The problem with using psychoanalysis on children

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Michael Richards, Edge Hill University

Children with problems or problem children? That is the question often asked by parents and teachers alike. If a child is naughty in school, are they a “bad” child or are they facing mental ill health?

Most analysis focuses on children being the problem – a highly individualistic take which resonates with Sigmund Freud’s theory of psychoanalysis. This is a theory which dates back well over a hundred years, with strong roots in focusing on childhood problems influencing adult behaviour.

Psychoanalysis developed over the course the 20th century, and although the approach has been dismissed by many, we live in a society where there is still an obsession with “psychoanalysing” children. This inevitably labels children as a problem rather than recognising the problems that affect wider society.

What drives behaviour?

Psychoanalysis specifically relates to Freud’s own school of thought, which believes a person’s behaviour is determined by early childhood experiences. According to Freud, a person has instinctive drives within the unconscious that influences their behaviour – unconscious material can be found in dreams and unintentional behaviour.

Freud’s focus was on specific sexual stages of development that influence our personalities as we develop in life. At the oral stage of development for example, (from birth to one year) Freud implied that oral stimulation could lead to an “oral fixation” in later life – such as sucking your thumb in times of stress.

Psychoanalysts believe that therapeutic interventions can bring the effects of this unconscious material into consciousness with the aim of resolving these issues.

Questioning Freud

Freud’s psychoanalytical theory, and other versions of psychoanalysis, are problematic for so many reasons. For a start, Freud’s theories are based on the “unconscious mind”, which is difficult to define and test. There is no scientific evidence for the “unconscious mind”. And it would be difficult to say who would be qualified to make assumptions about this when nobody really knows what the unconscious mind is.

For children, this means teachers, social workers, nurses, psychiatrists and other professionals make assumptions about them based only on their present behaviour – and without considering any wider social issues. This makes psychoanalysis ignorant of difference and diversity, and over-generalised. Particularly so when directed at young children – given that personality and behaviour can change over the course of someone’s life.

There’s no such thing as a ‘good’ or ‘bad’ child. Shutterstock

Research also shows that “naughty” behaviour in schools can be because children lack aspirations and a drive to do well. This can stem from many factors such as low self-esteem and high anxiety – as well as growing up in a low income household. Children who are in care, children with disabilities and children from Afro-Caribbean backgrounds are also more likely to be excluded from mainstream school if they live in deprived areas.

Stop blaming children

It is relatively easy to criticise the use of psychoanalysis, particularly when people are “psychoanalysing” without understanding what it is or isn’t. In this sense, Freud and the general idea of psychoanalysis has become a part of our language – and our analysis of trying to make sense of human behaviour.

And this is not without reason. Freud’s theories still play a role in the teaching and learning of many counsellors, psychologists and psychiatrists today, despite facing much criticism since its inception. Indeed, many types of therapies emerged post-Freud – including transpersonal therapy which is a more humanistic take on therapy – and many people have benefited enormously from these approaches.

But ultimately, the problem with psychoanalysis is that the focus is still primarily on the individual being the problem. And in the case of children, to keep focusing on them as the problem, while ignoring wider, social problems is dangerous.

Labelling a child as a ‘problem’ from a young age can have detrimental consequences. Shutterstock

Psychoanalysis does also not fully acknowledge the power of labelling and stereotyping that takes place within schools and in other aspects of a child’s life. It is almost like there is reassurance in focusing on a “problematic” child because there is always a box to tick, which might provide some idea of the “problem” and then result in a resolution.

But it is impossible to do this properly while ignoring the major issues children face in their world. This includes a lack of resources due to high poverty rates, alongside the increasing levels of mental health issues such as self-harm. Individuality can of course not be ignored but neither can the wider social problems that children face. This is important because ultimately it is these external factors that have the power to really influence the mental health and well-being of children.The Conversation

Michael Richards, Lecturer in Applied Health and Social Care, Edge Hill University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How caring for a child with complex health needs can be both isolating and extraordinary

Parent and carer.Author provided

Bernie Carter, Edge Hill University and Lucy Bray, Edge Hill University

Very few people would describe being a parent as easy. Not only does it require a shift in perspective so that your child, or children come first, but it also draws on knowledge and skills you didn’t know you would need.

Who would have thought that being able to remember the names of Pokemon characters or being able to spread Marmite onto a slice of toast in exactly the right way would ever come in useful – but it does.

However, parents who have a child with complex healthcare needs face a much steeper and more challenging learning curve. Because on top of the usual skills and worries of “ordinary” parenting, these parents have to be constantly vigilant about their child’s fragile health.

So imagine that – instead of keeping an eye on your child to check that they are not getting into too much mischief – every time you look at your child you are also undertaking a rapid head to toe clinical assessment. You’re checking their colour, their level of comfort, their breathing, their position, their expression, as well as using your sixth sense to determine whether or not “all is (relatively) well” or “something is wrong”.

Sounds stressful, right? But parents learn fast. Initially these assessments can feel overwhelming, because deciding if your child is in pain requires specific skills and knowledge. But although parents can feel unequipped to notice subtle signs of their child’s changing health, their fierce desire to protect and care for their child means they soon become attuned to the slightest shifts in their child’s behaviours.

Each parent starts to know their child’s “danger signs”. So they know for example that this little rattle in his chest is fine, but that chesty cough is likely to be the start of something serious. And by making hundreds of little decisions about their child, they develop expertise and confidence. They learn to know when all is well, or when to call their community nurse, contact their doctor or ring for an ambulance.

But despite all the knowledge and skills these parents gain, these decisions are difficult – and are something of a balancing act. One mother we spoke to explained that her son is “like a Rubik’s Cube” – one change shifts everything.

Not a nurse but…

In our research, parents spoke to us about how their role as a mother or father is often overwhelmed by all of the clinical tasks they have to undertake. Some of these parents told us about the dual nature of the role – both as a parent and a “nurse”.

The brilliant #notanursebut campaign was launched on carers rights day in 2015. And the videos the parents have made – as part of the campaign – provide a real insight into the everyday complex clinical skills that parents have to undertake.

All of this takes the role of parenting well beyond the ordinary and into something extraordinary, especially when a child with complex healthcare needs has brothers or sisters. And while typical school mornings are the usual challenge of getting children out of the house on time, with the right bags, shoes and PE kit and onto the right bus, in a “caring parent’s” world, these things have to happen alongside managing complicated medicine regimes and sorting out special tube feeds.

Exhausted and isolated

Most mornings, parents are doing this having had another night’s sleep broken by the need to attend to their child’s ongoing treatment. Parents become exhausted and the clinical aspects of the care can feel burdensome – but our research shows that parents often feel that they have been “left to get on with it”.

This persistent level of sleep deprivation can be relentless and draining and can take a toll on parents.

There is also plenty of evidence that shows that parents of children with complex healthcare needs experience higher levels of social isolation and depressive symptoms – with poorer levels of physical and mental health than parents whose children do not have complex health needs.

This is particularly the case for immigrant parents who struggle to access resources because they have fewer connections within their communities.

Persevering and reaching out

But in spite of the stress they experience, many parents talk of how their situation changes them for the better. They become more insightful and empathetic, and they want to support other parents facing a similar situation.

And our research with Scope’s Face2Face befriending scheme shows how parent to parent support can help people feel stronger, more confident and more able to deal with the challenges.

Parents of children with complex healthcare needs take parenting to higher levels using extraordinary skills. Parents persevere, they are tenacious, resilient and amazing, but we musn’t forget that these parents can also feel isolated and lonely. And it is by reaching out that we can help these parents to feel less alone in the day to day challenges that are being a parent.

The Conversation

Bernie Carter, Professor of Children’s Nursing, Edge Hill University and Lucy Bray, Reader in Children, Young People & Families, Edge Hill University

This article was originally published on The Conversation. Read the original article.