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Barbara Dockar-Drysdale

Reprinted by the kind permission of Maurice Bridgeland from his PIONEER WORK WITH MALADJUSTED CHILDREN, Staples Press (London), 1971.

Perhaps the most important of these, both in practice and in her advancement of the theory of therapeutic education, is Barbara Dockar-Drysdale.(19) Much of her work is derived not directly from Anna Freud but from her mentor for many years, Dr D. W. Winnicott, whose own important contributions to the development of child psychology and psychiatry stem not only from his experience of wartime hostels but also from the theories of both Anna Freud and Melanie Klein. Like Winnicott, who describes her as 'a sophisticated therapist and conceptualizer', Dockar-Drysdale attached more importance to the earliest period of infancy than did Anna Freud. The period of basic unity in which the child is unable to distinguish between inner and outer reality and inwhich he is utterly dependent on the mother for the satisfaction of his instinctual needs is seen as crucial. This is the essential 'primary experience' which if inadequate or interrupted will lead to maladjustment. (20)

It is within this concept that 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. Reality is, for him, incomplete in that he has been 'thrown back for all pleasure-pain experience on his limited part of the unity ... the desperate dread of self-destruction and the frantic hope of selfpreservation being the deciding factors in the subsequent history of such a child.(21) These children remain 'frozen' in a symbiotic state 'without boundaries to personality, merged with their environment, and unable to make any real object relations or feel the need of them'. They remain totally egocentric, using others for their own purposes. Since there is no past to regret and no future to consider they live for the moment without fear or remorse. They are often charming, subject to violent changes of mood and are invariably delinquent. Any relations which they appear to establish are merely a means to an end and will break down at the imposition of the slightest frustration which will lead to fury and the destruction of the frustrating environment. 'There is no gap between the instinctual need and the satisfaction of that need'.

Such a child, if untreated, is the prototype of the psychopath and the treatment is arduous, always doubtful of success, and dependent on the establishment of unity with the therapist so that the child may re-establish the primary state of dependency in order to experience the reality of separation.

Other children requiring essentially the same treatment are those which Dockar-Drysdale calls 'archipelago children'. These have suffered separation after the first steps of integration. They have, therefore, some 'ego areas' without any total personality. Their behaviour is consequently erratic and bizarre but they have some capacity for symbolization, which aids therapeutic contact. Others have become fixated at some point and have protected their 'embryo egos' by 'caretaker selves' which are set up as real. Regression is essential to allow a return to the point where the creation of the 'false self' became necessary.

The therapist's task in all cases is to give the child 'complete experience' so that he can find first unity then individuality. For the most difficult 'frozen' child the treatment begins by a process of 'interruption' in which he is made conscious of the reality of himself as a unit in the world. His behaviour is carefully observed and anticipated so that acts are made consciously, with an awareness of the consequences. If the child fails to close the gap in his defences he is likely to panic since he has to forge a new unity in the world. At this point he may begin a severe 'unfocused depression' interpreted as a 'state of mourning for the loss of the unity'. This profound depression and anxiety may become a generalized illness since 'a delinquent character can only become normal through the experience of a neurosis'. The next stage depends on a deep attachment to an available adult with whom a primary bond is established so that the eventual separation of the 'self' can be achieved.

Dockar-Drysdale describes this process in the case of John, a severely delinquent nine-year-old. 'Interruption' was caused by her making him acknowledge his real responsibilities for such minor delinquencies as throwing a towel into the bath.

John, usually very cool and tough, became pale, trembled and screamed terrible obscenities at me. I carried him back to the bathroom kicking and shrieking. I assured him again that he really had put the towel in the bath. He continued to scream, and screwed up his eyes. 1 stayed with him, holding him solidly, re-affirming the facts and reassuring him; till at last, dreadfully afraid and trembling, he took the towel out of the water. Even now he turned his face away so as to avoid seeing what he was doing, then quite suddenly he gave a great shuddering sigh, wrung out the towel and hung it on the side of the bath. After which he turned to me with a transfigured and radiant face and ran into my arms. I carried him upstairs, tucked him up in bed and he sank almost at once into a deep sleep, still holding my hand.... The child in becoming instantly unaware of having thrown the towel into the bath, was using the reality blindness which had become so much part of him that he unconsciously employed this defence in every aspect of his life. The therapist, by bringing the defence to a conscious level, made a gap, which produced panic which the therapist then relieved by offering steady support and help to face reality. Constant and consistent repetition of such interruption, and protection brought John to a point ... without panic. Finally, we see him at a stage at which he can allow himself to be aware of his motions ... he has changed from a bright hard young tough - a 'wild one' in the making - to an anxious little boy; stormy, difficult, but attached to a teacher, whose approval he values and whose disapproval causes him pain.(22)

Such an exacting approach to individual therapy raises special problems of organization in the school context within which Dockar-Drysdale, although essentially a therapist, has done most of her work. The structure of such a therapeutic 'agency' has to be sufficiently flexible to allow the necessary therapeutic role to be played by members of the staff regardless of their specific 'function'. Only in an organization largely free of timetable and with flexible staff functions is it possible to provide for that complete involvement which is necessary for the reliving of 'primary experience'. Since in any institution continuity of treatment with a single 'provider' is impossible, 'localized regression' in terms of partial co-operation between the child and a number of different adults is all that is available.(23) Nevertheless to provide as much continuity as possible, particularly at critical periods, between one particular adult and one child the staff has to accept considerable flexibility of role. Teachers, whether male or female, must be prepared to act as 'mothers', administrators must play supporting roles as 'teachers' and so on. Both children and staff may require regular support from a skilled therapist acting either as 'mother' or in the supporting role of 'father'. Dockar-Drysdale has been largely responsible in her school, the Mulberry Bush, for this function. The 'paternal' supporting role will also be derived from the structure of the society (although this will be subordinate to the 'mother's' role), and from supporters within the community.

Such a therapeutic community for very disturbed children will be subject to considerable strains and tensions. Staff members must thoroughly understand the nature of their task and the importance of others in its undertaking. They must be mature enough to accept the demands made without feeling guilty about their involvement and without entering into a 'collusive' relationship with the child within which they share its delinquent or neurotic attitude. Society, both inside the school and in contact with it from outside, must understand the essentially therapeutic approach to destruction and aggression. Damage to property for instance, at times very apparent at the Mulberry Bush, is seen as an essential working out of the child's aggression. The transfer of this aggression to people will eventually be welcomed since it will then be more accessible to therapy. Damage, theft, aggression will be followed by feelings of guilt which will be relieved, not by punishment or enforced restitution, but in a way appropriate to the child's inner need. Restitution may be direct or indirect, e.g. cleaning the room of someone from whom you have stolen, or, initially, may be some symbolic undoing'. Such a nonpunitive approach may not be easily understood by people who are not thinking in therapeutic terms and - like the aggression itself - this may put a severe strain on structure. But 'to understand all is to forgive all'.

Inevitably such an approach has not always found easy acceptance and the life of the Mulberry Bush has frequently been strained and threatened. Dockar-Drysdale's approach now, however, commands considerable respect and the school's existence at Standlake, in Oxfordshire, seems assured by the support of the D.E.S. and the Gulbenkian Foundation.

Like so many other pioneer ventures the Mulberry Bush school originated in the war at which time Dockar-Drysdale began a nursery school for her own children and for evacuees and their mothers. Apart from running a small family play-group in 1935 she had no previous experience, having lived a largely 'society' and academic life as the daughter of a professor of surgery of Trinity College, Dublin. The latter's death when she was fifteen had been for her a traumatic experience.

Her wartime work with disturbed children and their mothers brought her in contact with Milan Morgenstern, a refugee psychotherapist and friend of Anna Freud and Susan Isaacs. Morgenstern encouraged her to read Freud in the original. Her work also attracted the attention of Dr Dingwell of the National Association for Mental Health and of Miss Lindsay, an inspector of special schools. The Board of Education suggested that she should run a school for maladjusted children for an experimental period of five years and with considerable support and interest from educationalists, psychiatrists and psychologists she did so.

Doubting her ability and skill she worked for about eighteen months in the children's department of the Maudesley Hospital, attending conferences and doing varied therapeutic work with children under supervision from psychiatrists. She also underwent a three-year personal analysis which she found not only assisted her insight with the children but greatly helped her work with both parents and stall. She has subsequently become a full member of the Association of Psychotherapists, working both with adults and with children. She is best known, however, for her work with the latter, particularly at the Mulberry Bush.

When her husband was demobilized in 1948 they became co-principals of the school at Standlake. For the next fifteen years the school was an intensive psychotherapy unit for about forty primary-age children and twenty adults. All the children were very deeply disturbed but the purpose behind the intensive treatment was to return them to normal conditions as soon as possible - usually in about two years. The children were arranged into four official and many unofficial groups, graded in their degree of structure but with a strong bond with a single teacher. There was a strong 'support team' not only of psychiatrists and psychiatric social workers but also of auxiliary staff. The unending demands on the emotional and physical energies of the staff, particularly as it was a principle of the school never to close, produced certain recurrent crises. Recognition by the Ministry in 1959 produced new problems in the management of the school, now brought into closer contact with the expectations of the outside world. Dockar-Drysdale was supported by many influential psychiatrists and London clinics in maintaining her therapeutic approach and although she and her husband retired from the direct management of the school she continued as its therapeutic adviser. The present headmaster, John Armstrong, continues her policy and, in her own words 'out of the difficulties has emerged a therapeutic organization, in every area of which the provision of primary experience for emotionally deprived children remains the basic task.'

Since it involves highly specialized techniques of psychotherapy her treatment policies cannot be easily generalized either to the majority of schools or for the majority of children. She has, however, pioneered a technique of treating very disturbed children suffering from the effects of extreme emotional deprivation. She is almost alone as a pioneer in attempting to deal with the intractable problem of the psychopathic child in an educational environment and it is significant that one of the most important developments of her work has been at the Cotswold Community, an approved school run by Richard Balbernie,(24) to which institution for disturbed delinquents she is consultant psychotherapist.

Her aim has always been to achieve an objective of 'experience, followed by realization followed by conceptualization'. Experience is then put into a form which can be communicated.

REFERENCES

(19) DOCKAR-DRYSDALE, B, based on interview and on her collected papers in Therapy and Child Care. Longmans, Green, London, 1968 [Return to Text]

(20) ----- The provision of Primary Experience in a Therapeutic School. J. of Cl. Psychology and Psychiatry 7 pp 263-275. 1966: in Therapy and Child Care (above) pp 97-115 [Return to Text]

(21) DOCKAR-DRYSDALE, B, Residential Treatment of Frozen Children. in Therapy and Child Care,op.cit.,p18 [Return to Text]

(22) Ibid., pp 26-7 [Return to Text]

(23) DOCKAR-DRYSDALE, B. Role and Function in Therapy and Child Care, op.cit., pp 52-66 [Return to Text]

(24) BALBERNIE, R. Residential Work with Children, Pergamon, Oxford, 1966 [Return to Text]

© Maurice Bridgeland

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