” we are not overactive either to succeed or to avoid failure for our patient or ourselves; rather we serve by standing alongside and assisting thoughtfully from that position. Nor is this form of trying an exercise in endurance alone. We also “exercise” our knowledge, skills, belief and hope that can produce the insight which may lead to helpful outcomes. With this array of attributes, we can keep trying in useful ways. We know we might fail. But we can try again, as Beckett challenged us. At least by keeping trying we don’t commit the cardinal error of “letting down” the child. On those occasions practitioners know what is needed but choose for whatever reasons not to even bother to try, enough or at all. For the child being “let down” is a sudden break, a dropping, a final blow. That small bit of hope to which a child in adversity has often clung is now very vulnerable to being crushed completely and replaced by a bleak or raging despair.
VIII. In my closing remarks let’s first remember together how failing can make us feel: a failure, fearful, shamed, angry, in denial, wretched, dismal, deflated, blaming, vindictive – and occasionally curious, regretful and wiser.
We also know how important it is to accept failing or our human condition that makes failure a real possibility, while knowing at the same time that our trying again is often what the children remember most about us. In my experience many say so when they visit years later, “I come back to you because you never gave up on me, like so many others did.”
We recognize the risks in the way of trying again after we fail. We might:
- Discharge the child suddenly for lack of cooperation, or
- Retreat to an absolute certainty that denies reality and our role, and
- Soldier on doing more of the same in a futile gesture, or
- Retreat to a split off personal empire, or
- Slip into a delinquent sub – culture with other staff simply to survive, or
- Disengage to a physical presence but emotional unavailability, or
- Revert to excessive humour or sensational stories of “impossible children” to disguise denigration.
Or we can face our failures and become better able to do so by shining a strong light on them and bringing them out of the shadowy corners of our mind where we sometimes prefer to store them. We can:
- Move towards our discomfort and anxiety
- Name our feelings and actions and own them as part of ourselves and not just the faults of the child
- Experience them for a time, without rushing prematurely to rationalise them and take further action
- Talk about them with supervisors, consultants and colleagues, and not simply keep “going it alone” as we say in England
- Read and write about failure, feelings, reactions and responses
- In time be open to possibilities and act on the insights gained.
I accept that exposing ourselves and our failures is a threat itself, but it is also an opportunity for us, and especially for future occasions when we will encounter again in our practice impasse or looming failure. Now we shall know what to do when it feels like there’s nothing we can do – accept failure, if necessary, and continue to manage yourself even when nothing or no one else accepts your therapeutic management. Then maybe we will succeed in failing like Winnicott encouraged us to do – “in the patient’s way”.
And by Failing Better, perhaps we shall end up Feeling Better too. By recognizing our failures and inadequacies in our daily work, Main suggests that we shall gain some “personal easement…[becoming]less afraid of difficult situations and surer of our craft.” I would add that we may no longer need to swing between a professional omnipotence of power without responsibility and the despairing impotence of responsibility without power. Instead we can possess the steady potency of an authority that expresses a healthy integration of power and responsibility. Such authority works wonders for professional and organizational morale, which is so easily drained by uncontained fear or experience of failure.
Finally, if in fact I have failed today to catch and hold your interest helpfully, I apologise. But don’t you fail too! Use my failure to find a way now, in conversation with me or fellow Conference members, to clarify what is unclear, to challenge what you disagree with and to share your own reflections and understandings about failure. That way either it will work or we shall Fail Better together and make a contribution to “re – organizing” ourselves and our practice with the children.
References
Beckett, Samuel (1999), Worstword Ho, London, John Calder Publishers.
Davies, Robertson (1972), The Manticore, London, Penguin Books.
Dockar – Drysdale, Barbara (1968) The Problem of Making Adaptation to the Needs of individual children in a group, in R. Tod, Disturbed Children, London, Longman.
Frankl, Victor (2004) Man’s Search For Meaning, London, Rider Books.
Main, Tom (1989) The Ailment and Other Psychoanalytic Essays, London, Free Association Books.
Mason, Barry (1993) Towards A Position of Safe Uncertainty, Human Systems Journal, 4 (3 – 4), pp.189 – 200.
Nietzsche, Friedrich (1974) (Translated by W. Kaufmann) The Gay Science, London, Vintage.
Waddell, Margot (1989) Living in Two Worlds, London, Tavistock.
Winnicott, Donald W (1963) Dependence in Various Settings, in The Maturational Processes and the Facilitating Environment, London, Hogarth Press.