When children face separation or loss, they sometimes withdraw into a compliant state and it can be hard for the adults around them to remain open to what is happening for them at a deeper level. Even the most sensitive adults can fall into the trap of believing that a compliant or withdrawn child is genuinely ‘fine’. This ‘blind spot’ is particularly prevalent where the adults themselves are dealing with huge amounts of stress and anxiety.
These ‘blind spots’ can become dominant within institutions, giving rise to policies which appear to clash with young children’s underlying attachment needs. A good example is documented in the film ‘A two-year-old goes to hospital’, which challenged the historic policy of hospitals in the UK not to allow parents to visit their young children for fear of stirring up distress in the child and unsettling the staff.
Until the 1940s, hospitals in the UK discouraged parents from visiting their children during long stays in hospital. Weekly or even monthly visits were common, and in extreme cases, parents were only permitted to view their children through a window. The belief was that parental visits ‘unsettled’ the child and disturbed hospital routines. Staff had observed that the children ‘behaved better’ when they had no contact with their parents: they were less likely to cry, fuss or show overt signs of distress.
James Robertson, a psychoanalyst based at the Tavistock Clinic, challenged this mindset. He made a film showing a simple, close-up observation of a two year-old girl during her eight-day stay in hospital. The film was very straightforward but the impact was dramatic. The footage shows the little girl early on, crying bitterly and repeatedly for her mother; when her cries do not get answered and her mother fails to appear, the child is seen gradually withdrawing into a subdued and despondent state. She stops crying and no longer calls out for her mother. To a casual observer she appears to be fine. The film clearly shows that she is not; with the continuing inexplicable absence of her mother, and nobody to acknowledge her extreme levels of distress, she ceases to protest; but it is clear to the observer that she has given in to despair.
A two year old goes to hospital, by James and Joyce Robertson, 1952
Young children and separation – a groundbreaking film from the 1950s...
The film caused controversy and generated a major rethink of hospital policies. By zooming in on a child who was apparently ‘fine’, Robertson was able to show that when the adults around them are not able to help them with their distress, children internalise their feelings and become outwardly compliant. Where previously parental visiting was said to ‘upset’ young children, Robertson was able to show that it was merely revealing the distress which had been ‘hidden by the quiet exterior of the “settled” child’. Similarly, when the child cried to a friendly, sympathetic nurse, she was not causing the distress, but discovering it.” (Hendrick, 2003)
Soon afterwards hospitals began to change visiting policies, and eventually the principle of unrestricted visiting was introduced in UK hospitals, together with the provision of overnight accommodation for mothers of under fives. A review in Nursing Outlook announced that the film “. . . explodes the belief that a ‘good’ child is well-adjusted.”
James Robertson and his wife Joyce went on to make a collection of short films entitled ‘Young children in brief separations’, followed by a book of collected papers (Robertson, 1977). Their work has had a major impact on our understanding of the ways young children react to separations; above all highlighting the fact that when young children experiencing loss or separation cease to protest, cry or convey open distress, this is when the adults around them should be most worried. A compliant and withdrawn child in this situation is in a worse state than one who is still able to cry.
How this links to our research
We believe that our research findings highlight a similar kind of‘blind spot’ when young children are moved from foster carer into adoption, allowing well-meaning carers and professionals to fall into similar patterns of feeling relief when a child appears to be ‘fine’, and making decisions about restricting contact with former carers based on the fear that visits might ‘unsettle’ the children. Again, the assumption is so easily made that the ‘good’ child is ‘well adjusted’.
James Robertson gave some excellent advice to doctors and nurses which we believe is just as relevant today. Foster carers, professionals, and adopters may have the best intentions in mind when they plan moves to minimise the length of the transition, keep contact with former carers to a minimum and avoid painful displays of distress. However they will be doing a considerably better service to children by remembering that in allowing them to express their feelings they are ‘not causing distress, but discovering it’; and by doing so, they are allowing these children to have their feelings responded to and understood, giving them crucial experience of being accepted and receiving the comfort they need from the adults around them.
Hendrick, H (2003) Children’s Emotional Well-being and Mental Health in Early Post-Second World War Britain: The Case of Unrestricted Hospital Visiting, In Marijke Gijswijt-Hofstra and Hilary Marland (eds), Cultures of Child Health in Britain and the Netherlands in the Twentieth Century (London and New York: Rodopi, 2003),