Life Story Work

By Julie Kitchener

11th June 2011

It was a day that promised, in the words of Leslie Ironside, Director of the Centre for Emotional Development, ‘plenty of manure for your garden’. The less green fingered among us, or indeed those more ambivalent about life story work should, nonetheless, bear in mind Adam Phillips’s Winnicottian caution: ‘You never know what the unconscious will make use of.’ For me it was the rolls of decorator’s lining paper used by Richard Rose in his life story work with children. These came to mind unexpectedly in a recent session with one of my more disorganized and fragmented patients. Thrown into disarray each time he ‘rediscovered’ the scraps of drawings in his folder, he now draws avidly and communicatively on his newly supplied lining paper, unrolling and rolling away his previous creations.

Rose, pioneer of life story work with looked after children and self-confessed mental magpie, would have been pleased. ‘If by the end of the day you’ve picked up just one idea,’ he told us, ‘and you go away thinking, “I like that idea; I’m going to take it and use it,” I’ll feel I’ve done my job.’ Indeed, this one-day training led by Rose and held in June at the Centre for Emotional Development in Brighton, was an object lesson in object use, a full-on experiential learning process packed with activities and ideas, from the lining rolls, through techniques for information gathering (did you know that anyone can apply for a copy of anyone else’s birth certificate, or that a birth certificate is not proof of identity?), and information sifting, to the use of two glasses of plain and coloured water to demonstrate the emotional exchanges between developing child and mother, and the ‘internal working model’ that can evolve from this. This last idea, Rose himself admitted he had ‘nicked’. He has found it enormously helpful in conveying to foster carers something of a child’s early experience, especially once he places his hand over the top, to show how a child may close up emotionally: foster carer tries to pour in ‘love’ but there’s no opening, everything spills ‘the carer is left with a mess on her hands and the child sees nothing going in’. Leslie Ironside likened the two glasses demonstration to Winnicott’s use of the spatula in his ‘set situation’ – it captures the attention of those involved and, if, having made it your own you feel it has value, you can go on using it again and again. ‘It’s a question of having confidence in your tools.’

Of course, to the skeptical child psychotherapist, life story work itself can seem a dubious tool; in the wrong hands, yet another formulaic technique aimed at waving a magic wand over the problems of disturbed and damaged children. In contrast to the rich and complex ‘Bayeux tapestry’ that Rose brings to life with his rolls of lining paper, many of us who work in Looked After Children teams, or in residential settings will have come across the airbrushed versions of children’s histories that can pass for their ‘life story book’; the ‘tick-bock exercise’ one social worker at the study day described, that follows a child from placement to placement then sits languishing at the back of a cupboard. Perhaps this is what deterred other child psychotherapists from attending the Brighton study day. Of the 17 participants I was the only child psychotherapist (or, rather, ACP member, as Leslie Ironside corrected me; the title, it seems, is becoming increasingly widely used), among a collection of social workers, school counsellors, art therapists, midwives, health visitors and foster carers, all willing to dedicate seven hours on a bright if chilly Saturday to finding out more about this work. For, as Diana Cant, long-time consultant child and adolescent psychotherapist at Greenfields therapeutic community in Kent has argued so cogently, at its best life story work can give back to a child ‘the details of his life and history’, offering the possibility of exerting some control over his or her life ‘rather than feeling at its mercy’.[1]

Cant describes integrating life story work into her psychotherapy sessions with an adolescent patient. More often, we may find ourselves working alongside social workers or care staff involved in life story work, a collaboration that when it works well can offer a fruitful exchange of insights about the child’s experience, a joining together of inner and external world. I was prompted to attend the Life Story Work study day when a little boy I work with asked, ‘What’s a granddad?’ Prior to this I had had meetings with another patient’s keyworker and the residential liaison officer, trying to infuse some vitality and truth into the rather saccharine and ultimately misleading life-story book that her well-meaning social worker had produced. ‘I hate my name,’ this little girl had told me. ‘It doesn’t feel like my name.’ What might it mean to feel no connection with your name, or to lack any concept of a grandfather? And how might the experience of life story work help?

Richard Rose has a long history of addressing such questions. He is currently a deputy director of SACCS and the Mary Walsh Institute, a UK institution providing specialized therapeutic treatment based in residential and foster care settings for children severely traumatized by abuse and neglect. Before he joined SACCS 14 years ago, he had worked in child protection, coming to child and family social work from a background as a residential care worker. He now does life story work with children and their carers in the community and has a caseload encompassing children in Wales, Scotland and Northern Ireland as well as England. Two days before our workshop, he had arrived back from consultation and teaching work in Australia; he has recently been called on to work in Portugal. If the imagination and generosity with which Rose approached the study day are anything to go by, it’s not hard to envisage how well he might engage with any audience, and, more importantly, with a child in their life story work, as he attempts to discover, ‘Who is this young person, how does she feel, how does she think?’ Rose is a man who can breathe life into any story – not least the story of Abigail and her dubious lover Sinbad, a tale he used to illustrate how easy it is to elicit value judgments, how hard it can be to resist the quest for a simple, one-sided, black and white narrative, for adults as much as children.

Simply stated, for Rose the point of life story work is, ‘to establish an holistic understanding of children and their need for understanding their identity’. But Rose wanted us to explore the implications of this for ourselves. We were divided into groups (‘Right, who’s going to be your leader?’ – traditional lesson in power dynamics and their impact on feelings about sharing thoughts and ideas). Between us, we then had to generate one ‘eco plan’ detailing the pros of life story work (our group included creating a coherent narrative, integrating a sense of self, opening up the possibility of sorting past, present and future, the experience of learning about oneself through another…) and one detailing the cons (eg, the possibility of re-evoking recent trauma, or of creating an illusion of coherence and closure). The point, though, about this exercise was to contrast adult preoccupations with a child’s worries about life story work – ‘Do people really care what I think?’ ‘You won’t like me when you find out what I’ve done.’ ‘Will my family be told?’ ‘What if I find out I’m bad?’

From there we moved on to the process of information gathering, of creating a meaningful ‘information bank’. First though, in our small groups, we had to wade through a case study collated from all those sheaves of paper that can go to make up a child’s file, the catalogue of events, reports and assessments that appear to tell a story, but more often overwhelm and obscure. We were asked to take it in turns to read this out, so that we could experience the full mind-numbing impact, despite our best attempts to elicit facts or imaginatively engage with the child’s experience.

Rose appears to have perfected an approach to ‘opening up’ a file that extracts maximum information. He takes a single fact at a time, lists it in a box, then lists the next in chronological sequence, and so on. He then compiles all the questions prompted by these facts or the links between them (eg Mum has car crash, sent to hospital – is there an accident report? Who else was in the car? Was this the reason for the child’s early birth? And so on). These questions are guided by three principles: What is necessary to know? What is safe to share? What would the child want to know? Rose claims he can end up with 8,000 questions. That’s a lot of research work, and perhaps highlights how little ‘truth’ can be held in the fattest of files. It also explains how Rose knows that anyone can apply for a copy of anyone else’s birth certificate and that if you don’t want to appear in, you have to ensure your details are removed annually, as well as the fact that maternity wards are particularly responsive to requests for information, and will often provide the child’s original name tag as well as identify the midwife present at his or her birth. This information gathering, Rose maintains, ‘is the most important part of the whole process’. Indeed, it is the process rather than the product, Rose stressed, that is key to life story work.

There were plenty more excercises for us to process, including an interlude in which each group had to pick an organising theme and then illustrate feelings in terms of this theme. Our group chose ‘sea’. Now, try to imagine how you might portray silly, confused, happy, sexy, frustrated in this way. (In passing, I should mention, that our group won the ‘most interesting theme’ award from Richard Rose; well deserved, I thought, though probably down to the presence of an art therapist among us. However, Leslie Ironside, who was also in our group, rather disloyally – or diplomatically, depending on your interpretation – nominated the group who chose ‘food’ for their theme. And, lest anyone should feel hard done by, another group were commended on their ‘beautiful shoe’.)

These excercises can take it out of you, and it is worth noting, in relation to the children and carers he sees, that Rose works in one-hour sessions every fortnight – that is as much, he feels, as they can manage. So, perhaps taking pity on us, Rose took the floor for most of the latter part of the day, allowing us to sit in quiet attention for a while as he spoke about his work and showed some remarkable examples of the ‘books’ that children have created with him and their carers. Recently, Rose explained, he has tended to be called in to do life story work at a point when a foster placement is about to break down. So far, none of these placements has subsequently broken down; not a bad success rate and a result he attributes in part to the fact that he always works with the primary carer and child together, offering the containment for thoughts and worries to be opened up in a way that strengthens bonds. This suggests an immediate tension between life story work in Rose’s model and the work of a child psychotherapist – at least as it is widely perceived. It is telling that SACCS employ play therapists rather than child psychotherapists and the mantra of ‘no more secrets’ overrides questions of confidentiality.

Differences aside, there remains a healthy exchange to be had between child psychotherapists and those involved in life-story work. After all, you don’t get to do the sort of work Rose does without being a good listener. While, I confess, it was something of a relief after such an action-packed and technique-driven presentation to return to the simplicity of the child psychotherapist’s tools – the child’s box and oneself (albeit with my rolls of lining paper), it was disappointing to be the only child psychotherapist present on the day. As Diana Cant illustrated, there is room for some creative thinking on our part, particularly given that a willingness to confront uncomfortable truths is intrinsic to our work. ‘Whatever the past was, the child lived through it and survived,’ Rose told us in conclusion, quoting Vera Fahlberg, ’and so can live with the truth.’[2]

[1] ‘The Birthday Boys’ Journal of Child Psychotherapy, Vol 34, No2, August 2008, p212

[2] Helping Children When They Must Move, 1981, p51