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From: Smith College Studies in Social Work, March 1996, 66(2).

Joel Kanter, M.S.W., L.C.S.W.*

Introduction to
"Communicating with Children"

by Clare Winnicott


Largely unknown in the United States, Clare Winnicott was one of the postwar leaders in Britain's child welfare field. After gaining recognition for her wartime work with evacuated children (where she met her husband, Donald Winnicott), she developed Britain's first social work training program for child welfare workers, integrating a psychodynamic understanding of the child's inner world with an understanding of social and political realities. While teaching, she pursued psychoanalytic training and was one of the last analysands of Melanie Klein. She then assumed a prominent position with the British government, directing the nation's training initiatives in the child welfare field. These initiatives trained thousands of workers in Great Britain and she was awarded the Order of the British Empire in 1971 for her leadership in child welfare. After retiring from government service, she pursued a psychoanalytic practice and worked at editing and disseminating her husband's writings.

Throughout her career, Clare Winnicott wrote dozens of professional papers, most on child welfare work. Although some of her writings were well-known by British social workers, only one paper was published in the United States. In her writings, she consistently attempted to integrate the child's inner experience with the social reality of family life, the child welfare system and the larger society. For example, she noted that neglected and abused children still maintain a deep psychological loyalty and attachment to their parents; unless the attachment is acknowledged, foster home or residential placements often disintegrated. Similarly, she described the child's need for familiar physical possessions several years before husband's classic paper on "transitional objects". Using these and other observations, she outlined practical methods that child welfare workers could use to help their young clients survive, and even thrive, in the face of family and societal adversity. Similarly, she applied this understanding of children to the development of child welfare programs and policies.

Unfortunately, in both the United States and Great Britain, social work has often had difficulty sustaining an integration of the psychological and social worlds. Professionals interested in the inner world become psychotherapists and professionals interested in the outer world move into administration and policy development. In her work in the field, the classroom, the government bureaucracy and the consulting room, Clare Winnicott repeatedly reminded social workers and policy makers that both sides of this understanding are necessary and possible. In this paper, one of her final contributions before her death in 1984, she draws on both her social work experience with children and her psychoanalytic work with adults to eloquently discuss how social workers can more effectively service children in need.

(* Mr. Kanter is a Senior Case Manager at Mount Vernon Center for Community Mental Health, Fairfax County, Virginia, and also has a private practice in Silver Spring, Maryland. His edited collection “Face to Face with Children: The Life and Legacy of Clare Winnicott” will be published by Karnac Books in January, 2004.)


Clare Winnicott

Communicating with Children

The social work task in relation to children is, as we are well aware, a formidable one. Formidable in terms of the wide statutory responsibilities laid on the social services: to promote the welfare of children so as to prevent their reception into care or appearance before a juvenile court, to take action to protect children from physical or mental suffering and to provide suitable personal care for each child whose family cannot do so. Daunting as these fundamental practical tasks are, even more formidable is the emotional task laid on social workers who have to face the children themselves, in the difficult circumstances that bring them to the notice of the department. The uncertainty conflict and anguish, has to be met and understood by the social workers if the child is to have the chance to salvage anything of value for the future. If the pain in the situation is not recognized and shared, it cannot be experienced and worked through, and there is then no alternative to the building up of resentment which can last a lifetime, and waste a life, and lead many to prisons or mental hospitals.

As I see it, if we could only learn to respond effectively to children at the crisis point in their lives which brings them to us, and at subsequent crisis points which are part of growth, we might save many of them from becoming clients in one capacity or another for the rest of their lives. l am aware that this has implications for the priority system within the total social services, and I suggest that work with children does need to be reconsidered realistically within that context.

In my present work as a psychotherapist seeing young adults who for one reason or another need help to get on with living more harmoniously with themselves and others and/or to avoid mental illness or suicide, I with been struck with the fact of how early it was in their lives that things began to go wrong, and once wrong, how the difficulty perpetuates itself so that there is almost no escape from it without help, and sometimes not then. Out of 12 people I am involved with, only three have had what could be called a fairly normal home life. That is, that in spite of difficulties the children have felt loved and cared for, and had both parents available, and no traumatic separations in early life. The other nine people suffered early losses or traumas of one sort or another due to break up of marriages (one sent away at 2 and 1/2 and another at three), mental and physical illness of the mother causing early and indeterminate periods of separation, and quarrelling parents resulting in a chaotic home situation from the individual's birth onward. All of us working in the psychotherapeutic field are recognising that in the majority of cases the problems and illnesses of our patients had begun much earlier than had been recognised by previous workers in this field. In fact we now know that we can find that the illness pattern of the adult patient had been laid down in infancy and in early problems of relating to other people, in the first place to the mother. Theoretically I have known that this is likely to be so, but every time I meet it I am still surprised to discover how terribly true it is, and how devastating can be the results.

All the time my patients are teaching me over and over again, not so much in direct words, but by implication, and by the way they live and feel and think, that if only there had been someone at the point of crisis to encompass the child, to recognise that the child has feelings about what is going on, and to help him through the shattering effect of losing all that is familiar, then perhaps some of the shock and trauma could have been absorbed and need not have disturbed the individual's development as it did from then on. But in each case this did not happen, and individual development has been stunted or impaired, resulting in much unhappiness and depression. Recently, a 14year old, who had exhausted all the local authority's children's homes, assessment centres and several community schools, said to her social worker "None of you lot can hold me, I can do what I like. There isn't a place in the whole country that I can't get away from if I like." And we know that she is right, the holding was needed long ago in infancy, or very early in childhood. Then it would have made sense, and might have been accepted and made use of.

Of course, the pain of separation from those we love is for all of us a devastating experience, but for a dependent child the whole of his world collapses and everything loses meaning. The worst thing that can happen is that the trauma can be so great and the child feel so helpless in the face of it, that all feelings are clamped down on, leading to deadness and depression.

My own work of the last six years has therefore brought me back to a reevaluation of social work with children, and the hope that in the social services we will not be content simply with social work for children. The opportunity I have had to look back on the life stories of those who have come to me for help and support has provided ample evidence of the need for direct communication with children, and special measures at times of special need and crisis, and I feel convinced of the prophylactic nature of the work that could be done in this area, and of the need to concentrate on it and extend it.

Whenever a social worker intervenes in the life of a family which includes a child or children there is a story behind the intervention, and the social worker needs to know that story and its effect on each child, and to live through the experience with the child as fully as possible, without denying the pain, and accepting the sadness, anger and depression that the situation gives rise to. In this way, moments of great pain can become moments of truth, on which a future might be built in time. In crisis situations communication will not be confined to words only. The actual presence of the social worker reduces isolation and loneliness, and communicates concern and support. In times of acute distress the actual physical holding of a child is likely to be the only means of bringing any relief. Adults, too, often need the reassurance of a protective arm or an outstretched hand. The whole demeanour and tone of voice of the social worker conveys just as much, if not more, than the words he/she uses. The freedom that social workers have to use themselves in these situations will depend on each one's capacity to identify with others, and to imaginatively encompass the experience of their clients in any given situation. This is hard work, and takes its toll in terms of emotional strain which has to be recovered from. Social service departments need to allow for this strain on their social work staff, to understand it, and to devise ways of meeting it within the structure and organisation of the department. I suggest that this needs a lot of thinking over, especially in regard to periodic recuperative holidays.

So far I have talked about communication with children in crisis situations because my recent experience with young adults has brought home to me very vividly how much suffering might have been avoided if there had been someone outside the family to whom the boy or girl could have turned for help and understanding when things began to get difficult. Such a little help at that stage could have gone so far; but nobody in the child's environment recognised the distress signals, and often the children were considered naughty or rebellious. Perhaps social workers have a responsibility here in helping other professional groups who work with children to be more aware of distress, the situations likely to cause it, and how it could be relieved or prevented.

I should now like to discuss ways in which social workers communicate with children in the course of their daytoday social work responsibility for them. First I want to think about the purpose of communication, and secondly how we might try to do it, and finish by considering the important question of the role of the social worker in relation to the child.

The immediate purpose of communication as I have already suggested is to get into touch with the real self of the child which is what he is feeling about himself, and his life at the moment of meeting. We want to help children to remain in contact with themselves, and maintain a sense of their own unique identity and worth in relation to other people - at this moment - in relation to the social worker. As all children who come our way have been through painful experiences of one kind or another, we shall need to seek contact with the suffering part of each child because locked up in the suffering is each child's potential for living and for feeling love as well as for feeling fear, anxiety and hostility. In these situations there is a strong temptation to seduce children away from the reality of their feelings, and to offer distractions of one kind or another. If we do this we lead them up a blind alley from which they may never return. The greatest reassurance we can give to children is the feeling that they are understood and accepted right down to the painful sad bit in the middle. If we do not deny this painful bit of themselves, they need not do so, and their natural resilience can then take them on into life again. But if there is denial, this natural resilience can be used to distract them from true living (and how many people there are who go around saying they do not feel real).

In order to develop into a whole human being each child needs to be recognised and known as a person in his own right, with his own particular ways of thinking and feeling and expressing himself and with his own special thing to say, which distinguishes him from everyone else. It is when this is listened to and appreciated, that life be comes worth living because the thing most real to him, is real to others, and this links him to the world, to life, and to shared experiences and meaningful relationships.

Recently a past student sent me a poem written by a 14 year-old boy. It speaks for itself and for all children. Poem: from Books for your Children, 1975.

He always
He always wanted to explain things, but no-one cared,
So he drew.

Sometimes he would just draw and it wasn't anything.
He wanted to carve it in stone or write it in the sky.
He would lie out on the grass and look up in the sky, it would be only the sky and the things inside him that needed saying.

And it was after that that he drew the picture,
It was a beautiful picture. He kept it under his pillow and
Would let no-one see it.
And he would look at it every night and think about it.
And, when it was dark and his eyes were closed he could see it still.
And it was all of him and he loved it.

When he started school he brought it with him,
Not to show anyone, but just to have it with him like a friend.

It was funny about school
He sat in a square brown like all the other square desks and he thought it would be red.
And his room was a square brown room, like all these other rooms.
And it was tight and close. And stiff.

He hated to hold the pencil of chalk, with his arms stiff and his feet flat on the floor, stiff, with the teacher.
Watching and watching.

The teacher came and spoke to him.
She told him to wear a tie like all the other
boys.
He said he didn't like them and she said it didn't matter.

After that they drew. And he drew all yellow and it was the way he felt about morning. And it was beautiful.
The teacher came and smiled at him. "What's this?" she said
" Why don't you draw something like Ken's drawing?
Isn't it beautiful?"

After that his mother bought him a tie and he always drew airplanes and rocket ships like everyone else.

And he threw the old picture away.

And when he lay out alone looking at the sky, it was big and blue, and all of everything that he wasn't any more.

He was square and brown inside and his hands were stiff.
And he was like everyone else. All the things inside him that needed saying didn't need it any more.
It had stopped pushing. It was crushed.
Stiff.

Like everything else.

Perhaps it will not surprise anyone to know that this boy committed suicide soon after writing the poem. Of course, the problem existed before the boy went to school. He was cut off from communication in his home. The teacher had a second chance, so to speak, and if she could have taken it, things might have turned out differently, but that is not certain. It is not an exaggeration to say that a moment's communication of genuine appreciative recognition can be life saving.

Now I want to move on to the question of how we communicate with children. It is obviously impossible to generalise, but I will put forward some thoughts for consideration. I have already suggested that our presence, our attitude, behaviour, tone of voice, are all communicating something to the child, and we need to be fully aware of this situation, and sometimes put into words how the child might be feeling about us. In fact the method used by Virginia Axline and others of "reflecting back" to the child in simple direct words, what he is doing, and how he is behaving, is a very useful simple way of helping him see himself objectively, and come to know himself, through being recognised and known by us.

We recognise it as important that the purpose of our presence in the lives of children and their families made clear as soon as possible, in a way that a child can understand, so that he is not left anxiously guessing or suspicious or afraid. We are powerful agents in the lives of children, and we need to convey our concern for them as individuals, so that they have the opportunity to feel us as supportive, benign agents. Often this can be done quite simply by our remembering something about the last time we saw the child, something that we did together perhaps, or something that they said to us. I have purposely mentioned the value of our remembering something that the child said, because this will have more significance for him than anything we may have said, and the fact that we remember will carry more reassurance than any of our words could do. He will feel known, special. I feel very strongly about this question of listening to children.

How desperately some children need us to listen to them, and to try to understand what they say, and how easy it is to be too busy to listen. Inside each child there is a story that needs to be told - a story that no one has yet had time to listen to. It is through expressing himself that the child gets to know himself and sorts out his confusions, and develops his own self image, and sense of himself in relation to someone else who will stop to listen. Of course other people who are nearer to the children have more opportunity to listen to them, but social workers do need to listen if they are to gain the child's confidence and help him to gain confidence in himself. Moreover, there are things that cannot be said to those who are too near. Here are some actual things that have recently been said by children to their social workers. All the children express their fears, their doubts and uncertainties, their hopes, and their love and hate, sometimes in words, or by implication.

Children talking

Heather is 9½ and lives with her grandmother of 73 and her elder brother, following the death of her parents and younger brother in a car crash in which she herself was injured. She said to her social worker, "When I wave before turning the corner on my way to school, I wonder if it will be the last time I see her. Nan's all I've got left, that's why I cling to her. I don't want to go to boarding school. I'd be unhappy there. I just want to be with my Nan." There had never been any question of sending this child to boarding school, so the idea was entirely her invention, and really expressed her not surprisingly severe separation anxiety.

Anna aged 3½ was placed with foster parents at her mother's request, and the mother is undecided about wanting the child home. She has been in care for three months and on a recent visit said to the social worker, "I don't want to go home. When my Susan mummy came I cried. I'll go home, but only for a tiny while. I'll come back here, won't l?" How clearly this 3½ year old knows what she can do, and what she wants and where she is wanted.

Desmond aged nine years is in boarding school following the break up of his home after his father left. The social worker took him out for a ride in her car during his half term holiday and during the course of the journey he said "I really hate my dad, now that I know the truth he used to hit my mum and it was his fault the baby died. There are lots of things I hate about him, but some that I like. Can you give me his address so That I can write to him." Here is a boy struggling to come to terms with his difficult home situation and his hate of his father, which does not exclude some positive [feeling too. In this process of coming to terms with his life, the listening ear and the accepting attitude of the social worker is absolutely vital.

Susan aged 17 years was previously in care and known to her social worker over a period of three years. She is now married with a girl baby of one year. She has shown a repeated pattern of taking herself off when things go wrong, staying away for days, even weeks at a time. She said to her social worker recently "That's the trouble with me. I go off whenever things go wrong. l want to talk about it, but something inside tells me not to, so I run away, it doesn't matter where, but it doesn't help." I suggest that the reason why this girl doesn't talk is her great fear of her own violent feelings. If she expresses them she fears that she might lose control, they would sweep her along, and who knows what the end might be, for the baby and for herself I may be wrong in this conjecture, but I would certainly have these thoughts in mind with someone who runs away when things get difficult.

I want to mention the other aspects of communicating with children that are relevant to the practical technique of trying to do it as effectively as we can. They are:

1. the approach to children
2. the establishment of a neutral zone of shared experiences
3. the language of communication

These three questions are interrelated, and in attempting to describe them I am aware that I am not really describing techniques, but a whole approach and attitude to the work, which implies in the social worker a philosophy that can embrace this attitude and approach. This is not simply something that can be learned in a training course, although it can be discussed by students; but its roots lie in the individual social worker's value system. It raises the question of what kind of people we are, as opposed to what we do.

In approaching children for the first time, or in later times of special difficulty, we find that we avoid a direct approach, because it could be felt as threatening. If we ask questions we either do not get answers, or get fictitious ones that spring from the child's imagination and/or his attempt to hide from us. So we have long since given up this approach. Nor can we expect to talk downwards to children from our grown-up height, so we sit on the floor or on a low seat. Then we remember to start up the conversation by talking about something else - not about the child himself directly. I remember a terrified child being greeted by the words: "Hello Linda, how nice of you to come and see me in your red shoes." The response was immediate "And my red gloves, and my red scarf" which she proceeded to display. But the ice was broken and the child was willing to go on co-operating. The idea is to pick on something to talk about at the beginning that the child might be, or already is, showing interest in. The social worker might say, for example, "Has Teddy got a name?" or "That looks a nice game, shall we see if it is?" Or the social worker can simply sit down and do something herself like drawing that would be likely to gain the child's attention. This indirect approach is useful for older children too, and even for adolescents who would resent being expected to sit down opposite the social worker and talk. In fact the procedure of getting along side rather than face to face with children is an important way of facilitating communication. Then we have to remember that children will want to find out what we are like, and it is important that we show our hand and let them find out for themselves. On the whole they are more astute at this game than are our adult clients.

I now come to my second point about the technicalities of facilitating communication, and this concerns the whole area of shared experiences, which is such an important part of life, and of relating and of being related to. The ride in the car, or the game played together, or the TV programme watched, or even the visit to a clinic or hospital, all give opportunities for shared experience, and this is perhaps the most nonthreatening form of communication there is. It can build up confidence and mutual trust and provide a neutral safe area within which direct communication is possible when needed. Moreover, shared experiences can be talked about, and relived over again, thus enriching the inner life of the individual and at the same time building up his/her personal history which can be validated by the person who has shared it. An experience shared can be a complete experience and a permanent possession. If social workers are to know the children for whom they are responsible they will seek to create an area of shared experience between themselves and the child however limited it may have to be. Once established this area can be widened out to include other people and new experiences which will, hopefully, outlast the social worker's responsibility, which has a time limit to it.

Language and emotion

Now I come to the question of the language we use in communicating with children. This is an immensely complex a subject because it is multidimensional and I takes place on many levels at the same time. What is said is not necessarily what is heard, because what is heard reflects the capacity of the hearer not only to i comprehend, but to deal with the emotional implications of the communication. If social workers are to be anywhere near the mark in communicating with children they will need to hear what is said in terms of their total knowledge and understanding of the child's situation, and how he/she is likely to feel about it. Eg, a four year old boy was keeping his new foster parents awake in the night. When the social worker arrived he said at once "Auntie's keeping me awake at night". Was he telling a lie? I suggest that this has to be understood and responded to in terms of the child's anxiety in the new home, and his uncertainty of the new foster parents and how alarming it is to be sleeping for the first time alone in a room of his own in unfamiliar surroundings, instead of the safety of the nursery from which he had come. Aunty was keeping him awake. Another example is that of an eight year old boy who asked his social worker when they were alone together, "Do you like Aunty Margaret?" (his foster mother). Clearly what this child wanted was not to hear the social worker's opinion of his foster mother. He had his own views on the subject, and badly needed permission to express them. The point I want to make is that it is no good to answer questions which involve and expose feelings, in practical terms, because this means that although questions may have been answered, no communication has taken place whatsoever. Social workers have to train themselves to listen with a third ear, only thus will they catch and understand the real purpose of the communication and be in a position to respond appropriately, and help the child to a new understanding of himself and his anxieties.

I do not wish to give the impression that communication with children is not concerned with sharing factual information with them. They certainly need explanations in words that they can understand, about what is happening to them and their families, and about past and future happenings and plans. A great deal needs to be discussed and sorted out about real things that have happened, so that children can build up a realistic picture of themselves and what goes on around them. Recently a social worker student introduced her husband to a 10 year old boy in care and he asked "What's a husband, Miss?" and later he asked if this man was her only husband. A nine year old fatherless boy living in a children's home with his younger boy cousin John asked "If my Uncle Peter dies will I be John's father?" This was a genuine question. What a puzzling world it is when you have so little experience to call on in order lo sort out its complexities and how much factual help is needed to get things into some sort of realistic perspective.

Often social workers are in the position of having factual knowledge of a devastating nature about the lives, or the death of the parent (or parents) of a child in care. In the end the child will need to know these facts, but how are they to be imparted? Everyone will have their own views on this question, but I suggest that the imparting of painful and damaging information could be a long job, and that first, much hard work has to be done to build up the child's confidence, and trust, in the social worker through what I have called shared experiences. As these shared experiences are talked over and become part of the child's remembered history, it is likely that sooner or later questions about the past will be raised, tentatively at first, and then bit by bit the details will be filled in as the child becomes strong enough for the next part of the story. If the first question can be answered briefly and factually without anything added or commented on that is not implied in the question, then the process of finding out the truth is likely to progress at the child's pace. Let us only hope that the social worker stays long enough to see this process through to the point when the child can come to his own terms with the knowledge. But perhaps this is too much to hope in these days of rapid promotion and a high staff turnover rate?

Time limits

To finish I want to say something about the social workers' role in relation to children who are the responsibility of the social services. As I see it, the best work can be done when the professional nature of the role is fully accepted--because it has built into it a discipline based on knowledge and objectivity, and it includes an awareness of a time limit. This discipline therefore adds a realistic dimension to the work, and provides a focus for it. If we sidestep the professional nature of our work and mislead children into thinking that we are available indefinitely as their best friend, we are badly letting them down. What we are in a position to offer is warm, friendly, personal help aimed at enabling them to come to terms with themselves and their situation, and to provide opportunities for them to establish relationships and build up loyalties for themselves which can last a lifetime, and on the basis of which they can take their place in society.

True professionalism

I know that in social work today there is a swing away from professionalism because it is seen as tending to create a barrier between "us", the social workers, and "them", the clients. I feel sympathy with those who want to break through these barriers where they exist, but I do not think they have anything to do with what we call professionalism. In my view it is only if we can, as social workers, accept within ourselves the common humanity that binds us and our clients together, that we shall be able to empathise with them, and understand their vulnerability because we too, are vulnerable. Perhaps the most valuable gift that we bring to work with children is our own capacity to remain vulnerable, while accepting our professional discipline and role.

In conclusion, I hope I have suggested that there is a very real need for much more concentrated and specialised work with children in the social services than has yet been attempted, and that its expansion would in the long term be likely to relieve the total burden on the service. The kind of work I have envisaged in this paper is not so much highly skilled (although skill will grow) but it is highly sensitive and demanding, and a high degree of self awareness and powers of observation are needed by those who do it. In my view, special training is absolutely essential for this work, and I suggest that it could best be provided by specialised ongoing in-service training (in the form of group supervision by a suitable expert) for all social workers engaged in work with children at a given time. Such training would also secure the necessary support for the staff involved in this highly charged and challenging work.


* This material first appeared at the BASW conference on Child and Family Care and later published in Social Work Today, Vol. 8 (26), 1977 and reproduced by kind permission of the British Association of Social Workers. Also, permission to republish this paper has been approved and agreed upon by Mark Paterson and Associates on behalf of the Winnicott Trust.



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