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About Looking After Children in Hospital – 1953

20 Sunday Apr 2014

Posted by Christine in 1950s, Bowlby and Attachment Theory, Children in Hospital, Conferences and Lectures, Newspaper reportage, Public debate

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Attachment Theory, Childhood trauma, children, Children in Hospital, John Bowlby, Medical Profession, World Health Organisation

In my previous post I noted that Hungarian born and trained psychoanalyst Dr Andrew Peto was a speaker at Sydney’s twelve day Pacific Seminar on Mental Health in Childhood  in August 1953. Sponsored by the World Health Organisation with sixty delegates – medical practitioners, teachers, psychiatrists, psychologists and social workers -.from sixteen  west Pacific and South East Asian countries it was a talkfest on child psychology not seen before. The director of the seminar was Dr. F. W. Clements lecturer in child health at the School of Public Health and Tropical Medicine at the Universality of Sydney and  formerly chief of the Nutrition Section of W.H.O.  The purpose of the seminar was to  consider those forces in the child’s home and communal life that could help or hinder him in his growth towards a mature personality’. Curiously this international Congress was scarcely reported even though delegates were considering the leading research of the day. Melbourne’s Argus newspaper provided a brief overview of the conference under the heading: Experts have some cute ideas of how They’d Bring Up Mother” concluding that at the very least, professionals were better informed.The Sydney Morning Herald relegated the matter to the Women’s Pages with a major article on women doctors from South East Asia. In a thinly veiled attack upon these highly qualified professional women, the Herald wondered why they were not at home tending their children and carrying out household tasks.  Only one of the major Australian women’s magazine, the Australian Women’s Weekly contributed a well thought out item about a topic  covered during the conference about the needs of  children in hospital. As you will see the author, Veronica West, drew upon newly published Attachment research by John Bowlby and James Robertson.   West carefully negotiated some contentious issues between doctors and reformers.Thanks to the National Library of Australia’s website TROVE, we are able to read these articles easily. West wrote:

Are Australian hospitals mending the bodies of sick children while blindly subjecting their minds to emotional stress more damaging in many cases than the disease or condition from which they are suffering? Must the price of the child’s health be submission to an inflexible hospital routine which catapults him from the security of home to a world in which his two paramount fears are realised – desertion by his parents, injury at the hands of strangers? Is Australia to lag behind progressive English and American hospitals which encourage the presence of mothers at the bedside of their sick children? Many medical and hospital representatives who attended the Seminar on Mental Health in Childhood at Sydney University last August are asking themselves these questions.A few enlightened paediatricians (child specialists) and doctors have long been trying to introduce overseas reforms in Australia. The safeguarding of children from unnecessary, frightening experience and training the nursing staff in basic concepts of child psychology are other steps, being taken abroad.First to throw down an official challenge to the old hospital visiting system is the Royal Children’s Hospital, Melbourne. It now proudly announces the success of a scheme which makes hospital routine fit in with new daily visiting hours for mothers.

This article was set in motion by the distress of a friend who spent two weeks in an intermediate ward of a city hospital. She said she couldn’t forget the despairing cries of “Mummy, Mummy, where are you?” which she heard from a nearby children’s ward throughout the night. She was astounded to hear that mothers were only allowed to visit the children once a week. When my friend spoke to the night sister about the distress of the children, her anxiety for them was dismissed as maternal sentiment.

“Nonsense!” said the sister, “a sedative soon puts them to sleep. The kiddies are always like this for a couple of days after visiting days. We dread visiting days. They do more harm than good.” My friend was told that except for a few problem cases the children were perfectly happy with the nurses during the week. “They are quiet and good, and settled in, but as soon as mother comes they stage terrific tantrums.” When she told me the story my friend said that if her own child went to hospital and was as mentally distressed as some of the children she had seen and heard, she would insist, through her doctor, on reasonable access to her little girl. Was my friend being over maternal and foolish, or was she instinctively right? Í set about finding out.

West attended the Seminar on Childhood Mental Health in Sydney in August 1953. She wrote,

The Seminar on Mental Health in Childhood revealed something of the general impact of hospital experience on the child of pre-school age. Subjects discussed included depriving the child of the comfort of his mother’s presence, his fear of pain, the isolation and aimlessness of his existence, the uncertainty of ever getting home again, and the inner turmoil and emotional drive to which frail bodies were subjected.With two-year-olds or three year-olds, especially, it was pointed out, the immediate reaction was a period of agitated despair, during which the child screamed, refused food, and only exhaustion brought sleep. After i a few days he became the quiet, good, allegedly settled-in child-in reality the apathetic, frozen-emotion child who had reached a serious stage of mental sickness...Sir Ronald Mackeith, of Guy’s Hospital, London, told of reforms which remove the risk of hospital damage to the child’s personality. One of the simplest was the opening of wards to mothers, who fed, bathed, and generally assisted the staff in the care of their own child on their visits. The Royal Children’s Hospital, Melbourne, I discovered, had been experimenting with daily visiting for the smaller children over the past two years, had found this a success, and had introduced regular daily visiting for all children four months ago. The Medical Director, Dr. Vernon Collins, said that he regards the ideal as “free visiting where the parents may come to the hospital at any time.” He believes that this is essential to build up good relation ship between the mother and the nursing staff and to get the best care for the child.

Quoting this as an example, I interviewed leading paediatricians, medical men, child psychologists, hospital medical superintendents, matrons and sisters. I found the paediatriciains and doctors awake to recent research and already trying to apply the new methods to their patients, but still uncertain ol how general reforms could be carried out. Their reactions were surprisingly mixed, with individual but not collective antagonism to the new methods. Some had not heard of  visiting – hour reforms, and wary of the threat to hospital routine, were reluctant to hear of, or discuss, the subject. Others equally ill-informed listened kindly, but remained unshaken in their conviction that present methods were best. As an official spokesman put it, they were “sitting pat and waiting.”

West seems unimpressed by that response. She continued:  Here is the statement of the official spokesman of that hospital-the Royal Alexandra Hospital for Children, Sydney, which has 485 beds and treated 11,777 in-patients last year…

“Just say we are interested in the entire subject and an studying all the material available, but we prefer to wait and see. There will be no immediate alteration in the Sunday visiting day for the children.”

Here, too, are some of the opinions expressed at interviews: First, a talk with a hospital matron with many years’ experience in children’s wards. “I think the reforms will have to come,” she said. “The seminar undoubtedly opened the eyes of some of us who have long prided ourselves on the physical care of children in our charge. The most efficiently run ward in Sydney is not worth the constant reproach of the screams of the frenzied child, or the misery and listless apathy of the quiet child, star ing blankly, hour after hour at hospital walls.”

The most outspoken of the pediatricians who recently returned from England and who had instituted more liberal visiting hours in his hospital outside London said this: “Christmas is coming, and we will again have Press photographs of happy children and gaily decorated ward:and once again people will murmur warmly, ‘The hospitals are wonderful going to so much trouble for the children!’ “What the enlightened child expert would like is a little of this Christmas sentiment from hospitals and doctors spread over twelve months in our children’s wards.“When I was a medical resident I agreed with the general opinion that the weekly visiting day for mothers, with its aftermath of temperatures up and chaos in the wards, was an unnecessary evil. “Experience brought wisdom. In the London hospital I arranged for the mothers to visit the children daily, dropping in and out for brief visits on the way to town or after shopping.”The mothers sometimes fed the children, tidied beds washed them, and were of real assistance to the nursing staff. Reassured by the seemingly casual visits of the mothers the children were happy and contented, and were discharged mentally and physically well. “Certainly some cried when their mothers left, just as children here in our private ward« who enjoy the. privileges of more frequent visiting do. But a little weeping at temporary parting is one of our natural human emotions. It bears no relation to the violent reactions, or, worse, the disturbingly quiet ones, of the visit-starved public-ward child. Of course, we must have hospitals for sick children, and any physical pain inflicted is negligible to the suffering it spares the child, but too often both doctors and parents undertake to put a child into hospital without giving sufficient thought to the matter”.

The Doctor continued: “Some parents fall down on ‘he job of preparing the child for what lies ahead. They, in mistaken kindness, tell him fairy stories or refer to his approaching period in hospital as a ‘party.’ “What happens when the child arrives for the ‘party’?

“Generally he is whisked away from his harassed mother at the admission office, and, stripped of his favorite teddy bear or chewing rug, he is jet propelled into his new world. For the next six days until visiting day he is walled up in a world of white, forsaken bv his parents, helpless against the towering, white-clad, masked strangers who periodically select him for injury. It is not the pain-most children can take pain better than adults-it is the terror of what it is all about that breaks the child. While the comfort of the sympathetic nurse is often refused by the child in his des- pair, the reprimands and threats of the thoughtless, ill tempered nurse aggravate the situation. “Some of our hospitals allow the mother to accompany the child to his bed, get him used to the nurse, as well as letting him keep his cherished toys.

“In others where haste and ordered routine is the rule the opposite is the case. In many of these hospitals it is still the current practice on chaotic tonsillectomy morning to line up about a dozen young patients on a form out- side their ward or adjoining the theatre for upwards of an hour, and drag them off one by one.. for the operation.”

A woman pediatrician had this to say: “‘Certainly periods in hospital do not affect all children, temporarily or permanently. This is also true of epidemics, yet we would not deliberately expose children to such a risk, I believe a system of staggered daily visiting hours would be best, with full co- operation between the doctor in charge and the sister. Of course, some mothers because of domestic duties or because they live a long way from the hospital would not be able to make the daily visit.”

And what of the position in hospitals or wards where the children may stay months or even years? Two doctors stressed the need for closer contact between mothers and children in such hospitals.

“I commend any doctor or parent about to confine a child to one of these hospitals to study Bowlby’s report to the World Health Organisation***,” one of them said. “As he and the famous Sir James Spence point out, these hospitals, despite the various activities, occupations, and entertainments arranged for the children, overlook one important factor -the depriving of the child of his mother. Perhaps Australia cannot immediately emulate these reforms, but some of the broken mother-child relationship can be repaired by extending visiting hours.

Finally I saw child psychologist Miss Zoe Benjamin. Clinging to mother, temper tantrums, bed-wetting, hostility towards the mother, and kindergarten activities are all typical symptoms of hospital experience,” said Miss Benjamin. Handled sympathetically by parents, these usually disappear, but can lead to serious results. The experts quoted agreed that the most urgently needed reform was an increase in visiting hours in children’s hospitals, which must be championed by an enlightened medical profession generally.

I for one was surprised to find this article published as long ago as 1953. I remember attending lectures at Melbourne’s Royal Children’s Hospital during the 1980s when Isabel Menzies Lyth from the Tavistock Clinic spoke about the needs of children in hospital. Here she advocated what one 1953 Australian Matron also promoted: that the ward be divided into smaller units with children allocated to a ‘team’ of carers during their admission? It seemed, upon listening to Mezies lyth that her recommendations and their implementations were far more recent. It is to be wondered about why such a large newspaper as the Sydney Morning Herald failed to report upon this and other matters arising from this international conference. Was there some sort of external pressure upon its editorial team not to do so? It would be interesting to look into this a little more.

*** “Child Care and the Growth of Love”-Penguin edition summary of the John Bowlby report to the World Health Organisation

References:

Child Care Is Their Subject. (1953, August 20). The Sydney Morning Herald (NSW : 1842 – 1954), p. 5 Section: Women’s Section. Retrieved April 20, 2014, from http://nla.gov.au/nla.news-article18383141

Sick children need parents at their bedside. (1953, November 25). The Australian Women’s Weekly (1933 – 1982), p. 20. Retrieved April 20, 2014, from http://nla.gov.au/nla.news-article41447234

 

 

 

 

 

Psychoanalysis, Children In Care and Government Policy, Melbourne,Victoria, 1957

26 Saturday Jan 2013

Posted by Christine in 1950s, Government policy

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Attachment Theory, Child psychology, children, Children in Care, Curtis Report, emotional disturbance in children, Government Policy in Victoria, Influence of Psychoanalytic Theory, John Bowlby, Melbourne, State Children, State government report

In my wanderings around Melbourne’s libraries I  have stumbled upon a slim volume with a long title: Child Care Staffs in Institutions: Report on Survey Undertaken for the Children’s Welfare Advisory Council To Determine the Need for Courses of Training. It is softcovered and 111 pages in length, including eight appendices of proposed trainings for mothercraft nurses and the staff of occupation centres. A list of some fifty odd institutions covered in the report heads the field: a mixture of government and religious based institutions, many run by Roman Catholic orders. The report was commissioned by the newly formed Children’s Welfare Advisory Council on 18 September 1956. Established simultaneously with the implementation of the 1954 Children’s Welfare Act the Council was intended to form a link between government and voluntary child care institutions: a way of getting religious and secular institutions on to the same page, maybe. Up until then the two groups had operated separately. Some were happy enough with the new arrangement. Others clearly were not: perhaps the level of co operation from these organisations – particularly Catholic run organisations – were indicative of resistance to the new order. The report was completed in 1957.The powers be thought the public should read it too, so it was  released the following year.

This report is a remarkable historical document – signalling a response to post-war developments in Britain where psychoanalytic clinicians began to articulate the needs of neglected and abandoned children in the light of their experiences with evacuated children. Britain’s 1946 Curtis Report, Children Without Homes, ( ‘Report of the Care of Children Committee’)  written by former University of Western Australia lecturer and then member of Anna Freud’s group, Ruth Thomas.

There had been problems getting it incorporated into British policies, a matter taken up in the House of Lords by Lord Iddesleigh who explained:

Many children were suffering quite unnecessarily because the adults responsible for their upbringing in the various homes and institutions were untrained. There was a most serious lack of trained child workers, and the Curtis Committee therefore established a sub-committee to investigate the whole matter of training. This committee reported, and its report was adopted by the main Committee. There are three recommendations in the Interim Report which appear to have a particular urgency. In the first place, there is the recommendation for the appointment of a Central Training Council of qualified persons representing various bodies engaged in the field of child care. The function of that Central Training Council was to survey the whole field of training, and to establish such facilities as they considered needful. 

Lord Iddesleigh, was worried about a lack of response to the Committee’s findings and that the report and the children would be  forgotten.

Criticisms made by the Curtis Report are very painful, and the revelations are shocking. It it one of the most distressing features of the local authorities’ administration of Poor Law children that very often they are kept in workhouses not for six weeks which I believe is the legal period-but for months and months and months. I do not think that I should be doing my duty if I do not read to your Lordships one brief description of the conditions that prevail in these workhouses. One paragraph in the Report says: “The smell in this room was dreadful. A premature baby lay in an opposite ward alone. This ward was very large and cold. The healthy children were housed in the ground floor corrugated hutment which had been once the old union casual ward The dayroom was large and bare and empty of all toys. The children fed, played and used their pots in this room. They ate from cracked enamel plates, using the same mug for milk and soup. They slept in another corrugated hutment in old broken black iron cots some of which had their sides tied up with cord. The mattresses were fouled and stained. On inquiry there did not appear to be any available stocks of clothes to draw on and it was said by one of the assistant nurses that ‘everything was at the laundry and did not come back.’ The children wore ankle length calico or flannelette frocks and petticoats and had no knickers. Their clothes were not clean. Most of them had lost their shoes; those who possessed shoes had either taken them off to play with or were wearing them tied to their feet with dirty string. Their faces were clean; their bodies in some cases were unwashed and stained.”

This was one of the worst cases, Lord Iddesleigh acknowledged… but coupled with Britain’s history of providing barrack type accommodation for children, his description underlined the depth of the problem. Trained people, he reckoned -(he believed this to be work for women) – would do much to move the situation beyond  what it then was.

It is a very frightening thought, my Lords, the extent to which the happiness of deprived children is confined to not very competent little clerks and minor officials, who are often over-worked, who are not specialists in their subject, and whose horizon is bounded by very petty departmental considerations.(Lord Iddesleigh, 12 December 1946, Session 1946-47,House of Lords Hansard,George VI year 11,853,Fifth Series, Volume 144, cc.882-908).

A decade later, in Victoria, Australia,  David Merritt took up the main thrust of the report as he developed his research project. He argued that the  main danger of institutional life was ‘lack of interest in the child as an individual’, and the tendency to ‘remote and impersonal relations’. The children ‘continually feel the lack of affection’, he continued. It was ‘in striking and painful contrast to the behaviour of a normal child of the same age in his parents’ home’.

Merritt echoes earlier commentary on destitute and state children. In 1909, South Australian writer and activist, Catherine Helen Spence, had made similar observations during the first interstate congress of workers amongst State Children. Her work, in turn, drew upon the work of Florence Davenport Hill whose writings on children living in orphanages and workhouses eventually published in her 1889 book Children of the State  – influenced the direction of government policy in New South Wales and South Australia.  Challenging contemporary eugenicist views of poverty and illegitimacy, Spence argued that that the quality of environmental provision was far more influential for the development of children into contributing members of society than genetic inheritance. She asserted that children who were boarded out, rather than institutionalised, generally fared better than institutionalised children, in the long term, as a result of the bond formed with their foster parents.  At the same congress, a delegate from the New South Wales State Children Relief Board also warned of the detrimental effect of institutionalisation on the individual development of the child.

Recognition of the value of boarding out, and of sustaining the bond between parent and child as much as possible, found endorsement in John Bowlby’s Attachment theory. Perhaps its research base, for Bowlby had assembled his evidence, enabled observations such as Spence’s and anecdotes such as Davenport Hill’s, to be elevated into something more scientific. The effects of maternal deprivation were spelt out afresh. Quoting from Bowlby’s Child Care and the Growth of Love ( Penguin, 1953), Merritt recorded,

The direct studies are the most numerous. They make it plain that, when deprived of maternal care, the child’s development is almost always retarded – physically, intellectually, and socially – and that symptoms of physical and mental illness may appear. Such evidence is disquieting, but sceptics may question whether the check is permanent and whether the symptoms of illness may not be easily overcome. The retrospective and follow-up studies make it clear that such optimism is not always justified and that some children are gravely damaged for life. This is a sombre conclusion, which must now be regarded as established. (Bowlby, 1953, pp.19-20, quoted in Merritt, 1956, p.14).

There was an additional warning: that the effects of deprivation arising from separation in the early years conceivably led to the formation of psychopathy and delinquency. Bowlby’s work had had its origins in clinical work at the London Child Guidance clinic. He had exchanged ideas with D.W Winnicott. It was taking time, but the swing away from views of delinquency as a result of genetic inferiority, to acceptance of notions child development contingent on parental availability and consistency, continued to gain ground steadily during the first half of the twentieth century.

What was required of institutional staff, Merritt concluded, was possession of the ‘qualities and abilities necessary to encourage normal development of each of the children in their care’. Drawing from the Care of Children Committee  Merritt listed the essential features of out of home care: (Note: Forgive the use of the masculine pronoun –  convention in 1956)

(i) Affection and personal interest; understanding of defects; care for his future; respect for his personality and regard for his self esteem.

(ii) Stability; the feeling that he can expect to remain with those who will continue to care for him until he goes out into the world on his own feet.

(iii)Opportunity of making the best of his ability and aptitudes, whatever they may be, as such opportunity is made available to the child in the normal home.

(iv)A share in the common life of a small group of people in a homely environment.

It would be interesting to see the working documents and correspondence that were part of the formation of this report; to turn the pages of the files, to note what was typed copy, what was not; to see what was said in the margin notes and asides, to observe the stuff of a busy day in public service. Who were the clergy who refused to participate, who decided that Merritt’s questionnaires were irrelevant  to their work? And who were the child care staff that became frightened that his questions masked criticism. Can we have  a sense of their ages? their years of experience? and indeed, of those who were kind and who were not? These questions belong to deeper documentary research than I can do here. We can only explore, with Merritt, some of the conditions he found in the institutions he visited and form our own questions.

David Merritt visited seventy-one institutions, each on two occasions. He interviewed staff and provided them with questionaires. He observed  the daily life of children living within the institutions: voluntary and statutory childrens homes, migration homes, babies homes, voluntary and juvenile schools, babies homes and homes for special categories of children: intellectually disabled, deaf and children suffering from spasticity. Accommodation ranged from a training farm accommodating six boys, but with but three resident at the time, up to a statutory institution with a capacity for 250 but actually accommodating 260. The most common type of accommodation was the dormitory style -with mass dining rooms. The largest dormitory was one for 50 boys. Merritt provided statistics and graphs. Of 3,204 state children in 1956 the majority -1500 – were boarded out in Children’s Homes. Only 449 were boarded out in foster homes with 129 placed without payment in foster homes. About 107 children were living in ‘Juvenile schools – having come before the courts -104 were placed in special schools in conjunction with the ‘Mental Hygiene’ department, 304 were living with relatives and the rest variously in live-in employment, hospitals, or were livingin institutions while they were treated for psychological problems.Material provision was high – fresh rooms, plenty of toys but inconsistent care.It appeared that a high proportion of children were ‘educationally retarded’, Merritt said. It was not clear whether this was a consequence of parental neglect or institutionalisation or a result of the frustrations encountered at school.

Merritt seems to have seen himself to be  faced with the problem of reconciling a system which lacked a framework for understanding the emotional, attachment needs of children and adults, with emerging ideas about the  needs of children in out of home care. At times Merritt was critical of the staff – his progressive views conflicting with the old school practicality.’Some staff members saw no problem at all – children were either “dull” or “bright” and that was that. Others were inclined to attribute poor school results to such things as ‘difficulty concentrating, sheer laziness or bad heredity’. He commented” ‘It would be true to say that a number of persons I interviewed failed to show an awareness of the needs of children in this area’.

There was failure to recognise or understand emotional disturbance in children. Merritt’s frustration is palpable when he writes of one person in charge of 100 children or more who claimed there were no emotionally disturbed children amongst them. Closer analysis revealed children from broken homes, that about 50 were wards of the state, some were illegitimate and others ‘she regarded as mentally retarded’. He continued”

When asked about the children’s behaviour she described temper tantrums, bed wetting, stuttering, wilful destructiveness, sulkiness and pilfering amongst the types of behaviour she encountered. That none of these children were emotionally disturbed and consequently had a special need for affection and understanding appears highly unlikely to say the least.

While not all institutions and staff groups were lacking in such understanding there was room for more concern for the emotional and environmental provision for children in care, Merritt concluded after his visits. In many instances  ignorance of the nature and stature of children’s’ needs, inadequate numbers of staff contributed to the malaise – a fact  noted by the British Care of Children Committee. There was a need to modify the organisational structure of such institutions, to train staff, to work to bring the situation in Victoria up to those standards practised in other parts of the world.

Despite resistance by some staff to scrutiny and training there was acceptance and a desire for change. There had been agitation in the press – about institutional conditions and about the lack of training amongst their staff. There were perceptions of abuse, that child welfare practices were not right.  In september 1952 Melbourne’s Argus newspaper had reported extensively on two fourteen year old girls had been incarcerated in the large Bluestone building Pentridge Gaol – a place for the worst criminals and the location of many executions.  That the rival Sydney press gloated that such an event as gaoling young teenage girls would not occur in its state rubbed salt into the wound.

By 1954 a new Children’s Act had been passed by parliament. Merritt’s report, drawing on the understandings provided by psychoanalytic theories and clinicians, promised much – and, at least professional training for staff. It was the beginning of a revolution.

Ivy Bennett – Western Australia.

06 Saturday Aug 2011

Posted by Christine in Australian Women in Psychoanalysis

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Aggression in human development, Anna Freud, Donald Winnicott, John Bowlby, Lay Analysis

My trawl through   the National Library’s site, Trove, has enabled some interesting figures to emerge. One of these was the  Australian born psychoanalyst Ivy Bennett – now Ivy Gwynne-Thomas.  In the 1940s, 50s and probably the 60s scholarships of all kinds enabled  country kids to get an education – whether high school or often enough, University. And so it was with Ivy Bennett.  Born on 12 August 1919 in Wagin, a small wheat-belt farming community in Western Australia, she was the fifth child in a family of six. She grew up in Lake Grace, was one of seventeen pupils at a one-roomed, one-teacher school before gaining a scholarship to Albany High School in southern Western Australia. On her matriculation she  gained a Hackett Bursary to study Modern Literature at the University of Western Australia.

As she related to a journalist at Perth’s Sunday Mail in July 1950  it was ‘out of curiosity’ she picked a psychology unit to round off her degree and fell into a psychology career. A second Hackett award – a postgraduate Scholarship – enabled her to study for a Master’s degree in Clinical Psychology. Plans for further study in the United States were deferred when war was declared. In about 1942 she was tapped to teach psychology to airforce recruits at the University of Western Australia.

In 1946  a British Council Scholarship took her London and eventually enabled study for her Doctorate at The University of London and at the Anna Freud Clinic. The Western Australian press followed this part of her voyage, reporting her progress on each of her annual visits to Australia. She was young, attractive, representative of hope for the future. By 1950 it was clear that she wanted to train as a psychoanalyst and was planning to return home to work in Perth.  She was able to  extend her  scholarship to train as a lay analyst at the British Institute of Psychoanalysis and returned home, finally in January 1953.  She established her practice as a psychoanalyst from a house near King’s Park in the centre of the city in August 1953.

Although Ivy Bennett completed her doctorate in 1951 it was not until 1960 that she published it  under the title,  Neurotic and Delinquent Children (London, Tavistock Publications). Her research project, begun  under psychoanalyst Kate Friedlander’s supervision, sought to draw together her experience in experimental psychology and her interest in psychoanalysis. It was one step towards developing, in twentyfirst century parlance, an ‘evidence base’ for psychoanalysis – and understanding the influence of family and social circumstances as cause for mental health problems. For the historian, Ivy Bennett’s lucid exposition of work undertaken in the ‘child guidance’ arena by early practitioners who drew on Freud’s work to develop their programs,  shows Freud’s theories to be widening in scope and application during the first half of the twentieth century. W A White’s and Healy’s work with ‘delinquent chidlren’ in the United States aslo drew on that of Freud’s  contemporary, August Aichhon, who established one of the first child guidance clinics in Vienna during the 1920s.

In England Ivy Bennet also unequivocably affiliated with Anna Freud. She was the first student at Kate Friedlanders Child Guidance Centre at West Sussex – also under the supervision of Anna Freud. She drew primarily from  work of  Freud and Anna Freudians Dorothy Burlingham and Kate Friedlander as well as Cyril Burt to formulate her ideas about the causes of delinquency and neuroses in children.  Together with psychoanalyst Kate Freidlander Ivy Bennett designed a project aiming to  study the factors underlying the  presenting problems in a cohort of children she treated at the West Sussex Child Guidance Clinic. Friedlander’s untimely death in 1949 left Ivy Bennett to continue the project alone.

Ivy Bennett’s  argument, that understanding the causes of maladjustment was central to treatment, was central to her thesis. In her book an early paragraph reads,

The establishment of greater precision in our psychological understanding of the causation and development of maladjustment will possibly prove more important in the future than the invention and multiplication of remedial measures and new types of “treatment”. All these latter aim, in effect, at giving the child a new kind of human relationship to replace that which has contributed so greatly to the thwarting or distortion of his development in the past. ( Bennett, 1960, pp.3-4).

It was not about moulding a child’s character, Ivy Bennett argued. Research had revealed that developments in early infancy, if not in intrauterine life,  were expressed in later stages of a child’s development. Although she does not explicitly acknowledge the work of Melanie Klein whose work was influential in this respect, nor that of John Bowlby or the independent Donald Winnicott, her inclusion of their publications in her bibliography suggests she was well aware of their work. Ivy Bennett was also following developments psychoanalytic thinking as it moved away from psychosexual factors Freud had maintained were central to child development. The capacity to manage aggression was integral to the successful development of a child, Ivy Bennett argued. She wrote,’The problem of delinquency ‘is at bottom, that of dealing with uncivilised aggression beyond the control of society and often under the individual’s own control’. The understanding the phenomenon of Aggression – in delinquency and normal life – was a particular key, far more important than solving the ‘urgent practical clinical problems involving primitive and unsocialised aggression’. ( Bennett, pp.31-33). She  stressed the ‘importance of the role of consistency and continuity in the education and training of the child’. It involved understanding and working with the child’s family – parents and grandparents – as well as a child’s teachers and her community.

The War had .seen a shift amongst British psychoanalystsfrom theoretical emphasis on psychosexual factors  to aggression in the aetiology of neuroses and delinquency. Although Ivy Bennett was signalling a shift in her thinking away from Freud’s psychosexual theories as central to the aetiology of delinquent and neurotic children, she appears to have been dubious, or at least choosing not to move away from it altogether.  There was still more research to be undertaken about the role of aggression. The emerging field of group analysis would contribute. Illumination would come from advancing research in social psychology, cultural anthropology as well as in psychoanalysis. At this stage Ivy Bennett sustained her Freudian roots, writing

A blending, fusion and diffusion of both sexual and aggressive impulses takes place and is always present in the emotional sub-strata of community living. The success or failure of this blending or balance determines the varied nature of social life, both in its constructive and in its negative dissocial forms.  (Bennett, 1960, p. 32)

*   *    *

It may be that Ivy Bennett was part of a larger plan for Western Australians. In the early 1940s there had been a dream for  Perth  to lead psychoanalysis in Australia.  In 1943 the Perth Branch of the British Medical Association apparently drew up plans to establish the largest analytic training institute in the southern hemisphere at the University of Western Australia. This was the outcome of four years work. In 1939 psychologist Bill McCrae, well known to  the Australian public as a cricketer,  returned from the United States where he had studied psychoanalysis. Perhaps prevented from pursuing training due to the US practice of restricting analytic training to medical practitioners, McCrae began to work  to establish a training program for lay psychoanalysts.  He  began lecturing and writing  highlighting the  usefulness of psychoanalysis in education and ‘mental treatment’. He worked in conjunction with local medical practitioners, lectured at the Adult Education Board and, with the support of the medical fraternity, encouraged the teaching of psychology at the University from an analytic point of view. Potentially these lay analysts  would work along with the medical profession. A journalist from Perth’s Sunday Times newspaper appears to have drawn from the planning documents, writing:

The programme envisaged includes a school with analytically trained teachers from kindergarten to leaving standard, a wide scheme of adult and parent education, a clinic to be conducted on a no profit basis, a maternity hospital and eventually a Psychoanalytic Institute for the training of practitioners.

Further research is needed to understand these events and whether Ivy Bennett had a place in this. After all here was a youngish, attractive, talented and ambitious woman who was potentially well placed to contibute to such  developments. At the very least it may well be that the war meant that McCrae’s idea was permanently shelved. It appears though that such was the interest in psychoanalysis at academic and government circles that Ivy Bennett’s proposal undertake training in England was accepted by the British Council who funded her.

Ivy Bennett’s efforts to establish herself as a lay analyst  in Australia appear to have been disappointing. She made efforts to connect with colleagues in the Eastern States and was a founding member of the Australian Society of Psychoanalysts. She presented papers at conferences of the Melbourne Insitute of Psychoanalsyis. She left Australia in 1958 to work towards full membership of the International Psychoanalytical Society.

‘I trained to that level so I could have independent recognition in Australia, she told Michelle Slarke. The profession was ‘still dominated by the prejudices I had to fight all the way – the prejudices of medical and insurance authorities against women and lay analysts’.  (Slarke, 2003, p. 51). Marriage intevened. I understand that she had thoughts of returning to Australia but it was her husband’s professional opportunities that took her to Kansas in the United States where she was instrumental in the establishment of psychoanalytic training in that state. She also remembered her days at Lake Grace and has established a scholarship at the local high school to enable a young person to realise their dreams. Too..

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