Therapy in child care:
the foundation of therapeutic work at the school
During World War 2 Barbara Dockar-Drysdale and her family shared the original farmhouse with children placed with them during the national evacuation campaign. She soon experienced the challenging behaviour of a number of them.
After the war via monthly clinical consultations with Donald Winnicott, and a psychoanalytic training, she developed the residential treatment methodology that she later named “the provision of primary experience” (1990). Across the 1950’s and 1960’s she conceptualised this work, and later published it in her books ‘Therapy in Child Care’ (1968) and ‘Consultation in Child Care’ (1973).
Core concept: ‘the provision of primary experience’
‘Dockar-Drysdale’s primary experience seems to be an amalgam of the Winnicott concepts of ‘primary home experiences’ and ‘primary maternal preoccupation’. The term encapsulates what Dockar-Drysdale came to see as the essential element in therapy for children who had missed out on that early maternal provision….her view of primary provision could be summed up by saying that it was a matter of the caring adult having to feel and act like a mother with her new born baby, and with the same preoccupation and sense of vulnerability. (Reeves, 2002)
Within this concept of “the provision of primary experience” Dockar-Drysdale defined different syndromes of deprivation, and formulated treatment approaches to these:
“Dockar-Drysdale has done her most important work in seeking to explain the nature and needs of the ‘frozen’ or psychopathic child. The emotionally deprived child is seen as ‘pre-neurotic’ since the child has to exist as an individual before neurotic defences can form. The extent to which there has been traumatic interruption of the ‘primary experience’ decides the form of the disturbance. A child separated at this primitive stage is therefore, in a perpetual state of defence against the hostile ‘outer world’ into which he has been jettisoned inadequately prepared.” (Bridgeland, M. 1971)
In the early therapeutic milieu staff provided ‘close in’ experiences of containing and nurturing routines, and robust behaviour management. Close dependency on an adult was supported, and in the case of the ‘frozen child’ a localised regression to the ‘point of failure’ was therapeutically managed. Sometimes a symbolic adaptation, termed a ‘special thing,’ was introduced. This allowed the child an experience of primary adaptation to need, an experience of close bonding with a primary carer:This symbolic adaptation would often take the form of the child’s ‘focal therapist’ providing a food with a primary connotation being chosen by the child e.g. a rusk with warm milk.
They found that the provision improved the child’s sense of security, reduced delinquency (stealing as self- provision to ‘fill up’), and the localised time seemed to help children cope with their feelings of envy when having to share with others in the group care setting.
This ‘attachment’ model of meeting need, with attention to symbolic communication, still underpins our work. In Dockar-Drysdale’s view, for chaotic ‘unintegrated’ children the traditional ‘psychoanalytic hour’ was not enough, they required a total environment
in which therapeutic interactions could take place within the daily routines of
child care, she did not place the primacy of therapy as being outside of daily child care routines, hence the development of the concept and methods now known as ‘therapeutic child care.’
The Mulberry Bush School
Our aim is to reintegrate all children placed with us into an appropriate family and school