Child Guidance Service in Wartime
- Author:
Agatha H. Bowley
Psychologist, Dundee Child Guidance Clinic
” Business as usual ” as a slogan has never been so appropriate in the field of mental health services as during the past year. Many a time since the outbreak of war the women of England have been inspired with a desire to defend the marshes of Poland, the lakes and forests of Finland, the mountains of Norway, the dykes of Holland, the little hills of Belgium, and more recently the plain of Flanders. We have pictured ourselves administering first aid to the wounded, hot drinks to refugees, or just keeping cool under heavy fire ! But for most of us such portraits are drawn more from phantasy than from reality. Certainly we may do a little A.R.P. in our leisure time, but our duty is surely to our profession, and Psychiatry and Child Guidance is perhaps more necessary than ever before.
At the outbreak of war, in common with many others, I felt sadly bewildered and apprehensive, wondering what my job would be, and where and when the first bomb might fall. September 1st found me busily evacuating children from Dundee, and on September 5th, I was telephoning the Director of Education and the School Medical Officer to inform them that we were prepared to carry on Child Guidance work as usual in Dundee during daylight hours. The first few weeks were rather like a night- mare. Gas-masks and identity cards were much in evidence. Walking in the street was rather like playing musical chairs from shelter to shelter or from sandbag to sandbag. Outwardly we tried to appear calm and optimistic to the many anxious parents and children seeking advice. Evacuees flocked back to Dundee; schools and clubs remaining closed, the children thronged the streets, and delinquency increased (the figure has been put as high as an increase of 23 per cent, in some areas); wives were worried lest their husbands be called up immediately, and on account of the rising cost of living, and anxiety symptoms were rife. We tried to provide both educational and recreational activities, with the assistance of Training College students, for most of the children with whom we had been in contact before the war, and also for some of their brothers and sisters. We tried to make contact with cases whom we felt were most likely to react badly to war conditions, and in many cases were agreeably surprised. We spent many of our evenings helping to put to bed handicapped children billeted in an Open Air School?blind, deaf,t retarded and physically defective children waiting to be evacuated.
Work in Reception Areas
Owing to the general dislocation of educational and medical services our referrals for some time were not up to normal. We tried, therefore, to establish an advisory Child Guidance service in the nearby reception areas. By bus, or bicycle, or with a special petrol allowance by car, we made contact with the neighbouring billeting officers, and having enlightened them as to what constitutes a psychological problem, we endeavoured to handle those which were referred to us. Unfortunately in many cases children were returned whence they came at the first sign of delinquency, enuresis or other nervous symptom, and we were called upon to deal more often with returned than remaining evacuees. At present we are doing all in our power to impress on the authorities our willingness to assist with evacuation problems?to hunt out suitable billets for the so-called unbilletable child, to act as liaison officer between the irate foster-mother and the suspicious mother, to judge whether a particular child is more suited to a hostel or a private home, or whether evacuation without his parents is likely to prove disastrous, and to endeavour to treat psycho- logical difficulties arising out of evacuation.
A good deal of research work has been undertaken, in respect of evacuation Problems, notably at Cambridge, Liverpool, Birmingham, and in parts of Scotland. A bibliography of recent publications is included at the end of this article. Psychiatric Social Workers have been appointed by local authorities in certain areas to assist with psychological difficulties. But there has been a great deal of rather damaging literature published on the subject in the daily press. ” Evacuees ” are human beings. ” Being billeted ” involves some delicate adjustments of human relation- ships. Being separated from home and parents for the first time to the young child may represent almost a traumatic experience, especially when the duration of the separation has no definite time limit. But, of course, being exposed to the danger of air raids may constitute an even greater one. It is not only administrators, doctors, educators and well-meaning motherly people who are needed to make evacuation a success, but also child psychologists.
Much of our time recently has been taken up in giving advice about the how and why of evacuation. ” To let them go, or not to let them go,” that is the question that troubles many a worthy mother these days. It is not a question with a cut and dried answer, and may differ in some respect for every individual child. Here are a few of the conclusions I have reached from my own experience of evacuation problems, and from the reports of other people.
1. Babies under 3 years of age should not be separated from their mothers or nurses. Certainly they should be removed from the danger zones if at all possible, but even if weaning has been thoroughly successful in all senses of the word, such little people need a close contact with some familiar adult, and separation is likely to cause later if not immediate emotional difficulties. 2. Children between 3 and 5 years may in some few instances be happily evacu- ated with older brothers or sisters, if a homely affectionate foster-mother can be found. Nursery school evacuation, if this means the school going as a complete unit with its own teachers to an adequate premises with adequate staff may be satisfactory, but the difficulties due to epidemics, general organization and lack of adequate personal attention may be very great. 3. Children between the ages of 5 and 8 years are most likely to settle happily in the country if they go with brothers or sisters, or school friends, and are billeted in foster-homes of the same social status as their own. They need adequate play space, recreational activities, and schooling ; and regular visits from their parents once they have settled are most important.
4. Children over 8 years of age will most probably adjust to evacuation if they go with their own teachers, and can live under satisfactory boarding school conditions. It is essential that the unit is not too large, that an adequate domestic and medical staff is provided, and that educational equipment and recreational opportunities are suitable. Again contact with parents is very important. The oldest boys and girls are the most likely to adjust to these conditions if they are given the right balance of freedom and supervision. 5. Hostels are needed for the really difficult children who need special attention on account of their physical or mental health with a qualified staff to deal with such problems, as enuresis, somnambulism, excitability, fears, tics, stammering, delinquency and the like. They should be permanent hostels, but their population may well be a fluctuating one, and as the symptoms disappear they may be re-billeted.
6. Some medical centres are necessary with in-patient accommodation which can deal with children suffering from verminous conditions, impetigo, epidemics, and the like.
7. Children attending special schools?mental defectives, physical defectives, the blind and deaf of all grades?should be evacuated in their school units with their specialist staff, and adequate domestic assistance provided. Evacuation has not failed altogether, but it would have been more successful if air raids had actually occurred early in the towns, and if provision of the kind outlined under the heads of 4, 5 and 6 above had been provided beforehand.
Psychological Implications of Evacuation
Before we condemn the parent who refuses to evacuate her child in spite of all the persuasive propaganda she hears, we must consider the psychological implications of evacuation. The family unit for all its faults, and in spite of all the conflicts it causes, provides the most satisfactory background for the young developing child if it ensures adequate security, affection, and discipline. To break this unit at an early age means a great disturbance of security, and a great loss of affection. Evacua- tion may be interpreted by the child unconsciously as rejection, and the child may suffer a deep feeling of unworthiness, unlovedness, and inadequacy in consequence. Evacuation may be interpreted as a punishment, and has indeed been used as a threat to the naughty boy by many an overwrought parent recently. In fact, we found the fear of being evacuated to be far stronger than the fear of being bombed? the first, of course, being more of a reality than the second. If the child is already showing difficulties at home in most cases these will only be increased when evacuated, unless the perfect foster-parent who is prepared to take trouble and show real interest in the child can be found. Older children who are serene, well adjusted, fairly independent, and sociable, may well enjoy evacuation and benefit from it in a number of ways.
Mothers tend to cling to their offspring. How often we have heard recently: ” If we must be bombed, we would rather be bombed all together.” In these trying times, with their husbands frequently away from home, the thought of separation from their children is unbearable. In many cases the petty discomforts and com- plaints of the children have been exaggerated, and some children have even been brought home against their will, because their mothers were so lonely. This is very understandable. It is also extremely difficult not to feel jealous, or suspicious or critical of foster-parents especially if they win affection and respect from their foster- children. It is just in regard to such feelings that a trained Psychiatric Social Worker can provide such invaluable help by giving the parents a little insight into their feelings. A great deal needs to be done in the way of providing substitute interests for the non-evacuee parent, and social workers might well encourage mothers to take UP some war work if their children are away.
Propaganda Work
Finally Child Guidance workers can do a great deal in evacuation areas by carrying on their services as before and in doing a little ” keep cool ” propaganda, ^e have found that anxious parents have increased anxiety symptoms in their children. At the beginning of the war we drew up a small pamphlet to distribute to parents and billeting officers and others. It runs as follows :
Children in Wartime
Some Suggestions which may prove useful !? Try and keep your normal routine in the home. 2- Try and think of pleasant things to do in the long evenings. 3- Don’t talk too much about the War in front of the children. 4- Don’t expect the child to be frightened during air raid alarms. Remember he will take his cue from you.
5- If the child is worried about wearing a gas-mask, try to get him used to it gradually. Show him you are not afraid of wearing yours?but never put it on to frighten him.
6* Teach him not to believe all the rumours he hears.
Try and see that he has enough to do. 8* Don’t worry if he shows signs of nervousness from time to time. This may be a natural reaction to the strain of wartime. Ignore symptoms and avoid comment, and see that he gets regular food and sleep. Reassure him by your own calmness, your commonsense, and your cheerfulness.
As a symbol of our attitude we gave a very successful Christmas party to thirty children attending the clinic, and were able to provide a Father Christmas and a c?njurer in our roomy basement air raid shelter. We continue to stress the importance ?f trying to carry on work much as usual.
We have noted how some fathers who suffered from shell shock during the last war have had a recurrence of symptoms and this has affected their children. We have seen how in some cases air raid alarms have caused a temporary increase of nervous symptoms, but we have observed that usually the symptoms are related to much earlier unfortunate experiences in the child’s life. In one case the child got better when an actual raid took place, and German aeroplanes proved not so terrifying as phantasy had suggested. Depressed cases have sometimes improved, shaken out of their personal problems by exciting international events. Anxiety cases have released some of their inner anxiety by projecting internal conflict on to the external conflict.
Repressed aggression has found an outlet and in some cases the delinquent, having found a legitimate victim for his aggressive feelings, ceases to be delinquent.
The real test?large scale air raids?has not yet taken place, but often suspense and its confederate, morbid imagination, is harder to bear than real physical danger.
The morale of the civil population seems even better than before the war, when the uncertainty of one crisis after another kept us in a continual state of tension.
Psychologists have an important part to play in helping to preserve this morale.
Lectures which have been organized for A.R.P. workers are excellent, and anyone who is in contact with children should do his or her utmost to remain calm and cheerful and reassuring. Teachers have an important role to play, and many of them have been overworked and overworried by the constant changes that evacuation implies. Many of them have shouldered their new responsibilities most courageously.
We want to try and prevent the disastrous after-effects of a constantly tense and anxious state of affairs on the children; we must mitigate the horrors of warfare to some extent for the sake of the younger children, and the more sensitive children. It seems excusable at the present moment to demonstrate that war is to some extent a great and worth-while adventure, and that the courage and endurance that it inspires must be honoured. We need also to stress that we are fighting against oppression and tyranny, and for the preservation of our own and other people’s freedom to live and think and act as we feel we need. We must take a positive and constructive point of view and at the same time be eminently practical and teach the children what to do in an emergency.
REFERENCES
Burt, C. “The Incidence of Neurotic Symptoms among Evacuated Children.” British Journal of Educational Psychology, Feb., 1940, Vol. X, Part I. Valentine, T. ” The Specific Nature of Temperament Traits and a Suggested Report Form.” British Journal of Educational Psychology, Feb., 1940, Vol. X, Part I. Thouless, R. H. and Straker, A. ” Preliminary Results of Cambridge Survey of Evacuated Children.” British Journal of Educational Psychology, June, 1940, Vol. X, Part II. Vernon, M. D. ” A Study of some Effects of Evacuation on Adolescent Girls.” British Journal of Educational Psychology, June, 1940, Vol. X, Part II. Miller, Emanuel. “The Bed-wetting Problem.” Mental Health, Jan., 1940, Vol. I, No. I. Henshaw, Edna M. ” Some Psychological Difficulties of Evacuation.” Mental Health, Jan., 1940, Vol. I, No. I. Plaut, Paul. ” Refugee Children.” Mental Health, April, 1940, Vol. I, No. 2. MENTAL HEALTH 81 StLoe Strachey, O.B.E., J.P., Mrs. Borrowed Children : A Popular Account of some Evacuation Problems and their Remedies. John Murray. Cloth, 2s. 6d. Paper, Is. 6d. Simon, Lady. The Children in War Time : How to Rebuild the Educational System. W.E.A., 28a St. George’s Road, S.W.I. Price Id. ” Children in War-Time.” Reprint of articles on Evacuation Problems published in New Era, March, 1940, with Foreword by Earl De La Warr. New Education Fellowship, 29 Tavistock Square, W.C.I. 7d. Our Wartime Guests : A Psychological Approach to Evacuation. University Press of Liverpool. Hodder & Stoughton. 6d.
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